The 20th of September 2019, we attended a seminar entitled 'Female Genital Mutilation vs Labia Correction Surgery: where are the boundaries?' organized by Maastricht University. On this sunny late-summer day, health specialists, researchers, professors, students, activists and lawyers came together in Maastricht to discuss this important matter. I felt honored to be invited to take part in a panel discussion of this interdisciplinary seminar in the afternoon to share my ideas and point of view in relation to the subject. A few days before the seminar, I was also interviewed by the university newspaper 'The Observant', which can be found here (in Dutch).
The seminar was organized by Dr. Ingrid Westendorp, who works at the Faculty of Law of Maastricht University. This semester, Ingrid taught the master course 'Human Rights of Women' in the context of the Master’s programme 'Globalisation and Law' at the Faculty of Law of Maastricht University. In this course, she discussed with students how the circumcision of a 15-year-old girl from Gambia relate to a labiaplasty of a 15-year-old girl from the Netherlands. While Female Genital Mutilation/Cutting (FGM/C) is put away as a 'barbaric' tradition that mutilates gils, cosmetic surgery is accepted in our Western society. When I met Ingrid in June this year in Maastricht, we had a discussion about this complex issue. In the human rights discourse, there is general consensus that FGM/C is a violation of the rights of girls and women. States have criminalized FGM/C, both in the Western and non-western context. At the same time, Female Genital Cosmetic Surgery (FGCS) without any medical necessity is a phenomenon that has spread across Europe and North America at an alarming rate, but this is not considered a 'harmful practice' or a human rights violation.
The seminar was opened by Prof. Hildegard Schneider, who welcomed the audience. My colleague and friend Phyllis Livaha, who is a senior lecturer in the Social and Behavioral Sciences department at Erasmus University College, gave the first keynote speech in which she introduced the topic of the seminar. She has a background in political science and law and also writes her PhD on the topic of FGM/C in Kenya. Afterwards, Dr. Refaat Karim, a plastic surgeon in the Netherlands (who also performs clitoral reconstructive surgery for women who have undergone FGM/C), gave the second keynote which was a lively interactive presentation. First of all, Dr. Karim requested the audience to use the term 'labia reduction' instead of 'labia correction'. He explained that - because there is no medical need to perform the surgery - there is nothing that needs to be corrected: "All varieties of vulvas are anatomically ‘normal’, however the vulva tissue can be surgically reduced." From a medical point of view, Dr. Karim explained that the main difference between FGCS and FGM/C is that the clitoral body is always damaged in (any form of) FGM/C, whilst in cosmetic surgery the clitoral body is avoided by any means. Another difference, and perhaps the most important one, is that cosmetic surgery in the Netherlands is performed on adults (there is a guideline that says that esthetic surgery should not be done under the age of 18), whilst FGM/C mostly affects children.
WHO Definition of FGM/C
The program included presentations from anthropology, human rights, health law and ethics which provided a comprehensive context to the discussion. After each presentation, there was plenty of room for questions and discussion. In general, the group found common ground in relation to the fact that bodily autonomy, consent, choice, coercion and harm are the fundamental issues at stake in the debate regarding FGCS and FGM/C. In addition, the WHO-definition of FGM/C was considered to be problematic. When taking a look at the definition: "all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons," FGCS would qualify as FGM/C, as according to this definition all types of surgery to the female genital organs is considered FGM/C. The current WHO-definition therefore creates a double-standard in the debate.
The societal pressure that women face on a daily basis take on different forms. During the seminar, the social-commercial pressure on women who choose a corrective surgery on their genitals caused a lot of discussion. The group agreed that this should be considered by all stakeholders involved in the surgery procedure as a serious societal problem. During the presentation of Ingrid on the human rights aspects in relation to FGm/C and FGCS, we discussed the Joint General Recommendation No. 31 of the Committee on the Elimination of Discrimination against Women/general comment No. 18 of the Committee on the Rights of the Child on harmful practices. An interesting question is whether FGCS could be qualified as a 'harmful practice that affect the rights of women.' We compared the social-traditional pressure that women experience in FGM/C communities with societal pressure in Western countries. Can we advocate for States to prohibit the practice of FGCS based on the same human rights argument?
After the coffee break in the afternoon, the panel discussion took place. Dr. Karim, Dr. Tatenda Zinyemba (UNU-MERIT) and I shared our thoughts in relation to the presentations that we saw during the day and the complexities surrounded by the comparison between FGM/C and FGCS. I stressed the fact that FGM/C among children cannot be compared to FGCS performed on adults. However, I also explained that in some countries in Africa (Liberia, Sierra Leone, Gambia and Kenya), you do see a women's rights movement emerging who explicitly use the right to self-determination to make their claim. These women often agree that FGM/C should be prohibited for children, but at the same time they argue that they should have a right to undergo FGM/C as adult women. In this situation, we cannot close our eyes and we need to address these double standards. We also discussed the issue of medicalization of FGM/C, which is closely related to this debate.
The seminar was organized to shine a light on the practice of FGM/C and LRS and what it means for women worldwide and discuss the human moral and rights behind it. At the end of this fruitful day filled with debate and discussion, we collaboratively concluded that this goal was 100% reached. Finally what is really nice is that - most probably - a book will be published with contributions of all the presenters following this seminar. Dr. karim and I submitted an abstract focusing on the right to bodily autonomy in relation to FGM/C and FGCS. I'll keep you posted!