5 June 2018

Curbing the Cut: The Somaliland Dilemma

Guest Blog from Richard A. Powell, Mohamed Yussuf, and Bettina Shell-Duncan, Population Council “Evidence to End FGM/C”

For decades female genital mutilation/cutting (FGM/C) has been debated in dozens of countries around the world. But it is in Somaliland, in the Horn of Africa, where a recent fatwa, or religious edict, has rekindled a passionate debate of ‘zero tolerance’ versus ‘acceptable harm minimization’.1

On February 6 the Ministry of Religious Affairs in Somaliland issued a ban on the most severe form of FGM/C: removal of the external genitalia and suturing the vagina nearly completely closed (commonly known as infibulation or Type III FGM/C). Issued on the International Day of Zero Tolerance, this fatwa added to the ongoing discussion as to whether there is a religious or cultural basis for this practice.  At the same time, however, the fatwa declared that a nicking form of FGM/C (cutting the tissue surrounding the clitoris to draw a single drop of blood, but no removal of tissue or permanent anatomical alterations)is obligatory (waajib).2  This mandate falls short of total abandonment of FGM/C,  and reawakens the polarizing debate between zero tolerance of all forms of FGM/C versus harm minimization.

But just as important, it reflects recent changes in the practice that appear to be happening in Somaliland. A new Population Council study conducted in two regions of Somaliland, held in-depth discussions with 252 married and unmarried men and women. These interviews revealed that change is happening in this land where FGM/C prevalence, and its most severe type has been nearly universal (98%).

The discussions revealed a discernible shift away from infibulation to “sunna” (Arabic for duty, and a commonly used term for non-infibulating forms of FGM/C like pricking), especially in urban areas.   The study also documented that FGM/C is being conducted at younger ages, now commonly among girls between 5-8 years.

Interviewees seemed to have a mixed understanding of what constitutes “abandonment”, with many reporting they had or would abandon FGM/C, when in reality they had or were committed to abandoning infibulation in favour of a sunna form of cutting.

While the research gives us an idea of what change is happening on the ground, it and the fatwa still do little to resolve the dilemma for many Somaliland campaigners: do we support the fatwa because it seeks to minimize harm, or do we oppose it because it does not entail total abandonment?

On the one hand, there is the argument that minimized harm in the form of a non-infibulating sunna cut (especially pricking) is inherently more acceptable in terms of its physical, sexual, and psycho-social impacts than the much more invasive infibulating form.  There is a belief that minimized harm is an interim solution that is the ‘lesser of two evils’ and a step toward abandonment.

On the other hand, some abandonment advocates adhere to a zero-tolerance position: all forms of cutting, regardless of how minimal, are an unacceptable human rights violation and must be condemned, not condoned. They argue there is little evidence that acceptance of pricking is a step toward eventual abandonment of FGM/C.  In this camp, the fatwa is unacceptable; the integrity of the girl child should not be sacrificed on the altar of pragmatism.

Opponents of the minimized harm approach argue that regulations allowing less severe forms will serve to entrench the practice and undercut efforts aimed at total abandonment.  By creating the false impression that FGM/C can be performed safely, whether by reducing the type of cutting, medicalizing the practice or performing it on young girls who are believed to heal more quickly, the ultimate goal of protecting the rights of girls and women by eliminating all forms of FGM/C is thwarted, this reasoning goes.2

The debate has been joined by the former Somali Minister of Health, Education, and Social Services, Maryan Qasim, who welcomed the fatwa but added on her Twitter account: “A good step forward towards eradicating this harmful cultural practice that has harmed generations of Somali women. Time for FGM to end.”

What may be useful at this time is evidence that will help to answer such questions as: what are the short- and long-term consequences of pricking compared to other forms of cutting?  Does a shift to pricking undermine efforts to eliminate all forms of FGM/C?  Or does it create momentum for change in the practice and accelerate the transition toward total abandonment?  Programs seeking to end FGM/C altogether will subsequently be able to make more rigorous arguments against pricking on health grounds and if it at all plays a staging role in the practice’s abandonment.  Lastly, and crucially, can religious leaders be persuaded to advocate for ending FGM/C themselves?

If the current dialogue is not underpinned by reliable data, the antagonistic debate will continue unabated. Based upon polemics and anecdotes rather than grounded in empirical realities, the Somaliland dilemma will never be adequately resolved.


Richard A. Powell, Mohamed Yussuf, and Bettina Shell-Duncan are members of the UK Government’s Department for International Development-funded project, “Evidence to End FGM/C: Research to Help Girls and Women Thrive,” coordinated by Population Council. Powell and Yussuf are the authors of the Population Council report entitled Changes in FGM/C in Somaliland: Medical Narrative Driving Shift in Types of Cutting(January 2018).  Shell-Duncan is a professor of anthropology at the University of Washington in Seattle and a co-author of two recent studies on the medicalization of FGM/C


  1. Kimani S, Shell-Duncan B. Medicalized female genital mutilation/cutting: Contentious practices and persistent debates. Current Sexual Health Reports, 2018; 10(1): 25-34 https://doi.org/10.1007/s11930-018-0140-y
  2. Bhalla N. Somaliland issues fatwa banning female genital mutilation. Reuters, February 2, 2018. https://www.reuters.com/article/us-somalia-fgm-fatwa/somaliland-issues-fatwa-banning-female-genital-mutilation-idUSKBN1FR2RA