Search This Blog

Sunday, September 16, 2018

Female genital mutilation

From Wikipedia, the free encyclopedia

Billboard with surgical tools covered by a red X. Sign reads: STOP FEMALE CIRCUMCISION. IT IS DANGEROUS TO WOMEN'S HEALTH. FAMILY PLANNING ASSOCIATION OF UGANDA
Road sign near Kapchorwa, Uganda, 2004
Definition "Partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons" (WHO, UNICEF, and UNFPA, 1997).
Areas Africa, Asia, Middle East, and within communities from these areas
Numbers Over 200 million women and girls in 27 African countries; Indonesia; Iraqi Kurdistan; and Yemen (as of 2016)

Female genital mutilation (FGM), also known as female genital cutting and female circumcision, is the ritual cutting or removal of some or all of the external female genitalia. The practice is found in Africa, Asia and the Middle East, and within communities from countries in which FGM is common. UNICEF estimated in 2016 that 200 million women living today in 30 countries—27 African countries, Indonesia, Iraqi Kurdistan and Yemen—have undergone the procedures.

Typically carried out by a traditional circumciser using a blade, FGM is conducted from days after birth to puberty and beyond. In half the countries for which national figures are available, most girls are cut before the age of five. Procedures differ according to the country or ethnic group. They include removal of the clitoral hood and clitoral glans; removal of the inner labia; and removal of the inner and outer labia and closure of the vulva. In this last procedure, known as infibulation, a small hole is left for the passage of urine and menstrual fluid; the vagina is opened for intercourse and opened further for childbirth.

The practice is rooted in gender inequality, attempts to control women's sexuality, and ideas about purity, modesty and beauty. It is usually initiated and carried out by women, who see it as a source of honour, and who fear that failing to have their daughters and granddaughters cut will expose the girls to social exclusion. Health effects depend on the procedure. They can include recurrent infections, difficulty urinating and passing menstrual flow, chronic pain, the development of cysts, an inability to get pregnant, complications during childbirth, and fatal bleeding. There are no known health benefits.

There have been international efforts since the 1970s to persuade practitioners to abandon FGM, and it has been outlawed or restricted in most of the countries in which it occurs, although the laws are poorly enforced. Since 2010 the United Nations has called upon healthcare providers to stop performing all forms of the procedure, including reinfibulation after childbirth and symbolic "nicking" of the clitoral hood. The opposition to the practice is not without its critics, particularly among anthropologists, who have raised difficult questions about cultural relativism and the universality of human rights.

Terminology

photograph
Samburu FGM ceremony, Laikipia plateau, Kenya, 2004

Until the 1980s FGM was widely known in English as female circumcision, implying an equivalence in severity with male circumcision. From 1929 the Kenya Missionary Council referred to it as the sexual mutilation of women, following the lead of Marion Scott Stevenson, a Church of Scotland missionary. References to the practice as mutilation increased throughout the 1970s. In 1975 Rose Oldfield Hayes, an American anthropologist, used the term female genital mutilation in the title of a paper in American Ethnologist, and four years later Fran Hosken, an Austrian-American feminist writer, called it mutilation in her influential The Hosken Report: Genital and Sexual Mutilation of Females. The Inter-African Committee on Traditional Practices Affecting the Health of Women and Children began referring to it as female genital mutilation in 1990, and the World Health Organization (WHO) followed suit in 1991. Other English terms include female genital cutting (FGC) and female genital mutilation/cutting (FGM/C), preferred by those who work with practitioners.

In countries where FGM is common, the practice's many variants are reflected in dozens of terms, often alluding to purification. In the Bambara language, spoken mostly in Mali, it is known as bolokoli ("washing your hands") and in the Igbo language in eastern Nigeria as isa aru or iwu aru ("having your bath"). A common Arabic term for purification has the root t-h-r, used for male and female circumcision (tahur and tahara). It is also known in Arabic as khafḍ or khifaḍ. Communities may refer to FGM as "pharaonic" for infibulation and sunna circumcision for everything else. Sunna means "path or way" in Arabic and refers to the tradition of Muhammad, although none of the procedures are required within Islam. The term infibulation derives from fibula, Latin for clasp; the Ancient Romans reportedly fastened clasps through the foreskins or labia of slaves to prevent sexual intercourse. The surgical infibulation of women came to be known as pharaonic circumcision in Sudan, and as Sudanese circumcision in Egypt. In Somalia it is known simply as qodob ("to sew up").

Methods

diagram
Anatomy of the vulva, showing the clitoral glans, clitoral crura, corpora cavernosa, vestibular bulbs, and vaginal and urethral openings

The procedures are generally performed by a traditional circumciser (cutter or exciseuse) in the girls' homes, with or without anaesthesia. The cutter is usually an older woman, but in communities where the male barber has assumed the role of health worker he will perform FGM too. When traditional cutters are involved, non-sterile devices are likely to be used, including knives, razors, scissors, glass, sharpened rocks and fingernails. According to a nurse in Uganda, quoted in 2007 in The Lancet, a cutter would use one knife on up to 30 girls at a time. Health professionals are often involved in Egypt, Kenya, Indonesia and Sudan; in Egypt 77 percent of FGM procedures, and in Indonesia over 50 percent, were performed by medical professionals as of 2008 and 2016. Women in Egypt reported in 1995 that a local anaesthetic had been used on their daughters in 60 percent of cases, a general anaesthetic in 13 percent, and neither in 25 percent (two percent were missing/don't know).

Classification

Variation

The WHO, UNICEF and UNFPA issued a joint statement in 1997 defining FGM as "all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs whether for cultural or other non-therapeutic reasons". The procedures vary considerably according to ethnicity and individual practitioners. During a 1998 survey in Niger, women responded with over 50 different terms when asked what was done to them. Translation problems are compounded by the women's confusion over which type of FGM they experienced, or even whether they experienced it. Several studies have suggested that survey responses are unreliable. A 2003 study in Ghana found that in 1995 four percent said they had not undergone FGM, but in 2000 said they had, while 11 percent switched in the other direction. In Tanzania in 2005, 66 percent reported FGM, but a medical exam found that 73 percent had undergone it. In Sudan in 2006, a significant percentage of infibulated women and girls reported a less severe type.

Types

Standard questionnaires from United Nations bodies ask women whether they or their daughters have undergone the following: (1) cut, no flesh removed (symbolic nicking); (2) cut, some flesh removed; (3) sewn closed; or (4) type not determined/unsure/doesn't know. The most common procedures fall within the "cut, some flesh removed" category and involve complete or partial removal of the clitoral glans. The World Health Organization (a UN agency) created a more detailed typology: Types I–III vary in how much tissue is removed; Type III is equivalent to the UNICEF category "sewn closed"; and Type IV describes miscellaneous procedures, including symbolic nicking.

diagram

Type I is "partial or total removal of the clitoris and/or the prepuce". Type Ia involves removal of the clitoral hood only. This is rarely performed alone. The more common procedure is Type Ib (clitoridectomy), the complete or partial removal of the clitoral glans (the visible tip of the clitoris) and clitoral hood. The circumciser pulls the clitoral glans with her thumb and index finger and cuts it off.

Type II (excision) is the complete or partial removal of the inner labia, with or without removal of the clitoral glans and outer labia. Type IIa is removal of the inner labia; Type IIb, removal of the clitoral glans and inner labia; and Type IIc, removal of the clitoral glans, inner and outer labia. Excision in French can refer to any form of FGM.

Type III (infibulation or pharaonic circumcision), the "sewn closed" category, involves the removal of the external genitalia and fusion of the wound. The inner and/or outer labia are cut away, with or without removal of the clitoral glans. Type III is found largely in northeast Africa, particularly Djibouti, Eritrea, Ethiopia, Somalia, and Sudan (although not in South Sudan). According to one 2008 estimate, over eight million women in Africa are living with Type III FGM. According to UNFPA in 2010, 20 percent of women with FGM have been infibulated. In Somalia "[t]he child is made to squat on a stool or mat facing the circumciser at a height that offers her a good view of the parts to be handled. ... adult helpers grab and pull apart the legs of the girl. ... If available, this is the stage at which a local anaesthetic would be used":
The element of speed and surprise is vital and the circumciser immediately grabs the clitoris by pinching it between her nails aiming to amputate it with a slash. The organ is then shown to the senior female relatives of the child who will decide whether the amount that has been removed is satisfactory or whether more is to be cut off.

After the clitoris has been satisfactorily amputated ... the circumciser can proceed with the total removal of the labia minora and the paring of the inner walls of the labia majora. Since the entire skin on the inner walls of the labia majora has to be removed all the way down to the perineum, this becomes a messy business. By now, the child is screaming, struggling, and bleeding profusely, which makes it difficult for the circumciser to hold with bare fingers and nails the slippery skin and parts that are to be cut or sutured together. ...

Having ensured that sufficient tissue has been removed to allow the desired fusion of the skin, the circumciser pulls together the opposite sides of the labia majora, ensuring that the raw edges where the skin has been removed are well approximated. The wound is now ready to be stitched or for thorns to be applied. If a needle and thread are being used, close tight sutures will be placed to ensure that a flap of skin covers the vulva and extends from the mons veneris to the perineum, and which, after the wound heals, will form a bridge of scar tissue that will totally occlude the vaginal introitus.
The amputated parts might be placed in a pouch for the girl to wear. A single hole of 2–3 mm is left for the passage of urine and menstrual fluid. The vulva is closed with surgical thread, or agave or acacia thorns, and might be covered with a poultice of raw egg, herbs and sugar. To help the tissue bond, the girl's legs are tied together, often from hip to ankle; the bindings are usually loosened after a week and removed after two to six weeks. If the remaining hole is too large in the view of the girl's family, the procedure is repeated.

