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.”

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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.

 

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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.

Bohra women

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.

 

A Nigerian Nurse’s Perspective on Female Genital Cutting

By Brionna Wiggins

Female genital cutting (FGC) occurs in many countries around the world. Through my future posts, I hope to explore a few of these places by meeting with those who can speak on them. Many African countries and countries in the Middle East have been reported to have a large concentration of practicing communities. However, FGC is not limited to these areas, nor is it practiced by every single person in these regions. Recently, I spoke with Uzokau Chukwu, a registered nurse, about her thoughts on FGC.

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Brionna Wiggins with Uzokau Chukwu

Mrs. Chukwu is from a community in Imo State, Nigeria, where she spent her childhood until age 13, before moving to the United States. To her knowledge, FGC was not practiced  in the place she grew up. Instead, her community does an alternative practice, a tradition entirely without blood or cutting, where the area above the pubic bone is massaged.

“Older women in my village says it’s to reduce the sensation of a girl being overly sexed,” she said.  “They don’t cut anything.” According to her community, it still meets the security needs of those who fear raising a promiscuous daughter without cutting away at the body.

Mrs. Chukwu didn’t hear of FGC until she came to America and began her medical studies later in life. She worked alongside a student who came from a country with a high prevalence of FGC, so the topic was analyzed through an infection-control perspective.

The practice of FGC brings up health concerns, as girls may be laid directly on the ground for the procedure, and there is risk of severe injury or death. The operation may be done in a setting without sterile equipment.

“People were saying that some girls are dying after they go through that procedure,” she said. “They bleed to death or, you know, they cut so much nerve or into something, and then the places where they’re doing those things are not clean.”

Additionally, Mrs. Chukwu is left to ponder a handful of questions. How do practicing societies know if FGC works to reduce sexuality? Do they have alternatives? Did they notice a vast difference between those who are cut and uncut? Who came up with this practice? Who deemed it to be right? More importantly, who asks the girl for proper consent?

I agree with Mrs. Chukwu that FGC might be a slightly different matter if FGC was limited to consenting adult women rather than young girls. However, the idea of “cutting into someone’s body,” especially having to hold down the person as the procedure goes on, is disturbing. Although it goes without saying (I still asked), Mrs. Chukwu wouldn’t have herself, her daughters, or anyone else undergo the procedure. She wondered in passing if she was being too harsh in judging those who have their girls cut, but she also demanded concrete evidence that the cutting had any medical benefits at all. Ultimately, Mrs. Chukwu fears that FGC perpetuates the second-class status of women worldwide.

The conversation on FGC is definitely opening up to the general public on a worldwide scale as awareness grows. Admittedly, it’s hard to convince others to abandon FGC, as to do so is to challenge their beliefs, especially since it’s a practice that has persisted for generations. Hopefully, increased advocacy against FGC will spike awareness of its detriment to women and society.

More on Brionna:

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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.

A mother’s side of the story on female genital cutting

By Priya Ahluwalia

Priya is a 22-year-old clinical psychology student at Tata Institute of Social Sciences – Mumbai. She is passionate about mental health, photography, and writing. She is currently conducting research on the individual experience of khatna and its effects. Read her other articles in this series: Khatna Research in Mumbai.

Mother daughter hands

The proverb, “It takes a certain courage to raise children,” rings true, especially since much of the responsibility for a child’s development rests solely on the parental system. The parents significantly influence a child’s development, since the social connection formed with them serves as the prototype for all their future interactions. Through this parental interaction, the child learns values, traditions and learns to understand the culture. Within the cultural context of India, much of this responsibility shifts onto the shoulders of the mother. Due to the proximity and consistent presence of the mother, the child is naturally attuned to her and views her as their primary caregiver responsible for providing love, warmth, and protection. Any adversity experienced by the child may be seen as the mother’s inability to fulfill her responsibilities.

