Excising: cutting off all or part of a little girl's sex, her clitoris, her labia minora.

Words that send shivers down your spine.

“Cutting is violence against little girls. It is one of the most serious types of sexual violence”, says Ghada Hatem, obstetrician-gynecologist in front of a full room at the Delafontaine hospital in Saint-Denis (Seine-Saint- Denis).

Diaryatou Bah was circumcised at the age of 8, in Guinea Conakry where she lived before arriving in France. 

Four types of female genital mutilation

Type 1:

partial or total removal of the clitoral glans (small external and visible part of the clitoris and sensitive part of the female genitalia) and/or the prepuce/clitoral hood (fold of skin surrounding the clitoris). 

Type 2:

partial or total removal of the clitoral glans and the labia minora (inner folds of the vulva), with or without excision of the labia majora (outer skin folds of the vulva).

Type 3:

 infibulation: narrowing of the vaginal orifice by covering, carried out by cutting and repositioning the labia minora, or the labia majora, sometimes by suture, with or without removal of the foreskin/hood and clitoral glans (type 1) .

Type 4:

all other harmful interventions on the female genitalia for non-medical purposes, for example, pricking, piercing, incising, scraping and cauterizing the genitals.

Source WHO

"It happened one morning. A lady came and I was taken out into the wild. I found myself with aunts, neighbors and my grandmother. Two held my feet, two others hands. They put leaves on my face. No one explained to me what was going to happen to me”. , remembers his red loincloth and his cry.

"I'll never forget the knife, the feeling I had when the lady cut. The scream I let out. I'm 37 and I still have that feeling. I knew I was going to be circumcised one day because that's what we did to all the little girls, that it was the ritual. All the women in my family have undergone this". What follows is "indescribable pain, three weeks without" walk”. “It took me a while to understand.

Until the age of 20, I thought that all women in the world were circumcised”. 

A risk of mutilation increased by the pandemic and the war in Ukraine

This story is that of millions of other little girls around the world.

Africa, Middle East, Asia... 200 million women have been victims of sexual mutilation worldwide, 125,000 in France according to the Weekly Epidemiological Bulletin (BEH) published in July 2019. Figures that could be revised upwards , according to United Nations projections.  

The fault of the Covid but also of the war in Ukraine.

A terrible butterfly effect.

“In Africa, some circumcisers have taken up the knives again because the families do not have to eat, the schools being closed, the solution was to marry off their daughters, explains Isabelle Gillette-Faye, sociologist and director of the national federation GAMS (Groupe for the Abolition of Sexual Mutilation, Forced Marriage and other traditional practices harmful to the health of women and children). to three or four million by 2030”.   

Despite this bad omen, and even if it is advisable to remain "attentive", Isabelle Gillette-Faye prefers to bet on the achievements of 40 years of prevention and education. In France, the first cases of female genital mutilation appear at the end of the 1970s. Men from Sub-Saharan Africa, who had come to work in France, then brought their wives to France. Paediatricians from the Maternal and Infant Protection (PMI) discovered the first mutilated girls in consultation. In 1982, a three-year-old infant month dies in a Paris hospital, following an excision.Shock wave.The little girl's doctors file a civil action.  

Although excision is not specifically mentioned, genital mutilation is considered a crime punishable by 10 years' imprisonment and a fine of 150,000 euros, according to article 222-9 of the Penal Code.

Which took place in France or during holidays in the country when the victims, whatever their nationality, live on French soil. 

“Families find it difficult to understand that the law applies in France even if they have their children circumcised outside the national territory, whatever their nationality”, specifies the director of GAMS. 

Since the 1980s, nearly thirty trials of circumcisers or parents of sexually mutilated children have taken place in France.

In April 2022, a 39-year-old mother was given a five-year suspended prison sentence for having had her three eldest daughters excised, including a mentally handicapped one, between 2007 and 2013, during stays with their grandmother in Djibouti, his country of origin where sexual genital mutilation (SGM) has been banned since 1995. "We were only talking about West Africa then. We discovered that we could come from West Africa. 'Is, being judged and condemned, owing damages to one's children for having practiced female sexual mutilation even if it was outside the national territory”, says the director of GAMS who had attended the trial. 

The Excision prevention video, let's talk about it!

The family and community taboo

If the fear of the gendarme seems integrated today, how to explain the persistence of this community pattern?

For these uprooted families, perpetuating this tradition allows them to cling to their identity.

"Many use the religious argument, it would be written in the Koran, explains Ghada Hatem, founder of the Maison des femmes in Saint-Denis, specifying that it does not exist in any of the three religions of the book. There is also the fantasy that a "clean" woman is cut off, that it makes them more fertile, that the child has a better chance of being born alive...”.  

As for the taboo, it is almost absolute within the family, the community of origin.

