2.1 Introduction

This chapter considers effective ways to abolish female genital mutilation (FGM), sometimes called ‘cutting’. As shown in Sect. 2.2, the international community has been trying to end this practice for over 60 years since 1952. Although FGM rates among African children under the age of 15 years have declined dramatically over the past two decades, FGM is still prevalent in some communities.

Before discussing the principal arguments, I briefly outline the concept of FGM in the context of cultural relativism and local diversity in Africa.

2.1.1 FGM and Cultural Relativism

In some situations, people who tolerate FGM give the following responses to any critique of its practice: ‘Are you aware of its cultural relativism?’ or ‘Don’t you think we, developed countries, must respect FGM as a part of African culture?’.

They, cultural relativists, do not seem to be aware that FGM is a violation of children’s and women’s rights due to its potential to cause serious medical complications. There is no reason a practice that can kill women and girls should be termed ‘culture’.

The biggest problem with FGM is that it has been principally practiced on girls under the age of 18, who do not understand the risks of FGM and are unable to provide informed consent.Footnote 1 Regardless of the severity of its forms, FGM may cause psychological trauma stemming from pain, shock, and the use of physical force by those performing the procedure. Many women have described FGM—even type I, that is, clitoridectomy, or what may be called the Sunna style—as a traumatic event, which poses a sustained threat to their safety, even in adulthood.Footnote 2

In areas where type III FGM (infibulation) is common, medical staff whom I interviewed are well aware of the problems it causes before and during pregnancy.Footnote 3 Why, then, do people in these areas continue to practice FGM if it can rob women of their lives? A female medical staff member said, ‘FGM is just a tool for men to control women’. In many societies in Africa, FGM has been used to make men masters of female sexual function, and historically, to reinforce the idea that wives are their husbands’ property, as is typical of patriarchal societies. ‘To counter deeply rooted gender-based discrimination that often results from patriarchal attitudes and related social norms’Footnote 4 is required to achieve Goal 5 of the Sustainable Development Goals (SDGs), that is, to achieve gender equality and empower all women and girls. The international community thus needs to abolish FGM, a tool to maintain patriarchal values, and it needs to dismiss the opinion of cultural relativists. Practices like FGM, Sati and foot binding etc., that kill or potentially kill women and girls, should not be termed ‘culture’.

2.1.2 Local Diversity in Africa

When researchers talk about FGM in Africa, local diversity should be emphasised. In Africa, there are thousands of ethnic groups in 54 countries (55 if we include the Sahrawi Arab Democratic Republic in the Western Sahara). Not all ethnic groups follow the tradition of FGM. Of those that do, some have abolished their tradition of cutting and others have changed the common forms of FGM, while others, still, have continued practicing it. In many places where FGM prevails, local people have already decided on whether to abolish it, and whether to change the common form of FGM, as revealed in this book. Even if FGM is a part of African culture, cultural values are not immutable and do generally change over time. Nowadays, many community leaders in Africa do understand the risk of FGM. As shown in Sect. 2.1, FGM rates among African children under 15 years of age have declined dramatically over the past two decades. Furthermore, as seen in Sect. 2.2 and other chapters in this book, in some places the severe forms of practice are decreasing, and new, harmless substitutions have been introduced for the younger generations in Africa.

While girls in some communities are excised without their consent due to their young age, girls in the Gusii community, where prevalence rates are the third highest in Kenya according to the Kenya Demographic and Health Survey 2014 (2014 KDHS; KNBS 2015), actively request FGM (see Chap. 5). While girls in the Somali community, where prevalence rates of FGM are the highest in Kenya (KNBS 2015: 333–334), are generally cut when they are between the ages of 6 and 9,Footnote 5 girls in community A (see Chap. 6) are excised before their marriage. Community A also practices different forms of FGM. The traditional style of FGM followed by community A is type II. However, type I (the Sunna style) and the kati-kati style have been recently introduced. Therefore, girls can choose between three styles. Kati-kati is a Kiswahili word that means ‘in the middle’ and refers to the cutting in the middle of the clitoris. The kati-kati style is now the most popular among secondary school girls.

People who regard FGM as a culture that should be maintained, ought to understand the local diversity in Africa, considering that many families have taken the decision to refrain from cutting their girls, and many communities have modified their practice of FGM from severe to milder forms.

