Understanding Female Genital Cutting

aadenw95

UNDERSTANDING

FEMALE GENITAL CUTTING

IN THE DAWOODI BOHRA

COMMUNITY

({A SUMMARY OF SAHIYO’S STUDY})


INTRODUCTION

Since 2015, Sahiyo has been working with the Bohra community

to advocate for an end to the practice of Female Genital

Cutting, also known as Khatna or Khafz. In June 2015, before the

widespread media coverage of Khatna began, Sahiyo started

conducting a six-month online survey of Dawoodi Bohra women

around the world. This was the first such survey on the subject of

Khatna among Bohras.

This document outlines the results of that survey and the lessons

we can learn from it as activists working to end Khatna.

Bohras give many justifications for Khatna, but the Sahiyo survey

findings reveal that it is deeply-rooted in the community’s

culture. That is why, it is crucial for activists to understand the

complex social norms and cultural value systems that shape

this practice among the Bohra community. We must also remember

that there is a window for positive change in the future

generations of Bohras:

Even though 80% of the women surveyed in Sahiyo’s study

were cut, 82% said they would not want Khatna to continue on

their daughters.

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WHAT IS FGC?

Female Genital Cutting (FGC), also known as female genital

mutilation and female circumcision, is defined as “all procedures

that involve the partial or total removal of external genitalia or

other injury to the female genital organs for cultural, religious,

traditional and other non-medical reasons”.

According to the World Health Organization (WHO), this

procedure:

Has no known health benefits

Can cause a variety of both immediate and long-term health

consequences, because it involves removal or damage to healthy

genital tissue

Violates several principles of human rights, women’s rights and

child rights

Now, for the first time, the United Nations organization has

listed the “elimination of FGM/C by 2030” as a target under

Goal 5 of the Sustainable Development Goals.

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({ WHO’S CLASSIFICATION OF FGC )}

- to indicate differences in Types of FGC performed by different communities -

Type I

Partial or total removal of the clitoris and/or the prepuce

(clitoridectomy). When it is important to distinguish between

the major variations of Type I cutting, the following subdivisions

are proposed:

Type Ia - removal of the clitoral hood or prepuce only

Type Ib - removal of the clitoris with the prepuce

Type II

Partial or total removal of the clitoris and the labia minora, with

or without excision of the labia majora (excision). When it is

important to distinguish between the major variations that have

been documented, the following subdivisions are proposed:

Type IIa - removal of the labia minora only

Type IIb - partial or total removal of the clitoris and the labia

minora

Type IIc - partial or total removal of the clitoris, the labia minora

and the labia majora

Type III

Narrowing of the vaginal orifice with creation of a covering seal

by cutting and appositioning the labia minora and/or the labia

majora, with or without excision of the clitoris (infibulation).

When it is important to distinguish between variations in infibulations,

the following subdivisions are proposed:

Type IIIa - removal and appositioning of the labia minora

Type IIIb - removal and appositioning of the labia majora

Type IV

All other harmful procedures to the female genitalia for

non-medical purposes, for example: pricking, piercing,

incising, scraping and cauterization.

Source: World Health Organization, 2016

{5}


FGC AMONG

DAWOODI BOHRAS

Dawoodi Bohras, and other Bohra sects like the Suleimanis and

Alvis, typically practice Type Ia and Type IV FGC. In most cases,

the process involves removing a pinch of skin from the clitoral

hood at age seven, or between ages six and twelve.

The community refers to the practice as Khatna or Khafd –

a ritual that many Islamic scholars around the world do not

endorse. While the Quran does not mention Khatna, the Daim

al-Islam, a 10th century religious text followed by the Bohras,

endorses this practice.

Khatna possibly came down to Bohras centuries ago from Yemen

and Egypt, regions where FGC is widely practiced and where

Bohras trace their roots. Over the years, Bohras have continued

to follow this practice secretly even after migrating to countries

where there are laws banning FGC.

In 2016, as the topic of Khatna among Bohras gained media

attention, for the first time, religious leaders provided public

statements about the practice. Syedna Mufaddal Saifuddin, the

spiritual head of the Dawoodi Bohras, made a public speech in

April 2016 stating that the “act” must continue “discreetly for

girls”, implying that Bohras must secretly practice it even in

countries where it may be illegal.

