Mental Health Effects on FGM survivors

In this blogpost I will be focusing on the prevalence of psychiatric illnesses such as PTSD, depression, anxiety disorder and other mental illnesses in survivors of female genital mutilation. I will be focusing mainly on a study performed by Alice Behrendt and Steffen Moritz, Ph.D on Senegalese women to prove the correlation between FGM and mental illness. I will also draw upon two different journal entry from American Journal of Psychiatry. One journal entry focuses on unpacking a series of 10 studies based on mental illness and FGM, and the other focuses on the silent mental scarring survivors endure. I also draw from a research blog for an opinion from the Western World (UK) and a research article for a different opinion from Iraq. I quickly touch upon other policy papers and studies to emphasize the impact of the correlation of psychiatric illnesses and female genital mutilation.

The process of Female Genital Mutilation is physical scaring for young women and girls worldwide. As described in my peers blog “Medical Impacts of Female Genital Mutilation on Childbirth and Maternity”, FGM is the practice of removal of all or part of the external female genitalia for non-medical purposes. The illegal practice carries significant physical health ramifications including an increased chance of postpartum hemorrhage, HIV and shock. But, the practice also carries significantly painful mental health consequences.

According to a study conducted on 23 Senegalese women in Dakar who were victims of FGM, and 24 who were not. The study was the first to formally prove what experts have hypothesized for years; women that fall victim to FGM are at a higher risk then the general population of developing psychiatric illnesses. The results study on the 23 Senegalese women showed that to be true. 30% of these women had prevalent Post Traumatic Stress Disorder with accompanying memory problems, and 47.9% showed symptoms of psychiatric syndromes. The experts who performed the study attribute the higher risk of mental illness to the trauma these women endured during FGM.

After this study, many more of the kind came out connecting to what the original said; there is a definite correlation between mental health and FGM, specifically due to the trauma endured. Numbers between studies have varied from PTSD in victims being at as high of a rate as 44%, that’s up to 7 times higher than in the average young woman. But, no matter what the rate actually is, data has almost always proved that the risk is higher for mental illness for those who had endured the pain of FGM.

In many countries and cultures, PTSD, anxiety, depression, and somatic disturbances (unexplained mental disorders whose symptoms show as physical), are not treated due to strong stigmas and negative, harmful attitudes within religions and/or cultures, or fear from individuals. For a Western example, many doctors and psychologists have been treating patients with FGM trauma as if they endured cultural practice. New guidelines are being set into place by World Health Organization to treat patients with physical or mental FGM scars as victims of abuse. This attempt helps fight the stigma that victims of female genital mutilation should feel ashamed for the trauma they endured, which in turn helps fight the fears and stigmas that stop these women from getting help for mental illnesses.

There is a very clear, very direct correlation between psychiatric illnesses and the trauma that young women who fall victim to FGM practices world wide have to endure. Now, it is a global responsibility to acknowledge that and fight the stigmas and fears that stop women from getting the help they need, and let them continue to silently suffer mentally, emotionally and physically.

 

 

Sexual Pleasure After Female Genital Mutilation

A blog post published last week, found here, explores an unintended consequence of female genital mutilation: the significantly increased risk of complications, death, and infant mortality during childbirth after undergoing female genital mutilation. While it’s been reasonably well known in the western world that FGM carries with it serious physical dangers, there’s another consequence of the practice that’s very much intended, and that’s the lessened ability of women to experience sexual pleasure after FGM. 

A primary goal of FGM is respectability by means of sexual oppression. Because sexuality is such a taboo subject in regions where FGM is prevalent, and women’s sexuality even more so, to take away a woman’s sexual desire and her ability to experience pleasure is seen as a way of protecting her honor and reputation. This intact reputation is what makes her desirable to a husband, allowing her to lead a comfortable adult life, justifying the continuation of the practice. 

A survey conducted at an obstetrics and gynecology clinic in King Abdulaziz University Hospital suggests that FGM may not be as effective at curbing women’s sexuality as it had been thought to be. Of the women polled at the clinic, half had experienced FGM and half had not, and it was found that women who had undergone FGM were no more likely to experience pain during sex or a lessened desire for sex. However, they were less likely to experience arousal, natural lubrication, and orgasm during sex. The study was published in The Guardian by two Saudi Arabian doctors looking to change the practice of FGM from inside the cultural sphere, in the hopes of accomplishing more than outsiders could. 

