Newsweek Web Exclusive "The Kindest Cut"

October 21 2009, category: International NEWS

The Kindest Cut

In Colorado, a surgeon helps restore feeling—and so much more—to victims of female genital mutilation.
photos of "sila" (psuedonym) before, during and after treatment to reverse female genital mutilation - Dr. Marci Bowers performed surgery in Trinidad, Colo. in May 2009

Photos: Kristen Ashburn / Contact for Newsweek
Sila, a patient at Mt. San Rafael Hospital in Trinidad Colorado, prepares for her clitoroplastal reversal surgery (left). The surgery, (center) performed by Dr. Marci Bowers, reverses the effect of female genital mutilation and attempts to rebuild the clitoris, eliminate pain and restore pleasure. After the surgery, (right) Sila and Dr. Bowers embrace.

By Eve Conant | Newsweek Web Exclusive
Oct 20, 2009

One day, when Sila Folow was an 8-year-old girl living in Mali, four elderly women held her down on the dirt floor of an outhouse and, in keeping with local tradition, used a sharp blade to cut out her clitoris and most of her labia. Her grandmother and other villagers held a celebration. Sila, bleeding and in terrible pain, could not walk for weeks. Like millions of other African girls who are forced to undergo female genital mutilation—a ritual many women say is intended to ensure that they grow up to become sexually passive wives who will not stray from their husbands—Sila never recovered. She eventually moved to New York, married, and had two children. But she was reluctant to have sex with her husband. It hurt, and the scarring made it impossible for her to feel pleasure.

This May, Sila, now 38 years old, underwent a simple but profound operation to undo the past. She traveled to Trinidad, Colorado, where Dr. Marci Bowers, a gynecological and pelvic surgeon, has recently begun to perform "clitoralplasty" or "female circumcision reversals" on African women. A relatively new procedure, it reshapes the anatomy and, in 80 percent of patients, restores pleasurable sensation. "I want my womanhood back," Sila told Bowers when she first spoke to the surgeon about the operation. "I just want to know it's there. To have the feeling that I can fight against this culture."

As she awaited the anesthesiologist on the morning of the surgery, Sila—attractive, fun-loving, and talkative—was uncharacteristically quiet in her thin blue gown and hospital socks. She took a final phone call from her husband and mother, and set aside the romance novel she had brought to the hospital as a little joke. It was titled Good Girl Gone Bad.

The doctors wheeled her to the operating room, anesthetized her and got to work. Dr. Bowers cut away the thick scar tissue that had formed over Sila's wound and had obscured the remains of her clitoris. She then scraped away layers of a black, sooty material—the decades-old remnants of the ash poultice the local women had used to stop the bleeding. It had caused a low-grade infection that still hadn't healed—one reason Sila was always in pain. "They really got her good," Bowers said, shaking her head behind her surgical mask. Bowers used a cauterizing tool to quickly stop a sudden rush of blood. "That's arterial blood flowing there," she said. "You can see why so many girls have died after circumcisions." The root of the clitoris, which extends several centimeters beneath the surface of a woman's skin,is much larger than most people—and for many years scientists—ever suspected. Bowers exposed the remaining flesh of the organ and drew it out, securing it in place with delicate stitches that eventually dissolve. Finally, Bowers also did some cosmetic work to restore the appearance of Sila's labia.

A little less than an hour after it began, the surgery was complete. Two days after that, Sila was on her way home. In most cases, it takes three to six months to begin to tell if the operation was a success. However, the extent of Sila's injury was so severe—her reconstruction took twice as long as the average 30 minutes due to the level of scarring and the depth of the cut—it may take longer before she knows if the surgery worked. Still, "You should be able to feel something; there was two centimeters of scar tissue over the area," Bowers told Sila right after the operation.

"Just knowing it's out and I'm clean, I feel great," Sila said, still groggy from the anesthesia. She says she looks forward to the day when she can "have a romance with my husband."

