Dear Maasi is a column about everything you wanted to know about sex and relationships but were afraid to ask! It’s a partnership between Sahiyo and WeSpeakOut, and is for all of us who have questions about khatna (female genital mutilation/cutting or FGM/C) and how it impacts our bodies, minds, sexualities, and relationships. We welcome you to submit your anonymous questions. 

Dear Maasi,  

I am a man, and I have a few questions about FGM/C. I am wondering why it is that women who have gone through FGM/C continue to do it to their young ones? 

— Anonymous 

Dear Anonymous, 

Thank you for this question—it’s so important that men engage in these conversations too. It does sound counterintuitive that someone who has experienced FGM/C would wish to inflict it on their kids. But this issue is complex.  

• The writer and activist Mona Eltahawy asserts that “women are the foot soldiers of the patriarchy.” This means that while the men hold the power and make the rules, women are required to enforce them, consciously and unconsciously. Women often participate in patriarchy to remain safely within the bounds of community expectations and to resist the risk of being ostracized or outcast.  
• Leyla Hussein, a survivor, activist, and psychotherapist, challenges people to think about the ways that men quietly but directly support the practice, financially and morally. Maybe it’s not all on the women? 

I also think that to perpetuate FGM/C, the survivor must believe that FGM/C doesn’t cause harm. This belief is maintained by: 

• Not being able or willing to challenge or disobey religious/cultural leaders who spread myths that FGM/C is required, harmless, or beneficial. 
• The secretive, taboo nature of this social norm means that it’s hard to talk about it, let alone question its harm. 
• A lack of sexual education. This results in poor knowledge about sexual pleasure and function. It also helps to maintain toxic and patriarchal notions about sexuality and gender norms. 
• The traumatic and gaslighting nature of FGM/C may result in survivors doubting their own experience and/or not remembering some or all the details. 
• Another aspect of the trauma is that some survivors might not want to question FGM/C’s psychosexual harms, because it means facing a Pandora’s box they are not ready to open. Instead, they may steadfastly refuse to acknowledge the harm and opt to stay in denial of both their own and others’ pain. 

Silence maintains the status quo. Thankfully, we’re getting louder! Sahiyo, WeSpeakOut, and other survivor-led groups raise awareness and create spaces for storytelling and dialogue.  

And there is a group for male allies who would like to help end FGM/C – Bhaiyo – which I hope you’ll tell your friends about. 

Anonymous, I hope that clears up some of your confusion. Stay tuned for answers to your other questions, which I’ll get to in the coming months.  

And as always, remember that sexual pleasure is our birthright! 

—Maasi

About Maasi, aka Farzana Doctor:
Farzana is a novelist and psychotherapist in private practice. She’s a founding member of WeSpeakOut and the End FGM/C Canada Network. She loves talking about relationships and sexuality! Find out more about her at http://www.farzanadoctor.com

Disclaimer:
While Farzana is full of good advice, this column won’t address everyone’s individual concerns and should not be used as a substitute for professional medical or psychological care.

On May 30th, RTI International hosted a training for social workers on female genital cutting (FGC). Recognizing that many first responders and clinical providers in the U.S. are not adequately equipped to address FGC in their practice, this training provided continuing education units for licensed social workers. The training provided an introductory foundation for understanding what FGC is, including its prevalence in the U.S. and globally, and best practices for working with survivors of FGC. Overall, the workshop sought to increase attendees’ confidence in talking about and addressing FGC in their practice and provided resources to build further knowledge on the topic.

Derrick Simiyu is a programs, monitoring and evaluation professional and passionate about upholding women’s rights and gender equality which drove him to volunteering in a community based organisation that supports girls in areas of Sexual Reproductive Health Rights (SRHR) and Menstrual Hygiene Management (MHM).

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

The first time I heard about FGC was after high school. This came about as a result of networking with an activist against the extensive FGC in Kenya. I learned through this experience how dangerous FGC is and how activism is necessary to stop this damaging practice.

When and how did you first get involved with Sahiyo?

I first heard about Sahiyo in 2022. This was during my volunteership period in a community-based organization that champions for the rights of girls and young women. I realized that Sahiyo has the same values as the organization and so after seeing the opportunity for an internship, I immediately applied. I got an interview opportunity and that is how I first got involved with Sahiyo. 

