My experience of healing by attending the 2019 Sahiyo Activist Retreat in the U.S.

By Farzana Doctor

Country of Residence: Canada

Age: 48

When the first emails circulated about last month’s Sahiyo retreat in New York City, I wasn’t sure why I wanted to register, only that I knew I had to.  I felt anxious the week leading up to the event and couldn’t pinpoint the reason why.

During the opening exercise, when we listed our hopes for the weekend, a voice in my head said, quite definitively, “healing.” This surprised me because I’ve been thinking and writing about khatna since 2016, when I joined WeSpeakOut and began my healing journey. Over the previous years I’ve seen a therapist, talked to friends and family, and even finished writing a novel on the subject. What more healing was there to do?

But I put up my hand, and the notetaker recorded “healing” on the flipchart page. I felt vulnerable in my honesty, but I told myself to remain open to whatever could come from the gathering. Anxiety thrummed through my body.

On the second day, I listened to the woman across from me share her khatna memory, and a deep sorrow rose up in me as I recognized elements of shared experience. A painful penny dropped. I didn’t participate much in that session, just quietly wiped my tears and journalled my realizations.

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Later, in a pair-share exercise with the woman sitting next to me, I found myself relating to an aspect of her story, even though it was quite different from my own. It was like she was indirectly speaking to my fears and they quieted somewhat.

On the third day, I sat with my Saathi (my partner in the peer support program that Sahiyo is piloting) and I talked to her about ways I might shift my activism from “behind the scenes” to being more public. I was still anxious, but sharing with her also made me feel brave.

After the retreat I spent a few hours hanging out with another participant. She commented that I’d seemed grounded the whole weekend and I told her that I was good at wearing a calm mask. In fact, I had dissociated a little during some of the sessions, missing bits of the conversation and activity instructions. While I’ve long known that this is one of my coping strategies, saying it aloud to her, to another Bohri woman, was powerful in a way I couldn’t name right then.

But, after a week of reflection, I can name it now: the Sahiyo facilitators created an intentional space of respect and safety, and then twenty-one feminist Bohri women stepped into it. I’ve never experienced anything like that before.  

This was what was so incredibly powerful for me.  And so healing.

 

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The experience of hosting my very own Thaal Pe Charcha

By Xenobia

Country of Residence: India

Earlier this year in January, I attended the Sahiyo’s Activist Retreat in Mumbai, where I met some brilliant, fantastic people from all walks of life. Women shared their experiences, stories and life-lessons, and talked about how female genital mutilation/cutting (FGM/C) had impacted their lives, either directly or indirectly, and what they were doing about it. 

Shortly after I returned home to Pune, my mind was filled with a bunch of ideas that involved reaching out to more Bohra women, hearing about their experiences with the community in general, and speaking to more women of substance. One of the training sessions at the Sahiyo Activist Retreat was on how to host one’s own ‘Thaal Pe Charcha’ (TPC, loosely translated as ‘discussions over food’).

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Representational photo of Thaal Pe Charca cuisine

Thaal Pe Charcha is a flagship Sahiyo program that brings Bohra women together in an informal, private space, so that they can bond over traditional Bohra cuisine while discussing FGM/C and other issues that affect their lives.

I felt that the next logical step for me was to host my very own TPC. It would give me the opportunity to meet and talk to more women from my city about certain community-centric issues that affect all our lives.

Even though I have never really been an activist myself, I knew of Sahiyo, and the cause that they have been fighting for. I admired and respected them, and I had silently been fighting for the same cause all my life, too. 

Did I have my fair share of apprehensions? I absolutely did. And why wouldn’t I?

In a closely-knit community like ours, where one person’s word is law, it is so hard to try to reason with women and mothers, to give them more clarity by pleading with them to not hurt their children. Often, they never seem to be able to see beyond how you are “going against the community” or “against Moula”, even though the point has never been about that. There is a fine line between following someone and blind faith. No matter which country you are in, child abuse is still child abuse, irrespective of what you choose to call it or who performs it.

For my TPC, I managed to invite a few women for lunch – a mix of friends, cousins, acquaintances and colleagues. It was also the first time I had ever hosted a Bohra get-together by myself, without the usual family members around to really help me. So for me, that itself was a personal milestone. Strangely, I felt it brought me a step closer to warmly embracing other nicer aspects of our culture – getting people together, bonding over food, and discussing the many facets of our little world.

The conversations bordered around what each one was doing in their lives, professionally and otherwise. We discussed issues such as soft-feminism, journalism, opinions on certain movies and the debate on whether wives should take their husbands’ surnames after they are married. For a couple of the women who attended, FGM/C was a new concept they had never spoken about before. They asked questions about why it is performed, when they heard of it, and why we needed to stop practicing it on the next generation, especially since conversations around this topic have always been taboo for some strange, secretive reason in our community. The younger minds agreed that all customs with no solid reasoning usually always die a natural death, because no one likes doing things without a valid reason.

