Key Benefits:
( Plenary Assembly of 28 November 2013)
1. As part of the protection of the human rights of women and girls, the National Advisory Commission on Human Rights (CNCDH) was asked twice to decide on the issue of female genital mutilation (MSF). In a founding opinion in 1988, she asked the public authorities about the need to actively engage in the fight against these practices and the care of victims (1). In 2004, CNCDH conducted more extensive work on female genital mutilation in France and in countries of origin of immigrant populations. It made a number of recommendations to improve the protection and care of girls and women (2).
2. Female genital mutilation is one of the most barbaric violations of women's human rights today; They are recognized as a grave breach of the integrity of the person, the expression of physical and psychological domination over girls and women. They violate the respect for human dignity enshrined in the 1948 Universal Declaration of Human Rights. Although illegal in most states, female genital mutilation is still widely practised in some 30 countries, where it only declines very slowly. Every year, three million girls and young women suffer sexual mutilation, a girl or a woman excised in the world every 15 seconds (3). In France, in 2007, the number of women and girls who were maimed or threatened was estimated to be between 42,000 and 61,000, an average assumption of 53,000 women (4).
3. The discourse to combat female genital mutilation has long been based on public health issues, but female genital mutilation cannot be reduced to these medical problems. Women ' s sexual mutilation must first and foremost be combated in the field of human rights. It is then necessary to prefer the expression "female mutilation" to the expression "genital mutilation" or to the term "excision". The word "mutilation" emphasizes the gravity and destructive character of the act. The term "excision" refers to the most common type of mutilation, but it does not reflect all forms that may be taken into practice. The expression "genital mutilation" refers to the biological aspect of practice and its medical consequences, while the expression "female mutilation" reinforces the fact that practice is a violation of the human rights of girls and women.
4. Beyond the questions of culture and traditions, female genital mutilation is a serious violation of the physical integrity of the person. No one's right to the difference, no respect for a cultural identity can legitimize breaches of the integrity of the person, who are criminal treatments. The legitimate inclusion of respect for cultures could not induce a relativism that would prevent female genital mutilation in terms of violation of women's human rights.
5. Nearly ten years after the publication of her last opinion, CNCDH was able to see that progress had been made in France in the fight against female genital mutilation. However, many young girls, the vast majority of whom usually reside in the national territory, are still in danger. This is why it seems necessary to establish a new state of the place of female genital mutilation in France (I) and to analyse the policies of struggle and prevention, but also the protection of victims, their implementation and their effectiveness (II).
I. Status of female genital mutilation in France
Definition and typology
6. Female genital mutilation refers to all interventions resulting in a partial or total removal of women ' s external genitalia or other female genital mutilation for cultural or other reasons and not for therapeutic purposes (5).
7. WHO has established a more detailed classification of the various types of mutilation:
type I: partial or total removal of the clitoris: clitoridectomy;
type II: partial or total removal of the clitoris and small lips, with or without excision of the large lips: excision;
― type III: narrowing of the vaginal orifice with recovery by ablation and sealing of small lips and/or large lips, with or without excision of the clitoris: infibulation;
type IV: other mutilation processes: scarification, stretching...
8. In France, female victims of sexual mutilation have for the vast majority of them (80%) undergoing excision (Type II mutilation). There is also a significant proportion (15%) of women victims of infibulation (Type III mutilation).
Context of practices and consequences
9. Female genital mutilation is usually practised at home, by an excisor, without respect for hygiene or anaesthesia. Until the early 1990s, excisions were most often practised in France. The mediatized trials of excisors in the late 1980s have contributed to a sharp reduction in the practice of female genital mutilation in French territory, but it can be totally excluded that excisators continue to practice in France. It is now on the occasion of a trip to the home country of their parents (6) that girls, French or usually residing in France, are victims of mutilation, sometimes without their parents. As such, the CNCDH recalls that the juvenile judge has, since the law of 9 July 2010 (7), the possibility of enrolling a minor in the file of the wanted persons, for a period of two years, in order to prevent his release from the territory in the event of the risk of sexual mutilation abroad.
