This week, Insight breaks some deeply held taboos to look at a practice which is as personal as it is controversial.
JENNY BROCKIE: Hi, I'm Jenny Brockie, welcome and I should warn everybody here and at home that given the nature of tonight's topic, we going to be having an explicit discussion and Ubah, I'd like to begin that discussion by talking to you. Now you were born in Somalia and you were circumcised there at the age of 6?
UBAH ABDULLAHI: Correct.
JENNY BROCKIE: What do you remember of that day?
UBAH ABDULLAHI: In Somalia this is quite a normal process, it's almost like piercing your ears kind of thing because it's that common. So I was, my mum didn't know about it but my grandmother wanted to have this done for us.
JENNY BROCKIE: Why didn't your mum know about it? She didn't want you to have it done?
UBAH ABDULLAHI: My dad was completely against it and in fact he didn't talk to my grandmother or my mum for seven days after this had happened. So he was, they were both educated and didn't want to subject us to that pain and suffering, I guess. However, I knew that it was a normal thing and it was almost like coming of age for girls, so at the schools you went to everybody had it done.
JENNY BROCKIE: So you weren't frightened about it?
UBAH ABDULLAHI: Not at all.
JENNY BROCKIE: You hadn't heard stories about it hurting or anything like that?
UBAH ABDULLAHI: Not at all. It's not talked about that manner - it was never talked about in that manner. I didn't know any better so I thought yep, I'm excited about the concept because all the other girls had it done as well so I didn't mind.
JENNY BROCKIE: So it was perfectly normal?
UBAH ABDULLAHI: At the time, yes, it was actually perfectly normal.
JENNY BROCKIE: Now there are different types and different degrees of female circumcision, what type was yours?
UBAH ABDULLAHI: Mine I would classify it as type 2. So the first type would be the one that you actually have the clitoris minimised, the second type would be the clitoris of course minimised as well as they stitch you.
JENNY BROCKIE: Minimised meaning partially taken away?
UBAH ABDULLAHI: It's basically they cut it and when, whether it's a nurse or depending on who's cutting it, they cut it either a little bit or some of them cut a lot more all the way to the bottom. So I've had that cut, mine wasn't severe, the severity of some people, mine was just halfway through cut and then they sewed me up.
JENNY BROCKIE: So they stitch up the labia?
UBAH ABDULLAHI: Yes, all the way and then there's basically, just to be more, she asked you to cough, because it was a nurse who performed my circumcision and you had a little, almost like it's a clot that came out when you cough and that's the space I've had left.
JENNY BROCKIE: So just a really small space?
UBAH ABDULLAHI: Pretty much.
JENNY BROCKIE: And what was it like for you then as a child straight after that operation?
UBAH ABDULLAHI: On the day, of course it was a nurse so I've had, she's had topical, topical kind of gel, injection that she injected me to numb the space when she's, she was performing the procedure. After the procedure when the numbness had actually gone away that's when I started to feel the pain.
JENNY BROCKIE: Yes. Fuambai, you're originally from Sierra Leone, but you've lived in the US for most of your life. Now in your last year at university there, you made the decision to go home to be circumcised. Why?
FUAMBAI AHMADU: I was actually, there are quite some significant differences in the experiences that we've had. I was approached by my aunt and my mother and grandmother, they wanted me and several other girls in my family to join in Sierra Leone culture, a society we call it Bondo, to join Bondo. And I was very excited because you know, I left Sierra Leone when I was very young but I had very vivid memories of just the celebrations, the festivities, the Bondo masquerades, the dancing and seeing all these women, it was something that I always wanted to be a part of.
JENNY BROCKIE: How old were you when you'd made that decision?
FUAMBAI AHMADU: I was 21. So I was an adult and in college and there was no, there was no question in my mind that this is something I really wanted to do.
JENNY BROCKIE: And what did yours involve?
FUAMBAI AHMADU: The actual operation?
JENNY BROCKIE: The actual operation - yes.
FUAMBAI AHMADU: Typically in Sierra Leone it involves excision of the external part of the clitoris, the glands and the hood, and excision of the labia minora. So right, there's no, there's no….
JENNY BROCKIE: So you weren't stitched up in the way Ubah was?
FUAMBAI AHMADU: There's no stitching together, it's not a part of our own tradition in Sierra Leone.
JENNY BROCKIE: And what was that experience like for you, apart from the celebration that you describe - what was the actual operation and the aftermath of that like for you?
FUAMBAI AHMADU: Well the physical operation was definitely painful, it was, and for me coming from the US and having grown up predominantly in the US, I think I experienced a kind of culture shock that many of the young girls there didn't. So their experiences were quite different.
JENNY BROCKIE: Who did the operation?
FUAMBAI AHMADU: We have traditional circumcisers who have, you know, they're trained since they're very young, this is their vocation, this is what they do, so they've done hundreds and hundreds of operations.
JENNY BROCKIE: Same with you Ubah?
UBAH ABDULLAHI: No, I've had an actual registered nurse who performed mine but that was part of her function as well, so traditional nurses in Somalia probably would be circumcisers as well as midwives.
