Sahiyo Stories screened at Academy of Communications in Healthcare Workshop

By Renee Bergstrom, EdD

On January 30, 2019, I presented the workshop: Patient Engagement through Brief Focused Videos featuring the Sahiyo Stories at the Academy of Communication in Healthcare (ACH) Winter Course in Scottsdale, Arizona. ACH endeavors to promote empathy and better communication among health care providers, patients and families.

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Photo by Pixabay on Pexels.com

I prepared throughout my adult life to someday share my story to advocate to end female genital mutilation/cutting (FGM/C). This groundwork included learning through formal education, plus strengthening the emotional, social and spiritual foundation of my being. The purpose in showing the Sahiyo videos was two-fold: to promote deeper understanding of female genital mutilation’s impact on survivors, and to discuss the storytelling process and the feasibility of ACH engaging patients’ trauma stories through focused videos.

Three women attended the workshop I hosted, including the president of the organization who is a nurse midwife. After the workshop, their evaluations were positive.

“I think this was a powerful video that was personal to Renee,” a participant said after watching my video. “It provided an example of what might be possible to create for patients through ACH. That would be an entire different brainstorm session. This video was so impactful that it was hard to move on in this session.”

“Pre-work (writing story) was very helpful and heightened my receptivity/engagement.”

I found it crucial to share Sahiyo’s work with the very caring doctors and nurses who are fellow faculty members and have placed the link to the Sahiyo stories on the ACH library page.

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Renee Bergstrom, EdD, is an educator who advocates for relationship-centered medical care. She and her husband, Gene, have been married 53 years. They have three children, ten grandchildren and one great-grandson. They live in a dynamic art town in midwest America where they are very involved in the community. Renee has been an advocate for women’s justice throughout her life.

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For survivors and their doctors: An online tool about female genital cutting

By Brionna Wiggins

One day, fifteen years ago, while Karen McDonnell was teaching reproductive health at George Washington University (GWU), a student of hers was absent from the class. While that may not seem out of the ordinary, it was quite strange for this particular student. He was a diligent medical doctor from Guinea who attended the university for a Master’s in Public Health. He never missed a class before. Upon his return, Karen asked him if everything was okay.

He told her that he had almost lost his wife.

His wife had given birth to their first child, but when she was young, she underwent female genital cutting (FGC), and it caused complications during the delivery. No one knew how to properly care for her at the hospital while she delivered, and she nearly bled out. In short, those caring for her were unprepared for her case.

“This isn’t something I was interested in yesterday,” Karen said, alluding to the years she’s spent on this project and reflecting on how far she’s come in understanding FGC. She remembers hearing about it in undergraduate school. Back then, FGC was simply an issue mentioned in passing during class. For the students in her graduate school at that time, it may not have seemed like there was anything to be done about it. “It’s a cultural practice, you can’t change culture. So let’s make it safer,” Karen said the instructors told students. The best solution at the time was medicalization, perhaps even providing clean blades. Karen knew that it still didn’t seem right and didn’t feel comfortable with the idea. The blade may be cleaner, but the potential health issues would remain.

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Photo by mentatdgt on Pexels.com

Karen pressed on working at George Washington University, spending decades focusing on domestic violence in her work. But the incident with her student sparked the motivation for advocacy. “That student changed my life in opening my world to [FGC].”

Since then, Karen has worked with the former students and current students to educate others about how to care for those who have undergone FGC. She simply started by talking more in-depth about the practice with her students so they were made aware of the topic. Then two years ago, when the Office on Women’s Health came out with a funding mechanism for a medical project, Karen thought, Finally, we’re getting some attention here! They began working with survivors and RAHMA: a DC-based organization that addresses the stigma around HIV/AIDS in the American-Muslim community, as well as advocates against FGC. The team at GWU was awarded the health-focused funding to do work on a project that would teach other health practitioners how to give provisional care for those who have undergone FGC. Thus started the development of an online toolkit to educate women and healthcare providers on a topic that was once shrouded in secrecy. This toolkit is intended to be easily accessible and resource-filled with proper terminology and answers to questions that aren’t usually asked.

