Let's Talk About Sunat Perempuan

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Let’s Talk About Sunat Perempuan is a booklet created to explore questions about sunat perempuan or female genital cutting (FGC). You can skip through the resource if you know what you’re looking for, but if you are new or not sure where to go, it’s always a good idea to start at the beginning. 

⚠️Content warning⚠️

The content below contains images and figures relating to the female reproductive anatomies, as well as personal accounts which some readers may find disturbing or discomforting.

Introduction

In a 2020 pilot study, we found that an estimated 75% of Muslim women in Singapore have undergone female genital cutting (FGC). There is almost 100% medicalisation of the practice and it is performed at General Practitioner (GP) clinics. The most common type of FGC in Singapore is: 

Type I: The partial or total removal of the clitoral glans (the external and visible part of the clitoris, which is a sensitive part of the female genitals), and/or the prepuce/clitoral hood (the fold of skin surrounding the clitoral glans).

Type IV: All other harmful procedures to the female genitalia for non-medical purposes, for example: pricking, piercing, incising, scraping and cauterization. 

An anatomical structure of the female vulva. Figure taken from World Health Organisation, Care of Girls & Women Living with Female Genital Mutilation: A Clinical Handbook, 2018, Job aid V.

Faith

Is sunat perempuan compulsory or highly encouraged in Islam?

Is there any mention of sunat perempuan or FGC in the Qur’an?

No. There is not one verse in the Qur’an which mentions or discusses FGC, explicitly or implicitly[1].

Did Prophet Muhammad have any of his daughters undergo FGC?

No, he did not. Not one hadith (the Prophet’s narrated sayings) can be found to mention that any of the Prophet’s wives or daughters have undergone khitan––even when the practice was widely practised at Madinah during his time[2]. He decided and chose not to put his wives and daughters through khitan when many others did.

 Neither was (is) there a sharia text which instructed Muslims to have their daughters circumcised. In other words, the Prophet did not practise it on his daughters, and neither was he instructed to do so. Had female circumcision been among Islam’s precepts or principles, the Prophet would have been the first to apply the practice on his wives and daughters. Female circumcision was never an act he asked of newly converted Muslim women, or Muslim parents to perform on their daughters[3].

Why do some ulama believe FGC is an Islamic practice?

Ulama, or Islamic scholars, who argue that FGC is wajib or highly encouraged in Islam typically cite four Qur’anic verses as justifications or dalil (evidence)––none of which actually mentions or suggests FGC. These are

Surah Al-Baqarah, 2:124

Remember when [Ibrahim] was tested by His Lord with certain commandments, which he fulfilled. Allah said, “I will certainly make you into a role model for the people.” [Ibrahim] asked, “What about my offspring?” Allah replied, “My covenant is not extended to the wrongdoers[4].”

Surah Ali ‘Imran, 3:95

Say, “O Prophet, Allah has declared the truth. So follow the Way of [Ibrahim], the upright, who was not a polytheist[5].”

Surah An-Nisa, 4:125

And who is better in faith than one who fully submits themselves to Allah, do good, and follow the Way of [Ibrahim], the upright? Allah chose [Ibrahim] as a close friend[6].

Surah An-Nahl, 16:123

Then We revealed to you, O Prophet, saying: “Follow the faith of [Ibrahim], the upright, who was not one of the polytheists[7].”

However, as we can observe, these verses do not mention FGC. Ulama have advised the importance of understanding the contexts of the verses above[8]. Sheikh Yusuf Al-Qaradhawi has rejected the use of such Qur’anic verses to argue for FGC in Islam[9]. He asserts,

“Referencing [these sources] as legal [bases] for FGC is an exaggeration. The [verses are] actually discuss a wider, more principled issue than just about circumcision. The call for adhering to the religion of Ibrahim 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 associating others with Allah[10].”

Similarly, a former Grand Imam of Al-Azhar, Sheikh Imam Al-Akbar Mahmud Shaltut maintained that,

“Proving with verses from the Qur’an as evidence to legitimise khitan is excessive [and] unacceptable according to common sense. What’s more inaccurate is when [such verses are] used as evidence for [FGC]. This is because the instruction to [perform] khitan in the teachings of Ibrahim is khitan for males, [as] Nabi Ibrahim himself [did,] as mentioned in the [hadith]. So, it is weird to use the [hadith which narrates of Nabi Ibrahim’s male circumcision] as evidence for female khitan[11].”

Is there any mention of FGC in the hadith?

Similar to the Qur’an, there is not a single hadith sahih (authentic hadith) which mentions or discusses FGC, explicitly or implicitly.

A number of hadith are often referenced to argue for the case of FGC in Islam:

[Prophet Muhammad said:] "Ummi Athiyyah, When you do circumcise, restrict yourself to cut a minute part and do not excise [cut surgically] That will be far more pleasant for the wife and satisfying for the husband[12].”

[Ibn Abbas reported that Prophet Muhammad said:] “Circumcision is Sunnah for men and Makrumah [honourable] for women[13].”

These hadith, however, have been proven to be hadith dhaif, or weak (or inauthentic) hadith. In other words, they are unreliable sources of information and cannot be used to argue in legal matters. The first of the three appear to have been related by three separate individuals, all of whose transmissions are regarded as dhaif and untrustworthy due to their questionable genealogies of narrators[14]. The authenticity of the second hadith has also been cited as dhaif by Islamic scholars[15].

Another hadith often used to justify female circumcision as an Islamic practice is a sahih one narrated by Abu Huraira:

Abu Huraira reported that Prophet Muhammad said: “The five fitrah [basic good of human nature] consists of five: circumcision, shaving pubic hair, plucking the armpits, clipping the moustache and clipping the nails[16].”

This hadith can be compared to the hadith sahih below from Aisha, the Prophet’s wife: 

It was narrated by Aisha that Prophet Muhammad said: “Ten are the acts according to fitrah: clipping the moustache, letting the beard grow, using the tooth-stick, snuffing water in the nose, cutting the nails, washing the finger joints, plucking the hair under the armpits, shaving the pubes and cleaning one's private parts with water. The narrator said: I have forgotten the tenth, but it may have been rinsing the mouth[17].”