JENNY BROCKIE: So how did you feel about it afterwards, immediately afterwards?
FUAMBAI AHMADU: Immediately afterwards, you know, certainly there was a convalescence period was quite difficult and because I was an adult, I was able to process things, I think, in a much deeper way.
JENNY BROCKIE: Well there's a big difference between the two of there, isn't there?
FUAMBAI AHMADU: Yeah.
JENNY BROCKIE: I mean you're six, there's no choice really for a six year old but you're making a choice.
FUAMBAI AHMADU: Absolutely and very conscious and very aware and able to ask questions, in Sierra Leone it's very much a coming of age.
UBAH ABDULLAHI: Yeah.
FUAMBAI AHMADU: Ritual, it's a transition from girlhood to womanhood and it's parallel with the male initiation as well where boys are also, you know, they're initiated and they become men. So it's a very big deal, it's an important aspect of ethnic identity as well and because it's associated with women's power and especially so in Sierra Leone where women in a tradition…
JENNY BROCKIE: Why power, because in the west it's not associated with power at all, it's quite the opposite?
FUAMBAI AHMADU: Right, and you know I've struggled with that over the years as well to understand sort of western perceptions of the practice. Misunderstandings of the practice because in Sierra Leone I think in many other parts of Africa where these operations take place, it is very much associated with women's power and women's spheres of influence. In Sierra Leone no men are allowed to even ask questions about this operation, just like women would not interfere in men's initiation and men's rituals. They have share secret knowledge and experiences and so do women.
JENNY BROCKIE: Okay, I wanted to bring your sister in to this discussion because Sunju, you were also circumcised on that same day that Fuambai was, how old were you when you had it done?
SUNJU AHMADU: I was eight.
JENNY BROCKIE: Eight years old?
SUNJU AHMADU: Yes.
JENNY BROCKIE: Did you have a choice?
SUNJU AHMADU: No, I knew that we were going to Sierra Leone and we were going to join the women's society Bondo, but no.
JENNY BROCKIE: Bondo is the word to describe this ritual, yes?
SUNJU AHMADU: Yes.
JENNY BROCKIE: We have some footage, some home video of you and your sister on that day, I'd like to have a look at that. Can you tell us a little bit about how you feeling then, what you were understanding about what was going on?
SUNJU AHMADU: Sure. I was very excited to go back home, to go to Sierra Leone and as you can see, to be amongst the women in our family. We went through almost like three weeks of celebration and just being really the centre of attention. This was, that's me in the centre there and that's my sister behind me. And we were, we took part in the celebrations.
JENNY BROCKIE: Did you understand why it was being done?
SUNJU AHMADU: I didn't understand why.
JENNY BROCKIE: And how did you feel after the operation as an eight year old?
SUNJU AHMADU: It happened really fast for me so I don't remember pain.
JENNY BROCKIE: And did you have the same operation your sister had?
SUNJU AHMADU: Yes.
JENNY BROCKIE: Exactly the same.
UBAH ABDULLAHI: That's perhaps, I think that's why theirs is probably less traumatic than what our traditional circumcision was like because with Somalian one, when you get stitched up they actually tie your legs together so you don't, you basically hop along for a whole week. So you can't urinate, you can't, even when you wanted to do number 2 - it's extremely difficult process because for you, you basically have this whole area that's been wounded and everything that's normal becomes extremely excruciating pain.
JENNY BROCKIE: So traumatic for you?
UBAH ABDULLAHI: Extremely traumatic.
JENNY BROCKIE: As a six year old?
UBAH ABDULLAHI: Absolutely. It starts from that day onwards and then when you get your first periods and as a kid basically there's no space for it. When you go to the toilet and you wanted to urinate, it takes you a lot longer than it would for other people. If you wanted to go through just your whole life, your association with anything to do with like your womanhood, it's changed from that day onwards.
JENNY BROCKIE: I'm interested in the way you just dismissed the clitoris being taken away?
UBAH ABDULLAHI: No, no, that is very painful but for me the impact the stitching has on you is a lot further….
JENNY BROCKIE: A lot greater?
UBAH ABDULLAHI: Than you would have, also the clitoris of course that's your whole nerves and everything is taken away and that takes sensation of your adult sexual life, et cetera. But also not having to just urinate like normal people, not having to have your menstrual cycle just like normal people - that to me was the traumatic day that started on that day and it goes with you till the day you have kids or you have it reversed.
JENNY BROCKIE: Mansura, there are many different types of female circumcision. I think a lot of people probably don't understand that. Can you just explain to us what those different types are?
MANSURA DOPICO: Okay, you have what they call type 1 and even within that type 1 they have three different types which is sometimes just a ritualised so they would just scrape the clitoris and maybe and they might just apply some sort of herbs. And there is the other one where they'll just nick it so that it just has a little bit of bleeding but no lasting effect. Within that one as well they might just cut only the pupas or the hood a little bit but there's no, not taking the clitoris off. So that's the type 1.
Then you'd have type 2 which is equivalent to sometimes they call it clitoridectomy where I think that's the type Fuambai and Sunju had. You know that would entail cutting the clitoris or just part of it and sometimes part of the labia minora with it all of it or part of it.
