Sexual health human rights and the law

44 | Sexual health, human rights and the law
Many children in the world are coerced or trafficked
into prostitution (490), which is not only a cause
of serious ill health but is also a gross violation of
children’s rights. International and regional human
rights standards stress that states must protect the
child from all forms of sexual exploitation and sexual
abuse, the exploitative use of children in prostitution or
other unlawful sexual practices, and they urge states to
take priority action in this regard (34, 37, 303, 403).
5.2.7 Female genital mutilation
Female genital mutilation (FGM), a procedure
involving partial or total removal of the external
female genitalia or other injury to the female genital
organs for non-medical reasons, has been classified
as a type of violence against girls (292). An estimated
100–140 million girls and women worldwide are
estimated to have undergone such procedures and
3 million girls are estimated to be at risk of
undergoing FGM every year (94). FGM has been
reported in all parts of the world, but its practice is
most prevalent in the western, eastern and northeastern
regions of Africa, some countries in Asia
and the Middle East, and among certain immigrant
communities in North America and Europe (94).
FGM has no known health benefits. On the contrary,
it is known to be harmful to girls and women in many
ways, including direct negative effects on sexuality
and sexual health (94). The removal of or damage
to healthy, normal genital tissue interferes with the
natural functioning of the body and causes several
immediate and long-term health consequences.
Almost all those who have undergone FGM
experience pain and bleeding as a consequence
of the procedure. The intervention itself can be
traumatic as girls are often physically held down
during the procedure (491, 492). Even if performed
in a hospital, the procedure can result in severe
pain, shock, excessive bleeding, difficulty in passing
urine, infections, psychological trauma and death
(94). Long-term consequences can include chronic
pain, infections, decreased sexual enjoyment, and
psychological consequences such as post-traumatic
stress disorder (94). Women who have undergone
FGM are more likely to experience pain during sexual
intercourse, experience significantly less sexual
satisfaction and are twice as likely to report lack of
sexual desire, compared to women who have not
undergone the procedure (493).
FGM is used as a way of controlling female sexuality
(94). Some of the specific justifications offered for
FGM are linked to girls’ marriageability and are
consistent with the characteristics considered
necessary for a woman to become a proper wife.
It is often believed that the practice ensures and
preserves a girl’s or woman’s virginity (492, 494–496).
In some communities, it is thought to restrain
sexual desire, thereby ensuring marital fidelity and
preventing sexual behaviour that is considered
deviant and immoral (495, 497–499). FGM is also
considered to make girls clean and beautiful.
Removal of genital parts is thought to eliminate
parts viewed as masculine, such as the clitoris (496,
498, 500) or, in the case of infibulation, to achieve
smoothness, which is considered to be beautiful
(495, 496). A belief sometimes expressed by women
is that FGM enhances men’s sexual pleasure (501).
Any form of FGM reflects deep-rooted inequality
between the sexes, and constitutes an extreme form
of discrimination against women and girls.
FGM has been recognized as a form of violence and
a harmful practice that violates well-established
human rights principles, norms and standards,
including the principles of equality and nondiscrimination
on the basis of sex, the right to life
(when the procedure results in death), and the
right to freedom from torture or cruel, inhuman
or degrading treatment or punishment (94).
International and regional human rights standards
characterize FGM as a form of gender-based
violence and call upon states to take appropriate
and effective measures to eliminate all forms of FGM
(37, 339, 502) including the adoption of legislation
and ensuring that perpetrators are brought before
the courts (503). Measures should also include
the creation of public awareness in all sectors of
society, including through education and outreach
programmes, and the provision of support to victims
of FGM and other harmful practices, including
counselling, legal, vocational and health services
(37). The medicalization of FGM – that is, its practice
by any health-care provider – should also be
prohibited (37, 504).