The vagina is opened for sexual intercourse, for the first time either by a midwife with a knife or by the woman's husband with his penis. In some areas, including Somaliland, female relatives of the bride and groom might watch the opening of the vagina to check that the girl is a virgin. The woman is opened further for childbirth (defibulation or deinfibulation), and closed again afterwards (reinfibulation). Reinfibulation can involve cutting the vagina again to restore the pinhole size of the first infibulation. This might be performed before marriage, and after childbirth, divorce and widowhood. Hanny Lightfoot-Klein interviewed hundreds of women and men in Sudan in the 1980s about sexual intercourse with Type III:
The penetration of the bride's infibulation takes anywhere from 3 or 4 days to several months. Some men are unable to penetrate their wives at all (in my study over 15%), and the task is often accomplished by a midwife under conditions of great secrecy, since this reflects negatively on the man's potency. Some who are unable to penetrate their wives manage to get them pregnant in spite of the infibulation, and the woman's vaginal passage is then cut open to allow birth to take place. ... Those men who do manage to penetrate their wives do so often, or perhaps always, with the help of the "little knife". This creates a tear which they gradually rip more and more until the opening is sufficient to admit the penis.
Type IV is "[a]ll other harmful procedures to the female genitalia for non-medical purposes", including pricking, piercing, incising, scraping and cauterization. It includes nicking of the clitoris (symbolic circumcision), burning or scarring the genitals, and introducing substances into the vagina to tighten it. Labia stretching is also categorized as Type IV. Common in southern and eastern Africa, the practice is supposed to enhance sexual pleasure for the man and add to the sense of a woman as a closed space. From the age of eight, girls are encouraged to stretch their inner labia using sticks and massage. Girls in Uganda are told they may have difficulty giving birth without stretched labia.

A definition of FGM from the WHO in 1995 included gishiri cutting and angurya cutting, found in Nigeria and Niger. These were removed from the WHO's 2008 definition because of insufficient information about prevalence and consequences. Angurya cutting is excision of the hymen, usually performed seven days after birth. Gishiri cutting involves cutting the vagina's front or back wall with a blade or penknife, performed in response to infertility, obstructed labour and other conditions. In a study by Nigerian physician Mairo Usman Mandara, over 30 percent of women with gishiri cuts were found to have vesicovaginal fistulae (holes that allow urine to seep into the vagina).

Complications

Short-term and late

FGM harms women's physical and emotional health throughout their lives. It has no known health benefits. The short-term and late complications depend on the type of FGM, whether the practitioner has had medical training, and whether they used antibiotics and sterilized or single-use surgical instruments. In the case of Type III, other factors include how small a hole was left for the passage of urine and menstrual blood, whether surgical thread was used instead of agave or acacia thorns, and whether the procedure was performed more than once (for example, to close an opening regarded as too wide or re-open one too small).

photograph
FGM awareness session run by the African Union Mission to Somalia at the Walalah Biylooley refugee camp, Mogadishu

Common short-term complications include swelling, excessive bleeding, pain, urine retention, and healing problems/wound infection. A 2014 systematic review of 56 studies suggested that over one in ten girls and women undergoing any form of FGM, including symbolic nicking of the clitoris (Type IV), experience immediate complications, although the risks increased with Type III. The review also suggested that there was under-reporting. Other short-term complications include fatal bleeding, anaemia, urinary infection, septicaemia, tetanus, gangrene, necrotizing fasciitis (flesh-eating disease), and endometritis. It is not known how many girls and women die as a result of the practice, because complications may not be recognized or reported. The practitioners' use of shared instruments is thought to aid the transmission of hepatitis B, hepatitis C and HIV, although no epidemiological studies have shown this.

Late complications vary depending on the type of FGM. They include the formation of scars and keloids that lead to strictures and obstruction, epidermoid cysts that may become infected, and neuroma formation (growth of nerve tissue) involving nerves that supplied the clitoris. An infibulated girl may be left with an opening as small as 2–3 mm, which can cause prolonged, drop-by-drop urination, pain while urinating, and a feeling of needing to urinate all the time. Urine may collect underneath the scar, leaving the area under the skin constantly wet, which can lead to infection and the formation of small stones. The opening is larger in women who are sexually active or have given birth by vaginal delivery, but the urethra opening may still be obstructed by scar tissue. Vesicovaginal or rectovaginal fistulae can develop (holes that allow urine or faeces to seep into the vagina). This and other damage to the urethra and bladder can lead to infections and incontinence, pain during sexual intercourse and infertility. Painful periods are common because of the obstruction to the menstrual flow, and blood can stagnate in the vagina and uterus. Complete obstruction of the vagina can result in hematocolpos and hematometra (where the vagina and uterus fill with menstrual blood). The swelling of the abdomen that results from the collection of fluid, together with the lack of menstruation, can lead to suspicion of pregnancy; Asma El Dareer, a Sudanese physician, reported in 1979 that a girl in Sudan with this condition was killed by her family.

Pregnancy, childbirth

Materials used to teach communities in Burkina Faso about FGM

FGM may place women at higher risk of problems during pregnancy and childbirth, which are more common with the more extensive FGM procedures. Infibulated women may try to make childbirth easier by eating less during pregnancy to reduce the baby's size. In women with vesicovaginal or rectovaginal fistulae, it is difficult to obtain clear urine samples as part of prenatal care, making the diagnosis of conditions such as pre-eclampsia harder. Cervical evaluation during labour may be impeded and labour prolonged or obstructed. Third-degree laceration (tears), anal-sphincter damage and emergency caesarean section are more common in infibulated women.

Neonatal mortality is increased. The WHO estimated in 2006 that an additional 10–20 babies die per 1,000 deliveries as a result of FGM. The estimate was based on a study conducted on 28,393 women attending delivery wards at 28 obstetric centres in Burkina Faso, Ghana, Kenya, Nigeria, Senegal and Sudan. In those settings all types of FGM were found to pose an increased risk of death to the baby: 15 percent higher for Type I, 32 percent for Type II, and 55 percent for Type III. The reasons for this were unclear, but may be connected to genital and urinary tract infections and the presence of scar tissue. According to the study, FGM was associated with an increased risk to the mother of damage to the perineum and excessive blood loss, as well as a need to resuscitate the baby, and stillbirth, perhaps because of a long second stage of labour.

Psychological effects, sexual function

According to a 2015 systematic review there is little high-quality information available on the psychological effects of FGM. Several small studies have concluded that women with FGM suffer from anxiety, depression and post-traumatic stress disorder. Feelings of shame and betrayal can develop when women leave the culture that practises FGM and learn that their condition is not the norm, but within the practising culture they may view their FGM with pride, because for them it signifies beauty, respect for tradition, chastity and hygiene. Studies on sexual function have also been small. A 2013 meta-analysis of 15 studies involving 12,671 women from seven countries concluded that women with FGM were twice as likely to report no sexual desire and 52 percent more likely to report dyspareunia (painful sexual intercourse). One third reported reduced sexual feelings.

Distribution

Household surveys

map
FGM in Africa, Iraqi Kurdistan and Yemen, as of 2015 (map of Africa).

Aid agencies define the prevalence of FGM as the percentage of the 15–49 age group that has exerienced it. These figures are based on nationally representative household surveys known as Demographic and Health Surveys (DHS), developed by Macro International and funded mainly by the United States Agency for International Development (USAID), and Multiple Indicator Cluster Surveys (MICS) conducted with financial and technical help from UNICEF. These surveys have been carried out in Africa, Asia, Latin America and elsewhere roughly every five years, since 1984 and 1995 respectively. The first to ask about FGM was the 1989–1990 DHS in northern Sudan. The first publication to estimate FGM prevalence based on DHS data (in seven countries) was by Dara Carr of Macro International in 1997.

Type of FGM

Women are asked during the surveys: "Was the genital area just nicked/cut without removing any flesh? Was any flesh (or something) removed from the genital area? Was your genital area sewn?" Most women report "cut, some flesh removed" (Types I and II).

Type I is the most common form in Egypt, and in the southern parts of Nigeria. Type III (infibulation) is concentrated in northeastern Africa, particularly Djibouti, Eritrea, Somalia and Sudan. In surveys in 2002–2006, 30 percent of cut girls in Djibouti, 38 percent in Eritrea, and 63 percent in Somalia had experienced Type III. There is also a high prevalence of infibulation among girls in Niger and Senegal, and in 2013 it was estimated that in Nigeria three percent of the 0–14 age group had been infibulated. The type of procedure is often linked to ethnicity. In Eritrea, for example, a survey in 2002 found that all Hedareb girls had been infibulated, compared with two percent of the Tigrinya, most of whom fell into the "cut, no flesh removed" category.

Prevalence

graph
Percentage of the 15–49 group who have undergone FGM in 29 countries for which figures were available in 2016

FGM is found mostly in what Gerry Mackie called an "intriguingly contiguous" zone in Africa—east to west from Somalia to Senegal, and north to south from Egypt to Tanzania. Nationally representative figures are available for 27 countries in Africa, as well as Indonesia, Iraqi Kurdistan and Yemen. Over 200 million women and girls are thought to be living with FGM in those 30 countries.

