Sleeping researchers and lack of data on female genital cutting in Pakistan

By Huda Syyed

Two decades ago, I flipped through Reader’s Digest to distract my mind from schoolwork and the sweltering summer heat of Pakistan. My eyes glanced at the brief excerpt displayed mid-page with a glossy picture of a famous Somalian model, Waris Dirie. She exuded a sense of resilience, and I knew there was a meaningful story behind this woman. I was immersed in the daunting narrative of how she was blindfolded by her own mother to be cut. The pain was physically traumatizing, and she passed out. By the age of thirteen, Waris Dirie was coaxed by her father into the idea of an arranged marriage to an older man. Her dismay toward this proposal culminated into a desire to run away from home. 

She eventually found her way to London as a model. She still carried the realization that female genital cutting (FGC) extended beyond physical invasion, and resulted in health complications and deaths for many girls in Somalia. This encouraged her to become an activist, and she has dedicated herself to ending FGC. 

As I grew older and gravitated toward research and data collection, I found an article that mentioned FGC being practised in Pakistan. I was determined to gather contemporary data and historical understanding on it. Upon further readings, it became clear that FGC was a secretive practice in Pakistan in the Dawoodi Bohra community. 

A collective discernment of these realities pushed me to dig deeper and write a research paper that explored this practice and its socio-sexual effects. Apart from a few newspaper articles about FGC, there was not much information. It happens, but nobody talks about it. People from other communities are usually unaware that khatna is practiced in Pakistan. I was met with reactions of disbelief when I had discussions about it with non-members of the Dawoodi Bohra community. 

Sahiyo was one of the few reliable sources that recorded important data regarding FGC practices within the South Asian region (it also included Pakistan). Sahiyo focused on creating a culture of dialogue to uncover this practice; they also recorded numerical data, which could be helpful in tracing the frequency and historical context of FGC. Cutting is discreetly performed in residential spaces and not usually practised in conventional medical environments in Pakistan. Sahiyo surveys revealed this piece of significant information, which I later correlated with my own qualitative data. The interviews I conducted with a few participants in Karachi revealed that most of the young girls were cut at secluded spots inside a home, where some woman is well-versed with the physical practice of genital cutting. 

My main point of emphasis is that there is minimal research data on FGC in Pakistan, understandably so, because minority communities feel threatened or shamed for their cultural practices. 

Minorities in Pakistan have faced prejudice and threats in the past; hence, the need for cultural sensitivity while addressing FGC is imperative. Moreover, Pakistani society follows a patriarchal mindset, where female genitals or sex are uncomfortable topics to discuss publicly. This makes it challenging to have verbal discourse for the acquisition of qualitative data, because many women feel FGC should remain a secret. The lack of credible statistical data in Pakistan makes it difficult to track the frequency of FGC in contemporary culture. It is important to collect more data on FGC in Pakistan so it can be correlated with the socio-economic conditions, family set-up and religious leanings of young girls and women. Information of this sort could allow for a deeper understanding of bodily autonomy and factors that are more likely to foster a mutual respect for their bodies and its protection. 

There is a dire need for dialogue and engagement with the Dawoodi Bohra community from a culturally respectful distance. It is important for their community to feel unharmed and safe because this approach could lead to meaningful qualitative data that could help everyone understand the near permanence of FGC. 

Interviews, verbal discourse, and discussions are a gateway to accessing the historical, emotional, and psychological attachment of community members to this physically invasive practice. One of my interview participants expressed that FGC was a way of ensuring that a woman does not stray from her husband (possibly due to decreased sexual desire or libido response), and she did not see it as a harmful act. Keeping in mind such sentiments, it is vital to bridge the insider versus outsider dynamic by listening, recording, and preserving the anonymity of data respondents. 

If young girls and women in the Dawoodi Bohra community of Pakistan feel comfortable and secure discussing this topic with outsiders of the community, there will be more possibility of gathering useful data that could be utilized in creating support groups and spaces for those that have experienced physical or psychological strain or trauma due to cutting. 

Finding participants for qualitative data collection was a tedious task because very few women were willing to speak about this. Even within one community, there are those that deem FGC as a problematic practice; but there are also those that associate religious and cultural significance with it.

Researchers must take a softer approach that refrains from shaming the community for ancestral practices. The objective should be to safely record community narratives and observe their historical reasoning for FGC, so that long-term solutions can be sought that diplomatically create safe options and spaces for young girls to celebrate the freedom of bodily autonomy.

Population Council hosts webinar to discuss ending female genital cutting

By Hunter Kessous

The Population Council hosted a fascinating webinar, Using Research to Understand and Accelerate The Abandonment of Female Genital Mutilation/Cutting (FGM/C). It was the second of two webinars from a series titled, Evidence to End FGM/C: Research to Help Girls and Women Thrive. The most recent webinar reported some of the findings of a research consortium that began in 2015 and culminated this year. The research spanned eight countries and concluded with how initiatives to end FGM/C may be optimized. 

Speakers included Bettina Shell-Duncan, University of Washington (moderator); Nada Wahba, Population Council, Egypt; Dennis Matanda, Population Council, Kenya; P. Stanley Yoder, medical anthropologist; and Nafissatou J. Diop, UNFPA.

Dr. Matanda spoke on the use of data to inform programming. His research spanned Kenya, Nigeria, and Senegal, and sought to map hotspots for FGM/C. The data pinpointed the areas of each country in which FGM/C is most prevalent. Dr. Matanda’s findings also reveal how factors relating to a girl’s mother influence the likelihood that she will be cut. The results varied by region, but some of these factors included the mother’s ethnic group, her beliefs surrounding FGM/C, and if she herself was cut. The most important takeaway from Dr. Matanda’s research is that considering only national data masks local variations. He recommends linking regional data to subnational policies and efforts to prevent FGM/C from occuring to future generations of girls. 

Medical anthropologist Dr. Yoder responded to Dr. Matanda’s research, remarking that Kenya was the only country of the three where the level of education of the mother was found to have an effect on the risk of a girl being cut. He proposes modernization, the shift from traditional and rural to secular and urban, as an explanation for Dr. Matanda’s findings. I believe that Dr. Yoder’s theory illuminates a need for ongoing research on this subject that correlates the changes in Kenya’s social, economic, and political growth to changes in the continuation of FGM/C. 

