Report on the Conflation of Female Genital Mutilation/Cutting and Gender-Affirming Care and its Impact on Sustainable Development Goals

Introduction: A Setback for Health, Equality, and Justice

Recent political and legislative developments in the United States are creating a significant impediment to the achievement of several Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being), SDG 5 (Gender Equality), and SDG 10 (Reduced Inequalities). The deliberate conflation of Female Genital Mutilation/Cutting (FGM/C), a recognized human rights violation, with medically necessary gender-affirming healthcare is derailing decades of advocacy and threatening the well-being of multiple vulnerable communities. This report analyzes the issue, its legislative context, and its direct impact on progress toward global development targets.

Understanding FGM/C in the Framework of SDG 5 and SDG 3

FGM/C as a Violation of Gender Equality and Health

Female Genital Mutilation/Cutting is defined by the World Health Organization as any procedure involving the partial or total removal of external female genitalia or other injury to the female genital organs for non-medical reasons. This practice is a direct violation of fundamental human rights and a key target for elimination under SDG 5.3.2.

• Violation of SDG 5 (Gender Equality): FGM/C is an extreme form of gender-based violence and a harmful practice rooted in controlling female sexuality, perpetuating gender inequality.
• Violation of SDG 3 (Good Health and Well-being): The practice has no medical benefits and leads to severe, lifelong health complications, including obstructed childbirth, sensory deprivation, and psychological trauma, undermining the goal of ensuring healthy lives for all.

Advocacy groups, such as the Connecticut Coalition to End FGM/C, have been working to implement state-level legislation to strengthen protections, provide civil remedies, and improve healthcare for survivors, aligning with SDG 16 (Peace, Justice and Strong Institutions).

The Political Co-opting of Anti-FGM/C Advocacy

Legislative Confusion and Hostility

Efforts to outlaw FGM/C at the state level, such as in Connecticut, have been compromised by a political strategy that falsely equates the practice with gender-affirming care. During a legislative hearing, a bill to ban FGM/C was conflated with debates over healthcare for transgender individuals, leading to confusion and hostility. This conflation has been advanced at the federal level, notably through proposed legislation like Rep. Marjorie Taylor Greene’s “Protect Children’s Innocence Act.”

Key Distinctions Relevant to SDG 3

A critical failure in the legislative discourse is the inability to differentiate between a harmful, non-consensual practice and evidence-based medical care. This distinction is fundamental to achieving SDG 3.

1. Female Genital Mutilation/Cutting (FGM/C):
   • Performed without the individual’s consent, typically on young girls.
   • Has no medical value or health benefits.
   • Causes severe physical and psychological harm.
   • Recognized internationally as a human rights violation.
2. Gender-Affirming Care:
   • Provided with the full, informed consent of the patient and, for minors, their guardians.
   • Endorsed by major medical organizations as an effective treatment for gender dysphoria.
   • Based on established, evidence-supported standards of care (e.g., WPATH).
   • Aims to improve mental and physical well-being, in line with SDG 3.

Impact on Progress Towards Sustainable Development Goals

Undermining SDG 5: Jeopardizing the Movement to End FGM/C

The political weaponization of the anti-FGM/C movement is actively hindering progress toward SDG 5. Advocates report significant negative impacts:

• Erosion of Bipartisan Support: FGM/C has historically been a bipartisan issue, but its conflation with trans healthcare has made legislative support more precarious.
• Diversion of Resources: Nonprofits are forced to divert limited funding and energy toward combating misinformation rather than providing direct support to survivors and advancing protective legislation.
• Funding Risks: The controversy has led potential funders to deem the work “too risky,” threatening the financial stability of organizations crucial to achieving SDG 5.3.2.

Violating SDG 10: Increasing Inequalities for Transgender and Intersex Communities

Proposed federal legislation seeks to formally redefine FGM/C to include gender-affirming care for minors. This move directly contravenes SDG 10 by targeting and discriminating against a marginalized group. Furthermore, these bills often include explicit exceptions that permit non-consensual and medically unnecessary surgeries on intersex infants. This creates a legal paradox where:

• Consensual, medically necessary care for transgender youth is criminalized.
• Non-consensual, harmful surgeries on intersex infants are legally protected.

This legislative approach deepens inequalities and institutionalizes discrimination, representing a significant regression from the principles of SDG 10.

Conclusion: A Call for Evidence-Based and Rights-Focused Legislation

The conflation of FGM/C with gender-affirming care poses a multifaceted threat to the advancement of the Sustainable Development Goals. It undermines the global effort to eliminate gender-based violence (SDG 5), obstructs access to essential healthcare (SDG 3), and institutionalizes discrimination against vulnerable populations (SDG 10). Achieving these goals requires a commitment from policymakers to reject misinformation and uphold a clear distinction between human rights violations and medically necessary care, thereby ensuring that legislative frameworks protect, rather than harm, all individuals.

