Hannah is a lifelong lover of writing and a recent graduate from California State University, East Bay, where she earned a B.A. in English. She believes in the powerful use of storytelling to produce social change in communities fighting for equality. She hopes to use her voice as a writer to uplift the voices of others.

What was your experience of learning about female genital cutting (FGC) for the first time like?

I first learned about FGC in high school. I think I initially dismissed the topic of FGC, believing the lie that it is something that only happens in faraway, developing countries, and not in the U.S. where I live. I quickly realized that there are many people in the U.S. who have gone through or are at risk of undergoing FGC, and even though I am not directly affected by FGC, it does not mean I should not care about it.

When and how did you first get involved with Sahiyo?

Last December, I found myself struggling to find a job where I could utilize my love for writing. I was searching for an internship online, and I saw that Sahiyo was looking for an events and programs intern. My interview with Sahiyo was my first ever job interview, and on my 23rd birthday, I was honored to receive an offer to join the team. I have been working with Sahiyo since January 2023.

What does your work with Sahiyo involve?

My work with Sahiyo involves assisting in webinar planning. This includes planning the agenda and helping the social media team with advertising for the webinar. I also assist with other Sahiyo programs as needed.

How has your involvement with Sahiyo impacted your life?

My work with Sahiyo has made me realize that many people carry shame from things that have happened to them against their will. The stigma surrounding sex makes it especially difficult for survivors of FGC to come forward, so if anyone is brave enough to share their story, the least I can do is listen. Having listened to the stories of several survivors from the Voices to End FGM/C Fall 2022 Cohort, I have realized how important it is to uplift their voices in hopes that they may find some comfort in knowing that they are not alone, and their pain is valid and acknowledged.

What words of wisdom would you like to share with others who may be interested in supporting Sahiyo and the movement against FGC?

I would encourage people to begin talking about FGC with those around them. Many people are unfamiliar with FGC, much less the legislation surrounding the movement to end it. There are great webinars on Sahiyo’s social media accounts to share with friends and family. Most of all, those supporting the movement against FGC must become empathetic allies to survivors, creating a space for survivors to share their stories without fear of judgement. The world will become a much better place when we talk about the things that hurt us, and we stand beside those who are hurting.

On May 30th, RTI International will hostg a virtual workshop to educate those in the social work profession on female genital mutilation/cutting (FGM/C). 

This workshop, approved by the National Association of Social Workers (NASW) and available for continuing education units, will provide an introductory foundation for understanding what FGM/C is, including its prevalence in the U.S. and globally, and the role of social workers in addressing and responding to this issue. In addition, the workshop will share key competencies and best practices for working with survivors of FGM/C. Workshop Facilitators will be U.S. Executive Director Mariya Taher, and U.S. End FGM/C Network Director Caitlin LeMay.

Event Details:
Date: Tuesday, May 30th
Time: 3-5 pm ET 

Register for the virtual event here.

By Kiah Leone

As countries like the United States, Canada, Australia, and others become increasingly aware of the practice of female genital cutting (FGC) and its presence in their country, their healthcare systems are having to explore what support and quality services for survivors of FGC entail. Medical studies conducted across many of these countries have identified a significant lack of knowledge on behalf of healthcare workers when it comes to the practice of FGC. This lack of understanding regarding the practice, particularly the various sociocultural contexts within which it is perpetuated, can often leave survivors confronted with a healthcare system ill equipped to meet their particular needs. Unfortunately, instances of discrimination and stigmatization are not uncommon as a result, and such instances may cause survivors to feel discomfort, judgement, embarrassment, and fear in medical contexts, or to avoid seeking medical help and attention altogether. 

As part of my graduate degree in Social Anthropology, I decided to investigate the experiences of medical professionals in Canada as they navigated appropriate and culturally competent care for survivors. In 2018, I conducted a qualitative study with interviews of Canadian physicians and health care providers who had provided reproductive health care to survivors in Canada. The purpose of this study was not only to gain a deeper understanding of the role of physicians and medical personnel in providing reproductive health care to survivors of FGC, but to also learn how FGC was thought about, both within the Canadian healthcare system and in Canada as a whole. 

