Female Genital Mutilation: A Human Rights and Public Health Crisis in Somaliland

By: Mohamed Osman

Female Genital Mutilation (FGM) encompasses all procedures that involve the partial or total removal of the external female genitalia or other injury to female genital organs for non‑medical reasons. Internationally, FGM is recognized as a violation of the human rights of girls and women and reflects deeply rooted gender inequality. It constitutes an extreme form of discrimination and has no health benefits, while posing significant short‑ and long‑term risks to physical and psychological well‑being.

Classification of FGM

The World Health Organization (WHO) classifies FGM into four main types based on the extent of tissue removal and injury.
Type I (Clitoridectomy) involves the partial or total removal of the clitoral glans and/or the clitoral hood.
Type II (Excision) includes the partial or total removal of the clitoral glans and labia minora, with or without removal of the labia majora.
Type III (Infibulation) is the most severe form and involves narrowing the vaginal opening by cutting and repositioning the labia, often through stitching, sometimes accompanied by removal of the clitoral glans.
Type IV includes all other harmful non‑medical procedures, such as pricking, piercing, scraping, or cauterization.

Health Consequences

FGM causes extensive harm and offers no medical benefit. Immediate complications include severe pain, excessive bleeding, shock, genital swelling, infection, and in some cases, death. Long‑term consequences frequently involve chronic pain, recurrent urinary tract infections, menstrual difficulties, and vaginal complications. Women who have undergone FGM—particularly Type III—face increased risks during childbirth, including prolonged labor, obstetric tears, postpartum hemorrhage, and neonatal death.

The psychological impact is equally significant. Survivors often experience anxiety, depression, post‑traumatic stress disorder, and long‑lasting emotional distress, including loss of trust in caregivers who permitted or arranged the procedure.

Human Rights and Legal Context

FGM is most performed on girls between infancy and 15 years of age, often without consent and under unsafe conditions. As it involves the removal of healthy tissue and permanent bodily harm, FGM violates fundamental rights to health, security, bodily integrity, and freedom from violence. Although the practice is illegal in many countries, it persists due to entrenched cultural norms, social pressure, and misconceptions regarding religion.

Prevalence in Somaliland

Somaliland has one of the highest FGM prevalence rates globally. According to the 2020 Somaliland Health and Demographic Survey, between 98% and 99% of women aged 15–49 have undergone FGM. Most girls are subjected to the procedure between the ages of 5 and 9. Prevalence remains consistently high across urban, rural, and nomadic populations, with the highest rates observed among nomadic communities.

While overall prevalence has changed little, there is a gradual shift in the type of FGM performed. Historically, Type III (Pharaonic) procedures were dominant. Although still widespread, there is a growing trend toward Type I or II procedures, often referred to locally as “Sunni.” Some communities perceive this shift as a form of harm reduction; however, health and human rights organizations emphasize that all forms of FGM are harmful and unacceptable.

Social and Cultural Drivers

FGM persists due to a complex interplay of tradition, social conformity, and gender norms. In many communities, it is viewed as a prerequisite for marriage and a marker of purity, modesty, and social acceptance. Approximately 72% of women in Somaliland believe FGM is a religious obligation, despite the lack of support for the practice in Islamic scripture. This misconception remains a major barrier to abandonment.

A particularly concerning trend is the medicalization of FGM, whereby trained health workers perform the procedure in clinical settings under the mistaken belief that it can be made “safe.” Medicalization not only legitimizes the practice but also undermines global efforts to eliminate it.

Legal and Policy Landscape

Somaliland has taken steps toward addressing FGM, though significant legal gaps remain. A National Anti‑FGM Policy adopted in 2024 aims to integrate prevention efforts into the health and education sectors. Religious authorities have issued fatwas banning the Pharaonic form of FGM, but these edicts stop short of prohibiting all types. As of 2026, draft legislation to criminalize all forms of FGM remains under parliamentary debate, particularly regarding the inclusion of so‑called “Sunni” procedures.

Strategies for Elimination

Ending FGM in Somaliland requires a coordinated, multi‑sectoral approach. Legislative reform is essential to establish zero‑tolerance laws that criminalize all forms of FGM without cultural or religious exemptions. Within the health system, professional accountability must be strengthened to prevent medicalization and refocus services on managing complications rather than performing procedures.

Engagement with religious and traditional leaders is critical to correcting theological misconceptions and reshaping community norms. Community‑based dialogue, supported by media and public declarations, can facilitate collective abandonment and reduce social pressure on individual families. Finally, economic and educational empowerment—particularly for women, girls, and former circumcisers—plays a key role in addressing the structural factors that sustain the practice.

Conclusion

Female Genital Mutilation in Somaliland remains a profound public health and human rights challenge. While policy initiatives and social change efforts are underway, sustainable elimination will depend on aligning legal frameworks, health systems, religious leadership, and community norms toward the shared goal of protecting the rights and well‑being of girls and women.

About the Author

Mohamed Osman, a retired physician and public health specialist from Somaliland, is a Canadian citizen who has worked with Ottawa Public Health and Alberta Health Services. He is also recognized for supporting Somaliland’s recognition.

The views expressed in this article are the author’s own and do not necessarily reflect the Horndiplomat editorial policy.

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