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It took Serat years of struggle and sleepless nights to find the courage to defy her family’s wishes, but this summer the Ontario woman travelled to California for revolutionary new surgery to reverse the genital mutilation she endured as a teenager.
“It’s finally something I can move on from, can stop obsessing over,” says Serat, whose name has been changed to protect her privacy. After a Citizen story in March 2014 highlighted Serat’s plight, readers donated a plane ticket and $1,400 to help pay for the procedure.
There is little awareness — among victims and doctors alike — of the possibility of clitoral reconstruction here in Canada. Women must travel to the U.S. or Europe to get it.
It’s been a long, and painful journey for Serat, a charismatic 26-year-old who came to southern Ontario from war-torn Somalia at the age of five.
When she was 13, her aunt took her back to the Horn of Africa to visit her mother, who still lived there. When her mother discovered that Serat’s genitals were intact — unlike all the other girls her age in the community — she summoned a woman known as a ‘cutter.’ Early one morning, with the help of two others, the woman held Serat down in the mud hut where she’d been sleeping, spread her legs and cut off the tip of her clitoris and part of her labia.
Serat became one of the more than 125 million victims that UNICEF estimates have been subjected to female genital mutilation (FGM), mostly in the 29 countries in Africa and the Middle East where it is practised.
The physical scars eventually healed and the pain subsided, but the years of mental torment were just beginning.
This thoroughly Canadian girl had become a victim of what is a routine cultural practice thought to prevent promiscuity and make a girl marriageable in some African communities. To Serat, who’d never even heard of FGM before her trip, the practice was as foreign as rain falling in the desert.
For 15 years, Amran Mahamood made a living circumcising young girls in Somalia. Four years ago, she gave it up after a religious leader convinced her the rite was not required by Islamic law. She now fights the practice, also known as female genital mutilation.
“I didn’t know what happened to me,” she says, tears streaming down her face.
When she returned home from Africa, Serat locked herself inside a cocoon of self-imposed silence, unable to find help and unwilling to share her terrible secret with friends.
“I couldn’t stand the idea of the pitying looks,” she says. If affected every part of her life, and as the years went by, she suffered from depression and lacked self-esteem. She feared rejection and eventually became embroiled in an emotionally abusive relationship with a man from her Somali community who understood what she’d gone through.
Then, six years ago, a sliver of hope appeared. On the Internet she read about a French urologist, Pierre Foldes, who was pioneering reversal surgery for victims of FGM.
Foldes says it’s a little known fact that the clitoral body extends several centimetres under the skin, and even when the tip of the clitoris has been cut off, a lot of sensitive erectile tissue remains. By removing the scar tissue, Foldes says, some of the erectile tissue can be brought to the surface, often relieving pain, improving sexual sensation, and resulting in a more normal appearance.
Foldes has performed around 5,000 of these reconstructions, and has also taught the surgery to other doctors, including Dr. Marci Bowers, a transgender surgeon in California who started offering the operation in 2010.
“I was super excited” after contacting Bowers, Serat says. She sent the American surgeon photographs of her vulva, and Bowers promised she could help. With financial sponsorship from an organization called Clitoraid, Serat booked her operation.
But when she told her family of her plans a few days before she was scheduled to fly, they pressured her not to go through with the operation.
Bowers was not surprised.
“There are so many disincentives, there are so many people that worry ‘what’s my family going think, is this going to re-traumatize me, will it work’,” Bowers says.
Bowers does the surgery for free, but the operating room and travel costs add up to several thousand dollars. When Serat cancelled, she lost the sponsorship money to pay for the operation.
After the Citizen’s story appeared, though, readers offered to help. About a dozen people contributed enough to cover the $1,400 U.S. fee for the operating theatre. One Citizen reader, Ottawa businesswoman Kathy Jones, was so moved she bought an airline ticket for Serat, who now lives in the Toronto area.
“To know that I can do one small thing to help a woman change her life,” Jones says, “that is so rewarding for me to do that.”
The money sat in a bank account, and a year and a half and two more failed dates with destiny went by before Serat finally conquered her fears. Then, as the August sun rose over the city of San Mateo in the San Francisco Bay area, Bowers folded Serat into her arms as they met for the first time.
More than 20 Canadian women had already made the pilgrimage to Bowers’ surgery.
