From  Ayaan  Hirsi  Ali’s  book  “The  Caged  Virgin”


Genital Mutilation Must Not Be Tolerated!

Genital mutilation of girls is sometimes referred to as ''circumcision." Implicitly, this likens it to male circumcision. If male circumcision meant removing the glans and testicles, and adhering the remains of the penis to the empty sac, the comparison would be valid. It is not valid. "Circumcision" is a term that implies that the practice is acceptable. It is not acceptable. Nor is it culturally "excusable."

Genital mutilation of girls is the most underestimated violation of human rights and women's rights worldwide. In 2002, according to Amnesty International reports, between 1 million and 1.4 million girls were robbed of their genitals. The international community is more gripped by the spread of the HIV virus and AIDS than by the atrocious practice of genital mutilation in girls. 

Yet the health complications that circumcised women suffer are shocking, pernicious, and widespread. 

For instance, working in Ghana, Dutch urologist Hans de Wall was visited by an utterly distraught twenty-six-year-old woman who had been circumcised with a piece of broken glass when she was ten. Since the birth of a stillborn child, the woman had been constantly leaking urine and feces because of fistulas. These fistulas often develop when women have trouble giving birth due to the mutilation of their bodies, the narrowing of the vaginal canal. The mutilation also endangers the infants in their passage through the birth canal. Many first-time mothers are unable to labor successfully and the babies get stuck in their mother’s artificially narrowed birth canal. Some babies die as a result; some have birth-related handicaps and injuries.

The pressure of the stuck baby on the mother's internal tissues cuts off the blood supply, damaging the tissues and nerves—including nerves of the legs, leading to lameness—and also can rip holes in their urethras and bowels. The women suffer the grief of losing their babies—because of a cruel mutilation of their own bodies over which they had no control—and also suffer from the trauma of their internal injuries, which leave them completely incontinent.

Women with obstetric fistulas number in the Millions, according to the World Health Organization. And there are few doctors who can care for them. 

Often cast off by their families, abandoned, impoverished, embarrassed by their condition, they wait years for an operation to correct the fistula—if they can get to a medical center that does the procedure. Many suffer in silence and shame. Their isolation and disownment are not even a blip on their governments' radar screens.

According to a story in the New York Times, more than a third of one doctors patients in Nigeria are fifteen or younger; almost an other third are between fifteen and twenty; most were married be fore they had menstruated, at eleven or twelve. Even doctors who devote themselves to corrective surgery for obstetric fistulas cannot keep up with the demand for their services. And even after fistulas are repaired, labor with another baby can create new ones. Genital mutilation of girls leads to inevitable, later mutilations when the women are grown.

As with other forms of appalling violence against women, genital mutilation tends to stay in the sphere of public condemnation, United Nations resolutions, and other paper weapons. Concrete measures that would lead to banishing these practices seem a long way off. People have clung to the belief that, over time, the problem would disappear by itself, with economic development and the increasing availability of information and advice. Other concerns such as poverty, war, natural disasters, and AIDS are given a higher priority in these countries because of their more visible, immediate impact on the population as a whole.

In rich countries, where such calamities do not absorb all the attention, genital mutilation is associated with immigrants. When first brought to the public's attention, it evoked shocked reactions. In the Netherlands, for example, the practice was immediately condemned and made a criminal offense. However, this has not stopped parents from Africa and parts of Asia from mutilating their daughters in the Netherlands or elsewhere in Europe. Moreover, the government is well aware that these parents take their daughters back to their country of origin in order to subject them to the ritual of mutilation there. There is no excuse for tolerating this practice.

A medical report for the government advised the government to combat female circumcision first of all through preventive measures and by an information campaign, using legal sanctions only as a secondary aid. However, enforcement of the law is of primary importance because of the gravity of the offense and the serious implications for the victims. So my party and I are in favor of introducing a screening program that could help prevent female circumcision. Girls from "high-risk countries" should be checked once a year to see if they have been circumcised.

In the present debate in the Netherlands about how genital mutilation should be stopped, some argue that it should be assigned a separate heading in the criminal code. This change could be interpreted to mean that genital mutilation is not formally against the law now, which sends the wrong message to those who inflict it on girls. Others call for a more "open discussion" of mutilation within the immigrant community, and a third group believes that if people are educated about the consequences of mutilation, they will stop.

In my view, the fight against genital mutilation, in the Netherlands and other countries such as Canada and the United States, is primarily a matter of enforcing the law. After all, genital mutilation falls under the criminal offense of "willful, grievous bodily harm" as well as an "unqualified practice of medicine." Under our law, a doctor who has circumcised a woman, or assisted in such a procedure, can be brought before the medical disciplinary tribunal. Moreover, genital mutilation of girls falls under the definition of child abuse.

