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Female genital cutting and female circumcision, is the ritual removal of some or all of the external female genitalia. Typically carried out by a traditional circumciser using a blade or razor (with or without anaesthesia), FGM is concentrated in 27 African countries, Yemen and Iraqi Kurdistan, and found elsewhere in Asia, the Middle East, and among diasporacommunities around the world. The age at which it is conducted varies from days after birth to puberty; in half the countries for which national figures are available, most girls are cut before the age of five.
The procedures differ according to the ethnic group. They include removal of the clitoral hood and clitoral glans (the visible part of the clitoris), removal of the inner labia and, in the most severe form (known asinfibulation), removal of the inner and outer labia and closure of the vulva. In this last procedure, a small hole is left for the passage of urine and menstrual fluid, and the vagina is opened for intercourse and opened further for childbirth. Health effects depend on the procedure, but can include recurrent infections, chronic pain, cysts, an inability to get pregnant, complications during childbirth and fatal bleeding. There are no known health benefits.
The practice is rooted in gender inequality, attempts to control women’s sexuality, and ideas about purity, modesty and aesthetics. 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. Over 130 million women and girls have experienced FGM in the 29 countries in which it is concentrated. The United Nations Population Fund estimates that 20 percent of affected women have been infibulated, a practice found largely in northeast Africa, particularly Djibouti, Eritrea, Somalia and northern Sudan.
FGM has been outlawed or restricted in most of the countries in which it occurs, but the laws are poorly enforced. There have been international efforts since the 1970s to persuade practitioners to abandon it, and in 2012 the United Nations General Assembly, recognizing FGM as a human-rights violation, voted unanimously to intensify those efforts. The opposition is not without its critics, particularly among anthropologists. Eric Silverman writes that FGM has become one of anthropology’s central moral topics, raising difficult questions about cultural relativism, tolerance and the universality of human rights.
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Harold M. Reed, M.D.
The Reed Centre for Genital Surgery – Miami