Many women worldwide are mutilated every day, causing permanent psychological and physical damage as well as death to many.

The day Aya was mutilated remains vividly etched in her memory.

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Abducted from a playground in Egypt as a child, Aya (not her real name) was taken to a place she described as “scary.” The sense of danger she felt in her heart deeply affected her, fracturing her trust and bond with her mother, who was responsible for taking her there, and waking up alone after the operation to find her mother gone only deepened Aya’s mistrust towards her family.

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The brutal genital mutilation also affected Aya’s marriage, causing her to suffer from a vaginal spasm for two months after she had her first sexual interaction. From that moment on, her vaginal area became a source of pain for her, and it took her time to overcome this and normalize having sex.

As the world marked International Day of Zero Tolerance for Female Genital Mutilation, many women worldwide—just like Aya—are mutilated every day, causing permanent psychological and physical damage as well as death to many.

25% of female genital mutilation cases reported in MENA

Around 200 million women worldwide have gone through female genital mutilation (FGM). Close to a quarter of them live in the Middle East and North Africa region.

In a conversation with The Media Line, Nankali Maksud, UNICEF senior adviser, Child Protection, clarified that as there are many definitions of the MENA region, for UNICEF and in relation to FGM, MENA consists of Egypt, Sudan, Yemen, Iraq, and Djibouti.

“The prevalence of the practice is the highest in Djibouti (90%), Egypt (87%), and Sudan (87%),” she noted.

Maksud explained that there are many reasons why the practice continues to persist globally, adding that these are often tied to gender inequality. “Some societies use it as a rite of passage, while others use it to suppress girls’ sexuality. Religious texts are sometimes misinterpreted to justify it. In some communities where it’s prevalent, FGM may be deemed necessary for marriage or inheritance,” she said.

Sara Kira, founder and director of the European North African Center for Research, based in Egypt, told The Media Line that FGM is originally an African practice where it’s believed that it impacts girls’ code of conduct when it relates to sex. “It’s highly believed that this operation gets girls to preserve themselves without sex until marriage. The same line of thought applies to Egypt, too,” she continued.

However, this practice, which is also defined as a violation of human rights, causes significant scars on women, both physical and psychological. Heba El Zeni, a psychology therapist who treats survivors of FGM, told The Media Line that out of the cases she treated and dealt with, especially in upper Egypt, most women and girls call this crime “the unforgettable day.”

She notes that most women suffer from PTSD, fear of abandonment, and loss of trust in their families, especially their mothers.

“FGM causes women to either lose total confidence in their femininity or use it the wrong way, but mostly they relate their genital areas to pain, and they do not experience sexual orgasm as they should, and this causes a lot of family problems that they don’t know the reason behind,” said El Zeni.

El Zeni believes that the psychological effect on women that this crime leaves, is still neglected and is the reason behind many social problems. “Victims of this practice don’t usually get to be totally OK,” she added.

FGM is now firmly on the global development agenda, most prominently through its inclusion in the Sustainable Development Goal, which aims to eliminate the practice worldwide by 2030.

Maksud notes that all five of these countries in the MENA region, where FGM is still an issue, have seen some decline in the practice. She attributes this to many societal factors, including girls’ education, access to employment opportunities by women, and women’s leadership, among others. “All these indicate a generally positive trend in gender equality,” she continued.

In Egypt, while FGM is still an ongoing issue, said Kira, “There is a remarkable outcome of efforts held by both the state of Egypt and civil society. The percentage has dropped drastically.” She adds that today, female circumcision in Egypt is a crime punishable by law with aggravated imprisonment for anyone who requests female circumcision or who performs this procedure.

She explained that according to article 171 of the Egyptian Penal Code No. 58 of 1937, amended by Law No. 10 of 2021, for anyone who performs FGM, referring to doctors or practitioners of the nursing profession, the penalty shall be aggravated imprisonment for not less than five years if his crime results in a permanent disability, the penalty shall be aggravated imprisonment for not less than 10 years.

“The court also rules for the above-mentioned penalties to deprive the perpetrator of the doctors and nurses from practicing the profession for not less than three years and not more than five years starting from the end of the penalty period and closing the private facility in which the circumcision was performed for the period of execution of the penalty,” she added.

Kira says that in 2021, Egypt witnessed a first-of-its-kind ruling in a female genital mutilation case, as a court sentenced a father to three years in prison and a nurse to 10 years in prison in absentia for circumcising the daughter of the first accused, which caused permanent disability to the victim.

Maksud says that UNICEF has made significant investments in this issue in MENA through six main strategies, which are working with governments to create enabling laws and policies, increasing girls’ agency and assets, shifting social and gender norms, enhancing access to essential services and strengthening systems, and generating quality data and evidence.