title: Female genital mutilation: the penultimate gender abuse.
abstract: OBJECTIVE
  The five goals established for the development of this article were to: (1) provide an historical overview of the practice, (2) describe the procedure and its sequelae in realistic terms, (3) explore cultural justifications for the continuation of this action, (4) evaluate inherent moral/ethical/legal issues and, (5) focus worldwide professional attention on a gender-specific child atrocity.
  
  
  METHODS
  A review of the past and current historical, popular and professional literature was undertaken to determine the precursors, magnitude, settings, rationale, and moral-ethical-legal-treatment issues associated with this mutilating procedure.
  
  
  RESULTS
  Four forms of female genital mutilation were identified. These are: (1) sunna (removal of the prepuce of the clitoris); (2) clitoridectomy (removal of the prepuce and the clitoris); (3) excision (removal of the prepuce, clitoris, upper labia minora and perhaps the labia majora); and, (4) infibulation (removal of the prepuce, clitoris, labia minora, and labia majora). The "surgery" is performed most frequently by untrained midwives who use sharp rocks, razor blades, kitchen knives, broken glass, or even their teeth. As a rule, no anesthetics, antiseptics, analgesics or antibiotics are available to victims. Consequently, these females typically suffer from massive short-term and long-term physical, emotional, sexual and obstetrical sequelae.
  
  
  CONCLUSIONS
  The justifications tendered by proponents do not withstand moral-legal-ethical scrutiny. Female genital mutilation is a violation of human rights and an atrocity perpetrated against helpless individuals who are unable to provide informed consent and who must therefore be protected through education and legislation.
authors.affiliation: Department of Nursing, University of Central Oklahoma, Edmond, USA.
authors.forename: D G
authors.initials: DG
authors.lastname: Barstow
mesh_terms: D002648:Child; D002649:Child Abuse / Q000175:diagnosis / Q000331:legislation & jurisprudence*; D019093:Circumcision, Female / Q000009:adverse effects / Q000266:history; D003469:Culture; D005260:Female; D049673:History, 20th Century; D049690:History, Ancient; D006801:Humans