10. The practice of female genital mutilation is the expression of deeply rooted and inherent gender stereotypes in patriarchal communities. This practice is one of the means by which patriarchal power is imposed on women. In most societies, female genital mutilation is regarded as a cultural tradition, and is a body marking of community membership:
- they are often considered to be part of the necessary education of a young girl and her preparation for adulthood and marriage;
– they are often motivated by traditions relating to what is considered appropriate sexual behaviour. Female genital mutilation would reduce female libido, preserve prenuptial virginity and marital fidelity. They are associated with cultural ideals of femininity and modesty, according to which young girls are "clean" and "good" after the removal of parts of their anatomy considered "male" or "bad";
– although no religious text prescribes this intervention (8), people often think that it has a religious foundation.
11. The health consequences of women, related to the type of mutilation practised, are of several orders and can intervene at different times of life. The short-term medical consequences are the pain and shock condition resulting from the event. But there are also risks of death by hemorrhage, local infections, sometimes with an increased risk of virus contamination (e.g. HIV), traumatic injury by neighbourhood organs (vessia, anus), the risk of urinary retention. In the long term, medical consequences may be pelvic infections, sterility, menstrual difficulties and problems during pregnancy and childbirth (more frequent perineal tears and fetal suffering), vesico-vaginal or recto-vaginal fistula resulting in in incontinence problems or urinal discomfort (in cases of infibulation).
12. Women ' s sexual mutilations have primarily psychological, sexual and social consequences. Complications on sexuality occur very frequently: anguish at the time of sexual activity startup, alteration of sexual sensitivity, painful syndrome, frigidity. The psychological consequences are also very heavy: behavioral disorders, anxiety, depression, chronic irritability. Childbirth can be a very painful moment, during which the trauma of mutilation is recurring, sometimes leading to a rejection of the newborn. Women ' s sexual mutilation is therefore a serious violation of women ' s sexual and reproductive rights as a central element of their freedoms.
13. Sexual mutilation is a psychological trauma whose victims never completely heal. Thus, clitoral repair, if it represents a true hope for these women, cannot be considered a miracle or a must-see solution, but as a possibility of solving certain complications. Care for women victims of sexual mutilation should not be only surgical. A multidisciplinary care, where gynaecologist, psychologist and sexologist intervene, is necessary to accompany women in their decision-making, help them to update their expectations, make informed decisions, to enable them to reconcile with their bodies and to regain a psychological balance and harmonious sexuality.
Findings
14. It is very difficult in France to estimate the number of mutilated women and girls and even more to determine who are likely to be. However, the results of the "Excision and Disability (ExH)" survey published in 2009 by IED (9) resulted in a more accurate mapping of female genital mutilation and its prevalence (10) in national territory. Although difficult to achieve, the collection of data on the prevalence of female genital mutilation is essential to understanding the extent of female genital mutilation in the national territory. This data also helps to measure progress in the prevention and care of victims. Only objective data could assess the relevance of the policies implemented. The CNCDH deplores that the only data available for France dates back to the years 2004-2007 and that it is not expected to update this data on a regular basis. CNCDH therefore asks the public authorities to improve the collection of primary data on female genital mutilation, but also to conduct quantitative and qualitative studies to better estimate the risks of female genital mutilation in the second and third generations of women from immigration.
15. In thirty years, the available data show remarkable evolution. In the early 1980s, it was estimated that 80 per cent of mothers from countries where female genital mutilation was practised were excised and that 70 per cent of girls from those same countries were excised or risked being. Data from the ExH survey indicate that in the early 2000s 11% of girls whose parents are from countries practising female genital mutilation are excised and three out of ten girls are threatened.
16. France has been on the rise for several years in the fight against female genital mutilation. But, in recent years, women's rights associations have been alerting to disturbing developments of two types. First, variations in migratory flows have led to new populations in French territory, some of which come from countries or regions in which sexual mutilation is practised, which professionals in contact with these populations do not always suspect. It is therefore necessary to revert to the ideas received in terms of the geography of female genital mutilation: they do not concern only the populations of sub-Saharan Africa, but are more widespread and affect very diverse populations. All awareness-raising and training work on the prevalence of female genital mutilation in the world must therefore be carried out among professionals: doctors, midwives, nurses, workers, social workers, teachers, magistrates, etc., so that everyone can have a broad knowledge of the subject and can better prevent its risks.
