The forgotten history of female genital cutting in the United States

By: Sara Khattak

Female genital cutting (FGC) is a practice involving the partial or total removal of external female genitalia or other injury to female genital organs for non-medical reasons. While FGC is a form of gender-based violence that is often mistakenly understood to only occur in certain cultural traditions in Africa and the Middle East, the occurrence of FGC has a history in the U.S. that is less widely known. Understanding the history of FGC in the U.S. is crucial for recognizing the global nature and impact of FGC, and for understanding how to address and end the harmful practice.

In the late 19th and early 20th centuries, FGC was practiced in the U.S. and U.K. primarily by medical professionals. Despite the lack of scientific evidence supporting its effectiveness, FGC was often carried out as a medical treatment for various perceived medical and psychological conditions, including hysteria, “lesbianism,” and excessive masturbation. Another practice that should be considered a form of FGC is the “husband stitch.” The "husband stitch" refers to the practice of adding an extra stitch during the repair of a perineal tear or episiotomy after childbirth, ostensibly to tighten the vaginal opening for increased male sexual pleasure. Just this year, a lawsuit was filed in California against an OB-GYN who for decades allegedly performed FGC on patients.  These practices were influenced by prevailing attitudes toward women's sexuality and health of the time period, which included misconceptions about the female anatomy, a tendency to pathologize women's sexual desires, and a patriarchal medical system that often prioritized male sexual pleasure and control over women's bodily autonomy and well-being. Clitoridectomies fell out of popularity in the United States in the mid 1900’s, and by 1977 were no longer covered by insurance

At the federal level, however, FGC wasn’t prohibited until 1996. With the passage of a federal law it became illegal to perform FGC on a girl under the age of 18, or for the parent, caretaker, or guardian of a girl under the age of 18 to facilitate or consent to FGC being performed on her. Transporting a girl for the purpose of FGC became a punishable offense in the U.S. in 2013.

Even after FGC stopped being a legally recognized medical practice, and Congress passed a federal law making it illegal to perform, there were still reports of FGC being performed by health professionals in secrecy. In fact, in 2018, a medical doctor in Michigan was charged with performing FGC on minor girls who had traveled to Michigan from other states to undergo the practice. It was then reported that Dr. Jumana Nagarwala was a part of a secret network of medical providers who performed FGC on hundreds of girls in the U.S. 

The case triggered significant legal and ethical discussions in the media, amongst anti-FGC advocates, and legislators, not only about FGC, but also about children’s rights and medical ethics. It was also reported that FGC was occurring in some white fundamentalist Christian communities. The persistence of FGC in these communities underscored the need for a broader societal reckoning with how cultural and religious beliefs intersect with human rights, even within demographics not typically associated with this issue.

However, disappointment arose when the 2018 case was eventually dismissed on a technicality, relating to how the original law banning the practice was passed by Congress. This set back highlights the challenges in addressing FGC within the current legal frameworks. As a response, Congress passed the Strengthening the Opposition to Female Genital Mutilation Act of 2020, also known as the Stop FGM Act 2020, to ensure that FGC remained illegal to perform on a girl in the United States. 

Laws on FGC also vary at the state level. In Connecticut, for example, there are currently no state-level anti-FGC laws. The CT Coalition to End FGM/C, a survivor-led organization, has been working since 2020, advocating for the passage of laws that protect children from FGC and support survivors. 

Today, various efforts are being made to end FGC in the U.S. through education, advocacy, and community outreach programs. Educational initiatives aimed at informing healthcare providers, educators, and the general public about the harms of FGC and the legal implications of participating in or condoning the practice are being carried out by community-based organizations across the country. In the last 3 years, the Department of Justice,  Office of Victims of Crime, funded several programs aimed at preventing and responding to FGC, including grants for community-based organizations and law enforcement training initiatives on the practice.

Despite these efforts, significant challenges remain. One of the primary obstacles is the enforcement of the laws against FGC, as it can be difficult to detect or prove cases of the practice occurring. Additionally, there is resistance to ending the practice in some communities where FGC is seen as a social norm that must be done in the name of tradition, as a rite of passage, or due to it being an identity marker. Changing these deeply entrenched social norms requires sustained and sensitive engagement with community leaders and members from impacted communities.

Survivors of FGC play a crucial role in the movement to end the practice. By sharing their stories, survivors help to humanize the issue and bring attention to the physical and psychological trauma caused by FGC. Their voices are powerful tools for advocacy and education, helping to shift public perception of the practice and inspire action against it.

A large part of Sahiyo’s mission is working with survivors to share their stories and experiences, to inform communities, governments, and the public about the harms of FGC. These stories are critical in helping to enforce and create laws that address FGC because those who have gone through the practice have the most knowledge and understanding of why and how it should be prevented.  

If you want to learn more about Sahiyo’s work with survivors, listen to survivor stories here.