Researcher investigates womens' motivations for clitoral reconstruction

"I don't own my own sexuality." "I more or less take back my own body. I undo what they did."

This is how two Swedish girls describe their own motivation for going through an operation that reconstructs the clitoris after having been circumcised. The circumcision took place before they migrated to Sweden, and involved the removal of the outer part of clitoris.

The Norwegian researcher Malin Jordal at Uppsala University in Sweden has interviewed fifteen women about their motivation and their expectations connected to the operation before it was carried out. During the National conference on female genital mutilation in September, Jordal presented the preliminary results of her research project. The women characteristically expressed a desire to take back something that they had been deprived of by force.

New ideals

"The women I interviewed focused on the bodily experience, on pain, and on living with the experiences of female genital mutilation in a Swedish context."  

Many of the women said that they experienced shame of being different in their new home country. Even among circles consisting of nationals from their country of origin: Somalia, Eritrea, Gambia, Iraq and Sierra Leone.

"They encounter new sexuality and femininity ideals when they migrate from one context to another. They have also migrated to another context of feminist ideas. Many of the women felt that there was something wrong with them," says Jordal.

"It is just that [in my home country] I wouldn't have thought as much about what I'm missing, perhaps. The awareness wouldn't have been as present, but now you know that you're supposed to (…) have orgasms and that you should be able to enjoy (…) sex, that intercourse is not only for the man to enjoy (…)."

The women in Jordal's study expressed a hope that they would become "normal" after the operation. Another motivation factor mentioned by many of them was a hope for a better sexual experience.

Lack of research

Sweden is one of few countries to offer surgical clitoris construction, an operation involving the removal of scar tissue from circumcision and the pulling forth and attaching parts of the inner clitoris as a new outer clitoris. The operation has only been available since 2014 in Sweden, and is offered in combination with psychosexual counselling. It is also often conducted in combination with another, more common surgery such as the opening of stitched pudendal lips – the most comprehensive type of circumcision.

Since the practice is still new, there is very little research on the field. And according to plastic surgeon Hannes Sigurjónsson, there is no strong evidence to suggest that this type of reconstruction is effective and secure for the woman. He is part of the team conducting the operations at Karolinska University Hospital.

"We follow up the women for three years after the operation. The research is not ready yet, but we see that reconstruction may decrease the pain, give better functionality and retrieved sense of self. But we need more research both on this and on psycho sexual therapy."

Private project  

According to Malin Jordal, few of the women in her study had talked about the operation within their social circles. They perceived the topic as sensitive and private, and some feared that it would increase the stigma for the group of women who have been victims of female genital mutilation. The women described it as a personal project:  

"I find it really difficult to criticise cultures and religions and things like that, because there are always some good things in all cultures and all religions. And this is why I've made this very personal, I've just kept it to myself, (…) I have no opinion of others…"

For others, the operation became a reason for openness.

"They experienced that the opportunity for operation made it easier to talk about circumcision, since it made it possible to do something about it," says Jordal.

One of the women describes reading about the operation for the first time in a news report:

"I felt a small hope. I was so happy, and I thought 'finally I can get help now'. (…) In fact, I feel that I can talk about it now. I couldn't do that at all earlier, it was something I'd given up, I thought 'I'm going to be like this for the rest of my life'."

Jordal will continue her research in order to document the women's experiences after the operation.

"In this study I'm focusing on motives and experiences. I'm planning a follow-up study after a year to look at the results."

Facts

Fifteen women from the age of twenty to fifty-six participate in the study. They were between the age of two and ten when they were circumcised.

It is estimated that 38.000 women in Sweden are circumcised. In Norway, the number is estimated to 17.300 (Estimation made by Norwegian Centre for Violence and Traumatic Stress Studies, NKVTS based on register data from Statistics Norway).

Globally, more than 200 million girls and women have been victims of circumcision, according to UNICEF. Each year, approximately two million women are still circumcised.  

The tradition is probably 3000 years old, and occurs within several religious groups, primarily among Muslims and Christians. The operation is often justified by a need to control women's sexuality. The practice is referred to neither in the Quran nor in the Bible.