‘Something has been taken away’: Pakistan’s well-kept FGM secret

Seven-year-old Mariam was excited. Her mother had dressed her up in her favourite powder pink frock, with her hair in two pigtails held with butterfly clips, and had told her she would be going to a surprise birthday party for her cousin.

Instead, her aunt took Mariam, holding hands, to a worn-down building with layers of peeling walls and a cold metal table waiting inside.

There, a curly-haired old woman softly murmured reassurances that Mariam didn’t understand, grabbed her and restrained her on the table. Then the pain started – it was sharp, searing, unforgettable. The next 20 minutes would split her life into a “before” and “after” – and shatter her trust in the person she most believed in: her mother.

Two decades later, the 27-year-old survivor of female genital mutilation (FGM) still bears the scars from that day. “I feel like something is missing inside me. It’s as if something has been taken away, and that has turned into a negative part of my body.”

“It is an emotional deficiency. You are not able to describe your emotions when talking about sexual needs,” she says. “When looking for a mate,” she adds, “you have a deficiency in [your] emotional and sexual response”.

Mariam belongs to Pakistan’s Dawoodi Bohras, a sect of Shia Muslims mostly from the Gujarat region, among whom FGM is a common practice. Estimates suggest that between 75 percent and 85 percent of Dawoodi Bohra women in Pakistan undergo FGM either in private residences by older women – without any anaesthesia and with unsterilised tools – or by medical professionals in urban centres like Karachi. Pakistan has a Dawoodi Bohra population of an estimated 100,000 people.

Yet, many Pakistanis remain unaware that the practice is common in their country. Even as FGM in parts of Africa garners global headlines, a culture of silence in Pakistan means that the practice has largely gone on, unchecked by public scrutiny or legal intervention.

A shroud of secrecy shields the ritual, and Pakistan has no comprehensive national data on how widespread FGM is. Girls are subjected to FGM at an age when it is difficult for them to process it on their own. And the Dawoodi Bohra community does not even refer to the removal of the clitoral hood as mutilation – they call it circumcision, a rite of passage that must be gone through – that must not be questioned.

Women who choose to speak out against this practice are at times threatened with excommunication from the community. “When you question an authority, you are shown the way out,” says Mariam.

“Where will you go? You were born here.”

Resistance to an enduring practice

“Your parents want what’s best for you.” It’s a belief children hold tightly – until it breaks. As it did for Aaliya.

The 26-year-old remembers fragments of a process so painful that for years, it felt like a bad dream, too cruel to be real.

But the truth has lingered in flashes: the cold, unyielding table, the whispered promises that this was “necessary,” the sharp, physical and emotional, sting. “It felt like a bad dream, like it couldn’t have happened,” she says, her voice wavering with the shock of a trauma she did not understand at the time.

Fear was the emotion she felt while lying on the metal table. Betrayal is what she felt afterwards, along with excruciating pain. “What blows my mind is there’s an entire generation of people that are willing to do this to a child without even knowing why,” says Aaliya.

Globally, the push to end FGM has gained steam in recent years. Earlier this year, the Gambian parliament rejected a controversial bill to quash a 2015 ban on FGM.

But the Dawoodi Bohra community has so far stuck to the practice. In April 2016, Syedna Mufaddal Saifuddin, the current global leader of the Bohras reaffirmed the need for female circumcision, or khatna, in his sermon at Mumbai’s Saifee Masjid, despite increasing opposition from within the community and across the world.

“It must be done… if it is a woman, it must be discreet,” Saifuddin said, insisting that it was beneficial for both body and soul.

Doctors say, however, that FGM can lead to reproductive complications in women.

“Young girls can have an abscess, urinary complaints; they can face a multitude of issues in their married life as sexual health is affected a lot, they can have dyspareunia as well,” says Asifa Malhan, a consultant gynaecologist and an assistant professor at Jinnah Postgraduate Medical Center in Karachi. Dyspareunia is lasting or recurrent genital pain that occurs just before, during or after sex.

“As a health professional and a gynaecologist, I do not recommend to anyone that this should be done. It is very harmful.”