Similarly, in the case of khatna, which is a custom among the Bohri Muslims in India which involves partial or total removal of the clitoris, girls may subconsciously blame their mother for failing to “protect” them, although women understand that culture and tradition are responsible for the pain they experience. In my own research, when I conversed with participants I found that even when another female member takes them to be cut, the blame rests upon the mother alone. Initially, I found myself puzzled on this discrepancy in attribution. But during in-depth conversations with my participants, I found that all of them “trusted” their mothers to love them and to protect them. They stated that their mothers had “broken my trust” by continuing a practice without even attempting to understand its implications. Thus, the participants were angry because they had been betrayed. This experience has been discussed significantly in other research, as well. However, I wondered about the kind of emotions elicited in the mothers who were at the receiving end of their daughter’s anger.

Fortunately, I had the opportunity to talk to mothers. Through conversations with them, I found that even the mothers have been significantly impacted by the revelation that they had done wrong to their daughters. From a mother’s perspective, her world is crashing down as well. Through all these years she has developed a belief that khatna is good. It may make her daughter belong to their community. it may keep her safe. She acts on this belief with good intentions of protecting her daughter and doing what she believes is her motherly duty. As her child grows up, she does many such acts with good intentions to protect and love her daughter. Throughout her life, the mother forms the belief that I am a good mother who has checked off all the boxes. Several years later, she may find herself in a situation where she is now bearing the brunt of her daughter’s anger because she has failed to protect her child from harm, particularly of khatna. This revelation shatters a belief in khatna she may have fostered for more than half of her life.

In therapy, we always say that beliefs are the most difficult psychological construct to work with because all beliefs are interconnected. These interconnections form the self of a person. When one belief is broken, it causes a chain reaction where the other beliefs begin to be questioned. The same happens with a mother. Post-revelation she begins to question every aspect of her life, her identity, and her essence. A mother may then feel an overwhelming sense of failure and inadequacy. Biologically speaking, whenever we are overpowered, our fight or flight responses kick in. Therefore, the mother may respond to her pain with anger and denial. It is helping her keep her sense of integrity intact.

When the mother responds in anger and denies having done anything wrong, the impact it has on the survivor is severe It heightens her emotions.  It’s important to remember that both the mother and the survivors are fighting their own battles. Both parties need time to process this shock. Thus, it is essential that the space for change is provided by both sides.

Some of the pointers to remember during this time that are applicable to both the survivors and the mothers:

  • Remain empathetic. Both of you may be struggling.
  • Be kind. Do not raise your voices while talking. Do not accuse each other.
  • Listen when the other person talks. Both of you have the right to say your part.
  • Have conversations outside the purview of khatna.
  • Establish some routines with each other: eat together or go for walks together.
  • Respect each others’ decisions.

The dynamics of a relationship are bound to change once such an intense conversation takes place. It is essential that during this time of transformation, a sense of support for each other is established. At the same time, it may be difficult to do so, but it is imperative that this be done if the new dynamics are to mimic the love, warmth, and comfort that may have been present in the previous relationship. My participants themselves mentioned that although the dynamics between them and their mothers have changed, with time and space their bond has only become stronger.

A message to the survivors, you have the right to be angry. You have the right to be heartbroken. Give yourself time to feel all these emotions. Take care of yourself. Access some helpful resources.

For mothers who regret their decisions but do not know what to do, apologizing always helps. Not only would it heal you, but it may heal your daughter, as well.

For mothers in the dilemma of whether they should perform khatna on their daughters, please don’t do it. A life full of pain and regret is no way to live, neither for you and nor for your daughter.  

Reflections on Female Genital Mutilation/Cutting & Intergenerational Trauma

By Anonymous

Country of Residence: United States

I am not a survivor of female genital mutilation/cutting (FGM/C). In fact, my father is vehemently opposed to the practice. Even though I was shielded from FGM/C, I know loved ones who have undergone the procedure. One of those survivors is my mom.