The highest concentrations among the 15–49 age group are in Somalia (98 percent), Guinea (97 percent), Djibouti (93 percent), Egypt (91 percent) and Sierra Leone (90 percent). As of 2013, 27.2 million women had undergone FGM in Egypt, 23.8 million in Ethiopia, and 19.9 million in Nigeria. There is also a high concentration in Indonesia, where Type I (clitoridectomy) and Type IV [symbolic nicking]) are practised. The Indonesian Ministry of Health and the Indonesian Ulema Council both say that the clitoris should not be cut. The prevalence rate for the 0–11 group in Indonesia is 49 percent (13.4 million). Smaller studies or anecdotal reports suggest that FGM is also practised in Colombia, the Congo, Malaysia, Oman, Peru, Saudi Arabia, Sri Lanka, and the United Arab Emirates, by the Bedouin in Israel, in Rahmah, Jordan, and by the Dawoodi Bohra in India. It is also found within immigrant communities around the world.

graph
Percentage of the 0–14 group who have undergone FGM in 21 countries for which figures were available as of 2016.
 
Prevalence figures for the 15–19 age group and younger show a downward trend. For example, Burkina Faso fell from 89 percent (1980) to 58 percent (2010); Egypt from 97 percent (1985) to 70 percent (2015); and Kenya from 41 percent (1984) to 11 percent (2014). From 2010 household surveys asked women about the FGM status of all their living daughters. The highest concentrations among girls aged 0–14 were in Gambia (56 percent), Mauritania (54 percent), Indonesia (49 percent for 0–11) and Guinea (46 percent). The figures suggest that a girl was one third less likely in 2014 to undergo FGM than she was 30 years ago. If the rate of decline continues, the number of girls cut will nevertheless rise from 3.6 million a year in 2013 to 4.1 million in 2050 because of population growth.

Rural areas, wealth, education

Surveys have found FGM to be more common in rural areas, less common in most countries among girls from the wealthiest homes, and (except in Sudan and Somalia) less common in girls whose mothers had access to primary or secondary/higher education. In Somalia and Sudan the situation was reversed: in Somalia the mothers' access to secondary/higher education was accompanied by a rise in prevalence of FGM in their daughters, and in Sudan access to any education was accompanied by a rise.

Age, ethnicity

FGM is not invariably a rite of passage between childhood and adulthood, but is often performed on much younger children. Girls are most commonly cut shortly after birth to age 15. In half the countries for which national figures were available in 2000–2010, most girls had been cut by age five. Over 80 percent (of those cut) are cut before the age of five in Nigeria, Mali, Eritrea, Ghana and Mauritania. The 1997 Demographic and Health Survey in Yemen found that 76 percent of girls had been cut within two weeks of birth. The percentage is reversed in Somalia, Egypt, Chad and the Central African Republic, where over 80 percent (of those cut) are cut between five and 14. Just as the type of FGM is often linked to ethnicity, so is the mean age. In Kenya, for example, the Kisi cut around age 10 and the Kamba at 16.

A country's national prevalence often reflects a high sub-national prevalence among certain ethnicities, rather than a widespread practice. In Iraq, for example, FGM is found mostly among the Kurds in Erbil (58 percent prevalence within age group 15–49, as of 2011), Sulaymaniyah (54 percent) and Kirkuk (20 percent), giving the country a national prevalence of eight percent. The practice is sometimes an ethnic marker, but it may differ along national lines. For example, in the northeastern regions of Ethiopia and Kenya, which share a border with Somalia, the Somali people practise FGM at around the same rate as they do in Somalia. But in Guinea all Fulani women responding to a survey in 2012 said they had experienced FGM, against 12 percent of the Fulani in Chad, while in Nigeria the Fulani are the only large ethnic group in the country not to practise it.

Reasons

Support from women

Dahabo Musa, a Somali woman, described infibulation in a 1988 poem as the "three feminine sorrows": the procedure itself, the wedding night when the woman is cut open, then childbirth when she is cut again. Despite the evident suffering, it is women who organize all forms of FGM. Anthropologist Rose Oldfield Hayes wrote in 1975 that educated Sudanese men who did not want their daughters to be infibulated (preferring clitoridectomy) would find the girls had been sewn up after the grandmothers arranged a visit to relatives. Gerry Mackie has compared the practice to footbinding. Like FGM, footbinding was carried out on young girls, nearly universal where practised, tied to ideas about honour, chastity and appropriate marriage, and "supported and transmitted" by women.

photograph
Fuambai Ahmadu chose to undergo clitoridectomy as an adult.
 
FGM practitioners see the procedures as marking not only ethnic boundaries but also gender difference. According to this view, male circumcision defeminizes men while FGM demasculinizes women. Fuambai Ahmadu, an anthropologist and member of the Kono people of Sierra Leone, who in 1992 underwent clitoridectomy as an adult during a Sande society initiation, argued in 2000 that it is a male-centred assumption that the clitoris is important to female sexuality. African female symbolism revolves instead around the concept of the womb. Infibulation draws on that idea of enclosure and fertility. "[G]enital cutting completes the social definition of a child's sex by eliminating external traces of androgyny," Janice Boddy wrote in 2007. "The female body is then covered, closed, and its productive blood bound within; the male body is unveiled, opened and exposed."

In communities where infibulation is common, there is a preference for women's genitals to be smooth, dry and without odour, and both women and men may find the natural vulva repulsive. Some men seem to enjoy the effort of penetrating an infibulation. The local preference for dry sex causes women to introduce substances into the vagina to reduce lubrication, including leaves, tree bark, toothpaste and Vicks menthol rub. The WHO includes this practice within Type IV FGM, because the added friction during intercourse can cause lacerations and increase the risk of infection. Because of the smooth appearance of an infibulated vulva, there is also a belief that infibulation increases hygiene.

Common reasons for FGM cited by women in surveys are social acceptance, religion, hygiene, preservation of virginity, marriageability and enhancement of male sexual pleasure. In a study in northern Sudan, published in 1983, only 17.4 percent of women opposed FGM (558 out of 3,210), and most preferred excision and infibulation over clitoridectomy. Attitudes are changing slowly. In Sudan in 2010, 42 percent of women who had heard of FGM said the practice should continue. In several surveys since 2006, over 50 percent of women in Mali, Guinea, Sierra Leone, Somalia, Gambia and Egypt supported FGM's continuance, while elsewhere in Africa, Iraq and Yemen most said it should end, although in several countries only by a narrow margin.

Social obligation, poor access to information

photograph
Keur Simbara, Senegal, abandoned FGM in 1998 after a three-year program by Tostan.
 
Against the argument that women willingly choose FGM for their daughters, UNICEF calls the practice a "self-enforcing social convention" to which families feel they must conform to avoid uncut daughters facing social exclusion. Ellen Gruenbaum reported that, in Sudan in the 1970s, cut girls from an Arab ethnic group would mock uncut Zabarma girls with Ya, Ghalfa! ("Hey, unclean!"). The Zabarma girls would respond Ya, mutmura! (A mutmara was a storage pit for grain that was continually opened and closed, like an infibulated woman.) But despite throwing the insult back, the Zabarma girls would ask their mothers, "What's the matter? Don't we have razor blades like the Arabs?"

Because of poor access to information, and because circumcisers downplay the causal connection, women may not associate the health consequences with the procedure. Lala Baldé, president of a women's association in Medina Cherif, a village in Senegal, told Mackie in 1998 that when girls fell ill or died, it was attributed to evil spirits. When informed of the causal relationship between FGM and ill health, Mackie wrote, the women broke down and wept. He argued that surveys taken before and after this sharing of information would show very different levels of support for FGM. The American non-profit group Tostan, founded by Molly Melching in 1991, introduced community-empowerment programs in several countries that focus on local democracy, literacy, and education about healthcare, giving women the tools to make their own decisions. In 1997, using the Tostan program, Malicounda Bambara in Senegal became the first village to abandon FGM. By 2018 over 8,000 communities in eight countries had pledged to abandon FGM and child marriage.

Religion

Surveys have shown a widespread belief, particularly in Mali, Mauritania, Guinea and Egypt, that FGM is a religious requirement. Gruenbaum has argued that practitioners may not distinguish between religion, tradition and chastity, making it difficult to interpret the data. FGM's origins in northeastern Africa are pre-Islamic, but the practice became associated with Islam because of that religion's focus on female chastity and seclusion. There is no mention of it in the Quran. It is praised in a few daʻīf (weak) hadith (sayings attributed to Muhammad) as noble but not required. In 2007 the Al-Azhar Supreme Council of Islamic Research in Cairo ruled that FGM had "no basis in core Islamic law or any of its partial provisions".

There is no mention of FGM in the Bible. Christian missionaries in Africa were among the first to object to FGM, but Christian communities in Africa do practise it. A 2013 UNICEF report identified 17 African countries in which at least 10 percent of Christian women and girls aged 15 to 49 had undergone FGM; in Niger 55 percent of Christian women and girls had experienced it, compared with two percent of their Muslim counterparts. The only Jewish group known to have practised it are the Beta Israel of Ethiopia. Judaism requires male circumcision, but does not allow FGM. FGM is also practised by animist groups, particularly in Guinea and Mali.

