Female genital mutilation (FGM) is a practice in some cultures that cuts or otherwise alters the external female genitals. It is usually performed on young girls before puberty. FGM occurs in large parts of Africa and some of the Middle East and Asia. It has deep cultural meaning in the societies that practice it as a rite of passage and a means to ensure a woman’s suitability for marriage. However, many nations and international organizations condemn the practice as medically unnecessary and harmful and have outlawed it. This has resulted in controversy regarding outside organizations making decisions about practices that some populations view as socially and culturally acceptable.

Girls usually go through the procedure of genital mutilation before age 12. The external parts of the girl’s genitals are cut, usually removing the clitoris and sometimes cutting and joining the outer vaginal lips (labia majora) so they will fuse together. This reduces the opening to a small hole for urine and menstrual blood. The procedure is painful and frequently involves excessive bleeding. The lack of sanitary conditions means many girls are likely to contract infections as well.

After undergoing FGM, girls and women may experience problems with urination and menstruation. Sexual intercourse can be painful and uncomfortable for many months or even permanently. The procedure can also complicate pregnancy and childbirth.

As more of the women who have experienced genital mutilation have moved to areas where it is uncommon, physicians and other medical professionals have become more aware of the practice. Some women have chosen surgical procedures that remediate some of the damage and make pregnancy and childbirth easier.

FGM is most commonly practiced in 28 nations in Africa including Sudan, Chad, Sierra Leone and Djibouti. Female genital mutilation also takes place in some countries in the Middle East, such as Saudi Arabia, and among immigrant communities in the United States and Europe. The World Health Organization (WHO) estimates that between 100 million to 140 million girls and women have had FGM. Each year, three million girls and young women are at risk for the practice. Even the name of the practice contributes to the controversy. Western nations that oppose the practice have called it genital mutilation. In nations where FGM is part of the culture, it is generally not considered mutilation and is called female circumcision or female genital cutting. In 1996, the WHO adopted the term female genital mutilation.