Interestingly, though Aisha’s narration includes five more acts of fitrah, but none of the ten acts includes circumcision. More importantly, these acts, in both Abu Huraira and Aisha’s narrations, contain specific mentions which pertain to men, especially facial hair hygiene[18].

Applying the expectations of the hadith on women are neither fair nor valid. Circumcision for men, as highlighted in Abu Huraira’s narration, are intended and have proven to a certain extent to be beneficial and hygienic. This is not true for female circumcision. Instead, female circumcision can potentially cause biological, physical and psychological harm, as well as complications in sex.

Below is another hadith commonly cited to rule female circumcision as wajib or sunnah:

It was narrated that Aisha, the wife of the Prophet, said: “When two circumcised parts meet, then bath is obligatory. The Messenger of Allah and I did that, and we bathed[19].”

Although this hadith is a sahih one, its focus is not the circumcision of genitalia, rather conditions for when ablution is necessary after sex. According to ulama’s interpretations, the hadith explains that after penetration during sex takes place, ablution is necessary[20]. “Circumcised parts” can be said to refer to the reproductive organs of men and women, which were commonly circumcised during the Prophet’s time. The Prophet describing the male and female genitalia as circumcised does not mean that he was encouraging female circumcision or that he saw it as sunnah. The hadith therefore cannot be used to legitimise female circumcision as wajib or sunnah.

The hadith above, both the sahih and dhaif, have been questionably interpreted and used as dalil to justify female khitan as wajib or sunnah. Mentions of male circumcision have been unjustly and unreasonably extended to female circumcision, ignoring the distinct impacts circumcision has on men and women. There is no hadith that justifies the practice of female circumcision as an Islamic practice. 

What do the different mazhab (schools of thought) say about FGC?

These ambiguities from the Qur’an and hadith have resulted in diverse understandings and interpretations of Qur’anic verses and hadith by many Islamic scholars (ulama) about FGC. There has been no consensus on this issue throughout Muslim legal history. Ulama of fiqh (Islamic jurisprudence) from the four Sunni (a majority sect in Islam) mazhab differ in their stances on both the practices of male and female circumcision (or khitan):

14th century scholar, Ibn Hajar al-Asqalani mentioned in his Fath al-Bari, a commentary on hadith compendium of Sahih al-Bukhari, that the majority of ulama of other schools of jurisprudence except Shafi’i, rejects the compulsory ruling on female circumcision[22]. Even within the Shafi’i school, there were differences of opinion on the conditions that make it obligatory. Some Shafi’i scholars even disagreed with the opinion of Imam al-Shafi’i, the founder of the Shafi’i school of law.

According to Dr Khaled El Abou Fadl, a notable and respected scholar of fiqh and sharia, the Shafi’i ruling is based on the belief that circumcision was not harmful[23]. He contends that when fiqh matters have multiple opinions, other perspectives must be considered. In the case of FGC, scientific knowledge and perspective have demonstrated that female circumcision can potentially cause physical and psychological harm––from this understanding, such a practice should thus be forbidden[24].

What are the views of contemporary ulama on FGC?

In 1998, Islamic scholars from over 35 Islamic countries came together at Al-Azhar University, Cairo to discuss FGC, among other issues related to reproductive health[25]. They came to the conclusion that FGC is a practice that is non-obligatory in Islam, given that it has never been mentioned in the Qur'an, and there are no citations in Prophet Muhammad's hadith containing any evidence of authentic isnad (chain of narration) that could justify a sharia provision on such an important issue which has affects the lives of girls and women. 

A number of ulama have even gone as far as to assert FGC as haram. Their arguments are as follows:

There are also many regional opinions against sunat perempuan. In Singapore, the late Ustaz Zhulkeflee Haji Ismail, a former manager of PERGAS (Singapore Islamic Scholars and Religious Teachers’ Association) said that sunat perempuan “has no religious basis and no guidelines—except that it should not bring harm to believers[27].” In 2002, the then Minister-in-charge of Muslim Affairs, Yaacob Ibrahim, shared that he did not plan to circumcise his daughter since it is not a religiously required practice[28].

In the Malaysian state of Perlis, Mufti Dato’ Dr Mohd Asri Zainul Abidin has similarly stated that “it is not compulsory to circumcise women but it is not forbidden as long as it does not bring harm to her[29].” Dato’ Ismail Yahya, former Mufti of Terengganu, Malaysia, referenced the book,  Al-Qawaaed Al-Fiqhiyyah wa Tadbiqaatiha fil Mazaahib Al-Arbaah  by Syrian scholar Muhammad Mustofa Al-Zuhayli, who argued that "circumcision, if it is not made compulsory, it is haram (forbidden). Circumcision injures and cuts some parts of the body. It also reveals private part (aurat) to be seen by other people[30].” In the same book, he asserted the legal maxim that reads: “A policy/law made by the government for the people must benefit them[31].”

In Indonesia, Kongres Ulama Perempuan Indonesia (KUPI, Indonesian Womens’ Ulema Congress) in 2022 released a fatwa that declared that any cutting or injury of female genitalia without medical justification is haram[32]. Dr Nur Rofiah, a lecturer of Qur’anic interpretation at the Institute of Qur’anic Sciences and national advisory board member of KUPI, proposes an approach that centres women’s experiences as a lens for reading the Qur’an to overcome textual and contextual problems related to gender issues[33]. She argues that the Qur’an’s ethical trajectory has been impeded by patriarchal interests, which seek to sustain male privilege, and exclude women from shaping understandings of individual and collective well-being. She highlights how centring women’s lived experiences and the needs of the vulnerable can guide us in reshaping Muslim norms on gender and family relations. Women face many experiences men do not: menstruation, pregnancy, giving birth, puerperium (nifas) and breastfeeding; experiences which are more complex, of longer duration and feature greater pain than the bodily and reproductive experiences of men. Men do not experience the same realities as women, and it is therefore important to centre women’s experiences to achieve justice for women and girls in a way that honours their full humanity[34].