Interviews with medical professionals consisted of a series of questions regarding their level of education and training, experiences providing reproductive health care, knowledge of FGC and how they first came to learn about it, as well as their experiences providing care specifically for survivors. From these interviews, four major themes emerged: a lack of education and training amongst health care personnel in regards to FGC; reliance upon repeated encounters with survivors in order to develop a form of expertise in FGC-related care; a desire amongst participants to educate past, present, and future health care professionals on the practice of FGC; and the belief that FGC is an important topic of concern for reproductive health care specialists in Canada. What stood out across each of these themes was an emphasis on the importance of understanding FGC, rather than just learning how to accommodate survivors within a medical context. 

The physicians and health care providers who participated in my study all recognized the value and importance of education, training, and mentorship in the medical and health care concerning FGC in Canada. Providers explored the benefits of education and training, not only for their current and future medical students and residents, but also for their colleagues and peers to account for the diverse needs of their patients. From this study, I concluded that by continuing their own learning, making recommendations, and implementing education initiatives that provide early learning opportunities for others, Canadian health care professionals can improve the quality of care that survivors receive here in Canada. 

Kiah Leone (she/her) is a Doctoral Candidate in the School of Health Sciences and an Instructor for the Department of Anthropology at the University of Northern British Columbia (UNBC). Kiah’s research interests focus on improving female genital cutting (FGC) survivors’ experiences in accessing quality health care in Canada. She received her MA in Social Anthropology from York University and her BA in Anthropology from Vancouver Island University. Kiah is currently undertaking a study on the introduction of clitoral reconstructive surgery in Canada.

By Nazneen Vasi

The topic of Khatna, also known as female genital cutting (FGC), has always been interesting. Within my family,  there are those who are against it, and those who support it.

It is clearly not a religious custom, but more cultural. How did it even become a part of our culture? And why are community members advocating for FGC? In my opinion, there is no science or logic to legitimize this practice– just blind faith in the leaders of the community.

I joined the Voices to End FGM/C workshop to share my journey with FGC. My parents did not participate in this custom, and thus I was spared from being cut. A big thank you to them!

However, I have many family members and friends who have told me their stories. Among the stories, there are so many similarities. 7 years old, summer holidays, rickety old stairs, elderly lady, pain, the promise of ice-cream. Then as they became teens, and entered their 20’s, the realization and full physical, emotional, and mental impact of what had happened. 

Then: why did it happen to me?  There is no answer, except that it was done and continues to be done. 

The workshop has been incredible, learning the stories of other people, their honesty, reading their emotions, how they have coped, and moved forward. It takes courage to accept what has happened and even more courage to speak about it to strangers. 

As a pelvic physical therapist, I help women with pelvic rehabilitation throughout their lifespan. I want women to be aware about the resources available for them and their pelvis:

• Health care providers, including medical doctors, talk therapists, and physical therapists who specialize in all things pelvic. 
• Organizations, blogs, and medical journal articles.
• Community groups

As was the case in the Voices workshop, we should celebrate each other and work together, educating each other to stop this practice, and protect future generations.

Nazneen Vasi belongs to the Bohri community and advocates against the cultural practice of FGM/C. She currently resides in NY and works in women's health rehabilitation. 

Disclaimer

This blog was produced by Sahiyo under 15POVC-21-GG-00988-NONF, awarded by the Office for Victims of Crime, Office of Justice Programs, U.S. Department of Justice. The opinions, findings, and conclusions or recommendations expressed in this guide are those of the contributors and do not necessarily represent the official position or policies of the U.S. Department of Justice.

By Muna Osman

Why did you want to attend the workshop and share your story?

