*I want to start with a declaration.
Female Genital Mutilation is not something that happens only in non – Western countries. Europe is very much affected as well, counting around 600.000 women living circumcised. While the main (western) human rights campaigns focus mostly on Africa, underlying the undoubtedly devastating consequences of FGM on women’s lives, it is important to recognize our western, white identity and colonizer past approaching these phenomena. It would be frutiful to think and compare other western practices regarding the female genitalia (such as cosmetic surgeries etc) and reflect on the postcolonial perceptions we hold upon FGM and these western practices. Maybe what is needed is to get rid of our ‘white savior’ coat and approach other cultures’ practices with some postcolonial perspective and sensitivity.
To be circumcised is considered to be a rite from girlhood to womanhood. In most cases the girls are being circumcised just before puberty or during. The beginning of menstruation seems to be a peak point, since the girl is ready to get married and be “fertilized”. The common age FGM is carried out is between two and twelve years old (Barstow, 1999). In most countries, in which the female genital cutting takes place, it is performed by other, older, sacred for the tribe, women or untrained midwives, or, in recent years, by specialized medical stuff. What is extraordinary in this statement, is the fact that this patriarchal procedure is performed by women towards women, and in most cases without anesthetics, antiseptics, analgesics or antibiotics, using any available sharp tool, such as rocks, broken glasses, even the teeth of the performer (Barstow, 1999). This sadistic act is interpreted by some scholars as a psychological defense mechanism of the women to accept their inevitable, submissive role in their society and to internalize the physical and psychological pain they came through (Williams & Sobieszczyk, 1997).
This simplistic view of this endless cycle of pain has been criticized by some scholars, since it ignores completely the correlation of the practice with the social status the women have after the procedure. Their own social status, and also the status of their families, and specifically of their male relatives, is raised significantly (Rising Daughters Aware, 1999 in Whitehorn, Ayonrinde & Maingay, 2002). Even though men are not involved in the procedure, unless it is performed by male medical professionals, FGM is mostly about the male relative figures and the male, husband- to-be figure: “If your daughter has not been excised. . . . No man in the village will marry her. It is an obligation. We have done it, we do it, and we will continue to do it. . . . She has no choice. I decide” (Poggioli, 2008 ).
These are the words of a father from the Ivory Coast, giving an answer to the reason why the practice of female genital mutilation is still performing. Through this sentence, it is clear that the physical repression of the female body and sexuality affects the ethos and morality of the patriarchal family and more specifically the honor of the daughter’s male relatives and future husband. Some psychoanalytical findings indicate that the unconscious fear of the tainted, female sexuality leads to the need to suppress it (Lax, 2000). In some African tribes the fear lies in the belief that if the clitoris is not cut off, it will continue to grow into a penis-like, gruesome organ and the girl will loose her femininity (Abusharaf, 1998). By suppressing the female sexuality, men have conquered their unconscious fear and also won a more intense sexual pleasure because of the tightening of the vagina (Ng, 2000). This internalized belief of the impure female sexuality and the power of the male desires is depicted in the Egypt Demographic and Health Survey of 2014, which shows that around 50% of the women being asked, believe that husbands desire their wives being cut and that the practice prevents adultery.