What does your work with Sahiyo involve?

I currently work in Sahiyo as an events and programs intern. My work at Sahiyo involves researching new topics for webinars, planning webinar agendas, attending virtual events from other organizations, and writing reflections about webinars for Sahiyo’s blog.

How has your involvement with Sahiyo impacted your life?

When I first heard about FGC, I thought it was just a light matter that only affected women from marginalized communities in Kenya. My mindset changed when I got involved with Sahiyo because I realized that FGC was not only an African issue but a global issue that affects more than 92 countries in the world. Sahiyo has made me more mindful and careful with my words, especially toward survivors and practicing communities. I am more mindful of using cutting rather than mutilation because I now know the psychological effects that come with the word mutilation on the practicing communities and the survivors of FGC.

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

FGC has an impact on men as well as women in society. Men are indirectly affected when their daughters, spouses, or girlfriends have had FGC even though they are not directly afflicted in the same way that women are. This is why it is important for all men to join the fight against  FGC. Through Bhaiyo, Sahiyo has the structures in place for that. It is plain and simple: anyone can get involved in this movement and use their skills to combat FGC.

At Sahiyo, we recognize that our work to end female genital cutting (FGC) does not exist outside of Queer liberation, and members of the survivor community who are Queer have distinct experiences that deserve to be seen, heard, and made room for in the FGC sphere. Whether this means incorporating more gender-inclusive language, clarifying that outdated statistics only capture the experiences of women and girls, or providing a sense of community for Queer survivors, we are just getting started.

Pride Month is a time for celebration, protest, and remembrance, of the challenges, and joys, surrounding Queerness and Queer liberation. Occurring every June in homage to the Stonewall Riots, Pride speaks to the enduring spirit of resistance against challenges that have historically affected, and continue to affect, the Queer community. To this end, Pride has a multifaceted purpose: it is as much advocating against the ongoing oppression of Queer folks and calling attention to human rights abuses occurring globally as it is dancing in the street and raucously cheering at a parade.

To celebrate this Pride Month, we chose to uplift an angle of FGC survivorship and Queerness that honors and celebrates joy. Inspired by a conversation with Dena Igusti, a trans non-binary survivor of FGC, the significance of a “joy-centered campaign” became apparent:

“I think it would be really great to see more campaigns where it's seeing folks who are also Queer, who are also survivors, but also, overall, are also just doing well… Just hanging out, having fun, and also showing us outside of just trauma. I think it's one of those things, a combination of wanting to know that exists and that I'm not alone… But also I think it is also nice to know other aspects of these survivors outside of what was done to them.”

To Dena, seeing other survivors, or non-binary folks, outside of the context of their trauma gives them hope:

“What was so important for me was… seeing them outside of [survivorship] and after that; looking back and being like, ‘Yeah, I went through that.’ It was a wild ride, but they get to have this joy and hope of saying everything in past tense. ‘This was horrible.’ ‘This was awful.’ ‘This was painful, but I'm here now.’”

While we continue to push for inclusivity and intersectionality beyond the scope of this month, which includes discussing and working to address the unique challenges that affect Queer survivors, we hope to also uplift and celebrate our community members who are More Than A Survivor; they are here, Queer, and finding their joy. 

By Anonymous

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

I attended the workshop to finally tell my story and give it the voice it deserves. I have

never talked about my experience before, and as someone who wants to help other people share their stories, I knew that it had to start with me. For that reason I found this workshop impactful and learned a lot for myself, including how to work with those I hope to help in the future.

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

The story I chose to tell was very dear to me and something that informs a lot of the work I do

and want to get involved in. As someone who wants to go into the healthcare field, my experience with a a doctor regarding my FGM was not ideal and quite traumatising. I chose to tell my story so that those in the healthcare field better understand their role and impact on their patients.

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

I think I can speak for everyone when I say that I have been uplifted by the strong and kind people that were a part of this workshop. I loved the wide age range and the different ways our experiences have impacted us in different ways.

