After their genitals were cut, some women search for healing
She remembers it all: How female relatives held her down when she was 11, legs spread and genitals exposed. The fear that stiffened her body. The stranger in black holding the scissors. And the pain.
Like so many others, the 34-year-old Egyptian woman has lived with the psychological and physical repercussions of that day, when she was subjected to a practice many activists call “mutilation.”
For N.S., who asked to be identified only by her initials to discuss the sensitive topic, the trauma continuing into adulthood was accompanied by a desire to reclaim control over her health and body.
“I had a feeling of being incomplete and that I will never feel happy because of this,” she said. “It's a horrible feeling.”
A global target aims to eradicate the deeply entrenched practice by 2030, and protect the next generations of girls, though campaigners acknowledge the difficulties in achieving that. The United Nations has designated an International Day of Zero Tolerance for Female Genital Mutilation, or FGM, observed every Feb. 6.
Meanwhile, some women living with the consequences have embarked on deeply personal journeys to heal. They search for answers, sometimes scouring the Internet, amid treatment gaps in many countries, or shame and possible related sexual complications.
Prevalent in parts of Africa, the Middle East and Asia, cutting has been performed in communities of different cultures and faiths. It can be viewed as a rite of passage or linked to beliefs about chastity or femininity and cleanliness, and be fueled from generation-to-generation by social pressure.
“It's an entrenched social norm and really deeply rooted in cultural beliefs and sometimes in religious beliefs,” said Nafissatou Diop, an official with the United Nations Population Fund. “So to be able to make any change, people need to be convinced that this is not threatening their culture.”
It's estimated that at least 200 million women and girls are living with the aftermath of the practice, which can include partial or total removal of their external female genitalia and can cause excessive bleeding and even death. Long term, it can lead to urinary tract infections, menstrual problems, pain, decreased sexual satisfaction and childbirth complications, as well as depression, low self-esteem and post-traumatic stress disorder.
Some faith leaders have worked to eliminate the practice, while others condone it. In Egypt, where genital cutting has been widespread but illegal since 2008, top Islamic authorities condemn the practice. In online edicts or television appearances, they cite medical evidence of its harms and say it's a custom with no sound religious basis. Still, there's opposition to the bans in Egypt and elsewhere.
Besides resistance from some religious leaders and other “traditional gatekeepers,” Diop said the campaign to change minds is hindered by limited funding, lack of political will from some governments and a perception that ending cutting reflects a “Western-led agenda.”
Meanwhile, some women suffering the aftereffects post anonymously online in the quest for healing. They express feelings of distress, discomfort in their own skin, embarrassment or fears that being cut could stop them from getting married or condemn their marriages to failure. Some want information on medical procedures.
Some considering medical interventions have found specialized treatment, including in the United States and Europe, where opposition to the practice is longstanding. But in many countries, options can be scarce or too costly.
“There are so many treatment gaps in a lot of countries where FGM is really widely practiced,” said Christina Pallitto, a scientist leading the work on FGM at the World Health Organization. “A lot of health care providers receive no training at all.”
N.S. turned to a private clinic in Egypt, Restore FGM, that opened in 2020 and has promoted treatments on Instagram and other social media.
Dr. Reham Awwad, a plastic surgeon and clinic co-founder, said many patients' initial visits are emotional. “One of the first things they'll say is, `I've never spoken about this to anybody,'” she said.
The clinic, which also attracts clients from Sudan and elsewhere, offers surgical and non-surgical therapies. Psychological therapy is recommended, but many don't pursue it, Awwad said.
N.S. has struggled with anger at her parents and low self-confidence. She's wrestled with sensitive questions: Will sex hurt? Will cutting lead to sexual problems in a marriage? What about pregnancy and childbirth? She struggled with pain and difficulty reaching orgasm.