Sexual Dysfunction and Female Circumcision; Are they related?

The predominant discourse on female circumcision claims that any alteration of or ritual involving the female genitals, regardless of severity, results in sexual dysfunction. Despite the lack of credible scientific evidence, this myth remains stubbornly prevalent. The rite of Islamic female circumcision is limited to the nicking or slight cutting of the foreskin covering the clitoris, and never the clitoris. Belief that female circumcision, classified as Type 1a by WHO, causes, among other sexual dysfunctions, a loss of libido or desire to engage in sexual intercourse is a myth unsupported by scientific evidence.

Female genital mutilation/cutting (FGM/C) is an umbrella term used to label varying degrees of genital alterations.  Against an unfair label that is used to discredit the practice of Islamic female circumcision, it is important to differentiate between the different types of female genital alteration and accurately identify their respective scientifically evidenced health consequences. The WHO classifies the partial or total removal of the clitoris and/or the prepuce as Type I. This is further categorized into Type 1a, removal of the prepuce only, and Type 1b, the removal of the prepuce and the clitoris. Type II is classified as partial or total removal of the clitoris and the labia minora. Type III, the most extreme, includes infibulation, the removal of the external genitalia and fusion of the wound. Current estimates suggest that 90% of female genital alteration are of Types I and II with 10% falling under type III.  Unfairly, the most extreme form of female genital alteration has shaped public opinion and policy toward the Islamic rite of female circumcision.

Clinical studies regularly evidence that female circumcision does not impact sexual function.  In a study published in 2002, 1,836 Nigerian women of whom 45% had experienced genital alteration classified as Type I and Type II, no significant differences were observed in frequency of sexual intercourse between women with and without genital alteration. Female genital alteration in the group of women studied did not reduce sexual feelings.

Researchers in Cairo conducted a study to determine the effect of circumcision on sexuality. 147 women were divided into four groups: control (no circumcision); minorly circumcised – involving excision of the clitoral prepuce and in some cases small parts of the protruded labia minora (Type 1 FGM/C); and what the studies’ authors termed ‘mutilated women’ – excision of the glands, the whole clitoris and labia minora. The study concluded that sexuality was not affected in the minorly circumcised, or Type 1, cases.  In a 2002 study of over 2,000 Central African women, results regarding the occurrence of genital alteration and the frequency of sex were found to be inconclusive. It was therefore not possible to draw conclusions about how female genital cutting affects a woman’s desire for sexual intercourse and consequently there is a need to develop research methods further to investigate this question.

Female circumcision, included as a subset of female genital alteration in these studies and the least invasive of genital alterations, is not evidenced to cause or be correlated with a decrease in libido or desire to engage in sexual intercourse. Yet, despite this clear lack of evidence of an association to sexual dysfunction, these myths and assumptions cloud modern discussion of female circumcision. In order to have any meaningful progress in the discourse over the safety and health associated with Islamic female circumcision, a religious rite performed by millions globally, it is imperative that we do so in an environment sanitized of myths.

What about all the women who have had female circumcision who report difficulties with sexual relations as adults?
Unfortunately, female sexual dysfunction is extremely common 1 and is seen in societies that practice genital cutting as well as those that do not. For example, sexual dysfunction rates for women in the United States are reported as 43%, in Japan 57.9%, in India 64.3%, in Iran 46.2%, in Egypt 52.8%, in Turkey 48.3% and in Australia 60%.2 The causes of female sexual dysfunction are not completely understood but are thought to be heavily influenced by other illnesses and hormonal, social, psychological, and cultural factors.3 It is therefore likely that some women who have experienced female circumcision may also experience sexual dysfunction but this does not necessarily mean that their circumcision led to their dysfunction. Correlation does not equal causation. Finally, by fixating solely on circumcision as the cause of their sexual dysfunction women may inadvertently overlook other potential treatable conditions that could improve their sexual experiences.

 

For further reading:

NOTE: The content of the below articles do not necessarily represent the position of this website.  Any opinions expressed in the linked or hosted articles are the author’s own.

The association between female genital cutting and correlates of sexual and gynaecological morbidity in Edo State, Nigeria.Okonofu FE1, Larsen U, Oronsaye F, Snow RC, Slanger TE.

Available at: https://www.ncbi.nlm.nih.gov/pubmed/12387460

Defective sexuality and female circumcision: The cause and the possible management, Saeed Mohamad Ahmad Thabet, Ahmed S.M.A. Thabet

Available at: https://obgyn.onlinelibrary.wiley.com/doi/full/10.1046/j.1341-8076.2003.00065.x

“We Did It for Pleasure Only”: Hearing Alternative Tales of Female Circumcision, Lori Leonard

Available at: http://journals.sagepub.com/doi/pdf/10.1177/107780040000600203

Citations

  1. A systematic review of the literature on female sexual dysfunction prevalence and predictors, West SL1, Vinikoor LC, Zolnoun D
  2. Sexual dysfunction in the Australian population. Najman JM, et al. Aust Fam Physician. 2003.
  3. Female sexual dysfunction, Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/female-sexual-dysfunction/symptoms-causes/syc-20372549

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