Following Dr. Yoder’s analysis, Wahba presented her research on the intersection of FGM/C and gender in Egypt. Hers was a qualitative study with multiple intriguing findings. One discovery that I found especially important was that conflicted mothers have been turning to doctors to decide on their behalf whether or not their daughter should be cut. This could be a result of the increasing medicalization of FGM/C in Egypt. Another interesting finding was that if either one of the parents, whether it be the mother or the father, does not want their daughter to be cut, then she will not undergo FGM/C. While many programs working to end FGM/C target the mother as the decision maker, Wahba’s research clearly shows that mothers are not the only influential group. For this reason, more anti-FGM/C programs should shift their efforts to also educate fathers and doctors, particularly in regions with high rates of medicalization. 

Diop followed Wahba’s presentation to provide analysis of the research. Diop feels strongly that FGM/C is rooted in gender inequalities, yet not nearly enough programs acknowledge this fact. She claims many programs that address cutting are gender blind, focusing too much on the consequences of FGM/C in their approach rather than the root causes for why FGM/C continues in the first place. Diop’s comments were a strong call to action for all advocates to take a gender transformative approach in order to achieve abandonment of FGM/C. 

More information about this research project can be found here.

The webinar can be viewed here.

U.S. may deny asylum for females fleeing gender-based violence

By Hunter Kessous

(Follow this link to take action immediately and stand with survivors before July 15th.)

At the age of 17, Fauziya Kassindja narrowly escaped undergoing female genital cutting (FGC) and a forced marriage in her home country of Togo. She used a fake passport to make her way to the United States, and upon arriving at the border, explained to the officials that her document was fake and she was there to seek asylum. She was placed in a maximum security prison for nearly two years. Her case for refuge was initially denied, and was appealed to the highest immigration court in the U.S. where she was finally granted asylum. In 1996, Fauziya became the first to gain refuge in the U.S. on the grounds of escaping FGC. Her victory set the precedent for future immigrants to receive asylum from gender-based persecution. 

In addition to the precedent set by Kassindja’s case, there are multiple legal reasons why FGC qualifies as persecution. It violates multiple human rights documents, including the Universal Declaration of Human Rights, the International Covenant on Civil and Political Rights, and the Convention on the Rights of the Child among others. To qualify for refugee status, an individual must prove the persecution they fear is for reason of her race, religion, nationality, membership of a particular social group, or political opinion. FGC is often thought to be a religious requirement. It can also be argued that opposition to FGC is a political opinion. 

It seems obvious that FGC should be grounds for asylum in the U.S. Yet, women are still refused for reasons that are often untrue or impossible, such as “woman can refuse to be cut or “the woman can relocate.

Now, refuge for women escaping FGC may be significantly limited. A proposed rule by the Homeland Security Department and Executive Office for Immigration Review set to be finalized on July 15th, would radically restrict eligibility for asylum, especially for those fleeing gender-based violence (GBV) and for LBGTQIA+ individuals. The regulation bars evidence that supports an asylum claim if it could be seen as promoting cultural stereotypes. On this basis, a judge could refuse refugee status to a woman fleeing FGC because the judge may think it promotes a cultural stereotype. A woman escaping GBV could be denied asylum on the grounds that feminism is not a political opinion. It even allows officials to dismiss some asylum applications without a hearing. These are only a few examples of the many ways this rule would dismantle the U.S. asylum system.

We must act now to protect women and girls. The rule will go into effect July 15th, but before it is finalized the government must read and respond to comments sent by organizations and individuals. To submit a comment, follow this link. A sample comment is provided, but it is imperative to make your comment unique in order to ensure that it is read and responded to accordingly. 

For more resources to fight the finalization of this harmful rule, read this document containing websites for action-taking, informative webinars and articles, and sign-on letters. 

Population Council hosts second webinar on FGM/C research

By Hunter Kessous

The Population Council recently hosted a fascinating webinar, “Using Research to Understand and Accelerate The Abandonment of Female Genital Mutilation/Cutting (FGM/C).” It was the second of two webinars from a series titled, “Evidence to End FGM/C: Research to Help Girls and Women Thrive.” The most recent webinar reported some of the findings of a research consortium that began in 2015 and culminated this year. The research spanned eight countries, studying FGM/C, and researched how initiatives to end the practice may be optimized. 

Speakers included Bettina Shell-Duncan, University of Washington Seattle (Moderator); Nada Wahba, Population Council, Egypt; Dennis Matanda, Population Council, Kenya; P. Stanley Yoder, Medical Anthropologist; and Nafissatou J. Diop, UNFPA.

Dr. Matanda spoke on the use of data to inform programming. His research spanned Kenya, Nigeria, and Senegal, and sought to map hotspots for FGM/C. The data pinpointed the areas of each country in which FGM/C is most prevalent. Dr. Matanda’s findings also reveal how factors relating to a girl’s mother influence the likelihood that she will be cut. The results varied by region, but some of these factors included the mother’s ethnic group, her beliefs surrounding FGM/C, and if she herself was cut. The most important takeaway from Dr. Matanda’s research is that considering only national data masks local variations. He recommends linking regional data to subnational policies and efforts to prevent FGM/C from occuring to future generations of girls. 

Medical anthropologist Dr. Yoder responded to Dr. Matanda’s research, remarking that Kenya was the only country of the three where the level of education of the mother was found to have an effect on the risk of a girl being cut. He proposes modernization, the shift from traditional and rural to secular and urban, as an explanation for Dr. Matanda’s findings. I believe that Dr. Yoder’s theory illuminates a need for ongoing research on this subject that correlates the changes in Kenya’s social, economic, and political growth to changes in the continuation of FGM/C. 

Following Dr. Yoder’s analysis, Nada Wahba presented her research on the intersection of FGM/C and gender in Egypt. Hers was a qualitative study with multiple intriguing findings. One discovery that I found especially important was that conflicted mothers have been turning to doctors to decide on their behalf whether or not their daughter should be cut. This could be a result of increasing medicalization of FGM/C in Egypt. Another interesting finding was that if either one of the parents, whether it be the mother or the father, does not want their daughter to be cut, then she will not undergo FGM/C. While many programs working to end FGM/C target the mother as the decision maker, Wahba’s research clearly shows that mothers are not the only influential group. For this reason, more anti-FGM/C programs should shift their efforts to also educate fathers and doctors, particularly in regions with high rates of medicalization. 