I first found out about the Voices workshop when I met with Mariya. The meeting was in a different setting; I had no idea about the workshop before she told me about what Sahiyo does with these stories. After that meeting, I went back and looked at the videos and something struck a chord in me. The experience had always been in the back of my mind, but interestingly, I never actually sat down and thought of those moments. Maybe I didn’t have the courage, or maybe I just didn’t want to be the first to put myself out there. It’s a very taboo topic, and I didn’t know what doors I would open by talking about my experience. 

 When I was exposed to Voices, I began contemplating sharing my story. When I talked to my husband about it, he asked me what I would add to the story. He said, you already know what happened to you. What will you add in the story? I said, no I don’t know what happened to me. At that moment, I started crying, realizing that for fifty years I had not spoken about this to anyone. That’s when I decided that I had to share my story for myself; I had to acknowledge that this had happened to me. 

What story did you choose to tell and create into a digital story?

So because I had never spoken about this experience before, I didn’t know where to start. There was so much I had to say, but it was all coming at me from multiple directions. There was one thing that struck me most while remembering my story– my mother’s face. I was screaming and crying for help, and my mother’s face was cold and unflinching. She ignored my cries for help. I can see her face right now. 

That really has had an impact on who I am today. It is because of that memory that I cannot fully trust others; I never give anyone 100% access to me. After I made that connection, I decided that I wanted to tell my digital story using the voice of my younger self, a kid with no power. 

What have you learned or most enjoyed during the workshop and by meeting others who shared their stories?

I most enjoyed just that– meeting others who vocalized their stories and shared their experiences. Their stories normalized my own; their feelings validated mine. In the beginning, listening to others’ stories was very hard. At the end of each session, they kept saying: take care of yourself. But I felt like the session was taking care of me. I opened up. I started talking and writing about this experience, and started recording myself. 

As a nurse practitioner, it’s part of my job to talk about FGM. I’ve always been an advocate against it. I’ve talked about the short-term and long-term side effects, and the consequences survivors can live with. But as a professional, I feel a distance as I speak about this; I’m standing there talking to people about this practice and what they should and shouldn’t do, and I have a wall put up in front of me. 

What kind of impact would you like your story to have? 

I want every woman who lives in a community that practices this (because I know they do it in good faith, it’s a culture) to see the perspective of that child that they are overpowering and hurting. I want them to feel the pain, and hear the child who is going to go through such immense pain. 

Is there anything in your digital story that you would like to share?

Yes! I want to mention the artist who made the sketches for me. She took my story, listened to it, and illustrated it in a respectful way. She took my voice and what she knows about me and created such a detailed portrayal of my story. When I saw it, I was shook. It was like a flashback. The fan I talked about, the walls, the thing they put in my mouth (I think it was a sock), the rope they tied my legs with, the colors of the culture! She illustrated everything in a way that brought me back to that room. I really appreciate her work, and so I wanted to call her out. She’s a hidden artist, you know, she does it for fun. She paid so much attention to detail and it means so much to me. She’s really talented; she’s a hero and she came through for me. 

Dr. Muna Osman is a Doctorate Prepared Nurse Practitioner, and Board Certified Family medicine. Have accumulated professional experience as nurse 16 years and as Nurse Practitioner 5 years. She is the founder of Holistic Family Care & Aesthetics; also a Co-founder of Mama Amaan (Safe motherhood) Health Research group. She is a co founder if Washington coalition to end FGM/C. She is fluent in Arabic, Somali, and English. Her professional and research work focuses on innovative health care services and Health equity for refugee women healthcare and antenatal care.

Disclaimer
This blog was produced by Sahiyo under 15POVC-21-GG-00988-NONF, awarded by the Office for Victims of Crime, Office of Justice Programs, U.S. Department of Justice. The opinions, findings, and conclusions or recommendations expressed in this guide are those of the contributors and do not necessarily represent the official position or policies of the U.S. Department of Justice.