Then you have the type 3 which is infibulation and that entails, and again even within that what they do is they would cut the clitoris maybe, sometimes half of it, and remove the labia minora and majora and they would stitch it together and just leave maybe just the size of a pea for voiding and urination.
JENNY BROCKIE: Now all of this is called female genital mutilation in Australia. Is that what it is Fuambai?
FUAMBAI AHMADU: I didn't experience it as mutilation and I think most of the women in Sierra Leone who are initiated, are members of Bondo, would also not refer to it as mutilation. Also just as anthropologist who has studied female mutilation rituals in West Africa for many, many years and have written about it extensively, that most women do not experience it as mutilation and would never refer to themselves as mutilated.
JENNY BROCKIE: Mansura, you agree with that?
MANSURA DOPICO: I agree with that. I mean I've done my honours and my PhD on it and every person that I'd interviewed, they don't see it as mutilation?
UBAH ABDULLAHI: I've been told stories and this is very common in Somalia, when a girl gets married, she gets married into a household. There would usually the in-laws, et cetera that will be outside and usually when you're supposed to, the guy is meant to now break your virginity but because you're already sewn up, as a kind, it's a mark of their manhood, they actually need to break through that. So they have this basically males trying to penetrate in an area that you cannot even urinate on, trying to break them that way. So therefore you have, basically you have days and weeks of that, they're trying to break through, just the skin on the skin, trying to get through to the stitching that's been done manually to this woman.
So you can imagine us having the first sexual intercourse in itself is quite painful as it is as a virgin but having that, you know, as another level added to that, it's the most excruciating pain anybody would have and if they're enjoying that intimacy with their husbands, that's the first encounter they have of sexual experience with their husbands so I would call it definitely mutilation because I can't imagine it being called anything else.
JENNY BROCKIE: Where it gets interesting though is the law. You know, it's an offence to perform this operation in Australia, or to even take a child overseas to get this done. Juliana, I wanted to ask you about it because you launched an education campaign about this?
JULIANA NKRUMAH: Yeah, look I think the issue with the concepts is one that we need to really be clear about. What communities call the procedure is female circumcision, so which ever type it is communities call it female circumcision and respectfully, that is accepted. But when it comes to the legal issues about the practice and why people call it mutilation is because it is the outcome of the procedure, presents a woman who is mutilated.
FUAMBAI AHMADU: I do take issue with that and terminology does really matter. I think for a lot of women who do not experience themselves as mutilated, for whom this procedure is an important aspect of our identity and becoming a woman and we have our own words that we use to describe the practice, it is not mutilation, so these women, including myself, end up being stigmatised and having to endure a label and an experience that is just not ours.
JULIANA NKRUMAH: What the community presents to us is we don't feel like mutilated women, we should not be stigmatised and therefore respectfully we work with the language that the community gives us. But we don't use all the community's language in the written documents and the legal document because there is an accepted position by the United Nations and we work from that position and that is the language that is used by the United Nations.
JENNY BROCKIE: Do you think it is mutilation Juliana?
JULIANA NKRUMAH: Look if it was, and I'm coming from a position where I've looked at all the practices and all the communities and I've come to the point of complete respect for what is done in West Africa, as the Sierra Leonese do it, absolute respect for the cultural basis, and I'm known to say that if we take the operation and we separate it from the cultural milieu, that is mutilation and that is violence against women. When we position it in the cultural milieu that is completely different practice but I would wish that when we put it there, we would not even do the operation but allow people to go through the rite of passage for the purposes for which it delivers to women.
JENNY BROCKIE: Sonia, Grover in Melbourne, I wanted to ask you about this because you're a gynaecologist and you've been working closely with women in the African community in Melbourne for twenty years or so. Do you think it's mutilation?
DR SONIA GROVER: As a procedure that is done on young children, I find it abhorrent. But I think we also have to acknowledge the contradictions that are occurring, we accept that circumcisions happen in boys and we don't make a great fuss about that. We accept that white Anglo Saxon women are having labia plasties done and the number of those procedures have gone up five fold in the last ten years, which means that it must be culturally driven, and that's happening here in Australia and we're ignoring it. So we're taking a stand and telling one community that they're mutilating their bodies, and we're tolerating our white community, including teenagers, who are mutilating, doing things to their genitalia. So I find it very difficult. And we know from looking at our data at the children's hospital here in Melbourne that a substantial number of the young women, teenagers, are actually coming because their mothers think their genitalia look abnormal and are requesting labiaplasties. So tell me what the difference is.
JENNY BROCKIE: Tonight we're talking about female circumcision, why it's done and how women who've had it done feel bit. Ubah, before you were talking about your operation which involved the partial removal of your clitoris as well as the stitching up of your labia, how did that affected your sex life?
UBAH ABDULLAHI: Okay, for me, I actually, I was fortunate enough to have been brought here when I was much younger - my periods lasted two, three weeks and my menstrual period, and basically I couldn't…
JENNY BROCKIE: Your blood couldn't get out?
UBAH ABDULLAHI: My blood couldn't get through. So I've gone through, I had excruciating pain for about two weeks and each period I had was about the same and far worse and worse and worse. So eventually I went to see an Egyptian gynaecologist who understood the practice and who then said to me I can have this actually, I can open this for you.
