Dr. Leyla Hussein OBE is a psychotherapist specialising in supporting survivors of sexual abuse.She is the founder of The Dahlia Project, the UK’s first specialist therapeutic service for FGM survivors and Magool, an organisation that promotes the well-being of women who have undergone or who are at risk from FGM.
Here, she tackles the question of whether non-physical screening for FGM by medical professionals in the UK should be mandatory.
Editor's Note: This post contains details of violence.
Just imagine yourself as a 7-year-old child on an ordinary day, playing outside, and suddenly being grabbed by people you don’t know. Imagine the people you know and trust the most are spreading your legs apart. Before any cutting actually happens you are violated.
Then a sharp blade takes your genitalia, removing all your labia and clitoris. They stitch up your vagina, leaving you with a small hole from where you’re expected to menstruate, have intercourse, and give birth at some point.
This was similar to my experience. At the age of seven I underwent type II female genital mutilation (FGM).
For years after, no one ever asked about that experience, never talked to me about what had happened, until the day a practice nurse asked that question during a routine postnatal exam.
I was having a difficult pregnancy, blacking out whenever I was being examined vaginally.
But I had never made the connection until that day when the practice nurse said: “I see you’re from Somalia, can I just check if you have undergone this practice?”
And without hesitation, my response was: “Yes, but mine wasn’t the worse type, and there’s nothing wrong with FGM.” And I’m saying this with a month-old baby girl in my arms.
No one had ever brought this up during my entire pregnancy. I had lived in the UK since the age of 12 and, over a decade later, this was the first time ever anyone had asked me that question about whether I’d undergone FGM. Not the midwife; not the GP, who had been examining me throughout my entire pregnancy, and who had clearly seen my scars.
When I was finally asked this question it changed my life, because the practice nurse made me realise that the blackouts I was experiencing were actually because of flashbacks to what I had experienced as a child.
But most importantly, she took the opportunity to teach me about my body and the laws that protect children from harm, and I will always be grateful to her. It led to my daughter never being cut and it’s why I have become an activist today — because I realised many young women would be in the same position I was in.
Because of that experience and my work as a psychotherapist, I created the Dahlia project — a ground-breaking specialist service that provides a safe space and access to therapeutic support for survivors of FGM.
FGM is one of the worst forms of child abuse, and it does not occur in isolation. It is a practice which has its roots in patriarchal misogyny, which denies women and girls rights to their bodies and their sexuality.
If you pinned a 7-year-old down on a table and touched her genitals in the UK, you would be arrested because that is sexual assault.
UNICEF and the World Health Organisation estimate that over 200 million women and girls alive today have undergone FGM — and every 11 seconds another girl will undergo FGM. By the time you finish reading this article, countless young girls will have undergone this horrific practice all over the world.
And many women who are survivors are lacking the space to have these conversations, to talk about the trauma they have endured. So why shouldn’t asking whether a patient has undergone FGM be part of mandatory screening?
In a recent article published in the Telegraph, the Royal College of General Practitioners claimed there was “no evidence” that mandatory screening of women and girls in the UK will help eradicate FGM.
I would argue that my own experience would prove otherwise. Because of that nurse, I began asking questions about what had happened to me.
While I can understand the concern around mandatory screening, if done sensitively and in a non-physical manner, screening can be a lifeline for survivors who have never been able to address their trauma.
The article discusses a particular manifesto, written by Action:FGM — a coalition of organisations and survivors untied in the fight to eradicate FGM by 2030. The manifesto clearly states that FGM screening should be non-physical and that staff should undergo safeguarding training, so that they are properly equipped to help survivors in a way that supports them both physically and psychologically.
As a survivor and as an activist, prevention is absolutely key. We can’t keep missing girls for the fear of being seen as racist or “culturally insensitive”, because that comes from a place of privilege.
I would argue that it’s also a form of racism to say that girls like myself and my daughter don’t deserve the same protection as girls in this county that are white.
My biggest fear is that this country won’t act on tackling FGM until a young girl dies. So wouldn’t it be better to simply ask this question and encourage that opportunity for awareness and action, as it did for me? It’s entirely because of the nurse’s question, the non-physical screening, that my daughter isn’t cut today.
Image credit: Ali Naji