As explained in the first part of this article published last week, genital mutilation is a much broader term and may in fact include female genital cutting. In over 80% of cases of genital mutilation, enthusiasts are consenting; wanting to look wild and different. Female genital cutting on the other hand, involves cutting and throwing away not only the clitoris, but in addition, the fleshy hood over it, and the upper parts of the labia minora(the small vaginal lips). In some cases, the whole of the smaller vaginal lips are cut off in what might be referred to as crude and blind surgery
Where as the aim in female genital cutting is to presto a new woman, the reverse is often the case, because it is forced on the child or woman. Besides, more and more people are getting involved in marriages across cultures and what looks alright to one man may be seen and given more sinister interpretations by another , particularly if the latter comes from a different part of the world. Besides, and for reasons that will be discussed, removing the clitoris does not reduce a woman’s appetite for sex. There is evidence that in some cases, amputation of the clitoris actually puts a woman in a state of permanent arousal. Studies have shown that in some cases, women who had their clitoris removed before or after puberty exhibit lower threshold for foreplay and have in any atmosphere where intentions of sexual nature have been communicated actually demonstrated reduced capacity to delay sexual gratification . The implications of this can be imagined in terms of ability of a woman to overcome sexual temptations encountered as she goes through the different stages of life.
Like in the case of Shanice, the young woman who had her clitoris removed when she was five year old, there is usually the tendency to give the impression that what has to be done must be done to prevent unknown calamities befalling parents or the girl child, but the whole thing is rooted in falsehood and illiteracy. The girl child compared with a male of the same parent is particularly vulnerable to harmful traditional practices. This is also more likely the consequence of illiteracy and poverty. In rural communities, the traditional husband is more likely to be a polygamous father and to take issues concerning the health of a son very seriously while leaving the girl child for the wife and the older members of the family to watch over. This partly explains why a mother is more useful to her family, community and country if she is educated. An educated woman is more likely to have fewer children, protect them fiercely, initiate and sustain a clean break with harmful traditional practices. Female genital cutting the way it is done in many communities in the country is certainly harmful as discussed here under.
Complications Of Female Genital Cutting
There are many possible complications of female genital cutting; the ones that are commonly encountered can be classified into two broad groups; early and late
Early Complications
Haemorrhage
Among the early complications , bleeding and infection can be particularly dangerous
As was shown in the photograph, the cutting is done without preparations to control or arrest bleeding . Compared with adults, children do not have the amount of blood reserve that adults and pregnant women commonly have in situations of bleeding from wounds. Under the conditions of bleeding from open wounds created during cutting of the clitoris, prepuce and labia minora, the child may go into hemorrhagic shock and die from there. If she survives that period, damage to certain organs of reproduction as a result of the blood loss will manifest later by way of primary infertility , starting with menstrual problems. This is further complicated by the fact that unlike what is done in Hospitals, no laboratory tests are done to know the level of haemoglobin(Hb) and to know if the child has an underlying bleeding disorder.
Infections
As concerns infections, the real danger is Tetanus, but apart from that, using locally made cutting instruments that are not sterilized places the child at the risk of contracting Hepatitis B and the dreaded HIV/AIDS. Despite the much talked about ATS(antitetanus serum), only few cases of established tetanus infection survive, and of course, Hepatitis B and HIV/AIDS both have no cure; they can only be treated.
The clitoris is so intimately related to the urinary tract opening that infection (ascending) of the urinary tract is almost always associated with female genital cutting. The blind nature of the operation and the poor conditions of hygiene under which it is done increases the likelihood of urinary tract infection, pyelonephritis, nephritis , kidney damage and failure
When death occurs either from infections or haemorrhage, the truth is hidden, and the victim buried secretly to conceal primary cause of death
Late Complications
Chronic pain
Among the late complications, chronic pain is one common feature. Affected women often find it difficult to describe the pain or where it is coming from. However, many of them complain of pain during sex(dyspareunia) even with husbands who according to them are endowed with phallic organs below average in size. Other women complain of pain during sexual excitation, during sex and even after
Abnormal sensation
Other complaints include the following;
Sensation of something being present inside the vagina
Sensation of the womb coming down or trying to fall out
Excessive reaction to pain, and crying about pain even, when there is obviously no source of pain
Inability to hold urine(urinary incontinence) during sex; the bed is flooded with urine during sex or every five or so many minutes, wife interrupts the coitus to go and void
Abnormal sensation of sweet tingly, prickly or pins and needles pain
Inability to achieve orgasm in addition to a situation of sexual arousal that refuses to ebb or go down even days after sex, creating tension and the restless pubis syndrome.
Several medical terms including vaginismus, par aesthesia dyspareunia, hyperalgesia, allodynia, etc have been used to describe these abnormal sensations ,which can be understood from the fact that the clitoris is richly blessed with abundant supply of delicate nerve fibres that are better left alone. The clitoris is one of the few organs in the body designed with double nerve supply ;the pudendal nerve and the perineal branch of the posterior femoral cutaneous nerve. The organ also contains fibres from the sympathetic and parasympathetic chains of the autonomic nervous system .Recently scientists have been able to map the area of the brain(cerebrum) which receives, registers and controls activities of the clitoris and have found that the clitoris, nipple and other parts of the female body share commonalities in many respects.
Psycho social issues:
As told in medical sociology, even in churches; behind closed doors, how a couple wants to have sex, where, how and for what reasons are purely and truthfully for them to decide. No one , is expected to meddle in the matrimonial affairs of any pair in legitimate relationship.
Sexual needs and identity begin early in life . Indeed by the time a child reaches the age of five(earlier in some and later in others),she will have passed the initial rungs of the ladder of psycho sexual development as espoused by Sigmund Freud and will have begun to appreciate sexual identity. This identity takes many issues into consideration and will not be discussed here because doing so might not be appropriate for some children who though very young are able to assess information of sensitive nature from the internet. From this age of five, older or younger as discussed , any inappropriate physical activity of what ever nature or assault on the genitalia is likely to be written down in her mental diary and will remain there for the rest of her life. What ever she knows about her self in general and about specific parts of her body will be recorded, played and compared several times over in her brain as she grows and matures, interacting with her environment and exposed to positive and negative reinforcement, depending on many other factors. It thus becomes a huge problem with far reaching ramifications when a child is allowed to grow into adulthood with the knowledge that she is different in one particular part of her body compared with other women. In most of the situations in Nigeria, where in accordance with the rules and regulations of a church, intending partners are not allowed to come into any significant degrees of intimacy until union is solemnized, pre marriage counsellors may have issues with partner disclosure status ,with physical examination presenting matters of their own specific nature.
Social issues:
For women who have had the clitoris amputated ,a wide range of dysfunctional sexual responses have been documented. To begin with, no responsible man would want sex with his wife or partner to assume the form of rape ,and so for legitimate marital or spousal sex, one reason for foreplay is to adequately prepare a woman for reception and avoid vaginal hostility . Conscious of the fact that down below, she is not quite as complete as she should be, an affected woman may want to hide that part of her body considering herself inadequate before her husband ; intra psychic conflicts declare themselves, and with the mind searching for ways to cope with her seeming incompleteness, response might come in ways that may be interpreted as primitive, hostile(mind body disconnect), unusual, bizarre or inappropriate. She may even find herself unable to respond at all.
In any marriage or successful relationship, a partner finds fulfilment in being desired and this can be projected(at least to a large extent) by way of verbal and non verbal communication. While in bed, coldness, unusual demands and responses could be easily misunderstood and misinterpreted. It only takes a little miscalculation thereafter for affected couples to start filing papers for divorce sighting what they commonly refer to as irreconcilable differences
