Defying destiny
Bright, beautiful and charming, her brown eyes sparkling with intelligence and a sense of mischief, the young twentysomething Canadian woman seems the picture of the girl next door — except that she has a secret so traumatizing, so terrifying, she’s never told it to a single one of her girlfriends.
Sinking into a soft, black leather armchair, wearing jeans, a simple navy sweater and a brightly coloured scarf, she gently twirls a strand of her black hair around her index finger as she struggles to share her story.
“I believe that what was rightfully mine — what shouldn’t have been taken away from me — was,” says Serat, big, round tears caressing her cheeks. To protect her privacy, she has asked to have her name changed for this story. Other details have also been altered slightly.
Serat was born in war-torn Somalia, East Africa. At the cuddly age of three, an aunt who had moved to Canada a few years earlier persuaded her mother that Serat would have a better life in Canada.
“You’re coming with me,” her aunt told her, “so you can actually be somebody some day.’
The rest of Serat’s early years were spent in an idyllic rural setting in Ontario, where the local children cheerfully accepted the community’s first-ever African girl into their midst. She spent summers at friends’ cottages and winters skiing and going to the small-town school, delighting in drama, dance, and singing Christmas carols out in the snow. The Somali toddler had quickly become a thoroughly Canadian Miss.
But Serat never forgot her mother in Africa, and dreamed of seeing her again.
Finally, the summer she turned 13, before her first kiss, her grandmother gave in to her entreaties. Instead of the usual carefree summers spent at an Ontario lake, Serat and her aunt made the long journey to the Horn of Africa.
The reunion didn’t go as planned. The feisty Western teenager and her traditional African village mom had little in common and battled wills, and when a family emergency forced her aunt’s return to Canada, Serat’s fate was sealed.
Early one morning, three village women burst into the mud hut where she lay sleeping, razor blade in hand. Her mother had summoned them, shocked by the discovery that Serat had never undergone the traditional Somali rite of circumcision.
Serat started screaming and tried to run. “What are you doing, what are you doing,” but the women caught her, pinned her down, spread her legs, and after administering a local anesthetic, cut off the tip of her clitoris. After, they sewed part of her labia shut over the cut.
“I could see blood gushing, gushing down my thighs, then I passed out,” Serat says.
When she recovered consciousness, her legs were tied together. For a week, she was forced to stay like that, in constant pain and with difficulty urinating. She returned to Canada a couple of months later, physically scarred and emotionally traumatized.
Serat had become a victim of what is now known as female genital mutilation or cutting (FGM), a tradition in 29 countries concentrated in Africa and the Middle East. UNICEF’s latest report estimates there are 125 million girls and women alive today who have been cut, and that despite global efforts against the practice, 30 million more girls are at risk over the next decade.
The majority of those who have gone through this excruciating procedure are Muslim, but other religious groups also practise it. In the communities where it’s done, it is a valued and respected tradition, variously performed because it’s thought that it purifies the girl, prevents promiscuity and that uncut girls won’t be able to find a husband.
But it can have devastating results, including death. There are various types of FGM, the most severe is infibulation, which involves cutting the clitoris, the labia minora and majora, and then stitching the vaginal opening shut, leaving only a tiny hole for urination and menstruation.
Some girls bleed to death after the operation, others suffer from chronic infections and incontinence. In adulthood, sexual intercourse is often difficult and painful. Childbirth is also affected. A study by the World Health Organization (WHO) concluded that an additional one to two babies per 100 delivered in a hospital setting die as a result of FGM. The statistics for the vast majority of babies who are delivered in a rural setting are thought to be much worse. FGM can also lead to severe psychological problems, including post traumatic stress disorder.
Because no research has been done in Canada, no one knows how many Canadian girls like Serat have faced the same terrifying surprise while on holiday to their homeland, or have had the procedure done illegally in Canada.
What emerges from the 2011 Canadian census and UNICEF’s statistics on the prevalence of FGM is that with the recent waves of immigration from Africa and the Middle East, there could be upwards of 80,000 survivors living in Canada, including thousands of young girls and teenagers.
For girls who endured the mutilation as children before coming to Canada, the reality of what happened, and how different they are from other girls, may not hit until their teens, when high school biology, glossy magazines and sharing secrets with girlfriends reveal the truth.