{6}


However, in an official press statement in June 2016, the

religious authorities clarified that is a religious obligation that

must be performed in countries such as India where the practice

has not been made illegal, and must not be performed by

diaspora Dawoodi Bohra communities who live in countries

where it is illegal.

Meanwhile in May 2016, Syedna Taher Fakhruddin, the leader

of the Fatemi Dawat faction of Bohras, issued a statement

condemning FGM as an “un-Islamic and horrific practice”.

However, he maintained that Khatna as mentioned in the Daim

al-Islam is different from FGM, should not be done on minors

and should be left as a choice for adult women.

The purpose of the Sahiyo study was to understand the nature

of Khatna within the Dawoodi Bohra community, thus contributing

knowledge to the fields of gender violence, public health

and social work.

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KEY

FINDINGS

FROM THE

SAHIYO

STUDY

{8}


Before Sahiyo’s study of Bohra women around the world, there

have been a few small-scale efforts to research and document

FGC among Bohras since the 1990s. These include:

Rehana Ghadially’s study in 1991

(published in her essay All for Izzat)

Ghadially, a professor at the Indian Institute of Technology in

Mumbai, conducted oral interviews with 50 Dawoodi Bohra

women from Mumbai, as well as two traditional cutters.

Mariya Taher’s study in 2010

As a social work student in the United States, Taher interviewed

six Bohra women in the US who underwent FGC.

Sahiyo’s study both reinforced the observations made by

Ghadially and Taher, and also deviated from their studies in

some ways. Conducted between July 2015 and January 2016,

the Sahiyo study involved sending out online questionnaires

to Dawoodi Bohra women from around the world.

The survey report analyzed findings from 385 final participants.

The majority of the women were from India and the USA, and

67% of them were between 18-25 years of age.

THE SURVEY FOUND THAT 80% OF THE 385

RESPONDENTS HAD UNDERGONE FGC.

Other key findings are as follows

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TYPE OF FGC

Ghadially’s study observed that Dawoodi Bohras practice the

‘sunnah’ variety of FGC in which the prepuce or the tip of the

clitoris is removed. However, Sahiyo’s study showed that the

majority of survey participants (​65%​) were ​unsure of what type

of cutting they had experienced​, or how much of their genitals

were cut. Only ​21%​of survey respondents indicated that a part

of their clitoral hood had been removed.

TYPE OF FGC PERFORMED (n=309)

1%

21%

other

i don’t know

65%

3%

5%

5%

clitoral hood and all

of clitoris removed

clitoral hood and part

of clitoris removed

all of clitoral hood

removed

part of clitoral hood

removed

This indicates that there is a ​lack of knowledge about genital

anatomy ​among many Bohra women, and points to a need for

more education on that subject.

{10}


AGE OF FGC

Consistent with Ghadially’s findings that khatna was performed

on girls at the age of seven, 66%​of Sahiyo’s survey respondents

indicated that they underwent FGC between six to seven years

of age.

AGE OF PARTICIPANTS AT THE TIME OF KHATNA (n=309)

3%

1%

6%

13%

i dont know

11%

12+ years

10-11 years

8-9 years

6-7 years

0-5 years

66%

Sahiyo’s survey did not inquire as to why girls are cut at this

age, but Ghadially suggested that it could be because at age

seven, a girl is considered too young to understand what is

being done to her but still sufficiently mature to continue the

tradition when she has a daughter of her own.

{11}


WHO PERFORMS FGC

According to Ghadially, khatna is carried out by ​mullanis​,

midwives and doctors​. Sahiyo’s survey supports this claim, as ​

74%​ of the participants who were cut reported being cut by

a traditional cutter​and ​15% ​reported being cut by a ​health

professional​.

BY WHOM WAS KHATNA PERFORMED? (n=309)

other

6%

i don’t know

5%

nurse

1%

traditional cutter/ midwife

74%

general practitioner/

family doctor

gynecologist

5%

9%

0 10 20 30 40 50 60 70 80

{12}


REASONS FOR

PERFORMING FGC

Sahiyo’s survey participants had heard of multiple different

reasons for why khatna is practiced in the Bohra community.

The most common reasons were:

For religious purposes 56%

To decrease sexual arousal ​45%

To maintain traditions and customs 42%

For physical hygiene and cleanliness 27%

These findings are similar to the reasons that Ghadially had

found in her study. Back in 1991, Ghadially’s study indicated

that khatna was endorsed by the religious clergy, who often

provided permission and support to the traditional cutters (most

often Bohra women from low-income families). In 2010, Taher’s

study also indicated that the clergy recommended the practice

of khatna.

