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Pharaonic circumcision is one of the most severe types of female genital mutilation (FGM). Classified as Type III FGM by the World Health Organization (WHO), this type of cutting involves the removal of the clitoris and labia minora, and the creation of a solid seal by cutting the labia majora and sewing them together. This creates a smooth hood for the entire vaginal area and typically leaves only a small opening for passing urine and menstrual blood. In most countries, pharaonic circumcision is considered abuse or torture and efforts to stop this practice are made a priority. Where this practice is common and accepted, both women and men often perpetuate the abuse of young girls.
This ritual mutilation is most famously practiced in Northeast Africa, but it is also sometimes practiced in parts of Southeast Asia and the Near East. Given how controversial pharaonic circumcision has become, it is somewhat rare for this type of operation to be performed in a hospital under anesthesia or with the assistance of a doctor. Most of the time, this type of mutilation occurs "in the bush" with no anesthesia and instruments that have not been sanitized.
Typically, pharaonic circumcision is surrounded by ritual, and the procedure may mark a transition into adulthood. The actual surgery generally involves amputating the clitoris and labia minora, then sewing together the raw edges of the labia majora to form the characteristic hooded seal. In order for a wound this severe to heal, the girl's legs must often be bound together for several weeks. Intercourse is severely difficult with such a small hole, so a man must typically cut open his wife in order to insert his penis. Childbirth generally involves similar cutting, and the entire wound must sometimes be opened in order to prevent the death of the child.
While there are certainly arguments to be made that respecting the practices of other cultures is important, pharaonic circumcision is usually exempt from this consideration. Even though there are many cultural reasons this type of ritual is observed, it is widely accepted that female genital mutilation is dangerous for women and can lead to a lifetime of pain and suffering. Some of the most successful efforts to stop pharaonic circumcision and other forms of systematic abuse of women have been focused on "buying" young women from their families so that the pressure to find husbands for these girls is relieved. By paying parents not to mutilate their daughters, charities are often able to stop abuse in entire communities, because girls who have not been mutilated usually do not perpetuate this practice on their own children.