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Clitoroplasty isn't rocket science
August 25, 2013 4:41 AM   Subscribe

High hopes: the UFO cult 'restoring' the victims of female genital mutilation

The little building doesn't shout its purpose, for many reasons. First, this surgery is about female sexuality. Secondly, it is contrary to the beliefs and traditions of millions of families worldwide – brutal beliefs and traditions. And then there's the delightful surreality of the pair behind the procedure: the tall, blonde female surgeon – one of the best in the US – who happens to have been born male, and the cheerful French counsellor who follows the bizarre 1970s Raëlian sect that believes humans were created by extra-terrestrials for the purpose of unalloyed joy.

(previously)
posted by moody cow (28 comments total) 16 users marked this as a favorite

 
Amazing work. I agree, the UFO cult is a red herring in this story. I hope this gets widely read and that other surgeons are inspired to help.
posted by h00py at 5:38 AM on August 25, 2013 [2 favorites]


Very, very interesting article. Thanks for posting it, moody cow.

Not as simple as it appears on the surface. It's a little weird to me how these bits are presented:

"There may be some legitimate fear about interfering with other people's cultures, but when you talk to the husbands and boyfriends of the women they're not happy that their wives and girlfriends cannot respond sexually ..."

A quote from the surgeon - who seems otherwise very conscious about sexism - about a reason why other surgeons might not be training for this procedure. They'd be afraid of "interfering" with other people's cultures when a woman brings herself to the clinic and asks for this surgery --- but, if the *husbands* and *boyfriends* are for it, then you wouldn't be worried about "interfering"?

"The idea of reducing women's sexual pleasure with FGM so they can be controlled is falling apart because men are having sex outside their communities and seeing the difference, and it's creating problems within relationships, here but also in Africa..."

It's falling apart not because people are realizing that mutilating women is wrong, but because men are starting to decide it makes sex less pleasurable for them? ... Yay? It's presented like a completely positive thing. Clearly it's way better than not falling apart at all, but... the root of women being treated as sexual objects seems to still be there.

Ayanna, 23, a marketing assistant from the Pacific northwest who fled the civil war in Somalia, is in a quandary after her clitoroplasty, for she is not in love with her current boyfriend.

"I told him I was coming for the surgery and the way he was talking I'm worried he's going to expect me to be an instant sex machine," she says.


Ugh.

"My fiancé left me two months ago because I don't want sex," she'd told me when she first arrived at the clinic, her sad and bewildered tone mixed with a note of defiance. "I did start having sex with him, but I don't feel anything and I don't care for it. ... While some of Zaria's relatives dealt with her heartbreak by telling her she should just "get on with it" and have sex out of obedience, Zaria had what she describes as a "lightbulb moment" and began searching the internet. ... In just seconds she had come across an alternative solution. Next thing, she had taken out a loan, which she has "no idea" how she'll pay back

This is what I'm worried about. At the very end, Zaria says "I didn't do this to get back at my ex-fiancé, or get him back. This isn't about him or my family any more. It's all about me." Okay, if that's true for her, then that's good.

But I see an undercurrent, under the women who want the surgery entirely for themselves. There seems to be an undercurrent of some women who have already been brutalized, but who had reached a place of being okay, and just very simply aren't interested in sex, feeling pressure to get their genitals cut into a second time so they can be better sources of sexual pleasure. It worries me that nobody seems to be looking out for that.
posted by cairdeas at 5:58 AM on August 25, 2013 [20 favorites]


feeling pressure to get their genitals cut into a second time so they can be better sources of sexual pleasure

I think you really have to be reading the article sideways to get this impression. The overwhelming sense is that these women have come because they want back a normalcy that was taken from by force. They want to appear and feel as other women do. I see no equivalence between a procedure entered voluntarily under anaesthesia with full understanding and trustworthy professionals in charge, and a violent assault by an adult on a trusting child without warning or proper medical preparation.

The subtext of FGM reversal being better for men is useful, though, to push acceptance of the change this requires in the culture that mutilated these women in the first place. Remember that it is women who perform these mutilations, usually because they think it will make their little girls more desireable for men. Spreading the idea that FGM actually makes women less desireable adds a disincentive for the practice which, sadly but practically, might be a lot more effective for some people than raising awareness of the women's suffering.
posted by localroger at 7:09 AM on August 25, 2013 [14 favorites]


Spreading the idea that FGM actually makes women less desireable adds a disincentive for the practice which, sadly but practically, might be a lot more effective for some people than raising awareness of the women's suffering.

Thanks for explaining that to me!