Nafissatou Diop followed Wahba’s presentation to provide analysis of the research. Diop feels strongly that FGM/C is rooted in gender inequalities, yet not nearly enough programs acknowledge this fact. She claims many programs that address cutting are gender blind, focusing too much on the consequences of FGM/C in their approach rather than the root causes for why FGM/C continues in the first place. Diop’s comments were a strong call to action for all advocates to take a gender transformative approach in order to achieve abandonment of FGM/C. 

More information about this research project can be found here.

The webinar can be viewed here.

 

Population Council hosts webinar highlighting research on FGM/C

By Hunter Kessous

On May 14th, the Population Council hosted the first of two webinars comprising a series titled, “Evidence to End FGM/C: Research to Help Girls and Women Thrive.” Beginning in 2015 and culminating this year, the Population Council has led a research consortium spanning eight countries that studied the practice of female genital mutilation/cutting (FGM/C) and how initiatives to end the practice may be optimized. The first webinar, “Improving the Health and Legal System’s Response to FGM/C,” allowed researchers to present the findings of certain studies. 

Speakers included Bettina Shell-Duncan, University of Washington; Jacinta Muteshi-Strachan, Population Council; Agnes Meroka-Mutua, University of Nairobi; Samuel Kimani, University of Nairobi; Wisal Ahmed, World Health Organization; and Flavia Mwangovya, Equality Now.

Dr. Muteshi-Strachan explained the four themes of the research consortium: the first being to build the picture by exploring the who, what, where, when, and why of FGM/C, and how these details are changing. The second theme detailed interventions to end FGM/C: what is working, where and why. The wider impacts of FGM/C and interventions were explored. Finally, the fourth theme assessed what constitutes valid measurements of change. This is an exciting project, as it not only expands the body of research on FGM/C, but also adds new, fresh insight. 

FGM/C and the law was the first research topic covered. Dr. Meroka-Mutua spoke on the findings of her research in Burkina Faso, Mali, and Kenya. One discovery showed that the efficacy of a law can be limited by nature, content, administration and implementation. An interesting take away from this project was that laws working to end FGM/C can be more effective if written and implemented in a manner than does not seem to attack the cultures of the practicing communities. With the news of Sudan’s recent outlaw of FGM/C and the thriving, ongoing work toward passing more bans, Dr. Meroka-Mutua’s research feels all the more relevant and important. Going forward, policy makers would better serve their communities by keeping in mind these findings regarding the most effective wording for new laws.

Dr. Kimani presented his research assessing the health system response to FGM/C in Kenya and Nigeria, through both prevention and provision of curative services. The findings showed a need to integrate FGM/C interventions into existing health systems platforms, to perform targeted training of health care providers, and to improve data systems. Based off this research, nonprofits could expand their efforts into the healthcare setting, or perhaps new nonprofits will be created in order to tackle preventing FGM/C through health systems platforms.

Wisal Ahmed discussed the World Health Organization’s (WHO) action plans. One of these plans includes developing tools for health care providers to better support their communities. The most exciting of WHO’s action plans includes an FGM Cost Calculator, a data tool that reveals the savings in health costs associated with abandonment of FGM/C, proving the economic burdens of the practice. 

Finally, Ms. Mwangovya of Equality Now offered perspective on implementing research into programs and policies working to end FGM/C. She advises nuancing and contextualizing research, including thinking critically about the subjects used in a particular research study and how they compare (culturally, religiously, geographically, etc.) to the population one is working with is necessary to best optimize the results of the research.

More information about this research project can be found here.

The webinar can be viewed here. 

 

Farzana Esmail hosts fireside chat on FGC with co-founder of Sahiyo

By Hunter Kessous

Mariya Taher, U.S. Executive Director and co-founder of Sahiyo, and Farzana Esmail, survivor, mother and advocate, sat down together to have a virtual fireside chat on female genital cutting: part interview, part sincere exchange of stories, and part education. Upon introducing Mariya’s background, Farzana asks her to call on her expertise to explain female genital cutting (FGC) to the audience, using World Health Organization classifications and statistics regarding global practice. Throughout the chat, Mariya provides essential background on FGC, making this a great video to watch for people of varying knowledge levels on FGC. 

 

Farzana described her experience of discovering through Sahiyo’s Voices to End FGM/C that FGC is practiced not only in the Bohra community, but in Africa as well. Mariya explained that this misconception exists only because Africa is where the bulk of the research on FGC was occurring until recently. FGC has been recorded as being practiced in at least 92 countries. Sahiyo conducted research on the Bohra community and discovered 80% of women from their sample had been cut. 

Another finding of that same study was that 81% of women did not want FGC to continue for the next generation. Farzana asked the important question of why FGC continues to be practiced if so many women feel this way. Mariya used the concept of pluralistic ignorance to explain: the tradition lives on because nobody in the community talks about FGC and therefore, nobody knows that other women are also suffering and do not want to cut their daughters. Sahiyo’s social change platform was born to amplify the stories and voices of survivors. Mariya references a study finding that in order to achieve social change, 25% of a community is needed to reach a certain tipping point, which is slowly happening within the Bohra community. 

Mariya also discussed the shift from the Millenium Development Goals (MDGs) to the Sustainable Development Goals (SDGs) – an important global health policy. The MDGs were a UN framework created in 2000 that enlisted all countries who signed on to put an end to various issues globally and to measure their achievement towards these goals. The MDG goal to abandon FGC only applied to 29 or 30 relevant countries, which were mostly within Africa and the Middle East. The issue here is that FGC is a global issue. It is prevalent in South Asia and is practiced in at least 92 countries. The SDGs, which followed the MDGs, finally recognized that FGC is a global practice. The fifth SDG specifically calls on countries to decrease FGC globally and measure the prevalence rates within their communities. 

