It has affected more than 200 million women and girls who are alive today. The practice is concentrated in some 30 countries in Africa, the Middle East and Asia.[77] FGC affects many religious faiths, nationalities, and socioeconomic classes and is highly controversial. The main arguments advanced to justify FGC are hygiene, fertility, the preservation of chastity, an important rite of passage, marriageability and enhanced sexual pleasure of male partners.[11] The amount of tissue removed varies considerably, leading the WHO and other bodies to classify FGC into four types. These range from the partial or total removal of the clitoris with or without the prepuce (clitoridectomy) in Type I, to the additional removal of the labia minora, with or without excision of the labia majora (Type II) to narrowing of the vaginal orifice (introitus) with the creation of a covering seal by suturing the remaining labial tissue over the urethra and introitus, with or without excision of the clitoris (infibulation). In this type a small opening is created to allow urine and menstrual blood to be discharged. Type 4 involves all other procedures, usually relatively minor alterations such as piercing.[78]
^ Jump up to: a b c Aldridge, Robert W.; Story, Alistair; Hwang, Stephen W.; Nordentoft, Merete; Luchenski, Serena A.; Hartwell, Greg; Tweed, Emily J.; Lewer, Dan; Vittal Katikireddi, Srinivasa (2017-11-10). "Morbidity and mortality in homeless individuals, prisoners, sex workers, and individuals with substance use disorders in high-income countries: a systematic review and meta-analysis". Lancet. 391 (10117): 241–250. doi:10.1016/S0140-6736(17)31869-X. ISSN 1474-547X. PMC 5803132. PMID 29137869. All-cause standardised mortality ratios were significantly increased in 91 (99%) of 92 extracted datapoints and were 11·86 (95% CI 10·42–13·30; I2=94·1%) in female individuals