Having access to the right answers and accurate information definitely helped each of them in getting more clarity on the topic, even though not every single person wanted to necessarily talk about their personal experience. It is still daunting to talk about something so personal in front of a bunch of strangers.

But for me personally, it was important that the topic was at least touched upon, so that other women realise that this is a safe, non-judgemental place and that they could reach out to me if they wanted to speak about anything that bothered them at all. Apart from that, I do enjoy bringing new people together and nurturing relations with those I care about. So all in all, this was extremely special to me.

While this event was still pretty small-scale, I would love to host and be a part of bigger TPCs eventually, where more women can come together and share their stories, opinions and ways to raise awareness about the harms caused by the practice in question, and how we can all work together to promote the abandonment of FGM/C and save the many generations of girls and women in the future from physical, mental, emotional and psychological damage.

Speaking the truth about my experience with female genital mutilation

By Aisha Yusuf

(Aisha is one of our Sahiyo Story participants who continues to use her voice to advocate for change on female genital cutting.)

At the Pro-Voice storytelling event at the Frogmore in Boston on March 31, there were three storytellers, including myself. The event was organized by Rev. Susan Chorley to contradict the narrative of shame, judgement, and stigma directed at women’s bodies and women’s lives. It was intimate in the sense that we created a small circle and we also paired in groups to engage in discussion with the attendees after each storyteller presented their piece. I was the second storyteller.

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I told the crowd I experienced female genital mutilation (FGM) when I was five, but I didn’t really process it until I was thirteen. It took me many years to understand it and its impact on my life. I speak about it because I don’t want to be silent anymore.

For me, I’m still getting the hang of storytelling and so I was nervous when I first got up, but the feedback I got after the event was over made me glad I shared my story. A lot of the attendees were shocked to learn about the prevalence of FGM around the world and how many women it affects. One woman in particular stated that she was unaware that such a practice was happening here in the United States, and they were shocked to find out that it impacted so many girls around the world.

During our small group conversation after my speech, we discussed a cultural or family practice we would undo for our people or community and how it would change our lives. I gave a brief example of a 10-year-old girl who died as a result of FGM in Somalia last July. I stated that I wanted to undo this practice so that innocent lives do not have to suffer like the girls who’ve died because of FGM, and many other girls who will potentially experience it.

When each storyteller told their story, the attendees would write something positive on three cards for the storyteller, which they would get to take with them at the end of the event. After the last discussion, Rev. Chorley, who is also the Executive Director of Exhale, thanked the storytellers, attendees, volunteers and gave storytellers a book along with cards.

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Overall, I was happy to share my story with the general public, I didn’t expect to receive so much positive feedback. One woman in particular I remembered stated that she was moved by my story. After the event was over people were networking. This older American woman came up to me and stated that she was not ready for the story I told. She was in disbelief that this had happened to me and thanked me for sharing my story and bringing awareness to such a private and intimate practice. This moment in particular made me realize why it was important to tell my story of surviving FGM. She added that hopefully what I am doing can bring change for girls.

Survivor of Mumbai: Plight to End Female Genital Cutting

By Brionna Wiggins

(An alias was provided to protect the survivor’s identity and family.)

There was once a girl who was seven-years-old in Mumbai, India. She and her mother visited a woman so that she could have her “khatna” done. Her mother was an educated woman and later a principal of a school. Today, she was having done to her daughter what her mother had done to her. The mother did her research too, because the woman they visited was known to be quick and effective. There were claims that she inflicted the least amount of pain possible. The little girl paid her respects to the woman who would do the khatna without quite knowing why she was there. Before she knew it, she felt the pain. Then the woman guided her to the sink to wash her hands and pressed two cookies in her small palm–cookies that had been a favorite treat until then.

After the procedure was over, the mother carried the girl down the stairs. She was considered a “big girl” at the time and hadn’t been carried in ages. They got a taxi as well, despite the family being poor. The mere presence of the taxi testified to the importance of the event, not to mention the trouble she would have walking back to her uncle’s house. The mother spoke with an aunt there, saying she thought her daughter would cry for hours; but she seemed fine now, though. However, she was far from fine. Fatima wouldn’t talk about this event for another four decades.

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Photo by Adrianna Calvo on Pexels.com

As an adult, Fatima gained the courage to speak up about FGC. Three years ago, when Masooma Ranalvi started to advocate against the practice, Fatima found her voice. A survey by Sahiyo was also done, which revealed that no one spoke about the practice, but continued it even though the community that practiced it was considered educated and progressive. Female genital cutting (FGC) was a generational secret that about 80% of the surveyed population underwent. There is an understandable cause for worry within the community if one does not undergo it. Skipping out on the procedure could lead to a handful of issues, including a loss in social standing, or the local clergy harassing parents if you’re in the United States with your family back in India. Families persuade their women to have their daughters cut they believe to purify them and prevent promiscuity. Some succumb to the pressure, while others lie that the procedure was done so the constant nagging can subside. There’s also the option of vacation cutting (sending the girl away on a “vacation” for her to be cut) for those in America. Even all the way in Detroit, a personal shame makes it so that one may only talk about it amongst their closest friends. Fatima knows another woman, a lawyer in Houston, who went to Pakistan at age seven in order to be cut. It’s believed by some to be the ideal age because the girl is young and submissive, but old enough to remember what was done to her and continue the tradition when she has daughters.

