What young people really need help with are questions like what do I look like, what can work now that this has happened, and how can I move forward? says Camilla Palm, sexologist and researcher at Malmö University.
She has produced a guide for staff in schools, healthcare and social work. In many settings, female genital mutilation is an issue that rarely comes up and that staff are not used to talking about. Support materials focusing on sexual health have so far been lacking.
Multiple risks
Some feel that it has not affected them, others say that "I am cut off from that area, I don't want to touch it, it was a trauma when it happened and it is something that creates discomfort."
One of the risks is that sensation may change, either making you numb or hypersensitive where the procedure was performed. The perception of heat and cold may be affected, and scarring may cause pain or make the remaining underlying part of the clitoris unstimulated. Some women develop cysts.
Women who have undergone the most invasive form of circumcision and then been sewn together can experience such intense pain during intercourse that they suffer from vaginal spasms or hypersensitivity.
There is help.
The point of talking is that there is help available.
Sexual education goes a long way, says Camilla Palm.
Those who suffer from pain can, for example, receive help with sensitization exercises, that is, getting the vulva and vagina used to touch in different ways.
Being examined by a gynecologist or midwife and hearing what it looks like more precisely can also be helpful, says Camilla Palm. Many people lack a clear picture of what type of circumcision was performed and how it healed.
It's one of the most common questions: "What do I look like?"
Great variety
Knowledge of the great variation among those who have been subjected to genital mutilation is fundamental to having good conversations, she believes.
It can range from "I haven't thought about it much" to "I've always felt that something was wrong, what was done to me."
How the possibility of a good sex life is affected also varies, even among those who have undergone the same type of procedure.
"You can't remove all sexuality, because it is in so many parts of the body and brain," says Camilla Palm.
Genital mutilation is a collective term for several types of procedures. It can involve the removal of the clitoris and/or the clitoral foreskin, sometimes combined with the removal of the inner and/or outer labia.
Infibulation involves the inner and/or outer labia being tied together. A small opening is left for urine and menstrual blood to pass through. Other harmful procedures also occur, such as pricking, cutting, scraping and burning.
In some countries, the procedure is performed on infants. Most commonly, it is performed between the ages of 4 and 14.
The custom is on the decline.
Girls born or raised in Sweden are at low risk of being subjected to FGM, according to research. In cases where it occurs, the procedure is performed during a longer stay abroad during childhood. In Sweden, an estimated 68,000 girls and women have been subjected to FGM.
Source: Camilla Palm, Malmö University
