Female Circumcision Negligence and Abuse

Dr. Amal Ahmed Elbasheir,

Master of Community medicine, University of Khartoum, Sudan

There are different viewpoints about female circumcision. Some people totally abandoned it, while others went to the other extreme and involved into wrong practices. I focused on this issue "female circumcision, negligence and abuse" so as to try to exclude any existed contradiction. I seek to Allah the Almighty to make the result of this study a useful knowledge for all people, Amen.

Female Circumcision in Islam
Sheikh Mahmoud Shaltoot, member of Prominent Scholars Group said: ((Circumcision is an old habit since Prophet Ibrahim's (peace be upon him) era. At that time circumcision applied for both males and females. Many authentic sayings were told by the Prophet (P.B.U.H), such as: (five traditions existed in Man by instinct: circumcision, cutting from the moustache, pubic and armpit hair shaving, and nail slitting). Most Islamic scholars considered circumcision as an obligation for both sexes. While others asserted an obligation for male and an honor for the female)).
In this study we will show that the viewpoint, which proclaims equality between both sexes in circumcision, is the correct one.

The external Female Genitals
The external parts are the vaginal opening, the labia minora and majora and the clitoris. The clitoris, a small erectile organ resembling the penis, is in the joint of the labia minora, above the urethral meatus. The glans of the clitoris is sensitive like the glans of the penis. A skin (prepuce) covers the clitoris and is called preputium clitoris,which is the same as the prepuce of the penis (preputium penis). Smegma (smegma preputii) and microbes may collect and proliferate, beneath the prepuce, in both sexes.

Methods of female circumcision
1. The proper method (Sunni circumcision):
Islamic scholar Almawordi said: ((female circumcision is the cutting of the skin, which covers the nawah (clitoris) that lies above the urethral meatus)).
Dr. Mohamed Ali Al-Bar, a consultant of Islamic medicine in King Fahad Research Center, and Dr. Hamid Rashwan, a consultant in Sudan, also agreed on the same definition. Also the proper method of female circumcision was described in a book published in 1979 by WHO.
The female Sunni circumcision (like the male circumcision) can be referred to as Prepucectomy and neither Clitoridectomy nor clitoridotomy, which is mentioned in some books. Female prepucectomy is the cutting of the preputium clitoridis. It is done under local analgesia, and complete sterilization of instruments and skin area.The anaethetized prepuce is held with an artery forceps. The skin over the forceps is removed with a curved scissors. The forceps is left for some time to stop any bleeding from the cut edges. This operation is simple and safe, if done by a trained staff and using sterile instruments (it is simpler than giving a child the Triple vaccine injection). In case of lack of trained staff prepucectomy should be postponed, as problems from a wrong operation are frequently more than problems from the delay. Like all other simple operations, complications are rare and are not more than simple curable bleeding or inflammation. If there is more than mild bleeding, the cut edges of the prepuce should not be held together by a stitch. Instead 'Figure eight' stitch can be inserted at the bleeding point. This avoids covering of the clitoris again. The advantages of correct prepucectomy for both sexes exceed all alleged dangers, stemming from the wrong practices of female circumcision.
2. Wrong Methods:
Any cutting from the clitoris, or from the labia minora or majora is considered to be against Sunni circumcision (Prepucectomy). Stitching and adhesions of the labia (minora or majora) led to closure of the urethral meatus leaving a covered space that is difficult to clean. Also the small hole left causes psychological and physical troubles for both sexes in the beginning of their marital life.

