Witnessing the Scourge of Female Genital Mutilation: A Female Doctor’s Perspective from Ethiopia

15 May, 2024


By Dr. Yodit Sileshi Zewde (MD, MPH in Reproductive Health candidate)

Dr. Yodit is an SRH advocate born in Ethiopia, passionate about the reproductive health field, currently working in a public hospital’s obstetrics and gynaecology department


Female genital mutilation (FGM), also known as female circumcision or female genital cutting (FGC) is “all procedures that involve the partial or total removal of external genitalia or other injury to the female genital organs for non-medical reasons.” as defined by the World Health Organization (WHO) in 1997. It is a deeply entrenched cultural practice, perpetuated by a complex interplay of social, cultural, and economic factors. Despite efforts to eradicate it, FGM remains widespread in Ethiopia, affecting millions of women and girls. As indicated in the UNICEF FGM Country Profile on Ethiopia  (UNICEF, 2020), the country is ‘home to 25 million girls and women who have experienced FGM’ (Female Genital Mutilation/Cutting), the largest absolute number in Eastern and Southern Africa.

In different regions of the country, FGM/C is a recognized and accepted practice that is considered important for the socialization of women, curbing their sexual appetites and ‘preparing them for marriage’. It is considered part of a ritual initiation into womanhood that includes a period of seclusion and education about the rights and duties of a wife. In practice, as noted by Boyden et al. (2023), FGM/C ‘tends to be seen as a necessary precursor’ to marriage, particularly by families and communities most likely to engage in child marriage. By constraining girls’ ‘errant sexual behaviour’, and thus shaping their conduct, FGM/C practices ‘safeguard their social standing and marriageability.’

Data from the latest Ethiopia Demographic and Health Survey (EDHS, 2016) show that 65% of women and girls aged 15–49 years, 47% of girls aged 15–19 years, and 16% of girls under 15 years are circumcised. FGM/C is not, however, a homogenous phenomenon; there are disparities across regions and settings. For instance, nationwide, FGC is more prevalent in rural areas (68 %) than urban areas (54 %). Amongst women and girls aged 15–49 years, Tigray and Gambela have the lowest prevalence (24 % and 33 % respectively), and Somali and Afar regions have close to universal prevalence (99 % and 91.2 % respectively).

As a female doctor working in the reproductive health field in Ethiopia, I have been both witness to and combatant against FGM, one of the most pervasive yet hidden forms of gender-based violence. Unlike many who have suffered its consequences first-hand, I am fortunate to have been spared its physical trauma. However, my daily encounters with its survivors have provided me with an intimate understanding of its devastating impact on women and girls in my community.

The first time I heard about FGM, I was around 6 or 7 years old. I watched a commercial on television, which talked about how FGM was as a harmful traditional practice, and my babysitter asked my mother something along the lines of she was going to get them cut (them being me and my little sister), since we will be too old for it soon. I remember my mother responding angrily and scolding her for asking such a  question. I did not understand the practice at the time, but her response told me it was something wrong. As I grew older, I realised that most of my cousins from outside of the city had undergone some form of cutting at a very young age, while I was one of the lucky ones who did not have to. For them, it was a rite of passage; they did not view it as any different from male circumcision until they reached a reproductive age.

Years later, I joined medical school. Since the university I went to is located outside of the capital, I wasn’t surprised when I came across several women who had undergone FGM/C. I was surprised to find that a couple of my classmates were also survivors of the same practice. Despite being born and raised in the capital city Addis Ababa, going to reputed schools, and being born in educated families like mine, they were subjected to this harmful practice. To my astonishment, I overheard a fellow female medical student saying that supports the practice, although disagreeing taking it as far as infibulation (narrowing of the vaginal orifice with creation of a covering seal by cutting and apposition of the labia minora and/or the labia majora, with or without excision of the clitoris). She believed that stage 1 and 2 FGM were necessary for women, since a woman is supposed to be ‘calm, collected and not driven by needs of the flesh’. I was shocked to hear this from a soon to be doctor, knowing that she is likely to pass on this harmful practice to her future daughter, if she had one.

One of the most heart-wrenching aspects of my profession is bearing witness to the physical and psychological consequences of FGM/C. The immediate complications can range from severe pain, bleeding, and infection, to urinary problems, sexual dysfunction, and even death. However, it is the long-term repercussions that haunt me. Many survivors endure chronic pain, recurrent infections, and complications during childbirth, leading to obstetric fistulas, stillbirths, and neonatal deaths. The psychological scars run even deeper, manifesting as anxiety, depression, post-traumatic stress disorder, and a profound sense of shame and inadequacy.

I also remember a close friend of mine who was working in one of the regions in the country where the prevalence of FGM is 97%, telling me it was indeed rare to find a woman who has not been subjected to FGM. He recalled an incident; a 16-year-old girl brought into the emergency in the middle of the night for acute urinary retention (one of the complications of FGM). Her genital area was sewn up, leaving only a pea sized opening for her urine and menses to pass through. Through the years, the scarring had worsened to the extent that several cysts had developed, resulting in complete obstruction of her ureter.  The family was asked for permission for a procedure to reverse the damage, but they refused. She ended up being discharged with a suprapubic catheter (a urinary catheter inserted into the bladder through a small cut on the belly).

Ethiopia’s programme to end FGM contributes to the national commitment to end child marriage and FGM by 2025, and to achieve SDG target 5.3 by 2030. The programme is led by the Ministry of Women, Children and Youth as well as the National Alliance to End FGM and Child Marriage, which engages other ministries, civil society, non-governmental organizations and UN entities. Building on the country’s Constitution and strong legal framework to promote and protect girls’ and women’s rights, a National Costed Roadmap to End Child Marriage and Female Genital Mutilation/Cutting (2020-2024) was developed. The oversight of most campaigns is lack of emphasis on male engagement as well as limitations in sustaining the momentum of community engagement and empowerment efforts over time, especially in rural or remote areas where resources and attention may fluctuate. Furthermore, while efforts to change social norms are essential, a  top-down approach without adequate consideration for the cultural contexts and community involvement could face resistance, or result in potential exclusion from society due to stigma. (Landinfo et al. 2021)

In conclusion, as a female doctor living and practicing in Ethiopia, I bear witness to the silent screams of countless women and girls whose lives have been irreversibly altered by FGM. Although I may not have experienced its horrors personally, I am deeply committed to advocating for the rights of bodily autonomy and well-being of those who have. I believe in educating not only women but also men, while raising awareness on the short- and long-term complications of the practice. Furthermore, involving religious leaders in these interventions would be more effective, because several communities attach religious beliefs to the practice. Unfortunately, the current legislation has not taken a firm stance on the matter. If we got to a level where one can report FGM during clinical practice just like we do suspected sexual violence, it might help combat the issue. Through education, empowerment, and collective action, we can end the practice of FGM and create a future where every woman and girl can live free from violence and discrimination. I hope this blog fosters dialogue and raises awareness about the harmful physical and psychological effects of FGM in order to make that happen.


Boyden, J. E. (February 2013). Harmful Traditional Practices and Child Protection: Contested Understandings and Practices of Female Child Marriage and Circumcision in Ethiopia.

EDHS, C. S. (2016). Ethiopia Demographic and Health Survey. Addis Ababa: Central Statistical Agency.

Landinfo. (June 2021). Ethiopia – Female Genital Mutilation (FGM).

UNICEF. (2020). A profile of Female Genital Mutilation in Ethiopia.