Your overwhelming sense must be right. Clearly I was thinking sideways, I don't know where I came up with the idea that anyone might be feeling pressured for this.
posted by cairdeas at 7:17 AM on August 25, 2013 [3 favorites]


Clearly I was thinking sideways, I don't know where I came up with the idea that anyone might be feeling pressured for this.

I mean, I think I see where you came up with that idea, but it's a very unlikely outcome - women who had FGM surgery may be ambivilent about sex, but it's not because they made peace with their lot at all. It's more like someone who was an avid skier, then broke their leg really bad an the rehabilitation didn't go as perfect as it should have; and now skiing is painful, and their doctors tell them that "sorry, this is as good as it's going to get for you". They may come around to accept that they can't ski any more, but that doesn't mean that they no longer like skiing - they just have so much pain when they ski that it's not worth trying any more, and they've accepted that nothing can be done about it.

But if someone were to come along and say "oh, wait, I think we can fix your leg so it won't be painful when you ski any more," they'd absolutely try, because they never stopped wanting to ski. It's not like they decided they didn't like skiing any more and were being talked into it - they'd never stopped wanting to ski, deep down.

This is the same thing; I think you're reading "I accepted that nothing could be done and I just wasn't going to get to enjoy sex" as "I prefer being asexual". And while asexuality does exist, this isn't the same thing.
posted by EmpressCallipygos at 7:24 AM on August 25, 2013 [13 favorites]


The fact is that cutting girl's bodies like this is a terrible thing. Denying people something as normal as sexual pleasure to preserve some sort of social order is terrible.
It doesn't matter where it happens, it's bad.
Girls and women who have NOT undergone some variant of FGM can have trouble enjoying sex for a variety of reasons, and there are terrible health consequences.

In primitive settings, circumcision of males is every bit as dangerous.

No amount of hospital, sanitary conditions can make this operation safe.

I have been heartened to see many Muslim legal scholars come out against this operation.

It's something from the time of the Pharoahs.
posted by Katjusa Roquette at 7:52 AM on August 25, 2013 [2 favorites]


They'd be afraid of "interfering" with other people's cultures when a woman brings herself to the clinic and asks for this surgery --- but, if the *husbands* and *boyfriends* are for it, then you wouldn't be worried about "interfering"?

That quote stood out to me too, but when I reread it, it seemed a lot more like, in response to a reporter-raised issue: "I suppose that could theoretically be a problem, but here's a kinda immediate disproof of that, and anyway all we care about is the people who are actually hurt."
posted by bleep-blop at 8:42 AM on August 25, 2013 [2 favorites]


If the involvement of the Raelians is a "red herring", then why did the Grauniad put it in the headline of the article?
posted by Halloween Jack at 9:10 AM on August 25, 2013


pageviews
posted by LogicalDash at 9:11 AM on August 25, 2013 [3 favorites]


I imagine if the Raëlian information were left out, and "emerged" later, it would be a little bit of a thing. By putting that information out right away, the writing here might be a little protective.
posted by amtho at 10:34 AM on August 25, 2013 [3 favorites]


Your overwhelming sense must be right. Clearly I was thinking sideways

I think you are. I think you went into the article looking for an ox to gore.

These doctors are volunteers and many of the women traveled half-way around the world to get their services. But if a woman does something that might possibly make a man somewhere happier, no matter how much she wants it for her own reasons, she's just a stooge for the patriarchy amirite.
posted by localroger at 11:42 AM on August 25, 2013 [7 favorites]


The Raëlian angle is interesting because it represents a kind of David vs. Goliath match of religion vs. religion. There are a lot more Muslims than Raëlians in the world and in general Islam isn't considered quite the titter-worthy joke Raëlianism is. (To clarify, FGM is not strictly a Muslim practice, being a holdover from previous practices in areas later taken over by Islam; but Islam didn't exactly find it incompatible enough to forbid it where it was occurring.)

Now the Raëlians beleive, for whatever goofy reasons, that pleasure and particularly sexual pleasure is the highest best purpose of living things -- quite literally our reason for existing. And so to take a child who has never experienced this pleasure and remove her ability to ever do so would be, in such a world view, one of the most profane acts possible, tantamount to pissing in the holy water, and the act of reversing such an obscenity therefore one of the most sacred.

The leader of another great religion said "you will know them by their deeds." The Raëlian is doing this very thing, letting us know her by her deed that she is the opposite of the profane monsters whose work she is undoing. It is a direct and profound testament of the intent of her faith.
posted by localroger at 12:12 PM on August 25, 2013 [6 favorites]


women who had FGM surgery may be ambivilent about sex, but it's not because they made peace with their lot at all ... they never stopped wanting to ski. It's not like they decided they didn't like skiing any more and were being talked into it - they'd never stopped wanting to ski, deep down.