The relationship with the mothers, other female caregivers (for instance, the grandmother), the female performers (or Mtahra, as it’s called in the Bedouin-Arab culture) or other female figures, is also very deeply traumatized, since many women describe an emotion of abandonment and abuse by their own family: “Although some girls agree to do it, they are too young to understand what it means. They are intimidated by their mother’s or friends’ threats of being impure”, “It hurt me a lot. . . . I am scared of nice people. My mother gave me sweets to catch me” (al-Krenawi & Wiesel-Lev, 1999, pp. 436). It is worth noticing that, since almost only women are involved in the practice of FGM, in one or another way, the internalized hate for their bodies and the community, is depicted through the feelings of hatred towards the mother, the female performer, the women who has not been circumcised, or other female figures. These hatred feelings are not towards male figures, even though many women believe that their future husbands want their wives being cut or that they will not be able to get married if they do not go through this procedure (Egypt Demographic and Health Survey, 2014). In the contrary, an interviewed woman by al-Krenawi & Wiesel-Lev (1999), mentioned that “I will have a problem when I marry. The groom will run away from me. . . .Men are not to blame for it, but I will not be able to have sex with them. I think my husband will treat me well but I will be the problem. . . . I hate my mother” (pp. 436). Even though this practice is deeply patriarchal, it is not translated as such by the majority of the victims. As Simone de Beauvoir mentioned, the woman has no past, history or religion distinct from man, hence she is not able to unchain herself from the patriarchal oppression. This is the case with other oppressed groups and their oppressor as well (de Beauvoir, 1989).
One more thing that is necessary to be stretched out here is the fact that some male, medical professionals are not objected to perform FGM (Refaat et al., 2001 in Whitehorn, et al., 2002). This survey took place in Egypt, where about 75% of FGM is performed by doctors (When Health Workers Harm: The Medicalization of Female Genital Mutilation in Egypt, 2019). The belief about lower pain and less physical trauma leads to the medicalization of FGM and to a more lenient attitude towards it.
The physical and psychological trauma of the procedure follows the women for all their lives. Some scholars though argue that the psychological impact of being ostracized by the community, if a women does not perform FGM, is equal or even greater (Black & Debelle, 1995), Even this fact itself shows the tremendous consequences that women will face, either “decision” they take. In the communities where FGM is performed, the psychological morbidity is not unknown or ignored, but in fact it is considered culturally acceptable and an expected result. It is interesting how vivid the psychological and physical pain of the excised women exists in the life of the community, that it touched that peak of the iceberg where it is considered “expected” and “normal”. The brutality of this practice cannot be heard, since it is so deep rooted in the culture and the vitality of the tribes.
Even though in many countries FGM is illegal, the cultural coercion exists in the life of every newborn girl and her mother as a silent veil. “We were also taught, every day, that if we ever talked about this, if we even mentioned it, they would kill us…. My mother came to pick us up, and I kept asking, Why did they do this to me? Where were you?. She just responded, They told you not to say anything, right? Then don’t talk about it.” (Rudulph, 2014). Terror, horror, humiliation and extreme physical and psychological pain are the emotions described by the victims: “ I was in the throes of endless agony, torn apart both physically and psychologically.” (Joseph, 1996, pp. 3, 4).
Most studies regarding the consequences of FGM focus on the physical outcomes and the psychological damage is often neglected. Notwithstanding, though, a series of mental health problems occur before and after FGM. This psychological burden is examined according to the Western psychiatric standards and the actual experience will never be accurately translated. Even with this culturally obstacle in understanding the victim’s experience, it is important to report the emotional trauma excised women are obligated to come through.
Anxiety, psychosis, Post Traumatic Stress Disorder (PTSD), depression, fear of sexual practices, hallucinations, and irritability are just some of the psychological consequences of the gamut following the mutilation of female genitals (Barstow, 1999). According to Behrendt & Moritz, 2005, the percentage of symptoms of PTSD and other psychiatric syndromes were statistically relevant between the circumcised women and the uncircumcised women: “ Over 90% of the women described feelings of intense fear, helplessness, horror, and severe pain, and over 80% were still suffering from intrusive re-experiences of their circumcision” (pp. 1001). These findings are confirmed by other studies as well (Vloeberghs, van der Kwaak, Knipscheer, & van den Muijsenbergh,, 2012; Reisel & Creighton, 2015; Knipscheer, Vloeberghs, van der Kwaak, & van den Muijsenbergh., 2015, etc.): “80% continued to have flashbacks to the FGC event; 58% had a psychiatric disorder (affective disorder); 38% had other anxiety disorders, and 30% had post-traumatic stress disorder” (Chibber, El-Saleh, & El Harmi., 2011, pp. 1). Other studies showed that circumcised women experience somatization, depression, anxiety and phobia. “Women may suffer feelings of incompleteness, anxiety, depression, chronic irritability and frigidity. Many girls and women, traumatized by their experience but with no acceptable means of expressing their fears, suffer in silence” (Elnashar & Abdelhady, 2007, pp. 243). Moreover, lack of trust and humility are experienced towards the family members and her own self, since the psyche of the mutilated woman is deeply wounded and its integrity is destroyed (Baron & Denmark, 2006).