2.1.3 The Aim of This Chapter

As explained above, it is natural for the international community to adopt a zero tolerance policy towards FGM because of its potential to cause serious medical complications and its role in perpetuating patriarchal values. While the decrease in FGM rates and changes in its common forms are considered great achievements by the zero tolerance policy, FGM has not been completely abolished. Why do people continue to practice FGM? Further, is the zero tolerance policy effective in the abolishment of FGM? To answer these questions, this chapter focuses on three topics.

  1. 1.

    Zero tolerance policy in the international community.

  2. 2.

    Zero tolerance policy in Kenya, and FGM in the Somali community.

  3. 3.

    Ways of abolishing FGM beyond the zero tolerance approach.

2.2 Zero Tolerance Policy in the International Community

Why must we abolish all forms of FGM? As already mentioned, even mild FGM (type I) can cause psychological trauma, which can threaten safety in adulthood. Furthermore, FGM is the product of a patriarchal system, and thus an obstacle to achieving Goal 5 of the SDGs.

2.2.1 Efforts of the International Community

The international community has made significant efforts to abolish FGM (Table 2.1). The seminar on ‘Harmful Traditional Practices Affecting the Health of Women and Children’ was held in Khartoum, Sudan in 1979, where, in addition to the presentation by F. Hosken, reports of several countries practicing FGM (Egypt, Ethiopia, Kenya, Nigeria, Somalia, Sudan, and so on) were presented by other speakers showing the details of the zero tolerance policy. The discussion and recommendations back then were quite similar to the ones currently being held.

Table 2.1 International, regional, and local efforts to end FGM (from 1952 to 2015, adoption of SDGs)
Full size table

The seminar did not question all the traditional practices. In fact, one of the participants classified traditional practices into three categories: harmful, harmless, and useful. The recommendations of this seminar ‘were proposed in support of useful practices and to abolish harmful ones. Special recommendations were made to correct harmful practices and to replace them with positive actions to promote better health’.

Given that FGMFootnote 7 was classified as a harmful practice, four recommendations were made in this seminar:

  1. (i)

    Adoption of clear national policies to abolish female circumcision

  2. (ii)

    Establishment of national commissions to coordinate and follow up the activities of the bodies involved, including, where appropriate, the enactment of legislation prohibiting female circumcision

  3. (iii)

    Intensification of general education of the public, including health education at all levels, with special emphasis on the dangers and the undesirability of female circumcision

  4. (iv)

    Intensification of education programmes for traditional birth attendants, midwives, healers, and other practitioners of traditional medicine, to demonstrate the harmful effects of female circumcision, with a view to enlisting their support along with general efforts to abolish this practice.

The seminar presented the reasons for carrying out FGM as follows:

  • Initiation into ‘adulthood’

  • Proof of virginity before marriage

  • Proof of virginity related to the payment of bride price

  • To reduce sexual desire in the girl and to protect the young girl from promiscuity.

With regard to religion, a speaker from Egypt mentioned that FGM was practiced by both Muslims and Christians, and that ‘there is no religious basis for the practice’. It only fits into ‘the people’s value system about virginity and family honour’.

This seminar presented the problems of FGM as follows:

  • FGM is ‘performed on female children, mostly at an age too young to be able to make any decisions on their own’. The operations are performed at a younger age because parents are afraid their daughters will refuse to submit to them when they are able to decide for themselves.

  • FGM incurs a heavy cost (mentioned by Hosken):

    1. 1.

      The costs due to loss of life

    2. 2.

      The costs incurred by making childbirth more hazardous

    3. 3.

      Costs of work time lost, health insurance, and social security

    4. 4.

      Costs of operations performed in hospitals.

  • FGM also leaves psychological scars on the woman. When women perceive themselves as victims of outdated customs and male prejudice, this results in negative attitudes about themselves.

This seminar also presented the measures against FGM as follows:

  • Legislation prohibiting FGM

  • Abolishing FGM through education given that health education seems to be the most effective method to stop the practice

  • Education for the practitioners of FGM (like the daya in Egypt), and a guarantee for the practitioners’ other sources of livelihood

  • Health practitioners, social workers, nurses, family planning workers, feminists engaged in education and outreach programmes, and educated people in general should form the first audience of instruction. They should be informed about the practice, the extent, and the reasons of its perpetuation, and how traditional and erroneous beliefs of women and women’s health and sexuality can be modified. It is important to engage this group first because of their prospective leadership roles.Footnote 8 (WHO Regional Office for the Eastern Mediterranean 1979).

