BILL ANALYSIS                                                                                                                                                                                                    



                                                          AB 2125
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Date of Hearing:  April 9, 1996

                   ASSEMBLY COMMITTEE ON HEALTH
                       Brett Granlund, Chair

   AB 2125 (Figueroa and Cunneen) - As Amended:  March 19, 1996

 SUBJECT:  Female genital mutilation.

 SUMMARY:  Implements outreach and education programs regarding  
female genital mutilation (FGM) and makes such activity a felony.   
Specifically,  this bill:

1)  Requires the Department of Health Services (DHS) and the  
Department of Social Services (DSS) to implement education,  
preventative and outreach activities in communities that  
traditionally practice FGM.

2) Provides that a person who commits FGM is punishable by  
   imprisonment in the state prison for two, four, or eight years.

3) Provides that a parent, guardian or other responsible person  
   charged with the care or custody of a child who allows the FGM  
   of that child shall be punishable by imprisonment in a county  
   jail for not more than one year or by imprisonment in the state  
   prison for two, four, or six years.

4) Excepts surgical operations necessary for the health of the  
   patient from prosecution.

5) Defines FGM as knowingly and intentionally to excise, cut or  
   infibulate the labia majora, labia minora, clitoris, or vulva  
   of another person under the age of 18 years.

 FISCAL EFFECT:  Creates a new crime, but includes a crimes and  
infractions disclaimer.

 EXISTING LAW: 

1) Requires DHS to maintain a program of maternal and child  
   health.

2) Maintains, through DHS, an Office of Refugee Health.

3) Makes mayhem a felony; defines mayhem as depriving a human  
   being of a member of his or her body or disabling, disfiguring,  
   or rendering it useless, or cutting or disabling specific parts  
   of the face of a person.

4) Punishes a conviction of mayhem by imprisonment in the state  
   prison for two, four, or eight years.

5) Makes child abuse a felony, punishable by imprisonment in the  
   state prison for two, four, or six years.

6) Provides, through the DSS, for Child Protection Services which  







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   deals with situation when a parent or parents are taken from  
   the home.





























































                                                          AB 2125
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 BACKGROUND:  This bill is sponsored by the authors.
FGM is a traditional practice which involves excising part or all  
of the external female genitalia for cultural reasons focused on  
female chastity, hygiene and aesthetics.  Currently, FGM is  
practiced in countries throughout Africa and the Middle East and  
in Muslim populations of Indonesia and Malaysia.  With the  
increasing number of students and refugees immigrating to the  
West, there is evidence that this practice occurs in the United  
States.  This bill responds to recent reports of at least five  
cases of FGM in Santa Clara County.  Other cases have been  
reported in the Bay Area and Southern California.

According to the Journal of the American Medical Association, most  
families that allow their daughters to undergo FGM do so out of  
fear that no man will want to marry an uncircumcised woman and  
that she will be ostracized from the community.  Many women  
believe that clitoridectomy and/or infibulatin are not only more  
hygienic, but will also increase a woman's fertility.  Some  
communities believe that the clitoris contains poison and can harm  
men during sexual intercourse and kill children during birth.  

FGM leaves long-term and permanent damage.  The complications that  
can result include chronic vaginal and uterine infections which  
can lead to sterility, urinary tract infections, severe pain  
during urination, menstruation, and sexual intercourse, and  
obstetric complications due to obstruction of the birth canal by  
scar tissue.  This may result in fetal death.

Three other states, Minnesota, New Jersey and North Dakota, have  
enacted legislation prohibiting this practice.  New York,  
Colorado, and Tennessee have bills pending in their legislatures. 

All forms of FGM are illegal in Sweden and the United Kingdom.   
France, the Netherlands and Belgium have made the practice illegal  
by prosecuting FGM under child-abuse laws.  The Vienna Declaration  
of the World Conference on Human Rights held that traditional  
practices such as FGM are violations of human rights.  Prohibition  
against this practice is also supported by the World Health  
Organization, the World Medical Association, UNICEF, and the  
International Federation of Gynecology and Obstetrics.