17. Then, while for several years the associations thought that a whole generation of girls, those born in France, had escaped sexual mutilation, it has been observed for some years that the target has actually changed: adolescent girls become a population at risk. There are many testimonies of young French girls born in France, who are discolated at the time of entering the college and are subjected to forced return to their parents' home country. There they are excised, married by force, and after several years return to France, often pregnant. This new phenomenon calls for special vigilance on the part of the public authorities.
II. - Combating female genital mutilation: preventing, protecting, punishing
18. In France, the problem of sexual mutilation affects various sectors: health, justice, education, social. It is part of a variety of interventions – from prevention to aftercare – and affects different ages of life – from infant to adult woman. It also concerns boys and men, who suffer the loss of family members or are collateral victims of these practices in their sexuality. The professionals involved are therefore very numerous. Health professionals, stakeholders in the migrant reception, youth and child assistance sectors, teachers, law enforcement and magistrates are forced to meet with girls and women in distress suffering from physical and/or psychological complications resulting from mutilation or in situations where they may be mutilated. It is necessary to train, in a specific manner, all of these stakeholders on female genital mutilation so that everyone has a knowledge of the phenomenon and is aware of what conduct he or she is responsible for.
Preventing female genital mutilation and protecting girls at risk of mutilation
19. Health professionals have a crucial role to play in the identification and support of women victims of sexual mutilation, the prevention and enforcement of the law. They should therefore be widely trained in this issue. The hearings showed that, despite the commitments made in 2006 by the Ministry of Health, very few doctors, midwives or nurses were now trained on the issue of female genital mutilation (11). This training must be both:
medically: recognize female genital mutilation, know how to take care of medical consequences and possibly focus on care for reconstruction;
anthropologically: knowledge of at-risk populations, prevalence, cultural justifications of female genital mutilation; and
legal: a reminder of criminal but also ethical provisions.
If Criminal code provides for a special status for physicians who, unlike ordinary citizens, are not required to report a crime (12), may report to the courts minors who are victims or are threatened with sexual mutilation without having their respect for medical secrecy (13). The code of ethics makes the doctor the "child's advocate" (14) and reports an ethical duty. In the face of a minor victim of abuse, the physician "must, except in special circumstances, be aware of, alert the judicial, medical or administrative authorities" (15). Doctors are required to systematically report female genital mutilation on minor children. Finally, it should be recalled that health professionals have an obligation to intervene in the event of immediate risk, to prevent the realization of female genital mutilation, under the terms of theArticle 223-6 of the Criminal Code.
20. The awareness of PMI doctors is a major element since most of the findings of excision are made in PMI. PMI doctors – but also school doctors and forensic doctors – should be subject to a special vigilance obligation (16). CNCDH was able to see that the weight of the prohibitions and representations on female sexuality had an impact on how young girls were taken care of medically, including a lack of eyes on women. Physicians should be encouraged to conduct a systematic genital examination in girls, as is already the case for boys.
21. An important preventive and protective work must be carried out in schools. First, it is necessary to conduct information work with students. Female genital mutilation, and more broadly the issue of violence against women, must be the subject of specific sessions in sexual education courses. These sessions must be articulated with awareness-raising and information activities, organized with the help of child protection services (general council, authorized associations...). They can be programmed as part of the activities carried out by the Education Committee on Health and Citizenship (CESC) to inform the French legal framework prohibiting female genital mutilation, forced marriages, marital rape and the resources that the student can contact. Finally, it is important to remind students that, even abroad, they can benefit, as a French national, from appropriate protection and assistance from the French embassy or consulate. In this regard, it is important to ensure that these services are made aware of this issue, such as French schools abroad.
22. Training work must then be carried out with members of the educational community, teachers and chiefs, but also medical-social personnel. The Act of 9 July 2010 provides that the initial and continuing training provided to teachers should incorporate elements of awareness of violence against women, the CNCDH recommends that the issue of female genital mutilation be integrated into these trainings. More broadly, anyone in the educational community must be sensitized to the issue of female genital mutilation. They are a serious child abuse, therefore, in the event of doubt or situation of concern, any national education staff member must:
• inform the head of establishment;
∙ address the information of concern to the departmental unit of the General Council, in order to establish an assessment and possible protection measures.
The attention of national education staff must focus on girls at the end of primary school or college who are at risk of discollarization. Any discollarization requires reporting to child protection services.