In a similar vein to the importance of recognizing FGC as a global practice, Mariya shares the importance of involving men in the movement to end FGC. Sahiyo amplifies not only the voices of survivors, but also of fathers, brothers, and husbands of survivors. The goal is to show that FGC negatively impacts entire communities, not only the women who undergo FGC. This is an important action toward abandoning FGC. Revealing FGC to be more than just a women’s issue or a cultural issue means every single person has the right and responsibility to get involved in the movement to end FGC. 

Many are talking about the very important issue of an increase in gender-based violence as a result of the pandemic and the lockdown. Mariya has not noticed an increase in FGC within Asian communities or within the U.S., but instead notes the distress that the lockdown causes many FGC survivors. The isolation makes it harder to seek help, and the sense of a loss of control can trigger a trauma response for survivors. It’s important to draw attention to this issue in order to provide survivors with the services they need. Read the full transcript here, and view this eye opening discussion here.

 

Let’s Talk FGC: A fireside chat with Mariya Taher and Farzana Esmail

Mariya Taher, U.S. Executive Director and co-founder of Sahiyo, and Farzana Esmail, FGC survivor, mother and advocate, sat down together for a virtual fireside chat on female genital cutting (FGC): part interview, part sincere exchange of stories, and part education. Farzana and Mariya intertwine pieces of their personal experience with the facts and information they provide on female genital cutting. This webinar explores FGC as a global practice, the many ways in which it is performed, how it impacts survivors, and related legislation. Mariya and Farzana share the progress toward abandoning FGC that has been made to date, the impact of COVID-19 on this progress, and Sahiyo’s theory for social change. 

Farzana: Mariya, thank you so much for doing this. Before I go on to introduce your illustrious background, if I could take just a few minutes to set the context of our conversation. This is a subject that is extremely personal because I have lived through this. I have long fostered the idea of bringing my story and sharing it in the hope that it triggers conversations, and, in time, banishes the fear and discomfort that surrounds it. We are discussing female genital cutting. 

Mariya, you have been named one of the six experts on female genital cutting by News Deeply. You have worked for over a decade in the anti-gender violence field, from research to policy, program development, and direct service. You have attained your masters in social work from San Francisco State University and went on to pursue a qualitative study titled, “Understanding Female Genital Cutting in the United States.” You have been diligently working on the issue of domestic violence within a number of organizations. In 2015, you founded Sahiyo, an internationally recognized, award-winning organization, to empower Asian communities to end female genital cutting. You sit on the inaugural Steering Committee to end female genital cutting with the U.S. End FGM/C Network. In Massachusetts, you work with The Women’s Bar Association to pass state legislation that would ban FGC and create education and outreach programs for survivors. The Manhattan Young Democrats named you 2017 Engendering Progress Honoree and ABC News did a special feature on you. You have been a prolific writer in fiction and nonfiction essays and short stories that have appeared on NPR, The Huffington Post, the Fair Observer, and a number of credible publications. 

Mariya, the first time that I spoke about FGC with a group of friends I experienced a sense of relief. It was almost cathartic, but I also sensed disbelief, despair, and huge discomfort. There are those who have perhaps never heard of this practice, then there are those who have heard but choose not to speak about it, and then there are those, like us, who have lived through this. So if we can begin today by you just defining for us what in fact is female genital cutting?

 

Mariya: Sure, well, thank you, Farzana, so much for inviting me to speak and for that wonderful introduction. And, this is an incredibly important topic for me as well, as you have spoken a bit about my background. It is also one because I grew up in it, and I underwent it myself when I was seven years old. I wanted to just give that context first before I explain what female genital cutting is because I think it is important to recognize that many girls who have undergone it actually don’t know what they have undergone or even realize that what they have undergone is female genital cutting, or another term that it’s referred to as is female genital mutilation, but for the purposes of our conversation I will tend to refer to it as female genital cutting or FGC. 

So, according to the World Health Organization, female genital cutting involves all procedures involving cutting or removal of part [or all] of the external female genitalia for nonmedical reasons. There are various forms of it. The World Health Organization has actually categorized it into 4 types, but each of these types are very broad in itself. So, type 1 is something that usually involves cutting or excision of the clitoral hood or part of the clitoris, but it is very broad and could also include removal of all of the clitoral hood and also part of the clitoris. Type 2, which is considered more severe, involves partial or total removal of the clitoris and labia minora, with or without excision of the labia majora – so it’s the inner and outer lips of the female genitalia. Type 3 is narrowing of the vaginal orifice by creation of a covering seal, so it is generally the most severe form. It is also known as infibulation, and it can involve removing all of the labia minora and labia majora as well. Then there is type four which is considered the “other” category, and this is really something that involves anything that doesn’t fit in types 1 through 3 which can be pricking, piercing, cauterizing. Those are the 4 broad categories defined by the World Health Organization. Just to give you a little more information of the statistics that we have on female genital cutting, about 90% of women and girls who undergo it undergo types 1 and 2. So, type 3 which is the most severe form only really accounts for about 10% globally, and I think that is really important to recognize, too. 

Farzana: Sure, Mariya, you know when I started to follow Sahiyo, I also got acquainted with a lot of survivor stories, and some of these stories resonated, and I could identify completely. For most of us, the impression that I gathered was that it happens between the ages of 7 and 9. It’s almost something that is led on by either your grandmother, or an aunt, or your mother. The backdrop is a dilapidated dimly lit building where an elderly aunt answers the door and performs the practice. Immediately after that, there is a celebration. While the survivor has gone through an incredible amount of pain, confusion, and almost a sense of betrayal. However, as I went on to read and follow Sahiyo over the years I learned that this practice isn’t skewed to a community or culture, but in fact is being practiced around the world, in many geographies, by indigenous communities. How right is that assessment?

Mariya: That’s correct. What’s interesting is that when people have heard of female genital mutilation/cutting, they have often heard of it in relation to it happening within the African context or amongst African diaspora communities. It’s a myth actually that it only happens within African communities or contexts. I think what you’re bringing up is the opposite because of where you grew up knowing this is something that happens within South Asian communities and the Dawoodi Bohra community, which is the community we both grew up in, but it wasn’t publicly acknowledged that it happened within this community. 