It is important to mention that some studies showed no significant difference in the measured levels of affective disorders, such as anxiety, depression, hostility, or PTSD between the examined and the control group (Kizilhan, 2011; Berg, Denison, & Fretheim, 2010; Applebaum, Cohen, Matar, Abu Rabia, & Kaplan, 2008). Although these findings seem contradictory to the experienced brutality of FGM, they could be interpreted in many ways. The meaning of perceived consequences can vary along with the socio-cultural context in which it is perceived and examined. For instance, Vloeberghs, Knipscheer, van der Kwaak, Naleie, & van den Muijsenbergh. (2011) showed that many women don’t consider themselves “victims” but rather “ordinary”, because FGM is a defining part of their culture and nurture. Other reasons why there are no statistically significant findings may be the incorrect culturally adaptation of the scales. For example, in the study by Applebaum et al. (2008) it was mentioned that the Post Traumatic Stress Disorder Scale that was used, was “adapted from Horowitz, et al.” (pp. 454), which is an American study and not a Bedouin – Israeli, as the examined population was.
Deepening the research on the psychological consequences of FGM will strengthen the importance on the protection of women’s rights. It is a brutal practice, that mars women’s bodies and psyches for a lifetime. It is an invasive practice that eradicates women’s right to a decent, secure and healthy life with dignity, without being subjected to any cruel and inhuman treatment. The World Health Organization describes health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (Constitution, n.d.). Consequently, FGM is a violation of women’s right to the highest attainable standard of health and in order to secure this holistic state of well-being, harmful practices, such as FGM, need to eradicated from women’s life.
Bibliography:
Abusharaf, R. M. (1998). Unmasking Tradition. The Sciences, 38(2), 22–27. https://doi.org/10.1002/j.2326-1951.1998.tb03367.x
al-Krenawi, A., & Wiesel-Lev, R. (1999). Attitudes toward and perceived psychosocial impact of female circumcision as practiced among the Bedouin-Arabs of the Negev. Family process, 38(4), 431–443. https://doi.org/10.1111/j.1545-5300.1999.00431.x
Applebaum, J., Cohen, H., Matar, M., Rabia, Y. A., & Kaplan, Z. (2008). Symptoms of Posttraumatic Stress Disorder After Ritual Female Genital Surgery Among Bedouin in Israel. The Primary Care Companion to The Journal of Clinical Psychiatry, 10(6), 453–456. https://doi.org/10.4088/pcc.v10n0605
Baron, E. M., & Denmark, F. L. (2006). An Exploration of Female Genital Mutilation. Annals of the New York Academy of Sciences, 1087(1), 339–355. https://doi.org/10.1196/annals.1385.018
Barstow, D. G. (1999). Female genital mutilation: the penultimate gender abuse. Child Abuse & Neglect, 23(5), 501–510. https://doi.org/10.1016/s0145-2134(99)00017-4
Behrendt, A., & Moritz, S. (2005). Posttraumatic Stress Disorder and Memory Problems After Female Genital Mutilation. American Journal of Psychiatry, 162(5), 1000–1002. https://doi.org/10.1176/appi.ajp.162.5.1000
Berg, R. C., Denison, E., & Fretheim, A. (2010). Psychological, social and sexual consequences of female genital mutilation/cutting (FGM/C): A systematic review of quantitative studies. Oslo: Norwegian Knowledge Centre for the Health Services (NOKC).