Fatima is happily married with her husband and has two adult children, both boys. However, if she ever had a daughter, she would not have let her undergo FGC. A friend of hers commented on this once, claiming she was fortunate to not have to deal with female issues, like urinary tract infections. Fatima’s mother was visiting at the time and overheard their conversation.

Her mother said something along the lines of, “Oh, our girls don’t get infections because we have this done to them,” referring to FGC.

The friend did not know of FGC and probably would have asked more if Fatima didn’t interject. “That’s not true,” she told her visibly shocked mother. “Let’s not talk about it now.”

Unfortunately, the time to talk about FGC never came for Fatima and her mother. When thinking about her late mother, Fatima believes that she would be upset with herself in learning that while her mother had the intention to genuinely help Fatima, the incident only harmed her at seven-years-old, and still does today.

Fatima doesn’t have any physical problems as a result of being cut, but the trauma from the event still resides within her. After all these years, she remembers the pain. She believes that she lives a relatively normal and happy life, but the memory of being cut is there.

She can’t talk about it without crying, even though she doesn’t want to cry. “Why was this done to me?” Fatima said that she didn’t want her tears to weaken the message to end cutting. Fatima wants FGC survivors to open up, speak up, and get the help they need. The next generation needs to be protected and supported. Fatima said that even with leading a relatively normal life, the trauma is still there. “I will never be a full woman. I will never know [the] full sex experience, and I will never know how it feels to be uncut.”

Brionnabiopic

 

More on Brionna:

Brionna is currently a high school senior in the District of Columbia. She likes drawing, helping others, and being able to contribute to great causes.

 

Female Genital Mutilation: A Human Rights Issue?

By Maryah Haidery

Country of Residence: United States

Last month, the Columbia University South Asian Feminisms Alliance organized a panel discussion in New York City to discuss female genital mutilation (FGM) in the broader context of human rights. I was honored to represent Sahiyo at this panel alongside Maryum Saifee, an FGM survivor and career diplomat with the United States Foreign Service; Aissata Mounir Camara, Co-founder of the There Is No Limit Foundation; and  Shelby Quast, Americas Director of Equality Now. The event was scheduled for a frigid Friday afternoon and I was only expecting a handful of people to attend. But when I finally made my way to the School of International and Public Affairs, I was pleasantly surprised to find the room was packed with students and reporters interested to hear what we had to say.

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The event began with a screening of three short videos highlighting Maryum’s, Aissata’s, and my personal history with FGM. After some brief introductions, we began a very impassioned hour-long discussion about our individual experiences as activists. Maryum began by stressing that it was important to view FGM as not just a cultural or medical issue but as a fundamental violation of human rights, including the right to live a life free from violence – especially gender-based violence. Shelby was particularly insightful about the legal implications of overturning the federal constitutional ban on FGM in the Detroit case and the subsequent appeals process. Aissata was passionate about informing the audience that FGM was “not just an African problem” but a growing problem here in the U.S., and one that affects all types of women regardless of ethnicity, age, religion and socio-economic status.

Keenly aware that I was lacking the extensive background and experience of my fellow panelists, I nevertheless tried my best to represent Sahiyo by discussing some of my recent initiatives, as well as some of the issues inherent in this sort of work. In keeping with the theme of the event, I discussed the challenge of framing FGM as a human rights issue. Some people hesitate in calling FGM a violation of human rights because they view rights through the lens of cultural relativism. Cultural relativism is the idea that right and wrong is subjective and varies based on culture. According to this view, definitions of human rights based on “Western” ideas, such as the UN’s Universal Declaration of Human Rights, can only apply to people from “Western” cultures, and different standards should be used to judge the practices of people from “non-Western” cultures like Dawoodi Bohra Muslims. Unfortunately, many politicians who have this view feel that supporting a ban on FGM may appear culturally insensitive.

I told the audience that although I felt that such views were understandable and often well-meaning, they were fundamentally flawed. This is because concepts such as “right and wrong” and “human rights” are not subjective but objective. They are based on the things that humans need in order to live and flourish. While it might be true that the human rights guaranteed in the UN’s Declaration of Rights are based on “Western” ideas, they are universal and meant to apply to all humans, not just the ones born in the West. So, if you adopt a culturally relativist position and contend that universal human rights don’t extend to certain Muslim women, then you are essentially arguing that you don’t think that certain Muslim women count as “human.” It’s not hard to see why this would be wrong.