History

Antiquity

The practice's origins are unknown. Gerry Mackie has suggested that, because FGM's east-west, north-south distribution in Africa meets in Sudan, infibulation may have begun there with the Meroite civilization (c. 800 BCE – c. 350 CE), before the rise of Islam, to increase confidence in paternity. According to historian Mary Knight, Spell 1117 (c. 1991–1786 BCE) of the Ancient Egyptian Coffin Texts may refer in hieroglyphs to an uncircumcised girl ('m't):

ama
X1
D53B1

The spell was found on the sarcophagus of Sit-hedjhotep, now in the Egyptian Museum, and dates to Egypt's Middle Kingdom. (Paul F. O'Rourke argues that 'm't probably refers instead to a menstruating woman.) The proposed circumcision of an Egyptian girl, Tathemis, is also mentioned on a Greek papyrus, from 163 BCE, in the British Museum: "Sometime after this, Nephoris [Tathemis's mother] defrauded me, being anxious that it was time for Tathemis to be circumcised, as is the custom among the Egyptians."

The examination of mummies has shown no evidence of FGM. Citing the Australian pathologist Grafton Elliot Smith, who examined hundreds of mummies in the early 20th century, Knight writes that the genital area may resemble Type III because during mummification the skin of the outer labia was pulled toward the anus to cover the pudendal cleft, possibly to prevent sexual violation. It was similarly not possible to determine whether Types I or II had been performed, because soft tissues had deteriorated or been removed by the embalmers.

The Greek geographer Strabo (c. 64 BCE – c. 23 CE) wrote about FGM after visiting Egypt around 25 BCE: "This is one of the customs most zealously pursued by them [the Egyptians]: to raise every child that is born and to circumcise [peritemnein] the males and excise [ektemnein] the females ..." Philo of Alexandria (c. 20 BCE – 50 CE) also made reference to it: "the Egyptians by the custom of their country circumcise the marriageable youth and maid in the fourteenth (year) of their age, when the male begins to get seed, and the female to have a menstrual flow." It is mentioned briefly in a work attributed to the Greek physician Galen (129 – c. 200 CE): "When [the clitoris] sticks out to a great extent in their young women, Egyptians consider it appropriate to cut it out." Another Greek physician, Aëtius of Amida (mid-5th to mid-6th century CE), offered more detail in book 16 of his Sixteen Books on Medicine, citing the physician Philomenes. The procedure was performed in case the clitoris, or nymphê, grew too large or triggered sexual desire when rubbing against clothing. "On this account, it seemed proper to the Egyptians to remove it before it became greatly enlarged," Aëtius wrote, "especially at that time when the girls were about to be married":
The surgery is performed in this way: Have the girl sit on a chair while a muscled young man standing behind her places his arms below the girl's thighs. Have him separate and steady her legs and whole body. Standing in front and taking hold of the clitoris with a broad-mouthed forceps in his left hand, the surgeon stretches it outward, while with the right hand, he cuts it off at the point next to the pincers of the forceps. It is proper to let a length remain from that cut off, about the size of the membrane that's between the nostrils, so as to take away the excess material only; as I have said, the part to be removed is at that point just above the pincers of the forceps. Because the clitoris is a skinlike structure and stretches out excessively, do not cut off too much, as a urinary fistula may result from cutting such large growths too deeply.
The genital area was then cleaned with a sponge, frankincense powder and wine or cold water, and wrapped in linen bandages dipped in vinegar, until the seventh day when calamine, rose petals, date pits or a "genital powder made from baked clay" might be applied.

Whatever the practice's origins, infibulation became linked to slavery. Mackie cites the Portuguese missionary João dos Santos, who in 1609 wrote of a group near Mogadishu who had a "custome to sew up their Females, especially their slaves being young to make them unable for conception, which makes these slaves sell dearer, both for their chastitie, and for better confidence which their Masters put in them". Thus, Mackie argues, a "practice associated with shameful female slavery came to stand for honor".

Europe and the United States

portrait
Isaac Baker Brown "set to work to remove the clitoris whenever he had the opportunity of doing so".

Gynaecologists in 19th-century Europe and the United States removed the clitoris to treat insanity and masturbation. A British doctor, Robert Thomas, suggested clitoridectomy as a cure for nymphomania in 1813. The first reported clitoridectomy in the West, described in The Lancet in 1825, was performed in 1822 in Berlin by Karl Ferdinand von Graefe on a 15-year-old girl who was masturbating excessively.

Isaac Baker Brown, an English gynaecologist, president of the Medical Society of London and co-founder in 1845 of St. Mary's Hospital, believed that masturbation, or "unnatural irritation" of the clitoris, caused hysteria, spinal irritation, fits, idiocy, mania and death. He therefore "set to work to remove the clitoris whenever he had the opportunity of doing so", according to his obituary. Brown performed several clitoridectomies between 1859 and 1866. In the United States, J. Marion Sims followed Brown's work and in 1862 slit the neck of a woman's uterus and amputated her clitoris, "for the relief of the nervous or hysterical condition as recommended by Baker Brown". When Brown published his views in On the Curability of Certain Forms of Insanity, Epilepsy, Catalepsy, and Hysteria in Females (1866), doctors in London accused him of quackery and expelled him from the Obstetrical Society.

Later in the 19th century, A. J. Bloch, a surgeon in New Orleans, removed the clitoris of a two-year-old girl who was reportedly masturbating. According to a 1985 paper in the Obstetrical & Gynecological Survey, clitoridectomy was performed in the United States into the 1960s to treat hysteria, erotomania and lesbianism. From the mid-1950s, James Burt, a gynaecologist in Dayton, Ohio, performed non-standard repairs of episiotomies after childbirth, adding more stitches to make the vaginal opening smaller. From 1966 until 1989, he performed "love surgery" by cutting women's pubococcygeus muscle, repositioning the vagina and urethra, and removing the clitoral hood, thereby making their genital area more appropriate, in his view, for intercourse in the missionary position. "Women are structurally inadequate for intercourse," he wrote; he said he would turn them into "horny little mice". In the 1960s and 1970s he performed these procedures without consent while repairing episiotomies and performing hysterectomies and other surgery; he said he had performed a variation of them on 4,000 women by 1975. Following complaints, he was required in 1989 to stop practicing medicine in the United States.

Opposition

Colonial opposition in Kenya

Protestant missionaries in British East Africa (present-day Kenya) began campaigning against FGM in the early 20th century, when Dr. John Arthur joined the Church of Scotland Mission (CSM) in Kikuyu. An important ethnic marker, the practice was known by the Kikuyu, the country's main ethnic group, as irua for both girls and boys. It involved excision (Type II) for girls and removal of the foreskin for boys. Unexcised Kikuyu women (irugu) were outcasts.

Jomo Kenyatta, general secretary of the Kikuyu Central Association and later Kenya's first prime minister, wrote in 1938 that, for the Kikuyu, the institution of FGM was the "conditio sine qua non of the whole teaching of tribal law, religion and morality". No proper Kikuyu man or woman would marry or have sexual relations with someone who was not circumcised. A woman's responsibilities toward the tribe began with her initiation. Her age and place within tribal history was traced to that day, and the group of girls with whom she was cut was named according to current events, an oral tradition that allowed the Kikuyu to track people and events going back hundreds of years.

photograph
Missionary Hulda Stumpf (bottom left) was murdered in Kikuyu in 1930 after opposing FGM.

Beginning with the CSM mission in 1925, several missionary churches declared that FGM was prohibited for African Christians. The CSM announced that Africans practising it would be excommunicated, which resulted in hundreds leaving or being expelled. The stand-off turned FGM into a focal point of the Kenyan independence movement; the 1929–1931 period is known in the country's historiography as the female circumcision controversy.

In 1929 the Kenya Missionary Council began referring to FGM as the "sexual mutilation of women", rather than circumcision, and a person's stance toward the practice became a test of loyalty, either to the Christian churches or to the Kikuyu Central Association. Hulda Stumpf, an American missionary with the Africa Inland Mission who opposed FGM in the girls' school she helped to run, was murdered in 1930. Edward Grigg, the governor of Kenya, told the British Colonial Office that the killer, who was never identified, had tried to circumcise her.

In 1956 the council of male elders (the Njuri Nchecke) in Meru announced a ban on FGM. Over the next three years, thousands of girls cut each other's genitals with razor blades as a symbol of defiance. The movement came to be known as Ngaitana ("I will circumcise myself"), because to avoid naming their friends the girls said they had cut themselves. Historian Lynn Thomas described the episode as significant in the history of FGM because it made clear that its victims were also its perpetrators.

Growth of opposition

The first known non-colonial campaign against FGM began in Egypt in the 1920s, when the Egyptian Doctors' Society called for a ban. There was a parallel campaign in Sudan, run by religious leaders and British women. Infibulation was banned there in 1946, but the law was unpopular and barely enforced. The Egyptian government banned infibulation in state-run hospitals in 1959, but allowed partial clitoridectomy if parents requested it. (Egypt banned FGM entirely in 2007.)

