The procedure is often accompanied by infibulation, or the stitching together of the vulva. This is usually done following the removal of the clitoris, when the woman’s labia major is sewn together, leaving an opening small enough for only urine and menstrual blood to pass through. Prior to marriage, the opening must be enlarged to allow for penetration during intercourse, a process that can take three or more months.
In addition to sexual dysfunction, a clitoridectomy has many long-term effects including incontinence, sterility, increased susceptibility for the AIDS virus, and even death. Medical complications are common since the person who performs the procedure is generally not medically trained, but rather a parent or elderly member of the community. The surgery is usually performed without anesthesia, with a razor, glass shard, or other unsterilized instrument. As a result, tetanus, hemorrhages, and massive scarring can also occur. There are also long-term psychological effects, including depression, anxiety, and reduced self-esteem.
Most women do not choose to undergo a clitoridectomy, as the surgery is typically performed on girls between the ages of four and eight. These girls are usually tied or held down during the procedure. Estimates suggest that approximately 130 million women and girls across the globe have been forced to have the surgery. Now considered a form of violence against women, the clitoridectomy has been banned in many areas of the world. Despite this, however, many cultures continue to practice the procedure.
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