At the end of the discussion, we responded to several questions from the audience. It was heartening to see how engaged everyone was. Someone asked how important we thought changing the existing laws would be for ending FGM. I answered that while laws could be important in underscoring our nation’s commitment to protecting the rights of little girls, laws alone would probably not result in changing the culture. That is why engaging with people and educating them is also so important. Shelby emphasized that laws were helpful in bringing exposure to previously taboo practices. But she also warned that it was important to ensure that laws were implemented in ways that helped communities instead of targeting them.  Several people were interested in finding out what they could do to help end the practice in their communities. Maryum urged audience members to educate themselves on the issue and pursue creative solutions. Camara agreed. “Knowledge is power,” she said. “Educate yourself. Break the silence. Find your talent and join in.” After the event, nearly everyone took home information on how they could support the various organizations represented, find upcoming Zero Day of Tolerance Activities, or sign a petition to ban FGM in Massachusetts. It was a day that seemed to exceed all expectations.  

The complexities of female genital cutting (FGC) in Singapore

By Saza Faradilla

Country of Residence: Singapore

This blogpost is the first in a four-part series about female genital cutting (FGC) in Singapore. This first installment details the historical, social and economic contexts of FGC in Singapore. It also explains the limitations of academic discourses on FGC in the Southeast-Asian region, and especially Singapore.

It was a Saturday afternoon in September 2016 when my dad picked me up from university and we headed over to a relative’s house in Sembawang. We only ever gathered there for special occasions. This time, it was my cousin’s second birthday. We entered the room, and it was full of relatives in brightly colored shirts, jubah (long Malay dress), jeans and scarves. Of course, the star of the evening, my 2 year-old cousin, Anisah, donned a red and blue sailor outfit. I went to pick her up and carried her around the room. A 38-year old female relative, wearing a simple combination of black t-shirt and jeans came over to speak to me, and my sister, who was also around us.

Relative (R): “Anisah minggu lepas dah kena sunat (Anisah was cut last week).”

Saza (Sa): “Apa? (What?)”

R: “Ya, kat doctor (Yes, at the doctor).”

Sa: “Huh, perempuan kena sunat? (Women need to be cut?)”

R: “Ya (Yes).”

Sa: “Tapi ini salah! Ini against WHO guidelines semua. Ini human rights violation (But this is wrong! This is against WHO  guidelines. This is a human rights violation).”

Sis: “You pun kena sunat. (You were cut, too).”

My jaw dropped. I had never known about this cutting, and I was completely unaware that it was performed on me. I did not know it was performed on young children, and consented to by their parents at medical clinics or with traditional midwives. My complete lack of knowledge until that moment about a practice that my relative described as necessary for women speaks a lot to the specific kind of female genital cutting (FGC) in Singapore: its hiddenness, prevalence amongst the Singaporean Malay community, the debate surrounding the procedure, and reactions to it.

This sparked an interest in researching about FGC for seminars during my undergraduate studies at Yale-NUS in Singapore, which eventually culminated in a year-long thesis on this practice.

Context of FGC in Singapore

It is unclear when the practice of FGC first began in Singapore. In 1998, researchers Andre Feillard and Lies Marcoes theorised that FGC reached Southeast Asia as part of Islamic traditions linked to the Shafi’i school of thought, but the spread of the practice to other parts of Southeast Asia is ambiguous. FGC in Singapore involves female Malays, who make up about 7% of the population (420,000 people). Out of these, there is an assumed prevalence of 60% of Malay women who have been cut. Previously, this procedure was performed by traditional midwives at homes, but now it is mostly conducted at 5-10 private clinics by female Malay doctors around the island. It costs about $30-50, and takes less than 30 minutes. There is no law or legislation banning FGC in Singapore.

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Photo by CEphoto, Uwe Aranas

In Singapore, Type I FGC is performed, though there is also a spectrum of this particular cutting – from symbolically placing a medical instrument (usually scissors) at the clitoris, to nicking the clitoral hood, to removing the hood itself. It is usually performed on young children below the age of five.

The Malay community holds differing views relating to this cutting. Some view it as mandatory, while others are more ambivalent, and some actively campaign against it.

Research (or lack thereof) on FGC in Singapore

FGC in the Southeast Asian region received very little academic attention until 1885. Andree Feillard and Lies Marcoes argued that it was only in 1885 that the Dutch ethnographer G. A. Wilken conducted a thorough survey of the practice in the region. He was the first to draw the conclusion that female circumcision was found exclusively among Muslims, which led him to believe that it was not an indigenous practice, but rather one “borrowed from the Arabs”.

