Utz-Billing I, Kentenich H
Department of Gynaecology and Obstetrics, DRK-Hospital Westend, Berlin, Germany.
J Psychosom Obstet Gynaecol. 2008 Dec;29(4):225-9. doi: 10.1080/01674820802547087.
This article gives an overview over the huge topic of 'female genital mutilation' (FGM). FGM means non-therapeutic, partial or complete removal or injury of each of the external female genitals. It concerns about 130 million women around the world. FGM is performed in about 30 countries, most of which are located in Africa. Four types of FGM are distinguished: type I stands for the removal of the clitoral foreskin, type II means the removal of the clitoris with partial or total excision of the labia minora. Type III is the extreme type of FGM. Not only the clitoris but also the labia minora and majora were removed. The orificium vaginae is sewn up, leaving only a small opening for urine or menstruation blood. Other types like pricking, piercing of clitoris or vulva, scraping of the vagina, etc. were defined as type IV of FGM. The mentioned reasons for FGM are: encouragement of the patriarchal family system, method for birth control, guarantee of moral behaviour and faithfulness to the husband, protection of women from suspicions and disgrace, initiation ritual, symbol of feminity and beauty, hygienic, health and economic advantages. Acute physical consequences of FGM include bleeding, wound infections, sepsis, shock, micturition problems and fractures. Chronic physical problems like anemia, infections of the urinary tract, incontinence, infertility, pain, menstruation problems and dyspareunia are frequent. Women also have a higher risk for HIV infections. During pregnancy and delivery, examinations and vaginal application of medicine are more difficult. Women have a higher risk for a prolonged delivery, wound infections, a postpartum blood loss of more than 500 mL, perineal tears, a resuscitation of the infant and an inpatient perinatal death. Mental consequences after FGM include the feelings of incompleteness, fear, inferiority and suppression. Women report chronic irritability and nightmares. They have a higher risk for psychiatric and psychosomatic diseases. FGM carried out by doctors, nurses or midwives is also called medicalisation of FGM and is definitely unacceptable. Regarding human rights, FGM refuses women the right of freedom from bodily harm. Specific laws that ban FGM exist in many countries in Europe, Africa, USA, Canada, New Zealand and Australia.
本文概述了“女性生殖器切割”这一重大议题。女性生殖器切割是指对女性外生殖器进行非治疗性的部分或全部切除或损伤。全球约有1.3亿女性遭受此害。约30个国家存在女性生殖器切割现象，其中大部分位于非洲。女性生殖器切割可分为四种类型：I型是指切除阴蒂包皮；II型是指切除阴蒂并部分或全部切除小阴唇；III型是女性生殖器切割的极端形式，不仅切除阴蒂，还切除小阴唇和大阴唇，阴道开口被缝合，仅留一个小孔用于排尿或经血流出；其他类型如针刺、刺穿阴蒂或外阴、刮擦阴道等被定义为IV型女性生殖器切割。女性生殖器切割的原因包括：维护父权制家庭体系、节育方法、保证道德行为及对丈夫忠诚、保护女性免受猜疑和耻辱、成年仪式、女性气质和美的象征、卫生、健康和经济优势等。女性生殖器切割的急性身体后果包括出血、伤口感染、败血症、休克、排尿问题和骨折。贫血、尿路感染、尿失禁、不孕、疼痛、月经问题和性交困难等慢性身体问题很常见。女性感染艾滋病毒的风险也更高。在怀孕和分娩期间，检查和阴道用药更加困难。女性分娩时间延长、伤口感染、产后失血超过500毫升、会阴撕裂、婴儿复苏和住院围产期死亡的风险更高。女性生殖器切割后的心理后果包括不完整感、恐惧、自卑和压抑感。女性报告有慢性易怒和噩梦。她们患精神疾病和身心疾病的风险更高。由医生、护士或助产士实施的女性生殖器切割也被称为女性生殖器切割的医学化，这绝对不可接受。从人权角度来看，女性生殖器切割剥夺了女性免受身体伤害的权利。欧洲、非洲、美国、加拿大、新西兰和澳大利亚等许多国家都有禁止女性生殖器切割的具体法律。