Advantages of Female Circumcision
According to Prof. Abdel-Alal Abdullah, Professor of Surgery in Sudan, some behavioral acts reported in sayings of the Prophet (peace be upon him) to be followed by people in various domains, were not results of research and laboratory experiments. The Prophet was fully confident that they were right, as the Omniscient Creator of the Universe inspired them. Advanced medical and health laboratory research have reached the great preventional benefits Muslims gain for adhering to ablution rituals and natural behavior reported in the Sayings of the Prophet (peace be upon him). And here we are, in the 15th Hijri century, discovering some of these facts, finding out that penis cancer does not affect circumcised male, but is 100% limited to the uncircumcised. The direct cause of this cancer is the secretions by the foreskin removed in the circumcision operation. Prof. Abdullah asserts that cancer affects uncircumcised females, though at a lower rate than males for difference in sizes of the prepuce and quantity of secretions.
Austaz Mohamed Al Lban mentioned that in female circumcision, the foreskin is removed because it prevents cleaning of the menstrual blood and urine, a matter that creates nasty smells.
In a report issued in 1989 , the British Lancet Magazine stated: (The genital organs in males and females constitute an important factor in occurrence of urinary tracts inflammation and nephritis. It is also found that these inflammations with their complications can be avoided by removing a small skin called the prepuce).
In the same line, Dr. Al-Bar wrote: (Female Sunni circumcision has many advantages that researchers reviewed in the medical Islamic Conference on "Islamic Sharia and Present Medical Issues".The advantages are:
- Prevention of inflammations resulting from accumulation of smegma and microbes beneath the prepuce of the female and male.
- Decreasing cancer rates in circumcised persons of both genders.
- Genital Herpes, chancroid and granuloma are less in circumcised men and women.
- Moderation of the sexual desires in circumcised persons of both sexes. The explanation of this is that, if the person is uncircumcised it is difficult for him or her to get satisfaction from the marital intercourse. This is because the sensitive glans of the penis or of the clitoris is covered with the prepuce which is a less sensitive skin, thus the uncircumcised male or female, keeps in permanent search for satisfaction.
In one of the WHO books, it was stated that "circumcision proper" is also sometimes practiced in the United States for treating non-occurrence of woman's climax in cases of loose or tight prepuce.
Dr. A.B Lurry, an American doctor, warned that the prepuce of the clitoris is sometimes very tight, so instead of prevention it becomes a source of permanent sexual agitation due to the natural secretions withheld beneath it. She added that many women have remained nervous for the rest of their lives, and early circumcision in a woman's childhood would be a definite cure.
With reference to views of these scholars and doctors we find that the advantages of woman circumcision are similar to those of male circumcision. These include:
Following removal of the prepuce of the clitoris, cleaning of the natural secretions, the menstrual blood and urine becomes easy and this protects the woman from many organic and psychological diseases.
Moderation of sexual desires via two means:
First the prepuce decreases the pleasure of the marrital sexual life, so after its removal the climax and satisfaction are realized. Also removal of the prepuce prevents accumulation of the natural secretions beneath it, thus the frequent arousal of the genital nerves around the glans vanishes. Here both married and single women are concerned.
An added advantage of female prepucectomy is that it may be the most useful alternative to replace the malpractice of the present women circumcision.
Also midwives may be more cooperative since they have an alternative, because circumcision is one of their sources of income generation.

The time of circumcising the female
The time of circumcision is not agreed upon. Al-Mawordi said that both the male and female should be circumcised before adolescence.
A medical check should be made before setting the girl's time of circumcision.

1. 1. Encouragement of female prepucectomy in Sudan and in the world at large. This may be the most useful alternative to replace the malpractice of the present female circumcision.
2. 2. Postponement of the girl's circumcision to the time at which we find a qualified medical cadre trained on female prepucectomy, this is because harm of wrong circumcision is greater than that caused by postponement.
3. More field studies are needed to investigate the incidence of gynecological problems in uncircumcised and circumcised females.
4. Women should pay due concern to such researches dealing with their problems.

*أسرار الختان، حسان شمس باشا.
*أسباب محاربة الخفاض في السودان، د. عبد السلام، ود. آمنة، وآخرون.
*الأمراض الجنسية، د. محمد علي البار.
*تحفة المودود بأحكام المولود، ابن قيم الجوزية.
*ختان الأنثى في الطب والإسلام، بين الإفراط والتفريط، د.آمال أحمد البشير، ط 1997م.
*سنن الفطرة، الأمين محمد أحمد.
*صحيح البخاري، للإمام أبي عبد الله محمد بن إسماعيل البخاري، 7/206.
*صحيفة الإنقاذ الوطني، الخرطوم ـ 5 نوفمبر 1994م ـ العدد (1732).
* Stedman's Medical Dictionary, 24th edition, P1135.
* Traditional practices affecting the health of Women & Children, WHO, 1987.
* Dr. Sit Elbanat Khalid Mohamed Ali, Master of Obstetrics & gynecology, University of Khartoum, Sudan.




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