These findings suggest that because khatna is so closely linked

to religion and tradition, Bohras perceive it as a ​necessity for

social inclusion​ in the community. FGC can be seen as a practice

that solidifies the community’s identity. It is also a marker

of several other social norms, including notions of marriageability,

sexual control, family honour and other codes of conduct.

This explains why the practice is highly valued and strongly

protected by the community.

There is also a ​fear of social boycott​among Dawoodi Bohras,

which leads to the belief that not practicing khatna would go

against the norm and lead to stigmatization from the rest of

the community.

{13}


PHYSICAL HEALTH

CONSEQUENCES OF FGC

In the objective part of Sahiyo’s study, ​23% ​of the women who

had undergone FGC reported experiencing ​physical health

issues immediately after FGC​, which included pain, bleeding,

and burning during urination. (Thirty-seven percent could not

remember if they faced any physical health issues).

DID YOU FACE ANY PHYSICAL OR HEALTH ISSUES

IMMEDIATELY AFTER KHATNA? (n=309)

23%

i don’t remember

no

37%

yes

40%

fever loss of sensation temporarily

unable to walk

{14}


However, in the subjective part of the study, where women

described their experience in their own words, ​98% mentioned

experiencing pain of some sort​. Survey respondents also

mentioned experiencing ​bleeding, screaming, being unable

to walk, sit on the toilet, pain during urination, and blacking

out ​due to the experience.

IMMEDIATE HEALTH EFFECTS AFTER KHATNA (n=71)

(respondents who said “yes”)

fever

loss of sensation

unable to walk

burning / burning while

urinating

1%

1%

4%

48%

bleeding

21%

discomfort

5%

pain

20%

0 10 20 30 40 50

burning /

burning while urinating

bleeding discomfort /

pain

{15}


Survey respondents recalled the experience as horrible or

scary and stated that they felt traumatized, or were angry about

having to undergo the experience. The following two quotes

illustrate the trauma felt by the survey participants immediately

after they underwent FGC.

‘Awful experience, painful beyond belief, lifelong emotionally and

psychologically scarring. I was taken to a tiny apartment, told to take

off my underwear and cut with a knife that was heated up on a stove.

There was ample blood and excruciating pain.’ (sic)

‘It was the most horrific experience of my childhood and something

that I will remember for the rest of my life. I was taken to some random

shack in some random village and a lady that I had never met in my

life held me down and took a knife to me. I just remember screaming

and crying through the entire thing and being in pain for the next week

or so. I would absolutely never have my child ever go through such

an experience in her life.’

PAIN SCALE

no

mild moderate severe very

severe

worst

pain

The narrative elements of the survey also revealed some other

common themes in women’s experiences of FGC. Several women

described being held down by their mother or another woman,

being cut by a “razor sharp object” and had a “powder mixture”

applied over the clitoris for healing. Many women remember

being told not to speak about the khatna to anyone.

{16}


EMOTIONAL IMPACT OF

FGC ON ADULT LIFE

Sahiyo’s study found that about half – ​48%​ of the participants

who had undergone FGC – stated that their khatna had left an

emotional impact on them. A significant number – ​35% ​– claimed

that FGC had ​affected their sex life as adults​, of which a majority

implied that their sex life had been impacted negatively.

However, since 65% of the participants were not aware of what

had physically occurred to them, Sahiyo’s study was unable to

conclude if FGC was the direct cause of their unfulfilling sex

life.

DID FGC LEAVE AN EMOTIONAL IMPACT ON ADULT LIFE? (n=309)

2%

did not respond

no

yes

50%

{17}


In their narratives, women described a variety of experiences.

‘I was privately distraught and enraged to learn that I had been robbed

of my basic feminine rights to sensuality and sexuality, and forever,

deprived of any clitoral sexual stimulation. This feeling disturbs and

traumatizes me even today. I feel robbed and cheated of my sexuality,

and feelings of inadequacy and incompleteness remain with me

till today, even at the age of 61. The emotions of impotent rage and

anger refuse to leave my mind or my spirit. After making a private

self-examination, I found that the prepuce or the entire foreskin of my

clitoris had been cut off.’

‘I am unable to reach a clitoral orgasm. If much stimulation of my

clitoris is attempted, I experience soreness and a burning sensation.