JENNY BROCKIE: So this was here?
UBAH ABDULLAHI: It was here in Australia.
JENNY BROCKIE: And how old were you when that happened?
UBAH ABDULLAHI: I was about 18 or 19, 18 when I decided to - it took me a long while to actually get the courage to have somebody examine me because once you go through that experience, you just don't want anybody to see that part of your body because I knew that mine was different to everybody else's and I didn't want to be seen by a doctor because I thought doctors here wouldn't probably understand.
JENNY BROCKIE: So your mother supported that?
UBAH ABDULLAHI: My mother initially didn't. Being a conservative Somalian female, raising four daughters in a very, like western society, she was fearful that we would probably stray and be sexually active earlier than we had to.
JENNY BROCKIE: But what about sexual pleasure?
UBAH ABDULLAHI: So then when I got married, I didn't know any matter. In fact the first time I saw my husband after my circumcision was done, I was very conscious for him to see me in that region because I still thought I would, it's like you're deformed almost, or in my head I thought I was.
JENNY BROCKIE: And what about your sexual pleasure though?
UBAH ABDULLAHI: To be honest with you, I don't think it affected me that much at all. The fact that my clitoris was not removed completely didn't, well perhaps was the reason why it didn't affect me to that point. And yeah, my sexual life is absolutely fine now but I probably wouldn't say the same about people who have had the whole clitoris removed.
JENNY BROCKIE: Fuambai, what about you? I did say it was going to be explicit and we do have to be go here because this is a very big part of this debate. I mean it is a big reason.
FUAMBAI AHMADU: Yeah. I was 21 at the time that I went and I was already sexually active and after undergoing, in fact I thought at the time and did ask a lot of questions that it would impact my sexuality because I'd grown up in western society, western culture and you know, we are raised typically to believe that this particular part of the body is the key source of pleasure and so on. So I was concerned about that and I was surprised to find out that there was absolutely no difference in terms of my sexual experience, sexual feeling, ability to achieve orgasm. There was absolutely no change at all.
JENNY BROCKIE: Ramsis, you're shaking your head and disagreeing a lot there. Now you're - I should point out that you're a GP in western Sydney and most of your patients are Sudanese, is that correct?
DR RAMSIS GAYED: Yes, yeah.
JENNY BROCKIE: What's your response to this as a GP seeing those women?
DR RAMSIS GAYED: Yeah, I will talk from the experience I have from my patients, I have a lot of females that have what we call it infibulation, that's the commonest type in Sudan which is… where they close everything.
JENNY BROCKIE: Infibulation is the type 3 sewing up?
DR RAMSIS GAYED: Yeah, yeah, and their experience that first of all besides all the complications of this operation, which is infections and severe psychological pain, not only of the procedure as kids but as the first sexual, intercourse experience.
JENNY BROCKIE: First sexual experience just like Ubah was describing?
DR RAMSIS GAYED: A lot of them have failed to have, I have some patients that didn't have orgasm for years and years because simply they just can't have this pleasure. Because of the severe pain that they had initially and then that continued every time, her husband would come close to her, that gives her the fear of the first encounters and then gradually things develop into even resentment.
JENNY BROCKIE: Mansura, you're disagreeing with Ramsis?
MANSURA DOPICO: I'm disagreeing because my thesis was actually - I wanted to have a look at the impact of infibulation on orgasm, right? And I think yes, what you went through could be, I'm not saying that people don't go through it but it was not the experience of all the people that I spoke to.
JENNY BROCKIE: Now you spoke to ten Eritrean women?
MANSURA DOPICO: I spoke to ten Eritrean women in here in Australia and ten in rural areas and what I wanted to have a look at, I wanted to compare the women who have been impacted by western views of sexuality, so I actually wanted to have a look at, you know, people in rural area that have absolutely no contact with western concept of sexuality and to compare them.
JENNY BROCKIE: Okay, so what did those women tell you?
MANSURA DOPICO: Well okay, the wedding night was actually quite horrendous but it was part of what you expect as a woman, when you get married that happens.
JENNY BROCKIE: I don't know that wedding nights are always horrendous for women.
MANSURA DOPICO: For women that have been infibulated, for women that have been infibulated, that's how they experienced it. As far as their orgasms are concerned, they were actually, there was no change between when you compare them to the normal uncircumcised women, the percentage of women that orgasmed were a lot similar.
JENNY BROCKIE: Ubah, you're pulling a face there?
UBAH ABDULLAHI: I disagree because a lot of them don't seek the pleasure of having to orgasm. To them it's like, in my community sex is not as discussed. It's not, it's not something women will gather around and say, usually all the women generally, hey, so how's your orgasm going? They don't.
MANSURA DOPICO: Actually, it was quite different. I found these women actually sharing and talking about what they did and when I went in there to talk about to actually ask them, and especially in rural Eritrea, they were asking me like what do you do in Australia? How do women do and I was actually being, I heard things that I've never heard before. Women masturbated and they came to orgasms and they were sharing all these things with me.