But EmpressCallipygos -- I don't think we can talk about women who have undergone genital mutilation as if they are a monolith who all feel the same way, considering millions of women have undergone it. I don't think it's really possible to say, with such certainty, that all of them "never stopped" wanting to enjoy sex. Lots of women, the world over just don't care about sex that much, period, and never have. Lots of women do, and lots of women just don't. You don't have to be asexual to feel that sex is not your highest priority in life, that perhaps, it just might not be worth it to you to undergo surgery to improve in that area.

All the other medical issues that can lead women to not enjoy sex, or to be disinterested in sex (hysterectomy, menopause, etc. etc.) are not the same as female genital mutilation. Yet, I would be stunned if female genital mutilation turned out to be the one and only medical issue causing women sexual pain/sexual problems, where every single woman would prefer to have a very invasive procedure to fix it rather that just not having sex.

I would also be stunned if this were the one and only time where, in a situation where men hold a vastly disproportionate share of the power, and want something from women, no women would be pressured into doing it.

And, not to you, EC, I'm pretty shocked that in a thread about female genital mutilation of all things, writing that you worry about women being pressured or coerced, is met with angry indignation about how you must surely be wrong and out to oppose men getting any pleasure and comparing you to a violent animal. Wow.
posted by cairdeas at 12:50 PM on August 25, 2013 [1 favorite]


I can only go by what the women themselves say. I didn't see them all saying "I never stopped wanting to ski!" I saw a lot of them saying, my fiance left me, my boyfriend is unhappy, I would have just had to submit, anyway...
posted by cairdeas at 12:53 PM on August 25, 2013


They'd be afraid of "interfering" with other people's cultures when a woman brings herself to the clinic and asks for this surgery ---

Oh, so it seems that many of the male surgeons might need a pair of testicles first.
posted by Brian B. at 1:10 PM on August 25, 2013


where every single woman would prefer to have a very invasive procedure to fix it rather that just not having sex.

To be clear: the article makes it very clear that this is not in fact a very invasive procedure:
Compared with the delicate gynaecological, urological and plastic surgery she uses for five-hour gender-reassignment operations, FGM-restorations are a doddle.
I can think of a lot of personal reasons for going through a minimally invasive procedure under anaesthesia just for restoring the normal appearance, much less possible functionality, of something that's going to become an issue if you ever plan to have an intimate relationship with anybody.
posted by localroger at 1:26 PM on August 25, 2013


Oh, and for comparison: In 2003 I spent about 12 hours in a dentist's chair, 3 weeks off work, 2 weeks on a liquid diet, and flew a total of 12,000 miles to have my teeth reconstructed after not having braces as a child followed by a disastrous period of bruxism. I am not a salesman and do not need a perfect smile to do my job. But never underestimate the attraction of looking normal when the default is something else. And my dentist never promised me that my new teeth might give me an orgasm.
posted by localroger at 1:34 PM on August 25, 2013 [7 favorites]


But EmpressCallipygos -- I don't think we can talk about women who have undergone genital mutilation as if they are a monolith who all feel the same way, considering millions of women have undergone it. I don't think it's really possible to say, with such certainty, that all of them "never stopped" wanting to enjoy sex. Lots of women, the world over just don't care about sex that much, period, and never have. Lots of women do, and lots of women just don't. You don't have to be asexual to feel that sex is not your highest priority in life, that perhaps, it just might not be worth it to you to undergo surgery to improve in that area.

I...didn't...make that comparison, that "all women who have undergone genital mutiliation feel this way." I was speaking of the women who have sought this surgery, and I think it is safe to assume that if a woman seeks out surgery to restore her sexual sensation, then she is indeed interested in restoring her sexual sensation.

I'm not entirely sure how you misconstrued my analogy. I was trying to explain the difference between "giving up on trying to fix a problem with sex being painful" and "actual asexuality as a preference." You will note, moreover, that I stated that asexuality was a thing, but that the women who sought this surgery probably weren't asexual. Presumably, if they were asexual, they would not have sought this surgery.



(Everyone else - I'm making sense, right?)
posted by EmpressCallipygos at 4:54 PM on August 25, 2013 [10 favorites]


I think this article is actually kind of terrible. I mean, I really appreciate that Walters wrote the story, and the Guardian ran it, because it's an important one. But Walters keeps (rudely) revisiting how Raëlism is an "outré cult", apparently without realizing that all religions seem wacky from the outside. (Without being rude, the resurrection of the body, transubstantiation, and baptism only make sense if you're steeped in a predominantly Christian culture. Sometimes not even then.) I think some of the reason we're arguing about what motivates women to seek clitoroplasty is that the reporter has done a lousy job laying it out.

