By Celia W. Duggar
A comprehensive new assessment  of the ancient practice of female genital cutting by the United Nations Children’s Fund has found that it is gradually declining in many countries, even some where it remains deeply entrenched.
The authors of the report, released Monday, describe the practice as “remarkably tenacious, despite attempts spanning nearly a century to eliminate it.”
But they also say teenage girls are now less likely to have been cut than older women in more than half of the 29 countries in Africa and the Middle East where it is concentrated. In Egypt, where more women have been cut than in any other nation, 81 percent of 15- to 19-year-olds have undergone the practice, compared with 96 percent of women in their late 40s.
“The numbers aren’t huge, but they’re going in the right direction,” said Bettina Shell-Duncan, an anthropology professor at the University of Washington who was a consultant on the report.
Over all, Unicef estimates that more than 125 million girls and women have undergone the practice and that 30 million girls are at risk of it over the coming decade. The report is the first in which Unicef assessed the practice among all age groups based on household survey data from all of the 29 countries.
In addition to Egypt, where 91 percent of those ages 15 to 49 have undergone the practice, countries with the highest percentages of women who have been cut include Somalia, at 98 percent; Guinea, at 96 percent; Djibouti, at 93 percent; Eritrea and Mali, at 89 percent; and Sierra Leone and Sudan, at 88 percent.
Unicef , in its first major report on the practice since 2005, found that the deepest declines in the prevalence of female genital cutting, also known as female genital mutilation, have occurred in Kenya, one of Africa’s most dynamic, developed nations, and — most surprising — in the Central African Republic, one of its poorest and least developed.
Researchers now say the prevalence of the practice in these two countries began to fall four or five decades ago and has declined over three generations of women. They said the progress in Kenya, a modernizing country where efforts to stop female genital cutting stretch back to the early 1900s, made sense, but they were at a complete loss to explain why cutting had plunged in the Central African Republic, to 24 percent in 2010 from 43 percent in the mid-1990s.
“We have no idea, not even a guess,” said Professor Shell-Duncan, who has done field work in Africa since 1996. She said researchers needed to get to the Central African Republic soon to figure out what is happening there.
The country has received no significant foreign aid to combat the practice that Unicef researchers knew of, and it has been the subject of no scholarly study that they could find.
While experts were amazed about the Central African Republic, they were disappointed that no significant decline had been detected in Senegal between the surveys done in 2005 and 2010-11. Tostan , a nonprofit group, has led a much-hailed and growing social movement there to stop the practice, with support from Unicef and other donors. Thousands of villages working with the group have declared their intent to abandon genital cutting.
Molly Melching, Tostan’s executive director, said in an e-mail that the momentum in Senegal had accelerated in the past five years and that changes in prevalence would probably become visible only in 2020, as girls who would otherwise have been cut grow old enough to be interviewed in household surveys. She also noted that the national surveys had not specifically sampled the villages where Tostan worked or evaluated the group’s impact.
Claudia Cappa, the lead author of the Unicef report, acknowledged Ms. Melching’s points but said “the real surprise for Senegal” was that support for continuing the practice among women and girls had not noticeably declined between the surveys.
The new report identifies intriguing trends in who is performing the cutting, the severity of it and people’s attitudes toward it.
In most countries, traditional circumcisers still do the cutting, but in Egypt a troubling shift has occurred as people have become more aware that girls can die from the procedure: the number of girls and young women cut by medical professionals, mostly doctors, has risen to three out of four from just over half in 1995.
“Women know more about the harms, but there is still social pressure to conform, and so they medicalize the procedure because the option is there,” said Francesca Moneti, a senior child protection specialist at Unicef.
Across all countries, one in five of the women and girls genitally cut has undergone the most severe form of practice, known as infibulation. It usually involves cutting and stitching together the vaginal labia, nearly covering the urethra and the vaginal opening, which then must later be cut open for intercourse and child birth.
But a trend toward less radical forms of genital cutting has taken hold in some countries, including Djibouti, where 83 percent of women in their late 40s report being infibulated — sewn closed — compared with 42 percent of 15- to 19-year-olds.
The report also found that support for the practice is similar between the sexes, though it is often seen as evidence of a patriarchal effort to control women’s sexuality. Often it is women who organize genital cutting and carry it out. In a few countries, Guinea, Sierra Leone and Chad, more men than women support its abandonment. And significant numbers of women do not know what boys and men think about the practice and often underestimate the proportion of them who want it to end, survey data show.
“In the United States, how many husbands and wives talk about sex?” asked Stanley Yoder, a senior qualitative researcher with ICF International, a consulting firm that advises governments, who has been involved in demographic and health surveys in Africa for 15 years. “Some do, but many don’t. There are things people don’t talk about.”
The most common reason women give for continuing genital cutting is to gain social acceptance. United Nations researchers for the first time cross-tabulated data on women’s views of the practice and whether their daughters were cut. They learned that many mothers who opposed genital cutting reported having had their daughters cut.
“This shows the gap between attitudes and behavior,” Mrs. Cappa said. “What you think as an individual is not enough to put an end to the practice because of social pressures and obligations.”
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