JENNY BROCKIE: Okay, Ramsis, response from you because your story is very different?
DR RAMSIS GAYED: Well I have spoken to, I have more than 20, 30 of those patients and that's about, I would say, 80 percent of them, that's their experience. It's a very painful traumatic thing, they remember and they cry when they talk about it.
JENNY BROCKIE: And the men, what do the men tell you?
DR RAMSIS GAYED: Now the men in general are very secretive about this. So of course there is a culture that the tighter the lady, the better the man. So I still remember when we in Sudan and we were delivering ladies, after we finished they will ask that we tighten them up. So we have to suture them tight again and when we ask them why you want that, because the man will get more pleasure. The main rule is not to have the pleasure but how to keep their husband happy the best way. Otherwise, he will go and marry another woman.
JENNY BROCKIE: Vivienne, you're with NSW Health, what are women telling you about this?
VIVIENNE STRONG, NSW FGM PROGRAM MANAGER: In women that have type 1 and type 2, more so in type 1, they don't seem to have as many difficulties orgasming as type 2, women who have had type 2 and type 3. It's very difficult to say that this is type 1, type 2 and type 3 because they don't fit into boxes.
JENNY BROCKIE: But overall what is the impression you're getting that the impact this operation is having on the women you see?
VIVIENNE STRONG: The greater impact is on women that have had type 3.
JENNY BROCKIE: And the impact meaning, what meaning?
VIVIENNE STRONG: Meaning impact upon their general health, on their ability to have intercourse with their partners, on all aspects of sexual pleasure. But of course the issue for many of the women is when it comes to child birth.
JENNY BROCKIE: Yes, which is a whole other question, which we'll discuss in a moment, but Sonia, what are they telling you and can we talk to you about that, about child birth?
DR SONIA GROVER: So the important thing with regard to child birth, is understanding if an infibulation has been done, where the stitching has been done, that it needs to be undone so that the baby can deliver and then they can have a normal delivery.
JENNY BROCKIE: And what if they ask you to stitch them back up again in the same way, it's not legal to do that?
DR SONIA GROVER: Um, it's very, very uncommon for women to ask to be stitched up again.
JENNY BROCKIE: Vivienne, what do you think, I'd just like to get a response here?
VIVIENNE STRONG: Well at this stage it's against the law to reinfibulate woman but it's not against the law to make women comfortable after they've given birth if they've been deemed infibulated prior to giving birth. So I don't see it as being….
JENNY BROCKIE: Comfortable?
VIVIENNE STRONG: Well after they've been infibulated there's a lot of very traumatised tissue, that can be corrected and that's within the law.
JENNY BROCKIE: And sewn up again! So it's a grey area?
VIVIENNE STRONG: It's a grey area - it's a very grey area.
FUAMBAI AHMADU: A white Australian woman can request a far more invasive procedure, vaginal rejuvenation, clitoralplexy which involves clitoral reduction, clitoral hood reduction, a whole range of procedures that in many cases is far more invasive than the African procedures.
JENNY BROCKIE: Ben, you're a lawyer, can you clarify this for us?
BEN MATTHEWS, QUEENSLAND UNIVERSITY OF TECHNOLOGY: Look, there are a few issues here. Australian law in every state and territory does prohibit the performance of FGM in all forms.
JENNY BROCKIE: Female genital mutilation?
BEN MATTHEWS: Female genital mutilation, and I will use that term because I think that's the more correct term. I acknowledge that there's differences in experiences and different levels of the procedure. Nevertheless Australian law does prohibit it in every state and territory. This reflects a growing trend worldwide, so 19 African nations now also have legislation which prohibits FGM all its forms and there's other international bodies, health bodies and international legal instruments which also prohibit it and there's literally thousands of religious leaders, community leaders in Africa who have now instructed their followers and issued edicts against FGM.
Now if you ask me that question about reinfibulation after delivery for a woman who’s had infibulation, that's a bit of a thorny issue. Right now it is technically illegal in Australia but I can conceive of cases where a woman who's been infibulated has such a different psychological state now that she would struggle to be left in a defibulated state. However, I think that's, that's one of the smaller issues facing us in this field and I could return to the labiaplasty and the cosmetic surgery point, if I could return to that for a moment. I'd like to draw a distinction between FGM and labiaplasty, I think they're fundamentally different.
JENNY BROCKIE: How are they different?
BEN MATTHEWS: They have qualitative differences. Right? FGM is done on children, on infants who cannot give true consent; it's done for cultural reasons, labiaplasty is not. Labiaplasty is requested, usually by adult women. Okay, it's usually requested by adult women. There may be some issues with minors in Australia requesting it.
JENNY BROCKIE: What about if FGM was requested by adult women as in Fuambai's case? I mean do you see that as different to labiaplasty?
UBAH ABDULLAHI: Just because it's called a different name.
JENNY BROCKIE: No, let him answer, I'm very interested, I'm very interested in whether you see a difference between the two.
BEN MATTHEWS: Legal prohibition on FGM reflects our society's, and many other societies' fundamental understanding of FGM as a breach of women's human rights and girls human rights and of their rights to health.
