Types of female genital mutilation

Female genital mutilation (FGM) comprises all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons.

In 1997, WHO classified female genital mutilation into four different types. These were subsequently subdivided to capture the subtypes of FGM in more detail.

The four major types of FGM, and their subtypes, are:

• Type I. Partial or total removal of the clitoral glans (the external and visible part of the clitoris, which is a sensitive part of the female genitals, with the function of providing sexual pleasure to the woman), and/or the prepuce/clitoral hood (the fold of skin surrounding the clitoral glans). The following subdivisions can be used:
• Type Ia. Removal of the prepuce/clitoral hood only.
• Type Ib. Removal of the clitoral glans with the prepuce/clitoral hood.

• Type II.  Partial or total removal of the clitoral glans and the labia minora (the inner folds of the vulva), with or without removal of the labia majora (the outer folds of skin of the vulva). The following subdivisions can be used:
• Type IIa. Removal of the labia minora only.
• Type IIb. Partial or total removal of the clitoral glans and the labia minora (prepuce/clitoral hood may be affected).
• Type IIc. Partial or total removal of the clitoral glans, the labia minora and the labia majora (prepuce/clitoral hood may be affected).

• Type III. (Often referred to as infibulation). Narrowing of the vaginal opening with the creation of a covering seal. The seal is formed by cutting and repositioning the labia minora, or labia majora. The covering of the vaginal opening is done with or without removal of the clitoral prepuce/clitoral hood and glans (Type I FGM). The following subdivisions can be used:
• Type IIIa. Removal and repositioning of the labia minora.
• Type IIIb. Removal and repositioning of the labia majora.

• Type IV. All other harmful procedures to the female genitalia for non-medical purposes, for example pricking, piercing, incising, scraping and cauterization.

Deinfibulation refers to the practice of cutting open the sealed vaginal opening of a woman who has been infibulated (Type III). This is often done to allow sexual intercourse or to facilitate childbirth, and is often necessary for improving the woman’s health and well-being.

Some women undergo a narrowing of their vaginal opening again after being deinfibulated during childbirth, which is known as reinfibulation. WHO recommends against reinfibulation because it increases health risks throughout the life-course.