By Kiah Leone

In celebration of World Sexual Health Day on September 4th, I had the opportunity to sit down with Dr. Awwad to learn about the types of care and support Restore offers survivors as they navigate their relationships with their bodies, their partners, and themselves. The results of this discussion will be shared in two parts: I first explore how FGM/C impacts survivors' sexual health and the types of surgical and non-surgical therapies Restore offers their patients. The second part of this series will discuss tailoring sexual education for survivors and Restore’s role in FGM/C prevention.

When Restore opened in June 2020, it became Egypt’s first-ever multidisciplinary female genital mutilation/cutting (FGM/C) clinic. Co-founded by aesthetic and reconstructive surgeon Dr. Reham Awwad and urogynecologist and aesthetic gynecologist Dr. Amr Seifeldin, Restore offers a patient-centered approach to health care, where every FGM/C survivor’s treatment plan is tailored to meet their individual needs. Clinicians provide a number of different treatment options, but what makes Restore multifaceted is their emphasis on non-surgical interventions and helping survivors by practicing psychosexual care and sexual education. 

“FGM/C impacts a woman’s sexual health on a massive level. First of all, the way I see it is that it starts from the day it happens”.

In Egypt, FGM/C is most commonly performed between the ages of 7 and 15 years-old, and the pratice will often cause survivors to experience some type of disconnect with that part of their body. 

“There’s a word in Arabic [Kamla], which means complete. So, you always hear women saying ‘I don’t feel complete’, ‘I don’t feel confident’, ‘I don’t want my husband to look at me.’” 

One of the well-known impacts of FGM/C on sexual health is related to physical sensation. Sensations can range from decreased, to painful, to completely non-existent in cases where survivors may have experienced nerve damage. 

“It’s an uncomfortable part of their body that they don’t feel the same about as they do with the rest of their body. At least that’s the impression that I’ve gotten from the women I’ve spoken to.” 

This lack of sensation can negatively impact survivors’ experiences with self-exploration, intimacy, or sexual intercourse with their partners.

To address these cases of limited to no physical sensation, Restore offers survivors a number of different surgical and non-surgical treatment options, ranging from clitoral reconstructive surgery, to regenerative and functional gynecology to platelet rich plasma (PRP) injections into specific sites of the genitalia.  

However, before beginning any of these surgical or non-surgical treatment options, Dr. Awwad will ask patients with decreased sensitivity whether or not they feel pleasure if they are touched anywhere else on their body.

“If [the patient] answers ‘no’ then I know there is definitely a psychological aspect involved.”

This psychological component to physical pleasure is why psychosexual care is crucial for survivors of FGM/C, and why clinicians at Restore employ a multi-disciplinary approach when it comes to tailoring the treatment plans to their patients’ needs. 

“We keep our treatments side by side. For example, if we have a medical intervention that we’re going to do [and] we believe that it will be more successful after psychological counseling, we will wait… you will get a much, much, much better result than if you just do a medical intervention. [With just a medical intervention] you might not get the result that you want. So, we try to push for this when it comes to issues of sexual health”.

This is especially true when it comes to some surgical treatments, such as clitoral reconstructive surgery, where there may be a risk that the patient might relive their experience of being cut. 

“You have to understand that there is a psychological aspect that ties into your sensation. That is why we always, always recommend for every single one of our patients to have at least one free assessment with our counselor or psychosexual therapist.” 

Offering patients at least one free psychological care session is one of the many ways that  Restore is working to eliminate the barriers to care services that survivors of FGM/C face.

“Psychological care costs money. That’s why we are trying to do a program to get funding just for psychosexual counseling, so we can make it easier for [survivors] to continue [care] because we know they will need months of therapy and they can’t afford it.” 

This type of funding would be invaluable to survivors who have had to discontinue their therapy sessions due to financial constraints. When looking toward the future of Restore, Dr. Awwad sees herself and her colleagues not only providing medical treatments and psychosexual therapy, but also conducting research on how to really impact the future of treating FGM/C. 

“It’s important we have more options. Clitoral reconstructive surgery and psychological counselling is not enough – it is not even anywhere close to enough.” 

To find out more about Restore, or to learn how you can support the funding of their curated care-programs for survivors, please visit Restore's website or follow them on Instagram.

Learn more about psychosexual care for FGM/C survivors from Sahiyo’s trauma series here. You can also learn more about the former webinars hosted by Sahiyo on sexual health and wellbeing here and here.

by Abbas Ali Bohari

This is a heartfelt poem about a Bohra father’s greatest regret. The poet, who hails from Indore, India, spent years praying for the birth of a child and was finally blessed with a daughter. A few years later, he found out that she had been subjected to khatna, or female genital cutting, behind his back. This is a poem about his grief for her, his regret, and his plea to the world to end the cutting of girls in the name of religion.