And when that truth hits, there is nowhere to turn.
Serat has lived with her secret for more than a decade. Her emotional scars are still raw and she feels isolated.
“There’s a complete wall of silence around this issue here,” she sighs, unable and afraid to lift the veil of secrecy herself.
About 14 years ago, Somali-born Kowser Omer-Hashi, then a midwife living in Toronto, made it her mission to speak out about FGM, and to protect girls from being taken back to Africa to have it done. Along with Dr. Beverley Chalmers, an adjunct professor in obstetrics and gynecology at the University of Ottawa, they surveyed more than 400 female Somali immigrants on their birthing experiences in Canada.
More than 80 per cent reported that caregivers made hurtful comments to the women, reflecting “a total lack of understanding of what FGM is, that it actually exists, and what to do about it from an obstetric point of view,” according to Chalmers.
FGM is illegal in Canada, but the survey found that almost half of the women said they would like to have their daughters circumcised.
Omer-Hashi worked with doctors, spoke to social workers and educated health professionals. As a result, she was ostracized and threatened by her own community. Her health, her marriage, her job were all affected. Eventually it all “became too much” and she stopped.
Today, she blames her white host community for letting her down by refusing to get involved.
“That’s why FGM has survived hundreds of years,” she says. “People keep their hands off, saying, ‘That’s their tradition,’ and that attitude is wrong, wrong, wrong.”
In Britain, another major destination for immigrants from Africa and the Middle East, numerous charities and a helpline have been set up to help victims and those at risk, and the government has committed $65 million to the battle to stop FGM worldwide.
“It’s time we broke the silence,” British education minister Lynne Featherstone announced last month, revealing that all government hospitals will now have to record information on patients who have suffered or are at risk of FGM.
In Canada, there is currently not a single group or organization dedicated exclusively to combating or helping victims of the tradition.
“Who can I talk to, who can I tell?” asks Serat. “It’s really hard to accept that nothing is being done for Canadian women who have already been through it.”
There are more than 100 support groups in Canada for everything from Asperger’s to Tourette’s syndrome, but not a FGM support group.
On her return to Canada, Serat’s aunt told her to accept what had happened and move on, but she couldn’t. She felt incomplete, ashamed and devastated.
She Googled pictures of female genitalia on the Internet, compared them to her own, and cried. She heard girlfriends giggle and talk about all the sexploits on Sex and the City, and stayed silent.
Her journey took her to several doctors, including a cosmetic surgeon, but no one could, or would, help. Canadian doctors still have little or no training in FGM, its consequences or treatment.
Last November, in a new policy statement, the Society of Obstetricians and Gynecologists recommended training on this issue be included as part of the Canadian medical curriculum, but that’s of little help to survivors of FGM victims today.
“We need to raise awareness of this issue (and start) support groups,” says Dr. Margaret Burnett, chair of the society’s committee on social and sexual issues.
For years, Serat searched for answers, trying to figure out if there was anything that could be done to help her “rediscover myself as a woman.” Finally, while surfing the web late one night, she came across a ray of hope, hope that she could defy her destiny.
It came in the form of French urologist Pierre Foldes, who started treating women who had been through FGM while working with WHO more than two decades ago, and developed a revolutionary reversal procedure. He discovered that the clitoris actually extends up to 11 centimetres under the skin.
“Nothing was written about the clitoris, but there are hundreds of books about the penis,” he says.
While the tip of the clitoris may have been cut, extensive sensitive erectile tissue remains. That tissue can be exposed by removing the scar tissue covering it, and, after a few months, results in pleasurable sensations, even orgasms, for many FGM victims.
Foldes now performs 50 reversal procedures a month, all paid for by France’s health service. The promising results of his pioneering surgeries were recently reported in the peer-reviewed medical journal The Lancet.
“Sexual pleasure is a human right, and to remove that pleasure from half the population is a crime, it’s a way to dominate women,” says the surgeon, who is not popular with conservative sections of France’s immigrant community.
Foldes has operated on more than 4,000 women, and has taught the procedure to doctors from around the world, but no one has so far come from Canada.
However, Foldes did train a U.S. surgeon, Dr. Marci Bowers, from the picturesque town of Trinidad, Colorado, and five years ago, she became the first doctor in North America to do FGM reversal surgeries. Her day job is gender reassignment surgery, and she has a year-long waiting list for people wanting to change their sex. But it’s her passion for her pro bono work on FGM victims that is fierce.
