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After Genital Cutting in Somalia, a Woman Chooses Reconstructive Surgery in America

The decision to undergo reconstructive surgery wasn't easy for a Somali woman who describes the weeks following surgery as being 'by far the hardest of my life.'
Photo by Rachel Beth Anderson/VICE News

'Reversing Female Circumcision: The Cut That Heals.' Watch the VICE News documentary featuring Ayan here.

Women who went through female genital cutting before coming to America face unique challenges. It is as if we were designed to live only in the society of our origin; we don't feel we fit in. We are told we have been oppressed and mutilated. We are viewed as scarred victims with no sexual feelings. We feel mainstream American doctors don't understand us.

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But we never want to be defined as victims — we are more than that. We have been through civil wars and lived in refugee camps where water and food were scarce. We are nurses, teachers, childcare providers, social workers, mothers, and leaders in our community. We are not oppressed by men or by religion; it is bigotry to say Islam or any other faith teaches female genital cutting or mutilation. No, this happened to us because of societal pressure. My mother allowed it so I could be accepted by the small town in Somalia where I was born, and where the rate of cutting was probably 100 percent. She had no choice, and I forgave her like she forgave her mother for doing it to her.

My journey of doing reconstructive surgery was the best and the hardest thing I have ever done for myself. I came to America 20 years ago as a teenager with my family. Finally, I wanted to end my fear of pain due to the extensive scar tissue, and I hoped to alleviate my severe menstrual pain. I also wanted to learn more about my genitalia. I knew I had been cut and sewn, but I did not know to what extent, or if there was anything that could be salvaged. I was angry at this tradition. I wanted the symbol of it to be removed from my body.

Until my pre-surgery assessment, I had never dared to see an OB-GYN. As a nurse, I felt ashamed to tell the doctor it was my first time. It made me feel like I was not practicing what I preached to patients — early screening and prevention. I feared a doctor would not know what to do with me, since most are not familiar with female genital cutting. I thought the doctor would only feel bad for me and view me as a mutilated victim. But to my surprise, the doctor I saw was very kind and somewhat knowledgeable about female genial cutting.

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Increasing awareness and education is the best weapon against this practice. Blaming and ridiculing will not stop anything.

Female genital cutting and infibulation was invented by men centuries ago to control women by suppressing their sexuality. But it has evolved to become a tradition passed on by women who have lost touch with the identity of female genitals in their natural form. Instead, they see the altered, cut genitalia as the norm. They despise the natural appearance of female genitalia and fear the labia and clitoris will become enlarged as girls mature into adulthood. One elderly Somali woman once asked me if the labia minora look like birds wings, and whether the clitoris is hanging in uncut women. They believe left alone, genitalia will lead to hyper sexuality and promiscuity, which can bring shame to the family and lead to difficulty finding husbands.

The cutting is usually done when fathers are away. My father was on a business trip when it was done to my sister and me; to this day he doesn't really know what happened to us. My friend was cut when her family still lived in Egypt. Her father was opposed to the idea, but her aunt told him it was the only and the best decision a mother makes for her daughter. Her mother then called the cutting lady to the house, where she boiled her instruments and cut my friend and her younger sister. She dwells on how she might have escaped from this tradition if it wasn't for that "evil" aunt.

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There has recently been progress in abandoning the practice in Somalia. It is now outlawed in some parts of the country, but that will not easily stop a tradition that is deeply embedded in the minds of those who believe in it. Increasing awareness and education is the best weapon against this practice. Blaming and ridiculing will not stop anything.

VICE News documented Ayan's experience in 'Reversing Female Circumcision: The Cut That Heals.'

After my reconstructive surgery was done, I was surrounded by supportive women. I knew I was doing the right thing for myself, but I was also scared knowing every surgery comes with the possible risk of complications such as infection and nerve damage. The last thing I wanted was to cause myself more damage.

I don't remember coming out of the anesthesia. But I was told that I was screaming. "What did you do to me? Why does it hurt between my legs? What happened to me?" I yelled until I was given an intravenous injection of Demerol. I wouldn't act that way normally, and I feel it was a glimpse into my subconscious.

After I recovered from the anesthesia, I was able to stand up and dress myself. I was calm and relieved that the surgery was over and successful. I applied my ice pack regularly to decrease the swelling, motivated to be a good patient and do what I instruct my patients to do to promote healing.

In the evening, I still had not looked at myself post-surgery. I was hesitant and thought I should wait until the swelling went down. I decided to ask my friend Fardowsa, who is a labor and delivery nurse, to look. I watched her facial expression as she pointed her cell phone's flashlight at me.

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"How does it look?" I asked.

"It looks good," she said. "It looks like a normal vagina — the clitoris is there."

I grabbed the phone from her and beamed the flashlight between my legs while I held a mirror in the other hand. She was right. The scar tissue was removed. I was immediately overcome by a feeling of completeness. It was an unfamiliar feeling.

The first few weeks after the surgery were by far the hardest of my life. At one point, I thought about how it might negatively affect my prospects for marriage — I guess there was a trace of the tradition embedded deep in me. At another point I was angry. I asked myself, "What the hell were they thinking sawing my skin like a piece of cloth?"

It has now been six weeks since the surgery, and I am healing beautifully. Today I have far less menstrual pain, which is the best thing I could ever ask for, and my doctor said I should expect complete healing in about eight weeks. Reconstructive surgery really can reverse physical damage caused by female genital cutting.

It just can't remove the emotional damage.

'Reversing Female Circumcision: The Cut That Heals.' Watch the VICE News documentary featuring Ayan here.