Alongside KUPI, the following have shared their position and arguments against FGC:

There is no mention of sunat perempuan in the Qur’an. There is no mention of sunat perempuan in the hadith. No evidence exists of Prophet Muhammad having his daughters undergo sunat perempuan. No consensus has been reached on sunat perempuan by religious scholars and ulama worldwide. 

Is sunat perempuan really an Islamic practice?


Notes
  1. Global Muslim Women Shura Council, Female genital cutting: Harmful and Un-Islamic, Women’s Islamic Initiative in Spirituality and Equality, 2017.
  2. Pera Soprianti and Andi N. Faizah (Eds.), Sunat Perempuan: Antara Fakta dan Cita Sosial Islam, Srengseng Sawah, Jakarta: Rahima, 2021, pp. 36, 56.
  3. Ibid.
  4. Qur'an 2:124, quran.com, translation from Mustafa Khattab, The Clear Quran, https://quran.com/en/al-baqarah/124.
  5. Qur'an 3:95, quran.com, translation from Mustafa Khattab, The Clear Quran, https://quran.com/en/ali-imran/95.
  6. Qur'an 4:125, quran.com, translation from Mustafa Khattab, The Clear Quran, https://quran.com/en/an-nisa/125.
  7. Qur'an 16:123, quran.com, translation from Mustafa Khattab, The Clear Quran, https://quran.com/an-nahl/123.
  8. Muhammad Munir, “Dissecting the claims of legitimization for the ritual of female circumcision or female genital mutilation (FGM),” International Review of Law,  6, 2014.
  9. K. H. Husein Muhammad, “Female Circumcision - Tafsir 27th Edition,” Rahima, April 18, 2011, last modified August 17, 2017. See also Pera and Andi, Sunat Perempuan: Antara Fakta dan Cita Sosial Islam, p. 40.
  10. Ibid.
  11. Mahmud Shaltut, Al-Fatawa, 12th Edition, Cairo: Dar al-Shuruq, 1983. See Issue 332. 
  12. Narrated by Abu Dawud, Sunan Abu Dawud 5271. See 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, p. 8. On its weakness and inauthenticity, see also, Mesraini, "Female Circumcision: Between Myth and Legitimate Doctrinal Islam," Jurnal Syariah, 18(1), 2010: 229-246, p.237; Muhammad Lutfi al-Sabbagh, "Islamic Ruling on Male and Female Circumcision," World Health Organisation, Regional Office for Eastern Mediterranean, 1996, pp. 17-18.
  13. See Serour and Abd El-Hameed Ragab, "Female Circumcision," p. 9. The weakeness and inauthenticity have also been discussed by a number of Islamic scholars; for examples, see Mesraini, "Female Circumcision," p. 237; al-Sabbagh, "Islamic Ruling," p. 19. 
  14. Dr Mohamed Selim Al-Awa, FGM in the Context of Islam, UNFPA Egypt Cairo: The National Council for Childhood and Motherhood: 2012, p. 2.
  15. Ibid., p. 3; Serour and Abd El-Hameed Ragab, "Female Circumcision," p. 9.
  16. Narrated by Abu Huraira, Al-Adab Al-Mufrad, Book 55, Hadith 1292, https://sunnah.com/adab/55/11.
  17. Narrated by Aisha, Sahih Muslim, Book 2, Hadith 71, https://sunnah.com/muslim:261a.
  18. Al-Awa, FGM in the Context of Islam, p. 7. 
  19. Narrated by Aisha, Sunan Ibn Majah, Book 1, Hadith 342, https://sunnah.com/ibnmajah:608.
  20. Al-Awa, FGM in the Context of Islam, p. 6
  21. Pera and Andi, Sunat Perempuan: Antara Fakta dan Cita Sosial Islam, p. 50; Ibrahim Lethome Asmani and Maryam Sheikh Abdi, De-linking Female Genital Mutilation/Cutting from Islam, The Population Council and the United States Agency for International Development, 2008, p. 13; Quentin Wodon, "Islamic Law, Women's Rights and State Law: The Cases of Female Genital Cutting and Child Marriage," The Review of Faith & International Affairs, 13(3), 2015: 81-91, p. 86. 
  22. See Mohamed Imran Mohamed Taib, "Not a Clear-Cut Issue: Female Circumcision as a Contested Tradition," Progresif.net, https://progresif.net/not-a-clear-cut-issue-female-circumcision-as-a-contested-tradition/.
  23. The Usuli Institute,“The Impermissibility of Female Circumcision,” YouTube Video, 16:45, September 23, 2020, https://www.youtube.com/watch?v=FMq74aqmCQU.
  24. Ibid.
  25. Serour and Abd El-Hameed Ragab, "Female Circumcision," p. 6.
  26. See Pera and Andi, Sunat Perempuan: Antara Fakta dan Cita Sosial Islam, pp. 52-55. For more on Sheikh Yusuf Al-Qaradhawi, see his 2009 fatwa shared on Target, “International Union for Muslim Scholars,” https://w3i.target-nehberg.de/HP-08_fatwa/index.php?p=fatwaQaradawi; 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.
  27. 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.
  28. Ibid.
  29. R.AGE, “Amalan berkhitan di Malaysia,” YouTube Video, 12:40, November 5, 2018, https://www.youtube.com/watch?v=Y7HjRDtjvIc&t=0s; R.AGE, “Perlis Mufti membincangkan amalan khitan di Malaysia,” YouTube Video, 1:49, November 12, 2018, https://youtu.be/WJfTEgtxsms. See also Perlis State Fatwa Committee's position that FGC is neither mandatory nor obligatory in Islam, "Hukum Khitan Anak Perempuan," Jabatan Mufti Negeri Perlis, https://muftiperlis.gov.my/index.php/himpunan-fatwa-negeri/136-hukum-khitan-anak-perempuan.
  30. Muhammad Mustafa Zuhayli, al-Qawa'idal-fiqhiyyah wa tatbiqatuha fi al-madhahib al-arba'ah, Damascus, Syria: Dal al-Fikr, 2006, pp. 740-741.
  31. Ibid., pp. 493.
  32. Kongres Ulama Perempuan Indonesia, “Fatwa KUPI II: Hukum P2PGP Tanpa Alasan Medis adalah Haram,” KUPI, November 28, 2022, https://kupi.or.id/fatwa-kupi-ii-hukum-p2gp-tanpa-alasan-medis-adalah-haram/.
  33. Nur Rofiah, "Approaching The Qur'an Through Women's Experiences," (webinar, Musawah, Kuala Lumpur, Malaysia, February 16, 2021), https://www.musawah.org/blog/webinar-approaching-the-quran-through-womens-experiences/.
  34. See Ziba Mir-Hosseini, Mulki Al-Sharmani, Jana Rumminger and Sarah Marsso (Eds.), Justice and Beauty in Muslim Marriage: Towards Egalitarian Ethics and Law, (London: Oneworld Publication, 2022).
  35. K. H. Husein Muhammad, Fiqh Perempuan, Banguntapan Yogyakarta: IRCiSoD, 2019; K. H. Husein Muhammad, Itjihad Kyai Husein: Upaya Membangun Keadilan Gender, Jakarta: Rahima, 2011. Watch Dr (Hc) K. H. Husein Muhammad share his position and argument at the webinar on sunat perempuan in Indonesia organised by United Nations Population FundIndonesia,“Webinar SWOP 2020: Pencegahan FGM/C di Indonesia,”YouTubeVideo, 1:58:45, 2:01:00, July 15, 2020, https://www.youtube.com/watch?v=OoqN5BqWX3I.
  36. See Mohamed Imran, "Not a Clear-Cut Issue: Female Circumcision as a Contested Tradition."
  37. Faqihuddin Abdul Kodir, “Affrming Female Circumcision Prohibition.” In Women’s Rights in Islam: Writings Compilation on Tafseer and Hadiths of Swara Rahima Magazine, 3-9, Srengseng Sawah, Jakarta: Rahima, 2020, p. 3. 
  38. Kementerian Pemberdayaan Perempuandan Perlindungan Anak Republik Indonesia, Panduan Advokasi dan Sosialisasi Pencegahan Sunat Perempuan bagi Tokoh Agama, Jakarta, August 2018.