By Trisha Kini

On June 24, 2022, the U.S. Supreme Court made the devastating decision to overturn Roe v. Wade, thus denying women and those assigned female at birth (AFAB) the right to safe abortions and bodily autonomy. Bodily autonomy, the foundation for gender equality, is a fundamental human right that impacts health, education, income, and safety. The lack of access to abortion in the absence of  Roe vs. Wade not only has harmful consequences for people with unintended pregnancies, but could also disproportionately impact women and AFAB people who may belong to communities that practice female genital cutting (FGC). 

Several harmful health complications can arise during pregnancy or childbirth for a survivor of FGC. According to a study by the World Health Organization, the perinatal mortality rate of FGC (type III)* survivors was higher than non-survivors by 55%. The study also found that survivors had a higher rate of cesarean sections, genital tract trauma, and postpartum hemorrhages. Survivors of FGC deserve the right to equitable healthcare options to protect them from these potential high risk, life threatening consequences; this includes the right to safe and legal abortions. 

Sahiyo interviewed three professionals involved in the anti-FGC movement across public health, reproductive health, and law disciplines in an effort to understand if the overturning of Roe v. Wade could impact survivors of FGC. The following explores highlights of our conversations surrounding abortion, FGC, health disparities, and reproductive health stigma with Karen McDonnell, PhD, Associate Professor, Milken Institute School of Public Health, and Author of FGM Toolkit; Sakina Sharp, Co-Founder of Awaaz, Lawyer, and Sahiyo Board Member; and Lizzy Dupont, MD, OBGYN. 

*Also known as infibulation, FGC Type III is the narrowing of the vaginal opening through the creation of a covering seal (WHO)

Reproductive Health, Justice, and FGC

Reproductive health and justice, which are essential human rights, imply that persons should be able to have the choice and freedom to safely reproduce, and to decide if and when they want to do so. Both the overturning of Roe v. Wade and the harmful practice of FGC directly inhibit reproductive health and justice.   

Dr. Karen McDonnell, Associate Professor in Prevention and Community Health, emphasized that ruling Roe v. Wade is important for an individual's right to bodily autonomy, and their sense of choice, trust, and safety. The overruling also disproportionately impacts those who experience distrust in healthcare, and this often includes survivors of FGC.

“To have that trust be violated really does inhibit our reproductive justice and our reproductive health. FGC does affect women's reproductive health and well-being. That has been demonstrated, and so by taking that freedom, trust, and care away, you're already talking about a vulnerable group of women from the start. Now you're making them even more vulnerable.” 

It is not uncommon for survivors of FGC to feel hesitant when seeking healthcare in general. Dr. Dupont works with individuals primarily identifying as women through adolescence, birth control consultation, and pregnancy of various types, including patients who have undergone FGC. She highlighted how excluding FGC as part of the medical school curricula impacts the quality of care providers offer, thus affecting survivors of FGC. 

“We're certainly not trained (in most medical schools or residency programs) on how to care for women who have undergone FGM/C. And so patient’s anxieties about approaching us as providers or about having an exam are well-founded.”

Could this additional layer of concern caused by the overruled Roe further result in barriers for survivors of FGC seeking abortions? 

Drawing Parallels: The Overruled Roe vs. Wade, FGC, and Bodily Autonomy

We often found parallels in our conversations surrounding FGC and the overturn of Roe vs. Wade. Sakina Sharp, a lawyer who has several years of experience in advocacy against domestic violence and FGC, drew a preliminary connection to women’s agency when discussing the connection between the Dobbs decision (which overturned Roe v Wade) and FGC. 

“The issue of FGC is around taking away women's agency. Decisions are made on behalf of women and little girls without them ever knowing about it or consenting. And the Dobbs decision does the same, right? It takes away women's agency, it takes away their right to decide what they want to do with their bodies. You want to see laws trending in a way where in a modern society there is recognition of women as full beings and women being able to do what they want to do with their body.” 