 

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My parents are from Somaliland, which lies on the northwestern part of Somalia, but we now live in the United States. FGM/C has evolved into a cultural practice in Somaliland that has strong social roots. There is a lot of stigma if you aren’t cut (guilt, shame, neglect). My experience within the Somali community is that FGM/C has been discussed within the realm of religious theology as an acceptable form of practice. The only problem is that there is no religious text in the Quran that advocates or allows this practice. Granted, FGM/C is practiced around the world for a variety of reasons. But it is vital to highlight our personal experiences which will enable us to find collective solutions to end the practice.

I didn’t know much about FGM/C until I immigrated to the United States. The irony is that it’s a common practice passed down through generations, but it’s a closely guarded secret. No one talks about it unless it’s your time to undergo the procedure. After I looked into the different forms of FGM/C and the harmful effects, I was immediately repulsed by the actions of my community. I was enraged that the perpetrators of FGM/C were not held accountable for committing a human rights violation. I just can’t fathom how my community would eagerly rally against islamophobia, but turn a blind eye to FGM/C.

I faced a dilemma. I was harboring these feelings against my community because I just couldn’t understand the rationale of the people who are advocates of FGM/C. I was concerned that my emotions were clouding my judgment. One day I built up the courage to ask someone who could provide me some context: my mom. I am not sure why I waited until the end of this year to ask my mom why FGM/C is so prevalent in our community, but perhaps I was petrified of how she would react. I was fortunate to have the guidance of Mariya Taher (co-founder of Sahiyo) to prepare me for this day.

The type of FGM/C procedure that my mom endured is common amongst Somali women. Known as infibulation, it is typically the most severe form. My mom was very candid in her experience as she vividly disclosed the trauma and pain she went through. During our intense conversation, I interrupted her because at some point, it was too painful to digest. In the end, she confided in me. “We weren’t educated at that time, and we just did what we thought was right,” she said.

We can’t trace when the practice of FGM/C had its initial roots in my family, but something clicked inside my head in relation to intergenerational trauma. My grandmother was exposed to the same FGM/C procedure as my mom. Despite the agony, my grandmother is convinced it was the right thing to do. After all, that’s all she knows. Even though my grandmother made the decision for my mom to go through FGM/C, it doesn’t mean that she is a terrible individual. If I had to describe my grandmother, the first thing that would come to mind is her independence. She is fierce, loving, generous and vocal. She would never hesitate to express her opinion. It’s a shocking that my grandmother advocated for the practice of FGM/C because it just didn’t fit in with her persona. This is where intergenerational trauma comes into effect.You endure a traumatic experience and one of the ways to cope with that specific experience is to normalize it. If you are not provided the proper mechanisms to manage trauma, it will manifest itself often at the expense of your loved ones.

For a long time, I believed that FGM/C was only practiced in my community. Then I was exposed to data that demonstrated the wide reach of FGM/C. I believe that education and dialogue are crucial to creating solutions for the practice to end. We must not shame communities, but bring awareness of the life threatening risks associated with the procedures that so many girls endure. I believe in humanity and even though the practice of FGM/C is harmful, there is still room for hope.

A response to the letter written by Tasneem Yunus Burhani, Mubaraka Tambawala, Farida Mustafa Hussain, Fatemah Hussain, and Shakera Bohra published in Detroit News

By Umme Kulsoom Arif

In response to your letter published in The Detroit News,Dawoodi Bohra Women of Detroit speak up,” I write to you as a woman who grew up in a part of the Dawoodi Bohra community, just like you. I am also a woman of faith and education, a woman who loves her country as well as her Dawoodi Bohra community, who balances religion and patriotism in a trying, divisive time. And just like you, I am frustrated and saddened by the propaganda and misinformation that has spread surrounding the case of Dr. Jumana Nagarwala because I too am a survivor. A survivor of a harmful practice that violated my human rights, robbed me of my personal integrity, and — in punishing me for my own femininity — left me permanently scarred, both mentally and physically: khaftz.

