As we mentioned in the first part of this articles, the operation of female circumcision is performed in different communities by a variety of people and with various tools. In more educated communities, a trained doctor performs the operation with sterilized equipment.
In the more ignorant societies, a traditional birth attendant performs the operation using a variety of tools ranging from unsterilized knives and razors to sharp stones taken straight from the ground.
The range of complications exists in relation to female circumcision ranging from short-term to long-term. The short-term complications include bleeding, infection, pain, urinary retention, stress, shock, and damage to the urethra and anus. In the case of minor operations, most wounds heal with few long-term problems.
Cases have been reported where girls have suffered repeated infections, soreness and intermittent bleeding for many years. The stitch used to tie the clitoral artery may not be absorbed totally, becoming the focus for an abscess. The tough scar over the clitoris may split open during childbirth.
Infibulation, on the other hand, is accompanied by an expansive list of long-term complications that needs further discussion out with this article.
However, besides the greater risk of infections and general damage to the area, some complications include: hematocolpos, dysmenorrhea, pelvic infections and infertility, more frequent indication for Cesarean section delivery, difficulty in penetration during the wedding night due to tight scarring of the vaginal opening, dyspareunia and vesico-vaginal and recto-vaginal fistulae.
The psychological aspect of human sexual arousal is a complex phenomenon that is not fully understood by experts. It involves emotions, concepts of morality, past experience, acceptance of eroticism, fear of disease or pregnancy, dreams, and fantasies.
The combination of physical messages from sensory organs and the emotional images culminate in a psycho-physiological state during which a person is able to experience orgasm. The erection of the clitoris is only secondary to the higher center stimulation in which its function is to lead the stimulation to its destination and orgasm during a sexual act. So whether the clitoris is present or absent it makes no difference as regards chastity, as it has a secondary role.
Female orgasm has both clitoral and vaginal components. Evidence suggests that orgasms require clitoral stimulation while vaginal stimulation, though pleasurable, is a minor triggering mechanism: also direct clitoral stimulation is a greater stimulus than coitus, which causes pelvic pressure and traction on the clitoral hood.
With infibulation, there is destruction of practically all the nerve endings in the outer sex organs that convey the pleasurable sensations to the brain. She is left with the sensations from the vestibule at the vaginal orifice and the vagina itself whose nerve endings respond more to pressure than touch.
If she has an orgasm then it is what is called “vaginal orgasm” in contrast to the more effective “clitoral orgasm.” Studies performed found that 29.8% of infibulated women found sexual satisfaction or had orgasms compared to 48% of 1st degree circumcised women.
With clitoridectomy, some of the sensitive tissue at the base of the clitoris, along the inner lips and around the floor of vulva, are still intact and will give sensory sexual messages if properly stimulated.
In addition, other sexually sensitive parts of the body, such as the breasts, nipples, lips, neck and ears may become hypersensitized to compensate for lack of clitoral stimulation and thus enhance sexual arousal.
In normal uncircumcised females, orgasm does not always occur. In excision, some local sensitive areas still exist in what is left of the clitoris, labia minora and vestibule, besides the pressure response of the vagina.
This explains why, in spite of excision, about one third of those excised still get satisfaction and a pleasurable sensation and another 42% reach orgasm, compared to the 1st degree circumcision where 27% have satisfaction and 48% reach orgasm.
No satisfaction at all was present in 39% of infibulated women, 25% of those of 1st degree circumcision, and much less in the uncircumcised category.
In Dr. Barakat’s study, in which 97.6% of those interviewed had excision of the clitoris with partial or total excision of the labia minora, 72.8% of the women experienced orgasms.
Medical Indications for Circumcision
Indications for female circumcision were documented in 1959 by an American physician, WG Rathmann MD, who performed many female circumcisions in the United States during his long years of practice.
These indications in general terms are of functional need: lack of ability to have a climax or ability to have one only with considerable difficulty; and an anatomic or mechanical factor that needs correction.
According to Dr. Rathmann, the two common problems that make the highly sensitive area of the clitoris unable to be stimulated are phimosis and redundancy. Sebaceous glands around the clitoris attempt to prevent adhesions of the prepuce to it.
This sometimes fails and the clitoris is adheres tightly to the prepuce. This defect may range from 25% of the normal surface adherent to complete coverage.
A prepuce for the protection of the clitoris is normal and useful, but if it is excessive and extends past the eminence of the clitoris it can prevent contact and is harmful. In general, the greater the degree of phimosis or redundancy, the greater the probability of satisfactory results by its correction.
Religious Aspects of Practice
Whatever the origin of female circumcision, it did not originate in the Islamic tradition, contrary to popular belief.
Both Muslims and Christians have circumcised their daughters since early times, and there is considerable evidence that the practice existed long before Christianity and Islam. There is no question that female circumcision preceded Islam in Africa.
In relation to Islam there are some sayings of the Prophet Muhammad (peace be upon him) which are interpreted differently by Islamic scholars. In one of these sayings the Prophet (PBUH) says to Umm Atteya, “If you circumcise do not go deep (i.e. do not encroach on the clitoris) because it would be useful to the wife and desirable to the husband “.
The majority of Islamic scholars doubt the authenticity of these hadiths. This view was supported by a declaration of the former Sheikh (head) of Al-Azhar, Sheikh Tantawi, basing his declaration on many references, old and new, and among them some eminent Islamic scholars such as Sheikh Shaltout, a previous head of Al-Azhar.
Another previous Sheikh of Al-Azhar, Sheikh Gad El-Haqq, was in favor of the authenticity of these hadiths and thus, favored circumcision, but on the condition that “it should not cut the clitoris or any part of it.” “Only a part of the skin of the hood should be removed.” “The operator should pay compensation if he removes or injures the clitoris”.