FGM

FGM describes any deliberate, non-medical removal or cutting of female genitalia. Different regions and communities practice various forms of mutilation. Some forms of cutting are quite common and they are classified as shown below.

It is not unusual to not know what type of FGM you may have. It can be difficult to understand what form your vagina takes after FGM, whether or not you still have labia or a clitoris, whether your vaginal opening is closed. We hope this information will help people to better understand their FGM and to be able to be able to describe their FGM to their partners or to healthcare workers.

Type 1 FGM

Clitoridectomy: partial or total removal of the clitoris (a small, sensitive and erectile part of the female genitals) and, in very rare cases, only the prepuce (the fold of skin surrounding the clitoris).

This practice is extremely painful and distressing, damages sexually sensitive skin and is an infection risk.

Type 2 FGM

Excision: partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (the labia are the ‘lips’ that surround the vagina).

This practice is extremely painful and distressing, damages sexually sensitive skin and is an infection risk.

Type 3 FGM

Infibulation: narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and sewing over the outer, labia, with or without removal of the clitoris or inner labia.

This practice is extremely painful and distressing, damages sexually sensitive skin and is an on-going infection risk. The closing over of the vagina and the urethra leaves women with a very small opening in which to pass urine and menstrual fluid. The opening can be so small that it needs to be cut open to be able to have sexual intercourse. Cutting is also needed to give birth and can cause complications which harm both mother and baby.

Type 4 FGM

Other: all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping, stretching and cauterising the genital area.
Daughters of Eve are interested in furthering understanding and recognition of the forms of mutilation which are currently categorised as “Type 4”. By developing better descriptions and definitions we believe we can help women and healthcare workers to deal with rarer forms of FGM.

FGM is against the law in the UK and is recognised as a form of child abuse. Undergoing the practice can affect girls and women in many ways and there are often long term effects on your physical and emotional health.

This page provides details about potential health problems and gives advice about how to live as halthily as possible with FGM.

Mental and Emotional Health

Any situation that leaves you feeling overwhelmed and alone can be traumatic and undergoing FGM can be one of those experiences. You may not really remember what happened to you but that experience can be held within your mind at a deeper level. This may lead to many painful feelings. These can include low self esteem, depression, anxiety and anger. You can feel like this even if you wanted to go through FGM because that is what happens to all girls in your community. It is likely to have been a very painful and frightening experience for you. Flashbacks, panic attacks and sometimes nightmares are usual following very distressing experiences.

What is a flashback?

A flashback is a temporary state of remembering something painful or traumatic which has been hidden for quite some time in the subconscious mind. Flashbacks can be triggered at any time by anything such as a smell or a sound and you may feel you are right back there in the traumatic situation. If this happens to you try to remember that this is a memory and remind yourself of the time and date now. Flashbacks can be very frightening but they are the body’s way of healing.

You may wish to seek counselling and there are a number of organisations that can help you.

Counselling is a way of talking through your feelings and experiences and looking at how you have managed them. The counsellor does not give advice but can help you to find more positive ways of managing those feelings.Sexuality, Sex and Intercourse

It can often be difficult for women who have been through FGM to think about having sex. You may be really worried that it will be painful because of the scar or that you may not have an orgasm if your clitoris has been removed. Women often choose to have a de-infibulation before they get married. However, as many women have sex before getting married they may also choose to have the procedure at any time. Your health professional will not judge you and will respect your need for confidentiality.

You may find that you have frequent vaginal discharge and though some discharge is normal for women it may mean you have an infection. You can talk this through at your GP’s or at a sexual health clinic.

Many women who have had FGM do enjoy a happy and satisfying sex life and it is possible to have an orgasm even though your clitoris was removed. It could help you to talk to your partner about your feelings and anxieties.

Sexual Health

The World Health Organisation recognised that the practice of FGM can deny girls and women the right to the highest attainable level of sexual health.

There are several recognised types of FGM and the more severe the cutting the more impact that has on your physical health. However, undergoing any type of FGM can cause emotional and psychological difficulties.
Pregnancy and Labour

Pregnancy can be an anxious time for women who have had FGM because of the worry about the delivery especially if you have a long and closed scar.

When you first meet your midwife they will ask you certain questions which are designed to establish if a woman has any problems that could affect her pregnancy. As part of this the midwife should ask you whether you have undergone FGM. This is to ensure that you receive the best care and to enable you to talk through your anxieties. You can have a de-infibulation during your pregnancy and that is best done at around 20. However in some cases it can be carried out up to 32 weeks of pregnancy.