In the only anthropological study of FGC in Singapore, Gabriele Marranci (an Australian anthropologist)  explained why this practice is so hidden. He suggests that this is a form of “religious ethnic resilience within an environment affected by an increasing push towards globalisation and national identity”. According to him, the structural inequalities faced by the minority Malay community have led them to hold strong to traditional rites and rituals as a way of ensuring the togetherness of the community. Here, he also references Kevin Hertherington’s concept of the Bund, which is defined as “an intense form of affectual solidarity, that is inherently unstable and liable to break down very rapidly unless it is consciously maintained through the symbolically mediated interaction of its members”. Secondly, he also points out that the government is keen to keep FGC hidden to avoid “opening a debate in Singapore that would not only involve the Malay Muslim community, but all Singaporeans as well as international observers”. Taking a pro-FGC stance would upset the international human rights community such as the United Nations and NGOs as well as receive backlash from the local feminist community. On the other hand, criticising FGC might be seen as an “attack on the Malay community itself”. A third reason is that the Malay Muslim community do not see this cutting as significant or think it necessary to be brought up for discussion. It is a tradition that is simply accepted as part of an early childhood ritual. However, Marranci does not clearly address the idea that if the cut is so hidden such that the women themselves are unaware of it, how does that solidify the identity of the community? As such, my research aims to build upon this question by understanding the reasons that compel Malays to practice female genital cutting.

Part 2 of this series will focus on cleanliness and religious reasons given for female genital cutting in Singapore. 

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Saza is a Senior Executive of service learning at Republic Polytechnic in Singapore. She recently graduated from Yale-NUS College where she spent much of her college life developing her thesis on female genital cutting in Singapore. A highly under-researched, misunderstood and personal issue, Saza sought to understand the reasons behind this practice. Saza is passionate about women’s rights and empowerment and seeks to assist marginalized populations as much as possible.

Wrestling with trust and fear in regard to female genital mutilation

By Farzana Esmaeel

Country of Residence: United Arab Emirates

Trust and fear are two emotions that have an interesting correlation to input and output of human behavior. One emotion, trust, establishes safety and comfort for individuals whilst the other, fear, displaces the very premise of safety and comfort. At the age of 7, you don’t articulate emotions; you feel them. And your mother is your beacon of trust. She loves you, comforts you, cares for you and sacrifices for you. Then, when trust is removed, it’s only natural to feel extreme pain and deceit at her hands the most.

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My sister and I were taken to a dilapidated, dimly lit building at the far end of the city on the pretext that we were going to meet an aunt for a check-up. At the tender age of 7 when mum tells you we are going for a check up you don’t appreciate entirely its meaning, and at the time it meant to me that we were going to see a doctor.

What followed was unprecedented, and a memory that will be etched in our minds forever. Sadly.

The pain was too much to bear as 30 years ago, female genital mutilation (FGM) in the Dawoodi Bohra community was generally more practiced under callous and less “sterile” ways. (Yet, even today, when it is practiced by licensed white coat doctors under more hygienic conditions, it doesn’t make the practice correct.) The overarching feeling I took after my experience 30 years ago was deceit.

My mother is a simple, non-confrontational, less informed person, who at the time of my sister and my cutting, played into the hands of a community (mindset) that propagates fear: fear of being ‘ostracized’ for not having FGM done, fear of her daughters being ‘impure’, fear of standing up against cultural norms and practices. Though today, this same woman hasn’t once told either of her daughters to carry out this inhumane practice on her granddaughters. She now understands the pain and futility of it all.

FGM is a practice entrenched with ‘fear,’ stripping human ‘trust,’ and inculcating in young girls early on to be apologetic about their sexuality and their desires. It is on us to be the change. We must question this violation of human rights and ensure that we raise our voices against this harmful practice, not just for our daughters, but the many more daughters all around us.     

 

Experiencing Sahiyo’s Activist Retreat in Mumbai

By Xenobia

Country of Residence: India

There are those who talk about change, and then there are those who do things and bring about the change.  I would like to tell you about the time I decided to be a part of the Sahiyo’s Activist Retreat in Mumbai, and met such wonderful people who, in my eyes, were nothing short of superwomen.

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I cannot even begin to describe how amazing it is to meet like-minded people all driven by the same cause. It is honestly inexplicable. In today’s times, do you know what good, honest peer support feeling is like? Let me tell you: it was out of this world amazing! Did a couple of seemingly insignificant days change my life? Yes, they did. Prior to this event, was I feeling anxious and apprehensive about what it would turn out to be like? Oh, extremely. Was I nervous? Yes. Was I also curious about what would I take away from this retreat? Yes. Did I think it was going to be all about a bunch of women getting together to purely rebel against a cause? I will admit, yes.

I knew about Sahiyo, and the cause that they are fighting for. I admired and respected them because I had been fighting for the same cause all my life, too, but silently. Many members of the Bohra community do not react well to independent thinkers, so it takes a lot of courage and true liberation to speak your mind on a public platform. Naturally, one ‘black sheep’ tends to have heard about the other. But immense respect for them aside, I was partly curious about what I would really learn here, and partly interested in what could be done to rightly channel the feelings I felt toward the people who endorse female genital mutilation (FGM).

