Female Genital Mutilation or Cutting (FGM/C)[1], commonly known as sunat perempuan in Singapore, Indonesia and Malaysia, is defined by UNICEF as the injury or partial or total removal of the external female genitalia organs for non-medical reasons. Based on a pilot study of 360 Muslim women, 75% of Muslim women have been cut. Previously, this procedure was performed by traditional midwives at home, but now it is mostly conducted at a handful of private clinics by female Muslim doctors around the island. It costs about $30-50 and takes fewer than 30 minutes. There is no law or legislation banning FGC in Singapore. 

As with any body modification, the patient should understand the nature and potential risks and benefits. In the case of sunat perempuan (literally, “female circumcision”, but more accurately, female genital cutting), where the patient is usually too young to speak or give consent, parents should know how it is done and the possible risks in order to make an informed decision on this practice for their daughters. We hope that this article will demystify FGC and help parents come to an informed decision.

[To learn more, please see this interview with the authors, Saza Faradilla and Sya Taha, on Political Agenda].

Myth #1: Sunat perempuan is practically harmless and different from what is done in Africa.

While it is true that the forms of FGC done in Southeast Asia do not involve infibulation—removal of external female genitalia and narrowing of vaginal opening—these local forms still cause physical and psychological harm. The procedures done by doctors in Singapore vary from symbolic cutting, nicking the clitoral hood to draw blood, scraping it, to cutting the tip of the clitoris. Descriptions of the amount of skin removed in sunat perempuan are “the size of a quarter-grain of rice, a guava seed, a bean, the tip of a leaf, the head of a needle”.[2]

Despite the relatively small amount of tissue injured or removed, all the above procedures fall under the World Health Organization’s definition of female genital mutilation Type 1 (partial or total removal of the external part of the clitoris and/or its prepuce) and Type 4 (all other harmful procedures to the female genitalia for non-medical purposes).

This is not as harmless as previously thought because genital development occurs in two stages: in the womb and during puberty. Hence, the vulva of a baby or young girl is immature compared to an adult woman, as it will develop in size and shape during and after puberty.[3] Usually, before puberty, only a centimeter of clitoral hood, and half a centimeter of the labia minora are visible. The removal of any amount of tissue from an infant means disproportionately more nerve endings lost and scar tissue created, compared to that of an adult woman.

Fig. 1: Female prepubescent genitalia

Since the immature vulva is small and difficult to distinguish, doctors may also accidentally lacerate the labia or urethra. One common harmful physical side effect of any cut is scarring or adhesions of the labia minora, labia majora or vaginal walls.[4] A keloid scar[5] can continue to grow well into adulthood, even completely obscuring the vaginal and urethral openings, causing difficulties in urination, pain during sexual intercourse, obstructed labour or tearing of the scar during vaginal childbirth.[6] Another side effect of an exposed clitoris after reduction of the clitoral hood is desensitisation or over-sensitisation, which can negatively impact sexual pleasure in adulthood. 

There is also psychological trauma. Infants and children feel the same “intense fear and/or helplessness” as adults when restrained and physically injured; they are just unable to articulate it.[7] One common defense mechanism to acute pain is neurological shutdown (lethargy or falling asleep immediately afterwards), which negatively affects interactions with the caregiver.

In the long term, FGC has negative implications for the nervous system and, therefore, mental health. In the immature nervous system of babies and children, exposure to acute pain will “activate the body’s biological stress response systems”, which negatively impacts childhood brain development.[8] This is further supported by a study showing that women who experienced any type of FGC before the age of one have higher hair levels of stress hormones as adults.[9]

Myth #2: Sunat perempuan is obligatory or highly encouraged in Islam. 

Many Muslim parents in Singapore believe that FGC is a requirement for being Muslim, going as far as to say that it will ensure their daughter’s chastity and obedience. Locally, FGC is more prevalent in the Malay Muslim community compared to other local Muslim communities, as they usually follow the Shafi’i mazhab (school of jurisprudential thought). Research has shown that the practice of sunat perempuan came to Southeast Asia as part of Shafi’i Islamic traditions.[10] Shafi’i scholars believe that sunat perempuan is obligatory based on a verse from Surah An-Nahl (16:123) in the Qur’an: “Then We revealed to you to follow the religion of Abraham, inclining toward truth; and he was not of those who associate with Allah.”[11]

However, other scholars note the importance of context.[12] According to Egyptian Sunni theologian Sheikh Yusuf Al-Qaradawi:

The verse is actually talking about a wider, more principled issue than just about circumcision. The call for adhering to the religion of Abraham is an invitation to the belief in tawheed (oneness of God) by means of rational, scientific argumentation as well as the abstention from polytheism or worshipping and associating others along with Allah. 

