Sunday, 13 October 2013

Female Genital Mutilation: Pyschological and sexual impacts

A friend wanted me to look at the psychological impacts of FGM and here are some,

In some instances girls and women from FGM practising communities visit a clinic complaining of a wide variety of physical problems for which no sign can be found when they are examined. Their complaints are, in fact, "psychosomatic" – that is, they are psychological problems which the client experiences, or disguises, as physical discomfort. Anxiety about their genitals or about sexual relationships may manifest themselves in psychosomatic symptoms. Often the girl or woman is unaware that her symptoms are based on psychological anxieties. But in some cases the woman is aware of the fact that the symptoms she is presenting are not the real cause of her problems, but she is too shy to discuss them directly them with anybody.


Genital mutilation is commonly performed when girls are young and uninformed and is often preceded by acts of deception, intimidation, coercion, and violence by parents, relatives and friends that the girl has trusted. Girls are generally conscious when the painful operation is undertaken as no anaesthetic or other medication is used.

 In a lot of instances they have to be physically restrained because they struggle. In some instances they are forced to watch the mutilation of other girls. The experience of genital mutilation is associated with a range of mental and psychosomatic disorders.

 For example:

Girls frequently report disturbances in their eating and sleeping habits, and in mood and cognition. Symptoms include sleeplessness, nightmares, loss of appetite, weight loss or excessive weight gain, as well as panic attacks, instability of mood, difficulties in concentration and learning, and other symptoms of post-traumatic stress. As they grow older, women may develop feelings of incompleteness, loss of self esteem,

depression, chronic anxiety, phobias, panic or even psychotic disorders.


Girls may suffer feelings of betrayal, bitterness and anger at being subjected to such an ordeal. This may cause a crisis of confidence and trust in family and friends that may have long term implications. It may affect the relationship between the girl and

her parents, and may also affect her ability to form intimate relationships in the future, even perhaps with her own children.


Girls and women sometimes express feelings of humiliation, inhibition and fear that have become part of their lives as a result of enduring genital mutilation.


Sexual problems of FGM:


Painful intercourse (dysparaenia), due to tight introitus as a result of infibulation vaginal stenosis, stimulation of the clitoral nerve or clitoral neuroma.


Difficulty or impossibility of penetration by husband/partner due to narrowing of the vaginal orifice as a result of infibulation or scarring.


Various forms and degrees of sexual dysfunction due to injury or removal of the clitoris, which is a key organ in female sexuality (The clitoris and labia

minora are supplied with a large number of sensory nerves, which are connected to the brain and plays an important role in female sexual arousal).


Inability to reach orgasm


Complications of FGM during labour and delivery


Reduced vaginal opening, which will present a direct mechanical barrier to delivery and will interfere with other procedures required for both assessment and management during labour. A tight introitus may, for example, prevent vaginal examination, and result in mistakes being made in assessing the degree of cervical dilatation, and monitoring the stage of labour and fetal presentation.


Labour may be obstructed as a result of scarring of the external genitalia which prevents the normal stretching of the perineum to allow the passage of

the baby.


Prolonged second stage due to scarring of the perineum and a tight vaginal opening.


Tears during delivery due to rigidity of the perineum as a result of scarring of the tissues around the introitus.


Development of obstetric fistulae as a result of prolonged labour, during which the foetal head presses against the bladder or rectum.


Death as a result of rupture of the uterus due to

obstructed labour.


Help us end this horrific practice.

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