Needless to say, I couldn’t stop talking about this retreat when I returned home! There were some brilliant, fantastic people there from all walks of life, sharing their experiences, sharing their stories and how they heard of FGM, how it has impacted their lives, and what they are doing about it. Our co-hosts Insia and Aarefa were warm as ever, right from introductions and group bonding activities, to efficiently addressing counter arguments and introducing us to a world of relevant introspection, as opposed to traditional garish rebelling. There was also a talk given by a reputed gynaecologist, where we learned so many essential truths about the details of FGM that no one else talks about. So enlightening!

It was as if there was a strange connection between all of us toward the end of the program. It’s not news that Bohras suffer from a major identity crisis anyway, considering most cultural aspects are borrowed from different parts of the world with no real roots anywhere. For someone who always found it hard to really fit in anywhere, it was as if I had found home at last. In spite of everyone at the retreat coming from such different backgrounds, locations and mindsets, it was really amazing.

I, personally, have always felt very strongly about FGM/C and the concept of a random third person deciding what should be done with my body without my consent. But this experience and interaction has not only changed the way I see things, but has also made my resolve and conviction stronger – about fighting for every girl child out there, subjected to any such torture and abuse, until I have no life left in me, irrespective of how long it takes.

For showing me how to efficiently channel all that I feel toward all forms of injustice done to women, and for this beautiful chapter of my life, I will be forever grateful to Sahiyo.

 

The Disturbing Trend of Medicalising Female Genital Mutilation

by Lorraine Koonce-Farahmand

In the Zero Tolerance campaign to end Female Genital Mutilation (FGM), what has been noted is the arc of progress. Increasingly, women and men from practising groups have declared support for ending FGM; and in several countries, the prevalence of FGM has decreased significantly. A BMJ Global Health study reported that the rates of FGM have fallen dramatically amongst girls in Africa in the last two decades. Using data from 29 countries going back to 1990, the BMJ study found that the biggest fall in cutting was in East Africa where the prevalence rate dropped from 71% of girls under 14 in 1995, to 8% in 2016.  Some countries with lower rates – including Kenya and Tanzania, where 3-10% of girls endure FGM – helped drive down the overall figure. Nevertheless, UNICEF’s groundbreaking report shows that whilst much progress has been made in abandoning FGM, millions of girls are still at risk.

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Flourishing against this backdrop is the compromise of medicalisation of FGM that competes against progress in the Zero Tolerance Campaign. A disturbing number of parents are seeking out healthcare providers to perform FGM. According to the World Health Organization (WHO), medicalisation is when a healthcare provider performs FGM in a clinic or elsewhere. Such procedures are usually paid for under the assumption that medicalisation is not FGM, and is done to mitigate health risks associated with the practice. Consequently, in recent years, the medicalisation of FGM has taken place globally, particularly in Egypt, Indonesia, Kenya, Malaysia, Mali, Nigeria, Northern Sudan, and Yemen. In many of these countries, one-third or more of women had their daughters cut by medical staff with access to sterile tools, anesthetics, and antibiotics. The non-governmental organization, 28 Too Many has investigated the involvement of health professionals and has highlighted what must be done to reverse this trend. 28 Too Many reported that the medicalisation of FGM in Egypt is an enormous challenge. Currently, 78.4% of incidences of FGM in Egypt are carried out by health professionals. Egypt had the highest rate of health workers performing FGM at 75%, with Sudan at 50% and Kenya at 40%. A 2016 study by The United Nations International Children’s Emergency Fund (UNICEF) and the Africa Coordinating Centre for the Abandonment of FGM/C (ACCAF) also found that FGM is increasingly being performed by medical practitioners.   

Parents and relatives seek safer procedures, rather than outright abandon FGM. The medicalisation trend has conveniently forgotten that FGM violates women’s and children’s human rights to health, to be free from violence, to have the right to physical integrity and non-discrimination, and to be free from cruel, inhumane, and degrading treatment. The “just a nick” is essentially gender-based violence (GBV). What is being “nicked” is still part of a woman’s labia majora, labia minora or clitoris. The medicalisation of FGM perpetuates that women are inferior human beings. This is not in harmony with international human rights standards.

There is also clearly an economic incentive for promoting medicalisation. Medical personal perform it for financial gain under the premise that if the crux of the issue is the health side effects and pain, by using sterilised instruments and medication the problem has dissipated. The misguided assertion that medicalisation is a viable option is ignoring the fact that all types of FGM have been recognised as violating human rights. These rights that have been codified in several international and regional treaties mirror worldwide acceptance and political consensus at various UN world conferences and summits. Committees such as The Committee on the Elimination of All Forms of Discrimination against Women, (CEDAW), the Committee on the Rights of the Child, and The Human Rights Committee have been active in condemning FGM. Medicalisation goes against the principles enshrined in these treaties and conventions.