It is notable that no arrests have been made to date in spite of there being good reason to believe that girls who are normally resident in the Netherlands are subjected to ritual mutilation during the summer holidays, either in the Netherlands or abroad. It seems unacceptable, under the circumstances, that there is no monitoring of this serious crime. The Dutch government's attitude toward genital mutilation seems to be one of passive tolerance: genital mutilation is prohibited by law, but in practice, the authorities turn a blind eye. Following up all the recommendations of the government medical report, management and coordination of all the institutions involved in the fight against genital mutilation, and facilitating dialogue and debate in the ethnic communities that practice genital mutilation do not necessarily guarantee that the parents of the girls at risk will comply with the law.

The government should be committed to introducing a screening program because it regards safety and the enforcement of law as two of its highest priorities. In the 2004 budget for the Department of Justice, we read: “An important contributory factor to public safety is that citizens observe the laws, as the majority will tend to do." And a little further on: "it has been noted that enforcement of the law is unsatisfactory. This should be improved in the coming years." In its proposal for a safety program to help girls at risk of mutilation the cabinet moreover declares its intention to focus on prosecuting graver crimes and "giving priority to the victims of crimes with a serious impact."

Genital mutilation falls into the category of extremely serious crimes and has a substantial negative health impact—even a crippling effect—on the victim. 

Its consequences include: "shock, bleeding, abscess formation; and at a later stage, complications affecting the urinary tract, as well as labor and delivery; psychiatric, psychosomatic, and psychosocial effects for young girls . . . After the procedure girls can become introverted, reticent, withdrawn, and may show signs of behavioral disturbances such as eating disorders and phobias." Genital mutilation can also “lead to posttraumatic stress disorder. For the girl experiences a sense of powerlessness, a lack of control, consent, and information, and suffers intense pain."

Are there openings in the law for the introduction of a screening program?


Article II of the Dutch constitution guarantees the inviolability of the individual's human body. This article is the little brother of Article 10 of the constitution, which safeguards the individual's right to personal privacy. Both articles matter for our proposal; in terms of international treaty law, they are the counterparts of Article 8 of the European Convention on Human Rights (ECHM) and Article 17 of the United Nations Covenant on Civil and Political Rights (signed in 1966).

Yet Muslim reactionaries as well as all other political parties and politically correct politicians who want to preserve genital mutilation argue against a screening program. Their sophistic contention is that a compulsory checkup for a young at-risk girl is a medical intervention that encroaches on the right to the inviolability of the individual's (the girl's) body and encroaches on the girl's and the parents' right to personal privacy.


The ECHM outlines in detail how and under what circumstances the government may lawfully breach the constitution. It is essential that there are enough compelling reasons for such a transgression, otherwise it becomes pointless to have a constitution. The ECHM lists a number of grounds on which the government has the right to breach the constitution. They are (freely translated): border security, public security, national economic welfare, the prevention of national disarray and penal offenses, the protection of health and moral standards, and the protection of individual rights.

In other words, a breach of the constitution can be justified if it prevents the occurrence of a crime (willful, grievous bodily harm). This exceptional ground seems the obvious argument on which to build our case. The ECHM offers the possibility of lawfully imposing medical treatment, provided it can be demonstrated that doing so is of vital importance in the prevention of crime.

Proportionality is one aspect of this "demonstrating it is of vital importance." Is the violation of individual rights outweighed by the importance of preventing the crime? In other words: does the end justify the means?

The legal debate about how best to combat genital mutilation centers on this question. I believe that without compulsory screening there is no effective way of preventing genital mutilation. Therefore, the program is a necessary step. Moreover, the constitution requires the government to take preventive measures in order to protect the integrity of the human body. It gives the government the duty to act.

My party and I are instructing the government to take steps that will prevent genital mutilation. Regarding the question of proportionality, an annual examination by a female nurse working for the local health authority is vastly preferable to allowing girls to be put at risk of serious mutilation. This legal argument far outweighs the main objections against medical examination.

Yet another sophistic legal objection against the introduction of a screening program is that it contradicts our constitution by singling out a specific group to be screened and not the entire. Dutch population. These obstructionists argue that imposing a compulsory medical examination on a group of people from high-risk countries is a form of discrimination.

Other antagonists argue that the intrusion of an annual screening test stigmatizes the parents and so also becomes a heavy burden for the child. These people do not think that the introduction of compulsory screening is proportional to the crime. 

Other antagonists illogically argue that there is no reason to suppose that somebody from a country with a high incidence of genital mutilation is automatically going to become involved in mutilation in the Netherlands—despite ample evidence to the contrary.