The policy against FGM has not changed much since the early days. Readers can find the same discussions and recommendations as those mentioned above in the documents. Although many African countries have anti-FGM laws and anti-FGM programmes, not much has been achieved yet in the promotion of secondary and higher education, higher prevalence of health education, and the reduction of patriarchal values.

2.2.2 Universal Declaration of Human Rights

The international community considers FGM to be a violation of children’s and women’s rights. Universalists claim that FGM violates the fundamental universal human rights under the Universal Declaration of Human Rights (UDHR) (UNFPA 2014), which is regarded as the customary international law that binds all nations as follows:

  • The right to be free from discrimination (Article 2)

  • The right to life (Article 3)

  • The right to physical integrity (Article 1)

  • The right to health (Article 25)

  • The right not to be subjected to torture or degrading treatment or punishment (Article 5).

Article 26 (right to education) can also be included because type III FGM can retain menstruation, cause strong pain, and prevent girls from going to school (Sect. 2.2).

2.2.3 SDGs

As mentioned, to achieve Goal 5 of SDGs (achieve gender equality and empower all women and girls), it is required ‘to counter deeply rooted gender-based discrimination that often results from patriarchal attitudes and related social norms’.

Target 5.3 of Goal 5 of the SDGs aims to ‘eliminate all harmful practices’, including FGM (United Nations Statistics Division 2021a). SDGs have been adopted by all 193 United Nations member states. Nawal El Saadawi, an Egyptian feminist, psychiatrist, author, and campaigner against FGM, pointed out that FGM is the product of a patriarchal system (El Saadawi 2015) and indeed African women whom I have met have confirmed that it is a tool for men to control women. As such, the international community needs to abolish it.

2.2.4 Changes in Africa

The prevalence of FGM in Africa is shown in Chapter 1 (see Fig. 2). As mentioned, there, not all ethnic groups in Africa follow this tradition. Some groups with the tradition of FGM have already decided to abolish it, while others continue to practice it despite the zero tolerance policy of their governments and the international community.

According to the news in November 2018, FGM rates among African children under 15 years of age have shown a ‘huge and significant decline’ over the past two decades (“Mixed messages on FGM” 2018). In East Africa, the prevalence decreased from 71.4% in 1995 to 8.0% in 2016. In North Africa, it decreased from 57.7% in 1990 to 14.1% in 2015. In West Africa, it decreased from 73.6% in 1996 to 25.4% in 2017 (Kandala et al. 2018).

As shown in Table 2.1, one of the targets of the ‘Regional Plan of Action to Accelerate the Elimination of Female Genital Mutilation in Africa (1996–2015)’ is for ‘the proportion of females in the age group 1–20 years undergoing female genital mutilation to be reduced by 40% by the year 2015’. For those under 15 years of age, this target can be said to have been achieved.

While the efforts of the international community and local NGOs have paid off as we receive this good news for children under 15 years, researchers should highlight the fact that the zero tolerance policy has not succeeded in abolishing FGM completely.

2.3 Zero Tolerance Policy in Kenya and FGM in the Somali Community

2.3.1 Zero Tolerance Policy in Kenya

This section outlines the zero tolerance policy in Kenya. UNFPA-UNICEF stated that the ‘Government of Kenya recognizes that FGM/C is a fundamental violation of the rights of women and girls. Decrees and bans against FGM/C were issued in 1982, 1989, 1998 and 2001’ (UNFPA-UNICEF 2013).

The Children Act of 2001 prohibits FGMFootnote 9 and other harmful practicesFootnote 10 that ‘negatively affect the child’s life, health, social welfare, dignity or physical or psychological development’ (Article 14), and imposes a penalty of ‘imprisonment not exceeding twelve months’, or ‘a fine not exceeding fifty thousand shillings or to both such imprisonment and fine’ (Article 20) (Republic of Kenya 2001, revised 2012).

The Constitution of Kenya 2010 also guarantees women and children the right to life (Article 26), the right to equality and freedom from discrimination (Article 27), the right to dignity (Article 28), and the right to freedom and security of the person (Article 29). Article 44 prevents any person from compelling ‘another person to perform, observe, or undergo any cultural practice or rite’ while Article 53 guarantees every child the right to be protected from ‘harmful cultural practices’ (Republic of Kenya 2010).