The disturbing medicalization trend continues to argue that this less severe form of FGM can protect girls and women from harm. This was echoed in The Economist article of June 18th, 2016, Female Genital Mutilation: an Agonising Choice’. In the article, it was asserted that because three decades of campaigning for a total ban on FGM have failed, a new approach is warranted. The article advocated “nicking” of girl’s genitals by trained health professionals as a lesser evil. This reasoning was echoed in the Journal of Medical Ethics by two U.S.-based doctors, Dr. Kavita Shah Arora, Director of Quality, Obstetrics, and Gynaecology at the MetroHealth Medical Center in Cleveland, and Dr. Allan Jacobs, Professor of Reproductive Medicine at Stony Brook University. They wrote that “we must adopt a more nuanced position that acknowledges a wide spectrum of procedures that alter female genitalia.” They assert that they do not believe minor alterations of the female genitalia reach the threshold of a human rights violation. They also asserted that the nicking of the vulva and removing the clitoral hood should not be considered child abuse. They posit that by undergoing these acceptable procedures in the U.S. during infancy, girls can avoid the risk of being sent abroad for more extensive procedures.

These doctors and writers from influential respected journals are often held in high esteem by decision-makers, policy-makers, and experts. However, the advocation of medicalisation grotesquely undermines the hard and courageous work undertaken to end FGM worldwide. The medicalisation trend has ostensibly failed to recognise that the proposal of removing the clitoral hood and “just nicking” the vulva contradicts the WHO’s statement that there is absolutely no reason, medical, moral or aesthetic, to cut any part of these exterior organs.

There are compelling reasons why the medicalisation of FGM is fundamentally wrong.

  • The medicalisation is and would be carried out on young girls between infancy and the age of 15. Medicalisation is an attack against the sexual and psychological integrity of young girls. Many are not in a position to say no, unable to give informed consent or to effectively resist the practice.
  • Medicalisation reflects a deep-rooted inequality between the sexes and constitutes an extreme form of discrimination against women. In some communities in order to be married a female is not considered an adult and “marriageable” without undergoing FGM, which may be performed to define her gender and/or ethnic identity. In many African communities, marriage is a women’s predominate source of economic survival. The medicalisation trend reinforces and supports this lack of choice women must make in order to be accepted in their society.
  • Accepting certain types of FGM would lead to confusion for communities and health professionals. It will adversely affect the work done on raising awareness of FGM and prevention and protection of girls.
  • The risk of a well-founded fear of persecution would be seriously undermined for asylum seekers. Asylum seekers with potential claims for international protection, either for themselves or for daughters, could plausibly be denied refugee status if confusion is created on whether or not the type of FGM they would be potentially subjected to constitutes a well-founded fear of persecution.  

The medicalisation of FGM is not an appropriate response to the health risks associated with FGM. All FGM causes a variety of negative outcomes for the health and psychological well-being of women and girls. Medicalisation fails to eliminate long-term gynaecological and obstetric complications, as well as the lifelong emotional, psychological and sexual problems. It does not prevent the feelings of anxiety, betrayal, depression, low self-esteem, panic, phobia nor other psychological issues. As FGM has no proven medical benefits, as professionals who have sworn to the Hippocrates oath to do no harm, ultimately, it is unethical to contribute to the continuation of a procedure that is quite harmful and disabling for women. Medicalisation of FGM gives it an aura of normalcy, legitimacy, and acceptability. The mutilation of females is outrageous when considering that the alterations proposed are both traumatic and life-changing.

An additional concern of the medicalisation trend is the bleak message that removing a female body part for non-medical reasons is acceptable as it is just a “nick.” Who will be there to determine the measure of the “nick”? What part shall be nicked? The clitoral prepuces? The labia minora? Near the special receptacles of nerve endings that are clustered in the clitoris?  The skin of the inner surface of the labia? Is the medicalisation trend assuming that this undefined “nicking” by a chosen trained professional now is safe and correct?

The implication that it is just a nick obscures and trivializes the underlying degradation that this nick imposes on a woman and the senseless attack on women’s’ genitals for no other reason than that they are female. It reinforces the sense of inferiority on this already marginalised gender.

FGM is not open for debate without violating international law and medical ethics. As long as it is accepted in any form, FGM will thrive. Partial FGM is simply not acceptable. A nick is simply unacceptable.  The key phrase is zero tolerance.

More about Lorraine:

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Lorraine is is a British solicitor and a New York lawyer. She is currently an international law professor in the Anglo-American Law degree programme at the Universitié De Cergy where she lectures on gender law and human rights, and at the Universitié De Paris-Dauphine where she lectures on the Legal Aspects of Gender Violence. She is often an invited speaker on GBV and FGM. Recently, she was invited as a speaker to lead the medicalisation workshop at the End FGM European Network conference that was held in Paris.

