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Obstetrics and Gynaecology

Circumcision Of The Female

This topic may be out of place in a book on Islamic aspects, for the practice is neither Islamic nor ordained by Islam. There is however erroneous confusion in many circles that ascribe it to Islam. The procedure long antedates Islam, and its geographical distribution is different from the map of Islamic peoples. For thousands of years it was prevalent in the Nile valley viz Egypt, the Sudan and Ethiopia, as well as in limited communities in Arabia, Russia and South America. Its exact origin in history is unknown. The reason is said to be moral, for if the external genitals are reduced this is thought to tame down sexual desire and helps girls not to succumb to their sexual desire. This is of course not so, for sexual appetite is aroused by psychological and hormonal mechanisms.

In its mild form the operation entails a trivial trimming of the margins of the labia minora. The extreme form, infibulation, entails removal of labia minora and clitoris, stitching the raw margin leaving a small opening for egress of urine and mensis and ingress of the penis at sex. This extreme form was present especially in the Sudan, and at child birth an anterior episiotomy has to be made.

Typically, the operation is performed during childhood, more often by the old village lay woman than by the doctor. It is nowadays almost gone one more dying habit. Complications were rare, and included haemorrhage, sepsis, urethral injury, implantation dermoid and dyspareunea, apart from the psychological aftermath. After marriage, circumcision might result in undermining sexual pleasure by making the woman less prompt to attain orgasm.

Female circumcision was known within Judaism, Christianity and Islam. ..but none of the three religions specifically ordained or prohibited it. At the time of the prophet there was a tribe who subscribed to circumcision of their girls. The woman who used to perform it for them Was called Om Rafiea. Seeing that they strongly clinged to their Custom and receiving no divine guidance for its prohibition, the prophet advised Om Atiya :

"Take the minimum Om Atiya and don't exceed it for it is more pleasurable to the husband and protective of chastity (by satiating the woman's desire). " (Ibn Maja)

During a long career in gynaecology and obstetrics dealing with patients practically from all muslim countries, we find that the practice of circumcision is confined only to Egypt, the Suadn and Ethiopia. Women from other muslim, Arab and non-Arab, countries are not circumcised. Lately the operation Was made illegal and it is indeed very rare in the contemporary child population.

Regarding male circumcision the ruling is different. In Islam male circumcision is a sunna (commendable but not obligatory and no sin or punishment if omitted). Patriarch Abraham ordained it and it remained through  his progeny, jews (children of Isaac) and muslims (prophet M ohammad is a descendant of Ismail). The scipping of male circumcision by christians was introduced by Paul but not by Jesus Christ, who was himself circumcised .

Modern medical literature suggests a protective role of male circumcision against penile carcinoma and carcinoma of the cervix of the uterus, but persual of this matter is really beyond the SCope of this book.