Els Leye and Ino Kehrer 109 Women in Africa, the Maputo Protocol11, calls on States to adopt legislative measures to prohibit all forms of FGM, including its medicalization and paramedicalization12. Purpose FGM is performed for a number of reasons: to make a girl ready for marriage, to mark her as becoming of age and asserting that she is a full member of society, to preserve her virginity prior to marriage or control her sexuality, to purify her, or because of tradition. Although male circumcision is equally widespread, the extent of cutting (removal of foreskin) in male circumcision is far less invasive than most cases of FGM. Moreover, some health benefits of male circumcision have been assessed, while this is not the case for FGM. On the contrary, removing (major) parts of the female sexual organ interferes with its normal functioning, which is irreversible and has a lifelong effect. Reasons for male circumcision also do not intend to control sexuality or preserve virginity13. As such, FGM is a gender-specific act, and an expression of the deeply entrenched subordinated status of women. As discrimination is one of the elements in the CAT’s definition of torture, the purpose element is therefore always fulfilled if the acts can be shown to be gender-specific14. State involvement Article 5 of the Maputo Protocol declares that, “States Parties shall prohibit and condemn all forms of harmful practices which negatively affect the human rights of women and which are con­ trary to recognized international standards. States Parties shall take all necessary legislative and other measures15 to eliminate such practices”16. If States fail to act with due diligence to protect, prevent, investigate, and punish FGM, this too can amount to torture under the CAT. As Special Rapporteur Manfred Nowak stated in his 2008 report, article 1 of the CAT includes the State’s fail­ ure to protect persons within its jurisdiction from torture and ill-treatment committed by private individuals, and reinforces the Declaration on the Elimination of Violence against Women, adopted by the General Assembly in resolution 48/10417. The obligations of the State regarding FGM will be further elaborated in Section 3. African Commission on Human and Peoples’ Rights. Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa. Adopted by the 2nd Ordinary Session of the Assembly of the Union. Maputo, 11 July 2003. 12 UN. General Assembly. Human rights Council, Seventy session. A/HRC/7/3. Promotion and protection of all human rights, civil, political, economic, social and cultural rights, including the right to development. Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, Manfred Nowak. 15 January 2008, § 53. 13 World Health Organisation and UNAIDS. Male circumcision: global trends and determinants of prevalence, safety and acceptability. 2008. 14 A/HRC/7/3/, § 30. 15 These measures are: (a) awareness-raising through information campaigns, formal and informal education, and outreach; (b) prohibition, through legislative measures backed by sanctions, of all forms of FGM, including the medicalised procedure; (c) support for victims of FGM in the form of health care, legal counsel, psychological care and support, and education and training; (d) protection of women who are potential victims of FGM or other forms of violence, abuse or intolerance. See Leye E and Middelburg M. Female genital mutilation in Europe from a child right’s perspective, in Routledge International Handbook of Children’s Rights Studies (Vandenhole W, et. al. eds., Routledge International Handbooks, London and New York, 2015) pp. 295-315. 16 Article 5, Elimination of Harmful Practices. African Commission on Human and Peoples’ Rights. Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa. Adopted by the 2nd Ordinary Session of the Assembly of the Union, Maputo, 11 July 2003. 17 A/HRC/7/3, § 31. 11