 

How doctors responded to my genital mutilation: An American woman’s 70-year journey

By A. Renee Bergstrom, EdD

Country of Residence: United States

Renee chronicles her experiences with American physicians from the time she was cut at three years of age until seventy years later when she became an advocate against female genital mutilation. She also shared her story during the Sahiyo Stories Workshop to encourage other women to speak out.

  • 1947—age 3—My mother took me to a doctor because she was concerned that my little face turned red when I touched my clitoris. This fundamentalist Christian physician believed masturbation to be a sin and practiced his religion with a scalpel in a Wahpeton, North Dakota, clinic. He removed my visible clitoris. Some of my sensitive tissue fused to my inner labia.

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  • 1959—age 15—I drove myself to the same clinic not realizing this was where my mutilation took place. I complained to the doctor about the uncomfortable tugging sensation from my scar. He did not examine me or offer a solution. (Separating the scar may have solved the problem.) Instead, he gave me a brochure on the sin of self-pleasuring.
  • 1965—age 21—During my premarital examination (why were these required?), I told the doctor I was not sure I would be able to have “normal” orgasms like other women. He faced the wall and did not comment.
  • 1967—age 23—During my first childbirth, my scar did not stretch, so second stage labor came to a halt. I was given anesthesia against my will and did not wake up until four hours after our daughter was born. My obstetrician had performed an extensive episiotomy to enable her to be delivered vaginally. He did not mention the details of my birthing experience while I was in the hospital or at my six-week postpartum checkup. Later, when intercourse was uncomfortable and my vagina seemed lumpy, I returned to discuss the problem. He showed me pictures of normal female genitalia in an anatomy book and said, “Renee, you don’t look like other women.” He thought I could have had a bike accident as a child. He was shocked when I told him my story. I believe he prescribed lubricating gel to use until I healed completely, which took a couple of months.
  • 1968—age 24—When I was pregnant with our second child, I made an appointment with the same obstetrician. I waited and waited in the examination room and finally another obstetric physician came in. He said the other doctor was leaving to put IUDs in African women and would not be available to provide my care. In retrospect, I think his experience with me touched him deeply and he couldn’t face me to say goodbye. I came home crying and my husband thought there was something wrong with the baby. I had hoped to continue my obstetrical care with this compassionate physician so I felt a great loss. The next doctor assigned to me urged me to allow him to connect me with William Masters and Virginia Johnson of the research team. He thought they would be interested in my sexual response and would pay me well to participate in experiments. He suggested this at every visit and I repeatedly declined. He anesthetized me for the delivery. I awakened in a cold delivery room with my feet still in the stirrups, my episiotomy unstitched and my struggling son in a bassinet out of my reach. The OB team had left me to attend to another woman’s emergency.
  • 1970—age 25—I gave birth to our second son eleven months after his brother was born. I was semi-awake as he moved through the birth canal. The baby urinated immediately and the doctor held him so he peed in my face. I missed the first two birthing experiences and this rude, unfeeling man tainted the one when I was alert. Being cut took away my dream of the deeply spiritual joy of birthing.
  • 1981—age 37—I began my End FGM advocacy when I received funding from the Women’s Desk of the Lutheran World Federation to spend two weeks in Geneva, Switzerland, discussing the issue with international organizations there. My empathetic primary care physician was required to write a letter confirming that I was indeed cut.
  • 1981—In preparation for my 1981 Geneva trip, I attended the University of Minnesota Week of Enrichment designed to help doctors, pastors and therapists respond compassionately to those who bring a variety of sexual issues to them. This allowed me to practice telling my story in a small group supportive environment. When word got out that I was in attendance, a surgeon came and offered to create a faux clitoris for me with one of my nipples. I thought about it for awhile, then declined the offer in the parking lot while she stood next to her car. She was visibly angry, so I responded, “Why should I allow another part of my body to be mutilated when sexual intercourse is sufficiently satisfying?”
  • Later 1980s—age 40s—Two physician interactions stand out in my memory. I saw a dermatologist for a boil on my labia. When I shared my genital history, she was furious. Such a refreshing response! Previous physicians hid their emotions as if to protect the medical profession. The second experience was disturbing. I fell on metal bleachers at our children’s track meet with a resulting large hematoma on my labia. The beautiful young emergency room physician appeared to suggest that my husband had caused the injury, probably because she saw my strangely mutilated body. I didn’t provide details because there were thin curtains separating me from other patients. A couple of weeks later, we read that she walked into a lake and ended her life. I wonder if she just couldn’t tolerate witnessing the abuse cases she faced in the E.R.
  • 1997—age 53—My genital scar began to separate. My very caring female primary Unknowncare physician helped me deal with the pain and taught me to massage the area to speed the process, finally ending fifty years of the annoying tugging sensation.
  • 2017—age 73—After several years of sharing my story with compassionate physicians in the Academy of Communication in Healthcare, a male senior faculty member apologized to me from the medical profession for what I suffered. Accepting his apology helped free me to move forward with END FGM advocacy.