I think that the stories you are describing are very typical of the stories that we hear from survivors who have experienced it within the Bohra community, but there are elements that also ring true for survivors from various different communities. One of the reasons Sahiyo engages in storytelling, and a lot of work is around collecting stories and making this subject that was for so long known as taboo come out into the public, so that we are recognizing that it is okay to talk about that. It’s important to talk about that, to share your stories, and to recognize that there [are] a multitude of stories out there. So, we have heard the stories of girls who are taken by their mothers or aunts under false pretenses, and the dilapidated building you spoke about is an element of a story we hear girls who have gone to Mumbai and had it done often talk about. But, we have also had stories of girls who have been taken to health care professionals and had it [done]. We have other stories of girls who are older and have had it [done]. In the Bohra community it’s typically done around 7 to 9, but globally it’s done in many different communities. There is evidence now that it’s being performed in over 92 countries globally, and it can be done anywhere from birth to adolescence. Even adult women undergo it. So it’s very much a global issue. It is found in every continent of the world, except for Antarctica. It’s something that just in the last few years that we are really recognizing how global it is. 

Farzana: It’s interesting you say that, Mariya, because in one of the surveys I was reading on one of your webinars there was mention that there was research done with 400 women where about 80% of them said that they had undergone FGC and 81% of them, in fact, said that they would not want it to continue, and they wouldn’t do this practice on their own daughters. Then why is it that we still see the prevalence of this practice?

Mariya: That’s a good question. Sahiyo, one of the first things we did when we came together, was we realized that we needed to do a larger scale study to understand how prevalent it was in the Dawoodi-Bohra community. Previous to that there were a couple of small-scale studies, but we wanted to do something to get a larger number. We did this small study where we had women who grew up in the Bohra community globally take part, and we had over 400 women take part in it. About the statistics you referred to, we analyzed, I think, about 384 women’s data after we collected it all. We found that, out of that number, 80% of the women had undergone FGC, which confirmed for us that it was prevalent. That’s something that we anecdotally knew but didn’t have evidence. We also found that 81% said they did not want it to continue onto the next generation. That was surprising to us, and, at the same time though, what it made us realize is that female genital cutting, or khatna as it is called in the Dawoodi Bohra community, is a social norm – meaning it has been justified in all these ways, and that one way in which it is continuing is that, because it has been justified, there’s a sense of belief that even if you don’t want it to continue, you think others in your community are continuing it, so it is being continued. There’s a term in psychology called pluralistic ignorance, and that is basically what we found happening, and part of it was because nobody was talking about this. And if nobody is talking about this then, of course, nobody knows that people are suffering the physical, sexual, emotional consequences of undergoing this. People don’t know that other people don’t want it to continue. So, the first step in terms of combating that pluralistic ignorance is storytelling. It’s coming out in the open. It’s speaking about that, and that’s really the basis of our work and why we do storytelling was because of that research, because we found that there was this huge population that didn’t want it to continue, so we were like how do we break the silence. So that’s really our theory of change; that’s what we recognize and need to work towards. 

Farzana: That’s very, very interesting, again, Mariya, because I personally believe that these kinds of practices go back institutionally in terms of legitimizing fear. There is a shame around it, as well, that makes it difficult for people to have conversations on this. In fact, we are discouraged– systematically discouraged– to have any kind of discourse. What I also found interesting is the reference you made in terms of it being more than just a physical violation, because primarily this practice, that does come across as a violation of physical well being, but, in fact, is almost like an onion peel where there are so many layers that you can keep peeling and those are so deeply entrenched with fear, with purity culture, patriarchy, gender roles, promiscuity, shame. It’s, therefore, so important to be able to see this with a much wider prism, more holistically. This is not just a physical violation, but an emotional violation. It’s a mental violation. In your experience of working with survivors, what do you believe is one of the biggest challenges to overcome?

Mariya: That’s such an important question, but a very hard question. I think it’s important to also recognize that the repercussions of FGC vary from survivor to survivor. Of the stories that I have heard, personally, through our blog and in support groups, I think what I always come away with is the emotional impact that it has regardless of a person’s background, the severity they have undergone, how they underwent it – that emotional impact is something that lasts a lifetime. It comes across in many different ways: we have stories from women who don’t remember being cut, which is actually very common, because with trauma, the way your brain protects you, it switches it off. We have had stories of women who do not remember they were cut, and, sometimes, until somebody else told them they were cut, didn’t even realize it. But in determining that information it’s almost like going through PTSD again, too, and for some women it is almost like piecing together pieces of a puzzle. They are recognizing or wondering if certain impacts on their sexual lives are a part of it. It is something that, unfortunately, there’s not enough research around the sexual impact, particularly amongst Type I, we don’t really know. But, again, sexuality is very much connected to your emotional state and to your mind. So that’s one thing across communities and individuals that I come away with is that emotional impact. But, again, this is something that affects people physically, sexually, in many different ways. It’s important to recognize every survivor is going through their own journey in terms of what they are dealing with. 

Farzana: You know, in my case, if I could just use my reference, just for a few minutes here. Perhaps this analogy will sound a bit absurd, but I will go with this analogy. It’s like childbirth: you forget the physical pain, because the emotional sense is so heightened with joy. Similarly here, the physical pain is forgotten. I don’t remember the pain, but the sense of deceit at the hands of my mother has been huge. But again, I completely recognize that my mother came from a generation that was less educated, less informed, less encouraged, perhaps not encouraged at all to speak their mind. But again, it is the same woman who today hasn’t enforced on me or has expressed those views for me to practice it on my daughter. So I do believe there is a huge hope of change, and because Sahiyo is so dedicated to ending FGC. In your opinion, how far are we from the day that this is something that we won’t see happen? I know you don’t have a crystal ball but…[laughs]

Mariya: Social change takes time, it takes a lot of work. There is a lot of work to still be done, but…

Farzana: How far perhaps– sorry to interrupt– if perhaps you could tell us how far have you come from the time that you started?