You may also have the scar cut during the labour to help with the delivery; the decision when to have the procedure should be yours in consultation with your midwife. It is important to talk through any worries with your midwife.

The midwife may also refer you to children’s services. This is because FGM causes harm to children and it is covered by safeguarding policies. You do not need to feel anxious about this. Many people fear social services but they will support you and help you with your decision not to have any daughters cut.
Cervical Smear Test

Cervical screening is not a test for diagnosing cervical cancer. It is a test to check the health of the cervix, which is the lower part of the womb (often called the neck of the womb).

This test is offered at regular intervals to all women between the ages of 25 and 64. This test is usually carried out in your GP practice or at a women’s health clinic. It is sometimes a little uncomfortable but it should not be painful.

If you have had FGM you may be anxious about having this test and it is important to talk to the nurse about your anxieties. Undergoing any vaginal examination may trigger a flashback for you or a panic attack because it makes you remember the time you were cut. If this happens to you do ask the nurse to stop and let them know how you feel. They may refer you to a specialist clinic to have your smear taken.
Periods

Your monthly period can also be very painful (dysmenorrhoea) and prolonged because of the long scar restricting the blood flow. It is usual for any woman to have pain with her periods but for girls and women who had had FGM this can be worse and last longer. Sometimes the scar of the cutting is very long with a tiny opening and this will make it worse for you.

If you are experiencing any of these difficulties you are not alone and it is important to talk with someone. You can talk to your GP, practice nurse and health visitor or you can ring one of the specialist centres. Daughters of Eve can help you by providing support and information.
Passing urine

If you have had the most severe type of cutting often called infibulation or being closed this can affect your physical health in several ways. The long closed scar will cover the urethra (where you pass urine) and often most of the vaginal opening. This makes going to pass urine very difficult and it may take a long time as the flow is restricted by the scar. You may need to go more frequently or spend many minutes trying to empty your bladder. Some of the urine may collect in the area of the scar and when you lie down it can leak out. This can be embarrassing but it does not mean you have incontinence.

FGM is the deliberate mutilation of female genitalia. This is often the removal or cutting of the labia and clitoris. The World Health Organization describes FGM as any procedure that injures the female genital organs for non-medical reasons. FGM has no health benefits and is in fact very harmful to health in many ways.

FGM is illegal. Even if carried out by a healthcare professional or if it takes place outside the UK. It is a form of gender-based violence, it is a human rights violation and it is a form of child abuse.

FGM is damaging.The lives of women and girls can be ruined by FGM. It causes physical and mental health problems which can go on for all of their lives. It is also extremely distressing and damages women’s relationships and how they feel about themselves.

FGM does not need to happen. No one should be forced to have FGM and the law should protect women and girls who are at risk. See our page for information to Get Help Now.

Why does FGM happen?

There are huge pressures on families and communities to ensure daughters have FGM. Many people have FGM forced on them and have no choice whether it happens. People have strong and deeply held beliefs that FGM is a good and necessary thing for girls to go through.Tradition
FGM happens to women and to girls in adolescence, childhood and even sometimes when she is a baby. It is seen by some as a right of passage into womanhood and a condition of marriage. Some believe that vaginas need to be cut and that women will be unhealthy or unclean or unworthy if they don’t have FGM. These beliefs are very strong and parents genuinely think that they are doing the right thing for their daughters.

In communities where all women have FGM and all girls are expected to have it, FGM can seem normal. It can seem like there is no other choice and it is very difficult for girls to challenge these traditions.

Sexuality and fertility
There is a common belief that women need to have FGM to have babies. In fact FGM does not improve fertility but can cause infertility and an increased risk of childbirth complications and even deaths in newborns.

FGM does not have any sexual benefits but in fact damages or removes sexually sensitive skin and can make sexual intercourse painful, difficult and even impossible without re-cutting the entrance to the vagina. It can make relationships difficult and stop couples enjoying a good sex life together.Religion and belief
Some people practice FGM as part of their religion and there can be huge pressures to make girls have it done. However FGM is not recommended by any religion or in any religious texts. It is not religious but might have become symbolic in some communities as a demonstration of faith. In fact it is not a condition of belonging to any faith group.

Christianity, Judaism and Islam unanimously agree that your body is a temple of God. The practice of FGM is a harmful custom that is not advocated in any holy script.

Hear what religious leaders from different faith groups have to say about FGM on this page.