The members of the team include a variety of survivors, advocates, health professionals, and others on-board with the multi-year program. In-depth interviews were conducted for both survivors of multiple countries and health-care providers that worked with survivors. The interviewers asked a myriad of questions: Tell us your experience? How did you get involved? If you had a toolkit, what would you want in there? What would you want providers to know? What do you want women to know?

What’s even better is that women are coming forward with the willingness to share their stories, thanks to increased awareness and support from organizations such as Sahiyo that encourage them to do so. A turning point for these women had to do with their health: they started questioning why they had urinary infections and trauma they’ve carried since childhood. Beginning this conversation was the first step.

The online toolkit is useful for survivors, their doctors, and others in the community. It will have an optimized search and curated content, which ensures that the information is scholarly, reliable, accurate, and useful for the website visitors. While doctors would ideally ask their patients about certain conditions that affect them, this resource can potentially fill in their gaps of knowledge when interacting with their patients. Additionally, the kit would cover essential concepts for survivors to ask health professionals. The team plans to have a community tool section that can be used by men and religious community leaders.

Karen and many others are making a difference by working on this resource for survivors and their doctors. By understanding the complications that accompany their condition, it will ensure they receive proper support.

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.

I have a story to tell – I was NOT cut: Reflecting after the Sahiyo U.S. Activist Retreat

By Anonymous

Country: United States

Age: 50

I may not be able to share the same emotional or physical experiences of some of the other Sahiyo participants who attended the Sahiyo U.S. Activist Retreat in March 2019 and who have undergone khatna, but I have a story to tell. My mother, myself, nor my daughter have undergone khatna, and that is not the end of the story, but the beginning of this restlessness in me to do something for others in my community who have undergone it.

Khatna conversation made landfall on my household when my daughter was 7-years- old. There was pressure from my mother-in-law to have my daughter cut. Her argument was that she would never suggest something that was bad for her granddaughter. There was no Sahiyo platform to educate my family members then so one could imagine my struggle twelve years ago. Seeing my mother-in-law so upset, my sisters-in-law got involved and they insisted that I should just lie to my mother-in-law to end the matter. I had been told to shut my mouth in my monthly Bohra menij groups, also. “Don’t do it, but speak about it otherwise.”

Let’s fast forward to after the Sahiyo retreat that I attended in March. A few days later, I met a friend Copy of IMG_3166at a gathering who had brought her 9-yr-old daughter along. I was very curious and worried if she had gotten her daughter’s khatna done, so I asked the question. She replied that she hadn’t and that she was, in a strange way, thankful that the conversation about the Detroit incident happened at the same time as when it was time for her daughter’s khatna. She saw all that was happening with the case and thought against the act. She wanted to know if I knew more about the case and I was thankful I attended the Sahiyo retreat, as I was able to give her more details about the case and was comfortable and confident to hold a dialogue on khatna.

My thought is that the Detroit case is very important. Even if the outcome may or may not be to our liking, it did cause a big stir in our Bohra community and at least one more girl was spared the blade.

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

By Farzana Doctor

Country of Residence: Canada

Age: 48

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

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

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

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

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

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

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

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

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

 

Speaking the truth about my experience with female genital mutilation

By Aisha Yusuf

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

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

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

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

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

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

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

Survivor of Mumbai: Plight to End Female Genital Cutting

By Brionna Wiggins

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

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

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

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Photo by Adrianna Calvo on Pexels.com

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

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

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

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

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

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

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

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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.

 

Wrestling with trust and fear in regard to female genital mutilation

By Farzana Esmaeel

Country of Residence: United Arab Emirates

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

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

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

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

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

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

 

Experiencing Sahiyo’s Activist Retreat in Mumbai

By Xenobia

Country of Residence: India

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

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

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

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

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

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

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

 

The Disturbing Trend of Medicalising Female Genital Mutilation

by Lorraine Koonce-Farahmand

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

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

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

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

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

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

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

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

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

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

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

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

More about Lorraine:

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

 

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.

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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.