Hey, leave those clits alone!

Warning: This post is graphic. It describes female genital mutilation and other negative practices.

“It should look like a flower,” sighs the speaker Madame Traore, cueing visuals of pastel Georgia O’Keefes, potpourri, and oddly, Kathy Griffin. We are sitting in a classroom at a three-day workshop on excision, women’s reproductive health, and children’s rights. All the local big-wigs are here: mayors, school directors, imams (Muslim priests) and radio DJs; trained midwives and traditional medicine women; town criers and local NGO workers. While I am the only foreigner amidst over 60 Malians, I realize I am also one of the movers in my community, and I am heartened to see how many people are passionate about this issue. I see my friend, who, disturbingly, I found out performs excision on the village girls, sometimes 20 girls with one knife. At least she’s here. And today, together, we are talking about the “should.”

We begin by discussing traditional practices here in Mali that can be detrimental, specifically those common in three ethnicities present at the meeting: Dogon, Peul, and Malinke. In addition to female genital mutilation and male circumcision, many of those present talked about practices such as ear and nose piercing, tattoo of the lips and the gums, scarring (often done on the sides of the face, next to the eyes or down the middle of the forehead), teeth filing, blood-letting, and taboos against certain foods for pregnant women and children. They also cited more traumatic practices of tribal initiation for men, extreme diets or force feeding for to-be brides, levirat and sororat, the tradition of marrying the brother/sister of your deceased spouse, degrading customs for sterile women such as putting hot pepper into the vagina or burning pubic hair, forced early marriage of girls, and forced child labor.

The common and arguably the most damaging practice that affects girls in these cultures is excision. Excision, the softer term used here for various types of female genital mutilation/cutting (FGM/C) or female circumcision, is extremely prevalent in Mali, one of the highest occurrence rates in the world with estimates ranging from 90- 95%. In my region, Kayes, the rate is at a heartbreaking 98%. Mali does not have a law that prohibits excision, despite efforts by the former president Konare to pass a bill in 2002 to criminalize it. Historically, female circumcision has links to Egypt, and is practiced in parts of Africa, particularly in the western and eastern countries, as well as in the Middle East. While excision is not a practice mentioned in the Koran or the Bible and has been discouraged by Islamic religious authorities, many of the participants cited a biblical origin. In the story, Sarah forces Abraham to circumcise Hagar, the Egyptian slave who bore Ishmael. God then commands Abraham and Sarah to circumcise themselves in response to their actions. There is also tribal traditions that are used to explain excision. Stories from the Dogon tribe include the belief that babies are born of both sexes, and just as the “feminine” foreskin must be removed from the penis, the “masculine” clitoris must be removed from the vagina, which also ties into Egyptian origins.

While in the past excision had sometimes been a ritual of the wedding ceremony, it is now normally performed on girls between the ages of birth until five years, and sometimes until puberty. The extent of the mutilation ranges from just the partial or total removal of the clitoris, known as clitorodectomie, to excision, the most common form, which includes the ablation of the clitoris, the labia minora and/or parts of the labia majorta, which is most common form in Mali. Rarer types include infibultation, a narrowing of the vaginal orifice where the clitoris and both inner and outer labia are ablated and sewn to create a small opening. The last type includes a variation of mutilations, including pricking the clitoris with needles, introducing corrosive substances to the vagina, and introcision, where the vagina is expanding through stretching or tearing the perineum (the area between the vagina and rectum).

The possible consequences of FGC are manifold and can be debilitating. The most obvious result of excision is reduced sexual pleasure, but is by no means the only effect the practice can have on the women and their families. The procedure itself can cause hemorrhaging, which could also occur as the vagina ruptures during childbirth, leading to anemia and possibly death. In addition, the scarred tissue creates a narrower birth canal, where the infant’s head sometimes cannot pass through easily, and sometimes even not at all. Often during a women’s first childbirth, the head becomes misshapen as the still soft skull becomes indented trying to pass through the vagina, which can lead to head trauma and possibly long-term brain damage. Mme. Traore explains that often, these infants do not cry right after birth, as their reflex center is affected. This explains all the bewildering silent birth I’ve seen. There can be difficulty during sexual intercourse, which can result in forced penetration, vaginal tearing, and rupture of the perineum. Infibulation can cause an accumulation of menstrual blood and urine, which can lead to uterine infections and sterility. Uncontrollable urination can also occur as the urinal passage can become defective. The procedure is often performed by untrained women and with unsterlilzed tools. These unsanitary conditions increase their risk of infection, including tetanus, HIV, and hepatitis B. Finally, girls who have undergone excision, particularly at a later age, can experience psychological trauma from the ordeal, affecting their sexual and social relationships.

Then why is it done? Participants cite reasons including hygiene, preservation of virginity, fidelity, increased male sexual pleasure, esthetics, society initiation and cultural/tribal identity. They agree that lowered sexual sensitivity is a major underlying factor, which is intended to reduce the risk of wife infidelity. While women have told me they believe the clitoris is unclean, there is no evidence of any hygienic advantages to excision; on the contrary, the procedure, the healing process and the subsequent possibility of vaginal tearing during intercourse and childbirth increases their risks of contracting infections, including HIV and other STIs. It is also believed that it helps facilitate a healthy childbirth, which also has no medical support; excision can actually create serious difficulties for the mother and the child, sometimes resulting in the need for a Cesarian section or even the possibility of maternal and infant death. As detrimental as it can be, however, excision has a strong traditional foundation and is important to feminine identity and social acceptance. As surprising as it may seem, a great deal of the push for the continuation of excision comes from the mothers and the older generation of women, who, in addition to wanting their daughters to have a normal status in their society, believe that it is necessity for their hygeine, reproductive health, and spiritual well-being.

During our talks on female and male reproductive systems we argue about women’s rights, the appropriate age for first marriage, and even a very humorous, if not awkward, debate on penis size (yes, men are men everywhere). We look at children’s rights, and how excision and forced early marriage of girls– girls are typically married off around age 15 in my village, as early as 12 - violates their vulnerability and their rights to a healthy childhood. Finally, we end the last day planning an activity to fight-excision in our individual communitites. The school director of my village suggests a theater competition, where the girls and boys will put on plays about the dangers of excision and the importance of promoting children’s rights.
At the end of the third day, we all gather together for a picture, and make our way back to our villages. I see my friend, who tells me that she has learned a lot. The Mayor says he wants to work on campaigns with the doctor of my health center, and is excited to see the theater competition. As for me, I will work in the background to support anti-excision campaigns. Though I find myself passionately against excision, frustrated by its recklessness and disturbed by its consequences, I am the foreigner, and I know I can never truly understand its complex role in female identity here. This is not my culture, and I know in the end it is not my fight.