Authors: Hibo Wardere
Is removing tonsils a necessary ‘mutilation’ of children’s bodies? Making them go under a general anaesthetic – and all the risks that entails – purely because a
mother has decided a child would be better off without their tonsils? And then you could go on: perhaps some might argue that Western women who undergo breast augmentations, or labia surgery, or
piercings are, to a lesser or greater degree, mutilating themselves. People in some FGM-practising communities have even used this as a defence of their own choices – that white women in the
West are allowed to trim their labia but African women aren’t. And then aren’t those women also doing it to fit into society’s idea of what’s beautiful, and specifically
men’s idea of what is attractive? As O’Donovan says: ‘Women modify and commodify ourselves in every way – why do we wear high heels, for example?’
And yet these things have been seen as acceptable in British society – just like removing the clitoris was to some in Victorian times. It is impossible and categorically wrong to compare a
child being forced to undergo FGM to a grown woman deciding to have a boob job. But is there a case to be argued that, at completely opposite ends of the scale, they represent a woman’s
desire or the pressures of a society on women to live up to the perception of what men want? They are females adapting themselves – or, in the case of children, females adapting one another
– for the male ideal, to be more socially acceptable and therefore a more attractive prospect to men.
While we accept that FGM performed on a child is child abuse, some have contended that a grown woman has a
right
to choose whether to undergo the procedure, even if in truth that woman
is only cutting herself to avoid being ostracised by her community.
But in my view, even a teenager who is considered a woman, and who seemingly goes along with her own mutilation, is not doing so because she is fully informed. She is coerced and brainwashed
into thinking that it will make her a woman in the eyes of her community, her peers, her mother and her future husband. Someone being subjected to that amount of pressure cannot possibly make a
choice from free will alone – whatever their age. I do agree that women everywhere are under pressure to look or behave in a certain way because they believe that’s what men or the
society around them wants. It is a sad admission that women’s bodies are constantly being dictated to in many different ways, and all over the world.
Sunna
and medicalising FGM will do nothing but collude in the subordination of women in a patriarchal society, when women around the world are fighting for rights that are equal to
those of men. We can’t on the one hand argue that Western women should receive equal pay with men, and then allow African or Asian women to be cut in the name of chastity. Surely equal rights
mean parity among
all
women, regardless of their skin colour or the country where they were born? Culture is no excuse for the mutilation of women, nothing is. And it doesn’t matter
where or when or how you do it, the effects of FGM are catastrophic. There must be a zero tolerance to FGM, and this is from a woman who has been through it and knows the consequences. I
didn’t need to arrive in Britain to know that FGM was wrong; I knew it from when I was six years old.
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A
s with any kind of child abuse, the pain doesn’t end when the act does. There are long-term physical scars that need to heal, not
to mention the psychological ones. To this day I still haven’t had any kind of therapy to deal with my experiences; my healing has come from sharing my story. I like to think it’s
worked for me, but it is also an ongoing process. It was only in the last few months, for example, as I wrote these pages, that I was able to look between my legs for the first time with a mirror.
And it wasn’t as frightening or horrific as it had once been, when I’d seen those photographs all those years ago. Perhaps because I’d come to terms with my story, and I’d
learned to love myself and my body for all the positive things it has done, like giving birth to seven children. I realised I had more to be grateful for than angry about.
But it has taken me years to get to this stage, and many women who have gone through FGM might not have identified themselves as victims of abuse yet. It might only be when they go for their
booking-in appointment with a midwife that they are asked the question about whether they have been cut, and for the first time in their lives they are offered help. It is wonderful that we can now
offer women the chance to talk, especially when I think back to my own antenatal experiences. But we have to take a holistic approach to deal with survivors of FGM – it’s about more
than just ending the practice; it’s also about supporting the women who are still suffering. In the summer of 2015, I met with doctors who are opening a specialist FGM hospital clinic in my
borough, a place where women can be deinfibulated, receive counselling, perhaps even undergo reconstructive surgery if that’s what they feel will help them to come to terms with their body.
But as with anything, it is all dependent on funding, and the government is only just realising they have an obligation to provide the right services to help these women.
The physical side effects suffered by victims of FGM impact on them constantly. In a 2004 study of young Somalians living in London, many women talked of how their circumcision had altered their
way of life, how they had even adapted themselves to walk differently for fear of breaking open their wounds.
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This was always my worst fear after I was mutilated too, the
terror that I might come unstitched and would need to go through the agonising experience all over again – there was no more running, skipping or jumping for me, or for any of these girls,
after that day.
Aside from the genital trauma, constant urinary tract infections and back pain, the list of symptoms experienced by some women after FGM goes on: kidney infections, chronic pain due to trapped
or unprotected nerve endings, cysts, abscesses and genital ulcers, chronic pelvic infections, and an increase in genital infections like bacterial vaginosis. In contrast, other survivors report no
ill effects as a result of their circumcision – these are the same women, however, who go on to mention in passing that it takes them fifteen minutes to urinate. I imagine these women simply
have not connected the pain and discomfort they suffer as an adult to the abuse they suffered as a child, which would not be surprising if they were babies when the FGM took place and were too
young to remember it.
One nurse on the front line helping women is my friend and fellow campaigner Joy Clarke. Joy has worked as a midwife at north London’s Whittington Hospital for two decades; fifteen years
ago she opened one of the country’s first-ever dedicated FGM antenatal clinics at the hospital.
People have tiptoed around the cultural issues in the past. When I wanted to open a clinic people said, ‘Why are you getting involved? It’s not your
culture.’ I remember midwives themselves from Nigeria telling me, ‘I have had it done and I’m OK.’ But my responsibility has always been to the woman and the baby, to
make her life better. We’ve come a long way, but people still question the need for an FGM clinic. But I don’t care – at the end of the day I need to save lives.