Analysis of SDGs, Targets, and Indicators

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being: The article discusses the severe medical complications resulting from Female Genital Mutilation/Cutting (FGM/C), such as obstructed childbirth and sensory deprivation. It also addresses the necessity of gender-affirming care as an effective medical treatment for gender dysphoria and the lifelong health complications from nonconsensual surgeries on intersex infants.
• SDG 5: Gender Equality: This is a central theme. The article explicitly defines FGM/C as a “human rights violation and one of the most extreme forms of gender-based violence.” The entire narrative revolves around eliminating this harmful practice, challenging gender-based discrimination, and protecting the bodily autonomy of women, girls, and transgender individuals.
• SDG 10: Reduced Inequalities: The article highlights the inequalities faced by multiple marginalized groups. This includes immigrant communities where FGM/C is more prevalent, transgender youth whose access to healthcare is threatened by discriminatory legislation, and intersex infants subjected to nonconsensual surgeries that are explicitly permitted in proposed bans on gender-affirming care.
• SDG 16: Peace, Justice and Strong Institutions: The article focuses on the role of legal and political institutions. It details the efforts to pass state-level legislation in Connecticut to ban FGM/C, the failure of this bill to reach a floor vote, and the introduction of federal legislation that conflates FGM/C with gender-affirming care. This demonstrates a struggle for justice and the need for strong, non-discriminatory laws and institutions.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. SDG 3: Good Health and Well-being

   • Target 3.7: By 2030, ensure universal access to sexual and reproductive health-care services. The article’s focus on ending FGM/C, a practice that severely harms female genital organs, and the need for “better health care for survivors” directly relates to this target.
   • Target 3.8: Achieve universal health coverage, including… access to quality essential health-care services. The article discusses the provision of gender-affirming care, which is “broadly endorsed by the medical community as an effective treatment,” and the need for reconstructive surgeries for FGM/C survivors, both of which fall under essential healthcare.

2. SDG 5: Gender Equality

   • Target 5.2: Eliminate all forms of violence against all women and girls… including… harmful practices. The article is centered on the movement to end FGM/C, which it calls “an act of gender-based violence.”
   • Target 5.3: Eliminate all harmful practices, such as… female genital mutilation. This target is explicitly and repeatedly addressed. The work of organizations like the “Connecticut Coalition to End FGM/C” and “Sahiyo” is aimed directly at achieving this target.
   • Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights. The principle of consent is a key theme, contrasting nonconsensual FGM/C and intersex surgeries with consensual gender-affirming care, thereby upholding the right to bodily autonomy.

3. SDG 10: Reduced Inequalities

   • Target 10.3: Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies and practices. The article details the fight against proposed discriminatory laws, such as Rep. Marjorie Taylor Greene’s bill, which targets transgender youth while creating exemptions for nonconsensual surgeries on intersex infants. The push for a law banning FGM/C in Connecticut is an effort to promote protective legislation.

4. SDG 16: Peace, Justice and Strong Institutions

   • Target 16.2: End abuse, exploitation, trafficking and all forms of violence against and torture of children. FGM/C is described as a practice “most often performed on young girls without their consent.” The article also highlights nonconsensual surgeries on intersex infants, which “cause lifelong complications” and are performed on children with “no ability to consent.”
   • Target 16.3: Promote the rule of law… and ensure equal access to justice for all. The entire legislative battle described in the article—advocating for a ban on FGM/C at the state level and fighting federal bills that misrepresent it—is an effort to use the legal system to provide justice and protection for vulnerable groups.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. SDG 5: Gender Equality

   • Indicator 5.3.2: Proportion of girls and women… who have undergone female genital mutilation/cutting. While the article does not provide statistics, the entire advocacy effort it describes is aimed at reducing this proportion to zero. The existence of the practice in the United States, particularly in immigrant communities, is the problem this indicator is designed to measure.

2. SDG 10 & 16: Reduced Inequalities & Strong Institutions

   • Existence of protective legislation: The article implies that a key indicator of progress is the number of states with laws banning FGM/C. It states that “Connecticut is one of only a handful of states without a law banning female genital mutilation and cutting.” The successful passage of such a law would be a measurable indicator of progress.
   • Existence of discriminatory legislation: Conversely, the introduction and potential passage of discriminatory laws, like Rep. Greene’s “Protect Children’s Innocence Act,” serves as a negative indicator. The article details how this bill seeks to “revise a federal statute outlawing FGM/C to include gender-affirming care for minors,” which would be a setback for equality and justice.
   • Access to justice and healthcare for survivors: The article mentions the push for state laws that “incorporate education, civil remedies and better health care for survivors.” The availability and accessibility of these services for survivors of FGM/C can be considered a qualitative and quantitative indicator of progress.

4. Table of SDGs, Targets, and Indicators

Source: 19thnews.org