In 1959, the UN asked the WHO to investigate FGM, but the latter responded that it was not a medical matter. Feminists took up the issue throughout the 1970s. The Egyptian physician and feminist Nawal El Saadawi criticized FGM in her book Women and Sex (1972); the book was banned in Egypt and El Saadawi lost her job as director general of public health. She followed up with a chapter, "The Circumcision of Girls", in her book The Hidden Face of Eve: Women in the Arab World (1980), which described her own clitoridectomy when she was six years old:
I did not know what they had cut off from my body, and I did not try to find out. I just wept, and called out to my mother for help. But the worst shock of all was when I looked around and found her standing by my side. Yes, it was her, I could not be mistaken, in flesh and blood, right in the midst of these strangers, talking to them and smiling at them, as though they had not participated in slaughtering her daughter just a few moments ago.
photograph

In 1975, Rose Oldfield Hayes, an American social scientist, became the first female academic to publish a detailed account of FGM, aided by her ability to discuss it directly with women in Sudan. Her article in American Ethnologist called it "female genital mutilation", rather than female circumcision, and brought it to wider academic attention. Edna Adan Ismail, who worked at the time for the Somalia Ministry of Health, discussed the health consequences of FGM in 1977 with the Somali Women's Democratic Organization. Two years later Fran Hosken, an Austria-American feminist, published The Hosken Report: Genital and Sexual Mutilation of Females (1979), the first to offer global figures. She estimated that 110,529,000 women in 20 African countries had experienced FGM. The figures were speculative but consistent with later surveys. Describing FGM as a "training ground for male violence", Hosken accused female practitioners of "participating in the destruction of their own kind". The language caused a rift between Western and African feminists; African women boycotted a session featuring Hosken during the UN's Mid-Decade Conference on Women in Copenhagen in July 1980.

In 1979, the WHO held a seminar, "Traditional Practices Affecting the Health of Women and Children", in Khartoum, Sudan, and in 1981, also in Khartoum, 150 academics and activists signed a pledge to fight FGM after a workshop held by the Babiker Badri Scientific Association for Women's Studies (BBSAWS), "Female Circumcision Mutilates and Endangers Women – Combat it!" Another BBSAWS workshop in 1984 invited the international community to write a joint statement for the United Nations. It recommended that the "goal of all African women" should be the eradication of FGM and that, to sever the link between FGM and religion, clitoridectomy should no longer be referred to as sunna.

The Inter-African Committee on Traditional Practices Affecting the Health of Women and Children, founded in 1984 in Dakar, Senegal, called for an end to the practice, as did the UN's World Conference on Human Rights in Vienna in 1993. The conference listed FGM as a form of violence against women, marking it as a human-rights violation, rather than a medical issue. Throughout the 1990s and 2000s governments in Africa and the Middle East passed legislation banning or restricting FGM. In 2003 the African Union ratified the Maputo Protocol on the rights of women, which supported the elimination of FGM. By 2015 laws restricting FGM had been passed in at least 23 of the 27 African countries in which it is concentrated, although several fell short of a ban.

United Nations

In December 1993, the United Nations General Assembly included FGM in resolution 48/104, the Declaration on the Elimination of Violence Against Women, and from 2003 sponsored International Day of Zero Tolerance for Female Genital Mutilation, held every 6 February. UNICEF began in 2003 to promote an evidence-based social norms approach, using ideas from game theory about how communities reach decisions about FGM, and building on the work of Gerry Mackie on the demise of footbinding in China. In 2005 the UNICEF Innocenti Research Centre in Florence published its first report on FGM. UNFPA and UNICEF launched a joint program in Africa in 2007 to reduce FGM by 40 percent within the 0–15 age group and eliminate it from at least one country by 2012, goals that were not met and which they later described as unrealistic. In 2008 several UN bodies recognized FGM as a human-rights violation, and in 2010 the UN called upon healthcare providers to stop carrying out the procedures, including reinfibulation after childbirth and symbolic nicking. In 2012 the General Assembly passed resolution 67/146, "Intensifying global efforts for the elimination of female genital mutilations".

Non-practising countries

Immigration spread the practice to Australia, New Zealand, Europe and North America, all of which outlawed it entirely or restricted it to consenting adults. Sweden outlawed FGM in 1982 with the Act Prohibiting the Genital Mutilation of Women, the first Western country to do so. Several former colonial powers, including Belgium, Britain, France and the Netherlands, introduced new laws or made clear that it was covered by existing legislation. As of 2013 legislation banning FGM had been passed in 33 countries outside Africa and the Middle East.

North America

In the United States an estimated 513,000 women and girls had experienced FGM or were at risk as of 2012. The Centers for Disease Control's previous estimate was 168,000 as of 1990. A Nigerian woman successfully contested deportation in March 1994 on the grounds that her daughters might be cut, and in 1996 Fauziya Kasinga from Togo became the first to be granted asylum to escape FGM. In 1996 the Federal Prohibition of Female Genital Mutilation Act made it illegal to perform FGM on minors for non-medical reasons, and in 2013 the Transport for Female Genital Mutilation Act prohibited transporting a minor out of the country for the purpose of FGM. In addition, 24 states have legislation banning FGM. The American Academy of Pediatrics opposes all forms of the practice, including pricking the clitoral skin. The first FGM conviction in the US was in 2006, when Khalid Adem, who had emigrated from Ethiopia, was sentenced to ten years after severing his two-year-old daughter's clitoris with a pair of scissors.

Canada recognized FGM as a form of persecution in July 1994, when it granted refugee status to Khadra Hassan Farah, who had fled Somalia to avoid her daughter being cut. In 1997 section 268 of its Criminal Code was amended to ban FGM, except where "the person is at least eighteen years of age and there is no resulting bodily harm". As of July 2017 there had been no prosecutions. Canadian officials have expressed concern that a few thousand Canadian girls are at risk of "vacation cutting", whereby girls are taken overseas to undergo the procedure, but as of 2017 there were no firm figures.

Europe

According to the European Parliament, 500,000 women in Europe had undergone FGM as of March 2009. France is known for its tough stance against FGM. Up to 30,000 women there were thought to have experienced it as of 1995. According to Colette Gallard, a family-planning counsellor, when FGM was first encountered in France, the reaction was that Westerners ought not to intervene. It took the deaths of two girls in 1982, one of them three months old, for that attitude to change. In 1991 a French court ruled that the Convention Relating to the Status of Refugees offered protection to FGM victims; the decision followed an asylum application from Aminata Diop, who fled an FGM procedure in Mali. The practice is outlawed by several provisions of France's penal code that address bodily harm causing permanent mutilation or torture. All children under six who were born in France undergo medical examinations that include inspection of the genitals, and doctors are obliged to report FGM. The first civil suit was in 1982, and the first criminal prosecution in 1993. In 1999 a woman was given an eight-year sentence for having performed FGM on 48 girls. By 2014 over 100 parents and two practitioners had been prosecuted in over 40 criminal cases.

Around 137,000 women and girls living in England and Wales were born in countries where FGM is practised, as of 2011. Performing FGM on children or adults was outlawed under the Prohibition of Female Circumcision Act 1985. This was replaced by the Female Genital Mutilation Act 2003 and Prohibition of Female Genital Mutilation (Scotland) Act 2005, which added a prohibition on arranging FGM outside the country for British citizens or permanent residents. The United Nations Committee on the Elimination of Discrimination against Women (CEDAW) asked the government in July 2013 to "ensure the full implementation of its legislation on FGM". The first charges were brought in 2014 against a physician and another man; the physician had stitched an infibulated woman after opening her for childbirth. Both men were acquitted in 2015.

Criticism of opposition

Tolerance versus human rights

photograph
Academic Obioma Nnaemeka criticized the renaming of female circumcision to female genital mutilation.

Anthropologists have accused FGM eradicationists of cultural colonialism, and have been criticized in turn for their moral relativism and failure to defend the idea of universal human rights. According to critics of the eradicationist position, the biological reductionism of the opposition to FGM, and the failure to appreciate FGM's cultural context, serves to "other" practitioners and undermine their agency—in particular when parents are referred to as "mutilators".

Africans who object to the tone of FGM opposition risk appearing to defend the practice. The feminist theorist Obioma Nnaemeka, herself strongly opposed to FGM, argues that renaming it female genital mutilation introduced "a subtext of barbaric African and Muslim cultures and the West's relevance (even indispensability) in purging [it]". According to Ugandan law professor Sylvia Tamale, early Western opposition to FGM stemmed from a Judeo-Christian judgment that African sexual and family practices—including dry sex, polygyny, bride price and levirate marriage—required correction; African feminists "take strong exception to the imperialist, racist and dehumanising infantilization of African women". Commentators highlight the appropriation of women's bodies as exhibits, such as the 1996 publication of the Pulitzer-prize-winning photographs (above) of a 16-year-old Kenyan girl undergoing FGM. The photographs were published by 12 American newspapers, without the girl consenting either to be photographed or to have the images published.

The debate has highlighted a tension between anthropology and feminism, with the former's focus on tolerance and the latter's on equal rights for women. According to the anthropologist Christine Walley, a common position within anti-FGM literature has been to present African women as victims of false consciousness participating in their own oppression, a position promoted by feminists in the 1970s and 1980s, including Fran Hosken, Mary Daly and Hanny Lightfoot-Klein. It prompted the French Association of Anthropologists to issue a statement in 1981, at the height of the early debates, that "a certain feminism resuscitates (today) the moralistic arrogance of yesterday's colonialism."

Comparison with other procedures

photograph
Martha Nussbaum: a key moral and legal issue with FGM is that it is mostly conducted on children using physical force.

Nnaemeka argues that the crucial question, broader than FGM, is why the female body is subjected to so much "abuse and indignity", including in the West. Several authors have drawn a parallel between FGM and cosmetic procedures. Ronán Conroy of the Royal College of Surgeons in Ireland wrote in 2006 that cosmetic genital procedures were "driving the advance" of FGM by encouraging women to see natural variations as defects. Anthropologist Fadwa El Guindi compared FGM to breast enhancement, in which the maternal function of the breast becomes secondary to men's sexual pleasure. Benoîte Groult made a similar point in 1975, citing FGM and cosmetic surgery as sexist and patriarchal.

