Cultural Sensitivity within a Feminist Global Health Movement
Julia Tan, BSc student in Global Health at the University of Toronto
To recognize the distinct struggle women face, the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) was created, in succession to the Universal Declaration of Human Rights (UDHR) [1]. The convention focuses on areas in which women have unequal outcomes, such as education, employment and housing [1]. In addition to the CEDAW, the United Nations (UN) has recognized a list of harmful traditional practices that discriminate against women, calling for their abolishment to further promote gender equality [2]. Among this list is early marriage, dowry prices, son preference and female genital cutting (FGC) [2].
FGC involves the removal of all or parts of a woman’s external genitalia, for varying cultural reasons [2]. FGC is mostly practiced in African countries, along with some countries in the Middle East [2]. Western key players, such as the UN and the World Health Organization (WHO) have pushed for the abolishment of FGC due to the many health complications that are associated with the practice. Women who undergo FGC are at risk for difficulty during childbirth and hemorrhage, both of which could lead to death [2]. As a result, many Western countries have created laws that ban FGC to protect the health of women, and they encourage countries where FGC is most prevalent to do the same. However, tensions arise when advocacy against FGC is promoted because it would require altering cultures and societies that practice FGC. We must seek to understand the tensions that arise when calling for FGC’s abolishment to develop meaningful solutions to end it.
One critique regarding advocacy for abolishing FGC is that these calls are often rooted in an ethnocentric manner from Western countries [3]. This is seen in the discourse used by the UN and WHO. These organizations use the term “female genital mutilation” (FGM) rather than FGC. The term “mutilation” creates negative connotations, as it dehumanizes the women who have undergone this procedure, painting them as mutants [3]. This term also demonstrates a lack of understanding towards the cultural reasons and meaning behind this procedure, as the West generally views this practice as barbaric and unenlightened. Rather than FGM, the term FGC should be used as it has neutral connotations and promotes cultural relevance [3]. When evaluating the cultures that practice FGC, a cultural relativist approach should be taken to avoid offending other cultures and to attempt to reach a mutual understanding of one another [4].
While the cultural value of FGC differs between countries, many of the reasonings behind FGC are connected to the idea of marriageability [5]. For example, some countries that practice FGC consider the external genitalia of a woman to be manly or unhygienic, leading to the belief that the removal of these parts will make a woman more attractive to a man [5]. Additionally, women who undergo FGC may be seen as more marriageable, as FGC may help ensure chastity and faithfulness within the relationship [5]. This directly reflects the cultural values and ideas around sex outside of marriage in the societies that practice FGC, as FGC may ensure virginity until marriage. This can be rooted in the fear of ripping the stitching in place from FGC, leading to the woman having to admit to promiscuous behaviours in order to seek health care. All of these reasons to perform FGC are recognized as discriminatory towards women by WHO and the UN, justifying their calls to have this practice banned.
However, the most common factor for undergoing FGC is from societal pressures. FGC is perceived as the norm in many practicing cultures. For example, upwards of 91% of Egyptian women and 98% of Somali women have had FGC performed on them [6]. Through ethnographic field studies, it has been found that many women who have undergone FGC have felt a strong sense of belonging to her community after having the procedure performed [3]. Additionally, women have reported feeling proud to be cut, as they view this practice as a rite of passage into womanhood [3]. While these experiences are not universal, it shows that not every experience with FGC is negative, contrary to the language used by the UN and the WHO. As a result, we must consider the importance of cultural acceptance and whether calls to outright ban the practice is justified.
Although there are laws in many Western countries that prohibit FGC from being practiced, it is difficult to enforce. This drives many immigrant families underground to have the procedure done, which may create more health risks since medical attention is less likely to be sought out due to the fear of punishment [7]. There have been trials in the United States where parents were facing 10 years to life in prison for having FGC performed on their daughter [7]. Punishment of this sort demonstrates a lack of compassion for the girl who underwent FGC, as she certainly would not want her parents in jail for life, which can cause feelings of alienation and shame. Western countries have struggled to see that parents who believe in FGC truly think that they are doing what is best for their daughters [7]. Therefore, we must ask if this punishment is justifiable for the act. While ending FGC should be a priority, it must not be done in an ethnocentric manner, as criminalizing this act has had little success in ending the practice. Consequently, we must work to reform FGC, as this may be the only way to ethically alter cultural patterns.
Western feminists who seek to end this practice must do so in a manner that respects the culture where FGC originates. One such way to go about ending FGC is to focus on women’s education and empowerment, considering a negative correlation between educational status and FGC has been reported [8]. If a woman is educated on potential health risks associated with the practice, she is less likely to have the procedure performed on her, along with her daughters [8]. This is why the focus must be on creating educational programs that encourage and empower women to make decisions regarding their own body, which will likely create progress in ending this practice altogether [8]. Additionally, if a woman is well educated, she may be seen as more marriageable, regardless if she has undergone FGC or not, as being skilled is likely to generate a second income for the family [12].
While women’s rights movements such as the CEDAW have undoubtedly raised awareness for the importance of gender equality, it does not come without creating tensions, as it tries to alter cultural patterns. Focusing on educating women about their rights, along with the health risks of FGC, gives power back to the cultures practicing FGC. This is the most ethical way to target FGC, as prioritizing education takes a cultural relativist viewpoint, rather than an ethnocentric approach. To end this practice for good, we must work to understand the cultures that practice FGC. This is the only way we can create meaningful solutions and be feminists for all, regardless of cultural differences.
References
1. Convention on the Elimination of All Forms of Discrimination against Women. Available at: https://www.ohchr.org/en/professionalinterest/pages/cedaw.aspx. (Accessed: 10th December 2020)
2. Fact Sheet No.23, Harmful Traditional Practices Affecting the Health of Women and Children. (1995). Available at: https://www.ohchr.org/documents/publications/factsheet23en.pdf. (Accessed: 9th January 2021)
3. Chauhan, R. The Female Circumcision Controversy: An Anthropological Perspective, and: Female Genital Mutilation: A Guide to Laws and Policies Worldwide (review). NWSA Journal 14, 230–233 (2002).
4. Danial, S. Cultural Relativism vs. Universalism: Female Genital Mutilation, Pragmatic Remedies. Prandium 2, 1–10 (2013).
5. Female genital mutilation. World Health Organization Available at: https://www.who.int/news-room/fact-sheets/detail/female-genital-mutilation. (Accessed: 9th January 2021)
6. Prevalence of female genital mutilation. World Health Organization Available at: https://www.who.int/teams/sexual-and-reproductive-health-and-research/key-areas-of-work/female-genital-mutilation/prevalence-of-female-genital-mutilation. (Accessed: 9th January 2021)
7. Earp, B. D. Does Female Genital Mutilation Have Health Benefits? The Problem with Medicalizing Morality. Journal of Medical Ethics Blog (2017). Available at: https://blogs.bmj.com/medical-ethics/2017/08/15/does-female-genital-mutilation-have-health-benefits-the-problem-with-medicalizing-morality/. (Accessed: 9th January 2021)
8. Monahan, K. Cultural Beliefs, Human Rights Violations, and Female Genital Cutting. Journal of Immigrant & Refugee Studies 5, 21–35 (2007).
9. Graamans, E., Ofware, P., Nguura, P., Smet, E. & Have, W. T. Understanding different positions on female genital cutting among Maasai and Samburu communities in Kenya: a cultural psychological perspective. Culture, Health & Sexuality 21, 79–94 (2018).
About the Author
Julia Tan is from Winnipeg, Manitoba in her third year at the University of Toronto, specializing in Global Health. She is interested in health promotion and research in health policy.