Joy sees women every day who have suffered Types 1, 2 and 3 FGM. But, she says, often the problem is that the women themselves don’t understand what has been done to their bodies. Dr
Comfort Momoh agrees: ‘What people need to realise is that some of these women have had complications all their lives, but they don’t physically relate the complications to FGM.
It’s just something they’ve lived with.’
It is only in recent years that awareness of FGM has risen in the public’s consciousness. Having been under the social radar for years, it has since become a much-discussed subject –
this is unquestionably a positive thing, but one of the outcomes of this new focus is that suddenly survivors are under society’s spotlight, and they’re being told that the way they
look is wrong. Research has revealed that many migrant women are anxious about seeking help once they arrive in this country for fear of being judged by medical professionals here, and I can
identify with that. I was terrified to open my legs to a doctor for the first time and allow her to see what had been done to me. That’s something we need to bear in mind – we must not
isolate these women further. Clinical psychologist Amanda O’Donovan says she has seen some of the negative results of media campaigns labelling FGM as child abuse in British newspapers.
For some women who’ve come to my clinics it was the framing of it as child abuse that they found upsetting and difficult because they had made peace with their
bodies. Obviously there is a political and social will to end this practice but there is a need to balance the campaign to end the practice with an understanding of the woman’s individual
experience, because out of a global population of millions who are being cut, not every woman will be carrying psychological damage.
Research on just how much women do suffer psychologically with the effects of FGM is still ongoing; personally, I’ve woken up sweating and screaming in the night from recurring nightmares
my entire life. These and the flashbacks I experience in my waking day can be debilitating in themselves. I’m certainly not alone. There is evidence that women suffer unbearable psychological
consequences as a result of undergoing FGM. Post-traumatic stress disorder (PTSD) is often high on the list of how women are affected. A Manchester study found that 75 per cent of women who’d
suffered FGM admitted having the same recurrent and intrusive memories of the event.
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In Egypt, 94.9 per cent of women reported emotional trauma of some
kind.
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And in 2012, a UK study by the New Step for African Community project reported the long-lasting emotional damage left by FGM on those interviewed, particularly the
difficulty they felt of suffering in silence. That’s what I remember, the loneliness of suffering in a community where everyone is cut and yet no one talks about it.
A 1992 study looking at the psychosexual difficulties experienced by women who’ve undergone FGM found that anorgasmia (inability to orgasm) was regularly reported.
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Likewise another study in 2001 found that 80 per cent of women reported ‘significant sexual difficulties’, with 45 per cent reporting a lack of desire for sex, 49 per cent reporting
reduced pleasure and more than 60 per cent of women saying they were unable to orgasm.
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Being sewn up makes sex in itself practically impossible; some healthcare workers insist
that unless a woman has been opened, she cannot achieve full penetration through an infibulated vagina and a man alone cannot open her due to the rigid scar tissue. Where this is the case, it is
thought that a woman gets pregnant when a man ejaculates at the opening of her vagina and the sperm swims up to her cervix.
Either way, as a practice that is primarily carried out to prevent women from having or enjoying sex, it is wholly effective. I’ve found it impossible to enjoy an intimate life with my
husband, not only perhaps because my clitoris has been removed and is still covered, but mostly because of the psychological trauma. I can only speak for myself of course, but I have only ever
associated my vagina with pain and trauma. Naturally, that upsets me deeply, because how can my husband enjoy himself when he sees how much I suffer? I have been denied the basic right of a healthy
sex life and I believe there are many women who feel as I do. The brutality of what took place between our legs would obviously leave its mark, and yet that doesn’t stop any of us craving
intimacy with the men we love. For me, it’s impossible for it not to have a negative impact, although I am aware that there are plenty of FGM survivors out there who report that they do have
a good sex life. Of course, one woman’s experience can differ so much from another’s and it’s impossible for one woman to speak on behalf of all FGM survivors.
Increasingly in Britain, clinics like those run by Joy Clarke and Dr Comfort Momoh are seeing women who, like me, wish to be ‘opened’ before marriage. For some women, like Fatuma
Farah, part of coming to terms with what has happened to them psychologically involves this physical process of deinfibulation too.
For me, the most damage FGM caused was the relationship with my mother, but at the end my mother passed away, and whatever happened between us, I forgive her. But I’m
still left with myself, so something had to happen within myself and my body to end what had begun. For us FGM victims, the morning that we were cut was the beginning of something that has to
end somewhere, and that ending has to come in the way it began, with a reversal operation. Something has to happen to our bodies to get closure. Of course to different women it means different
things. But for me it was having the operation and convincing myself that I could make my vagina look as natural as I could. Also, for me, marrying someone from an FGM-practising community and
him accepting my body for what it is was a huge part of the healing process.
Not every woman feels the same about their deinfibulation, though, and Amanda O’Donovan warns that, for some, more surgery on that area can be extremely traumatic in itself.
For many women it can be an act of reclaiming their body, but one patient who had a reversal done was actually really upset and traumatised by it. She couldn’t
remember her FGM, but she had images of what it might have been like and that sense of starting again with the deinfibulation was just as traumatic for her. It is not a reversal because
it’s not possible to return your body to the way it was when you were born. Some women feel, ‘Now I’m just surgically altered in a different way,’ and that’s
another change to process. A lot of women do feel very empowered though, having made that step, and feel like their bodies look like they do because of something they’ve
chosen
to do, rather than something that was done to them without their choice or consent. And, of course, when deinfibulation resolves any reproductive, gynaecological or urinary issues, that’s
really important for the woman’s health and wellbeing.