Carla Obermeyer has argued that FGM may be conducive to a subject's social well-being in the same way that rhinoplasty and male circumcision are. Despite the 2007 ban in Egypt, women there wanting FGM for their daughters seek amalyet tajmeel (cosmetic surgery) to remove what they see as excess genital tissue.

Cosmetic procedures such as labiaplasty and clitoral hood reduction do fall within the WHO's definition of FGM, which aims to avoid loopholes, but the WHO notes that these elective practices are generally not regarded as FGM. Some legislation banning FGM, such as in Canada and the US, covers minors only, but several countries, including Sweden and the UK, have banned it regardless of consent. Sweden, for example, has banned operations "on the outer female sexual organs with a view to mutilating them or bringing about some other permanent change in them, regardless of whether or not consent has been given for the operation". Gynaecologist Birgitta Essén and anthropologist Sara Johnsdotter argue that the law seems to distinguish between Western and African genitals, and deems only African women (such as those seeking reinfibulation after childbirth) unfit to make their own decisions.

The philosopher Martha Nussbaum argues that a key concern with FGM is that it is mostly conducted on children using physical force. The distinction between social pressure and physical force is morally and legally salient, comparable to the distinction between seduction and rape. She argues further that the literacy of women in practising countries is generally poorer than in developed nations, which reduces their ability to make informed choices.

Arguments have been made that non-therapeutic male circumcision, practised by Muslims, Jews and some Christian groups, also violates children's rights. Globally about 30 percent of males over 15 are circumcised; of these, about two-thirds are Muslim. An eight-member American Academy of Pediatrics circumcision task force issued a policy statement in 2012 that the health benefits of male circumcision outweigh the risks; they recommended that it be carried out, if it is performed, by "trained and competent practitioners ... using sterile techniques and effective pain management". The statement met with protests from a group of 38 doctors in Europe, who accused the task force of "cultural bias". At least half the male population of the United States is circumcised, while most men in Europe are not. Several commentators maintain that children's rights are also violated by the genital alteration of intersex children, who are born with anomalies that physicians choose to correct.

Dehumanization

From Wikipedia, the free encyclopedia

Nazi soldiers gather up Polish Jews for deportation to death camps during the Warsaw Ghetto Uprising. In his report on the suppression of the uprising, Jurgen Stroop described Jews and resistance fighters as "bandits."

Dehumanization or an act thereof can describe a behavior or process that undermines individuality of and in others. Behaviorally, dehumanization describes a disposition towards others that debases the others' individuality as either an "individual" species or an "individual" object, e.g. someone who acts inhumanely towards humans. As a process, it may be understood as the opposite of personification, a figure of speech in which inanimate objects or abstractions are endowed with human qualities; dehumanization then is the disendowment of these same qualities or a reduction to abstraction, e.g. Technology revolutions cause the dehumanization of labor markets to the point of antiquation.
 
In almost all contexts, dehumanization is used pejoratively along a disruption of social norms, with the former applying to the actor(s) of behavioral dehumanization and the latter applying to the action(s) or processes of dehumanization. As social norms define what humane behavior is, reflexively these same social norms define what human behavior is not, or what is inhumane. Dehumanization differs from inhumane behaviors or processes in its breadth to include the emergence of new competing social norms. This emergence then is the action of dehumanization until the old norms lose out to the competing new norms, which will then redefine the action of dehumanization. If the new norms lose acceptance then the action remains one of dehumanization and its severity is comparative to past examples throughout history. However, dehumanization's definition remains in a reflexive state of a type-token ambiguity relative to both scales individual and societal.

Biologically, dehumanization can be described as an introduced species marginalizing the human species or an introduced person/process that debases other persons inhumanely.

In political science and jurisprudence, the act of dehumanization is the inferential alienation of human rights or denaturalization of natural rights, a definition contingent upon presiding international law rather than social norms limited by human geography. In this context, specialty within species need not apply to constitute global citizenship or its inalienable rights; these both are inherit by human genome.

It is theorized to take on two forms: animalistic dehumanization, which is employed on a largely intergroup basis, and mechanistic dehumanization, which is employed on a largely interpersonal basis. Dehumanization can occur discursively (e.g., idiomatic language that likens certain human beings to non-human animals, verbal abuse, erasing one's voice from discourse), symbolically (e.g., imagery), or physically (e.g., chattel slavery, physical abuse, refusing eye contact). Dehumanization often ignores the target's individuality (i.e., the creative and interesting aspects of their personality) and can hinder one from feeling empathy or properly understanding a stigmatized group of people.

Dehumanization may be carried out by a social institution (such as a state, school, or family), interpersonally, or even within the self. Dehumanization can be unintentional, especially on the part of individuals, as with some types of de facto racism. State-organized dehumanization has historically been directed against perceived political, racial, ethnic, national, or religious minority groups. Other minoritized and marginalized individuals and groups (based on sexual orientation, gender, disability, class, or some other organizing principle) are also susceptible to various forms of dehumanization. The concept of dehumanization has received empirical attention in the psychological literature. It is conceptually related to infrahumanization, delegitimization, moral exclusion, and objectification. Dehumanization occurs across several domains; is facilitated by status, power, and social connection; and results in behaviors like exclusion, violence, and support for violence against others.

“Dehumanisation is viewed as a central component to intergroup violence because it is frequently the most important precursor to moral exclusion, the process by which stigmatized groups are placed outside the boundary in which moral values, rules, and considerations of fairness apply.”

David Livingstone Smith, director and founder of The Human Nature Project at the University of New England, argues that historically, human beings have been dehumanizing one another for thousands of years.

Humanness

In Herbert Kelman's work on dehumanization, humanness has two features: "identity" (i.e., a perception of the person "as an individual, independent and distinguishable from others, capable of making choices") and "community" (i.e., a perception of the person as "part of an interconnected network of individuals who care for each other"). When a target's agency and community embeddedness are denied, they no longer elicit compassion or other moral responses, and may suffer violence as a result.

Animalistic versus mechanistic

In Nick Haslam's review of dehumanization, he differentiates between uniquely human (UH) characteristics, which distinguish humans from non-human animals, and human nature (HN), characteristics that are typical of or central to human beings. His model suggests that different types of dehumanization arise from the denial of one sense of humanness or the other. Language, higher order cognition, refined emotions, civility, and morality are uniquely human characteristics (i.e., traits humans have that non-human animals do not). Cognitive flexibility, emotionality, vital agency, and warmth are central to human nature. Characteristics of human nature are perceived to be widely shared among groups (i.e., every human has these traits), while uniquely human characteristics (e.g., civility, morality) are thought to vary between groups.

According to Haslam, the animalistic form of dehumanization occurs when uniquely human characteristics (e.g., refinement, moral sensibility) are denied to an outgroup. People that suffer animalistic dehumanization are seen as amoral, unintelligent, and lacking self-control, and they are likened to animals. This has happened to Jewish people during The Holocaust, and indigenous people subject to colonization and slavery. While usually employed on an intergroup basis, animalistic dehumanization can occur on an interpersonal basis as well.

The mechanistic form occurs when features of human nature (e.g., cognitive flexibility, warmth, agency) are denied to targets. Targets of mechanistic dehumanization are seen as cold, rigid, interchangeable, lacking agency, and likened to machines or objects. Mechanistic dehumanization is usually employed on an interpersonal basis (e.g., when a person is seen as a means to another's end).

Related psychological processes

Several lines of psychological research relate to the concept of dehumanization. Infrahumanization suggests that individuals think of and treat outgroup members as "less human" and more like animals; while Irenaus Eibl-Eibesfeld uses the term pseudo-speciation, a term that he borrowed from the psychoanalyst Erik Erikson, to imply that the dehumanized person or persons are being regarded as not members of the human species. Specifically, individuals associate secondary emotions (which are seen as uniquely human) more with the ingroup than with the outgroup. Primary emotions (those that are experienced by all sentient beings, both humans and other animals) and are found to be more associated with the outgroup. Dehumanization is intrinsically connected with violence. Often, one cannot do serious injury to another without first dehumanizing him or her in one's mind (as a form of rationalization.) Military training is, among other things, a systematic desensitization and dehumanization of the enemy, and servicemen and women may find it psychologically necessary to refer to the enemy as animal or other non-human beings. Lt. Col. Dave Grossman has shown that without such desensitization it would be difficult, if not impossible for someone to kill another human, even in combat or under threat to their own lives.

Delegitimization is the "categorization of groups into extreme negative social categories which are excluded from human groups that are considered as acting within the limits of acceptable norms and/or values."

Moral exclusion occurs when outgroups are subject to a different set of moral values, rules, and fairness than are used in social relations with ingroup members. When individuals dehumanize others, they no longer experience distress when they treat them poorly. Moral exclusion is used to explain extreme behaviors like genocide, harsh immigration policies, and eugenics, but can also happen on a more regular, everyday discriminatory level. In laboratory studies, people who are portrayed as lacking human qualities have been found to be treated in a particularly harsh and violent manner.

Martha Nussbaum (1999) identified seven components of objectification: "instrumentality", "denial of autonomy", "inertness", "fungibility", "violability", "ownership", and "denial of subjectivity".

