The Sovereignty of the Body: How Far Is Culture Allowed to Go?

Liberal democracies and international law commit themselves to pluralism, tolerance and cultural self-determination. They also commit themselves to universal human rights. Most of the time those two commitments sit beside each other without trouble. Sometimes they don't.

The relativist position is that moral values, legal norms and social practices are the products of particular histories, societies and places. No culture stands on neutral ground, so none is entitled to pass judgment on another, and imposing an outside standard is a form of imperialism wearing the clothes of concern. The universalist position is that human beings hold certain rights by virtue of being human, and that some harms are grave enough to be condemned and prevented wherever they happen.

Argued at that altitude, neither side can win. So take a practice where the disagreement has consequences. Female genital mutilation covers all procedures involving the partial or total removal of the external female genitalia, or other non-medical injury to the female genital organs. It is defended as culture. It is prosecuted as assault. Whatever else it is, it is the place where the question has to be answered: how far is culture allowed to go?

What the practice does

Nobody who practises FGM believes they are committing an atrocity. That is the first thing to understand about it, and the hardest.

In communities where it is common, the cut is a rite of passage and a long-established social norm. It is tied to the control of female sexuality — used to secure virginity before marriage and fidelity after it by suppressing sexual desire and pleasure. It is also tied to honour. Families conform out of fear of stigma, of social exclusion, and of the damage refusal does to a daughter's marriageability. In patriarchal structures the cut becomes a precondition of womanhood, inclusion and respectability, which means a mother who declines is not read as protecting her child.

FGM has no documented medical benefits. What it has is a list of harms.

The immediate ones are excruciating pain, severe haemorrhage, shock, acute infections such as tetanus, urinary retention, and in some instances death. The lasting ones are chronic urinary tract infections, painful menstruation, vaginal discharge, painful intercourse, obstetric complications — obstructed labour, excessive postpartum bleeding, caesarean sections — and a raised risk of newborn death.

The psychological damage is documented too. A systematic review of observational data found that women who have undergone FGM show significantly higher rates of post-traumatic stress disorder, clinical depression, anxiety and somatisation than women who have not.

And the practice is adapting. More and more, parents bring their daughters to doctors, nurses and midwives rather than to traditional cutters, on the assumption that a trained hand makes it safer, or at least less harmful. In Egypt, 75% of girls aged 0–14 have been cut by medical staff, against 15% of older women. Nothing about what is done to them has changed. What has changed is that it now arrives with clinical authority behind it.

Nussbaum: what a life requires

Martha Nussbaum, working alongside the economist Amartya Sen, built the capabilities approach on a refusal of the relativist claim that values are purely contextual. There are, she argues, cross-cultural requirements for a life of human dignity, and she sets them out as Ten Central Human Functional Capabilities. A political and social order is just only if it secures a minimum threshold of each of them for every citizen.

FGM fails at least three.

It shortens lives and sometimes ends them, which is the capability of life — being able to live a human life of normal length and not die prematurely. It causes obstetric, reproductive and genitourinary illness, which is bodily health. And it destroys what Nussbaum calls bodily integrity: "having one's bodily boundaries treated as sovereign... being secure against assault, domestic violence, and having choice in matters of reproduction and sexual satisfaction."

That last one is where the weight sits. The procedure permanently alters a child's bodily boundaries without her consent, and takes away her capacity for pain-free sexual function before she is old enough to know she had it. What remains is close to what Sandra Bartky called the "immanence of mere bodily being" — a person who might have been an agent of choice reduced to a damaged physical object.

Culture, read this way, goes too far when it dismantles the capabilities a decent human life is assembled from.

Kymlicka: protection, and restriction

Will Kymlicka is a liberal defender of minority group rights, which makes the limit he draws more useful than an opponent's would be. Multicultural Citizenship (1995) turns on a distinction between two things a cultural group might ask for.

The first is protection from outside: the claim a minority makes against the dominant society around it, to keep its identity, language and resources from being marginalised or swallowed. Liberal theory supports this readily, because it shields minorities from being outvoted out of existence and widens the range of lives available to the people inside them.

The second is restriction from inside: the claim a group makes to limit the civil, political and bodily liberties of its own members in the name of tradition, purity or cohesion. Here Kymlicka's answer is no. A culture may defend its borders against erosion. It has no authority to oppress or physically alter the people within them to enforce conformity.

FGM is an internal restriction of the most literal kind. It uses physical modification and social terror to restrict girls' bodily autonomy, sexual freedom and agency, in the service of a hierarchy that was in place long before any of them were born. On Kymlicka's terms it cannot be accommodated, because the rights of the group never outrank the rights of the individuals the group is made of.

Okin: behind the door

Susan Moller Okin put the question to multiculturalism directly in her 1999 essay, Is Multiculturalism Bad for Women?