Sila's operation was only the fourth time Dr. Bowers had done the procedure, but she has more than twenty years of experience in reconstructive surgery. Bowers learned the procedure in Europe by observing , a French urologist and surgeon who pioneered the technique after years of humanitarian work in Africa. He has received death threats from radical Islamists for his work as a surgeon and for his other efforts to reduce violence against women, he says. But he continues to train doctors and to perform the surgery. The French surgeon—reached by telephone outside Paris—tells NEWSWEEK that more than 3,000 women have come to him, largely because in France, , genital reconstruction surgery is covered by national health insurance. (In the United States insurance companies are still mostly unfamiliar with the surgery—only one of Bowers's patients has so far gotten full medical coverage for the procedure; others are still fighting with their insurance companies or have paid out of their own pockets.. Bowers performs the surgery free of charge, and the hospital caps its fees at $1,700. "As the French surgeon has said, you cannot charge money to reverse a crime against humanity," she says. "Sexuality is a right."

Bowers speaks from personal experience. She was born male and underwent "gender reassignment" surgery to become a woman 11 years ago. She now specializes in sex-change operations; she has performed some 700 of them, and is one of the leading gender-reassignment specialists in the U.S. The small Colorado town where her clinic is located has long been known as the sex-change capital of the world thanks to work of Dr. Stanley Biber , a pioneering surgeon in the 70s whose practice she took over. Asked if she is worried about the death threats that have followed the French surgeon, Bowers doesn't flinch. "I've jumped through enough fires and over enough barbed-wire fences in my life by now. I do not fear for my safety."

Bowers expects that the restoration technique she performed on Sila "will explode" in popularity as word gets out to the thousands of other circumcised African women who live in the United States. (Female genital mutilation is practiced in both Christian and Muslim communities and has been performed on some 100 to 130 million women worldwide, and some of those women may have been mutilated here in the U.S.). Since Sila, Bowers has performed four additional surgeries with two more scheduled for this month A California nurse, Ngozi, who was circumcised as a newborn in Nigeria and also had her labia entirely cut away, came to Bowers in August. She is already feeling results, she tells NEWSWEEK. "Before, I would look at my textbook and look at myself and they were two different things. I wasn't even human." Bowers performed not only the clitoral operation but also plastic surgery to create labia for Ngozi, 34. "Now when I look at myself I feel like a woman." Says Ngozi, who says she has even experienced orgasms for the first time in her life. "It's beautiful, I just love it, it feels like you're melting. Before it irritated me when my husband tried to touch me, now I reach out to him."

But here and even in Europe, many women fear being ostracized by their immigrant communities if they undergo the operation. Sila, whom NEWSWEEK followed before, during and after her operation, has the same concerns. She asked that her full name not be used for this article—Sila is her nickname—because she worries friends and family in America and Africa will once again treat her as an outcast. Sila knows about the stigma uncircumcised girls suffer in some African communities. Her mother, who was 14 when she gave birth to her, was vehemently opposed to female circumcision and for years refused to subject Sila to the procedure. In Mali, where nine out of 10 girls are forced to undergo the ritual, Sila stood out. Her cousins and friends had all been circumcised, many as infants. They teased her for being unclean and wouldn't let her eat at the same table with them. When Sila was 8, her mother moved to the United States, leaving her grandmother to raise her. The grandmother soon arranged for Sila to be made "normal." But the women who performed the circumcision the first time weren't satisfied with their work. Three weeks later, they held her down and cut her again. (In one way, Sila says, she was lucky. Some African girls are subjected to an even more extreme and dangerous ritual called an infibulation, which involves sewing up the vagina, leaving only a small opening for urine and menstrual blood.)

In 1989, when Sila was a teenager, her mother invited her to come live with her in the United States. She went to high school and college, and became a U.S. citizen. Dating was awkward. When she'd meet a young man, says Sila, "I'd think, he's cute, but if he knows he will run away. I would go out with them but when it came time for bed I'd say, 'Bye!' " She married an African man at age 20. Her husband was understanding. "He had lived in the U.S. a long time," she says. "He thinks the circumcisions are wrong." But her avoidance of intimacy strained their relationship. An avid reader, Sila devoured American romance novels with a tinge of jealousy and confusion, "I'd think, I wish I had that."