Even though the overturn is not directly connected to the human/women’s rights issue of FGC, it is a step back in the movement to give women power over their bodies. 

Dr. Dupont drew a similar parallel when addressing the importance of respecting patients' decisions. 

“In general, in all of reproductive health, we want to respect the patient's autonomy and ability to make decisions for herself/themselves. I think, FGC and abortion care both fall under that ethical principle. The underlying principle is that as physicians or midwives, nurses, nurse practitioners, whatever provider may be seeing the patient, it's our job to respect the patient's autonomy and to support their desires clinically.” 

Health Disparities 

A study at Kaiser Family Foundation found that the overturning of Roe v. Wade disproportionately impacts women of color; this is caused by health disparities such as limited access to healthcare, as well as underlying systemic inequities that make access to abortion (particularly for those living in states where it is now illegal) more challenging. 

Dr. McDonnell explained that survivors of FGC may now be at a larger disparity, as FGC is largely practiced by communities of color. 

“When you look at the prevalence, when we ask about FGC worldwide, we do see that majority of women are women of color who have experienced FGC, so you'd take knowing that and then what the overturning of Roe v Wade is going to do to exacerbate those disparities and further limit the quality of care, the access to care. It goes to show that we are going to see those disparities further exacerbated without those safeguards that Roe v Wade has instilled.” 

Dr. Dupont highlighted that the decision impacts any group of people who already have limited access to medical care. 

“It's not just people affected by FGC, it's people of color, and people of low socioeconomic status. It's low health literacy, low English competence. All of these people are going to have even more limited access to abortion care. So let's say somebody already doesn't have insurance, doesn't speak English, doesn't know how the hospital system works, and has also undergone FGC. That's one more barrier that limits their access.” 

Abortion Stigma 

The Planned Parenthood Action Fund defines Abortion Stigma as the set of attitudes and beliefs, conscious or unconscious, that abortion is bad, shameful, or wrong. 

Sakina Sharp highlighted the parallels that exist within the experience of having undergone FGC and seeking an abortion, particularly around stigma. While FGC is a practice impacting those AFAB in over 90 countries across Africa, Asia, the Middle East, as well as diaspora communities, it remains a difficult issue to openly talk about. This is often due to the secrecy and shame associated with the practice, otherwise known as stigma. The stigma of having undergone an abortion or seeking one can be similar to that of experiencing FGC. 

“It's very similar in terms of the shame that a woman has to bear when she's going through a situation where, you know, she might feel alone and she can't just go to Planned Parenthood and get an abortion, especially in Texas. Or in Oklahoma, right? And then she has to seek out resources sometimes without any support.” 

Healthcare systems and supporting survivors of FGC

As the post Roe era unfolds, it is imperative that healthcare systems take action to support survivors of FGC when providing their services. Our speakers stressed the importance of learning about the practice as a first step. Dr. Dupont highlighted the essentiality of incorporating FGC into the national standard of education for medical professionals. 

“Anyone who's going to do a pelvic exam needs to be familiar with the history, the terminology and basic management.”  

Dr. McDonnell shared a similar perspective on how providers can better support survivors; she discussed the importance of utilizing existing resources such as the FGM/C toolkit. If providers are not able to advise patients seeking abortions, they should be able to provide resources for patient support, even if it is an online provision of resources. 

“This is what we need to be doing immediately while we're working on a state and on the federal level to recreate the provisions that were afforded by Roe v. Wade. So we have an immediate need and we can't lose sight of where we need to go.” 

As we finished interviews, this quote by Sakina Sharp stood out to me as an action step going forward:

“I think there needs to be a recognition that these issues are connected. That it's sort of trauma on top of trauma for people who have experienced… both or have the ability to experience both. I also think it's important for organizations like Sahiyo or organizations, who are, you know, focused on FGC, to understand that there is a connection between the two [FGC and access to abortion] and stand with the people who are working on increasing access to abortion.”