एक पिता का अफ़सोस

कई बरसों रहे दोनों बेकरार

रहमान ने लगाया बेड़ा पार

बुजुर्गों की दुआओं का भी असर

गुड़िया रानी आयी हमारे घर

रौशन कर दिया हमारा संसार

लायी खुशियों की सौगात अपार

अब ना करू किसी की दरकार

मालिक बस तेरा ही शुक्रगुज़ार

हँसते हँसाते गए बरस गुजर

एक दिन ऐसा आया खूंखार

मज़हब के नाम पर मचाया अंधेर

मासूम के जिस्म को किया दागदार

कसम ख़ुदा की मैं नही ख़तावार

पीठ पीछे किया सारा अत्याचार

कही नही मिली दींन में तफ़सीर

हैरां हूं कब से शुरू हुआ ये फ़ितूर

शरीयत का अंग बताते ज़ाहील ज़ोकर

पर मुख़ालिफ़त करते इल्मी ज़ानकार

मगरिबी तहज़ीब करे इंकार

मशरीकी कौमे बैठी लाचार

खत्म करो नाजायज़ विचार

सज़ा पाये सारे जो है हक़दार

*अब्बास* करे अफ़सोस बारबार

बचा ना पाया अपना लख्तेज़िगर

By Umme Kulsoom Arif

This September, from the 15-19th, Sahiyo will host its annual Activists Retreat in person for the first time since the COVID-19 pandemic. For many Sahiyo volunteers and retreat alumni, it will be the first time in several years that activists, volunteers, and survivors will meet in person; we would love to have you attend!

The 2022 Sahiyo Activists Retreat was the first time I spoke about my experience as a female genital mutilation/cutting (FGM/C) survivor in a real-time group setting. Though virtual, being surrounded by other survivors and activists candidly sharing their experiences with one another, offering sympathy and support, was an experience I will never forget, and I am incredibly grateful for it.

Activism is work. Whether private or public, it can feel very exhausting to make yourself vulnerable time and again, speaking about an often stigmatized and hidden subject. It can also feel incredibly lonely to speak out against deeply held convictions and traditions that seem to go back generations. Before 2022, I felt adrift in my trauma and my grief, wanting to be an activist but feeling unsure of what I could provide, and also afraid of the obstacles I would face in speaking up.

In my 2022 Retreat Reflection, I spoke candidly of that fear. My gender identity and sexuality have been shaped by my experience with FGM/C This had lead to me feel reluctant to share my experiences, especially as I myself felt trapped in the angriest stage of grief. The 2022 Activists Retreat, however, came with community and confirmation that my emotions were valid, that I was enough for wanting to speak up and speak out. The 2022 Retreat taught me how to grieve, taught me the value of community, and taught me the most important thing — we are not alone.

This year, in May, I had the honor of attending a one-day virtual retreat, where I met and spoke to survivors and those whose parents protected them from FGM/C, a perspective I had not anticipated hearing from, and simultaneously, one that brought me much joy. The voices of those who have begun to break the tradition of FGM/C are vital to the activist movement, and I am delighted to hear more of them joining the conversation. 

We are delighted to offer travel scholarships for domestic travel to Atlanta, Georgia, as well as housing and meals. I invite you to join us for three days of healing and hope, all supported by Sahiyo’s incredible team and wonderful Retreat Planning Committee.

On August 8th, Sahiyo hosted a training for the Virginia Department of Criminal Justice, titled “Cross-Collaborative Work: Incorporating Female Genital Mutilation/Cutting Survivors into Support Services in Virginia.” Even with growing recognition of FGC in the U.S., many service-providers, including law enforcement, are not adequately equipped to address FGC in the United States. This training provided an introductory foundation for an understanding of FGC, as well as the role the legal system and victims advocates have in addressing and responding to this issue. In addition, the training addressed key competencies and best practices for working with and interacting with survivors of FGC and/or practicing communities. 

This training was attended by 60+ members of the Virginia Department of Criminal Justice Services, including victims advocates, researchers, law enforcement, legal services, healthcare providers, and others.

Sahiyo is excited to announce the upcoming publication of our new report, Examining the Current State of Critical Intersections: Female Genital Mutilation/Cutting and Social oppressions. The report explores how different forms of oppression intersect to limit survivors’ access to resources, as well as how the work to end FGM/C is connected to other themes across the human experience. 

In July 2021, Sahiyo hosted a public webinar titled, “Critical Intersections: Anti-Racism and Female Genital Mutilation/Cutting (FGM/C)." The discussion highlighted how systemic racism negatively effects the fight against FGM/C. The webinar was highly successful, engaging more than 300 people. 

Using that momentum, Sahiyo launched a research project to further understand how different forms of oppression affect marginalized communities that practice FGM/C and how to connect with other activist movements to strengthen our efforts to end FGM/C. 

