Genital Practices in Other Countries

This page was last updated on Sunday, November 10, 2013


Special Care

The content of this web page may not be suitable for persons who have not obtained the age of 18 years for it describes unfamiliar feminine body practices in other parts of the world. I have chosen this title because its subject matter is sensitive and others use this subject as an example of male domination of women. This is not true. Since the subject matter in this essay can be disturbing to some, I ask that they accept that these are cultural practices and are not a result of male domination.

Many people may not know that women practice these procedures by their own doing. They are a result of cultural differences and adaptations that people (both men and women) still practice in several parts of the world. I want to make it clear that I do not support these practices.  The World Health Organization describes these practices as a violation of human rights and rightly so. I want to make this clear.  The customs of infibulation and clitoridectomy predate Islam (circa 610 A.D. in Mecca) and the writing of the Qur'an (Koran).

In Islam, God selects prophets to urge people to worship God alone and to teach them to live according to God's commandments. So the most important prophets are the messengers of God. They are Abraham, Moses, David, Jesus, and Muhammad in chronological order.  Islam calls for the circumcision of men but not women.  Imams agree that infibulation, clitoridectomy, and similar practices are opposed to God’s creation and wisdom.

Some Definitions

I have added some definitions to the beginning of this essay because the words are more likely to be unfamiliar to most persons. The other reason is simpler, placing these words at the beginning of the essay allows the reader to print the first page for key definitions rather than printing the entire essay to find them.

Circumcision - An uncircumcised penis has a loose fold of skin called the foreskin or prepuce that covers the glans (head of the penis). Circumcision is the practice of surgically removing the foreskin that covers the head of the penis without the use of an anesthetic though the operation is not medically required. There is a medical condition called phimosis that occurs when the foreskin tightens about the head of the penis that can obstruct the flow of urine. According to many physicians, circumcision reduces the risk of cancer of the penis that occurs in about one out of 400 uncircumcised males.

The procedure known as clitoridectomy has been wrongly called female circumcision. Females do not have a penis, they have a urethral outlet is enclosed by the labia majora. Females do have a clitoris, a small erectile organ of the vulva that some say is homologous to the penis in males. This particular procedure results in the removal of all or part of the clitoris.

This ritual is often conducted by the elder women in sub-Saharan Africa. The people in this part of Africa are Islamic and these women believe that female circumcision is required by Islam but clitoridectomy is not mentioned in the Koran, the Muslim holy book.

A clitoridectomy is the excision (removal) of all or part of the clitoris.

Congenital means existing or dating from birth. This is not quite right because a congenital condition is often acquired during the child’s development in the uterus and not through heredity.

An episiotomy is a surgical incision of the perineum to enlarge the vaginal opening for obstetrical purposes during the birth process.

A fistula is an abnormal passage that leads from an abscess or hollow organ or part to the body surface. It is also a surgically created passageway to permit the flow of fluids or secretions.

Hematocolpos may occur when the vagina fills with menstrual blood and is not released. It is often caused by the combination of menstruation with an imperforate (no holes) hymen.

Hematometria occurs when the uterus fills with (menstrual) blood and is not released into the vagina. The cervix is a structure that is located between the uterus and the vagina. This can be caused by a congenital stenosis of the cervix, or by a complication of a surgical treatment, with stenosis of the cervix.

Parenchyma is the essential and distinctive tissue of an organ or an abnormal growth as distinguished from its supportive framework.

Pyelonephritis is a disorder that causes the inflammation of the lining of the pelvis and the parenchyma of a kidney.

Stenosis is the narrowing or constriction of a body passage or orifice.

Vesical refers to the urinary bladder such as vesical burning or urinary burning.

 

Female Genital Anatomy From Inside to the Outside

A female’s genital anatomy consists of two ovaries, one on the left side and the other on the right side. The ovaries are connected to the uterus by two fallopian tubes, one extending from the left ovary and the other extending from the right ovary.

The uterus is connected to the vagina by the cervix, the narrow outer end of the uterus. The vagina is a canal that leads to an external orifice that is within the labia minora (smaller lips). The labia major (larger lips) encloses the labia minora (smaller lips), the urethra and the clitoris. The urethra is an opening that leads back to a bladder that holds urine. In females, the urethral outlet is enclosed by the labia majora.

The clitoris is a small erectile organ that is homologous to the penis in males. The homology is that the clitoris in females and the penis in males is that they are both erectile organs. The urethra passes urine from the bladder in females. In males, the urethra passes urine from the bladder to the urethral outlet that is at the tip of the penis.