The skiing analogy breaks down, sadly. Most FGM happens when girls are pretty young (so they may suspect they'd like skiing, but if it's even snowed, they haven't had a lot of runs yet). More importantly, sex, even more than most human activity, is a social act. Yes, sexual pleasure can be solitary, but sex is socially bound six ways to Sunday. It's pretty unlikely that a woman brave enough to seek this surgery - a survivor of the physical and emotional trauma of FGM, and the day-to-day structural bigotry bullshit of being an African Muslim woman immigrant to the US (the majority of patients) - would do so solely to meet male expectations. But sex is so much about making other people happy that I can't imagine very many women would seek surgery without the motivation of pleasing a partner.

I think Walters did an utterly crummy job with that, and I suspect very strongly indeed that both Ms. Gary and Dr. Bowers - as well as their patients - have much more nuanced and interesting perspectives than came to light in this piece.
posted by gingerest at 1:40 AM on August 26, 2013 [2 favorites]


I thought it was a surprisingly good article considering the medium: a national daily. The reason people are arguing the motivations of women seeking clitoroplasty beyond what was in the article is what makes Metafilter great--well, to me anyway.

What I liked about the article was how I thought the writer managed to balance the demands of the medium and the subject at hand. I loved how she afforded us a look at Dr Bowers and her great pride in how the female anatomy is not easily erased or denied:
At the stroke of the scalpel, a prominent nub of raw pink flesh practically pops up, suddenly protruding from the tissue surrounding it.

"There! That's her womanhood right there," Bowers declares triumphantly. She pauses for effect. "It's like a magnificent tower in the forest." What's barely understood, Bowers explains, is that when the clitoris is cut off in FGM, it's like losing just the visible "tip of the iceberg".

"The clitoris is much larger than previously advertised. Even after they cut off the tip, about 99% of the clitoris is actually still intact, but hidden beneath the surface. We can access that." Apparently women possess another eight inches of unseen clitoral erectile tissue that lies under the skin, arching around the vagina. "Two inches longer than the average penis," says Bowers, archly.
But to me the crux of the article is when Bowers points out that not many other surgeons perform these procedures because:
"these patients are African, Islamic and female. There's a cultural bias or indifference there, combined with good old racism and sexism in a traditionally paternalistic medical profession."
posted by moody cow at 4:52 AM on August 26, 2013 [1 favorite]


So, gingerest, are you saying that these women are all actually asexual, the way cairdeas seemed to be implying? Because I came up with the skiing analogy to explain that there is a difference between asexuality and "giving up on sex because it hurts too much", was all.
posted by EmpressCallipygos at 6:00 AM on August 26, 2013


Oh, of course not. I think the analogy has merit, it just doesn't quite cover all the important bits. My understanding of what cairdeas was saying is that she was concerned about whether these women, whose agency was impinged by their families when they were vulnerable as girls in their cultures of origin, were choosing this surgery for themselves or for others, and whether their agency was again impinged by well-meaning health providers and even their presumably loving partners. I think it's impossible to tell from the article, and I'd like to hear (a lot) more from the women themselves.
Ultimately, though, unless I hear some explicit personal testimony otherwise, I would here as always err on the side of assuming that a woman has the autonomy and understanding to make her own decisions around her sexual health. (I originally and unthinkingly wrote "grown woman" but I err on the same side for adolescent girls, assuming they aren't in demonstrably coercive situations)
posted by gingerest at 6:17 AM on August 26, 2013 [1 favorite]


You don't have to be asexual to just not be terribly interested in having sex -- especially if all your experiences of it so far have been uncomfortable or painful. (Just because your personal feelings were brought about by oppressive practices doesn't mean they're invalid.) Nothing in this particular article set off alarm bells for me, but yes, this sounds absolutely open to pressure. Not that that means it shouldn't be done, of course.

(Also, sure it may not compare to other types of genital reconstruction, but two months of healing time is not nothing.)
posted by ostro at 7:32 AM on August 26, 2013


According to the World Health Organisation more than 140 million women worldwide live with the effects of FGM.

Does that mean 140 mutilations?! Holy fuck. Thanks for posting this. And thanks to the Raelians (who seem just a bit less crazy now), and thanks to the French for considering this a human right.
posted by finnegans at 5:59 PM on August 26, 2013


(Also, sure it may not compare to other types of genital reconstruction, but two months of healing time is not nothing.)