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You claim that khaftz “in no way can be defined as female genital mutilation,” but do you know what FGM even is? The World Health Organization defines FGM/C as “all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons.” So educate me, then — what is the medical reason for khaftz? Why must it be done? Why must a girl be lied to, held down, or drugged so that a blade can be taken to her genitals and a part of her clitoris sliced away?

You call the procedure “harmless,” so I ask you — where does the harm begin in your minds? Where do you draw the line between the “ritual” you defend and the “more barbaric practices from around the world” you claim to condemn? Is it not harmful to deny your daughter the right to her own bodily autonomy? Is it not harmful to violate her right to be free of torture and degrading treatment and to teach her that her body is “wrong” and must be surgically altered based on the words of religious men?

The Quran does not ask this of us, so I ask you — who does? When countries around the world — including the United States — have signed human rights treaties both condemning and outlawing all forms of FGM, who demands that our daughters be subjected to a cutting or scraping without their consent and with no medical reasoning behind it?

Though you claim to be patriotic Americans who follow all the laws of the land, you challenge a law meant to protect the most vulnerable members of the country’s population — its children. How can you in good conscience, claim that khaftz is “much more akin to a body piercing” when a child would never consider getting a piercing in such a sensitive area?

Many of you are lucky to have suffered no consequences — physically or mentally — from khaftz, but your experiences are far from universal. You lie to yourselves when you purport to be representative of all the survivors of the khaftz. You lie to your daughters when you claim that there are no negative effects to the practice. You do a disservice to your community when you hide the truth of this harmful form of gender-based violence behind pleas for tolerance and claims of political persecution. By claiming that your experiences are universal and by defending this harmful practice, you have a direct hand in perpetuating violence against women.

Is that the future of the Dawoodi Bohra community? A future where we must look our children in the eyes and tell them that they have no ownership of their bodies? A future where our daughters must be subjected to sexual trauma and placed at risk for future infection, for future complications in childbirth, or for chronic pain in a most sensitive area? The Dawoodi Bohra community cannot adhere to archaic violence in the name of tradition. The world around us has changed, and today we know more about our bodies and the consequences of our actions than we ever did. We must grow as people, as a community. We must come together to help, not harm.

You may be educated women, but you blind yourself to the true nature of khaftz and its harm. You beg for tolerance and understanding but you do not try to understand the pain you inflict on your daughters when you have them cut. I beg you to take the time to listen to women the world over who have been harmed by khaftz.

Read also “Other Views on FGM.”

Trauma and Female Genital Cutting, Part 5: The “C” Word… and I Don’t Mean Circumcision

(This article is Part 5 of a seven-part series on trauma related to Female Genital Cutting. To read the complete series, click here. These articles should NOT be used in lieu of seeking professional mental health and counseling services when needed.)

By Joanna Vergoth, LCSW, NCPsyA

Since the ritual of Female Genital Cutting (FGC)  involves the clitoris, it seems important to learn more about this organ and its function. But first a bit of history, or—more appropriately—herstory.

In over 5 million years of human evolution, only one organ exists for the sole purpose of providing pleasure — the clitoris. Yet, from ancient times to the present, the anatomy of the clitoris has been discovered, repressed, and rediscovered. Hippocrates, the Greek physician, born circa 460 B.C., called the clitoris “columella”: the little pillar. About 500 years later, Galen, an anatomist renowned in Rome, denied its existence. Centuries later, the 1901 edition of Gray’s Anatomy included a drawing of the female pelvis in cross-section, showing a small protrusion with the label “clitoris” (Gray, 1901). In the 1948 edition of Gray’s Anatomy, there is an analogous illustration of female genital anatomy (Goss, 1948). Yet, the label of the clitoris is now gone. The clitoral protrusion of the older illustration is also removed. As a result, the clitoris has now been erased (Moore & Clarke, 1995).

