The female cut: For whose benefit?

Only a month into marriage and Lucy wanted to quit due to unbearable pain during sex.  “I cannot bear it!” she exclaimed when she sought care at the sexology clinic.

“If I must have sex as part of marriage I would rather be single.” She looked away as tears welled up in her eyes.

She had walked in alone. Despite complaining about pain to her husband, she says he did not seem concerned.

“Could it be that he feels more manly when I writhe in pain?” she asked rhetorically. “I have learnt to cry quietly because the more I complain the harder and rougher he gets, injuring me even more!”

 Lucy’s genitals had been severed when she was young. She underwent the popular but painful culture of female genital cutting.

This totally changed the anatomy of her vagina.

The clitoris and surrounding tissues were mutilated and literally absent. There was a big scar around the vaginal opening extending into the vaginal canal. She must have suffered a severe infection after the procedure leading to matting of tissues as they healed. The vaginal opening was itself reduced to more than half the normal size.

Lucy’s situation was difficult. Under normal circumstances, tissues of the vagina are elastic and this allows for expansion during sex.

In addition, lubrication reduces friction, making the act painless and pleasurable. Elasticity and lubrication are lost in cases like Lucy’s, making sex painful. The vaginal cavity gets bruised and may even lacerate under such circumstances.

Unfortunately, not many women in Lucy’s situation seek care. According to the latest statistics from the Ministry of Health, one in every five women in Kenya is living with scarred genitals from genital cutting. In some communities, up to 98 per cent of women have been cut.

A strong belief in communities that practice genital cutting is that it tames women from becoming ‘sexually wild’ and seeking sex with multiple partners.

Further, good women are taken to be those who do not enjoy sex. The right to enjoyment of sex as enshrined in the international code of rights is foreign to such communities.

The operation of genital cutting is traditionally carried out by women in the community. Most men do not even know the difference between a cut and uncut genital.

In one study to find out if men in communities that practice genital cutting had ever seen or recognised a cut genital, over half reported that they did not know the difference.

SUFFERING CONSEQUENCES

In fact many had never seen the genitals of their own wives since sex was done in darkness and under blankets with eyes closed.

This then begs the question: for whose benefit is genital cutting? It pains the woman and makes sex an agony. The man lacks knowledge of what it is and how to handle it, and in childbirth, it leads to severe complications that affect the wellbeing of the whole family.

For Lucy, the safety of her genitals was now water under the bridge; she was already suffering the consequences of the practice. She would never enjoy sex like other women.

Childbirth was going to be another bad experience when the time came for it; she would have to undergo a Caesarean section to avoid bad tears on the scarred vagina. She was lucky to access hospital care; most women in the villages suffer these experiences quietly.

To save the marriage, a decision was made to do surgery to enlarge the scarred vaginal opening as well as open up constricted parts of the vagina.

Lucy’s husband grudgingly accepted the procedure after counseling. He was reassured that the procedure would not recreate the cut off genitals. This important if the mother-in-law and other close relatives of Lucy were to accept her after the surgery.

Six weeks later, Lucy was well healed but still not totally free from pain during sex. Natural lubrication was inadequate; the glands that produce the lubricant had been destroyed by the genital cutting. She was put on artificial lubricants to ease friction during sex. She would have to use the lubricant throughout her active sexual life.

Another important aspect of care was sex coaching. It was sad that Lucy’s husband felt manly when she had pain during sex.

The couple was made to understand that sex is supposed to be pleasurable and is not a contest in which the winner enjoys pleasure as the helpless suffer pain. They trained to communicate their feelings during sex to be of the same heart and soul during sex.

“So now I know better, I am a hero when my wife gets pleasure, not pain during sex!” exclaimed Lucy’s husband during our last meeting. I nodded as we both gave each other a familiar man to man smile of satisfaction.