I also very rarely experience vaginal orgasm because of lack of sufficient

arousal and stimulation of my genitalia particularly the clitoris.’

HAS KHATNA AFFECTED YOUR SEXUAL LIFE? (n=309)

10%

i am not sexually

active

35%

i don’t know

no

32%

yes

23%

{18}


IF KHATNA AFFECTED SEX LIFE, IS IT POSITIVELY OR ADVERSELY? (n=71)

(respondents from previous graph)

left answer blank

3%

unsure

3%

adversely

87%

positively

7%

‘Given that my circumcision was done more for symbolic reasons to

merely satisfy the religious decree, the procedure didn’t have any

adverse physical implications (thankfully) in my life. Having said this,

since I was obviously not sexually active at the age of 6-7 years, I am

unaware if the procedure has positively or negatively affected my

sexual life!’

‘The khatna has not left any obvious physical evidence. No gynecologist

or other medical doctor has ever remarked or even noticed that

my genitalia looked at all different. There have been issues with my

inability to properly enjoy sexual intercourse, however I don’t believe

that these are linked to the khatna. Rather medical professionals have

said these are due to other factors. Frankly, as confused and angry as

I was as a young girl, and as much as I think this abhorrent and unnecessary

practice should end, I don’t believe that it had a lasting physical

impact on my sexual health.’

Despite the varied experiences relating to the emotional and

sexual life of survey participants, the overall negative reactions

of the women points to the need for ​support services for

survivors who have faced emotional or psychological trauma

due to FGC – more so, perhaps, than the need for physical

health-related support services.

{19}


MEN’S KNOWLEDGE

OF FGC

Ghadially’s 1991 survey claimed that a girl’s FGC was kept an

absolute secret not only from outsiders, but also from men in

the Dawoodi Bohra community. Yet, when respondents from

Sahiyo’s survey were asked if ​men were aware of FGC in the

community​, an overwhelming majority reported “​yes​” (​72%​).

ARE MEN AWARE OF KHATNA? (n=309)

15%

i don’t remember

no

13%

yes

72%

Considering Ghadially’s case study was conducted in 1991,

and with the advent of the internet, social media, and the fact

that the media in India has highlighted the issue of FGC within

the last two years, Sahiyo’s findings might reveal that the

topic of FGC is no longer considered a guarded secret amongst

men from the community.

{20}


However, when asked if men were aware of when a female

relative underwent FGC, ​39%​ were unsure and ​34%​ believed

that men were not told about it.

ARE MEN TOLD OF THE PRACTICE WHEN IT HAPPENS? (n=385)

i don’t know

27%

no

39%

yes

34%

?

!

{21}


CONTINUATION

OF FGC

In 1991, Ghadially found that more than 70% of the women she

interviewed had continued khatna on their daughters without

questioning it. Sahiyo’s survey, however, revealed a different

trend: ​82% ​of the 385 women interviewed indicated that they

were either unlikely or extremely unlikely to continue FGC on

their daughter​.

WOULD YOU CONTINUE KHATNA ON YOUR DAUGHTER? (n=385)

10%

3%

5%

most likely

likely

7%

undecided

unlikely

extremely unlikely

75%

This increased figure shows that trends towards

abandonment of the practice have perhaps already begun.

It is important for activists and the media to highlight these

positive stories of Bohras who are choosing to abandon

FGC, so that they can inspire others.

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CONCLUSION

Understanding various findings of the Sahiyo study could help

us, as activists, determine what approach to take while working

to end FGC.

From the Sahiyo study, we find that:

FGC IS DEEPLY ROOTED IN THE CULTURE OF

DAWOODI BOHRAS AS A SOCIAL NORM​.

What is a social norm? It is a ​prescriptive ​and ​self-enforcing ​

social convention that everyone in the community is expected

to follow. Whoever does not follow the majority is considered

as strange or deviant.

To help the community abandon this norm, we need ​multisectoral,

coordinated efforts​that must include cultural, religious,

human rights and health perspectives. Our activism must account

for cultural considerations, such as the significance of FGC to

the community.

We need to develop a collaborative, coordinated movement

that:

Prioritizes education and outreach on FGC.

Engages with community leaders and members, survivors of

FGC, service providers and law enforcement agencies.

Keeps abreast with systematic changes within the community’s

culture in order to look for windows of opportunity in which

abandoning FGC can be encouraged.

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