“In the community, as always in violence, it is silence that prevails. And silence is the guarantee that we will be able to maintain the practice”, regrets the obstetrician-gynecologist. explain why they do this to us, confirms Diaryatou Bah.

Over there what is not normal is a girl who is not circumcised.

They call her impure, but above all she won't be able to get married.

For her to remain a virgin until marriage, she must be circumcised”. 

Sometimes these women are even unaware that they have been circumcised.

“I see women circumcised daily or at least weekly. Some of them do not know that they have been, says Agathe André, midwife at Nanterre hospital, who came to find out about the violence. sexual and sexist experiences at Delafontaine hospital. There is no perfect way to say it, but it is important that we inform them, especially when they give birth to a little girl. They will potentially return to the country, if not what on vacation. They must have the information that in France, it is forbidden”.  

"Many women don't know if they are circumcised because they were circumcised in the cradle, confirms Isabelle Gillette-Faye. Very often, they discover it at their gynecologist's, sometimes during their delivery. "I have patients who were very angry, says Dr. Hatem.

They had sometimes given birth four times in France and no one had ever told them anything”.  

Willingness to ostrich?


Out of fear, most often.

Because like other violence against women, words must be weighed so as not to accentuate or awaken a trauma that is sometimes well buried.

“If you approach the subject in an inappropriate, humiliating, critical way, you will do a lot of harm to the young woman in front of you, warns Dr Hatem who trains practitioners in good practices.  

"From the moment you use the word 'normal' to describe a vulva, you do damage, adds the director of GAMS, evoking her experience but also the sexes remade in pornographic films. It is an aggression for these women mutilated women who already have a tendency to self-flagellate because they tell themselves that they are not normal”.  

For the founder of the Maison des femmes de Saint-Denis, a victim expects above all that "you explain to her what it is, what has been done to her, the consequences, if she can live normally and what you have to offer him”.

Repair the Living 

In addition to the desire to reclaim their bodies, victims sometimes suffer silently for many years.

In addition to pain, sexual problems can multiply: lack of desire, pleasure, shame... the trauma is deep.

Female circumcision, forced marriage, rape, abuse... "The average fate of a little girl in Sub-Saharan Africa is often a continuum of violence," says Ghada Hatem. 

To help them rebuild, a repair of sexual mutilation is possible.

In 1984, Pierre Foldès developed the only surgical method to repair the clitoris.

“Everything is absolutely repairable, emphasizes the urological surgeon. The technique is sufficiently reliable and there is an extremely low failure rate”. 

Because not everything is cut by excisers.

“There is a block of scarring that hides what remains of the clitoral glans. The technique consists of finding all these dead parts, gently removing them, explains the surgeon, co-founder of Doctors Without Borders, trained in war medicine in Africa. In this process, the clitoral stump was pulled upwards by the scarring and the pubic bone. When these abnormal adhesions are removed, the clitoris will descend and reposition normally."   

In 35 years, more than 6,000 women have gone under the expert knife of the surgeon whose waiting room is always full.

The victims sometimes come from very far away.

And are ready to wait to be taken care of by Dr. Foldès.   

Female circumcision, also a men's affair

But beware, surgery is far from being an end in itself.

“The goal is not to restore the clitoris but to restore normal sexuality, warns the man who created Women Safe & Children with Frédérique Martz, the first care center for women victims of violence, in St-Germain-en -Laye. We must take all the traumas, treat them at the same time and accompany them. If we operate on them, there is an accompaniment that lasts up to two years. We will treat the patient's trauma, relearn her to live with a normal organ and try to reconstitute your sexuality. From the moment you take the time, it repairs itself much better”. 

Repairing a woman's mutilated sex without repairing her mind inevitably leads to failure.

"Some are disappointed because they do not see any improvement. Often, it is because the course is not optimal, insists the practitioner of this reconstructive surgery. "We have recovered in our units women who were decompensating after the operation, regrets Isabelle Gillette-Faye.

Sometimes they skip the steps and go directly to a surgeon for surgery.

There is a real market for cosmetic surgery.

At GAMS, we have chosen to promote global care units”.  

To eradicate this violence against women, all eyes are now on men.

In Belgium, awareness campaigns entitled “Men speak out” have been launched by GAMS.

Men Speak Out aims to mobilize men in the fight against female genital mutilation.

© GAMS Belgium

In France, the national federation also works with the association Femmes Entraide et Autonomie (FEA).

"We absolutely have to get out of our heads that it's a question of women and that men don't have to be involved, underlines Isabelle Gillette-Faye. "We have to integrate men so that they say "I don't don't marry a woman who is circumcised", insists Ghada Hatem. Women circumcise little girls for men. If they say no, we will stop circumcising them". 

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