Last year she was reading a book with a character who'd had a sex change and wondered if she could change herself too—not into a man, but into a "real" woman. If a man can be made to feel like a woman, she thought, maybe they could fix me?

She surfed the Internet and discovered the French surgeon. She arranged an appointment, but the cost of the trip was high and French health care wouldn't cover an American patient. She found a small nonprofit organization on the web called Clitoraid, which had helped to fund Dr. Bowers's training in France. The organization has unusual backers: it is run primarily by volunteers of the provocative French Raelian movement—the pleasure-promoting "UFO religion" whose members believe life on Earth was created by a race of advanced aliens and who emphasize human sexuality. Clitoraid, however, reaches out to women of all religions and focuses solely on connecting women with trained surgeons in order to "create real, long-lasting changes for women who have been forced to experience clitoral excision or genital mutilation against their will" according to its mission statement. It has been the primary source of referrals to Dr. Bowers and has provided some financial aid to some of her patients, In late May, Sila flew to Colorado for the surgery. Like many of Bowers's patients, she stayed at a guesthouse for people awaiting sex-change operations. She was charged just $35 per night, less than half the usual rate.

Sila had spoken with two of Bowers's first three patients. Mariam—she agreed to give only her first name—was circumcised as an infant in Mauritania and now lives in Virginia. She spoke with NEWSWEEK seven weeks after her surgery and was still healing, but had begun to recover some sensation. "When I cross my legs or sit in a certain way, I feel something," she says. "It's kind of exciting. You keep wanting to do it." She is still haggling to have her hospital stay covered by insurance. "I've gone through this hell, why are they going to say this is cosmetic?" she says. "They don't even know what they're talking about. If a person is missing something, it's not cosmetic."

After the surgery, Sila showed anger for the first time at the women who cut her as a child. "They were so mean, so mean to me," she said as she rested on the couch in the guesthouse. "I want to go back and"—she made a shooting motion—"t-t-t with a gun." But she quickly reverted to her cheerful self. "Even if I feel something just one time, it will all be worth it." She knows she'll be criticized by fellow immigrants who may read this story, but hopes that eventually those who practice female circumcision will come to recognize it for what it is—a primitive and barbaric act. "They'll call me an infidel now, but later they will say it is a good thing," she says.

The night before her operation Sila could barely sit still, much less sleep. It was, she wrote in her journal, her last night "as an incomplete woman." At one point, she took a call from her mother. In African culture, says Sila, "usually you don't talk about things like this with your mother." But when she told her mother that she was going to have the operation, her mom was envious. "Oh, I'm too old to do it," she told her daughter. That was how Sila learned that her mother, too, had been circumcised. And now her mom hopes to be one of Dr. Bowers's next patients.

Combating female genital mutilation in Iraqi Kurdistan

August 29 2009, category: International NEWS
A Wonderful Contact in Iraqui Kudistan was discovered and Now know about Clitoraid!

See main site STOP FGM KUDISTAN here

15. August 2009, von Administrator
Kurdish Herald Vol. 1 Issue 4, August 2009
By Haje Keli

As the first organization in Iraqi Kurdistan to open a women’s shelter, WADI is an authority on women’s issues in the region, an area of great concern to any activist or observer concerned with true democratization and respect for human rights. When the organization’s “Nawa center” opened in 1999, the social acceptance for such an institution was scarce, and the group’s volunteers faced daily challenges of various types. In some people’s eyes, women’s shelters are seen as institutions that break up homes, and the female beneficiary is believed by those people to be bringing shame upon her family. Furthermore, even the employees of the organization have faced ridicule for their efforts. Mr. Falah Murad Khan, the director of WADI’s office in Sulaymaniyah, Iraqi Kurdistan, laughingly recalls an incident where he was phoned by an anonymous caller telling him that he should be ashamed that, as a man, he was working on “feminine” affairs. This was after Mr. Khan appeared on a radio show talking about WADI’s efforts to fight female genital mutilation.