Just The Tip of The Clitoris

In reality, what we generally think of as the clitoris—what we can see and feel—is just the pea size tip of the clitoris, called the “glans”. The glans, located at the top of a woman’s vulva, at the point where the labia majora meet (near the pubic bone), contains approximately 8000 sensory nerve fibers—more than anywhere else in the human body. In fact, the amount of sensory nerve fibers in the glans is twice the amount found on the head of a penis.

More Than Meets The Eye

Many people assume that all there is to the clitoris is the glans, but with the clitoris, what you see is not what you get. Helen O’Connell, an Australian urologist, and her colleagues have corrected that misconception (O’Connell, Sanjeevan, and Hutson, 2005). Using modern imaging techniques such as Magnetic Resonance Imaging (MRI), O’Connell has shown that there is much more to the clitoris than what meets the eye. They discovered that the glans of the clitoris is simply the tip of an extensive organ.

In fact, three-quarters of the clitoris is inside the body. As shown below, the clitoris is a MRI clitwishbone-shaped structure that is about 3 ½ in. (9 cm) in length and 2 ½ in. (6 cm) in width. The glans extends backward into the clitoral body. The glans then split into the two leg-like parts, the crura, which are composed of erectile tissue and are next to the vagina and urethra (see MRI photo below of internal clitoris). The vestibular bulbs are two elongated masses of erectile tissue situated on either side of the vaginal opening.

The Clitoris and Its Place within the Vulva

The vulva is a single term used to describe all the external female genital organs. These sub parts internal clitorisorgans include the labia majora, the labia minora, the clitoris, the vestibule of the vagina, the bulb of the vestibule, and the glands of Bartholin. The two sets of labia (lips) form an oval shape around the vagina. The labia minora are smaller and surround the vagina. The labia majora are larger, and, after puberty, the outer part of the labia majora is covered with pubic hair.

Since there are large portions of the clitoris extending through the pubic area, sexual responsiveness is not limited to direct or indirect stimulation of the clitoral glans (Wallen and Lloyd, 2011). Due to this extended internal structure, the clitoris can respond to stimulation of the external vaginal labia, the vagina itself, and the anus. As a woman draws closer to orgasm, the clitoris can swell by 50 percent to 300 percent. According to O’Connell, “The vaginal wall is, in fact, the clitoris.” If you lift the skin of the side walls of the vagina you will find the bulbs of the clitoris (O’Connell 2008). O’Connell proposed the notion that during vaginal intercourse it is the “clitoral complex” that is stimulated.

Clitoral anatomy and FGC: Removing the glans of the clitoris does not mean the whole organ is destroyed.

The issue of clitoral anatomy is also significant concerning the practice of image5clitorectomy. Type 1 FGC: Often referred to as clitoridectomy, is the partial or total removal of the clitoris (a small, sensitive and erectile part of the female genitals), and in some cases, only the prepuce or hood (the fold of skin surrounding the clitoris). The clitoral hood varies in size, shape, thickness, and other aspects of its appearance from woman to woman. Some women have large clitoral hoods which appear to cover the clitoral glans. Others have much smaller hoods which leave the clitoral glans exposed. While the biological function of the clitoral hood is simply to protect the clitoral glans from friction and other external forces, this body part is also an erogenous zone. It provides natural lubrication, which makes stimulation of the clitoral area more pleasurable. As the clitoral glans itself is often too sensitive to touch, many women gain pleasure from having the glans indirectly stimulated through the clitoral hood. 

Although female sexual pleasure is often hindered by clitoridectomy, many women report that they are still able to enjoy sex (Lightfoot-Klein, 1989, Kelly and Hillard, 2005). One researcher has found that even infibulated women may still have the ability to achieve orgasm. Dr. Lucrezia Catania, who has studied and treated FGC-affected women in Italy for two decades, has found that when some of the sensitive tissue of the labia minora and clitoris remain intact, infibulated women can experience orgasm, while others cannot and instead feel pain.