JENNY BROCKIE: We should clarify a little bit about labiaplasty and David, you do those operations, don't you?
DR DAVID CAMINER, PLASTIC SURGEON: I do, yeah. I do labiaplasties more commonly than any other type of genital surgery.
JENNY BROCKIE: Okay, and this is women who come to you. What age are they normally?
DR DAVID CAMINER: They range anywhere from probably 17 to mid 50's. Mostly the people seeking labiaplasty come for other aesthetic reasons or for comfort reasons. And the usual thing is that they request the labia minora to be shortened. Very different to a type of circumcision and a completely different operation to infibulation.
JENNY BROCKIE: And is it mostly for cosmetic reasons, mostly for appearance?
DR DAVID CAMINER: I wouldn't say - split, I would say half, half, maybe a little bit more cosmetic than, than, than comfort.
JENNY BROCKIE: And what ethnic background would most of your patients come from?
DR DAVID CAMINER: A variety. There's no, I certainly don't deal with any African people, I see mainly Europeans who request labiaplasty.
JENNY BROCKIE: Ben, would you consider that cultural, the reasons that women are having those operations done?
BEN MATTHEWS: Not necessarily. Labiaplasty and other operations can be done to cure or alleviate a medical condition.
JENNY BROCKIE: But what if they're just done for cosmetic - what I'm trying to get at here is just the difference, the actual difference. Now we know there's a difference if you're a six year old and you have no choice, that's a big difference?
BEN MATTHEWS: Yes.
JENNY BROCKIE: But let's say we're talking about two adult women and one wants to have an operation for cultural reasons because she's from Sub Saharan Africa, or wherever, another one wants to have a labiaplasty done because she doesn't like the look of her genitals and she wants to actually change the look of them. Do you think there's a qualitative difference in those two procedures?
BEN MATTHEWS: Look, I can see the argument against me but I still think there is, I think…
JENNY BROCKIE: It's not against you?
BEN MATTHEWS: Against my viewpoint. I think the request for cosmetic enhancement of various forms is to enhance the appearance or the function of something.
UBAH ABDULLAHI: So just because culturally if somebody feels their clitoris is a lot bigger than everybody else that's of the same culture, isn't that for cosmetic purposes in the long, whether they do it culturally or not? It's an adult making an informed decision to have that.
FUAMBAI AHMADU: In African societies it's also believed to make a woman more beautiful, it’s also aesthetic reasons.
BEN MATTHEWS: I think that's fine but I don't call that FGM.
JENNY BROCKIE: Okay, Juliana?
JULIANA NKRUMAH: I think we should bring the whole discussion back to what we are in here to talk about. Number one, it's not an African practice and it's really important that we don't stick it on Africans. Seriously.
UBAH ABDULLAHI: Because there's a lot of issues.
JULIANA NKRUMAH: There are different countries that are known to have FGM as a practice and the two things we're talking about don't have similarity. One is completely different to the other. One is a cultural practice that has operation on the genitalia of a young person, a female child for cultural and non therapeutic reasons and that definition then takes everything else out of the discussion that we are having.
JENNY BROCKIE: Ben?
BEN MATTHEWS: I think the difference is the motivation behind the procedure. On the one hand we've got the purely cosmetic, on the other we've got a cultural practice which is imposed only on women for reasons, many different reasons, one of which is fundamentally to preserve virginity and marriageability and for family honour.
FUAMBAI AHMADU: That is not true, that is not true.
UBAH ABDULLAHI: Males and females do get circumcised, it's not gender related.
FUAMBAI AHMADU: It's not true. It happens, there are different justifications or reasonings for it, depending on where it's being done.
WOMAN: What is this rite of passage and what is this power that you gain? What power do you have that I don't have that I come from a Catholic European Australian background that you seem to have that I don't? Or women who have had circumcision seem to have that I seem to be missing out on because I haven't had my, my genitals removed or been stitched up?
FUAMBAI AHMADU: For us, do you want me to answer?
JENNY BROCKIE: Let Ubah answer this one.
UBAH ABDULLAHI: Okay, these are two different topics. One is an adult making a decision, whether it's tattoo or you want to reduce your clitoris, you want to have piercing in your clitoris, whatever it is you might want to choose. It's up to you. As an adult you should have that option to make that decision. However, a child having their genitals removed or deformed in a form where they would suffer physically, emotionally, basically for the rest of their life because of that decision made by somebody else as a child for them, that to me that's what I have an issue with and that's what the government should regulate and should have control over, not an adult having to have some kind of surgery.
JENNY BROCKIE: Lady up the back, you wanted to say something?
WOMAN 2: What I wanted to say was that doing it on a child is actually child abuse. It's a form of power and control and it's a form of sexual abuse.
JENNY BROCKIE: Sunju, yes?
SUNJU AHMADU: I was a child when I underwent initiation, I was eight and I don't need psychological therapy. I wasn't abused, I didn't experience sexual abuse, this wasn't my mother, you know, showing me any kind of, you know, control and so I'm just, what I'm saying is that experience.
JENNY BROCKIE: Vivienne?