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

I want those who have not yet vocalized their experiences to see my story and get inspired. It was  very hard and emotionally taxing at first, but the more I spoke and wrote about my story, the more I felt in charge; of how I want to see my story portrayed, most importantly by not allowing my story to be hidden anymore.

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.

Originally written by  Serenity Serafini, PT, DPT

May is Pelvic Pain Awareness Month. Pelvic pain has been reported by some individuals after undergoing the harmful practice of female genital cutting (FGC). This can include pain with vaginal intercourse, termed dyspareunia, which is reported in almost 24.9% of FGC survivors Chronic pelvic pain after FGC has also been reported. In this blog series, Pelvic Health specialist Nazneen Vasi provides tips, strategies, and suggestions for healing pelvic pain amongst FGC survivors. This blog is part two in a two-part series. 

Many individuals report pelvic pain after undergoing female genital cutting (FGC). Pelvic pain often leads to higher tone and tightness within the pelvic floor muscles, and often have difficulty relaxing these muscles as a result of persistent pain. Learning to stimulate the vagus nerve and relax the body can lead to relaxation of the pelvic floor muscles and reduce pelvic pain. This allows the body to heal better and return to a better state of balance.

Stress plays a substantial role in physical health and overall well-being. Understanding the body and how daily habits influence the way it works can be a helpful tool in gaining control over pain and improving quality of life. 

Our autonomic nervous system- the system responsible for regulating the processes of the body- has two components: 

Sympathetic nervous system (SNS): This system is characterized by the “fight or flight” response that prepares us to operate in emergency or dangerous situations.. It also slows down systems that aren’t as important, such as digestion and urination.If a dog is chasing you, you don’t want to stop to pee!

Parasympathetic nervous system (PNS): This system is characterized by the “rest and digest” response that controls our bodily functioning during more ordinary times. The PNS is understood to be largely controlled by the vagus nerve.1 Through this nerve activity, or vagal tone, the PNS is responsible for regulating functions that allow our bodies to rest and restore energy, repair and heal, as well as build our immunity.¹

Both nervous systems are necessary throughout our daily lives and allow us the flexibility to adapt to our surroundings. However, issues arise when we lack appropriate balance and lose our ability to shift seamlessly back and forth between these systems.

How does Stress, the Autonomic Nervous System, and the Vagus Nerve relate to Pelvic Pain?

Individuals with pelvic pain tend to have elevated tone or tension of their muscles at rest and often experience increased difficulty with relaxing their pelvic floor muscles. It is important to seek to resolve originating factors of pelvic musculoskeletal pain, often including an overactive SNS, instead of simply addressing the muscles and soft tissues alone. People who suffer from pelvic pain can benefit from learning how to implement lifestyle strategies that stimulate the vagus nerve and facilitate PNS activity to physiologically quiet the nervous system so the muscles of the pelvis can relax and heal for better long-term effects.  

Six Tips to Stimulate your Vagus Nerve and Decrease Pelvic Pain: 

1. Intentional Deep Breathing:

• In any comfortable position,take deep, intentional breaths, allowing the abdomen and rib cage to expand like a balloon filling up with air.
• Breathe in for four seconds, and out for six to eight seconds. This lengthened exhale increases vagal tone, which helps to destimulate the SNS and increase PNS activity.
• Repeat for 5 breaths with eyes open or closed.

2. Meditation Imagery:

• In any comfortable position, close your eyes and take deep, calm breaths.  If you want, combine this technique with the breathing described above.
• Envision a time, place, or event that makes you feel safe, peaceful, and content. 
• Visualize with all of your senses: what do you see, hear, smell, feel, taste?

3. Hand Warming:

• Imagine one of the following scenarios: a) holding a warm mug of tea,  b) holding your hands over the soft glow of a fireplace, or c) curling your fingers into soft, warm sand.

• Now, envision a warmest color, slowly glowing brighter around your hands and wrists and say or think to yourself, “My fingertips are getting warmer; my palms are getting warmer; my wrists are getting warmer.”
• This technique helps to reset your autonomic nervous system and promotes feelings of calm by improving blood pressure, circulation, and pain response.2
• Practice this for at least 30-60 seconds at a time.

