10/10/12 – Women who have undergone female genital mutilation (FGM) have a significantly lower sexual quality of life finds a new study published today (10 October) in BJOG: An International Journal of Obstetrics and Gynaecology.

FGM is defined as any procedure ‘involving partial or total removal of the external female genitalia without medical reasons’.

This study, carried out by researchers at King’s College London, looks at the impact of FGM on the sexual quality of life of women who have undergone this procedure and compares them to a similar group of women who have not undergone FGM.

Seventy three women who had undergone FGM were compared to 37 women from a similar cultural background. Criteria for inclusion in the study included, women aged 16 or older, women who have undergone FGM, or to be from a cultural background where FGM is frequently practiced but not undergone FGM.

Sixty-three out of seventy-three (86.3 %) of the women whom had undergone FGM were from Somalia, Sierra Leone, Nigeria and Eritrea, whereas of the women who had not undergone FGM thirty-two out of thirty-seven (86.49%) were from Nigeria and Ghana.

The women completed a questionnaire containing the Sexual Quality of Life–Female (SQOL-F) questionnaire. This was divided into two parts: part one of the questionnaire asking demographic questions and the second part containing the SQOL-F questionnaire, previously used for measuring sexual quality of life in women with female sexual dysfunction aged over 18 years.

Demographics measured included, age, country of birth, civil status, number of children, smoking status, alcohol consumption, self-reported history of depression and type of FGM.

Overall the study found that women who have undergone FGM have a significantly lower overall SQOL-F score. Using the self reported questionnaire, with the highest score being 100, women who had undergone FGM rated their sexual quality of life on average 26.4 points lower than women who had not undergone FGM.

The researchers also conducted further analysis by dividing the total number of women into those who were sexually active and those who were not sexually active. They found that in sexually active women FGM type III is associated with the lowest sexual quality of life scores.

Professor Janice Rymer, Dean of Undergraduate Medicine and Professor of Gynaecology, King’s College London and co-author of the paper said:

“FGM is abuse of women and we need to do all we can to eradicate the practice. We can help to do this by educating people about the harm that it causes and this study adds to our knowledge as we show, not surprisingly, that FGM has a detrimental effect on a woman’s sexual life.

“FGM is always traumatic and has no known health benefits, and the complications range from bleeding and infection to death. Although the physical complications have previously been reported, the effects on sexual function and satisfaction were poorly understood.

“As a result of high rates of migration of women from nations where this practice is considered commonplace, to areas where it is not, it is important to all multidisciplinary practitioners to have an understanding of the impact of this practice on the women that we provide care for. The effect of a reduced or poor sexual quality of life is likely to have an effect on the general well being of women. It is important to raise the profile of the damage that is caused with regards to sexual function in the hope that this may go some way to eradicating the procedure for future generations.”

BJOG Deputy Editor-in-Chief, Pierre Martin-Hirsch, added:

“FGM is a harmful and unacceptable practice. This study highlights that it has a lasting impact not only physically but emotionally. It is important that healthcare workers are aware of FGM and with an expansion of the migrant population they may see increasing numbers of women affected.”

Full text: Andersson, S., Rymer, J., Joyce, D., Momoh, C. and Gayle, C. (2012), Sexual quality of life in women who have undergone female genital mutilation: a case–control study. BJOG: An International Journal of Obstetrics & Gynaecology. doi: 10.1111/1471-0528.12004

September 2012 – Parliamentarians from Burkina Faso, Mali, Côte d’Ivoire, Nigeria and Togo met in Ouagadougou on 5 September to discuss the problem of female genital mutilation/cutting (FGM/C) in their country, particularly in border areas. For several years now, Burkina Faso has been a pioneer in Africa in trying to stamp out the excision of women and young girls, a practice that has been illegal since 1996. However, FGM/C persists and prevalence is still greater than 75 percent in several areas, particularly in several border zones.