Health

Is sunat perempuan a safe procedure when done by a doctor?

Sunat perempuan is not taught in any medical curriculum[1]. Doctors learn it from other colleagues as there is no formal training, guidelines or assessment on how to perform the procedure. In Malaysia, doctors who perform FGC learn about the procedure by observing midwives perform it, reading books, watching videos and asking religious figures[2]. They can then adapt and modify according to “what suits them best[3].”

Evidently, in Singapore, doctors may accidentally cut “too much,” lacerating part of the clitoris or labia[4]. Doctors that perform sunat perempuan also do not usually check on the medical history of the infant which may lead to complications such as excessive bleeding.

This medicalisation of FGC has been strongly condemned by the World Health Organisation that says “regardless of whether FGM is carried out by traditional or medical personnel, it represents a harmful and unethical practice, with no benefits whatsoever, which should not be performed under any circumstances[5].” The World Medical Association also “condemn[s] the practice of genital mutilation or cutting of women and girls, regardless of the level of mutilation, and opposes the participation of physicians in these practices[6].”

Not all doctors understand or have the knowledge of clitoral anatomy to operate around this area safely. A 2019 study found that the clitoral nerves responsible for sensation and orgasm are similar in size to the nerves running along the shaft of the penis and index finger[7]. These nerves (see dorsal nerves in figure below) also sit only millimetres under the surface of the clitoral hood of an adult, and therefore may be even closer for infants. 

A depiction the anatomic structures of a cross-section of the clitoral body[8]. Note how close the nerves are to the surface.

Each nerve contains an average of 5,140 nerve endings, which means that the clitoris is an extremely sensitive organ with an average of 10,281 nerves concentrated in an adult clitoris[9]. In comparison, the hand which is much larger than the clitoris contains 18,000 nerve endings[10]. 

Dr Paul Pin, a researcher from the study, emphasised that “[the nerves] are very large, [close to the surface] and therefore very susceptible to injury if you don’t know what you’re doing[11]”. Gino Pecoraro, of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, explained that these findings show how important it is to avoid unnecessary surgery in this area[12].


A Mother's Experience

I went to a Muslim female doctor, recommended by my uncle yesterday. This morning, still some blood was seen. Then, I noticed that there was something dangling...To my horror, it seems like the labia was cut on the top and it's blue black.Went back to dr, wanted to know what's wrg. she did not see the baby yet, but was holding a container with scissors, I said, ur not cutting my girl again. Then, when she saw the cut, she kept saying that it's the labia. I insisted that the cut was not meant to be there, the circumcision was completed as the top was removed. She must have cut too much. My eldest girl's circumcision was ok (another doctor). She was not apologetic but kept saying the baby will recover, I got pissed off. I asked whether this is the way it's meant to be. She started talking about circumcision in Egypt - who cares what's done elsewhere! She made me more angry. I kept asking if it meant to be like this. She claims the labia might reattach, or drop off. Uh? I looked more confused and was so sad... Then, before I got out the door, she admitted she might have cut too much and apologized. I'm still sad....Anyone with similar experience? What happens to your girl? 