De-Infibulation/Reversal
It is possible to have a small procedure to open the scar and this is often called a reversal or de-infibulation. This is done in a specialist clinic usually with a local anaesthetic which is an injection which will numb the area so the nurse, doctor or midwife can open the scar. The skin will be stitched at either side of the scar to keep it from healing together again and you will usually heal very quickly. The stitches will dissolve and you will not need to have them removed.

You may not want your family to know you are considering this and the specialist will understand and respect your need for confidentiality.

It may be important for you to talk through your feelings before you decide to have this done. This small operation is often called a reversal and that can be confusing because it does not mean that any tissue that has been removed can be replaced. You will certainly be able to pass urine much more quickly and that can sometimes be a surprise. You have been used to your body being this way for a long time and once the reversal is done you may need to get used to it being different. Your body will look changed but most girls and women soon get used to this as their symptoms improve quickly.

It is often helpful to talk this through and all the staff at the specialist clinics will understand your concerns.

What if I don’t speak much English?
Do not worry about this. All health services should provide you with a professional interpreter who will be present at your appointment to help you. The interpreter usually needs to be booked in advance so it would help if you can make them aware when the appointment is booked.

If you need to go urgently to any professional service they will have access to telephone interpreting or you can take someone you trust who speaks English to help you in an emergency.

If you are worried about any aspect of your health do not be afraid to talk a health professional. Daughters of Eve will be able to provide you with details of specialist services if they are available in your area.

At Daughters of Eve we are committed to supporting young people who are at risk of FGM or who have had FGM. But our long-term aim is to work towards the elimination of the practice, so that no one has to live at risk of FGM.

There is a growing movement across the world against FGM, people are speaking out and protesting against the practice. As awareness spreads and support grows we are seeing a change of attitudes. The shame and secrecy which surrounds FGM is being challenged with

Another world is possible, and we are working in hope for an end to FGM!

For a list of organisations which campaign against FGM, please go to our links and resources page.

Speaking out against FGM
An important part of the campaign against FGM is fighting the taboo. By bravely talking about their experiences, women and girls break the secrecy around FGM and stop the misunderstandings. These testimonies are so important to give voice to silenced women and give us all the honest truth about FGM. Speaking out and sharing with others is an important act
Istar’s Story
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My name is Istar I am 28 years old mother and a student. I would like to share my experience of under going FGM, this will be the first time I’ve ever written about my experience this will be the one chance the child within me voice will be heard.I was 6 years old when it happened, all I know is that I was playing outside our house with other children who lived near by, I also remember a lot relatives and family friends where at the house a lot food and sweets were cooked that day but strangely my parents weren’t there, didn’t think much of it at the time.

The nightmare started as my younger sister was called in to the house by aunts I followed but was told to wait outside again didn’t think much of it at the time. One of my neighbour daughter who was playing with us came to me, “You must be excited” my response: what for? I didn’t know what she was talking about. “You will be a big girl now all you have to do is be very brave and don’t cry”. I still didn’t understand what she meant. When she explained what was going to happen to me, all I wanted was my mom to come and rescue me , I ran so fast trying to hide in the house at the same time I can hear my little sister scream , I never heard such scream, even today when I shut my eyes I can hear her screaming.

“Get Istar it’s her turn” I could hear my aunt saying. I kept running around the house until I got caught and dragged to the table were I was surrounded by two of my aunts, one of our neighbour and two men I didn’t know who their were at the time but realised that one of them was the circumcisers well that’s what people call them if I had give them a title it would be the children’s butcher.

The other man grabbed hold of my legs trying to pull them apart; I fought him as much as I could, but I was only six years old, I had no energy left within me, when he succeeded, I remember him saying to me “Behave you silly girl and stop crying it doesn’t hurt” my lower part of my body was out of my control I tried to move my upper part of my body but my aunts held me down and stuffed big cloth in my mouth so I wouldn’t scream so loud, god that was all their were worried about. As this was happening all I wanted was my mother she was always there for me, WHY NOT THIS TIME?

When he was done I felt so ashamed that these people saw my private parts and these men actually touched it and hurt me. Brave girl Istar everybody said, I remember getting a lot of sweets, toys and money to congratulate me. At the time I thought you now part these people now and you are treated differently “The very special girl now”. Again as this was happening to me all I wanted was my mommy.

As I got older I’ve realised the damage FGM has caused me physically and mentally, I was led to believe I’ve had type1 but later in my early twenties realised I’ve actually undergone Type2, but the mental scar I carry till today it’s very difficult to explain I’ve blocked it out for many years pretended that it never happened but I could no longer ignore it especially after my beautiful little girl was born, I knew as a mother I couldn’t let that happened to my daughter but that meant facing the demons from the past.