Female genital mutilation in FranceBMJ 1995; 310 doi: https://doi.org/10.1136/bmj.310.6994.1592 (Published 17 June 1995) Cite this as: BMJ 1995;310:1592
- Colette Gallard, family planning counsellora
The French Family Planning Association first protested to the World Health Organisation in 1977 about its continuing silence concerning the genital mutilation of girls in Africa and the Far East; that same year the French delegate to the regional council of the International Planned Parenthood Federation brought the issue before its medical commission.
At the time, this protest was based more on feminist concern for the defence of women's rights than on the family planning association's experience of female genital mutilation; but over the next few years, with the arrival in France of African immigrants' wives and families, mother and child protection centres and family planning centres, where our members worked as counsellors, saw the problem surface in a tangible way.
Some of these centres are in areas with high migrant populations, and coming face to face with the facts of female genital mutilation was often quite a brutal experience. The social pressure of these traditions and their psychological repercussions on women, as well as the physical damage inflicted, were first brought home to me through seeing a happy, communicative little Malian girl whom I had followed from birth, return from a “holiday” in Mali rendered aphasic from shock (and needing several years of psychotherapy to speak again); the traditions became very clear as I talked with her horrified mother.
In France, in the family planning association as elsewhere, the first reaction to the facts was to consider that westerners should not intervene in this cultural issue. It was only after a long period of raising awarness among medical and paramedical staff, magistrates, institutions, and the general public that the problem began to be seen as something other than just an example of folklore or a barbarous sign of under-development.
Sadly, it took the death of two little girls in 1982 to bring the issue out into the open and to oblige the authorities to take a stand on the perpetration of these practices in France.
Action was undertaken in two main fields. Firstly, we aimed at prevention. A paediatrician working at a mother and child protection unit produced an information booklet on the different forms of female genital mutilation and their medical consequences, particularly during labour.1 This was for medical and paramedical staff and (a major priority) for interpreters. Discussions were organised for the women who attended the centres.
At the initiative of a working party set up by Yvette Roudy, minister for women's rights, measures were proposed for information to be given through French consulates to immigration candidates (generally men) and then, after their arrival, through immigrant workers' associations by using leaflets and illustrated material on general family legislation in France (non-recognition of polygamy, compulsory schooling, vaccinations, etc) as well as on the prohibition of and punishment for female genital mutilation.
At the same time, hospital teams began studying the high incidence of caesarian section among these women and the worrying fact that they sometimes refused, despite difficult labour, to undergo such sections because of their fear of having to restrict the number of their pregnancies afterwards.
The second method of action was penal repression. In France female genital mutilation falls under Article 312 of the Penal Code: “grievous bodily harm to a minor under 15”; but it was not until a white French woman mutilated her daughter's sexual organs in a fit of dementia and was sentenced that female genital mutilation of African girls too was accepted as grievous bodily harm by the judicial system. Sentences can be from three months upwards in prison with fines.
The first case came before court in 1982. At the request of African women's associations the family planning association brought a civil suit; it was a difficult decision to make for the association, whose activities are generally educative and preventive rather than repressive. But the African women's associations were afraid of losing credibility among their compatriots if they were on opposite sides at court, and they pointed out that we would be racist to accept female genital mutilation for black girls and not for white girls. Since then, several cases have been before the courts, and sentences have been passed on excisers as well as fathers—not, as previously, only on mothers.3
Malians in Paris
Systems and scale
Today, ministries and public institutions feel directly involved. Prevention kits (posters and leaflets) have recently been published and distributed by the prefecture of the Ile de France as a result of the work of several associations. Now used only in the Paris area, this material will soon be available all over France.
Medical and social teams can and do report children at risk or who have suffered female genital mutilation through the normal channels for cases of child abuse; magistrates are increasingly prepared to take such cases seriously. Priority aspects of care when a child appears at risk are support of and information for the parents or mother, alerting school authorities when the child is of school age, and avoiding “holidays” in the country of origin.
At the moment an estimated 100000 immigrants live in the Paris region. This figure is based on numbers of relevant immigrant residence permits for 1989. Studies of national figures give 40000 women and 14000 young girls from cultures practising female genital mutilation in France in 1989; the predicted figure for girls in 1993 was 25000.4
If only half of these women are excised it can be said that 20000 women and 12500 girls living in France have either suffered female genital mutilation or will do so. Of these, 90% live in the Ile de France (Paris region); most are from Mali, a few from Senegal.
In April 1994 I was present as the government funded representative of the French family planning association at a conference organised at Addis Ababa by the Inter-African Committee against Traditional Practices Harmful to Women's and Children's Health. The French speaking states whose immigrants brought the problem to France were among the 24 African states who manifested concern by their presence. During the meeting they exchanged their experiences on means of prevention of female genital mutilation, with the target of total eradication for the year 2000.
I felt that this unanimous aim was the clearest demonstration of the progress achieved through years of action and of intense effort to raise awareness in the countries where female genital mutilation is carried out and among their nationals living in France.