Since 2011, the law ‘Prohibition of Female Genital Mutilation Act’ prohibits FGM from being performed on women of any age. ‘A person, including a person undergoing a course of training while under supervision by a medical practitioner or midwife with a view to becoming a medical practitioner or midwife, who performs female genital mutilation on another person commits an offence’. If the person above ‘causes the death of another, that person shall, on conviction, be liable to imprisonment for life’ (Article 19). ‘A person who commits an offence under this Act is liable, on conviction, to imprisonment for a term of not less than 3 years, or to a fine of not less than two hundred thousand shillings, or both’ (Article 29) (Republic of Kenya 2011).

2.3.2 FGM in the Somali Community

I now explain why Somali people in Kenya continue to practice FGM, and illustrate the efforts of local people to abolish FGM. More than 40 ethnic groups comprise Kenya’s population, with the Somali accounting for 5.8% of the country’s population (2019 est.). Most Kenyans are Christians (85.5%, 2019 est.) (CIA 2021), but most Somalis are traditional pastoralists and Muslims who follow the Shafi’i school (Abdullahi 2017: 132). According to the 2014 KDHS, the FGM prevalence rate in Kenya is 21%, but among the ethnic groups that practice FGM in Kenya, the Somali women showed the highest prevalence rates at 93.6% (KNBS 2015: 333).

Percentage distribution of Somali women aged 15–49 years who underwent FGM by type of FGM:

  • Type I: 1.4%

  • Type II: 64.6%

  • Type III (infibulation): 32.3%

  • Do not know/missing: 1.6% (KNBS 2015: 333).

Percentage distribution of Somali women aged 15–49 years who underwent FGM by age:

  • Under 5 years old: 5.2% (including women who reported having FGM during infancy but did not provide a specific age)

  • 5–9 years old: 72.7%

  • 10–14 years old: 18.9%

  • over 15 years old: 0.2%

  • Do not know/ missing: 2.9% (KNBS 2015: 335).

The 2014 KDHS also shows the percentage of girls aged 0–14 years who underwent FGM according to age and mother’s background. In total, 36% of girls whose mothers are Somali underwent FGM. Of them, 1.5% were younger than 5 years; 40.0%, 5–9 years; and 76.4%, 10–14 years (KNBS 2015: 337). These figures show that even after the Children’s Act of 2001 which prohibits FGM for children under 18 years, most Somali girls have still undergone FGM. Somali girls in Kenya are generally cut when they are between 6 and 9 years old. These girls are too young to understand and consent to the risk of FGM.

The effects of FGM are as follows:

  • Excessive bleeding

  • Infection (including HIV/AIDS)

  • Mental trauma

  • Delay in delivery causes the child and/or mother to die.

Type III FGM especially causes strong pain because menstrual blood is unable to flow out, and it prevents girls or women from going to school or work. FGM is a big obstacle to women’s and girls’ empowerment.

2.3.2.1 Reasons for Practicing FGM

FGM is extremely harmful to wives and daughters. Why do Somali people still practice it?

Generally, FGM is practiced for a variety of reasons in Africa. In some places it is believed that girls must be cut to control their libido. In others, there is a perception that intact girls are dirty or ugly, that the clitoris could kill their husband during intercourse or kill their first-born child at birth, or that FGM is proof that they can endure the pain of childbirth and so on. FGM is also regarded as a rite of passage into adulthood (see Chapters 5, 6 and 7).

The most common reason the Somali continue practicing FGM is for proof of girls’ virginity. Traditionally, girls are forced to marry at around 14 years old by their fathers and FGM is seen as a prerequisite for marriage because Somali men view it as proof of virginity. There are other reasons for poor families to continue this practice, such as bride-price, exchange of bride with livestock, money and so on, all of which are deeply rooted in patriarchal values. With regards to the bride-price, the father of a girl who is not excised will not be paid the bride-price in full. Poor families need the bride-price for daughters not only to maintain their daily lives but also to pay the bride-price for their sons’ brides.

Somali people also practice FGM because of peer pressure. According to the 2014 KDHS, about 82.7% of women and 87.0% of men (15–49 years old) feel that FGM is required by the community (KNBS 2015: 341).

Another reason is their religious beliefs. While some Somalis, who were educated and spoke English, told me that FGM had nothing to do with Islam, most Somali who live in remote areas still believe that FGM is required by Islam. According to the 2014 KDHS, 82.3% of Somali women and 83.4% of Somali men believe that their religion requires FGM (KNBS 2015: 340).

Among the four Sunni schools, only the Shafi’i school considers the practice obligatory for women. The Somali people mainly adhere to the Shafi’i school, which was historically introduced through its connection with Yemen Islamic education centres.