Mariya: I want to recognize also that there have been women and researchers even within the Bohra community that have been bringing this to the world’s attention prior to Sahiyo, as well. I want to also just acknowledge the women from past generations and men from other communities that have been working on this topic in various cultures and communities, too. Just to recognize that is something that’s been ongoing and there has been a lot of amazing important work being done for decades. Having said that, I do think that we have seen a lot of progress in the last five years, as well, in terms of acknowledging that this happens within many Asian countries and communities. And that is something we are seeing from the largest levels from looking at systematically, even looking at the UN in terms of measuring FGM/C. There is something called the Sustainable Development Goals which have come out from the UN. The Sustainable Development Goals are a framework which every country who signs onto the SDGs they are responsible for making progress towards those goals. Then there’s SDG number 5 which is specific to FGC and decreasing FGC globally. I am bringing that up because prior to the Sustainable Development Goals, there was a platform called the Millennium Development Goals that was a similar framework towards measuring achievement towards various social ills globally. Within the MDGs they did have a target to decrease FGC globally, but it was only amongst what they considered relevant countries, so countries that had prevalence rates, which was mostly in sub-Saharan Africa and the Middle East. So at that time, it was only amongst, I think 29 or 30 countries. The SDGs, this new framework, actually accounts for the fact that it is global. It is no longer just counting the estimates within those 29-30 countries, it’s actually globally. It’s a huge, huge deal because it’s recognition that this is a global issue. That is progress within itself. I just want to mention that in terms of the highest levels. 

In terms of the lower level, the communities and individuals, we are hearing more stories. More survivors are sharing their stories. More people are coming out to publicly say we shouldn’t do this. That’s huge, and I do think that we are getting to that tipping point that we need. There’s research that shows once you get 25% of a community to reach a certain tipping point, that’s when you see change within social norms. I feel like we are getting to that tipping point. I want to recognize that I don’t think that– I want to be hopeful that it ends in my lifetime. But, I also want to recognize that change is happening, and I think we need to celebrate that change and those small wins along the way. 

Farzana: Sure, of course. Legislatively, what does it look like? Are more and more countries warming up to the idea of putting a ban to this practice? Is that something that is a huge hurdle to cross?

Mariya: That is. I think legislation is important because it is a framework in which countries can, and it is a tool you can use for prevention. We are seeing more and more countries passing legislation. Within the U.S., it’s a very long story, but our federal statute was actually challenged, and so our Congress is working on a stronger piece of legislation. Individual states have been working on state laws. So, that has been amazing to see the past few years. Within Africa, most countries have it banned. It’s challenging within Asia. That is because Asia has only recently come on the map in terms of FGC being performed, and it is a very different circumstance where it is actually protected in various countries. We are seeing people challenging those social norms and that legislation. In India, we are seeing groups working towards passing a state law and are really urging the Supreme Court in India to have a ban on FGC. In that context it’s being challenged as, ‘Are we protecting girls from harm versus a religious minority right?’ You’re seeing different challenges, but you’re seeing overall that the conversation at a global level is increasing. Again, that is a first step in the right direction. 

Farzana: Apart from [countries in] Africa, are there any other countries that have gone ahead and banned the practice?

Mariya: Yeah, there are many countries that have laws against it. I don’t know off the top of my head the number. But, for instance, in Europe there are many countries that have legislation against FGC, recognizing that it happens in various countries there. Australia does as well. There was a court case that really brought it to light a few years ago. There’s attempts to strengthen the legislation within Australia, too. It is something that you are seeing in many different countries.

Farzana: In one of the stories that led me to further read was khatna [as FGC is called in the Bohra community] packages, travel packages. It was almost as if you could do a khatna tour. So if it was a practice that was forbidden in the country of residence, you could actually take a trip down to India for four to five days, have this practice done, and then come back again. So that was extremely disturbing to know that they were actually selling it is a package for tourists. 

Mariya: I had not heard of the khatna packages, but it is very common to hear. There’s a term I don’t really like using, but it’s vacation cutting: the idea that girls are taken to various countries and countries of origin to have their FGC done. It sounds like this is the khatna package that you have heard of.

Farzana: Yes, yes, that’s right. 

Mariya: I wasn’t aware of that term, but it can be more complicated than that, too. In my circumstance, it wasn’t that my parents took me to India to have it done, specifically. It was that we went to India to visit relatives and it was the summer that I was 7 that it happened. But it is a growing concern that, as countries are creating laws and policies, that might be a repercussion or unintended consequence that they might be taken to other countries. There also are laws. For instance, in the U.S., there is a vacation cutting provision, where if a girl is taken out with the intention to have that done in another country, a person can still be prosecuted. So that’s one thing to be aware of. As we are talking about legislation in general, I think law is an important framework, but I dont think law alone will end this practice. I do think it is really important to recognize that we need community education. We need to work in a very multi-sectoral approach. We are really looking at changing against social norms, and you really need to have community dialogue and education. It is much more important than legislation, but legislation does help to reinforce that something is not acceptable within a community. But, it is really that changing of a mindset that is what we are trying to do. 

Farzana: I completely agree. I think it becomes even more incumbent upon us to be able to come out and share these stories. Change can only come out if there are conversations happening around it. We have got to somehow muster up enough courage to share our stories and hopefully that should bring change. Mariya, you also touched upon something that I have questioned several times, and that is the role of men. How important is the role of men in this practice of FGC? 

Mariya: Involving men is very important, and something Sahiyo really tries to do, as well. We really look at FGC as a community issue, and we are really trying to show that FGC affects obviously the survivor, the women who undergo FGC, but it also affects the entire community. Particularly, we have stories from men who talk about hearing how it impacted their mothers. We have stories from men who have talked about how it impacted their wife and their own marital relationship. We have stories from brothers who have talked about learning that it happened to their sister and wondering if that is part of what divided them in terms of their relationship. It is something that we need to recognize as a community. We have to come together to work to make sure nobody is harmed – future daughters, future sisters, future mothers are protected from this form of gender-based violence, which can impact their lives in many different ways throughout their lives. It’s something that we work very hard to make sure that men’s voices are heard, that they are allies, and that they also are sharing their stories. Particularly, for a very long time within the Bohra community (and this isn’t true for every community, but is in an element that you find often). But for a long time within the Bohra community, men were not aware of this issue or it was something that was considered a women’s issue. That is changing. I think it is changing because of social media, because of technology, because people are just talking about it more, and, so now, in the younger generation, everybody knows about this issue now, it seems like. That’s a huge cultural shift, too, where you see, just a decade ago, men not being very aware of this to now recognizing that men are aware and can be allies and help protect future generations. 