However, American professor of fiqh (Islamic jurisprudence) Dr Khaled Abou El Fadl argues that the Shafi’i ruling is based on the belief in that context that circumcision was not harmful. He further advises that when fiqh contains multiple opinions on a topic, other perspectives must be considered. In this case, from the scientific perspective, female circumcision brings physical and psychological harm and should thus be forbidden.[13]

There are several hadith[14] (recorded Prophetic sayings) that have been used to support sunat perempuan but were found to have weak authenticity (da’if). The hadith below is often cited in support of FGC: 

As reportedly narrated by Aishah, the wife of the Prophet: “When the two circumcised parts meet, then a bath is obligatory. The Messenger of Allah and I did that, and we bathed.”[15]

However, it uses a unique Arabic linguistic form known as taghlib, where one “dominant” word is used to refer to two things. For example, “the two moons” to refer to the sun and the moon, or “the two Marwa” to refer to the two hills of As-Safa and Al-Marwah. Hence, it is ambiguous whether women were cut or not. Even if all these hadith mention FGC, it can be interpreted as a description of a practice of that social context and time period, not necessarily a mandate.

Finally, going back to the core texts of Islam, there is no specific mention of the practice in the Qur’an[16] and no recorded evidence of the Prophet circumcising his daughters.[17] The Prophet also never asked newly converted adult Muslim women to be cut.[18]

There are also local opinions against sunat perempuan. The late Ustaz Zhulkeflee Haji Ismail, a manager of PERGAS (Singapore Islamic Scholars and Religious Teachers’ Association) said that it “has no religious basis and no guidelines—except that it should not bring harm to believers”.[19] Then-Minister-in-charge of Muslim Affairs Yaacob Ibrahimstated in 2002 that he does not plan to circumcise his daughter because it is not a religiously required practice.[20]

Globally, female genital cutting has also been denounced by former President of Al-Azhar University, Ahmad Omar Hashim; former Grand Mufti of Egypt, Ali Gomaa[21]; Sheikh Professor Yusuf Al-Qaradawi (Qatar)[22]; the International Federation of Islamic Scholars[23]; the Organization of Islamic Cooperation[24]; Grand Ayatollah Ali al-Husayni al-Sistani (Iraq)[25]; and other notable religious scholars.[26]

Myth #3: Sunat perempuan is part of our culture. 

The final misconception about sunat perempuan is that it is an essential and beneficial part of Malay or Muslim culture and should thus be passed down through the generations. However, culture is dynamic and changes according to the time and place. If a cultural practice is found to have many potential harms and no proven benefits, it should not continue. 

One Malay custom that has been virtually abandoned in the last century is tooth-filing, usually done between the ages of 15 and 16, just before sunat, to symbolise the girls’ readiness for marriage.[27] Another Malay custom that has changed is the closing of pierced ear holes upon marriage, as most women continue wearing earrings as a sign of beauty well into adulthood. Yet another rarely practised custom is barut, or the wrapping of the mid-section of a newborn baby round-the-clock until they learn to crawl. These customs changed because we discovered the harms of teeth-filing on dental health, and of excessive swaddling of a newborn’s midsection on physical development.

Societal pressure is the strongest factor as to why many parents seek out sunat. Young mothers especially may face pressure from older relatives. It reveals many parents’ hopes and anxieties about raising their daughter to be solehah—a good, religious, and chaste Muslim woman.

We all want to be acknowledged as being responsible parents. Performing cukur rambut (hair shaving and almsgiving) and aqiqah (animal sacrifice and almsgiving) are both valid ways to celebrate the birth of a child and express gratitude to God, without the risk of the physical or psychological harm of sunat perempuan.

In our advocacy work surrounding female genital cutting in Singapore, we are often met with defensive reactions that our community is not ready for an open discussion of such a sensitive, taboo topic. As invested members of our Muslim community, we hope to engage and sustain empathic, judgment-free and informative discussions surrounding female genital cutting. 

Let’s normalise changing long-held beliefs and do better when we know better. 

How can I help?