In some of the countries where FGM is most prevalent, cutting involves removing the tip of the clitoris, all the labia, and suturing the vagina virtually shut, leaving only a tiny opening the size of a pinhole for urination and menstruation. Called infibulation, it can cause a lifetime of pain and other complications. Fortunately for Serat, her mutilation was not extreme.
After the examination, Bowers told Serat she could restore her vulva and improve sensations, and that her genitalia would look “99.6 per cent like anyone else’s.”
Serat was over the moon. The next day, with a simple 45-minute surgery, Bowers was able to reconstruct virtually normal genitalia for Serat.
Many women’s who’ve been through FGM think they have no clitoris left, but Bowers says that removing the tip of it is ‘“like taking a chip off the iceberg and thinking it’s going to sink. It doesn’t happen.”
Clitoral reconstruction is now available in a handful of European countries, including Switzerland, where it’s covered by health insurance. Dr. Jasmine Abdulcadir, a gynecologist who leads a special FGM clinic at Geneva University hospitals and is an FGM consultant for the World Health Organization, says the surgery is promising but cautions that the surgery is not yet well documented and more studies are needed to determine possible complications, safety, and efficacy.
Abdulcadir says that because many women with FGM do actually experience some sexual pleasure, and sometimes even orgasm, counselling is often enough to restore body image and a sense of self. Patients who do go ahead with the operation have psychosexual multidisciplinary assessments and care before and after the surgery.
“You have to take care of her brain, her heart, her past experiences, her genitalia,” says Abulcadir. “All these aspects contribute to a good sexual function.”
In Canada, there is no such multi-disciplinary approach, no specialized FGM clinics, no clitoral reconstruction available, and no official government statistics on the prevalence of FGM.
“There is a code of silence, and that’s why we don’t find out,” says Raheel Raza, a human-rights activist and the president of the Council of Muslims Facing Tomorrow, based in Toronto.
“The feminist movements have not touched this issue, and if it was white girls, they would have,” Raza says. “Which part of cutting off a girl’s genitals is not barbaric?”
In the United Kingdom, there are numerous organizations helping FGM survivors including a help line, and a new law in England and Wales requires professionals including teachers, doctors and social workers to report any cases of FGM among children under 18. The British government also requires hospitals to keep statistics on the prevalence of FGM in its patient population. Support materials are available to schools both to educate and to help prevent FGM.
In contrast, there no organizations in Canada dedicated to FGM prevention or education, and no tracking of girls and women affected, despite the large numbers of immigrants from affected communities.
An analysis of the 2011 Canadian census and UNICEF’s statistics on the prevalence of FGM in the communities that practice it indicates there could be upwards of 80,000 survivors living in Canada — including thousands of young girls and teenagers — and yet there is little help available here.
Dr. Hassan Shenassa, an Ottawa gynecological surgeon, has seen many FGM survivors in his office. The older generation of women who came here as adults have positive body image, he says. They accept and even approve of what happened as part of their culture.
But it’s a different story with women who came as children and have become part of Western society and culture. Many have sat in his office, crying.
“Some of them say this is an assault and that it ruined their lives; they can’t enjoy sex and a lot of them can’t even have sex.”
Shenassa can’t forget one beautiful, bright law student who came to him for help. Like Serat, she’d come to Canada as a toddler and was sent back to Somalia for a holiday, on her own, at thirteen. When she got there, she discovered that she’d been sent for what’s called ‘vacation cutting,’ and was forced to undergo the most severe form of FGM.
“It was such a betrayal of trust by her family … she was a Canadian girl,” he says.
Shenassa was able to deinfibulate her — opening the scar tissue over the vagina to enable her to urinate and menstruate without pain, to have sex, and eventually to bear children vaginally — but he had no way to treat her emotional pain.
He didn’t know about the possibility of clitoral reconstruction, but says he may be interested in pioneering the procedure in Canada.
“I’m happy to be the lead person for it,” he says. “If it actually works, I’ll start doing it, and learn it and do it properly and teach other people so they can help these women.”
But clitoral reconstruction surgery is unlikely to be widely available in Canada soon because there isn’t much demand for it, according to Dr. Margaret Burnett, the president of the Society of Obstetricians and Gynecologists of Canada.
“It may be that it is not widely known about … (but) if this isn’t being requested or talked about by our patients, then it tends not be a priority for us.”
But Serat dreams that one day every Canadian girl who has suffered like her will have a chance to feel “complete again.”