23. The training of police and gendarmes is also an important element. Awareness-raising on female genital mutilation could be included in the training module on child abuse. This training will improve the filing of complaints, the care of victims by judicial police officers and the performance of investigations ordered by investigating judges.
24. It is also necessary to include in training and information activities with immigrant families specific information on female genital mutilation: informing these populations of French legislation and the risks involved, but also of the evolution of legislation and practices in countries of origin. Populations in exile sometimes tend to "refugee" in the practice of traditional identity customs, even though they fade in their country of origin.
International protection
25. In three judgments rendered on 21 December 2012 (17), the Council of State put an end to the jurisprudence of the National Court of the Right of Asylum (CNDA) since 2009 in respect of protection – under asylum (refugee status or subsidiary protection) – of young girls born in France and threatened with excision in case of return to their country of origin. The State Council considered that a girl born in France could, under certain limiting conditions, be recognized as a refugee "at the risk of being exposed to the practice of excision in the country of which she is a national". In fact, the Council considered that, in countries and societies where excision is the social standard, unused children are a "social group" within the meaning of the Geneva Convention of 28 July 1951 and are thus able to obtain refugee status.
26. At the same time, with respect to parents of children at risk of female genital mutilation, the Council of State found that they themselves could claim refugee status or subsidiary protection but on the condition that they personally risk persecution or ill-treatment in their country of origin as a result of their opposition to sexual mutilation. Apart from this, they cannot claim for themselves any protection. What about parents of children who have been granted refugee status, but who themselves cannot claim refugee status? A circular from the Ministry of Interior (18) states that they must be systematically invited by the OFPRA to present themselves at the prefecture of their home with the decision granting their child protection under asylum, in order to apply for themselves a residence permit. The Code of entry and residence of foreigners and asylum (CESEDA) does not provide for the granting of a special title to the parents placed in this situation, prefects are invited to issue, as part of an exceptional admission to the stay, a temporary residence card with the mention "private and family life". In practice, given the time limits for prefecture cases, these provisions place families in difficult living situations: without the right to stay, parents cannot claim neither legal employment nor certain rights relating to the legality of stay. In this regard, the CNCDH recalls that Directive 2011/95/EU of 13 December 2011 broadens the concept of "member of the family", to the "father and mother of the beneficiary of international protection or any other adult who is responsible for it by law or practice in the Member State concerned, where the beneficiary is a minor and unmarried". It invites the legislator to amend the CESEDA accordingly to grant refugee parents full effectivity of the right to asylum.
Punir: the French legal framework
27. There is no specific legal qualification in French law for acts of sexual mutilation. Such a qualification is not desirable to the extent that female genital mutilation is an indisputable violation of physical integrity, which is Criminal code sanction. These practices are currently being prosecuted and punished in criminal matters:
- violence resulting in permanent mutilation or infirmity, an offence punishable by ten years imprisonment and 150,000 euros fine (art. 222-9 of the Criminal Code). The penalties incurred, when the offence is committed against a 15-year-old minor, are fifteen years of criminal detention (art. 222-10, first paragraph, of the Criminal Code) or twenty years if committed by an ascendant or any person who has authority over the minor (art. 222-10, penultimate paragraph, of the Criminal Code)
- violence that resulted in death without intent to give it, offence punishable by fifteen years of criminal imprisonment (art. 222-7 of the Criminal Code), or twenty years of criminal detention in respect of a minor aged 15 (art. 222-8, first paragraph, of the Criminal Code) or thirty years if committed by an ascendant or any person who has authority over that minor (art. 222-8, last article, of Criminal code)
- torture or barbaric acts punishable by fifteen years ' imprisonment (art. 222-1 of the Criminal Code), or twenty years if committed on a 15-year-old or a person particularly vulnerable because of his or her age (art. 222-3, second paragraph, of the Criminal Code).
28. The French law obviously applies to foreigners when mutilation is committed in France, but also when it is committed abroad. In this case, the perpetrator of the crime, whether French or foreign, may be prosecuted in France, provided that the victim is of French nationality (art. 113-7 of the Criminal Code) (19) or, if it is foreign, that it usually resides in France (art. 222-16-2 of the Criminal Code) (20). Parents may be prosecuted as accomplices, under the restrictive conditions of thearticle 113-5 of the Criminal Code.
