Excise: cut all or part of a little girl's penis, her clitoris, her labia minora. Words that send shivers down your spine. “Excision is violence against little girls. It is one of the most serious forms of sexual violence,” says Ghada Hatem, obstetrician-gynecologist in front of a packed room at the Delafontaine hospital in Saint-Denis (Seine-Saint- Denis). This practice, which some describe as "traditional", "religious" or even "obligatory", is struggling to disappear, including in France where it is nevertheless punishable by law. 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 foreskin/clitoral hood (fold of skin which surrounds the clitoris).
Type 2:
partial or total removal of the clitoral glans and the labia minora (internal folds of the vulva), with or without excision of the labia majora (external skin folds of the vulva).
Type 3:
infibulation: narrowing of the vaginal opening 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 they took me into nature. I found myself with aunts, neighbors and my grandmother. Two held my feet, two others held them. hands. They put leaves on my face. No one explained to me what was going to happen to me”. The founder of the association “Women’s Hopes and Struggles”, author of “They stole my childhood” , remembers his red loincloth and his cry.
"I will never forget the knife, the feeling I had when the lady cut it. The scream I let out. I'm 37 years old and I still have that feeling. I knew I was going to be excised one day because that's what we did to all the little girls, it was the ritual. All the women suffered that in my family." What followed was "indescribable pain, three weeks without being able to 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 mutilations 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 which could be revised upwards , according to United Nations projections.
Blame it on Covid but also on the war in Ukraine. A terrible butterfly effect. “In Africa, some excisers took up knives again because families did not have food, schools were closed, the solution was to marry off their daughters,” explains Isabelle Gillette-Faye, sociologist and director of the national federation GAMS (Group for the Abolition of Sexual Mutilation, Forced Marriage and other traditional practices harmful to the health of women and children). At the global level, we have gone from a risk of two million children victims of genital mutilation per year, to three or four million by 2030”.
Despite this bad omen, and even if it is appropriate to remain "attentive", Isabelle Gillette-Faye prefers to rely on the achievements of 40 years of prevention and education. In France, the first cases of female sexual mutilation appear at the end of the 1970s. Men from Sub-Saharan Africa, who came to work in France, then brought their wives to France. Pediatricians from Maternal and Child Protection (PMI) discovered the first mutilated little girls in consultation. In 1982, an infant aged three month dies in a Parisian hospital, following an excision. Shock wave. The little girl's doctors file a civil suit.
Although excision is not specifically mentioned, genital mutilation is considered a crime punishable by 10 years of imprisonment and a fine of 150,000 euros, according to article 222-9 of the Penal Code. Whether they took place in France or during a vacation in the country as long as the victims, whatever their nationality, live on French soil.
“Families have difficulty understanding that the law applies in France even if they have their children excised outside the national territory regardless of their nationality,” specifies the director of GAMS.
Since the 1980s, nearly thirty trials of excisers or parents of sexually mutilated children have taken place in France. In April 2022, a 39-year-old mother was sentenced to five years in prison for having had her three eldest daughters, including one mentally disabled, excised 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 only talked about West Africa then. We discovered that we could come from South Africa. “Is, being tried and convicted, owing damages to your children for having practiced female sexual mutilation even if it was outside the national territory,” says the director of GAMS who attended the trial.
The Excision prevention video, let’s talk about it!
The family and community taboo
If the fear of the police seems integrated today, how can we explain the persistence of this community pattern? For these uprooted families, perpetuating this tradition allows them to hold on 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 in the book. There is also the fantasy that a “clean” woman is cut, 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 cases of violence, it is silence that prevails. And silence is the guarantee that we will be able to maintain the practice,” regrets the obstetrician-gynecologist. “We excise girls without us explain why they are doing this to us, confirms Diaryatou Bah. What is not normal there is a girl who is not circumcised. She is called impure but above all she will not be able to marry. So that she remains a virgin until marriage, she must be circumcised”.
Sometimes these women do not even know that they have been circumcised. “I see women excised daily or at least weekly. Some of them do not know that they have been excised,” confides Agathe André, midwife at Nanterre hospital, who came to find out about the violence. sexual and sexist at Delafontaine hospital. There is no ideal 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 prohibited”.
"Many women do not know if they are excised because they were excised in the cradle, confirms Isabelle Gillette-Faye. Very often, they discover it from their gynecologist, sometimes during their delivery. "I have patients who were very angry, underlines Dr Hatem. They had given birth sometimes four times in France and no one had ever said anything to them.”
Want to bury your head in the sand? Certainly. Out of fear, most often. Because like other forms of 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 attack on 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 was done to her, the consequences, if she can live normally and what you have to propose to 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: absence of desire, pleasure, shame... the trauma is profound. Excision, 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 their lives, repair of sexual mutilation is possible. In 1984, Pierre Foldès developed the only surgical method to repair the clitoris. “Everything is absolutely repairable, underlines the urological surgeon. The technique is sufficiently reliable and there is an extremely low failure rate”.
Because not everything is cut by the excisers. “There is a scar block which hides what remains of the clitoral glans. The technique consists of searching for all these dead parts, removing them delicately,” explains the surgeon, co-founder of Médecins sans frontières, trained in war medicine in Africa. In this process, the clitoral stump has been drawn by the healing upwards and towards the pubic bone. When these abnormal adhesions are removed, the clitoris will descend and reposition itself normally.
In 35 years, more than 6,000 women have passed 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.
Excision, also a men's affair
But be careful, 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, with Frédérique Martz, Women Safe & Children, 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 support them. If we operate on them, there is support 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. As long as you take the time, it can be repaired much better.”
Repairing a woman's mutilated penis 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 decompensated after the operation, regrets Isabelle Gillette-Faye. Sometimes, they skip the steps and go directly to see a surgeon to have surgery. There is a real market for cosmetic surgery. At GAMS, we choose to promote global care units.”
To eradicate this violence against women, eyes are now turning towards men. In Belgium, awareness campaigns entitled “Men speak out” were 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 women's issue and that men don't have to be involved," emphasizes Isabelle Gillette-Faye. "We have to include 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 excising them."
Halimata Fofana and Tiphaine de Foucher, today’s guests
11:11
World Day Against Female Genital Mutilation © FRANCE 24
*This article was first published on February 6, 2023.
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