Though FGM may not always accomplish it’s goal of curbing women’s sexual desire, it cannot be ignored that they have greater difficulty becoming aroused and achieving orgasm. Women subjected to FGM are being denied their right to their own sexuality and the message is clear nonetheless that they do not have ownership of their bodies.

Additionally, the survey conducted by the Saudi doctors is not representative of the experience of all women who have undergone FGM. Many women do endure pain during sex as a result of FGM, despite not being statistically more likely to. Despite the possibility of sex being agonizing for these women, they are still expected to have sex with their husbands in order to be dutiful wives. Time and time again, from the time they are cut as girls to the time they are obligated to have sex with their husbands as women, women’s agency over their bodies and their sexuality is taken away from them. In this regard, FGM accomplishes exactly what it sets out to: it takes away control. 

Naturally, the impact of FGM on a woman’s sexual desire will vary immensely from woman to woman. Though surveys have found that many women are still able to experience orgasm, many women find that not only is sex not pleasurable, but it’s painful. Several Egyptian women gathered to share their own experiences with sex, with descriptions ranging from boring to painful. Women who were bored with sex spoke of accepting that it wouldn’t be pleasurable for them but pretending that it was for the sake of their husbands, and others who found it painful said they hate the experience. Women who lose their ability to experience sexual pleasure all too often come to view sex as a duty for the means of procreation rather than a shared experience, wondering why they would need to keep having sex after already having children.

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Mariya Karimjee describes her own experience with sex after undergoing female genital mutilation.

Mariya Karimjee said of her own experience losing her virginity at the age of 27 “the pain was everywhere. I couldn’t figure out what hurt and where.” She had always feared that she would never be able to enjoy a sexual experience; her right to enjoy her sexuality had been stolen from her at the young age of seven. Stories like hers never cease to be heartbreaking because so many girls and women have this ownership of their bodies and their sexuality stolen. The message is clear that women’s bodies and lives are not their own, and this mentality won’t end until governments crack down on abusive practices such as this. 

 

Bibliography:

Randerson, James. “Saudi Doctors Work to Change Attitudes to Female Genital Mutilation.” The Guardian. Guardian News and Media, 13 Nov. 2008. Web. 17 Nov. 2016.

Dean, Laura. “» Global Post: ‘I Hate It. It Hurts’ – Egyptian Women Talk about Sex after Female Genital Mutilation.” » Global Post: ‘I Hate It. It Hurts’ – Egyptian Women Talk about Sex after Female Genital Mutilation. N.p., 16 July 2015. Web. 01 Dec. 2016.

Kutner, Jenny. “What It’s Like to Have Sex After Undergoing Female Genital Mutilation.” Mic. N.p., 13 May 2016. Web. 01 Dec. 2016.

Medical Impacts of Female Genital Mutilation on Childbirth and Maternity

Female Genital Mutilation (FGM) is a widely known and widely disputed practice in which a young girl’s clitoris and/or labia is removed or mutilated and in it’s most serious form, the vaginal opening is narrowed or stitched closed. 

The three types of FGM are as follows:                                                         Type I: The prepuce and clitoris are removed                                                 Type II: The clitoris and labia minora are removed                                         Type III: Part or all of external genitalia is removed and the vaginal opening is stitched shut or narrowed. 

For the most part, this cultural practice presses on for a few reasons, the first being marriageability. Young women are often only able to find husbands to support them if they have undergone this procedure, quelling or eliminating their sexual desire to prevent impurity before marriage. Because finding a husband is of such importance in the regions where FGM is most prominent, specifically much of Africa, south Asia, and Australia, practitioners continue to justify the practice despite the severe pain caused to the girls. 

Besides the cultural implications of sexual oppression, FGM carries physical health ramifications as well, especially in the realm of maternity and childbirth. According to a study published in a policy brief on Reproductive Health and Research, women who undergo type III FGM are 30% more likely to require cesarean sections and 70% more likely to experience postpartum hemorrhage  than women who have not endured genital mutilation.

