Reversing female circumcision remains taboo

RNW, by Karima Idrissi and Willemien Groot, 6 February 2011, by RNW News Desk

(photo: Isaad Mohammadani)

Isaad Mohammadani (28) is an active and intelligent young woman from Darfur who came to the Netherlands in the summer of 2009. She is married to the love of her life and they have a three-year old daughter. Isaad was circumcised as a girl and is considering an operation to have the process reversed.

Today is United Nations-sponsored International Day of Zero Tolerance to Female Genital Mutilation. This is Isaad’s story.

Female circumcision reversal

In order to reverse female circumcision,
the surgeon first has to see whether there
is still healthy tissue under the scars.

The reconstruction of the clitoris involves
drawing the internal part outward and covering
it with mucous membrane from the inside of
the vagina. The injuries to the labia are
covered with skin from the buttocks.

Isaad underwent a far-reaching form of genital mutilation, sometimes called pharaonic circumcision or infibulation, in which the clitoris and the labia are removed.

In Sudan having your daughter circumcised is almost compulsory, she explains. “If you don’t, the girl will be bullied at school and her parents will become social outcasts.”

The ritual is barely a matter for discussion in Sudan despite the risks involved and a legal ban on infibulations, in force since 1946.

The World Health Organisation estimates that 90 percent of Sudanese women have been circumcised. If a girl survives the mutilation, it affects her entire life, both psychologically and physically. The procedure leaves her with such a narrow opening that urinating and menstruating become difficult.

Isaad lost her first baby during childbirth because she did not receive the special help she needed.

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She speaks candidly about her physical mutilation and its effects on her sex life. “I’m often reluctant to have sex,” she confides. “Sometimes I manage to reach a climax, but only because my husband helps me. We try hard to create the right mood.”

But she is not content with only having occasional orgasms. “I would like to feel complete, both physically and emotionally. I want to overcome my inferiority complex.” She is considering having an operation to reverse her circumcision.

New development

Since 2010, an Amsterdam hospital has specialised in reconstructive surgery for circumcised women. The operations are a relatively new development in plastic surgery. The hospital team therefore works closely with Pharos, a Dutch knowledge centre specialising in refugee and migrant healthcare, and the Dutch gynaecology association (NVOG).

Dr Refaat Karim, the man behind the surgical team, has now carried out two of the operations, the first of their kind in the Netherlands. There is little medical literature on the subject and the long-term effects on the patient are unknown.

Quality of life is expected to improve, but this will probably vary according to the individual. And not every woman is a suitable candidate for surgery. In some cases it’s considered irresponsible to operate for medical or psychological reasons.

Tough call

Deciding whether or not to have the operation is a tough call for Isaad. Despite the problems she encounters due to her mutilation, reconstruction is still very much taboo, even among well-educated women from Darfur. She cannot even contemplate getting any support from her family in Sudan. “They would never approve. I wouldn’t even tell them.”

One of the women operated on in Amsterdam is a friend of Isaad. She says she feels better and is now able to enjoy her sex life. But Isaad continues to have her doubts.

“I’m afraid to lose what it’s taken me so much trouble to achieve, especially in my sex life. A doctor in Belgium is already performing these operations, but they’re not always a success. It’s a 50-50 chance. What if the operation goes wrong, or if I end up not feeling anything anymore?”

Related Article:

Female genital mutilation causes aggression