Males have a prostate gland that is located at the base of the male’s urethra. Upon ejaculation, the prostate gland secretes an alkaline viscid (sticky) fluid. The fluid gathers sperm cells from the testes and the mixture is ejaculated through the male’s urethra and out through the urethral outlet at the tip of the penis.

The Hymen

The hymen is a fragile membrane that partially encloses the opening to a female’s vagina. I wish to stress ‘fragility’ for some females have never realized that they ever had a hymen. In the past, females were not allowed to ride a horse or use a bicycle as a man would do. The existence or non existence of a hymen is no indicator of a female’s character.

It may be interesting to know that ‘Hymen’ is the name of the Greek god of marriage, perhaps this why some women choose hymen restoration. The problem is that a surgeon can create a hymen that is totally occluded and I cannot imagine anyone wanting a totally occluded hymen. The reason for this is that the vagina naturally produces vaginal fluid that has to be drained. If this drainage does not occur, the vagina could become infected and this is called hematocolpos.

Toxic Shock Syndrome

In the latter part of the 1970's (1977) Toxic Shock Syndrome became an issue. This is an acute disease associated with staphylococcus aurei, a bacterium that occurs in menstruating females using tampons. This condition presents the symptoms of nausea, fever, diffuse erythema (abnormal redness in the skin), premenstrual shock, and diarrhea. The misuse of the tampon by females led to this condition. It is normal to leak premenstrual blood in some amounts. But in large amounts it may be an indicator of septic anemia that can lead to other problems such as blood insufficiently and anemia where the red blood cells and platelet cells are compromised (destroyed).

The problem was that women did not understand that tampons occluded natural drainage. A normal hymen has perforations that allow menstrual blood to pass but an occluded hymen does not allow menstrual blood to pass. The important part is that every female should be examined by a physician for an occluded hymen. If the vagina is obstructed, then the physician may take such steps to remove the obstruction and allow proper drainage.

Infibulation

The word "infibulation" is derived from the Latin word "fibula," meaning a clasp. This term has been given to a mutilating procedure in which the vagina is partially closed by approximating the labia majora in the midline. Although clitoridectomy may be included, the essential part of the operation consists of partial closure of the vulva and the vaginal orifice. This custom is deeply rooted, is applied to all social/economic classes and has been done since earliest recorded time. In the past, anthropologists have called the area encompassing Northern Somalia, across the Gulf of Aden, to the southern tip of the Arabian peninsula the ‘land of the sewn women’.

Other ritual sexual operations sometimes done in Africa include male and female circumcision, clitoridectomy, and ritual excision of the labia. These operations differ from infibulation in that there is no attempt to cover the vaginal orifice.

A detailed description of this procedure is beyond the scope of my web site. The procedure is usually done on a Sunday, which is a working day for Muslims. The children’s ages range from four to eight years old and a local anesthetic is used. The process of infibulation replaces the vulva with the victim’s flesh that joins the thighs from the pubis closing the vulva and vagina.

The Consequences of Infibulation and the Effects on Childbirth

In some countries, the age of marriage begins when a girl is 12-years-old. Although polygamy may be practiced, divorce is easily obtained as determined by local custom. A bride-price is a payment given by or for a prospective husband to the bride’s family. Since the custom of the bride-price is observed, some girls are sold into marital and sexual slavery.  When an agreement is made, one of the bridegroom’s closest female relatives will examine the prospective bride to ensure that the infibulation is intact. After the ceremony, the husband or one of his female relatives will enlarge the vaginal opening so that intercourse can occur. At the time of the mother's birth to a child, the infibulation has to be opened widely to permit the delivery to take place. After childbirth, the infibulation is restored. To preserve an infibulation, the physician may have to do an episiotomy which would not be necessary if this custom was banned.

Gynecological Problems

A colposcope is a magnifying instrument used to inspect the vagina and the cervix. The problem is that scars, cysts, and stones can form. Hemorrhage and infection may occur and scars may require excision. If the vagina has been too tightly closed, then Hematocolpos will develop at the time of onset of menstruation and must be relieved by opening the sown or attached labia.

Urinary retention is another complication that results from obstruction of the external orifice. Stones formed in the vagina and the patient also suffered from Pyelonephritis. Accidental injuries to the urinal-genital system during the separation of the infibulation at delivery are frequent and can be unavoidable.  Furthermore, these injuries often cause troublesome vesical-vaginal fistulas (leakage). There are many other problems that are beyond the limited scope of this paper but at least it is a beginning.

 

The World Health Organization (WHO)

For additional information, the address of The World Health Organization's website is provided below.

http://www.who.int/mediacentre/factsheets/fs241/en/index.html

Edward Steven Nunes
 

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