29. France is the country of the European Union in which there has been the largest number of criminal proceedings for acts of sexual mutilation: about 29 trials since 1979 (21). However, the data are unclear and, in the matter of collecting information on the treatment of female genital mutilation by the judicial services, the CNCDH regrets the lack of a tool to gain a better understanding of the judicial activity in this area: the number of cases registered and continuing cases, the rate of prosecution and the rate of criminal response, the number of convictions and the quantum of sentences imposed.
30. The fight against female genital mutilation is going through a judicial struggle. The fighting carried out at the end of the 1970s by women's sexual mutilation associations recognized the criminal nature of female genital mutilation and the incompetence of the correctional court for the benefit of the court of siege (22). The major trials of the 1980s and subsequent convictions allowed a sharp decline in practice in French territory. But in order for the enforcement of sentences to play its role of prevention and reparation for victims, it is important that the prosecutions be effectively initiated and that the penalties imposed are deterrent (23). The CNCDH notes a trend towards the correction of rape cases, and hearings raise concerns that the same may be true for female genital mutilation (24). This process of judicial correctionalization (25) should be used only with discernment, after the agreement of the victim, fully informed of the procedural consequences of his choice, including the penalties incurred.
31. Given the trauma experienced by the victims of sexual mutilation and the difficulty they may experience in bringing themselves to the civil party against members of their own family, it is essential that they be given the support of the judicial authority. In this connection, the CNCDH invites the seals to include the issue of female genital mutilation in the next circular on general criminal policy instructions. These instructions provide a real awareness of some of the issues raised by prosecutors, and they have already demonstrated their effectiveness in other areas, such as domestic violence.
32. The aim is also to ensure that the law is applied to all and all by improving the training of judges in the area of female genital mutilation. Currently, the issue of female genital mutilation is too cross-cutting and is not subject to specific development, both in the initial training programme for justice auditors and in the ongoing training programme for judges.
Conclusion and recommendations
33. For 30 years in France, many efforts have been made to combat female genital mutilation. These efforts have helped to reduce the prevalence of female genital mutilation in France, and their practice in the national territory has almost disappeared. However, many girls and girls are still at risk of being maimed, especially during a trip abroad. CNCDH was also able to note a certain shortcoming in the mobilization of public authorities against female genital mutilation. It is therefore essential to recall that much remains to be done to prevent them.
34. Female genital mutilation, which is both violence against women and child abuse, must be treated as such. It is necessary to make women ' s words visible and legible about female genital mutilation: this violence, in fact invisible, creates a social handicap and encloses victims in sexual inequality. Issues related to their identity, sexual life and violence are issues requiring the implementation of specific actions. As such, the CNCDH recommends that:
― training professionals in the medical, judicial, social and social sectors of national education, as part of initial and ongoing training. This training will need to be done through the creation and systematic integration of a module on female genital mutilation in training programs. Professionals should be trained on the geographic, social, family context of women and families concerned and the impact of female genital mutilation, not only on health, but also on sexuality and affective life. A joint resource guide for all professionals, on the basis of what has already been done for doctors (26), should be disseminated in a systematic and updated manner to complete ongoing training;
better informing in the school environment: it is necessary to integrate, in sexuality education sessions and in sexual violence prevention activities, awareness of female genital mutilation;
― launch a new national campaign for information and prevention of female genital mutilation. This campaign, to be effective, will have to be the subject of joint work with field actors;
― improve the collection of statistical data on female genital mutilation to assess the impact of prevention campaigns and training of professionals. These statistics should also allow for the development of a work of reflection and analysis on populations affected or threatened with mutilation and their evolutions;
– to complete the process of ratification of the Istanbul Convention (27), which aims in particular to establish international cooperation in the fight against female genital mutilation. This is particularly important given the transnational dimension of female genital mutilation. This cooperation is essential to facilitate the protection of young girls, but also to facilitate the prosecution of perpetrators and accomplices of these serious acts;
act internationally to promote the elimination of female genital mutilation in countries of origin of immigrant women. This must be both diplomatic, to encourage the adoption of legislation prohibiting female genital mutilation, and financially by providing support to local associations to combat female genital mutilation.
(Not unanimously adopted.)