In a region plagued by various issues of gender discrimination, WADI has devoted much of its efforts as of late to one particular, serious issue: female genital mutilation. This practice involves partial or total removal of the external female genitalia, which more specifically includes partial or total removal of the clitoris and the labia minora. This painful surgery is customarily performed on women usually between the ages of 4 and 12, without regard for medical concerns or sanitation. The procedure itself is customarily done by a woman using a razor or knife, and no anesthetic is provided. Following the cutting, the woman’s bleeding wound is covered with ash and sometimes icy water is used in an attempt to control bleeding. The victim of this procedure may indeed bleed to death or contract a potential lethal infection.

This phenomenon has been widely discussed over the last few years in Kurdistan; although no one has ever provided any real data regarding the number of Kurdish women who have been victimized in this awful way. This changed in 2003, when WADI sent out teams of workers to knock on the door of every house and ask the women if they had been “circumcised”. This bold idea bore fruits, as the different teams discovered disturbing tendencies among the rural population of Kurdistan and then developed a plan of action to address this issue.

WADI assembled teams consisting of specially trained employees and assigned them to different areas such as Raniya/Qaladize, Germiyan, Erbil and Sulaymaniya. These teams, consisting of only women, traveled around villages and knocked on doors, seeking to inform the people about genital mutilation. The first year of the project was dedicated to using data obtained to map the various areas that have been specifically affected by trends of female genital mutilation. The teams began contacting women in certain villages, gathering them to view a film produced by the organization about genital mutilation. The film is a sort of documentary where doctors and religious scholars speak of negative effects of genital mutilation. The doctor in the film speaks about the damage done to women from a medical point-of-view, while the Islamic cleric states that it is non- Islamic to circumcise girls. There are also women in the film, victims of genital mutilation, who share their painful experiences. After viewing the film, there was time for a discussion among the women, and according, to WADI’s employees, some of them realized that genital mutilation was a bad thing and stated that would not put their own daughters through it.

The following year the WADI teams went back to the same homes and spoke to the same women that they had met who were shown the film, with the purpose of finding out if the women had indeed spared their daughters from circumcision, or if they had succumbed to pressure from the rest of the village. The film would be shown again, but now the WADI teams would concentrate specifically on the unconvinced women. The third year, the teams yet again went back to the villages they were assigned to the first year and spoke with the same women from the last two years. From 2005-2008, the WADI teams visited a total of 84 villages.

As the American-led war against Saddam Hussein approached in 2003, the WADI organization trained groups of workers to provide immediate assistance to internally displaced women and children as a result of the war. When it became obvious that the war did not impact women and children in the Kurdistan autonomous region, the organization switched its focus and traveled to various villages to see what sort of aid women were in need of. This is when the teams discovered that females in many of Kurdistan’s rural areas had similar stories of post-circumcision complications. Many of the village women had been genitally mutilated, and reported that, as a result, they suffered physically and sexually.

A major long-term - indeed lifelong - complication of so-called circumcision is that women lose a sense of sexual desire. Unfortunately, not everyone sees this as a negative consequence. Mr. Khan explained, “This is not seen as a problem, as sex is viewed as being for the enjoyment of the man only.”

In 2004, the teams of WADI spoke to 1,500 women in the Germiyan region, and 907 of them admitted to being victims of female genital mutilation. At the same time, the team assigned to the Erbil region discovered that 380 of the 440 women they spoke to subject to the practice.

Four female employees of WADI present during the meeting in Sulaymaniyah told various stories about the people they met and discussions they had during the course of their work. During their many meetings with the women of villages, they discovered that some women were mutilated during their wedding day. They had also been told that some women had been mutilated so badly that parts of their inner thighs had been sliced off in the process.

One would hope that the local government would be the first in line in addressing the serious issue of female genital mutilation. Sadly, according to Mr. Khan, the Ministry of Health and the Ministry of Endowments and Religious Affairs were, at first, very open to collaboration with WADI, but after all the plans were set, they withdrew their support. According to Mr. Khan, the Ministry of Health claimed that the statistics presented by WADI were inaccurate, and it was impossible that so many females could have been subjected to genital mutilation. Mr. Khan explained that the sudden reluctance of the ministries to cooperate with WADI might be because the government sees this sort of work as possibly generating bad publicity for the region.