Pelvic Nerve

The clitoris has enormous potential for arousal, but what may affect sensitivity is the supply of nerve endings and the individual pattern of each clitoris, which explains the variation in women’s preference for stimulation. The pelvic nerve branches in individual ways for every woman. The pathway distribution is quite different and far more diffuse from male sexual wiring, which is much more uniform.

Some women’s nerves branch more in the vagina while other women’s branch more in the clitoris, or in the perineum (the skin between the anus and vagina) or in the mouth of the cervix. No two women—not even identical twins—have the same pattern and distribution of nerves. This complex system of nerve endings extends into the pelvis and is in fact far larger on the inside than it is on the outside. When stimulated, the erect clitoris tightens around the vagina. This means that “vaginal orgasms” are actually caused by the clitoris, not nerves on the vaginal walls themselves. Whether brought on by penetration or external stimulation, all orgasms are clitoral. 

Not only can the anatomical facts of the clitoris help alter cultural biases and mythologies, but correct knowledge of clitoral anatomy may help enhance a woman’s appreciation and experience of her body.


The information for this article was sourced from:

  • Blechner, Mark, J., “The Clitoris: Anatomical and Psychological Issues.” Studies in Gender and Sexuality, 18:3 (2017): 190-200.
  • Wolf, Naomi. Vagina A new Biography. New York: Harper Collins, 2012
  • https://en.wikipedia.org/wiki/Clitoris

The images included were researched from internet sources.

About Joanna Vergoth:

Joanna is a psychotherapist in private practice specializing in trauma. Throughout the past forma logo15 years she has become a committed activist in the cause of FGC, first as Coordinator of the Midwest Network on Female Genital Cutting, and most recently with the creation of forma, a charity organization dedicated to providing comprehensive, culturally-sensitive clinical services to women affected by FGC, and also offering psychoeducational outreach, advocacy and awareness training to hospitals, social service agencies, universities and the community at large.

Trauma and Female Genital Cutting, Part 4: Psycho-sexual functioning

(This article is Part 4 of a seven-part series on trauma related to Female Genital Cutting. To read the complete series, click here. These articles should NOT be used in lieu of seeking professional mental health and counseling services when needed.)

By Joanna Vergoth, LCSW, NCPsyA

When discussing psychosexual functioning following FGC, it is critical to acknowledge and recognize that many women who have undergone FGC will not experience sexual health problems. It is also important to note that many women with intact genitals do experience sexual difficulties. Female sexuality is a complex integration of biological, physiological, psychological, sociocultural and interpersonal factors that contribute to a combined experience of physical, emotional and relational satisfaction.

Nevertheless, symptoms of Post Traumatic Stress Disorder (PTSD) can interfere across the continuum of sexual behavior affecting desire, arousal, physical and/or psychological pleasure. The amygdala is the organ in the brain that alerts us to possible danger and responds to the danger by triggering the fear response along with the release of the stress hormones.  A state of negative hyperarousal persists for those who have been re-triggered by some person, place or memory associated to the original trauma while suffering from PTSD (see The Body and The Brain). Biopsycholsocial factors impacting sexual function

For some women affected by Female Genital Cutting (FGC), re-traumatizing triggers can be their initial (and ongoing) sexual experiences. Not only can the physical position (identical to that required for FGC) induce a flashback, but the already traumatized genital area can feel repeatedly violated with sexual activity, gynecological exams—or childbirth itself. [Note. in Sahiyo’s Exploratory Student on FGC in the Bohra community, 108 women reported that their FGC (khatna) had adversely affected their sex life – See Graph on the right]  Khatna sex lifeWhen these flashbacks occur the brain’s fear circuitry takes over and the hippocampus can no longer communicate effectively with the amygdala to allay its fears. This condition often leaves those affected feeling emotionally charged with generalized fear(s) that persist even after the traumatic event has passed. (See also ‘The Clitoral Hood – A Contested Site’) 

There are 3 primary psycho-sexual complications commonly associated with FGC:

  • painful intercourse (may be due to narrowing of vaginal canal; or excessive scarring, or clitoral neuromas, or infibulation or chronic infection);
  • difficulties reaching orgasm;
  • and, absence or reduction of sexual desire. 