This report is the first of a series on this research, and identifies current understandings of critical factors intersecting with FGM/C and outline the gaps in our knowledge. The publication is organized around seven core themes that intersect with FGM/C: religion, climate change, feminism, race and racism, law and policy, queer gender and sexuality, and bodily autonomy. This review serves as a significant starting point for Sahiyo’s own data collection for the  Examining Intersections Between FGM/C and other Social Oppressions Research Project, the results of which will be disseminated in Feb 2024.

The Women Deliver 2023 Conference (WD 2023) took place in-person, as well as virtually, from 17-20 July 2023, in Kigali, Rwanda. The conference convened around 6,000 people in Kigali, and over 200,000 people online. Amongst those attending the conference was Jo Keogh, Sahiyo U.S. Advisory Board member as well as a founding member of the Connecticut Coalition to End FGM/C. She reflects on her experience in Kigali:

Many things impressed me about Rwanda: the beauty of the land, the warmth and hospitality of the people, and, of course, the exciting experience of attending the Women Deliver Conference. Being in the presence of people committed to ending FGM/C from all over the globe was both moving and encouraging. Especially profound was hearing stories from frontline workers who have made ending this harmful practice their personal mission. Our own Mariya Taher is among them.

 I knew before traveling to the conference that Mariya is well-known here in the States for her tireless work around ending FGM/C. What I didn’t realize is that she is recognized and respected internationally for that work. Representatives from organizations fighting FGM/C all over the world knew who Mariya was. When I told people at the conference that I was with Sahiyo, their eyes would light up. It was remarkable to witness.

 I am so grateful to have had the opportunity to attend the Women Deliver conference and to understand the impact that Sahiyo has had the world over. The more I learn about Mariya, the more I admire who she is and all that she has accomplished.

Learn more about the 2023 WD Conference.

Sarah is a recent UCLA graduate with an English major and Philosophy minor. Through her experiences in university and teaching abroad, she has developed a strong interest in human rights issues, particularly those affecting women. She is excited to be a part of an organization which amplifies women’s voices and strives to enact change through collaborative discourse and education. 

What was your experience of learning about female genital cutting (FGC) for the first time like?
My friend who plans to attend medical school andand become an OBGYN had learned about FGC in one of her classes, and she educated me on its wide-scale impact. 

When and how did you first get involved with Sahiyo?
I learned about Sahiyo in late 2022 when searching for grant writing internships through LinkedIn. When I stumbled upon Sahiyo’s job posting for a development intern, I took a deep-dive into Sahiyo’s blog to learn more about FGC. What I learned was that my impression of FGC was largely inaccurate. While I thought type 3 FGC was the norm, I learned there are actually 4 types of FGC, with type 1 being the most common. I had also thought FGC occurred mainly in African countries; I learned from Sahiyo that it also occurs in many Asian countries and the U.S. Realizing how little I knew about FGC, I developed an interest in learning more, and knew working for an organization like Sahiyo would provide the opportunity to further my education while also positively contributing to the organization’s daily operations. 

What does your work with Sahiyo involve?
As a Development Intern, I help acquire donors for future fundraising events like our International Women’s Day Celebration and Silent Auction, write donation appeal emails, and draft letters of intent for grant applications. 

How has your involvement with Sahiyo impacted your life?
Sahiyo has opened my eyes to how greatly Americans need to be educated on FGC. Looking back six months ago, I now see how uninformed I was on what FGC even is, let alone its pervasiveness. Working for Sahiyo has allowed me to further understand why FGC occurs, who practices it, and why many communities continue the practice. FGC is a complex, nuanced issue that requires an empathetic approach when educating practicing communities on its harms, instead of pure condemnation. Sahiyo has not only educated me, it has also allowed me to start conversations with people in my community about FGC, which will hopefully have a ripple effect. 

What words of wisdom would you like to share with others who may be interested in supporting Sahiyo and the movement against FGC?
It’s never too late to start educating yourself or others about FGC. Even for those who know about FGC, I encourage you to continue learning, as the work to end FGC is ever-evolving and requires organizations and advocates to employ new tactics for promoting positive change.

Sahiyo is eager to welcome Kaneez Madraswalla as our newest U.S. Advisory Board Member. A resident of New Jersey, Kaneez Madraswalla is a trained lawyer and Vice-President of Compliance at QBE North America, based in New York City

She co-leads the QBE Women’s Initiative Network, facilitating illuminating employee engagement events. Her other volunteering activities have included counseling survivors of domestic violence, refugee assistance, and grassroots political awareness.

Though she was not exposed to female genital cutting (FGC) as a child, Kaneez is an aspiring feminist and Bohra woman raised by a strong mother and enlightened father; she is a strong supporter of Sahiyo and is determined to see the end of FGC in the Bohra community and beyond.