Taken from a MummySg forum, posted on October 2012[13]


Notes
  1. Abdul Rashid, Yufu Iguchi and Siti Nur Afiqah, “Medicalization of female genital cutting in Malaysia: A mixed methods study,” PLOS Medicine, 17(10), 2020.
  2. Abdul Rashid, Yufu Iguchi and Siti Nur Afiqah, “Female Genital Cutting in Asia: The Case for Malaysia,” in Female Genital Mutilation/Cutting: Global Zero Tolerance Policy and Diverse Responses from African and Asian Local Communities, Kyoko Nakamura, Kaori Miyachi, Yukio Miyawaki, Makiko Toda (eds.), 109-126, Springer, 2023, p. 116. 
  3. Ibid.
  4. ifah03, “Sunat, female circumcision - but the dr cut too much, llabia is cut and dangling,” MummySG Singapore Motherhood and Parenting Forum, October 2, 2012, http://www.mummysg.com/forums/threads/sunat-female-circumcision-but-they-dr-cut-too-much-llabia-is-cut-and-dangling.99146/
  5. World Health Organisation, WHO guidelines on the management of health complications from female genital mutilation, World Health Organisation, 2016, p. 8.
  6. World Medical Assembly, “World Medical Association Statement on Female Genital Mutilation,” World Medical Association, June 15, 2020, https://www.wma.net/policies-post/wma-statement-on-female-genital-mutilation/
  7. Joseph A. Kelling, Cameron R Erickson, Jessica Pin, Paul G. Pin,  "Anatomical dissection of the dorsal nerve of the clitoris," Aesthetic Surgery Journal, 40(5), 2020: 541-547.
  8. Ibid. 
  9. Maria Ulko, Erika P. Isabey, Blair R. Peters, "How many nerve fibers innervate the human glans clitoris: a histomorphometric evaluation of the dorsal nerve of the clitoris," The Journal of Sexual Medicine, 20(3), 2023: 247-252.
  10. Franny White, "Pleasure-producing human clitoris has more than 10,000 nerve fibers," OHSU News, October 27, 2022, https://news.ohsu.edu/2022/10/27/pleasure-producing-human-clitoris-has-more-than-10-000-nerve-fibers.
  11. Kelling et al.,  "Anatomical dissection of the dorsal nerve of the clitoris."
  12. Ruby Prosser Scully, "Misunderstanding the vulva may be leading to pain after labiaplasties," New Scientist , December 30, 2019, New Scientist, https://www.newscientist.com/article/2228249-misunderstanding-the-vulva-may-be-leading-to-pain-after-labiaplasties/.
  13. ifah03, “Sunat, female circumcision - but the dr cut too much, llabia is cut and dangling,” MummySG Singapore Motherhood and Parenting Forum, October 2, 2012, http://www.mummysg.com/forums/threads/sunat-female-circumcision-but-they-dr-cut-too-much-llabia-is-cut-and-dangling.99146/

Is sunat perempuan only a harmless small cut?

Sunat perempuan has been proven to lead to many physical health risks and psychological traumas. 

The average length of the clitoral hood/glans of a female newborn is about 6.7 mm[1]. The clitoral hood is highly adherent to the glans of the newborns, meaning it sticks very closely to the clitoral glans. Therefore, it can be difficult to retract the clitoral hood from its glans to “safely” cut or prick the clitoral hood separate from the actual tissue[2]. The clitoral hood/glan can also grow into 37 mm in adults[3]. Removing any part of the clitoris, no matter how small, is actually removing growing tissue. 

The clitoris is an extremely sensitive organ with an average of 10,281 nerves concentrated in an adult clitoris[4]. In comparison, the hand which is much larger than the clitoris contains 18,000 nerve endings[5]. Although the amount of nerve endings in an infant clitoris has not been researched, any injury to the infant clitoris can still cause an immense amount of pain for the infant[6]. 

A 2015 study by Oxford University suggests that babies feel pain just like adults[7]. The researchers found that 18 of the 20 brain regions active in adults when they experienced pain were also active in babies. MRI scans also showed that babies’ brains had the same response to a weak ‘poke’ (of force 128mN) as adults did to a stimulus that was four times as strong (512mN) which actually suggests that babies have a much lower pain threshold.

There is no standard definition on which and how much genital tissue should be cut to classify it as sunat perempuan. Descriptions of the amount of skin removed are “the size of a quarter-grain of rice, a guava seed, a bean, the tip of a leaf, the head of a needle[8].” Anecdotal descriptions minimise the procedure by saying that it ‘potong sikit sahaja’ (is only a tiny cut) and ‘keluarkan setitik darah’ (release a drop of blood). 

Procedures of sunat perempuan done by doctors differ. Some doctors nick the prepuce to draw blood, some scrape or cut away part of the prepuce (clitoral hood), while some cut the tip of the clitoris. The only harmless sunat are the symbolic/ceremonial forms where nothing is removed: a knife is placed on the genitals and prayers are recited, or the area is swabbed with antiseptic. However, the sunat perempuan done in Singapore typically involves cutting away some genital tissue.

Genital development occurs in two stages: in the womb and during puberty[9]. Hence, the vulva of a baby or young girl is immature compared to an adult woman, and will develop in size and shape during and after puberty. While there is great variation in size and appearance, what is usually visible before puberty is only about a centimetre of clitoral hood, and half a centimetre of the labia minora. 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.  

One common harmful physical side effect of any cut is scarring or adhesions of the vulvar tissue (e.g. labia minora, labia majora, vaginal walls)[10]. A keloid scar[11] 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[12]. Other potential complications are clitoral abscesses or cysts, haemorrhage, infections, shock, sepsis, or even death.

Another side effect of an exposed clitoris after reduction of the clitoral hood is desensitisation or over-sensitisation, which may negatively impact sexual pleasure in adulthood. A study by Sahiyo on FGC in the Dawoodi Bohra community, where FGC is generally done at 6 to 7 years old, has shown that the long-term effects on mental well-being include “fear, submission, inhibition and the suppression of feelings[13].”