“If the equivalent procedure were done on men there would be global thermonuclear conflict,” she says. “People would be at each other’s throats, seeking revenge and restitution. And here we’ve tolerated this for millions of women worldwide.”
So far, Bowers has operated on 50 women, including 15 from Canada. Bowers’ goal is to make sexual intercourse and childbirth easier, enable women to experience sexual pleasure — 68 per cent of FGM victims reported pain during sex in the Canadian survey — and help them regain a sense of female identity.
It’s that last part she especially identifies with. Bowers was born a man, but after a marriage and three children, followed through on her conviction that she was born the wrong sex. Mark Bowers became Marci Bowers.
“When I see so many of these women say I’ve lost my identity, that really pulls on my heartstrings,” says the surgeon.
Soon after Serat discovered French pioneer Foldes online, she also came across Bowers and booked an appointment. “Hope was building, and I actually started to believe that this was going to happen,” she says.
Bowers does the surgeries for free, but the travel and hospital costs can add up to thousands. An international charity, provocatively called Clitoraid, provides financial help to those yearning for the reversal operation. It’s an interesting irony — one of the reasons behind FGM is to ensure virginity before marriage. Clitoraid is part of the Raelians, a religious sect founded on the belief that extra terrestrials created humans, and that our sole purpose here is to experience pleasure, especially sexual pleasure, of which many FGM victims are deprived.
Clitoraid covered Serat’s flight and hospital costs and she was one of eight women booked in for surgery during an especially cold week of Colorado winter.
The women arrived, one by one, all African expats, picked up at Denver airport by volunteers and driven the three hours to the tiny town of Trinidad. There were women from the U.S., Japan, Korea, Austria and two from Canada.
Serat was not among them. At the last minute, she told her aunt and her cousins in Canada about the surgery, and they pressured her to cancel.
Nadine Gary, the patient coordinator for Clitoraid, was not surprised. Most patients, she says, fearing their families’ wrath, make the trip in secret.
“Here we have someone who has been mutilated, they’ve already felt so much pain, they want to be repaired, but at the same time they want to feel the agreement from their family and they’re not getting it.”
The night before the surgery, at the aptly named Morning After Guest House, the women shared their stories, many for the first time. They cried over what was taken from them, and laughed in anticipation of pleasure to come.
Kady, originally from the Ivory Coast, spoke of 22 years of pain during sex with her husband. Fozia, 21, told of four aunts and five cousins in Toronto who have all been mutilated, and spoke of her hope that one day the silence would end so they too could get reconstructed.
The following day, Bowers operated on the women, restoring clitorises and creating more natural looking genitalia. Every case is a learning experience.
“We say three out of four should experience an improvement in sensation,” Bowers says.
For the women, just knowing that they had back something of what they’d been missing, was enough.
“Our hearts were broken; we had no hope, nowhere to turn,” says Fozia, whispering through a haze of tears. “We were not like a normal girl, and now we are complete.”
Burnett hopes to have Foldes, the French pioneer of the surgery, speak about his work at one of the SOCG’s annual clinical meetings to help build Canadian expertise in this area.
“The whole procedure is very on the up and up and sounds most reasonable to me, so I think to be able to offer it to women, to have it as an option, is a godsend,” she says.
There’s no happy ending to Serat’s story, at least for now. She feels stuck in an emotionally abusive relationship with a Somali man from her community who knows what happened to her.
She says she’d leave him in a second if “I didn’t have that fear of having to explain where my clitoris went to a new romantic interest. The recoiling, rejection that could happen with someone new is a constant and numbing fear.”
Serat says she’s now found the courage to see Bowers, who has since moved to the outskirts of San Francisco, and get the surgery done.
“Regardless of what my family have said, regardless of what my friends don’t know, I need to do this for me.”
But Clitoraid won’t sponsor her again, the surgery is not covered by OHIP, and on a retail industry salary, she can’t afford the trip.
And so, for the moment, Serat’s dream of regaining her womanhood, of being complete, remains just that. A dream.
Giselle Portenier is a journalist and award-winning documentary filmmaker who has focused on human rights, especially the human rights of women and children. She lives in Vancouver.