My wife just had a very large and worrisome possible skin cancer mole removed. She has cancelled travel plans because of the healing process. It will only be one month though, the infected hair follicle being a bit less of an insult than the trusted matriarch with a knife. Even for my teeth reconstruction, which was mostly on bone, it was about a month (after a month of travel and surgery) before I could just eat something without thinking about it.

Two months healing is not a big thing, not when you measure it against a lifetime of being something other than what you want to be. The bigger question is whether you enter the procedure with understanding, with appropriate measures to help you with the pain, and with adequate safeguards should something go wrong.

So, pretty much, you are wrong. Two months healing and minute risk of side effects pretty much is nothing. Rich people with means endure more all the time just to look pretty. And I tend to think of genitals as being kind of like teeth in that it is a very personal thing whether you think it should look a particular way or not. There are lots of people who think I wasted the ten thousand dollars I spent on my teeth. I'm afraid I can't think of a polite way to reply to them.
posted by localroger at 6:16 PM on August 26, 2013


gingerest: I'd like to hear (a lot) more from the women themselves.

I'd love to as well. I think that would be very interesting and very important.

So, pretty much, you are wrong. Two months healing and minute risk of side effects pretty much is nothing.

The second sentence is entirely your own opinion, localroger. I'd like to respectfully suggest that repeatedly asserting "you are wrong" about matters of opinion, or things that are not entirely known, in this particular thread, especially to female users, might not be the most helpful thing to do.
posted by cairdeas at 7:07 PM on August 26, 2013


Hmm, yeah, localroger, I just spent two months healing up from a mid-sized non-elective surgery, and I wouldn't go through that again for any reason but threat to life. I don't think that your experience or your wife's or my own gives us any basis to decide what's a big deal to other people. I understand what you're saying - yes, to some people, two months of healing *is* nothing - but that doesn't actually mean that cairdeas is wrong, because to other people, it is a huge deal-breaker. A woman who went through the sexual trauma of FGM might be a bit more alarmed by the prospect of two months of acute genital pain than a woman who is dissatisfied with her natural genital appearance but has never experienced genital injury. Or she might not. There's a lot of room for variability among 140 million women.

I also think it's possible to be concerned about whether women are being retraumatized by this experience without "looking for an ox to gore." These women were sexually traumatized as children, often at the hands of beloved family members. Survivors of childhood abuse often have to work hard to learn to trust and empower themselves, because compliant behavior is such a common survival mechanism. I don't know whether women who've experienced FGM - a single episode of severe sexual and physical abuse - are similar to survivors of chronic childhood abuse, or whether the cultural and family contexts in which FGM happens differentiate it. So it would be good to hear more from the women, and to know how the referral process to Clitoraid works, what follow-up counseling looks like for surgical patients, what the practice is for women who are referred but opt not to pursue surgery. The restorative surgery is simple (from the surgeon's standpoint), but the recovery of sexual and psychological health may be very complex and independent from surgery and its recovery curve.
posted by gingerest at 8:32 PM on August 26, 2013 [1 favorite]


The women who are being helped with these operations were mutilated before they had any agency in their life at all. Regardless of any hypothetical theories about why they might now undergo what would have to be a painful operation, what is being offered is a chance to get back a fundamental part of themselves that was taken from them by force. That's not a bad thing in any circumstance.

This was an article about two women from interesting backgrounds who have come together to do this incredibly worthy thing. I would love to read another article focusing on the women who've had this operation, absolutely, but that's not the main focus of this article.

When I read about how current research has shown that the clitoris is not just a little nub of joy but something much more, my first thought was how this research could help women who have undergone FGM so they could be given a chance of retrieving what was taken from them so needlessly.

I really do hope that this becomes standard knowledge amongst all gyneological surgeons and that the surgery is able to be offered by and to many more people. (I hope even more that the surgery becomes completely redundant within a lifetime because .. well. The because should be obvious).

Life is full of horrific things and women being forced to do something against their will is one of them, but the worst possible scenario should never negate the chance of allowing someone to feel whole again in a way that they would never be able to without the surgery.

It seems likely to me that the women who are undergoing the operations organised and performed by these two particular women would not be undergoing them lightly or without full prior knowledge of recovery time. I also think that they should be given the benefit of the doubt as far as motivation. Someone who has been the victim of a terrible thing is not going to be a victim in every part of their life. Or maybe they will be? In the end, a person's experiences are their own. It's just about the most private thing in the world. Being open to the possibility of further abuse is not a bad thing but what ifs should never stop the possibility of something so worthwhile from being available to those in need.
posted by h00py at 4:13 AM on August 27, 2013


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