In addition to the impact on women themselves, there are also significantly higher risks for their children – babies born to women who have undergone FGM are more likely to need to be resuscitated or to die perinatally, according to the study. The risk of death increases depending on the type of FGM the mother has undergone, and statistics published in the policy brief state death rates among babies to be “15% higher for women with type I, 32% higher for those with type II and 55% higher for those with type III.”

Click here to view the policy brief on the impact of FGM on childbirth in Africa. 

Female Genital Mutilation is not a new practice; it has been silently endured by women and their children for generations upon generations for the sake of tradition. The sexual oppression of women has been prioritized over their health and well being, and the topic has only relatively recently become a matter of public international concern. Because women have, unsurprisingly, not been valued in the regions where FGM is most prevalent, minimal research has been done on the actual as opposed to ideological impacts of FGM, and access to health care for women suffering the ramifications is even more minimal. 

 

 

Female Genital Mutilation – Not Just a Problem for Africa

This blogpost is about Female Genital Mutilation, specifically the practice in Eurocentric, Westernized countries. Many people believe FGM is only a practice found in Africa/ “developing” nations, but by using 2 news articles, one large-scale European one (BBC-The first ever FGM figures show nearly 6,000 new cases in England), and the other a smaller news source from the Arab world (Nature Middle East- Bringing to life the case against female genital mutilation), I will shed light on FGM happening in westernized countries. By using these sources for individual stories and using a scholarly article (Healthcare in Europe for Women with Genital Mutilation), I further delve into how culture and immigration has brought FGM to the western world. Using a policy paper (UNICEF’S data work on FGM/C), I found helpful statistics about FGM and the silent, painful practice all over the world.


         When we as a society think about FGM (Female Genital Mutilation) we think about a cultural practice taking place predominantly in Africa and what the Western world deems as “developing” nations. But, how true is that fact? 680,000 women in Europe endure the painful and illegal process of FGM practices, but only a handful of people executing this practice are prosecuted. 

        FGM is, in some cultures, a traditional cultural practice that includes partially removing or fully removing a pubescent girls’ external genitalia for reasons that are non-medical. This is seen by many as a necessity to raising females, and motivated by societal beliefs for controlling sexual behavior within young girls. The practice has no medical benefits, and can in fact, cause harm later in a women’s life. Many countries including Chad,  Egypt, Eritrea, Ethiopia, Ghana, South Africa, Tanzania, Canada, Europe, and America have outlawed the practice and try to prosectue those doctors who subject young girls to the painful practice. Interestingly, France has also started cracking down on FGM and on top of prosecuting the doctor they also prosecute the parents.

       Although government officials have been cracking down on FGM to protect their girls, nobody is being charged. It seems that the governments of many Westernized countries are just sweeping FGM under the rug and pretending it doesn’t happen, though in places like the UK, where the practice has been illegal since 1985, authorities have been unable to successfully prosecute even one case. But, that doesn’t mean it’s not happening, according to a study by Equality Now and City University in 2015, around 103,000 women and children were living with FGM in the UK. 

     Many times, people immigrate from their home country for a multitude of reasons, war, financial instability, as a refugee, seeking better education, and the list could go on. When said people come to the new country, they often bring their cultures with them. That is how Female Genital Mutilation came to be practiced in places like the UK and other parts of the Western world. Nut, many cases of FGM in Westernized countries aren’t acknowledged because theres a common social stigma that something like genital mutilation would never happen in the “developed” world, so, many women continue to suffer from the harmful side effect of the practice silently.

     There’s also another stigma and a stereotype attached to Female genital mutilation. The practice of FGM carries lots of stereotypes, including that it’s a ‘savage and dangerous practice’. But, what about similar genital plastic surgery alterations made for non-medical reasons performed in Eurocentric countries by doctors. Why is FGM only savage and dangerous and illegal when performed in third world countries? Why is one version of a fairly similar surgery looked upon highly while the other is condemned? Why does society allow plastic surgery to exist, but ignore the existence of FGM as a worldwide problem, not just a problem for developing countries?

      These questions and stigmas are necessary for us as a global society to face, advocate for, and attempt to solve in order to create a better, safer, healthier world for all girls and women, regardless of what culture is or where they live.