Medicalization of FGM

Plastic surgery and social pressure

There was widespread discussion amongst our members on the issue of genital plastic surgery which is freely available to adult women and which is becoming increasingly popular in Europe and North America. While some see it in an entirely different light from Female Genital Mutilation, others argue that social pressure and the desire to conform to social norms of beauty affect the free and informed consent of women who undergo it. 

In Burkina Faso, Professor Charlemagne Marie R Ouedraogo argues that:

“Medicalized FGM has nothing to do with intimate surgery. Adults undergo the medical procedure for a reduction of hypertrophic labia, and we perform it as a gynecological surgery. The same is true for reductions of enlarged clitoral labia. This has nothing to do with FGM in the Burkinabe context. 

Any consenting adult can do what they want with their body, such as plastic surgery or any other form of surgery, such as pricking or piercing, etc”

Thus, on the one hand, genital plastic surgery or other practices of female genital modification are seen as a personal choice which goes hand in hand with the free disposal of one’s body. On the other hand, they are perceived as the result of social pressure on women’s bodies and linked to the women’s will to conform. 

“At GAMS Belgium, we have opened the debate within our team on other forms of practices which also affect the external genitalia of women and which could be considered as a social norm imposed on women’s bodies.

The current “fashion” of reducing the labia minora is one of them. In Belgium we see young girls under the age of 18 or just 18 years old who have barely discovered all the facets of their sexuality and who ask for plastic surgery in order to conform to a criterion of “beauty”, without any proven hypertrophy (with a risk of complications that is never 0% whenever surgery is being performed). Wouldn’t a session with a sexologist who could reassure her not be more ethical than immediately opting for surgery ?

Having this more holistic approach to everything that is imposed on women’s bodies in all societies also helps to balance the debate and not see the world in black and white. Whether in Europe or in Africa, women are still under social pressure today to correspond to the role expected by society…and this translates first and foremost into societal control over their bodies. ” (Fabienne Richard)

It should be noted that national contexts are also different. Debates on cosmetic genital surgery have more meaning and relevance in Europe and North America than in Burkina Faso, where the demands are of a different nature.

“In Burkina Faso we are not dealing with requests for cosmetic reduction (…). Besides, our fight is to protect the underage girl who doesn’t take responsibility for herself. It is not a question of going against the will of adults to do with their bodies what they want. It is a minor and it does not deserve to be focused on in view of the priorities in Burkina Faso. ” (Charlemagne Marie R Ouedraogo).

In the continuity of the debate, the case was reported of a little-known practice that has been going on in Senegal, the ablation of southieutes or condylomas.

“There is a traditional phenomenon in Senegal that is harmful in the eyes of health practitioners and is considered by some to be a form of FGM. It is a phenomenon that consists of cutting something out of a woman’s vagina to facilitate penetration on her wedding night. The person on whom this thing, called condyloma by some, is cut, is certainly of legal age but is constrained by social norms that force her to undergo this ordeal. ” (Fatou Kebe)

The practice responds to myths and social expectations under the guise of medical necessity, since condylomas are indeed a medically treated pathology in sexually active women with HPV but cannot concern virgins, from whom they are supposedly removed.

Dr. Hashim Hounkpatin testifies:

This practice is performed on “virgin” women for whom it is assumed that the “first time” will be difficult or impossible. And since it is the wedding night, the marriage must be consummated. 

For the sake of clarity of terminology, the condyloma refers in medicine to a mass that appears on the genitals due to a virus transmitted during sexual intercourse. Is is really condylomas that are cut off or is it the hymen or something else? 

Here is a text I found on Facebook on this topic:

The condyloma or sothieute – 

It is fairly common in our countries for some virgins to be told that they are sick and that this will prevent them from consummating their marriage. 

On the medical level, these types of patients are not recognized. Admittedly, the sothieutes exist but they are different.

Sothieutes also called genital condylomas or genital warts, are growths that look a little like a rooster’s crest on the female genitalia or anus. They can be so numerous that they can make vaginal delivery dangerous for the baby.

They are due to HPV (Human Papilloma Virus).

These condylomas are sexually transmitted and thus present only on women and men having unprotected sexual intercourse.

The condylomas described by traditional healers to explain the difficulties of penetration are not recognized by medicine. In almost all cases, these difficulties of penetration are due to the stress of the woman and the lack of gentleness of the husband, which creates a vaginismus in the woman: a contraction of the muscles of the vagina making the penetration difficult or even impossible.

The recommended treatment in this situation is gentle foreplay to relax the woman and lubricate her – sometimes with the use of lubricating gels and painkillers.

This condyloma described by traditional healers just gives them an opportunity to “cut” something and thus to make an excision. This traditional treatment is strongly discouraged.

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