Sexual difficulties can occur because for FGC survivors, positive sexual arousal mimics the physiological experience of fear. Once these hormonal and neuroanatomical associations have been forged through the intense experience of trauma and the associated PTSD symptoms, it can be difficult to uncouple them. PTSD SexIn these instances, arousal frequently signals impending threat rather than pleasure. Thus, the biology of PTSD primes an individual to associate arousal with trauma and this impairs the ability to contain the fear response—which in turn impedes sexual functioning and intimacy.

Due to repeated pain during sexual activity, women may develop anxiety responses to sex that restrict arousal and increase frustration—all of which can contribute to vaginal dryness, muscular spasm, painful intercourse and/or orgasmic failure. Women may actively avoid sexual activity to minimize feelings of physical arousal or vulnerability that could trigger flashbacks or intrusive memories. Others have reported that merely the fear of potential pain during intercourse and the frustration around delayed sexual arousal contributes to the lack of sexual desire. Recurring pain triggers memories adversely affected by the cutting. Chronic pain and distasteful memories reinforce each other and create a situation of mutual maintenance.

Emotional and/or physical pain during intercourse diminishes the enjoyment of both the woman and her partner. Complications such as these can contribute to feelings of worthlessness, inhibit social functioning and increase isolation. In fact, many women have expressed feelings of shame over being different and ‘less than’. Some may experience their circumcised genitals, now deemed ‘different’, as shaming. Others may feel responsible for the relationship distress that results and carry a burden of guilt for being unavailable to “provide” sex. They may perceive their anxiety and difficulty about permitting penetration as something they must overcome.

The psychological issues for younger women who have undergone FGC and are living in Westernized societies may be especially complex. These women (and their partners) are subjected to different discourses of sexuality that centralize erotic pleasure and frame orgasm as the endpoint of sex for women and men. Some women may struggle with what are deemed irretrievable losses. Feelings of aversion may extend beyond sex to physical closeness or even intimate relationships in general. In other situations, a woman may feel inferior to other women or less entitled to positive relationships, so that she may engage in an unsatisfactory or even damaging relationship which could further diminish her self-esteem. Another underlying belief behind FGC is that women’s genitals are impure, dirty or ugly if uncut. As a result of this perception, the female body is viewed as flawed—forcing women to modify their physical appearance to fit standards far removed from health, well-being and gender-equality objectives.

Unfortunately, the very nature of this subject often doesn’t allow for much insight, since FGC has always been shrouded in secrecy. Women may be reluctant to disclose because of the fear of being judged, since FGM/C is perceived by outsiders to be illegal, and abnormal. The belief that sexual matters are to be kept private also makes FGC-affected women inclined to keep quiet about their symptoms and suffer in silence or attribute their pain to other sources. However, healing from the trauma through talk therapy as well as open discussions about strategies for obtaining sexual pleasure after FGC can be critical for women to regain control of their sexual identity.

For more information about the Psychosexual Consequences affecting the Clitoris see Trauma and Female Genital Cutting, Part 5: The “C” Word…and I Don’t Mean Circumcision.

About Joanna Vergoth:

Joanna is a psychotherapist in private practice specializing in trauma. Throughout the past 15 years she has become a committed activist in the cause of FGC, first as Coordinator of the Midwest Network on Female Genital Cutting, forma logoand most recently with the creation of forma, a charity organization dedicated to providing comprehensive, culturally-sensitive clinical services to women affected by FGC, and also offering psychoeducational outreach, advocacy and awareness training to hospitals, social service agencies, universities and the community at large.