In Psychology higher-order cognitive processes like social cognition may occur between a human and human, or human and non-human, human and object. The assigning that occurs in social cognition suggests a non-human target can have projected internal life, or conscious emotional and cognitive experiences. Mental states projected onto objects and non-human forms of life can occur without intention. Studies by Heberlein, Adolphs, Tranel & Damasio, Heberlein AS, Adolphs R, Tranel D, Damasio H. Cortical regions for judgments of emotions and personality traits from point-light walkers explore the constants of biological motion perception within areas of the human brain, where participants would infer intent among objects which do not have any emotion or cognitions. It is also possible for subjects to anthropomorphize a spectrum of inanimate objects and non-human life forms. In children there is a common pattern of projecting the imaginary other, both humanlike and not, and a child is able to interact with the imaginary other without much effort as if the projected other exists. With the ease of anthropomorphic projection, children's lack of social cognition unto human counterparts is surprising. Dehumanized perception often means a cognitive bias experienced through lack of consideration for thoughts, feelings, and general mental contents of a social target's cognition. This dehumanized perception can occur when the target has elicited disgust or further negative responses when in contact with the dehumanizing subject. Humans seen as having certain lower social standings such as people suffering from addictions and homeless persons are often perceived as being low in cognitive warmth and low in social competency reliability. This often elicits more frequent disgust compared to certain higher social standings when projected cognitions by the dehumanizing subject. Humans can suddenly consider the mental cognitions of those persons who experience emotions of a social variety, linking in-groups of positive social figures to pride, connecting in-groups of wealthy and the upper class feelings of envy, and experiencing pity towards in-groups of the disabled and the elderly. Through a study by Fiske, Cuddy, & Glick in 2007, a stereotype content model showed that social targets such as the elderly and wealthy were trustworthy, friendly, and of capable ability due to perceived competence and warmth. However, in-groups of the disabled, poor, persons with addictions, and immigrants were recorded as disgust-inducing due to projected low warmth and incompetence.

Dehumanized perception has been indicated to occur when a subject experiences low frequencies of activation within their social cognition neural network. This includes areas of neural networking such as the superior temporal sulcus and the medial prefrontal cortex. A study by Frith & Frith in 2001 suggests the criticality of social interaction within a neural network has tendencies for subjects to dehumanize those seen as disgust-inducing leading to social disengagement. Tasks involving social cognition typically activate the neural network responsible for subjective projections of disgust-inducing perceptions and patterns of dehumanization. "Besides manipulations of target persons, manipulations of social goals validate this prediction: Inferring preference, a mental-state inference, significantly increases MPFC and STS activity to these otherwise dehumanized targets." A 2007 study by Harris, McClure, van den Bos, Cohen & Fiske suggest a subject's mental reliability towards dehumanizing social cognition due to the decrease of neural activity towards the projected target, replicating across stimuli and contexts.

Facilitating factors

While social distance from the outgroup target is a necessary condition for dehumanization, some research suggests that it is not sufficient. Psychological research has identified high status, power, and social connection as additional factors that influence whether dehumanization will occur. If being an outgroup member was all that was required to be dehumanized, dehumanization would be far more prevalent. However, only members of high status groups associate humanity more with ingroup than the outgroup. Members of low status groups exhibit no differences in associations with humanity. Having high status makes one more likely to dehumanize others. Low status groups are more associated with human nature traits (warmth, emotionality) than uniquely human traits, implying that they are closer to animals than humans because these traits are typical of humans but can be seen in other species. In addition, another line of work found that individuals in a position of power were more likely to objectify their subordinates, treating them as a means to one's own end rather than focusing on their essentially human qualities. Finally, social connection, thinking about a close other or being in the actual presence of a close other, enables dehumanization by reducing attribution of human mental states, increasing support for treating targets like animals, and increasing willingness to endorse harsh interrogation tactics. This is surprising because social connection has documented benefits for personal health and well-being but appears to impair intergroup relations.

Neuroimaging studies have discovered that the medial prefrontal cortex—a brain region distinctively involved in attributing mental states to others—shows diminished activation to extremely dehumanized targets (i.e., those rated, according to the stereotype content model, as low-warmth and low-competence, such as drug addicts or homeless people).

Race and ethnicity

Dehumanization often occurs as a result of conflict in an intergroup context. Ethnic and racial others are often represented as animals in popular culture and scholarship. There is evidence that this representation persists in the American context with African Americans implicitly associated with apes. To the extent that an individual has this dehumanizing implicit association, they are more likely to support violence against African Americans (e.g., jury decisions to execute defendants). Historically, dehumanization is frequently connected to genocidal conflicts in that ideologies before and during the conflict link victims to rodents/vermin. Immigrants are also dehumanized in this manner. In the 1900s, the Australian Constitution and British Government partook in an Act to federate the Australian states. Section 51 (xxvi) and 127 were two provisions that dehumanised Aboriginals. 51. The Parliament shall, subject to this Constitution, have power to make laws for the peace, order, and good government of the Commonwealth with respect to: (xxvi) The people of any race, other than the Aboriginal people in any state, for whom it is deemed necessary to make special laws. 127. In reckoning the numbers of the people of the Commonwealth, or of a state or other part of the Commonwealth, Aboriginal natives shall not be counted. In 1902 the Commonwealth Franchise Act was passed, this categorically denied Aboriginals from the right to vote. Indigenous Australians were not allowed social security benefits e.g. Aged pensions and maternity allowances. However, these benefits were provided to other non-Indigenous Australians by the Commonwealth Government. Aboriginals in rural areas were discriminated and controlled as to where and how they could marry, work, live, and their movements were restricted.

Objectification

Fredrickson and Roberts argued that the sexual objectification of women extends beyond pornography (which emphasizes women's bodies over their uniquely human mental and emotional characteristics) to society generally. There is a normative emphasis on female appearance that causes women to take a third-person perspective on their bodies. The psychological distance women may feel from their bodies might cause them to dehumanize themselves. Some research has indicated that women and men exhibit a "sexual body part recognition bias", in which women's sexual body parts are better recognized when presented in isolation than in the context of their entire bodies, whereas men's sexual body parts are better recognized in the context of their entire bodies than in isolation. Men who dehumanize women as either animals or objects are more liable to rape and sexually harass women and display more negative attitudes toward female rape victims.

The role of nations and governments

Sociologists and historians often view dehumanization as central to war. Governments sometimes represent "enemy" civilians or soldiers as less than human so that voters will be more likely to support a war they may otherwise consider mass murder. Dictatorships use the same process to prevent opposition by citizens. Such efforts often depend on preexisting racist, sectarian, or otherwise biased beliefs, which governments play upon through various types of media, presenting "enemies" as barbaric, as undeserving of rights, and as threats to the nation. Alternatively, states sometimes present an enemy government or way of life as barbaric and its citizens as childlike and incapable of managing their own affairs. Such arguments have been used as a pretext for colonialism.

The Holocaust during World War II and the Rwandan Genocide have both been cited as atrocities facilitated by a government sanctioned dehumanization of its citizens. In terms of the Holocaust, government proliferated propaganda created a culture of dehumanization of the Jewish population. Crimes like lynching (especially in the United States) are often thought of as the result of popular bigotry and government apathy.

Anthropologists Ashley Montagu and Floyd Matson famously wrote that dehumanization might well be considered "the fifth horseman of the apocalypse" because of the inestimable damage it has dealt to society. When people become things, the logic follows, they become dispensable, and any atrocity can be justified.

Dehumanization can be seen outside of overtly violent conflicts, as in political debates where opponents are presented as collectively stupid or inherently evil. Such "good-versus-evil" claims help end substantive debate (see also thought-terminating cliché).

The role of terrorists and rebels

Non-state actors—terrorists in particular—have also resorted to dehumanization to further their cause and assuage pangs of guilt. The 1960s terrorist group Weather Underground had advocated violence against any authority figure, and used the "police are pigs" idea to convince members that they were not harming human beings, but simply killing wild animals. Likewise, rhetoric statements such as "terrorists are just scum", is an act of dehumanization.

Systematic destruction

A study investigating racialized law enforcement violence is using virtual simulators to investigate "shoot or don't shoot" responses. The studies conducted that participants' responses were affected by racial bias. When the simulator presented an armed Black man, participants shot faster and more accurately compared to an armed White man. In response to the "don't shoot", command of an unarmed Black man participant's reaction time was slower and less accurate compared to an unarmed White man. The Center of Disease Control statistics on law enforcement killings between 1999 and 2011 showed that American youth of African ancestry between the ages of 15 and 19 are 2.8 times more likely to be killed by law enforcement than the national average of all races and age groups. A study conducted with predominately White female undergraduates as well as predominately White male law enforcement found that participants overestimated the age of American children of African ancestry by 4.59 years, translating to boys of thirteen and a half years of age would be misperceived as legal adults. Annually, 250,000 children are processed through to adult correctional facilities; this is at the impairment of their physical and mental health. In comparison to children at juvenile facilities, children sentenced as adults are, five times as likely to be sexually assaulted, twice as likely to be assaulted by a correctional officer, and eight times as likely to commit suicide. Implied dehumanization estimated the inclination of excessive force used by law enforcement against American suspect of African ancestry compared to other races. The work of Herbert Kelman, "Violence without moral restraint: Reflections on the dehumanization of victims and victimizes", illustrates how the above dehumanization of Americans with African ancestry is occurring. The apprehension towards murdering human beings is so overwhelming that the victim must be removed from their human status if systematic murdering is to occur. The victims are then dehumanized by placing them "outside the boundary in which moral values, rules, and considerations of fairness apply", the principle of mortality is no longer applicable. To establish others as entirely human, signify the sorrow from their death, despite racial background, as well as our individual relationship with the person. When referring to identity, the death is individualized; when referring to community, the death is experienced personally. The involvement of the bureaucratic apparatus is one of dehumanization.