Farzana: And that’s reassuring. Again, here if I can use an anecdote of my personal story where my father was an extremely protective father. He was extremely careful about the way that we were brought up. But, this was one of those issues where he was almost sidelined by my aunt, by the women in the family, because this was something that men did not get into. Like I said, systematically this is devised to be so patriarchal in nature, and that’s why it’s thriving. It’s also sprinkled with fear. It’s almost, you can’t be questioning the establishment and, therefore, you can’t be questioning the practice. That, I think, is intrinsically one of the reasons men don’t know enough about it, don’t know about it at all, and those who know about it perhaps couldn’t say very much. But, it is reassuring to know that’s changing because that is important. They are also stakeholders in this process of change. 

Mariya: I agree. 

Farzana: Mariya, we possibly cannot reflect on the times we are living in, which is the pandemic. It is really, really disheartening when one reads that across the world we are seeing a huge surge in domestic violence during this period of lockdown. There are some estimates that the UN has put out saying they are expecting about 31 million new cases to emerge if the lockdown continues another six months. That’s a hugely staggering number. How does FGC fit within the spectrum of the pandemic?

Mariya: That’s a great question. I was actually listening to a webinar the other day and right now it seems like there might be a difference in terms of the impact of COVID within African communities and amongst Asian communities. I think last week even there was a headline that came out with some initial findings from an organization in Somalia. FGC had increased significantly there because people were at home, so they were taking advantage of the fact that girls were not at school, so they would have the time to heal. Cutters were going door to door. Their economic well-being depended on this business, so they were looking to see if they could cut girls. So you are hearing that happen. Anecdotally within Asia, you’re not hearing that as much. The speakers on the webinar, one of them was my fellow co-founder Aarefa (I should mention I co-founded Sahiyo with four other women) – so, Aarefa was on that webinar and me and her have had some conversations on this issue about what we have been hearing. Anecdotally, we are not hearing an increase of FGC amongst the Bohra community at this time. I think there might be several reasons. One part might be that it tends to be more medicalized now, and so as hospitals and health care professionals are overwhelmed with COVID, that’s sort of becoming secondary. But also the fact that within the Bohra community it doesn’t have to happen at seven. Seven is sort of the minimum age, so people could potentially be waiting a few months, or however long, to have it done. A couple of the other guest speakers from countries within Asia were saying that they feel it might be being postponed, too. I think within Asia, too, we do see it happen as a more medicalized version, and we do see Type 1 and Type 2 much more often than we see Type 3. Again, there is no official high level data on this, but anecdotally it might be actually halted right now due to the pandemic. So it’s interesting to see the difference in how it is emerging amongst different continents. I think we will really see the impacts after the pandemic is over and once we are really able to collect more data on this. What I do want to say though, is even if the prevalence rate might be different, the fact that there’s survivors seeking out support – that is something that is having a huge impact right now. Sahiyo has had a few support groups and some of the things that we are hearing is the sheltering in place, the pandemic type atmosphere that we are having is actually triggering some trauma responses by being in lockdown, and feeling like having a lack of control. And the fact that it’s harder to seek out support right now in terms of mental health professionals or being able to chat with others. That is an impact that we are seeing, in terms of being able to receive services if you need it, as a survivor. 

Farzana: Yes, this pandemic has been unprecedented for many reasons and this is something perhaps that if we can reach out with more and more stories hopefully we will be able to give comfort. Mariya, we can go on, but I am also cognizant that we have a time limit. Thank you so much for doing this. Kudos to your team, to you, for having done such wonderful work. May you continue to make a difference, change lives, and hopefully come to that point in our lifetimes where we could probably see the end to this practice. If I can just end the conversation on a quote by Martin Luther King, Jr: “The ultimate tragedy is not the oppression and cruelty by the bad people, but the silence over that by the good people.”

Mariya: That’s a wonderful quote to end with. Thank you so much for inviting me.

Farzana: Thank you, I really appreciate this. Thank you so much.

Part II–Medicalising khatna within the Bohra community: A Struggle of Tradition and Modernity

By Fatema Kakal

(This is Part II in a series about female genital cutting within the Bohra community. Read Part I here.)

While religion and religious leaders, along with culture and tradition can be drivers of female genital mutilation/cutting (FGM/C), law can play an additional critical role in disincentivizing khatna. The arrests in the U.S. and Australia due to the medicalisation of FGM/C, led to the reiteration of laws in countries that prohibited FGM/C. Laws in many countries around the world critique FGM/C as a human rights violation and child abuse. While some consider these laws to be racist, this leads to a feeling of marginalization and alienation due to the attack on traditional and cultural value systems. People became more conscious of the laws, and began reconsidering khatna, because of the risks involved. These laws helped initiate dialogue and discourse.

The Bohras are a fairly progressive and modern community, where traditions are not separate from their modernity, but play a crucial role in consolidating their Bohra identity. Continuing khatna defies Western notions of modernity and embraces tradition. Instead of abandoning tradition, the Bohras are renegotiating the traditional practice and embrace modernity through medicalising khatna. Medicalisation is a tool to modernize and legitimize khatna, but also serves as a technique for social control. By supporting medicalisation, validated by modernity, and establishing khatna as a safe and religious practice, the clergy is reinventing and perpetuating khatna as a traditional practice, responding to external pressures that threatened to marginalize or alienate the Bohras. The clergy is thus reiterating and reinforcing Bohra identity as being one of modernity and tradition.

Thus, khatna was no longer taboo, and a growing discourse has led to people taking increasingly different positions, and making more conscious decisions about continuing the practice. While mothers and women of the family used to be primary decision-makers of continuing khatna for the daughters of the family, fathers are increasingly involved in making the decision. It is no longer an extremely hidden practice, and parents do research before making the decision whether or not to cut their daughters. While some people follow mandates by religious leaders, others find it important to follow the law. People are conscious of the potential harm. For the devout, tradition must be followed, but by ensuring that harm is minimized. They choose to visit medical professions for khatna. For others, the risks of khatna outweigh its religious importance, and they have decided to abandon the practice. For others, consent is crucial, and believe khatna requires a girl’s consent. Since children are incapable of giving informed consent, people believe their daughters can choose to undergo the procedure as an adult, thereby making an informed decision.

