Pleasure, womanhood and the desire for reconstructive surgery after female genital cutting in Belgium

Clitoral reconstruction: challenges and new directions

“…Some women who undertake CR consider it transformative: they are no longer "the same" as they were before the procedure; they are living "a new life" [52]. The surgery, along with psychosexual therapy, is alleged in some cases to bring profound change to their relationships, sexuality and even to their sense of womanhood [37]. In the Global North, contemporary psychological coaching techniques are widespread and are supposed to regulate different areas of human life.…”

“…This change in perspective is often accompanied by a perceived or experienced sense of stigma [32,33], with a consequent negative impact on sexuality and sexual pleasure [34,35]. The reasons cited by women who seek to undergo CR as a form of redress for FGM/C include poor self-image, poor body image [22], as well as questions linked to gender identity (e.g., a sense of being a 'true woman' or 'fully feminine') [36,37]. A wish to improve sexuality in terms of desire and of sensation has also been reported [22,38,39], as has the wish to reduce painful sensations or to avoid embarrassment experienced during sexual relations [36].…”

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

“…Swedish gynecologists refuting the negative effect of the clitorectomy on women's sexual function (Jordal et al, 2020) highlight the internal structures of the clitoris, and thus perceive it impossible to "cut" the clitoris in any substantial way, as most of the clitoral organ will remain under the surface and be accessible to stimulation through the vagina (O'Connell et al, 1998). Healthcare providers and FGC scholars instead warn that an overemphasis of the physical consequences of FGC may become a self-fulfilling prophecy, causing women to anticipate their sexual function as "damaged" (Johnsdotter, 2018;Jordal et al, 2020;O'Neill et al, 2021). In contrast, cut women living in societies where FGC is highly regarded may perceive their sexual function positively, as suggested by Esho (2012) who studied FGC and sexual function among the Maasai people in Kenya.…”

“…Villani (2022) notes that questions of pleasure and desire are largely embedded in social expectations and norms, which should be considered when studying the sexual consequences of FGC. It has been argued that cut women's encounter with Western values-which tend to assign higher significance to women's sexual rights to desire and pleasure, and to the importance of the clitoris in securing these things -affects their perceptions of their own sexuality and its relation to FGC (Johnsdotter, 2013;Ziyada et al, 2020;O'Neill et al, 2021). A more thorough understanding of the complexity behind cut women's understanding and meaning-making of the potential connection between FGC and sexual experiences, including the socio-cultural-symbolic nexus (Esho, 2012), could inform care providers, sex counselors, policy-makers, and others aiming to provide healthcare for this group of women.…”

Mental and sexual health outcomes associated with FGM/C in Africa: a systematic narrative synthesis

“… 13 Other research has pointed out that there is enormous emotional and physical pain associated with the practice as well as reconstitutive measures that take place. The psychological debilities associated with FGM/C as well as the trauma that follows implies poor self-esteem, self-efficacy and turmoil about ones gender and sexual identity, 14 which persists even after the reconstitute surgical process. However there are studies which present evidence that clitoral reconstruction after FGM using sensate labial flaps result in significant improvement of sexual function, clitoral sensation, genital aesthetics and self-esteem.…”