4. Mindfulness Meditation:

• Mindfulness is the practice of being fully present in the moment and allowing ourselves to become aware of where we are, what we’re doing, and what’s happening within our bodies.
• Body scanning is a helpful technique that allows us to practice mindfulness within the context of body awareness and encourages relaxation in a systematic way.
• First, lie in a comfortable position and focus on the sensations of your breathing or your heartbeat 

• Then, begin to notice the muscles of your face and jaw. Slowly let go of each muscle by picturing your body as warm, heavy, and relaxed.
• Continue this process until you have relaxed each part of your body. 

5. Warm Baths:

• Moist heat helps to relax chronically tight, sore muscles and relieve pain.
• Try adding 1-2 cups of Epsom salt for extra relief!
• A warm bath can promote a mental state of relaxation and decrease feelings of stress and anxiety. 

6. “Me Time”:

• Make time for something that makes you happy- whatever that looks like to you.

• Not only is it okay to put aside a little time for yourself, it is necessary.

One thing to note is that practicing relaxation techniques and letting go of stress can sometimes lead to an emotional release, which may be different for each person. If this occurs,notice your thoughts without judgment, and allow yourself to feel however it is that you’re feeling in the moment. Be gentle with yourself. 

It may take time to find the combination of techniques and/or the frequency of performing the techniques that works for you. Keep in mind, these tips help some people, but they might not work for you. Please don’t feel that you’ve failed if these suggestions do not end your pain. 

This blog was created for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a health condition.

References

1. Porges, SW. The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation. New York: W.W. Norton, 2011.

2. Coady, D. Fish, N.  Healing Painful Sex. New York: Seal Press, 2011.

Sahiyo U.S., StoryCenter, and Asian Women’s Shelter would like to announce that recruitment is open for our 2023 Voices to End FGM/C hybrid digital storytelling workshop. 

Since 2015, Sahiyo has provided various storytelling platforms for survivors and community members around the world to share their experiences of female genital cutting (FGC); in particular, Voices to End FGM/C, a digital storytelling project, brings individuals impacted by FGM/C together in order to heal, build community with one another, and create digital stories that can be used to support surivors and educate and prevent future generations form undergoing this harm.

More about the workshop: 

When: The virtual sessions will take place on Tuesday, August 14th and Tuesday, August 22nd, 2023, from 4-6 pm Pacific / 7-9 pm Eastern (U.S. time). In order to be confirmed, applicants must be able to attend all workshop sessions, both virtual and in-person. 

The in-person sessions will take place on August 26th and 27th, 2023, from 9 am to 5 pm PT in Oakland, CA. Please note that the travel days to and from the workshop will be on August 25th and 28th, 2023.

Who: The workshop is open to those based in the U.S. who have experienced FGM/C, as well as family members, friends, advocates, and others who would like to share a story about why it needs to end.

What: Each participant will learn to create their own simple video through the use of voiceover audio, still images, and video clips. This participatory media process will be guided by facilitators from Sahiyo, StoryCenter, and Asian Women’s Shelter.

Following the workshop, Sahiyo will support storytellers in publicly sharing their videos as part of our ongoing education and advocacy work to end FGM/C.

If you’re interested in taking part, please fill out the application by Friday, July 15, 2023.

If you would like more information on this revolutionary storytelling experience, please email Mariya at This email address is being protected from spambots. You need JavaScript enabled to view it..

To view digital stories from previous Voices to End FGM/C workshops, click here. 

By Body Harmony Physical Therapy

May is Pelvic Pain Awareness Month. Pelvic pain has been reported by some individuals after undergoing the harmful practice of female genital cutting (FGC). This can include pain with vaginal intercourse, termed dyspareunia, which is reported in almost 24.9% of FGC survivors. Chronic pelvic pain after FGC has also been reported. In this blog series, Pelvic Health specialist Nazneen Vasi provides tips, strategies, and suggestions for healing pelvic pain amongst FGC survivors. This blog is part one in a two-part series. 

FGC can cause a multitude of physical, emotional, and sexual effects for the person who has undergone it. Some individuals who have undergone FGC continue to report pelvic pain beyond the initial stage of tissue healing. Persistent pelvic pain can be an overwhelming experience. 