VIVIENNE STRONG: I guess that the issue in Australia is one of human rights. As a child you have no say in whether or not you're circumcised and to the degree of circumcising that occurs. As an adult around labiaplasty, in theory, you're making an informed consent and that would be a distinct difference between.
FUAMBAI AHMADU: And male circumcision?
VIVIENNE STRONG: Beg your pardon?
FUAMBAI AHMADU: Is male circumcision?
VIVIENNE STRONG: Is allowed, yes.
FUAMBAI AHMADU: Without the consent?
VIVIENNE STRONG: Of a small child, yes, it's an issue.
UBAH ABDULLAHI: I also agree with a boy child should be circumcised.
VIVIENNE STRONG: It's an issue but we can only deal with one at a time.
JENNY BROCKIE: Can I ask us, I mean we've recently seen charges laid in relation to this in Australia. Do you think that this operation is being practiced much here?
VIVIENNE STRONG: I would be surprised if level 3 and level 2 were being practiced. I would say possibly 1 and 4, level 4, which is just a ritual nicking of the clitoral hood would be being practiced without anybody's knowledge quite easily.
JENNY BROCKIE: Tonight we're talking about female circumcision and is it women who are primarily driving this procedure?
JULIANA NKRUMAH: You see, women are survivors of female genital mutilation, they live with it when it's been done to them as children. But women are also the custodians of the practice and that is why it hurts mothers and sometimes grandmothers to have to put their girls through this practice. Now that's not funny, for a mother who knows her own pain to have to allow her child to go through that.
JENNY BROCKIE: So why are they doing it?
WOMAN: Why allow - you can stop it, you can say no.
JULIANA NKRUMAH: I think it's very important for us to understand that something that is not part of our culture is difficult to understand.
UBAH ABDULLAHI: In the traditional cultures usually when your daughter is going through that, they don't see it as harm. It's been done for generations. People don't do that to harm their children, they do them, they do them.
WOMAN: Then what are they doing it for?
UBAH ABDULLAHI: It's a cultural reason, it's just like piercing your ears, it's a girl, this is what they do.
WOMAN: So it's for adornment then? Because we wear earrings for adornment?
OBAH ABDULLAHI: That's pretty much it.
FUAMBAI AHMADU: Can I responds?
WOMAN: So you cut your children up who are under 18 years of age.
UBAH ABDULLAHI: I don't belittle other people's cultures, everybody has culture is very, very --
WOMAN: My culture, my culture doesn't mean that skin is removed or the child is bleeding--
UBAH ABDULLAHI: Really? What do you call tattoos?
WOMAN: You mentioned your own mother and father didn't agree to it and your grandmother did it.
UBAH ABDULLAHI: They didn't and I don't agree right now but what I'm saying to you what people do, people make choices, people's cultural….
WOMAN: You cannot compare a hole in the ear….
JENNY BROCKIE: Let her finish.
WOMAN: I'm sorry.
UBAH ABDULLAHI: People make choices not because they want to harm their children. It's because they feel the culture will either ostracise their child or they will not be successful in many ways, impossible thing, so they do them for the good, they think they're doing it to better their child. They don't do them to harm them. So that's what you need to understand.
JENNY BROCKIE: One of the perceptions I think you is that somehow men are driving the procedure in the west, I think that's the perception rather than that it's women driving, would that be a fair thing to say? I mean it seems to me that's the popular, you know, why? Yes, you're nodding your head?
MALE: I think in the western world all we think of it as these cultures being patriarchally driven and therefore it must be a patriarchal practice. But I'm astonished tonight that that's hardly ever been raised and it's not. So my perception of what the issue was has been completely set aside by these ladies telling us how it really is.
JENNY BROCKIE: Okay, does religion come into it at all?
FUAMBAI AHMADU: Religion does not come into it.
JENNY BROCKIE: Because you were raised as Christians, right?
FUAMBAI AHMADU: Raised as Christians, female initiation and male initiation cross religious lines…
JENNY BROCKIE: I just want to get to the bottom of this because I think it is a perception that some people have that it's connected to religion.
FUAMBAI AHMADU: Both practices pre-date, Christianity, Islam and so on. So in response to you, it's an important aspect of our identity as women, it's how we become adult women. This is something that we positively choose.
JENNY BROCKIE: Sheikh Isse, you're an Imam in Victoria and you're originally from Somalia. Now can you clarify for us what Islam says about female circumcision?
SHEIKH ISSE MUSSE: Islamically people feel that it's a religious duty to circumcise children, male and female, and they use, people use quotation from prophet Mohamed, peace be upon him, when he was instructing the woman in charge of circumcision. But if you carefully look at the saying of his, you do not find that it amounts to mutilation or genital mutilation, it doesn't amount to that.
JENNY BROCKIE: What is it then?
SHEIKH ISSE MUSSE: Because he said to her: Do not go deep, don't cut deep so that the husband and the wife later on can have gratification. What he's saying is if the whole external is removed, then there would be no gratification and it will be a terrible thing.
JENNY BROCKIE: So this is the ritual nicking that you were talking about earlier Mansura, this kind of thing?
