The International Day of Zero Tolerance for Female Genital Mutilation was held on 6 February. This is also a topical concern in Finland: tens of thousands of women and girls living in Finland come from countries where the tradition of female circumcision continues to be practised.
Female circumcision is an ancient tradition
Female circumcision is an ancient cultural tradition which has been practised around Africa, Asia and Middle East. In these cultures, circumcised girls have been perceived as beautiful, accepted, valued and marriable. The aim of circumcision has been to protect the girl and the practice has also been considered to include effects that promote cleanliness.
As a result of internationalisation and international migration, knowledge of the tradition of circumcision and the tradition itself have spread worldwide. In contrast with the beliefs associated with the practice, the tradition brings no benefits but instead causes many physical and mental long-term health risks. Female circumcision is a form of violence against girls and women that is prohibited in the Criminal Code of Finland.
Guidelines on the prevention of female circumcision
In Finland, female circumcision became a topical issue in the 1990s. Health care professionals were faced with a new issue and had no guidelines to follow. In 2004, the Finnish League for Human Rights published recommendations on female circumcision and in 2009, the Family Federation of Finland published an action plan on the sexual and reproductive health of immigrants which dealt with topics such as female circumcision. In 2012, the Ministry of Social Affairs and Health published the national action plan for the prevention of circumcision of girls and women, which was coordinated by the National Institute for Health and Welfare.
Combating female circumcision in a culturally sensitive way
Two different ”worlds”, both of which wish the best for the child, collide in the work for combating female circumcision: on one hand, there is the ancient tradition of female circumcision intending to protect girls, while, on the other, there are principles aiming to protect the child in connection with the child’s integrity and human rights.
Preventive efforts require understanding the issues underlying the tradition and using a culturally sensitive approach. While those affected by the tradition must be treated with respect, they must also be provided with appropriate information about the harmful impacts of the tradition and the criminalisation of female circumcision at the same time. This might be the first time when women and girls are able to perceive a link between their unspecific lower abdominal pain and difficulty urinating and the circumcision that has been performed on them. Nonetheless, it is not easy to abandon this ancient tradition which has been considered to be beneficial. Therefore, preventive work requires cooperation, time and patience.
Addressing the issue is important
Addressing female circumcision in preventive work is the most important and, perhaps, the most difficult task of professionals. The subject may seem foreign and difficult or overly sensitive. It might seem easier to ignore addressing the issue or shift the responsibility onto another professional.
However, professionals must always address female circumcision whenever they encounter clients or patients from countries where the tradition is still carried out. The topic is addressed with both women and men. It is possible to get started by addressing the topic of the client’s or patient’s country of origin and its culture. A map depicting the prevalence of female circumcision may be helpful.
Professionals are responsible for preventing female circumcision
Maternity and child health clinics, early childhood education and care, schools, and reception centres play a significant role in preventing female circumcision. The health risks and unlawfulness of female circumcision can be discussed with both children and their both parents in connection with health examinations. At schools, female circumcision can be discussed as part of subjects such as health education in accordance with the valid curriculum. The topic of female circumcision and related health risks, attitudes and significance to girls’ identity can also be addressed in discussion groups.
Long holidays by pupils and students to their former homeland still engaging in the practice may cause suspicions of a threat of female circumcision. In this case, the matter is discussed with the child’s parents and, if necessary, a social worker. A child welfare notification is filed if, after the discussion held with the child’s parents, it still appears that female circumcision is one of the purposes of the holiday. Police is an important partner if a threat of female circumcision is suspected or if it is known that a girl residing in Finland has been circumcised.
Circumcised girls and women have an opportunity to undergo surgical reconstruction or defibulation. While defibulation is a technically simple and quick procedure, a girl or a woman arriving to surgery needs to be provided with emotional support and an opportunity to discuss the issue both before and after the operation. The need for discussion and emotional support is even more obvious in case of surgical reconstruction.
Training and updating the action plan
The message of studies carried out by the National Institute for Health and Welfare has been clear: there is need for providing professionals with training and conducting a follow-up to the action plan for the prevention of circumcision of girls and women. Preventive work must be seen as a common concern to ensure its success. The National Institute for Health and Welfare will update the existing action plan, whose core issues will include training for professionals and creating practices for protecting the welfare of girls and women who have already undergone female circumcision.
We can be proud of the fact that we are taking the issue of female circumcision seriously here in Finland.
This blog post, written by research manager Reija Klemetti, was originally published in THL’s blog in Finnish on the International Day of Zero Tolerance for Female Genital Mutilation, Feb. 6, 2018.
Action plan for the prevention of circumcision of girls and women 2012-2016 (FGM), Ministry of Social Affairs and Health (Finland), 2012