Pain, whatever the severity, can consume our thoughts and steal much of our cognitive energy, leaving us feeling exhausted and stressed. Pain can elicit not only physical responses, but also mental and emotional responses; one of the most common outcomes is fear of movement. Often, we become fearful of experiencing the pain itself and we are concerned we might be “making things worse” by moving through our daily activities. After experiencing pain for a while, the brain can begin to anticipate pain and as a result, a person may come to fear movement itself. 

A gentle yoga program can help improve our health and reduce pain by re-establishing comfortable movements and minimizing nervous system responses that increase stress and inflammation.

How Does Yoga Decrease Pelvic Pain?

Yoga is an ancient practice that cultivates awareness through careful observation of the mind, the body, and the present moment. When dealing with pain, it can become easy to disconnect from or even feel resentful of the part of our body that’s experiencing it. Sometimes we can feel hopeless because we don’t understand how to best love and heal the part(s) of us that hurts. The mindful practice of yoga allows us to reconnect with our body and observe it as it is. Introducing conscious breathing and slow movements at the pelvis, hips, ribcage and spine that feel safe, and maybe more importantly, feel good is essential to the process of healing.

Yoga, under the right guidance, can help to:

• decrease anxiety, depression, and fear
• encourage mental and emotional grounding
• enhance body awareness and the mind-body connection
• balance the nervous system to promote rest, relaxation, and restoration
• lengthen and stretch muscles/soft tissues
• support the functional relationship of the diaphragm and pelvic floor
• re-educate muscles and correct muscle imbalances
• improve strength and balance

8 Gentle Yoga Poses to Reduce Pelvic Pain

Remember, these postures and movements should feel good. Move, stretch, and breathe within your own comfort zone at a speed that feels right for you. If these poses or movements hurt, stop and consult a pelvic health physical therapist. If you are pregnant or have hypermobility disorders or mixed connective tissue disorders such as Elhers Danlos, consult a physical therapist first before engaging in a yoga practice.

Happy Baby

Benefits: Stretches and decreases the activity of the muscles of the pelvic floor and the inside of the thigh.

Bound Angle (seated, supported reclined, or laying down)

Benefits: Hip opening stretch for the muscles and connective tissues of the inside of the thighs.

Supported Savasana

Benefit: Calms the nervous system and relaxes the lumbo-pelvic girdle. This is a great pose for the end of a busy, stressful day. Here you can perform deep breathing exercises, meditation, or relaxation techniques such as progressive muscle relaxation and mindful body scans.

Supported Child’s Pose

Benefits: Child’s pose is often a very soothing posture that calms the nervous system. Mimicking the fetal position, child’s pose can evoke feelings of safety and peace. This pose also increases flexibility of the lumbopelvic region and allows us to breathe deeply into the back and sides of our ribcage.  

Table Top Rock Backs:

Benefits: For some people, child’s pose might feel too intense as it requires a lot of bending at the hips which may irritate people who have pudendal neuralgia or tight hips/pelvis musculature. Rock backs are a good way to ease into a more flexed hip position and isolate controlled mobility of the hip joints.

Cat Cow 

Benefits: Improves spinal mobility and segmental control of our vertebrae. Spinal mobility plays an important role in pelvic health as the pelvic floor attaches to our tailbone- the base of our spine. We also need spinal mobility and control in order to breathe optimally and activate our core efficiently.

Supported Puppy

Benefits: This pose helps to lengthen the spine and maximally stretch the pelvic floor muscles.

Sphinx

Benefits: Stretches and lengthens abdominal connective tissues and the front of the hips. Sphinx also helps to strengthen the shoulders and increases spinal mobility.

For more information and videos on yoga for pelvic pain, check out Dustienne Miller, CYT, PT, MS, WCS at Your Pace Yoga.

Keep in mind, there is no one size fits all yoga or exercise program! These yoga postures and movements can provide gentle, pain-free movement alternatives to help you manage your pain, but you still may need to schedule an appointment with a pelvic health PT to create a comprehensive, holistic plan to address your specific needs. Contact Body Harmony Physical Therapy to learn more about movement alternatives, relaxation techniques, and pain management strategies for pelvic pain.

This blog was created for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a health condition or before beginning a new exercise routine.