Her charge against Kymlicka, and against multicultural theory generally, is that it looks in the wrong place. Defences of group rights concentrate on the public and the macro — language laws, land rights, political representation — and stop at the front door. Behind that door is where gender is taught, where patriarchal control is exercised, and where FGM actually happens.

Her observations are uncomfortable and difficult to argue with. Most cultures are deeply patriarchal, and a good many treat the control and regulation of women by men not as an incidental feature but as one of their aims. A great deal of what any tradition concerns itself with is personal status, marriage, child-rearing and control of the female body. So when a state grants a group special autonomy to preserve its traditions, it often hands that group's patriarchal male elites the means to carry on as before — now with the state's blessing, and out of view.

Culture is not a single harmonious thing. It is gendered and it is contested, and somebody inside it always has more power to define it than somebody else. Protect "culture" without asking who holds that power, and what has been protected is the power of dominant men to mutilate girls who have not agreed to it.

Change from inside

None of this licenses a campaign of moral correction aimed at other people's societies. The evidence points the other way. The changes that hold are the ones a community arrives at itself.

The UNFPA-UNICEF Joint Programme on the Elimination of Female Genital Mutilation has made theology part of the work. Many people who practise FGM believe it is religiously required of them. It is not, and the institutions with the standing to say so — Al-Azhar University, Nahdlatul Ulama, Majelis Ulama Indonesia — have said so in public fatwas and declarations. That carries further than any outside condemnation could, because it lifts the obligation without asking anyone to give up their faith.

The rest is conversation, and it is slow. When traditional leaders, grandmothers and fathers talk openly about what the practice does to health and to rights, communities move toward abandoning it, and they tend to do it collectively rather than one household at a time. In 2025 alone, over 190,000 community leaders publicly denounced the practice, and thousands of communities have made public declarations replacing it with alternative rites of passage that leave the girl intact.

For women already cut, there is clitoral reconstruction, pioneered by Pierre Foldès. The surgery exposes the remaining undamaged portion of the clitoral shaft beneath the scar tissue, restoring anatomical integrity and sensation.

A qualitative study of survivors in Sweden who underwent the procedure found mixed results. Some were disappointed, logistically or aesthetically. The majority reported reduced physical pain, improved sexual desire and pleasure, and a restored sense of self. What comes through the interviews, though, is that the surgery was doing something the clinical account doesn't capture. As one survivor put it:

The possibility of having a choice is very important, it feels like I can regain the power over my body.

Where the line falls

Cultural diversity is worth defending. It gives people meaning, language and somewhere to belong, and a society that flattens it is poorer for it. But culture is not sovereign. It is a human creation, still being made, and it remains answerable to the people living inside it.

The line falls where four things are true at once:

• the practice causes documented, severe and irreversible physical and psychological harm;
• it is imposed on minors who cannot consent;
• it functions as an internal restriction, designed to suppress the basic liberties and bodily boundaries

of the group's own members, women in particular;

• and it operates in a private sphere that public justice does not reach.

When all four hold, culture has gone too far.

The body belongs to the person living in it, and that claim comes before anything a tradition can claim over it. The work worth supporting is the work communities are already doing to dismantle these restrictions from within — so that the next generation of girls inherits everything else their culture has to give them, and keeps their bodies as well.

Sources

• Clinical Care — Female genital mutilation (FGM) prevention and care — Sexual and Reproductive Health and Rights (SRHR). WHO guidelines and resources on managing complications.
• FGM Joint-Programme Annual Report 2025 — UNFPA WCARO. Data on systems transformation, religious fatwas, and community declarations.
• FGM/C Fact Sheet, 23 June 2023 — George Washington University School of Public Health. U.S. prevalence and legal context.
• Female genital mutilation — World Health Organization (WHO). Fact sheet detailing definitions, immediate and long-term complications, and medicalization.
• Medicalization of Female Genital Mutilation — CoP FGM. Statistical trends on healthcare providers performing FGM globally.
• Psychological consequences of female genital mutilation: A mixed-method systematic review — PubMed. Observational data linking FGM to PTSD, depression, anxiety and somatisation.
• The benefits and disappointments following clitoral reconstruction after female genital cutting: A qualitative interview study from Sweden — PLOS. Study by Malin Jordal et al. (2021) on the somatic and psychosexual outcomes of reconstructive surgery.
• Chalabi, Azadeh (2020). A Rapprochement between the Universality of Human Rights and Cultural Relativism. University of Liverpool Law School. On deconstructing the universalism/relativism binary and the non-Western origins of rights.
• Kymlicka, Will (1995). Multicultural Citizenship: A Liberal Theory of Minority Rights. Oxford University Press. The foundational distinction between external protections and internal restrictions.
• Nussbaum, Martha C. (2000). Women and Human Development: The Capabilities Approach. Cambridge University Press. The formulation of the Ten Central Human Capabilities as a universal metric of justice.
• Okin, Susan Moller (1999). Is Multiculturalism Bad for Women? Princeton University Press. The feminist critique of the private-sphere blindspots in multicultural group rights.