SHEIKH ISSE MUSSE: Yes. The Sharia view is we have to weigh up everything that we do. How much disadvantage is there, how much advantage is there, it's the concept of utility. Whenever the disadvantage is quite outweighed, then it becomes prohibited.
JENNY BROCKIE: Okay, so what do you think about female circumcision? Do the disadvantages outweigh or do the advantages outweigh?
SHEIKH ISSE MUSSE: Well given the stories that the victims have told and how traumatic it is and the pain involved and all those issues, well, it is disadvantaged more than any assumed advantaged. So on that face it becomes prohibited Islamically.
JENNY BROCKIE: Alpha, you've been listening to this and I've been catching you from time to time shaking your head and looking quite alarmed by some of it. Now you have three girls?
ALPHA PECOS BAH: Yes.
JENNY BROCKIE: Aged 16, 12 and 7?
ALPHA PECOS BAH: Yes.
JENNY BROCKIE: And the two that were born in Sierra Leone were both circumcised there?
ALPHA PECOS BAH: Yes.
JENNY BROCKIE: Did you have any say in that?
ALPHA PECOS BAH: With my own daughters I had no say absolutely. I was just a lay person, I did not know anything about it. All I knew about is about circumcision on men. Female genital mutilation that has to do with our parents, I had no say absolutely. And with the third girl born in this country, now I fear taking her back even back home because if I take her back home I have to make sure she is chained to my, you know, wherever I go she must be with me or else the least mistake the grandmother will just, you know, or whoever will just snatch her from me and then within minutes the act is done.
JENNY BROCKIE: Okay Fuambai, a fellow Sierra Leonean, your response?
FUAMBAI AHMADU: I, about his, you know, your fear taking your daughters to Sierra Leone, or your daughter who hasn't been circumcised to Sierra Leone, again, women are not there on the ground looking to kidnap uncircumcised girls and go forcibly circumcise them.
JENNY BROCKIE: But Ubah, that's what happened to Ubah?
UBAH ABDULLAHI: Not me, my grandmother wanted to and that's…
JENNY BROCKIE: I mean but that's effectively, no, I just want to make the point, that is effectively Ubah's story, that her parents were out at work and her grandmother took her off to have it done without her parents knowing.
FUAMBAI AHMADU: I can't comment on that specific…
ALPHA PECOS BAH: Yeah, but you must understand there are different ethnic backgrounds. For example I'm a Fullah.
FUAMBAI AHMADU: You're a Fullah, you're a Fullah, okay.
ALPHA PECOS BAH: Are you Mendes?
FUAMBAI AHMADU: I'm Konos.
ALPHA PECOS BAH: Konos, yeah. You are Konos.
JENNY BROCKIE: Explain that to us as briefly as possible.
ALPHA PECOS BAH: Okay, that is very interesting. She is Konos, I'm Fullah but I'm from Konos. I'm born and bred in Konos. Born, bred and lived in Konos.
JENNY BROCKIE: What’s the difference, it means a lot to you- I don't know what you're talking about.
FUAMBAI AHMADU: Exactly.
ALPHA PECOS BAH: They are not out there to snatch girls, you know, to do the act but with my own ethnic background being a Fullah, I'm 100 percent confident that if I take her there now, I'll have to make sure that she's chained to my hand where ever I go, even when I'm sleeping she'll have to sleep with me.
JENNY BROCKIE: Fuambai, does that make more sense to you now?
FUAMBAI AHMADU: In terms of how Fullah practice female circumcision, and I think also the role of Islam, most Fullahs are Musli m and so Islamic ideology or Muslim ideology is quite important in terms of how the practice is interpreted. And ideas about virginity and chastity are more important among them.
JENNY BROCKIE: Okay, where does this leave us in terms of the law in a country like Australia? Now at the moment it's illegal, that is the law, the law is that it's unacceptable here. Juliana?
JULIANA NKRUMAH: Our law does not single out African communities. Our law covers all countries that have female genital mutilation as a customary practice. That's number one. I believe the law needs to be reviewed to include cosmetic surgery because that is causing a lot of problems in our general community.
JENNY BROCKIE: Sonia, what do you think we should do in relation to the law?
DR SONIA GROVER: I think we should be consistent with what we're doing. I think the idea that people can consent as adults sounds very sensible and we should not be doing things to children, absolutely.
JENNY BROCKIE: Ubah, would you do this to your girls?
UBAH ABDULLAHI: I personally would not touch a child of mine, whether it was a female or a male child, I would not subject them to any kind of mutilation. Skins are there, they are born perfect, I would not remove a finger so I would not remove any genitalia parts.
JENNY BROCKIE: Fuambai, Fuambai, if you had a girl, if you had a daughter what would you do?
FUAMBAI AHMADU: If I had a daughter I would want her to have the same experience that I had, which was being able to consent, and for us it's not female circumcision, it's a whole experience of female initiation. It's something I'm very, very, very proud of and, you know, I have the utmost respect and admiration for the women in my family. I would want her to have that experience but I certainly would want her to make that choice, it has to be her choice.
JENNY BROCKIE: We have to leave it there. I'm sure people will want to keep discussing this and we do have to wrap it up but you can keep talking on line. Go to our website, Twitter or Insight's Facebook page.