  1. Following our campaign on Instagram @endfgcsg
  2. Donating to fund our webinars, workshops and campaigns 
    1. Bank transfer to DBS Account: 120 – 156200 – 0 
    2. PayNow/Paylah to Afifah: 8322 6846
  3. Speaking to the people around you about FGC 
  4. Writing in to the Ministry of Health sharing that you are aware of FGC happening in Singapore and you are concerned for the health of infants undergoing it

Note: A similar article will also be published on VICE on 6 February 2021. 


Further Reading

Saza Faradilla, The Complexities of Female Genital Cutting

Beyond the Hijab: Stories About Muslim Women in Singapore

Gabriele Marranci, Female Circumcision in Multicultural Singapore: The Hidden Cut

South China Morning Post, Female genital mutilation in Singapore: a Muslim rite that the UN deems a human rights violation

Southeast Asia Globe, A cut, unseen


References

[1] For many human rights groups, any procedure that involves the laceration or cutting of the female genitals is defined as “mutilation”. For other activists, however, the term “mutilation” carries too much bias, and they choose to reference the procedure as “female genital cutting”, instead. In this article, we are using FGC throughout as this is the prevalent term in Singapore.

[2] Sara Corbett, “A Cutting Tradition,” The New York Times, January 20, 2008, http://www.nytimes.com/2008/01/20/magazine/20circumcision-t.html.

[3] K. E. Brodie, E. C. Grantham, P. S. Huguelet, B. T. Caldwell, N. J. Westfall and D. T. Wilcox, “Study of clitoral hood anatomy in the pediatric population,” Journal of Pediatric Urology 12 no. 3 (2016): 177.e1-177.e5.

[4] Yvonne A. Zurynski, Premala Sureshkumar, Amy Phu and Elizabeth Elliott, “Female genital mutilation and cutting: a systematic literature review of health professionals’ knowledge, attitudes and clinical practice,” BMC international health and human rights 15, no. 1 (2015): 32; Abdulrahim A Rouzi, Nora Sahly, Estabraq Alhachim, Hassan Abduljabbar, “Type I female genital mutilation: a cause of completely closed vagina,” The journal of sexual medicine 11, no. 9 (2014): 2351-2353; Laural Q. P. Paterson, Seth N. Davis and Y. M. Binik, “Female genital mutilation/cutting and orgasm before and after surgical repair,” Sexologies 21, no. 1 (2012): 3-8; Adriana Kaplan-Marcusan Kaplan, Suiberto Hechavarría Toledo, Miguel Luis Martín Mateo and Isabelle Bonhoure, “Health consequences of female genital mutilation/cutting in the Gambia, evidence into action,” Reproductive health 8, no. 1 (2011): 26; Sharifa A. Alsibiani and Abdulrahim A. Rouzi, “Sexual function in women with female genital mutilation,” Fertility and sterility 93, no. 3 (2010): 722-724.; W. C. Yoong, R. Shakya, B. T. Sanders and J. Lind, J, “Clitoral inclusion cyst: a complication of type I female genital mutilation,” Journal of Obstetrics and Gynaecology 24, no. 1 (2004): 98-99; Abdulrahim A. Rouzi, Othman Sindi, Bandar Radhan and Hassan Said Ba’aqeel, “Epidermal clitoral inclusion cyst after type I female genital mutilation,” American Journal of Obstetrics and Gynecology 185, no. 3 (2001): 569-571. 

[5] Keloid scars is the overgrowth of scar tissue that forms over a wound. Keloid scars can grow to be larger than the original wound.

[6] SAHIYO, “From birth to motherhood, a Singaporean Malay’s experience of Female Genital Cutting,” February 13, 2017, last accessed on December 21, 2020, https://sahiyo.com/2017/02/13/from-birth-to-motherhood-a-singaporean-malays-experience-of-female-genital-cutting/

[7] Anke Köbach, Martina Ruf-Leuschner and Thomas Elbert, “Psychopathological sequelae of female genital mutilation and their neuroendocrinological associations,” BMC Psychiatry 18, no. 1 (2018): 187.

[8] Michael de Bellis and Abigail Zisk, “The biological effects of childhood trauma,” Child and adolescent psychiatric clinics of North America 23, no. 2 (20140: 185-222.

[9] Köbach et al., ““Psychopathological sequelae of female genital mutilation.”

