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      Gender equality and human rights approaches to female genital mutilation: a review of international human rights norms and standards

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          Abstract

          Two hundred million girls and women in the world are estimated to have undergone female genital mutilation (FGM), and another 15 million girls are at risk of experiencing it by 2020 in high prevalence countries (UNICEF, 2016. Female genital mutilation/cutting: a global concern. 2016). Despite decades of concerted efforts to eradicate or abandon the practice, and the increased need for clear guidance on the treatment and care of women who have undergone FGM, present efforts have not yet been able to effectively curb the number of women and girls subjected to this practice (UNICEF. Female genital mutilation/cutting: a statistical overview and exploration of the dynamics of change. 2013), nor are they sufficient to respond to health needs of millions of women and girls living with FGM. International efforts to address FGM have thus far focused primarily on preventing the practice, with less attention to treating associated health complications, caring for survivors, and engaging health care providers as key stakeholders. Recognizing this imperative, WHO developed guidelines on management of health complications of FGM. In this paper, based on foundational research for the development of WHO’s guidelines, we situate the practice of FGM as a rights violation in the context of international and national policy and efforts, and explore the role of health providers in upholding health-related human rights of women at girls who are survivors, or who are at risk. Findings are based on a literature review of relevant international human rights treaties and UN Treaty Monitoring Bodies.

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          Perception of primary health professionals about Female Genital Mutilation: from healthcare to intercultural competence

          Background The practice of Female Genital Mutilation (FGM), a deeply-rooted tradition in 28 countries in Sub-Saharan Africa, carries important negative consequences for the health and quality of life of women and children. Migratory movements have brought this harmful traditional practice to our medical offices, with the subsequent conflicts related to how to approach this healthcare problem, involving not only a purely healthcare-related event but also questions of an ethical, cultural identity and human rights nature. Methods The aim of this study was to analyse the perceptions, degree of knowledge, attitudes and practices of the primary healthcare professionals in relation to FGM. A transversal, descriptive study was performed with a self-administered questionnaire to family physicians, paediatricians, nurses, midwives and gynaecologists. Trends towards changes in the two periods studied (2001 and 2004) were analysed. Results A total of 225 (80%) professionals answered the questionnaire in 2001 and 184 (62%) in 2004. Sixteen percent declared detection of some case in 2004, rising three-fold from the number reported in 2001. Eighteen percent stated that they had no interest in FGM. Less than 40% correctly identified the typology, while less than 30% knew the countries in which the practice is carried out and 82% normally attended patients from these countries. Conclusion Female genital mutilations are present in primary healthcare medical offices with paediatricians and gynaecologists having the closest contact with the problem. Preventive measures should be designed as should sensitization to promote stands against these practices.
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            The medicalization of female “circumcision”: harm reduction or promotion of a dangerous practice?

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              Female genital mutilation: the penultimate gender abuse.

              The five goals established for the development of this article were to: (1) provide an historical overview of the practice, (2) describe the procedure and its sequelae in realistic terms, (3) explore cultural justifications for the continuation of this action, (4) evaluate inherent moral/ethical/legal issues and, (5) focus worldwide professional attention on a gender-specific child atrocity. A review of the past and current historical, popular and professional literature was undertaken to determine the precursors, magnitude, settings, rationale, and moral-ethical-legal-treatment issues associated with this mutilating procedure. Four forms of female genital mutilation were identified. These are: (1) sunna (removal of the prepuce of the clitoris); (2) clitoridectomy (removal of the prepuce and the clitoris); (3) excision (removal of the prepuce, clitoris, upper labia minora and perhaps the labia majora); and, (4) infibulation (removal of the prepuce, clitoris, labia minora, and labia majora). The "surgery" is performed most frequently by untrained midwives who use sharp rocks, razor blades, kitchen knives, broken glass, or even their teeth. As a rule, no anesthetics, antiseptics, analgesics or antibiotics are available to victims. Consequently, these females typically suffer from massive short-term and long-term physical, emotional, sexual and obstetrical sequelae. The justifications tendered by proponents do not withstand moral-legal-ethical scrutiny. Female genital mutilation is a violation of human rights and an atrocity perpetrated against helpless individuals who are unable to provide informed consent and who must therefore be protected through education and legislation.
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                Author and article information

                Contributors
                + 41 22 791 11095 , khoslar@who.int
                Journal
                Reprod Health
                Reprod Health
                Reproductive Health
                BioMed Central (London )
                1742-4755
                12 May 2017
                12 May 2017
                2017
                : 14
                : 59
                Affiliations
                [1 ]ISNI 0000000121633745, GRID grid.3575.4, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, , World Health Organization, ; Headquarters, 20 Avenue Appia, Geneva, 1211 Switzerland
                [2 ]ISNI 0000 0001 2171 9311, GRID grid.21107.35, , Jhpiego, an affiliate of Johns Hopkins University, Gender Technical Advisor, ; 1776 Massachusetts Avenue, NW, Suite 300, Washington DC, 20036 USA
                [3 ]ISNI 0000000419368710, GRID grid.47100.32, Fellow, Global Health Justice Partnership, , Yale University, ; 170 15th St., New York, NY 11215 USA
                [4 ]ISNI 0000000121633745, GRID grid.3575.4, Department of Reproductive Health and Research, , World Health Organization, ; 20, Avenue Appia, CH-1211 Geneva 27, Switzerland
                Author information
                http://orcid.org/0000-0002-4054-3996
                Article
                322
                10.1186/s12978-017-0322-5
                5429526
                28499386
                0be29f32-de14-41dc-9494-d412cd2c614e
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 12 January 2017
                : 3 May 2017
                Categories
                Review
                Custom metadata
                © The Author(s) 2017

                Obstetrics & Gynecology
                human rights,gender equality,gender equity,gender discrimination,female genital mutilation,female genital cutting,female circumcision,gender norms,harmful traditional practices,violence against women,gender-based violence

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