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The child is made to squat on a stool or mat facing the circumciser at a height that offers her a good view of the parts to be handled....[A]dult helpers grab and pull apart the legs of the girl. If available, this is the stage at which a local anaesthetic would be used.There have been international efforts since the 1970s to persuade practitioners to abandon FGM, and it has been outlawed or restricted in most of the countries in which it occurs, although the laws are poorly enforced.Since 2010 the United Nations has called upon healthcare providers to stop performing all forms of the procedure, including reinfibulation after childbirth and symbolic "nicking" of the clitoral hood.The cutter is usually an older woman, but in communities where the male barber has assumed the role of health worker he will perform FGM too.
Procedures differ according to the country or ethnic group.Type III is found largely in northeast Africa, particularly Djibouti, Eritrea, Ethiopia, Somalia, and Sudan (although not in South Sudan).According to one 2008 estimate, over eight million women in Africa are living with Type III FGM.The practice is rooted in gender inequality, attempts to control women's sexuality, and ideas about purity, modesty and beauty.
It is usually initiated and carried out by women, who see it as a source of honour, and who fear that failing to have their daughters and granddaughters cut will expose the girls to social exclusion. They can include recurrent infections, difficulty urinating and passing menstrual flow, chronic pain, the development of cysts, an inability to get pregnant, complications during childbirth, and fatal bleeding.The surgical infibulation of women came to be known as pharaonic circumcision in Sudan, but as Sudanese circumcision in Egypt.