Regardless of the difficulties facing those who seek to combat female genital mutilation, there is actually a glimmer of hope. The WADI teams have discovered that, after fighting genital mutilation for years, there is now, in some areas, a certain stigma attached to the practice. The younger generation, upon choosing a wife, will ask her if she has been “circumcised”. If she has been, she becomes less desirable because now men know that a woman sexual urges decrease substantially as a result of this mutilation. Many men in the younger generation want their wife to enjoy sex as much as they do.

WADI is taking a special approach in tackling this serious societal problem, as, year-after-year, they work with the same people. The people who viewed the film about the genital mutilation were contacted the following year and the year after to see if they had “changed” their minds. This approach has the likely affect of giving those contacted a sense of importance and motivates them to be a more active part in this focused, individualized effort. At the same time, it provides for reliable data concerning the efficacy of WADI’s approach to education on the issue of female genital mutilation. One will hope that they can continue in their efforts despite the various obstacles that lie in their way, and receive increased support from both governmental and non-governmental groups to expand their efforts. It would be a true victory for Kurdish society if the practice of female genital mutilation could soon become a thing of the past.

see here to know more

Eliane says:
19. August 2009 19:14

Congratulations for your article and your studies about this difficult subject.
I have a good news for you. Today it is possible to repair the clitoris.

Today we have the chance to have a French urologist and surgeon who had developed a technique to help victims of FMG get their clitoral sensation back. Further we have created Clitoraid dedicated to ending FGM once and for all and to raising funds to pay for the operations of as many women as possible. Clitoraid mission: to help a many FGM victims as possible regain their dignity and their sense of pleasure and in the process, help eliminate FMG.

My name is Eliane and I represent officially “Clitoraid” for the Middle-East. We are a non-profit organization, created by the International Raelian Movement and based in US.


I invite you to discover who we are. The fact that it is now possible to repair, will activate the termination of this for all the girls to come.
Talk around you so that the world is changing for women :-)

Responsible of Clitoraid for Middle East

Clitoris hospital for Burkina Faso

May 14 2009, category: International NEWS

Posted on Monday 11 May 2009 - 15:50
Murtala Mohamed Kamara, AfricaNews reporter in Freetown, Sierra Leone

Females with mutilated clitoris can now breathe a sigh of relief following the construction of a hospital in Burkina Faso that would specialize in the reconstruction of the sex organ. The US non-profit organization Clitoraid is funding the $50,000 project which is dubbed "Pleasure Hospital."

The ‘Pleasure Hospital’ situated at Bobo- Dioulasso in the western part of Burkina Faso will help women especially victims of Female Genital Mutilation (FGM) wishing to have their clitoris restored after going through such ordeal.

‘Pleasure Hospital’ will offer free clitoral reconstruction surgeries to victims of FGM all throughout the West Africa region, according to the humanitarian news agency IRIN.

Mariam Banemanie, President of Clitoraid's local NGO partner, Voices of Women said "Clitoraid decided to build the clinic in Bobo-Dioulasso because it is at the crossroads of several West African countries." "The clinic will restore justice and give women the ability to feel sexual pleasure." Banemanie said whiles questioned "Burkinabé women are beginning to stand up for what they believe in - why should sexual pleasure not be a part of that?"

Some female journalists were striped naked in Sierra Leone early this year for mere reporting on FGM. The World Health Organization (WHO) which defines FGM as ‘any injury to female genital organs for non-medical reasons’ said over three million girls are at risk of it.

Abi Sanon, 36, who went through the reconstruction of the organ at a private clinic in Ouagadougou in 2006 after it was cut at a tender age said "I wanted to find my integrity and to know real pleasure. The procedure cost $320; my boyfriend contributed. It has really changed our lives. Before, I did not really know what pleasure felt like, and now it is not my boyfriend who calls the shots in our relationship - it is much more equal," she said.

Sanon told IRIN she was surprised at her family’s positive reaction when she informed them she had wanted the surgery, since she said talking about sexual pleasure is still seen as taboo in her country.

