ON THE IMPORTANCE OF A FRAMEWORK

I used to work at a special education school district during college summers, and one phrase in particular sticks out in memory from that experience. A veteran special education teacher told me, when referring to an autistic child in crisis, “Sometimes, you are so far deep in the mud that you don’t even know you’re there.” This means that at times, a person may not have any idea that their situation is not normal or changeable. They may not realize that there is any other way of life possible, or at least, possible for them.
 
This sentiment is useful when speaking to and about survivors of female genital cutting, which is the focus of my research. Female genital cutting is often practiced in cultures that also engage in the systematic disempowerment of girls and women and have well-established institutionalized misogyny rampant in the society. I know this because that is the culture that I come from. I was born and raised in the United States, but my parents are from Egypt and came here in their 20s-30s. Even though I am an American, I was raised with strong, conservative Egyptian culture at home. I was raised seeing that all my (smart, educated) women relatives sacrificed important careers (doctors, engineers, accountants) to become housewives or else they would not be accepted by their husbands. I was raised seeing that domestic violence was a normal part of being an Egyptian wife. I was raised learning that as a girl or a woman (or even more explosively, a young, unmarried woman), you are a threat to social order. Any time you zig instead of zag, the social fabric of community is threatened and you will be punished. I remember being ten (that’s 10) years old and accidentally bumping into a man in an aisle in a grocery store and being yelled at sharply by my father, saying that I was now too old to make careless mistakes like that and touch men in that matter. Perhaps the most distinct experience that instilled the required cultural shame into me was when I was in Egypt visiting the very elderly grandfather of one of my friends. I extended my hand to shake his, and before he shook my hand, he covered his own hand in a handkerchief so that his flesh wouldn’t touch mine. I was 10. And the memory of that situation still makes me feel dirty, at 25. So when I hear that approximately 90% of Egyptian girls and women have been through female genital cutting, I’m not surprised. Of course almost all girls and women there have been cut. This is a natural outgrowth of the value (or lack thereof) placed on girls and women.
 
When I speak to survivors of female genital cutting, many of them express how normalized the experience is. They acknowledge that it is just a part of life at their home country. This is a stark contrast to the horrified reactions I get from Americans when I speak about the proliferative existence of FGC overseas (and even among girls and women who live in the USA—Google search “vacation cutting”). Americans are often absolutely amazed that “any woman would let this happen to herself or her daughter.” How could a woman say no? In these places women literally often do not have the ability to say no. Their basic human rights are stripped and when that happens, your focus turns to survival. To survive as a member of these societies, as a girl/woman, you need to get cut. Further, it is the case that even if these people tried to resist, the cutting would still happen forcibly. I’ll use this opportunity to relay that I have never heard of a girl (older than infancy) or woman being cut who was not dragged and held down for the process. These women witness the circle of life. They see that girls who are not cut are shamed, frowned upon, unmarried, and undesirable. When they actually arrange for their own daughters to get cut, they usually understand that it will cause pain, but they see this pain as worth it. They see pain as a small price to pay for some social acceptance in a society or culture where being female is unacceptable to begin with. They see all their women relatives and women friends have been cut and have had their daughters cut. They see that the men in their society believe an uncut woman to look gross, unattractive, unwomanly. They realize that every woman they know has been cut and that there is no other way to be. Sometimes, they are not sure what happens when a woman is uncut. Does her clitoris grow endlessly? Does she emanate a foul odor all the time? Does she desire sex so strongly that she becomes maniacal? Who knows. All they know is that this is a part of life.
 
Female genital cutting is a huge human rights violation based on the destruction of bodily integrity and right to sexuality. But sometimes, even a human rights violation becomes socially acceptable, and in this case, even socially desirable. And the girls and women have knowledge withheld from them in such a way that they cannot even see that this is a human rights violation. And they definitely can’t be blamed for it. This is their framework. This is the framework that we, as doctors, researchers, and activists, need to recognize exists in these girls and in these women. To defeat female genital cutting, you have to get into this framework and wrap your own head around it before you can even fantasize about dismantling such a large institution. Leave the horrified expressions and “America knows best” ego at home, and understand that there are social forces beyond what we can even imagine at play that guarantee women and girls are subjected to this awful, awful act. And remember, “Sometimes, you are so far deep in the mud that you don’t even know you’re there.”