An End to FGM in Our Lifetime
I am incredibly honored to be here as your speaker today. When I say honored, I do so sincerely because I am an outsider, an onlooker, a woman of privilege, a surgeon, an activist, a western educated caucasion woman. And yet you have invited me and I am truly humbled. I uniquely value my own womanhood—because it also came with struggle, if you know anything about my personal history— and so, I suppose, it gives me special purpose to address this problem of FGM.
As a gynecologist and physician who has spent the past 25 years in women’s healthcare, I have been fortunate to have acquired additional surgical skills that allow me to create genitalia for transgender men and women. In my practice near
San Francisco, we— literally— deconstruct and reconstruct genitalia for this unique transgender population. So it was not surprising that in 2007, when Nadine Gary, the International Director of Clitoraid, approached me to learn a reconstructive
technique being performed and pioneered in Paris by Dr. Pierre Foldes—-to restore clitoral sensation —-not simply defibulation but sensation—-for women who had been genitally mutilated, I had no hesitation.
Civil rights activist Rosa Parks said, “never be fearful about what you are doing when what you are doing is right”. I knew immediately that this was right. I heard about threats to Dr. Foldes but had no fear. I heard about backlash, scorn, and skepticism from colleagues —-but was not afraid.
I was certain that a chance to restore sexual feeling for FGM survivors was important. I knew that the victims of FGM could not be happy with reduced or absent sexual sensation. I could see the misery from victims who had suffered painful sexual encounter after painful sexual encounter—–wanting to but unable to enjoy. I cared for the complications of FGM: the bladder infections, the cysts of trapped fluids, the obstructed labors. In Paris, I met a girl whose identical twin sister had died at 8 years old—-while undergoing FGM together.
And I knew of the lies of the cutters who benefitted economically by cutting, who knew the lies of FGM—but kept on cutting because cutting fed the families, ironically, of the cutters. I came to understand the celebration of FGM—as a ritual, as a coming of age, as tradition.
But also I came to appreciate the sense of sexual pleasure as one of the basic human senses—-as important as sight, smell, hearing, taste or touch. Imagine if there were a surgery invented to restore sight to a blind man or smell to a girl who had never smelt a rose or the aroma of a sautéed onion. I agreed that FGM was indeed a human rights violation. There was no question—-human rights had been and were being taken from these women and girls—-directly as a result of FGM.
When I reviewed Dr. Foldes’ so-called ‘clitoroplasty’ and came to Paris to view the surgery itself, I knew instantly that it had validity. The surgery worked! The clitoris was not removed fully in FGM—-it can’t be. Never. Why? Because the clitoris is much larger than any of us had ever been told—even gynecologists.
The damage caused by FGM—-among so many damages—was the obscuring of the clitoris by scar tissue. But the clitoris was large—-like an iceberg, I thought—and so was merely buried beneath scar tissue as a primary result of FGM. In reconstruction, we ALWAYS find the clitoris. It is always there. Always.
So the surgery is designed to expose what remains of the clitoris, to free it of scar tissue and to bring it to the surface of the skin.Later, when I spoke to women who had been reconstructed by dr. Foldes and later, myself, they had feeling….down there. Sometimes it was scary. Sometimes, there were other issues that surfaced. Occasionally, the surgery did not work as planned. But many reported orgasm for the first time —in their lives. The surgery worked. It was not a perfect surgery but it worked. There were risks of surgery but it worked.
Overwhelmingly. It worked. And in 2013 when Dr. Foldes published his study in the British journal, Lancet—of nearly 3000 women who had been reconstructed, the scientific community had proof that it worked. Moreover, the reconstructive surgery
that we and others now perform around the world—-is done free of charge. In many cases, we are also able to get insurance coverage. So the surgery gives hope to victims. It gives us control over identities that feel lost, over bodies that seem
incomplete, over relationships that could not flourish.
But surgery is not the answer. Surgery should not be the answer. Surgery should not be necessary. Surgery can never fully regain what has been lost. By FGM.And so, what I hope to do in these short words, is to construct an approach, to inspire a plan, to stimulate optimism that will result in an end to FGM in our lifetimes.
And I truly do believe, by the survivors who speak out, by the cutters who no longer cut, by the men who value the sexuality of their wives and lovers, by the parents who say no, by the media companies and news organization who continue to report our stories despite editors who say “too touchy”, “too controversial”, “too likely to offend” or , simply, “no”—that we are nearing an end to FGM.
And for that reason, for so many reasons, I know that what I am doing is right. And that for all of us to do what we are doing here today…that this gathering of amazing people …..is right.
I have no fear. WE have no fear. WE are standing up against FGM. WE are talking about FGM. By doing so, WE are taking action against FGM. WE are doing what is right.
I will conclude by saying that going forward what is needed is for us to further tell our stories. Poet Maya Angelou wrote, “there is no greater agony than bearing an untold story inside you”. Tell your stories. Educate the world. Teach these doctors
who, when encountering an FGM victim, call to their colleagues as though FGM bodies were rare, circus animals to be gawked over. Teach them that there are surgeries to correct this problem and that there is training available to learn how to
fix this problem. And that these doctors need to recognize this problem, be educated about this problem and address this problem with certainty and with calm.
Secondly, we need to talk to our parents and our relatives here and where FGM is still being practiced. We need to be honest about our experiences, about our pain, about our loss, about our fears—-so that slowly, surely, cutters will no longer cut. Respect the tradition but reject the practice of FGM.
And I will leave you with the words of Eleanor Roosevelt who once said, “You must [finally] do the thing you think you cannot do”.
An End to FGM in Our Lifetime