Psycho Sexual Health
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 therefore women are not equally affected.
After an infibulation, pregnancy and birth are sometimes difficult (Vloeberghs E. et al., 2011). Some women suffer incapacitating and stigmatising complications such as incontinence.
Somatisation, chronic pain or dysmenorrhea (strong pain and fatigue associated with menstruation cycle) affecting some women can lead them to auto isolate.
Moreover, the psychological complications of FGM can reinforce the physical problems as the women can fear being confronted to medical staff and have difficulties accessing healthcare services. Thus, the risk of ‘reliving’ 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” (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 run by midwives who are themselves affected by FGM and thus more able to build a relation of trust with the women they support (Ferenczi S., 2006).
The sexual life of women concerned by FGM can also be affected leading to relationship issues. In 2010, the Norwegian Centre of Knowledge on Health Services noticed that women concerned by FGM are more susceptible to suffer a decrease in their ability to experience sexual pleasure and have satisfactory sexual intercourses (Psychological, social and sexual consequences, 2010). 28 Too Many draws the same assessment as women with FGM seem to be more likely to feel shameful and embarrassed in intimate settings (28TooMany, 2016). The more sexuality is considered as a taboo for the affected women, the more the effects will be important and hidden. Besides, the mere idea of having sexual intercourse is not always pleasant but on the contrary, is approached with apprehension, or even fear.
It is important to be very careful with the studies addressing the sexual consequences of FGM. Sexual difficulties are not universal and do not concern all women living with a FGM. Besides, FGM are not always the only factor – a forced marriage or domestic violence, for instance, may also have an important influence on the women’s sexual life. It is also fundamental to consider the influence of the way excised women’s sexuality is looked at, of the normalising and stigmatising discourses surrounding women’s bodies and genitals, and of her knowledge of her own body (Johnsdotter S., 2019; Ahmadu F., 2010).
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