Notes
  1. Adesola Olubunmi Adekoya, Musili Bolanle Fetuga, Olumide Olatokunbo Jarett, Tinuade Adetutu Ogunlesi, Jean-Pierre Chanoine and Abiola Omobonike Adekoya, "Clitoral sizes and anogenital distances in term newborns in Nigeria," International Journal of Pediatric Endocrinology, 2019(1), 2019: 1-5.
  2. Hannah Nazri, "Female circumcision is unnecessary," Nazri, April 2, 2023, https://hannah.nazri.org/female-circumcision-is-unnecessary.
  3. Joseph A. Kelling, Cameron R Erickson, Jessica Pin, Paul G. Pin,  "Anatomical dissection of the dorsal nerve of the clitoris," Aesthetic Surgery Journal, 40(5), 2020: 541-547.
  4. Maria Uloko, Erika P. Isabey, Blair R. Peters, "How many nerve fibers innervate the human glans clitoris: a histomorphometric evaluation of the dorsal nerve of the clitoris," The Journal of Sexual Medicine, 20(3), 2023: 247-252.
  5. Franny White, "Pleasure-producing human clitoris has more than 10,000 nerve fibers," OHSU News, October 27, 2022, https://news.ohsu.edu/2022/10/27/pleasure-producing-human-clitoris-has-more-than-10-000-nerve-fibers.
  6. Hannah, "Female circumcision is unnecessary.
  7. "Babies feel pain 'like adults'," University of Oxford, April 21, 2015, https://www.ox.ac.uk/news/2015-04-21-babies-feel-pain-adults.
  8. Sara Corbett, “A Cutting Tradition,” The New York Times, January 20, 2008, http://www.nytimes.com/2008/01/20/magazine/20circumcision-t.html. 
  9. Katie E. Brodie, Eric C. Grantham, Patricia S. Huguelet, Brian T. Caldwell, N. J. Westfall and Duncan T. Wilcox, “Study of clitoral hood anatomy in the pediatric population,” Journal of Pediatric Urology, 12(3), 2016: 177.e1-177.e5.
  10. 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(1), 2015, p. 32; Abdulrahim A Rouzi, Nora Sahly, Estabraq Alhachim and Hassan Abduljabbar, “Type I female genital mutilation: a cause of completely closed vagina,” The Journal of Sexual Medicine,  11(9), 2014, pp. 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(1), 2012, pp. 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(1), 2011, p. 26; Sharifa A. Alsibiani and Abdulrahim A. Rouzi, “Sexual function in women with female genital mutilation,” Fertility and Sterility, 93(3), 2010, pp. 722-724.; W. C. Yoong, R. Shakya, B. T. Sanders and J. Lind, “Clitoral inclusion cyst: a complication of type I female genital mutilation,” Journal of Obstetrics and Gynaecology, 24(1), 2004, pp. 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(3), 2001, pp. 569-571.
  11. Keloid scars are the overgrowth of scar tissue that forms over a wound. Keloid scars can grow to be larger than the original wound.
  12. “From birth to motherhood, a Singaporean Malay’s experience of Female Genital Cutting,” SAHIYO, February 13, 2017, https://sahiyo.com/2017/02/13/from-birth-to-motherhood-a-singaporean-malays-experience-of-female-genital-cutting/.
  13. Mariya Taher, "Understanding Female Genital Cutting in the Dawoodi Bohra Community: An Explanatory Survey," SAHIYO, May 2019, https://sahiyo.files.wordpress.com/2019/05/sahiyo_report_final-5.21.19.pdf

Will they remember the pain of sunat perempuan when done at a young age?

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[1]. One common defense mechanism to acute pain is neurological shutdown (lethargy or falling asleep immediately afterwards), which negatively affects interactions with the caregiver.

A 2015 study by Oxford University, suggests that babies feel pain just like adults[2]. The researchers found that 18 of the 20 brain regions active in adults when they experienced pain were also active in babies. MRI scans also showed that babies’ brains had the same response to a weak ‘poke’ (of force 128mN) as adults did to a stimulus that was four times as strong (512mN) which actually suggests that babies have a much lower pain threshold.

In Singapore, as advised by the Mufti, private clinics are only supposed to cut girls up till the age of 2[3]. According to some local doctors, no numbing cream or anaesthesia is used. This means that the procedure is a form of physical trauma. Even though it is done with good intentions and at a very young age, it is a direct experience of gender-based violence. 

Post-traumatic stress is a normal response to the violation of a person’s physical integrity. Psychological impacts are severe especially during infancy as it is a time where the brain develops rapidly and makes it easily affected by the surrounding environment. Thus, traumatic experiences in infancy have more potential to lead to long-term negative psychological consequences. 


Notes
  1. 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.
  2. "Babies feel pain 'like adults'," Univeristy of Oxford, April 21, 2015, https://www.ox.ac.uk/news/2015-04-21-babies-feel-pain-adults.
  3. End FGC Singapore member Saza Faradilla's personal communication with a doctor (whose anonymity will be maintained) who performs FGC in Singapore in 2017, as part of Saza's Bachelors thesis. 

Is sunat perempuan necessary for hygiene?

None of the known forms of sunat perempuan have any health benefits. From a medical perspective, it involves the unnecessary removal and/or injury of healthy genital tissue[1].

The vulva and vagina, like all body parts, depend on a symbiotic community of beneficial microbial flora to remain healthy. All parts of our body can be kept clean with good hygiene practices. Whether someone has undergone sunat or not, their vulva still requires regular washing. We do not cut off other body parts to avoid having to clean them. Our bodies have been intelligently created to remain healthy and functioning with minimal intervention by us. 

In Malaysia, Associate Medical Professor from Universiti Kebangsaan Malaysia (UKM), Dr Harlina Siraj, considers sunat perempuan “insulting,” “risky” and with no “medical and scientific basis[2].” UKM Professor Dr Zaleha Abdullah Mahdy has also raised the problem of sunat as FGM in Malaysia at the Royal College of Obstetricians and Gynaecologists World Congress in 2018[3].