Human anatomy

In the United States of America, Americans of African ancestry were dehumanised via the classification of being deemed as a primate, not a human. The United States of America Constitution that took place in 1787 stated when collecting census data "all other persons" in reference to enslaved Africans will be counted as three-fifths of a human being. In the 1990s reportedly California State Police classified incidents involving young men of African ancestry as no humans involved. A California police officer who was also involved in the Rodney King beating described a dispute between an American couple with African ancestry as "something right out of gorillas in the mist". Franz Boas and Charles Darwin hypothesized that there may be an evolution process among primates. Monkeys and apes were least evolved, then savage and/ or deformed anthropoids which referred to people of African ancestry, to Caucasians as most evolved.

In science, medicine, and technology

Relatively recent history has seen the relationship between dehumanization and science result in unethical scientific research. The Tuskegee syphilis experiment and the Nazi human experimentation on Jewish people are two such examples. In the former, Africans Americans with syphilis were recruited to participate in a study about the course of the disease. Even when treatment and a cure were eventually developed, they were withheld from the Black participants so that researchers could continue their study. Similarly, Nazi scientists conducted horrific experiments on Jewish people during the Holocaust. This was justified in the name of research and progress which is indicative of the far reaching affects that the culture of dehumanization had upon this society. When this research came to light, efforts were made to protect participants of future research, and currently institutional review boards exist to safeguard individuals from being taken advantage of by scientists.

In a medical context, the passage of time has served to make some dehumanizing practices more acceptable, not less. While dissections of human cadavers was seen as dehumanizing in the Dark Ages, the value of dissections as a training aid is such that they are now more widely accepted. Dehumanization has been associated with modern medicine generally, and specifically, has been suggested as a coping mechanism for doctors who work with patients at the end of life. Researchers have identified six potential causes of dehumanization in medicine: deindivudating practices, impaired patient agency, dissimilarity (causes which do not facilitate the delivery of medical treatment), mechanization, empathy reduction, and moral disengagement (which could be argued, do facilitate the delivery of medical treatment).

From the patient point of view, in some states in America, controversial legislation requires that a woman view the ultrasound image of her fetus before being able to have an abortion. Critics of the law argue that simply seeing an image of the fetus humanizes it, and biases women against abortion. Similarly, a recent study showed that subtle humanization of medical patients appears to improve care for these patients. Radiologists evaluating X-rays reported more details to patients and expressed more empathy when a photo of the patient's face accompanied the X-rays. It appears that inclusion of the photos counteracts the dehumanization of the medical process.

Dehumanization has applications outside traditional social contexts. Anthropomorphism (i.e., perceiving in nonhuman entities mental and physical capacities that reflect humans) is the inverse of dehumanization, which occurs when characteristics that apply to humans are denied to other humans. Waytz, Epley, and Cacioppo suggest that the inverse of the factors that facilitate dehumanization (e.g., high status, power, and social connection) should facilitate anthropomorphism. That is, a low status, socially disconnected person without power should be more likely to attribute human qualities to pets or electronics than a high-status, high-power, socially connected person.

Researchers have found that engaging in violent video game play diminishes perceptions of both one's own humanity and the humanity of the players who are targets of the violence in the games. While the players are dehumanized, the video game characters that play them are likely anthropomorphized.

Dehumanization has occurred historically under the pre-tense of "progress in the name of science". During the St. Louis World's fair in 1904 human zoos exhibited several natives from independent tribes around the globe, most notably a young Congolese man, Ota Benga. Benga's imprisonment was put on display as a public service showcasing “a degraded and degenerate race”. During this period religion was still the driving force behind much political and scientific action, and because of this, eugenics were widely supported among the most notable US scientific communities, political figures, and industrial elites. After allocating to New York in 1906, public outcry led to the permanent ban and closure of human zoos in the United States.

History and colonialism

In Martin Luther King Jr.'s book on civil rights Why We Can't Wait, he explains "Our nation was born in genocide when it embraced the doctrine that the original American, the Indian, was an inferior race."

Mi'kmaq elder and human rights activist Daniel N. Paul has researched written extensively of historic accounts of atrocious acts of violence against First Nations peoples in North America. His work states European colonialism in Canada and America was a subjugation of the indigenous peoples and is an unequivocal violent series of crimes against humanity which has been unparalleled historically. Tens of millions First Nations died at the hands of European invaders in an attempt to appropriate the entirety of the land. Those hundreds of diverse civilizations and communities who thrived across North America millions of years before the exploits of Christopher Columbus were ultimately destroyed. Dehumanization occurred in the form of barbaric genocidal processes of murder, rape, starvation, enslavement, allocation, and germ warfare. Of the myriad of ways the English performed ethnic cleansing, one of the most frequent was the practice of bounty hunting and scalping—where colonial conquerors would raid communities and remove the scalps of children and adults. This war crime of scalping was most prevalent when maritime colonialists repeatedly attempted to eradicate Daniel N. Paul's ancestors, the Mi'kmaq. Scalping was common practice in many United States areas all the way until the 1860s in attempt to completely wipe out the remaining First Nations.

Compton's cafeteria riot predates the stonewall riots of 1969 and marks one of the first times in American history that non-hetero-normative peoples denied their oppressors taking agency by demanding human rights. This incident was a result of the rampant discrimination, abuse, and ultimately, dehumanizing acts of violence against the LGBT community in the tenderloin district of San Francisco. Up until the Compton cafeteria riot, the act of dressing in non-gender binary clothing was considered a criminal offence, and police would respond to "cross-dressers" with frequent violence and misconduct. Accounts of frequent sexual assault, police brutality, abuse of power, and constant arrests by local law enforcement towards those seeking refuge in the ghettos of the tenderloin have been told in the documentary Screaming Queens: The Riot at Compton’s Cafeteria.

Democracy and "dignity of man"

German philosopher and anthropologist of law Axel Montenbruck wrote that dehumanization is inextricably linked with both the "techniques of neutralization" (David Matza/Gresham Sykes) and to the obedience aspects of the Milgram experiment and in a wider sense with Philip Zimbardo's Stanford prison experiment.

Montenbruck continues that—in light of our common Western civilization—dehumanization is based on political Humanism, in terms of both human rights and Western democracy. Each of them are grounded in the "dignity of man" aspect. Therefore, its "negation" might be seen as dehumanization in our common Western sense. Furthermore, in light democracy, criminal law might be reduced to the simple formula: violating a person means an act of dehumanization by taking "freedom, unfairly and inhumanely". The reaction of a civilized Western society ought to be "taking freedom as well, but fair and humane".

Language

Dehumanization and dehumanized perception can occur as a result of language used to describe groups of people. Words such as migrant, immigrant, and expatriate are assigned to foreigners based on their social status and wealth, rather than ability, achievements, and political alignment. Expatriate has been found to be a word to describe the privileged, often light-skinned people newly residing in an area and has connotations which suggest ability, wealth, and trust. Meanwhile, the word immigrant is used to describe people coming to a new area to reside and infers a much less desirable meaning. Further, "immigrant" is a word that can be paired with "illegal", which harbours a deeply negative connotation to those projecting social cognition towards the other. The misuse and perpetual misuse of these words used to describe the other in the English language can alter the perception of a group in a derogatory way. "Most of the time when we hear [illegal immigrant] used, most of the time the shorter version 'illegals' is being used as a noun, which implies that a human being is perpetually illegal. There is no other classification that I’m aware of where the individual is being rendered as illegal as opposed to the actions of that individuals."

A series of examinations of language sought to find if there was a direct relation between homophobic epithets and social cognitive distancing towards a group of homosexuals, a form of dehumanization. These epithets (e.g., faggot) were thought to function as dehumanizing labels because of their tendency to act as labels of deviance. In both studies, subjects were shown a homophobic epithet, its labelled category, or unspecific insult. Subjects were later prompted to associate words of animal and human connotations to both heterosexuals and homosexuals. The results found that the malignant language, when compared to the unspecific insult and categorized labels, subjects would not connect the human connotative words with homosexuals. Further, the same assessment was done to measure effects the language may have on the physical distancing between the subject and homosexuals.Similarly to the prior associative language study, it was found that subjects became more physically distant to the homosexual, indicating the malignant language could encourage dehumanization, cognitive and physical distancing in ways that other forms of malignant language does not.

Art

Francisco Goya, famed Spanish painter and printmaker of the romantic period often depicted subjectivity involving the atrocities of war and brutal violence conveying the process of dehumanization. In the romantic period of painting martyrdom art was most often a means of deifying the oppressed and tormented, and it was common for Goya to depict evil personalities performing these unjust horrible acts. But it was revolutionary the way the painter broke this convention by dehumanizing these martyr figures. "…one would not know whom the painting depicts, so determinedly has Goya reduced his subjects from martyrs to meat."

Other topics

The propaganda model of Edward S. Herman and Noam Chomsky argues that corporate media are able to carry out large-scale, successful dehumanization campaigns when they promote the goals (profit-making) that the corporations are contractually obliged to maximise. In both democracies and dictatorships, state media are also capable of carrying out dehumanization campaigns, to the extent with which the population is unable to counteract the dehumanizing memes.

Accelerating change

From Wikipedia, the free encyclopedia https://en.wikipedia.org/wiki/Acc...