Supplement to Population Reports, Meeting the Needs of Young Adults, Series J, No. 41, Vol. XXIII, No. 3 October 1995. Published with support from the United States Agency for International Development. For additional copies contact Population INformation Program, Johns Hopkins Center for Communication Programs, 111 Market Place, Suite 310, Baltimore, MD 21202-4012, USA; fax (410) 569-6266; e-mail PopRepts@welchlink.welch.jhu.edu.

Continuing and long-term effects of FGM, particularly infibulation, can include formation of tough scar tissue, keloids, and cysts around the wound and stitch line, as well as shrinking of the artificial opening over the vagina. Other lasting effects include pain during urination. A girl may take as long as half an hour to urinate or may not be able to urinate for days (213, 296, 477). Infection of the wound can lead to reproductive tract infections and chronic pelvic pain. Women who become pregnant endure additional agony since the artificial vagina opening is too small for normal delivery. Often the opening must be cut to allow exit of the fetal head without tearing the tough tissue. This process may have to be repeated with each pregnancy (213, 478). Prolonged labor can lead to damage of the bladder and surrounding organs, resulting in vesicovaginal and rectovaginal fistulas (tears between the vagina and the bladder, or the vagina and rectum). Women who have these fistulas leak urine and/or feces and are often ostracized by their families and communities (213, 547). For the infant, obstructed labor can lead to brain damage or death. When a girl marries young, as is often the case in regions where FGM is most common, FGM further aggravates the elevated risk of obstructed labor inherent in childbirth before a young girl has matured physically.

The psychological and psychosexual consequences of FGM have not been well studied. Clearly, the agony endured during the operation must remain with many women for years, if not a lifetime. Pain during intercourse is common. Especially with severe forms of the procedure, the woman sometimes has to be cut open to allow penetration (27, 148, 296). There are reports of problems with potency among some men who fear that they cannot penetrate the women, and initial penetration can take as long as two to three months of repeated attempts (276, 296, 547).