A Survivor's Experience

“I was 21 years old when I found out that I had undergone female genital mutilation (FGM) at about 4 years old. I was already a vocal critic of FGM then, speaking out against it in rallies, but I had no idea that I was a survivor of the practice too. I didn’t question my frequent urinary tract infections, how sex was always painful, or why I’ve never had an orgasm.” 

Jeena Sharma's story on VICE[4]


Notes
  1. The Brussels Collaboration on Bodily Integrity, “Medically Unnecessary Genital Cutting and the Rights of the Child: Moving Toward Consensus,” The American Journal of Bioethics, 19(10), 2019: 17-28.
  2. Aedi Asri, “Muslim doctors against female circumcision”, Free Malaysia Today, October 17, 2016, https://www.freemalaysiatoday.com/category/nation/2016/10/17/muslim-doctors-against-female-circumcision/.
  3. Dr Zaleha Abdullah Mahdy presented a session on FGM titled “Stream 5 Global health: helping vulnerable women - female genital mutilation in Asia” at the Royal College of Obstetricians and Gynaecologists World Congress in Singapore held on 21-24 March 2018.
  4. Jeena Sharma, "The War Against FGM in Sudan Is Far From Over," VICE, August 12, 2020, https://www.vice.com/en/article/ep4kb4/the-war-against-fgm-in-sudan-is-far-from-over. This is an adapted excerpt.

Is sunat perempuan different from female genital mutilation (FGM)?

Sunat perempuan as done in Singapore falls within the World Health Organisation’s definition of FGM. The partial or total removal of the healthy and functioning tissue of the prepuce/clitoral hood or clitoral glans for non-medical reasons is considered Type 1 FGM[1]. Other types of sunat perempuan such as scraping, pricking, nicking or swabbing are considered Type 4 FGM. 

Some Muslims reject the categorisation of FGC as FGM due to its strong value-judgement. However, the definition of mutilation is to damage any part of the body which leads to a negative impact on quality of life[2]. As FGC can have severe and lasting negative physical and psychological impacts on a child, especially without consent, it is FGM.  


Notes
  1. World Health Organisation, “Female genital mutilation,” February 3, 2020, https://www.who.int/news-room/fact-sheets/detail/female-genital-mutilation.
  2. "Mutilation definition & meaning," Merriam-Webster, https://www.merriam-webster.com/dictionary/mutilation.

Culture

Is it my choice to sunat my daughter?

Do consider the issues of consent and physical integrity. Try to think about this from your daughter’s perspective: would she say ‘yes’ or ‘no’ to having her genitals cut, for any reason at all?

If you feel the answer is ‘yes’, then let your daughter make the decision for herself as a mature adult. As parents and caregivers, what kind of values do we promote when we force our children to undergo a painful procedure without asking them what they want or need? 

In Malaysia, Perlis Mufti Dato’ Dr Mohd Asri Zainul Abidin says, “[t]he problem is that we do [khitan] to our child. Our children have their own rights too. With that, I don’t think we have to continue this. Unless the child or woman grows up and she wants to do it. It is up to her[1].”

As parents, we carry the great responsibility for the health of our children, including repairing or mitigating any mistakes of the doctor or any side effects. All decisions that are not medically necessary should be made after thorough research and discussion on how it is done, the potential side effects and complications.


A Survivor's Experience

“I don’t remember when it happened to me. I don’t know the details either - of who did it, where they did it, or what they used. All I know is the pain of knowing that my body had been permanently altered without my consent by the people and community who I had no choice but to entrust to keep me safe from harm, and I was failed miserably by them. My scars are physical, psychological and emotional. I have to live with my feelings of disappointment, anger and injustice. FGC is harmful and unnecessary. But there is hope - this pain is avoidable. I refuse to pass down this trauma to my daughters. This ends with me.”

Shared with End FGC Singapore[2]


Am I a good parent if my daughter does NOT go through sunat perempuan?

Prophet Muhammad did not have his wives or daughters undergo sunat perempuan––even when the practice was widely practised at Madinah during his time[3]. He decided and chose not to put his wives and daughters through sunat perempuan when many others did.


A Mother's Experience

“When my daughters were born, I made the decision not to have them circumcised. Female circumcision is one of the most puzzling birth rituals in Muslim society. It has no health or aesthetic value whatsoever. Before I made the decision to cut or not to cut, I asked my friends and searched the internet for legitimacy.  Why, where and how was this done, I couldn’t find any valid answers. Then I turned to the one place where Muslims go to for answers, the Holy Qur’an. To my surprise there are no verses supporting it in the Qur’an. There’s only a vague hadith about male circumcision.

My two girls now live freely and uncut, and I have never regretted my decision to not violate their bodies for a cultural practice that has no place or validity in a our rational society. Just say no to female circumcision.”

Zubaida Ali's story on Beyond the Hijab[4]


Notes
  1. R.AGE, “Amalan berkhitan di Malaysia," YouTube Video, 12:40, November 5, 2018, https://www.youtube.com/watch?v=Y7HjRDtjvIc&t=0s;R.AGE, "Perlis Mufti membincangkan amalan khitan di Malaysia," YouTube Video, 1:49, November 12, 2018, https://youtu.be/WJfTEgtxsms.
  2. The account has been edited.
  3. Pera Soprianti and Andi N. Faizah (Eds.), Sunat Perempuan: Antara Fakta dan Cita Sosial Islam, Srengseng Sawah, Jakarta: Rahima, 2021, pp. 36, 56.
  4. Zubaida Ali, "Leave Them Alone," Beyond the Hijab, February 3, 2016, https://beyondhijab.sg/2016/02/03/leave-them-alone/. This is an adapted excerpt.

Does sunat perempuan prevent ‘wild’ female sexual desire?

Many believe that sunat perempuan will prevent a girl from becoming liar (wild)[1]. However, whether a woman has a high sex drive or many sexual partners depends on brain and character development, personality and other life experiences. Sexual desire stems from our brain, not from our genitals. The assumption that women naturally have excessive sexual desires that must be curbed is a harmful belief rooted in patriarchy. 