I say that the consequences of genital mutilation are so inimical to the well-being of the child that the government should give priority to its duty to act to protect someone from harm. We also believe that even if the risk of genital mutilation is not great, preventive measures are still needed in the light of what might happen and has happened. Female children whose parents come from high-risk countries do in fact run a very real risk of being mutilated because many parents still attach tremendous importance to the tradition.

The government medical report recorded evidence that young girls are subjected to mutilation during school vacations. Because of the hidden effects of the ritual—genitals are by definition covered parts of the body—society can disapprove of the ritual while at the same time denying that it is a problem. If children had their noses, or part of their ears cut off, the government would not be able to get away with its policy of passive tolerance.

Genital mutilation cannot be done legally; parents in the Netherlands know that it is against the law, which is why they have it done during the long school vacation and sometimes in their home country In doing so, they know that the girl can recover from her injuries without having to explain anything to the outside world. Closed groups, who live in the superstitious conviction that mutilation is good for a child, cannot be expected to be open about such matters. As a result of their conviction, the parents perceive mutilation of their own child not as a criminal activity but as an act of love, a parental duty to their daughter and to their immediate circle.

The government needs to weigh the importance of the parents' right to privacy against the child's right to health. Given the gravity of genital mutilation, my party and I would opt for the protection of the child. The services involved in the screening, such as the local health authorities, would treat all information concerning the children and their parents discreetly and protect them.

Merely declaring that the practice of genital mutilation is despicable and degrading is not going to solve the problem. It has not done so thus far, certainly The preventive effects of education are very limited and almost impossible to measure because of the hidden character and historical nature of the practice. The pressure on immigrants from family in the home countries (family ties are not severed by geographical borders) is too strong to be overcome merely through the provision of information and education. The argument that the tradition will eventually fall away, or that the practice will die out in the Netherlands because it is against the law, is unrealistic.

The proposal for a screening program may not be perfect, but it offers maximum results if the government enforces the law to abolish these abominable practices. 

It has the advantage of being clear to the parents: they know exactly what to expect. And it has two positive side effects: first, it encourages targeted, efficient delivery of information and education that otherwise would be ineffective and too diffuse. Second, it can make the Netherlands a role model for Europe and the rest of the world, and help eradicate genital mutilation on other continents as well.


For a screening program to prevent female circumcision, the government should take the following steps:

With the help of Amnesty International and the United Nations, draw up a list of high-risk countries.

Establish a program of compulsory medical examinations for children from these countries.

Make two lists: List A should contain the names of the girls who have already been subjected to mutilation, while List B should have the names of those who have not been harmed yet. Newborn girls are automatically added to List B.

Girls on List A are offered medical and psychological support.

Parents of girls on List B under eighteen are called up every year for a compulsory examination of their daughter.

Newly arrived immigrants from high-risk countries are automatically called.

The screening can be done by the local health service. If a girl on List B turns out to have been mutilated, this has to be reported to the Child Welfare Council, which will institute proceedings against the parents.


After much discussion about the pros and cons of screening tests, I secured a majority in the Dutch House of Representatives, thanks to the backing of the Labor Party, a social democrat party, which is in favor of periodic screening. Although the Labor representatives eventually gave unanimous support, this might not have happened without the support of Ella Kalsbeek, a member of parliament for the Labor Party, the party I left, who played a leading role. From the very outset of this debate the minister of health, Hans Hoogervorst, expressed his absolute horror of genital mutilation, considering it a form of child abuse, and showed himself in favor of introducing a screening program as soon as possible. In April 2004, he announced the establishment of a special committee with the Public Health Board to investigate the possibility of an effective screening program and to consider how the law can be used more effectively to identify incidents. Under Dutch law it could have become possible to prosecute not only Dutch citizens, but also foreigners with a fixed place of abode in the Netherlands who have assisted in or encouraged genital mutilation abroad in countries such as Somalia, where it is allowed, or countries where it is forbidden.

To my disappointment, the committee ultimately recommended that screening not be done. The minister of  health said he would not want to make screening compulsory but will offer high-risk communities the opportunity to have their children examined. Before the family is approached with this opportunity, however, the government must establish that the family is likely to practice female genital mutilation. The government will look at whether the family is from a high-risk country, if the mother of the child is circumcised herself (which can only be known if she has given birth to the girl in Holland and her status is known by a Dutch medical doctor or health worker).

I have no majority for my screening proposal. I have only my party standing with me. The program that the government has devised instead of the one we advised is a very expensive, inefficient system. Tragically, many Muslim immigrant girls will fall through the cracks.



Keith Hunt