Supported by AWEPA, the European Parliamentarians with Africa Association, in cooperation with the United Nations Population Fund, and following the activities organised in April this year, the parliamentarians from Burkina Faso, Mali and other neighbouring countries wished to further examine the question of transborder excision, identified as one of the reasons the practice persists. Mali shares a long border with Burkina Faso and other countries in the region, and, to date, has still not adopted a law against FGM/C, despite the efforts made in this direction by the network of Malian parliamentarians to combat violence against women. The absence of a law in Mali encourages people to cross the border to carry out excision. These borders are often open with very little control. The Belgian Senator and member of AWEPA, Mrs Dominique Tilmans, also taking part in this activity, broached the issue of excision in immigrant communities in Europe and, in several of her interventions, emphasised the need to continue awareness raising efforts, the crucial role of the parliamentarians as opinion leaders, but also the role of the media in this struggle, as well as the necessity of raising the awareness of men, given their role as head of the family and decision-makers within society.

After the attending MPs had exchanged experience and points of view, the meeting led to the adoption of a series of recommendations with a view to boosting the action of the parliamentarians against FMG/C, particularly pertaining to the cross-border phenomenon. From the point of view of the legislation, the parliamentarians recommended, among other things, that specific laws be adopted in the countries which don’t yet have any; that the texts be translated into the national languages and widely disseminated; that the networks of parliamentarians combating violence against women in the different countries be institutionalised, and cooperation encouraged between these groups for enhanced harmonisation of the national legislations; and that the involvement of regional organisations such as UEMOA and ECOWAS be sought, to facilitate the harmonising of the texts through directives. In terms of concrete action in the border areas, the parliamentarians also recommended that parliamentary focal points be set up in the border locations; the setting up of vigilance committees in the border villages be encouraged; periodic consensus frameworks be created at the borders and awareness raising actions be implemented and pursued in the border communities and areas.

The Bourkinan parliamentarians and the AWEPA team then went to Yatenga province on 6 and 7 September, to continue awareness raising operations at the level of the community. Two public audiences were organised in the villages of Zogoré and Sissamba in the municipality of Ouahigouya, with the support of two civil society organisations, the associations AMMIE and Santé Plus. The Burkinan MPs and the European parliamentarian, with the aid of audiovisual materials, spent a long time discussing the question with local population groups, to exchange information about the harmful effects of the practice, the contents and provisions of the law against mutilation, and the role of individuals – men, women, traditional chiefs and religious leaders – within family and community. Several people gave testimony – fathers, mothers, children and former excisers – in turn told of their experiences as a consequence of the practice which were often very hard or even tragic. In addition to the showing of an awareness raising film, a forum-stage play highlighted the ins and outs of FGM/C practices, consolidating the awareness raising efforts of the communities visited.

This activity was organised within the scope of AWEPA’s programme called “The role of parliamentarians in the abandonment of FGM/C”.

Photo: MPs discuss the approach chosen for awareness raising in the villages

The practice of female genital mutilation/cutting (FGM/C) has been banned in Somalia under the country’s new constitution.

An estimated 96% of women in the African country undergo the practice, with up to 140 million globally living with FGM/C.

Prominent Somali women’s advocate Fatima Jibrell told African humanitarian news service IRIN: “The fact that the new provisional constitution outlaws the circumcision of girls is a welcome development, but this will require education, awareness-raising and strong legal provisions.”

Photo: Clitoraid Leaders from Burkina Faso, Bane and Abi, who actively promote awareness raising against FGM in Africa.

Clitoraid is pleased to see the authorities in Côte d'Ivoire stand against female genital mutilation by sentencing 9 women circumcisers and their accomplices in Katiola (CI ) on July 20th, 2012, for their criminal sexual practices on about thirty girls during a ceremony.

"Many women hope that this sentence will be followed by many others to dissuade circumcisers and irresponsible parents from committing those horrendous crimes," said Abi Sanon, coordinator of Clitoraid in Africa.

These sentences are necessary steps towards the eradication of those crimes as are prevention, protection of victims and surgical repair.