The morning after her surgery, Serat was looking forward to a future with a better self-image and healthy romantic relationships.
“It’s like finding myself again.”
查看原文...
“It’s finally something I can move on from, can stop obsessing over,” says Serat, whose name has been changed to protect her privacy. After a Citizen story in March 2014 highlighted Serat’s plight, readers donated a plane ticket and $1,400 to help pay for the procedure.
There is little awareness — among victims and doctors alike — of the possibility of clitoral reconstruction here in Canada. Women must travel to the U.S. or Europe to get it.
It’s been a long, and painful journey for Serat, a charismatic 26-year-old who came to southern Ontario from war-torn Somalia at the age of five.
When she was 13, her aunt took her back to the Horn of Africa to visit her mother, who still lived there. When her mother discovered that Serat’s genitals were intact — unlike all the other girls her age in the community — she summoned a woman known as a ‘cutter.’ Early one morning, with the help of two others, the woman held Serat down in the mud hut where she’d been sleeping, spread her legs and cut off the tip of her clitoris and part of her labia.
Serat became one of the more than 125 million victims that UNICEF estimates have been subjected to female genital mutilation (FGM), mostly in the 29 countries in Africa and the Middle East where it is practised.
The physical scars eventually healed and the pain subsided, but the years of mental torment were just beginning.
This thoroughly Canadian girl had become a victim of what is a routine cultural practice thought to prevent promiscuity and make a girl marriageable in some African communities. To Serat, who’d never even heard of FGM before her trip, the practice was as foreign as rain falling in the desert.
For 15 years, Amran Mahamood made a living circumcising young girls in Somalia. Four years ago, she gave it up after a religious leader convinced her the rite was not required by Islamic law. She now fights the practice, also known as female genital mutilation.
“I didn’t know what happened to me,” she says, tears streaming down her face.
When she returned home from Africa, Serat locked herself inside a cocoon of self-imposed silence, unable to find help and unwilling to share her terrible secret with friends.
“I couldn’t stand the idea of the pitying looks,” she says. If affected every part of her life, and as the years went by, she suffered from depression and lacked self-esteem. She feared rejection and eventually became embroiled in an emotionally abusive relationship with a man from her Somali community who understood what she’d gone through.
Then, six years ago, a sliver of hope appeared. On the Internet she read about a French urologist, Pierre Foldes, who was pioneering reversal surgery for victims of FGM.
Foldes says it’s a little known fact that the clitoral body extends several centimetres under the skin, and even when the tip of the clitoris has been cut off, a lot of sensitive erectile tissue remains. By removing the scar tissue, Foldes says, some of the erectile tissue can be brought to the surface, often relieving pain, improving sexual sensation, and resulting in a more normal appearance.
Foldes has performed around 5,000 of these reconstructions, and has also taught the surgery to other doctors, including Dr. Marci Bowers, a transgender surgeon in California who started offering the operation in 2010.
“I was super excited” after contacting Bowers, Serat says. She sent the American surgeon photographs of her vulva, and Bowers promised she could help. With financial sponsorship from an organization called Clitoraid, Serat booked her operation.
But when she told her family of her plans a few days before she was scheduled to fly, they pressured her not to go through with the operation.
Bowers was not surprised.
“There are so many disincentives, there are so many people that worry ‘what’s my family going think, is this going to re-traumatize me, will it work’,” Bowers says.
Bowers does the surgery for free, but the operating room and travel costs add up to several thousand dollars. When Serat cancelled, she lost the sponsorship money to pay for the operation.
After the Citizen’s story appeared, though, readers offered to help. About a dozen people contributed enough to cover the $1,400 U.S. fee for the operating theatre. One Citizen reader, Ottawa businesswoman Kathy Jones, was so moved she bought an airline ticket for Serat, who now lives in the Toronto area.
“To know that I can do one small thing to help a woman change her life,” Jones says, “that is so rewarding for me to do that.”
The money sat in a bank account, and a year and a half and two more failed dates with destiny went by before Serat finally conquered her fears. Then, as the August sun rose over the city of San Mateo in the San Francisco Bay area, Bowers folded Serat into her arms as they met for the first time.
More than 20 Canadian women had already made the pilgrimage to Bowers’ surgery.
In some of the countries where FGM is most prevalent, cutting involves removing the tip of the clitoris, all the labia, and suturing the vagina virtually shut, leaving only a tiny opening the size of a pinhole for urination and menstruation. Called infibulation, it can cause a lifetime of pain and other complications. Fortunately for Serat, her mutilation was not extreme.
