Sex, Grief, and Psychic Trauma: Considering History and Politics in the Psychosexual Treatment of Women with FGC

Sculptors of African Women’s Bodies: Forces Reshaping the Embodiment of Female Genital Cutting in the West

“…For health-care providers to better understand this phenomenon experienced by a large subset of their patients with FGC, Black African women, they must consider the historical traumas of slavery, the exploitation of Sarah Baartman across 19th century Europe as the "Hottentot Venus," and other racialized stereotypes of Black women's bodies (Koukoui, 2019;Magubane, 2001;West, 1995). Such stereotypes appeared as recently as 2012 when a YouTube video,, 1 , 234 from Swedish World Art Day went viral, depicting a performance artist whose head was transformed into a 19th century minstrel blackface caricature and emblazoned on a bare-chested cake of a Black woman's torso.…”

“…Within the context of migration, ubiquitous stigmatization, stereotyping, “othering,” and body-shaming prevalent in public sociopolitical FGC discourse may engender an iatrogenic pathologization that negatively affects the genital self-image, sexual self-esteem, and sexual function of FGC-affected women (Brussels Collaboration on Bodily Integrity, 2019 ; Earp, 2020 ; Johnsdotter, 2018 ; Johnsdotter & Essén, 2016 ; Johnson-Agbakwu & Warren, 2017 ; Koukoui, 2019 ; Sharif Mohamed et al, 2020 ). Adolescents exploring their sexuality are particularly subject to this phenomenon, especially when engaging in relationships with partners outside of their own ethnocultural identity (Johnson-Agbakwu & Warren, 2017 ; Perron et al, 2020 ).…”

“…Adolescents exploring their sexuality are particularly subject to this phenomenon, especially when engaging in relationships with partners outside of their own ethnocultural identity (Johnson-Agbakwu & Warren, 2017 ; Perron et al, 2020 ). The cultural encoding of FGC is context-specific, with supportive sociocultural protections being lost once displaced from one’s homeland, creating traumatic stress and vulnerabilities both within and outside of the healthcare setting (Koukoui, 2019 ; Lien & Schultz, 2013 ; Schultz & Lien, 2014 ). It is the trauma that arises years later through migration, protracted displacement, when a woman is informed of the negative biomedical and sexual consequences of FGC.…”

“…From an etiological perspective, this new perception of FGC can trigger distress and at times the reification of trauma. (Koukoui, 2019 , p. 104)…”

“…A group of white-coated staff [came] and [looked] and [talked] to each other with disgust” (Scamell & Ghumman, 2019 ). Such experiences can generate feelings of inadequacy, discomfort, shame and anger, and are particularly impactful in light of inherent patient–provider power dynamics amidst engrained societal racial and cultural hegemony (Johnsdotter, 2018 ; Koukoui, 2019 ). Providers should be mindful of these dynamics before engaging their patients as teaching spectacles, and must be very intentional and sensitive to the language and tone used in their interactions with their patients (Perron et al, 2020 ).…”