Her 70-year-old mother has expressed interest in having the procedure once the hospital opens.

Clinic to fight taboo of female mutilation

May 11 2009, category: International NEWS

Kate Thomas, Foreign Correspondent

Abibata Sanon, above, is one of the first women in
West Africa to undergo the genital reconstruction
procedure at a private clinic. Olivier Asselin for The National

BOBO-DIALOUSSO, BURKINA FASO // Africa’s first clinic designated for the reconstruction of female genitalia will open in Bobo-Dialousso this year. The clinic will offer free reconstructive surgery to women from across West Africa.

About 70 per cent of Burkina Faso’s seven million women are victims of female genital mutilation (FGM), a deep-rooted practice in West Africa. The ritual, common in a stretch between Senegal and Benin, can cause complications such as serious infections, excessive bleeding and stillbirths.

Mariam Banemanie, the director of Voices of Women, a Burkinabé non-governmental organisation that is paying for the clinic with Clitoraid, an NGO based in Las Vegas, said about 90 per cent of Burkinabé women in their 20s feel no sexual sensation. “Currently reconstruction is only available in the capital for a fee upwards of 160,000 CFA [Dh1,200]. That option isn’t available to every woman, which is why we’re excited about the construction of the clinic in Bobo-Dialousso,” Ms Banemanie said. “Burkina Faso is fast becoming the crossroads for genital reconstruction surgery in Africa.”

Thousands of African women between the ages of 18 and 70 have expressed interest in undergoing the surgery in Burkina Faso, according to Marissé Caissy of Clitoraid. Some plan to travel to Bobo-Dialousso from such neighbouring countries as Ivory Coast and Mali for the operation. Ms Caissy said sexual sensation is restored in about 90 per cent of cases. Recovery takes at least six weeks.

When the clinic opens in October, Abi Ouardé, 24, will be one of the first women through its doors.

Ms Ouardé carries herself like a woman in a hurry. She drives a shiny new Yamaha moped, slings a leather bag over her shoulder, wears a sleek black dress and bejewelled heels that match the royal blue of the mudguards. As she skids to a halt and shimmies off the moped, heads turn. She looks every inch the liberated West African woman.

But something is missing from Ms Ouardé’s life and she is eager to restore it. At the age of four she became a victim of genital mutilation. “Because sexuality is taboo in Burkina Faso, circumcised women are not supposed to talk about the fact that they don’t feel any sensation. It’s seen as something we just have to put up with,” she said.

Three years ago, Abibata Sanon, 36, became one of the first women in West Africa to undergo the procedure at a private clinic in Ouagadougou. She has since become a symbol of the fight against FGM. “Having the surgery seemed like the perfect opportunity to take a stand against FGM,” she said. Ms Sanon’s longtime boyfriend was eager for her to have the surgery and even helped pay for it. But women say the fact that many men still favour the practice is the biggest hurdle in the battle for gender equality in West Africa.

“Some men believe that a woman will never stray if her ability to feel pleasure is removed. It’s time for our voices to be heard. People are beginning to understand the concept of women’s liberation. Women deserve to feel good about themselves,” Ms Banemanie said.

Although FGM is banned in several West African countries, including Ghana and Burkina Faso, it remains widespread. The practice was deemed illegal in Burkina Faso in 1996, but rights groups say perpetrators have switched tactics to avoid detection, targeting toddlers and babies whose cries do not raise suspicion.

Ms Banemanie said once the restoration clinic opens, its presence might even serve as a deterrent. “If cut women are able to restore themselves, perhaps people will realise that it’s no longer worthwhile to continue with the cutting,” she said.

Since having the surgery, the effect on Ms Sanon’s life has been remarkable. A few months after undergoing the procedure, she told her mother, who backed her father when he took her to be cut as a baby, about the operation. “The reaction of my 70-year-old mother shocked me. She was very supportive and even now she keeps asking me when the clinic will open. I wonder if she wants to have the surgery herself.”

And then there is the effect on her personal life. “Until I had the operation, it was my boyfriend that called the shots. Now our relationship is more equal.”

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