Black, J. A., & Debelle, G. D. (1995). Female genital mutilation in Britain. BMJ, 310(6994), 1590–1592. https://doi.org/10.1136/bmj.310.6994.1590
Chibber, R., El-saleh, E., & el Harmi, J. (2010). Female circumcision: obstetrical and psychological sequelae continues unabated in the 21st century. The Journal of Maternal-Fetal & Neonatal Medicine, 24(6), 833–836. https://doi.org/10.3109/14767058.2010.531318
Constitution. (n.d.). World Health Organization. Retrieved January 13, 2022, from https://www.who.int/about/governance/constitution
de Beauvoir, S. . (1989). The second sex. New York: Vintage Books
Egypt Demographic and Health Survey (2014). Cairo, Egypt: Ministry of Health and Population and ICF International.
Elnashar, A., & Abdelhady, R. (2007). The impact of female genital cutting on health of newly married women. International Journal of Gynecology & Obstetrics, 97(3), 238–244. https://doi.org/10.1016/j.ijgo.2007.03.008
Joseph, C. (1996). Compassionate accountability: an embodied consideration of female genital mutilation. Journal of Psychohistory, 24, 2-17.
Kizilhan, J. I. (2011). Impact of psychological disorders after female genital mutilation among Kurdish girls in Northern Iraq. The European Journal of Psychiatry, 25, 92–100.
Knipscheer, J., Vloeberghs, E., van der Kwaak, A., & van den Muijsenbergh, M. (2015). Mental health problems associated with female genital mutilation. BJPsych Bulletin, 39(6), 273–277. https://doi.org/10.1192/pb.bp.114.047944
Lax, R. F. (2000). Socially sanctioned violence against women: female genital mutilation is its most brutal form. Clinical Social Work Journal, 28(4), 403–412. https://doi.org/10.1023/a:1005119906627
Ng, F. (2000). FGM: its implications for reproductive health. An overview. British Journal of Family Planning, 26, 47–51.
Poggioli, S. (2008, January 26). French Activists Fight Female Genital Mutilation. Nrp. Retrieved October 26, 2021, from https://www.npr.org/templates/story/story.php?storyId=18376776&t=1635268134095
Reisel, D., & Creighton, S. M. (2015). Long term health consequences of Female Genital Mutilation (FGM). Maturitas, 80(1), 48–51. https://doi.org/10.1016/j.maturitas.2014.10.009
Rudulph, H. W. (2014, April 25). 3 Survivors Reveal the Brutal Reality of Female Genital Mutilation. Cosmopolitan. Retrieved October 26, 2021, from https://www.cosmopolitan.com/lifestyle/advice/a6504/female-genital-mutilation-survivor-stories/
Vloeberghs, E., Knipscheer, J., van der Kwaak, A., Naleie, Z., & van den Muijsenbergh, M. (2011). Veiled pain: Study in the Netherlands on the psychological, social and relational consequences of female genital mutilation. Utrecht: Pharos.
Vloeberghs, E., van der Kwaak, A., Knipscheer, J., & van den Muijsenbergh, M. (2012). Coping and chronic psychosocial consequences of female genital mutilation in the Netherlands. Ethnicity & Health, 17(6), 677–695. https://doi.org/10.1080/13557858.2013.771148
When health workers harm: the medicalization of female genital mutilation in Egypt. (2019, October 2). United Nations Population Fund. Retrieved October 26, 2021, from https://www.unfpa.org/news/when-health-workers-harm-medicalization-female-genital-mutilation-egypt
Whitehorn, J., Ayonrinde, O., & Maingay, S. (2002). Female genital mutilation: Cultural and psychological implications. Sexual and Relationship Therapy, 17(2), 161–170. https://doi.org/10.1080/14681990220121275
Williams, L. & Sobieszczyk, T. (1997). Attitudes surrounding the continuation of female circumcision in the Sudan: passing the tradition to the next generation. Journal of Marriage and the Family, 59, 966–981
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