Thus, the religious clergy’s pastoral power plays an important role in influencing people’s decision to continue khatna. Medicalisation of FGM/C can help negotiate embracing tradition and modernity. However, law also plays an important role in helping end the practice. The growing discourse around the practice has led to people making informed, conscious decisions about following khatna. FGM/C is conceptualized as a health and human rights issue, and a children’s rights issue, which is universal.

Thus, efforts against FGM/C should be focused on balancing universalization of children’s rights, human rights, and multiculturalism. Additionally, law plays a crucial role, because legislation can provide a universal stance against the practice, which can be used as a strong justification against it. Thus, community-wide change is required for individual families to abandon FGM/C, through education and activism from within the community, backed by law.

How COVID-19 may increase gender-based violence, including FGM/C

The UNFPA and UNICEF Joint Program on the Elimination of Female Genital Mutilation/Cutting (FGM/C) released a technical note about how the COVID-19 pandemic may affect women and girls adversely in regard to violence and inequalities. 

The COVID-19 pandemic has the potential to allow an additional two million cases of FGM/C due to restricted movement and confinement of people globally, disrupting the Sustainable Development Goal 5.3: Eliminating FGM/C by 2030. The closing of schools, restricted mobility and the inevitability of health care workers prioritizing COVID-19 patients heightens the need for supporting community-based women and youth groups identifying at-risk girls vulnerable to violence, including FGM/C.

The brief is meant as a guide for UNFPA and UNICEF Joint Program staff and partners, other United Nations agencies, governments, civil society, and non-governmental organizations, on how to assess the impact COVID-19 may have on FGM/C programs. The call to action includes integrating FGM/C in COVID-19 preparedness and response plans; access to prevention, protection, and care services and community-based protection; alternative approaches to community-based interventions promoting the abandonment of FGM/C; opportunities presented by the pandemic; and adaptive monitoring and evaluation.

 

Sri Lanka’s first survey on FGM/C: Survivors need space to talk and access to medical care

By Jumana S.

“It should not be up to the elders to stamp the body of a girl child at the age of seven, (a process that is irreversible irrespective of the extent of damage), and decide what her religious convictions should be.”
– Jamila, Dawoodi Bohra survivor of FGC, Colombo 

This fundamental right that every thinking individual commands is articulated by a survivor of female genital cutting (FGC) in a first of its kind report for the country titled, “Towards Understanding Female Genital Cutting in Sri Lanka.” 

The report, published by the Family Planning Association of Sri Lanka, is the very first research study detailing the status of FGC in the country. It highlights the absence of dialogue, absence of awareness of the issue among medical practitioners, and also the unique political situation in the country that makes public discussion on the issue susceptible to ethnic controversy. 

Released in December 2019, this detailed study interviewed 26 survivors with three main objectives: to understand the practice of FGC from the perspective of survivors; to interpret the practice in relation to their health, sexual pleasure, bodily integrity and relationship with family, community and faith; and to engage medical practitioners to help with solutions with the findings of the first two objectives. 

Amongst the many shocking findings of the study, what overwhelms is the absolute absence of dialogue on the subject until about three years ago in the country. Hence, not only the survivors do not have a recourse for psychological counselling for their personal trauma, but the medical fraternity is also not equipped to deal with complications arising due because of it in sexual health and childbirth. 

“Medical professionals were not aware of the practice until recently, and in the belief that it does not take place, had not looked for signs of it and it did not form part of routine examinations that are usually centered on reproductive concerns. Further that it may be difficult to observe, most doctors had not received formal training on the practice in Sri Lanka,” the report states. 

As for the wider dialogue and understanding of the issue, the report notes that, “It is in the last few years – from 2016 onwards – that the practice of female genital cutting has surfaced in public dialogue in Sri Lanka, including in the media. A few women, primarily from the Dawoodi Bohra Muslim community, came forward to speak about their experiences and ask the state for a response to stop this practice.” However, what preceded this, as recently as 2008, was a circular by the All Ceylon Jamiyyathul Ulama (ACJU) of Sri Lanka, that had issued a fatwa on ‘female circumcision’ in response to a query from a member of the public, saying it is obligatory and recommended, citing religious teachings as well as the view that circumcision is important to maintain cleanliness of the genitals and ‘for enjoyment in family life’ (ACJU, 2008).

In the consultation, 23 out of 26 survivors (88%) said their influencer was a woman with 17 of them claiming  it was their mother. The justification for the cutting given by the respondents were that it is perceived as a religious requirement; a means of establishing ‘Muslim identity’; for controling women’s sexual feelings; medically beneficial; a customary ritual; for improving sexual partners’ interest; and for improving sexual experience of the woman. The consultations revealed a notable trend of very little conviction and understanding of why the practice was followed. The reasons were not always strongly held and the justifications often relied on the interpretation of theological positions. 

Based on consultations, the researchers came up with six observations. The key is the absence of space for survivors to reflect and talk. “Women need spaces, conversation starters, information and solidarity to navigate the complexities that surfaced,” the report claims. 

Two critical observations are about the absence of formal training on the practice and the reluctance of medical professionals to engage. “FGC was not part of the medical training received in Sri Lanka,” as noted in the observations. “All medical professionals in the consultations stated they had not received training on the issue.”

Moreover, explaining the reluctance of the medical fraternity in engaging with the issue, the report observed, “Medical professionals expressed a reluctance to speak or engage publicly on the practice for the reason that such measures may be misconstrued as measures motivated by religious intolerance targeting a minority community. It spoke to the sense that the political context was not favourable to the Muslim community and there were strong possibilities that disruptive elements would create opportunity for mischief causing victimisation of Muslims, and drawing medical professionals and institutions into political conflicts.” 

A unique observation that comes out is the context of the dialogue in the incumbent political atmosphere in the country. The report underlines this at outset, as well as in the conclusion, that while addressing the issue, one needs to be “sensitive to the local context of intolerance and possible victimisation that public discussion of the issue may lead to.” The report, in its final recommendations, urges for “a non-judgmental and non-discriminatory approach for working on FGC in Sri Lanka.” 

Another recommendation that stands out is its insistence on understanding and addressing concerns raised by women of the Dawoodi Bohra community, “as the experiences of Dawoodi Bohra women of FGC in this consultation appears to be of a more severe form than that practiced by others in Sri Lanka.”