108 GENDER PERSPECTIVES ON TORTURE: Law and Practice Psychological risks Post-traumatic stress disorder Anxiety disorders Depression Long-term health risks Genital tissue damage Vaginal discharge Vaginal itching Menstrual problems Reproductive tract infections Chronic genital infections Urinary tract infections Painful urination Intent FGM is usually performed on non-consenting minors, by traditional excisors, traditional mid­ wives, or medical personnel. The act is done for non-medical reasons, and the decision to cut a girl is made by (one of) the girl’s parents, the broader family and/or the community at large. Parents decide to have their daughters cut in order to comply with the prevailing social norms in their communities. Even though they might be aware of the negative consequences on their daughter’s health and wellbeing, the perceived benefits outweigh these negative effects, hence the decision to cut their daughters. The intent to cut is therefore present. A more extensive interpretation of the criteria of ‘intent’ was elaborated by the creation of the concept of general intent, which is “a less demanding standard, requiring merely that the actor intended to perform the conduct as opposed to intending to create a particular result in violation of the law.”9 In the case of health care providers who perform the practice (so-called medicalization of the practice10), the element of intent is even more apparent. Health professionals, who are skilled and trained to prevent and cure health threats or diseases, adhere to the principle of ‘do no harm’ (the Hippocratic Oath). As health professionals, they should be aware of the negative impact of cutting healthy female genital tissue for non-medical reasons, and as such, when performing FGM, the purpose of intent is fulfilled. Indeed, Special Rapporteur on Torture Manfred Nowak stated in his 2008 report that the medicalization of FGM does not render the practice acceptable, and recalled that article 5 of the Protocol to the African Charter on Human and People’s Rights on the Rights of Miller, G.H (2005) Defining Torture. Floersheimer Center for Constitutional Democracy. Medicalisation refers to the situations in which the procedure (including re-infibulation) is practised by any category of health care provider, whether in a public or a private clinic, at home or elsewhere, at any point in time in a woman’s life (WHO, 2016, p. 8). 9 10