Most people who live in remote areas do not know which school they belong to, and simply follow the preachings of religious leaders. Thus, people will change their mindset only if the religious leaders change their interpretation. As shown in Sect. 2.3, because regional and national meetings of Muslim religious leaders have been held to discuss FGM (UNFPA 2010), some changes can be found in the Somali community.

In conclusion, I summarise what the educated Somali told me during interviews:

  • FGM is harmful for women.

  • FGM has nothing to do with Islam.

  • Recently, the type of FGM has changed from type III to type I in town, because a local NGO founded by local Somali women has persuaded local religious leaders not to accept type III and to abolish FGM.

2.3.2.2 Change of Common FGM Forms

The efforts of local people to abolish FGM should be emphasised. Many women’s groups have made efforts to abolish FGM in this area. For more than 20 years, an NGO which was founded by local Somali women has tried to persuade local religious leaders not to accept type III and to abolish FGM. As a result, several effects were observed:

Firstly, the prevalence of FGM has decreased. A small survey by researchers in 2018 showed that FGM prevalence among Somalis in Garissa, the former capital of North-Eastern Province, dropped to 62.5%. They insisted that the reason for this drop is partly the high awareness of the anti-FGM law (Derow et al. 2021).

Secondly, local NGOs have achieved a change in the common form of FGM. According to the 2014 KDHS, among girls under 15 years of age with Somali mothers, the prevalence of type I or II is 88%, and that of type III is 11% (KNBS 2015: 338). Currently, most Somali young girls have only gone through type I or II FGM.

Although this is a great improvement, it must be realised that many women have described even type I FGM as a traumatic childhood event, therefore, more efforts to abolish even type I FGM need to be undertaken.

2.3.2.3 The Negative Effect of Anti-FGM Law on Somali Women’s Health

Kenya outlawed FGM in 2011. The zero tolerance policy of the Kenyan government had a negative effect on many women in the Somali community. A married woman who lives in the capital, Nairobi, said the following:

Our Somali community don’t go to government hospitals to give birth due to their conditions (FGM/C). They go to private facilities because in government facility, the health personnel will be shocked and even say this one has been cut.

Married woman, IDI, Eastleigh (Kimani et al. 2020: 7)

The anti-FGM law and the zero tolerance policy discouraged Somali pregnant women who were cut when they were young from seeing non-Somali medical doctors at public hospitals and clinics. Such women are thus deprived of their rights to healthcare services. This situation is an obstacle to achieving Goal 3 of the SDGs, which aims to ‘reduce the global maternal mortality ratio’ (UNGA 2015).

2.4 Ways of Abolishing FGM—Beyond the Zero Tolerance Approach

2.4.1 The Role of Religious Leaders

Kenya outlawed FGM in 2011 and adopted the zero tolerance policy, but Somali people have continued the practice. Why could the anti-FGM law not completely abolish FGM in this area? Can it be said that the zero tolerance policy will be effective in abolishing the practice completely?

To abolish FGM, researchers and activists need to consider how to change people’s mindset. According to the 2014 KDHS, 81.2% of Somali women and 79.8% of Somali men (aged 15–49 years) believe that FGM should continue (KNBS 2015: 343). In this area, religious leaders have a strong influence on the behaviour of ordinary people. According to a report by UNFPA (2010), several regional and national meetings with Muslim religious leaders and scholars had taken place over the years due to the efforts of local NGOs, and after they were made to understand the medical harm caused by type III (infibulation), scholars took a stronger stand against FGM. This report anticipated future problems that would arise because religious leaders and scholars had not yet reached a firm consensus on abolishing all forms of FGM, and because some leaders did allow for less severe cutting of the clitoris, or light pricking to draw blood (UNFPA 2010).

Approximately 10 years have passed since the publication of this report. Religious leaders’ attitudes have changed people’s mindset, and parents tend to choose type I/II for their daughters in this area.

Recently a renowned Islamic scholar in Garissa claimed that FGM ‘is purely a cultural practice sneaked into religion to attract a larger audience’ (Wangeci 2017). Although it is expected that religious leaders will agree on abolishing FGM completely in the near future, it will take a little time. Until then, the ‘positive deviance’ approach will be more effective than the zero tolerance policy in changing people’s mindset.