 ARGUMENTS IN SUPPORT:  Proponents of this bill define FGM as an  
extreme form of child abuse carried out on children as young as  
three months old, but mostly on girls between six and eight years  
old.  Often, the procedure is performed without anesthesia,  
sanitary equipment, antibiotics or tools, and without medical  
supervision.  FGM is a life-changing operation that is performed  
before the girl is mature enough to understand the implications  
and the effect on her own sexuality in adult life.  It causes life  
long physical pain and emotional suffering.  Proponents declare  
this an unacceptable practice and urge it be stopped. 

This bill requires DHS to implement an outreach and educational  
program regarding FGM.  According to information provided by the  
authors' offices, physicians within the communities where FGM is  
occurring need education as to addressing the practice, their  







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mutilated patients, and the relationship between FGM and the  
women's culture.  Prevention of future medically unnecessary FGMs  
requires the dispelling of medical myths.  According to 




























































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proponents, awareness of the culture and tradition surrounding  
these practices will not only allow U.S. physicians to better  
understand the needs of their patients, but could also allow them  
a role in preventing future FGM.  

 ARGUMENTS IN OPPOSITION:  None

 REGISTERED SUPPORT / OPPOSITION:

 Support

Santa Clara County Medical Association
California Chapter of the National Association of Social Workers
FORWARD USA, together Against FGM
Santa Clara Valley Medical Center
Community Perinatal Project, Los Angeles County, Department of  
Health Services
California Health Federation
Children's Advocacy Institute
American Federation of Nurses, Social Services Union, Local 535,  
SEIU
Los Angeles County District Attorney's Office
The State Bar of California, Conference of Delegates
National Council of Jewish Women
American Association of Physicians of Indian Origin
Registered Nurses Professional Association
The City Council of the City of Monte Sereno
Women and Religion Task Force, Pacific Central District, Unitarian  
Universalist   Association
The Feminist Caucus of the American Humanist Association
Union of American Physicians and Dentists
California Commission on the Status of Women
California Medical Association
American Association of University Women, California
American College of Obstetricians and Gynecologists
California Healthcare Association
Attorney General's Office
American Association of Critical Care Nurses
Numerous California citizens

 Opposition:  None on file

 COMMENTS:  According to the Sacramento County District Attorney's  
Office, FGM could be prosecuted under Penal Code Section 203, as  
mayhem, or Section 288 as child abuse, with aggravated penalties  
for sexual assault.  However, these cases are never brought to the  
attention of the DA's Office because the abuse takes place in  
small communities.  Mimi Ramsey, founder of FORWARD USA, searches  
out the communities where this practice is occurring and attempts  
to discourage the mutilation.  A law specifically outlawing the  
practice of FGM could be a strong weapon in the fight against this  
cultural tradition.  It may help in the struggle to protect young  
girls.

This bill requires DHS to implement education and outreach  
programs in communities that traditionally practice this  







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mutilation.  According to Dorkenoo and Elsworthy, 1992,  Female  
Genital Mutilation:  Proposals for Change, a lay practitioner  
performs FGM.  This may be a tribal mid-wife, an aunt, a  
grandmother.  A medical professional is not involved.  U.S.  
physicians  are 


























































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confronted with the medical complications resulting from FGM,  
cutting a woman open for childbirth, and the ethical and medical  
considerations centered around requests by women, or their  
husbands, to be stitched back up.

The California Medical Association has voted to work with the  
Department of Health Services to provide education to immigrant  
communities on the health risks and legal liabilities of FGM.

There are some questions as to the costs and implementation of the  
outreach program.  The authors' offices report that discussions  
with DHS and Appropriations staff are ongoing with regard to  
appropriate funding levels, and the source of funding for the  
program.  It has been suggested that the bill be amended to limit  
the outreach to two pilot projects in communities known to have  
immigrant groups which traditionally practice FGM.  This may  
provide the greatest impact and stimulate outside/private interest  
in funding and administering additional outreach projects in other  
communities.


 Analysis prepared by:  Cindy L. Richburg, Esq. / ahealth /  
445-1770