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Throughout 1976 and part of 1977 I conducted ethnographic research in a small Sudanese village (Hofriyat, a pseudonym) located on the Nile some 200 km downstream of the capital city, Khartoum. Before I arrived in the area I was aware that Hofriyati females underwent genital mutilation in childhood, and I had read several descriptions of that operation (Barclay 1964;Widstrand 1964). Nothing, however, adequately prepared me for what I was to witness, as described herein. Initially I felt numbed by what appeared t o be the meaninglessness of the custom; yet, as time passed in the village, I came to regard this form of female circumcision in a very different light. In the present paper I discuss my growing appreciation of its significance, for it is only in understanding the practice, its meaningfulness for the women who undergo it, and its embeddedness in village culture, that those who are presently committed t o its eradication (see Assaad 1980; el-Saadawi 1980; Hosken 1979;Morgan and Steinem 1980; participants in the "Khartoum Conference," W.H.O. 1979) might approach the problem with the sensitivity it demands. villagers and the villageThe people of Hofriyat are Muslim. They are organized into several overtly patrilineal descent groups, only a few of which are corporate in any real sense. Furthermore, villagers are relatively endogamous: people marry within the patrilineage when possible and practical, otherwise they marry close kin of varying degrees and prefer as spouses people who live nearby. Along with most of the population of Northern Sudan, Hofriyati speak a dialect This paper represents an effort to understand why Pharaonic circumcision of females persists in the Sudanese village of Hofriyat despite numerous attempts to effect its eradication. After a brief consideration of the custom's proposed origins and functions, its rich symbolic context is examined in some detail. Here it emerges that female circumcision is intricately related to a wide variety of local customs and beliefs, all of which appear to be informed by several related idioms stressing the relative value of "enclosedness." The paper suggests that for those who have undergone it and who advocate its continuance, Pharaonic circumcision is an assertive, highly meaningful act that emphasizes feminine fertilit y by de-emphasizing female sexuality. [genital mutilation, circumcision, symbolism, women, Sudan, gender]

Examination of cultural and social factors surrounding zar spirit possession diagnoses in Northern Sudan suggests that a major issue addressed by the cult is the cultural overdetermination of women's selfhood. Circumcision and infibulation operate to establish in women a sense of self congruent with the cultural image of woman as reproducer. When experiences and expectations fail to mesh, some women fall ill and are ultimately diagnosed as possessed. Through acceptance of the possession diagnosis and participation in curing rites involving trance, a patient is given scope to expand and regenerate her sense of self and recontextualize her experiences, [ethnomedicine, women, Sudan, spirit possession, the self, gender identity]

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We used institutional ethnography to explore the social relations that shaped the reproductive health care experiences of women with female genital cutting. Interviews with eight women revealed that they engaged in discourse that opposed the practices of cutting female genitals as a human-rights violation. This discourse worked to protect those affected by the practices, but also stigmatized female genital cutting, making participants anticipate experiencing stigmatization during health care. Women’s engagement in this discourse shaped their emotional health work to prepare for such encounters. This work included navigating feelings of worry, shame, and courage to understand what to expect during their own appointment; learning from family/friends’ experiences; and seeking a clinic with the reputation of best care for women with female genital cutting. It is important to strive for more inclusive health care in which women do not have to engage in emotional health work to prepare for their clinical encounters.

Purpose of Review To examine the ‘zero tolerance’ policy for female genital cutting (FGM/C) in the international health community in light of the growing popularity of FGCS (female genital cosmetic surgery) worldwide. Recent Findings ‘Traditional’ FGM/C performed in Egypt and Sudan and cosmetic labiaplasty performed in Europe, the Americas, and Antipodes by medically trained gynaecologists and plastic surgeons are based on similar aesthetic logics: labia minora that protrude beyond the labia majora are deemed ugly, masculine, and ‘abnormal’. Drawing on the burgeoning medical, social science, and humanities literature surrounding labiaplasty, the paper documents the narrowing of aesthetic standards governing ‘normal’ genital appearance and finds that, in addition to adult women, thousands of (mainly Caucasian) adolescents have undergone these operations whose long-term health consequences are unknown. Summary Western heteronormativity, gender binarism, ageism, and the colonial association of protruding labia minora with animality contribute to body image insecurities and fuel the labiaplasty phenomenon, despite the ethical challenge that the procedures are clearly defined by the WHO as type II (a–c) female genital mutilations.