2.4.2 Positive Deviance Approach

The positive deviance approach is ‘a methodology that focuses on individuals who have ‘deviated’ from conventional societal expectations and explored—though perhaps not openly—successful alternatives to cultural norms, beliefs or perceptions in their communities’ (Masterson and Swanson 2000: 13).

International NGOs including the ‘Centre for Development and Population Activities’ and local NGOs in Egypt showed that this ‘positive deviance approach’ had succeeded in changing people’s mindset in Egypt, where 97% of all women were cut at that time. Local NGOs identified the remaining 3% of women who were not cut as positive deviants. In fact, the fathers, mothers, and husbands of these women were also labelled as positive deviants. This project (1998–2000) not only built the capacity of individuals and local organisations, but also provided the foundation for ongoing community-based exploration, reaffirming the important development principles of sustainability and ownership. The positive deviance approach also showed that positive role models for FGM abandonment already exist within communities and that these role models can take on important positions as advocates and strategists to end FGM (Masterson and Swanson 2000).

UNFPA (2010) mentioned an excellent point. Some ‘parents of the younger girls are avoiding the cut altogether. Although the most recent DHS data only register a drop in prevalence of 1.5% (97.5 in 2008/2009 compared to 99% 5 years earlier), ZeinabFootnote 11 pointed out that that includes all girls and women aged 15–49 years, and does not highlight changes occurring in the youngest generation’. This means that we can find positive deviants in the Somali community as well.

The zero tolerance policy being conducted by the United Nations and African governments will not achieve success without first persuading local people not to practice FGM. While religious leaders have great power to change people’s mindset, positive deviants also play an important role as positive role models against FGM in the community.

As mentioned before, according to the 2014 KDHS, 82.7% of women and 87.0% of men (15–49 years old) believe that FGM is required in the community (KNBS 2015: 341), while 82.3% of Somali women and 83.4% of Somali men believe that their religion requires FGM (KNBS 2015: 340). This means that at least 10% of the Somali can be expected to be positive deviants in FGM abandonment. The positive deviance approach may provide an excellent tool for the advocacy of FGM abandonment in the Somali community.

2.5 Conclusion

While the decrease in FGM rates and changes in the common types of FGM are considered great achievements by the zero tolerance policy, FGM has not yet been completely abolished. Why do people continue FGM? Is the zero tolerance policy effective in abolishing FGM? To answer these questions, this chapter focused on three topics.

  1. 1.

    Zero tolerance policy in the international community

  2. 2.

    Zero tolerance policy in Kenya, and FGM in the Somali community

  3. 3.

    Ways of abolishing FGM beyond the zero tolerance approach.

It was shown that the zero tolerance policy and anti-FGM law alone could not change the patriarchal mindset expecting girls to be cut. To abolish FGM completely, the positive deviance approach appears more effective than the zero tolerance policy. I hope to work with local NGOs using this approach to change people’s mindset in order to abolish FGM.

In addition to abolishing patriarchal values, eradicating poverty is crucial in the abolishment of FGM. Currently, the father of a girl who is not excised will not be paid the bride-price in full. In other words, to keep their status as masters of the house, to feed their families and prepare the bride-price for their sons’ brides, fathers in poverty accept FGM. Without eradicating poverty, FGM will not be abolished.

Nawal El Saadawi argued in her book, The Hidden Face of Eve: Women in the Arab World,

I disagree with those women in America and Europe who concentrate on issues such as female circumcision and depict them as proof of the unusual and barbaric oppression to which women are exposed only in African or Arab countries. I oppose all attempts to deal with such problems in isolation, or to sever their links with the general economic and social pressures to which women everywhere are exposed, and with the oppression which is the daily bread fed to the female sex in developed and developing countries, in both of which a patriarchal class system still prevails. Women in Europe and America may not be exposed to surgical removal of the clitoris. Nevertheless, they are victims of cultural and psychological clitoridectomy. (El Saadawi 2015: XLVI–XLVII)

Although El Saadawi did not mention Japan above, I argue that Japanese women are also ‘victims of cultural and psychological clitoridectomy’. Japan is also a patriarchal society, and many Japanese women, especially in rural areas, still feel like they are treated as the property of their husbands’ families. In fact, many Japanese still use the word ‘master’ to mention their own or other women’s husbands, suggesting that married women belong to the husband’s family in Japanese society.Footnote 12

As the case of Japan shows, it is difficult to change patriarchal beliefs. Although the situation in Japan and in Africa are completely different, both of them maintain the machine of a patriarchal society and it may require time to dismantle it, but it is surely attainable.