“Damaged genitals”—Cut women's perceptions of the effect of female genital cutting on sexual function. A qualitative study from Sweden

Abstract

Female genital cutting (FGC) is a traditional practice, commonly underpinned by cultural values regarding female sexuality, that involves the cutting of women's external genitalia, often entailing the removal of clitoral tissue and/or closing the vaginal orifice. As control of female sexual libido is a common rationale for FGC, international concern has been raised regarding its potential negative effect on female sexuality. Most studies attempting to measure the impact of FGC on women's sexual function are quantitative and employ predefined questionnaires such as the Female Sexual Function Index (FSFI). However, these have not been validated for cut women, or for all FGC-practicing countries or communities; nor do they capture cut women's perceptions and experiences of their sexuality. We propose that the subjective nature of sexuality calls for a qualitative approach in which cut women's own voices and reflections are investigated. In this paper, we seek to unravel how FGC-affected women themselves reflect upon and perceive the possible connection between FGC and their sexual function and intimate relationships. The study has a qualitative design and is based on 44 individual interviews with 25 women seeking clitoral reconstruction in Sweden. Its findings demonstrate that the women largely perceived the physical aspects of FGC, including the removal of clitoral tissue, to affect women's (including their own) sexual function negatively. They also recognized the psychological aspects of FGC as further challenging their sex lives and intimate relationships. The women desired acknowledgment of the physical consequences of FGC and of their sexual difficulties as “real” and not merely “psychological blocks”.

The relationship between dominant Western discourse and personal narratives of female genital cutting: exploring storytelling among Swedish-Somali girls and women

“…Scholarship on FGC has increasingly cautioned that a drawback from an anti-FGC discourse that categorizes cut girls and women as “mutilated” may negatively impact their body image, self-esteem, and sexual self-image, insofar as girls and women start defining themselves in terms of their “mutilation” (Johnsdotter and Essén, 2016 ; Earp, 2021 ). There is now a myriad of studies supporting this notion (Johnsdotter and Essén, 2004 ; Ahmadu, 2007 ; Malmström, 2016 ; Villani, 2017 ; Ziyada et al, 2020 ), reporting how some women have incorporated the standard narrative of themselves as “mutilated” (Villani, 2017 ; Ziyada et al, 2020 ), disfigured (Jordal et al, 2022 ), or victimized (Vloeberghs et al, 2011 ). Similarly, a recent systematic review of qualitative research on psycho-social wellbeing after FGC synthesizes how some women with FGC report feelings of shame, stigma, inferiority, or of being different in migration settings (O'Neill and Pallitto, 2021 ).…”

Changing gender norms around female genital mutilation/cutting (FGM/C): a key role for social work in the Global North

“…Likewise, the limited research on sexual pleasure has failed to reach any clear conclusions. Several studies have emphasized the difficulty of establishing direct links between FGM/C and the presence or absence of sexual pleasure (Obermeyer, 2005;Catania et al, 2007), given the need to consider other related factors, including self-image, relationship quality, and social stigma (Palm et al, 2019;Jordal et al, 2022). On the one hand, the medicalization of sexuality has produced a rather narrow approach to assessing sexual health (Giami, 2002), one that minimizes the social dimension and obscures the role played by socialization processes (Gagnon, 1990;Longmore, 1998).…”

“…More recent studies dealing with clitoral reconstruction have explored the relationship between stigma and gender norms (O'Neill et al, 2021;Jordal et al, 2022;Villani, 2022) by analyzing the impact of migration on the perception of self as a "mutilated" woman (Johnsdotter and Essén, 2016). For their part, postcolonial feminist critiques have highlighted how "othering" processes racialize those who have undergone FGM/C.…”

“A part of my life”. A qualitative study about perceptions of female genital mutilation and experiences of healthcare among affected women residing in Sweden

“…The largest estimated groups are born in Somalia, Eritrea, Ethiopia, Iraq, Egypt, Sudan and Gambia [13]. Although a few qualitative studies on women's experiences of FGM and its effect on health in migrant populations have been conducted, this field is still underresearched [14][15][16][17]. FGM is a global health concern and brings healthcare challenges in countries with large FGM-affected diasporas.…”