The real reason why girls are made to undergo FGM is not health, say critics of the practice.

The clitoris, the region where a woman derives the most sexual pleasure, is referred to as Haram ki boti (a sinful piece of flesh) by many in the community. “When our clitoris is called a haram ki boti, it becomes very clear that this practice is not done for hygiene or cleanliness purposes,” says Aaliya. “This is done to oppress a woman’s sexuality.”

The clitoris has the most nerve endings of any part of the human body and is the most sensitive part of the female body. When it is mutilated, the nerve endings are cut off, leading to a loss of sensation.

“Those girls whose clitoris has been removed cannot feel a certain sexual pleasure,” says Sana Yasir, a Karachi-based life coach with a medical background in psychology.

Medically, too, FGM is dangerous. Without a clitoris, injuries during sexual intercourse are more likely, Yasir says.

Breaking cultural barriers

According to the Pakistan Demographic and Health Survey 2017-18, 28 percent of the country’s women aged 15-49 have experienced physical violence, and 6 percent have faced sexual violence. Additionally, 34 percent of women who have ever been married have endured spousal physical, sexual, or emotional violence.

In a country with such widespread gender-based violence, the practice of FGM compounds the struggle for female victims.

“It is an extremely severe form of gender violence, the effects of which may not be experienced right away, but they are experienced over a prolonged period,” says Aaliya.

Pakistan has no specific law criminalising the practice. Although under the Pakistan Penal Code, broader provisions such as Sections 328A (cruelty to children), 333 (amputation or dismemberment) and 337F (laceration of flesh) could, in theory, be applied, no such prosecution has been documented to date.

Domestic violence and child protection laws in provinces broadly cover physical harm but do not mention FGM. In a 2006 National Plan of Action, the government acknowledged the issue, but no action has been taken to end it.

According to a 2017 survey by Sahiyo, a nonprofit based in Mumbai, India, working to end FGM in South Asian communities, 80 percent of respondents had been subjected to FGM. The survey focused on women from the Dawoodi Bohra community. Sahiyo is a transnational organisation with operations and campaigns extending to countries like the United States, the United Kingdom and other regions where FGM is practised.

Healthcare professionals say they face major challenges in trying to eradicate this practice. They can counsel a patient, but it does not stop there. What is needed, they say, is to engage with the community to explain, medically, the numerous disadvantages to this practice — and the fact that there are no scientifically proven benefits.

“The government should collaborate with doctors and visit the community where this practice is being carried out,” says Malhan. “Without it, there will be no solution to this problem, and we will face similar challenges in the future.”

This outreach, Yasir points out, needs to be done sensitively, with respect for the cultural traditions of the community.

Huda Syyed, who published research in the Journal of International Women’s Studies by Bridgewater State University on the lack of data and dialogue on FGM in Pakistan in 2022, said the practice is at times attached to a girl’s identity within the community. Among Dawoodi Bohras, it is seen to have religious and spiritual significance. It is usually passed on as an intergenerational practice.

“While doing my research, my approach was compassionate, contextual and community-focused because oftentimes communities are ostracised, persecuted and punished in different ways for customs and practices that are social norms, and sometimes they’re also besmirched and painted in a negative light,” says Syyed.

“Change is not possible by attacking communities and shunning them because then we risk the practice or the custom of FGM being practised underground; what we really need to focus on is including the community, working with them and bringing change from within.”

Syyed says that solutions have to come out of a conversation with the community, and imposing ideas from outside will not work.

“There are two parties when talking about this practice: some people who are open to dialogue and engagement about it but in a safe way where their community is not attacked because no community wants to be villainized, and then there are others who want to preserve their community and customs,” Syyed says.

Al Jazeera reached out to community leaders for their perspectives but has not received a response.

To Aaliya, how the community itself responds to the concerns of women like her is critical: “It’s important to promote the idea that I can belong to this community and still say no to female genital mutilation,” she says.

But whether the community is responsive, for survivors like Mariam, the time for silence is over.

“This practice took something from me,” she says, “and this ends with me taking it back.”

*Names of the survivors have been changed to protect their identities.