The extreme sexualisation of girls prioritises the community’s fear of ‘wild’ women over the girl’s own rights over her body, health and wellbeing. This objectification of girls normalises moral policing and sexual restrictions against women. The sexual control of women and girls is a form of patriarchy, not a practice in Islam. Islam supports the health and physical integrity of everyone; of women, men and children. 


A Survivor's Experience

“It took me years before I dared to explore that part of me. Years. And it was only when I was 25 when I finally got the courage to ask my parents if they [decided to have] FGC [performed on] me. And they did. And the flippant way they described it––like that small cut didn’t rob me of one part of myself, my sexual self––continues to hurt me till today. Because this is my body and I have to live with it. And that no matter how hard I try to touch myself, it just feels strange. Maybe I haven’t felt true desire. Maybe I don’t know how to do it.”

Shared with End FGC Singapore[2]


Notes
  1. Syed Abdillah Aljufri, “Kemusykilan: Khatan wajib bagi kaum lelaki dan perempuan”, Berita Minggu, October 20, 1985, 5; Haji Pasuni Maulan, “Faedah berkhatan dan cara menyempurnakan,” Berita Minggu, February 7, 1988, 5.
  2. The account has been edited and shortened. 

Is sunat perempuan a cultural practice and not an Islamic one?

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 is tooth-filing, usually done between the ages of 15-16, just before sunat, to symbolise one’s coming-of-age and readiness for marriage[1]. Another Malay custom that is rarely practised now is barut, or the wrapping of the mid-section of a newborn baby round-the-clock until they learn to crawl. We now know the harms of teeth-filing on dental health, and excessive swaddling of a newborn’s midsection on physical development.

The way that sunat perempuan is usually done today—a quick and discreet visit to the doctor, with little or no public celebration—strongly suggests that it is done to reassure and validate the baby’s parents and grandparents of their cultural or Muslim identity, and neither for the girl herself nor society at large. 

Research has shown that the practice of sunat perempuan came to Southeast Asia as part of Islamic traditions linked to the Shafi’i mazhab[2]. As a ritual, sunat perempuan is a way of preserving cultural identity and seeking acceptance of the baby and her parents from the wider community. This is especially so if there is a kenduri (ritual feast) done to celebrate her sunat.

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, or a good, religious, and chaste Muslim woman.

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

If culture and rituals are important to you and the people around you, you can consider symbolic or ritual cleansing, where no skin is removed and therefore, no harm is done. In Jambi, Indonesia, a midwife mentioned that she only cleaned the vulva when she was asked to do sunat perempuan on the infant:

If they still insist, I will merely clean [the vulva/genitalia]. We will clean the labia of the babies that are dirty to [please] mothers who are stubborn. Nothing is removed, and they will understand. If they still insist, we will say, ‘what can be removed if it is this small[3]?’


A Survivor's Experience

“I have grown to be less upset that I was cut because, to some degree, I get it: parents face(d) socio-religious and cultural pressures. I sympathise with that. These don’t excuse a parent’s complete and conscious negligence about the procedure, though.”

Shared with End FGC Singapore[4]


Notes
  1. Walter William Skeat, Malay Magic, Kuala Lumpur: Silverfish Books Sdn Bhd, 2018, p. 251.
  2. Gabriele Marranci, “Female circumcision in multicultural Singapore: the hidden cut,” The Australian Journal of Anthropology, 26(2), 2015: 176-292.
  3. Siti Nurwati Hodijah and Indraswari (Eds.), Intersection Between Tradition and Modernity: A Qualitative Study on Female Genital Mutilation/Cutting (FGM/C), A Research in 10 Provinces, 17 Regencies/Municipalities in Indonesia, Komisi Nasional Anti Kekerasan Terhadap Perempuan, 2019, p. 122. 
  4. The account has been edited and shortened.

Is sunat perempuan prevalent in Singapore?

There are no national statistics or research on the prevalence, type or health implications of sunat perempuan in Singapore. However, two independent surveys in 2016 and 2020 indicate a prevalence of 86 percent (n=119)[1] and 76.4 percent (n=360)[2] among Muslim women respectively.


Notes
  1. John Chua, “FGM: A native affliction on every inhabitable continent,” Al Jazeera, October 5, 2017, https://www.aljazeera.com/opinions/2017/10/5/fgm-a-native-affliction-on-every-inhabitable-continent/. 
  2. End FGC Singapore, “Pilot study on female genital cutting (FGC) in Singapore,” unpublished report, 2020.

I’ve decided not to sunat my child. How do I explain to my family and friends?

It is always hard when you feel like you’re the only one. Try to talk to your spouse, relatives or friends and ask that they support your decision. You may find kindred souls against sunat perempuan in community organisations like Beyond The Hijab, Penawar and other organisations.

If it is too difficult to convince family or friends, know that you do not have to justify your decision. Here are some strategies to respond to questions from unsupportive family and friends:

While refusing sunat can save your child, speaking out about your decision (when you are ready) can help save more children. Research has shown that when a critical mass of individuals collectively say ‘no’, it is possible to transform social norms and encourage the abandonment of the practice[1].


A Mother's Experience

“Many times, I had wanted to just give in and do what my mil (mother-in-law) wants me to do. But I really don't know if I could live with myself if I made my daughter go through sth so unnecessary just to appease someone who has no business over my daughter's private parts. This platform has really given me the support and strength I need to stick by my guns and do the right thing by my principles. We've finally decided to tell the white lie because honestly, as a first-time mother, this immense pressure and stress was the last thing I needed.” 

Shared with End FGC Singapore[2]


Notes
  1. Alexia Lewnes (ed.), Changing A Harmful Social Convention: Female Genital Mutilation/Cutting, UNICEF Innocenti Research Centre, 2005, 13.
  2. The account has been edited and shortened. 

Together, we can end sunat perempuan in our generation❣️

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