Mutual enhancement of physical, sexual and psychological complications

Physical, sexual, social complications due to FGM can also impact women’s psychological well-being. The more the type of FGM is serious the more the complications can be important and thus concern women unequally.

After an infibulation, pregnancy and birth are sometimes difficult (5). Some women suffer incapacitating and stigmatising complications such as incontinency.
Somatisation, chronic pain or dysmenorrhea (strong pain and fatigue associated with menstruation cycle) affecting some women can lead them to auto isolate.

Moreover, psychological complications of FGM can reinforce physical problems of women as they can fear being confronted to medical staff and have difficulties to access healthcare services. Thus, the risk of reexperiencing the event, the fear of being examined by a medical professional and possibly judged are all obstacles for women to access services. The WHO recommends for instance that “Psychological support should be available for girls and women who will receive or have received any surgical intervention to correct health complications of FGM” (3, Good Practice n°3). Furthermore, health care professionals behaviour can also have an influence on woman’s well-being, on her perception of herself, her confidence and thus on her ability to seek help.

In Somalia, shelters for women living with FGM are directed by midwives who are themselves affected by FGM and thus more able to build a relation of trust with the women they support. (8)

Furthermore, sexual life of women concerned by FGM can also be affected leading to issues within the couple. In 2010, the Norwegian Centre of Knowledge on Health Services notices that women concerned by FGM are more susceptible to suffer a decrease in their ability to experience sexual pleasure and have satisfactory sexual intercourses (11). 28 Too Many draws the same assessment as women with FGM seem to have a higher propension of feeling shameful, embarrassed in the intimacy (12). The more sexuality is considered as a taboo for concerned women, the more the effects will be important and hidden. Besides, the mere idea of having sexual intercourse is not always thought of with tranquillity but on the contrary, with apprehension, or even fear.

It is important to be very careful with the studies addressing sexual consequences of FGM. Sexual difficulties are not universal and do not concern all women living with a FGM. Besides, FGM are not the only responsible, a forced marriage or domestic violence, for instance, also have an important influence on sexual life. It is also fundamental to consider the influence of the way excised women’s sexuality is looked at, of normalising and stigmatising discourses surrounding women’s body and genitals, of her knowledge on her own body. (17; 21)

(3) OMS, Lignes directrices de l’OMS sur la prise en charge des complications des mutilations sexuelles féminines, 2018, Access here

(5) Vloeberghs E., Knipscheer J., Van der Kwaak A., Naleie Z., Van Den Muijsenbergh M., Veiled pain. A study in Netherlands on the psychological, social and relational consequences of FGM, 2011, Utrecht, The Netherlands : Pharos.

(8) Ferenczi S., Le traumatisme, Petite bibliothèque, Payot, n°580, Paris, mars 2006, 176 pages, cité in GAMS Belgique, – Femmes, excision et exil – Quel accompagnement thérapeutique possible ?, p. 48

(11) Psychological, social and sexual consequences of FGM/C : a systematic review of quantitative studies, Report from Kunnskapssenteret (Norwegian Knowledge Centre for the Health Services), No 13–2010. Access here

(12) Research blog by Serene Chung for 28 Too Many, The psychological effect of FGM, 2016. Access here

(17) Johnsdotter, Sara (2019): “The growing demand in Europe for reconstructive clitoral surgery after Female Genital Cutting: A looping effect of the dominant discourse?” Forthcoming, in Droit et Cultures. Access here

(21) Fuambai Ahmadu, Chapter 12: “Ain’t I a Woman Too?”: Challenging Myths of sexual dysfunction in circumcised women, in Shell-Duncan, Bettina, Hernlund, Ylva.; Transcultural Bodies: Female Genital Cutting in Global Context, 2015, pp.278-310. Access here

« The Community of Practice on Female Genital Mutilation » is part of the « Building Bridges between Africa and Europe to tackle FGM » project, supported by the « UNFPA-UNICEF Joint Programme on the Elimination of FGM ». The project is coordinated by AIDOS in partnership with GAMS Belgium.

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