[10] Gabriele Marranci, “Female circumcision in multicultural Singapore: the hidden cut,” The Australian Journal of Anthropology 26, no. 2 (2015): 176-292.

[11] The Qur’an, 16:123, translation offered by quran.comhttps://quran.com/16/123, last accessed on December 21, 2020.

[12] Muhammad Munir, “Dissecting the claims of legitimization for the ritual of female circumcision or female genital mutilation (FGM),” International Review of Law 2014, no. 6, (2014).

[13] The Usuli Institute, “On female circumcision,” YouTube Video, 16:45, September 23, 2020, last accessed on December 21, 2020, https://www.youtube.com/watch?v=FMq74aqmCQU.

[14] Narrated by Ahmad (20/719), Al-Tabarani in al-Kabeer (11/233), and al-Bayhaqi in Sunan al-Kubra (8/324). Sunan Abi Dawud, Book of General Behaviour, Book 42, Hadith 5251, available at https://sunnah.com/abudawud/43/499, last accessed on December 21, 2020.

[15] Sunan Ibn Majah, The Book of Purification and its Sunnah, Vol. 1, Book 1, Hadith 608, available at https://sunnah.com/urn/1256070, last accessed on December 21, 2020.

[16] Global Muslim Women Shura Council, Female genital cutting: Harmful and Un-Islamic, Women’s Islamic Initiative in Spirituality and Equality, 2017. 

[17] “Cendekiawan Islam beri pandangan berbeza,” Berita Harian, December 2, 2006, 21.

[18] R.AGE, “Perlis Mufti membincangkan amalan khitan di Malaysia,” YouTube Video, 1:49, November 12, 2018, last accessed on December 21, 2020, https://youtu.be/WJfTEgtxsms.

[19] Gillian Wee, “Singapore Muslims Invoke a Remnant of Surgical Tradition,” Los Angeles Times, November 17, 2002, https://www.latimes.com/archives/la-xpm-2002-nov-17-adfg-circum17-story.html. 

[20] Ibid.

[21] Gamal Serour and Ahmad Ragaa Abd El-Hameed Ragab, Female Circumcision: between the Incorrect Use of Science and the Misunderstood Doctrine, Executive Summary,” (Cairo: International Islamic Center for Population Studies and Research and UNICEF Egypt, 2013).

[22] See Yusuf Al-Qaradawi’s 2009 fatwa shared on Target, “International Union for Muslim Scholars,” https://w3i.target-nehberg.de/HP-08_fatwa/index.php?p=fatwaQaradawi, last accessed on December 21, 2020; and his 2012 written appeal to end FGM, also on Target, “Appeal to the World,” https://w3i.target-nehberg.de/HP-08_fatwa/index.php?p=appellQaradawi, last accessed on December 21, 2020. 

[23] Dr Mohamed Selim Al-Awa, FGM in the Context of Islam, UNFPA Eygpt (Cairo: The National Council for Childhood and Motherhood: 2012).

[24] Permanent Observer Mission of the Organisation of Islamic Cooperation to the United Nations, “Statement on Behalf of the OIC General Secretariat 57th Session of the Commission on the Status of Women,” March 11, 2013, https://www.un.org/womenwatch/daw/csw/csw57/generaldiscussion/observers/OIC.pdf.

[25] Rayehe Mozafarian, “Iraqi Grand Ayatollah al-Sistani issues Fatwa against FGM, Rayehe Mozafarian,” Stop FGM Middle East, August 6, 2014, last accessed on December 21, 2020, http://www.stopfgmmideast.org/iraqi-grand-ayatollah-al-sistani-issues-fatwa-against-fgm/

[26] “Fatwas Against FGM,” Stop FGM Middle East, undated, last accessed on December 21, 2020, http://www.stopfgmmideast.org/fatwas-against-fgm/

[27] Walter William Skeat, Malay Magic (Kuala Lumpur: Silverfish Books Sdn Bhd, 2018), 251.

Author

New Naratif

Author

Sya Taha

Sya Taha is a member of End FGC Singapore, a working group that was started in 2020 to focus on raising awareness and community engagement on the topic of female genital cutting, known locally as sunat perempuan, khitan, or khatna.
Author

Saza Faradilla

Saza Faradilla is a members of End FGC Singapore, a working group that was started in 2020 to focus on raising awareness and community engagement on the topic of female genital cutting, known locally as sunat perempuan, khitan, or khatna.

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