After the examination, Bowers told Serat she could restore her vulva and improve sensations, and that her genitalia would look “99.6 per cent like anyone else’s.”
Serat was over the moon. The next day, with a simple 45-minute surgery, Bowers was able to reconstruct virtually normal genitalia for Serat.
Many women’s who’ve been through FGM think they have no clitoris left, but Bowers says that removing the tip of it is ‘“like taking a chip off the iceberg and thinking it’s going to sink. It doesn’t happen.”
Clitoral reconstruction is now available in a handful of European countries, including Switzerland, where it’s covered by health insurance. Dr. Jasmine Abdulcadir, a gynecologist who leads a special FGM clinic at Geneva University hospitals and is an FGM consultant for the World Health Organization, says the surgery is promising but cautions that the surgery is not yet well documented and more studies are needed to determine possible complications, safety, and efficacy.
Abdulcadir says that because many women with FGM do actually experience some sexual pleasure, and sometimes even orgasm, counselling is often enough to restore body image and a sense of self. Patients who do go ahead with the operation have psychosexual multidisciplinary assessments and care before and after the surgery.
“You have to take care of her brain, her heart, her past experiences, her genitalia,” says Abulcadir. “All these aspects contribute to a good sexual function.”
In Canada, there is no such multi-disciplinary approach, no specialized FGM clinics, no clitoral reconstruction available, and no official government statistics on the prevalence of FGM.
“There is a code of silence, and that’s why we don’t find out,” says Raheel Raza, a human-rights activist and the president of the Council of Muslims Facing Tomorrow, based in Toronto.
“The feminist movements have not touched this issue, and if it was white girls, they would have,” Raza says. “Which part of cutting off a girl’s genitals is not barbaric?”
In the United Kingdom, there are numerous organizations helping FGM survivors including a help line, and a new law in England and Wales requires professionals including teachers, doctors and social workers to report any cases of FGM among children under 18. The British government also requires hospitals to keep statistics on the prevalence of FGM in its patient population. Support materials are available to schools both to educate and to help prevent FGM.
In contrast, there no organizations in Canada dedicated to FGM prevention or education, and no tracking of girls and women affected, despite the large numbers of immigrants from affected communities.
An analysis of the 2011 Canadian census and UNICEF’s statistics on the prevalence of FGM in the communities that practice it indicates there could be upwards of 80,000 survivors living in Canada — including thousands of young girls and teenagers — and yet there is little help available here.
Dr. Hassan Shenassa, an Ottawa gynecological surgeon, has seen many FGM survivors in his office. The older generation of women who came here as adults have positive body image, he says. They accept and even approve of what happened as part of their culture.
But it’s a different story with women who came as children and have become part of Western society and culture. Many have sat in his office, crying.
“Some of them say this is an assault and that it ruined their lives; they can’t enjoy sex and a lot of them can’t even have sex.”
Shenassa can’t forget one beautiful, bright law student who came to him for help. Like Serat, she’d come to Canada as a toddler and was sent back to Somalia for a holiday, on her own, at thirteen. When she got there, she discovered that she’d been sent for what’s called ‘vacation cutting,’ and was forced to undergo the most severe form of FGM.
“It was such a betrayal of trust by her family … she was a Canadian girl,” he says.
Shenassa was able to deinfibulate her — opening the scar tissue over the vagina to enable her to urinate and menstruate without pain, to have sex, and eventually to bear children vaginally — but he had no way to treat her emotional pain.
He didn’t know about the possibility of clitoral reconstruction, but says he may be interested in pioneering the procedure in Canada.
“I’m happy to be the lead person for it,” he says. “If it actually works, I’ll start doing it, and learn it and do it properly and teach other people so they can help these women.”
But clitoral reconstruction surgery is unlikely to be widely available in Canada soon because there isn’t much demand for it, according to Dr. Margaret Burnett, the president of the Society of Obstetricians and Gynecologists of Canada.
“It may be that it is not widely known about … (but) if this isn’t being requested or talked about by our patients, then it tends not be a priority for us.”
But Serat dreams that one day every Canadian girl who has suffered like her will have a chance to feel “complete again.”
The morning after her surgery, Serat was looking forward to a future with a better self-image and healthy romantic relationships.
“It’s like finding myself again.”
查看原文...
