The first of Sara Sori’s portraits depicting women at various stages of life shows a young, happy girl. “If you harm [a girl] at this stage she is ruined for ever. And this is the stage where I was violated,” says Sori, from Isiolo, in northern Kenya, who was forced to undergo female genital mutilation as a child.
Another portrait shows a girl with her mouth sewn shut, “giving in to what life has dictated for her and to prevent her from expressing any anger”. Another shows “the age of regret, of missed opportunities” of an older woman. “This is where my grandmother is now. I loved her so much. She wanted me to get married to a good man and the only way to do that was by getting the cut. She, too, went through similar initiation rites and cannot undo the past.”
Sori, 24, is using art to help process the trauma of undergoing FGM, a practice carried out among her pastoralist ethnic group, the Gabra, for generations.
According to the UN more than 230 million women and girls globally have undergone FGM – the partial or total removal of the external female genitalia – which continues despite being banned by the UN general assembly in 2012.
Health consequences – including infertility, infections and difficulty having sex and giving birth – are understood, but the emotional toll has received less attention. Organisations working to stamp out the practice tend to focus on advocacy and encouraging cutters to stop their work.
The few studies published into the psychosocial impact of FGM found depression, anxiety, post-traumatic stress disorder and sleep disorders were common among survivors. Research published in the Lancet last year found “very little attention” was being paid to the link between mental, sociopsychological and physical health consequences of FGM and recommended “a stronger focus on mental health needs and interventions” for survivors.
However, addressing the psychological impact of FGM is complicated by the involvement of victims’s family members, including mothers and grandmothers, in getting girls cut. Research conducted in the UK in 2016 highlighted the anger women felt towards their mother for allowing it. Some said they only forgave their mothers after they had died.
Since 2022, the Girl Generation, a consortium of African organisations fighting to end FGM, has helped more than 500 survivors in Kenya deal with the trauma. It is setting up programmes in Senegal, Ethiopia and Somaliland – countries with some of the highest rates of FGM.
As well as counselling, sessions for mothers and daughters provide a space to talk – for some it will be the first time. Women who go through the programme are encouraged to set up support groups in their own communities.
“Many survivors endure long-term health issues resulting from FGM … All these contribute to emotional distress and anxiety,” says Alice Ngari, movement building lead at the Girl Generation. “In communities where FGM is prevalent, survivors who experience mental health issues associated with FGM may face stigma and discrimination as FGM is perceived as the normal thing to do so it is not understood why anyone should suffer from that which is ‘normal’.
“If this multifaceted trauma is not addressed, the long-term psychological impact of FGM is that many survivors will carry trauma throughout their lives, affecting their self-esteem and trust in others especially because the [cutting] process is done by close family members and relatives.”
Dr Leyla Hussein, a British psychotherapist and FGM survivor who helped develop the programme, adds: “It’s sexual assault trauma. They [survivors] feel they are not good enough; that they shouldn’t enjoy life. One of the things I’m always, always trying to remind the women is to find joy despite the difficult pain they’ve had.”
Sori, who started attending Girl Generation-run sessions last year, developed severe depression as a teenager when she began to reflect on her experience of being cut. She started to mistrust everyone, assuming they were out to harm her, and was angry at her mother.
Her first pieces of art were “dark”. “I resented my mother and wondered why she did not prevent it,” she says. “But after going through the sessions, this is changing. I realised my mother, too, was dealing with similar trauma from FGM. Sitting together with mothers and daughters and receiving professional counselling helped me tone down.”
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In a church hall in Maasailand in Narok County, south-west Kenya, Emily Saanyonyo, 22, sits in a circle of 20 women and describes what happened when she was 11. “They stopped the cut when they got to the bone,” she says, seething with rage.
“It was humiliating but I was told I had graduated to becoming a woman.” Saanyonyo does not know what she would do if she met the woman who mutilated her. “Perhaps God will forgive her.”
The session is organised by Catherine Mootian, who set up the Binti ya Nguvu– Girls Redefined – initiative last year for other women who had been cut.
Along with psychological support, girls who dropped out of school are helped to continue their education and some receive grants to start a business.
“When they come here for the first time, they look vulnerable and uncomfortable when speaking about the emotional trauma they go through. On the second day, though, they do open up a bit,” Mootian says.
Most of the women still live with their mothers and grandmothers, she adds. They are slowly letting go of anger, learning that their family members were fulfilling the dictates of their culture, but “forgiveness will take time”.
“They are slowly learning to let go of resentment,” Mootian says. “It is a process. What is evident is their determination to stop the vice by talking to fellow women. Some now have gained the support of their husbands in the anti-FGM crusade, a bold step in a highly patriarchal society.”
Ruth Sencho, 29, gets upset as she recalls being cut by her stepmother when she was 13. They “told me not to fear, not to cry, that it was not good to remain uncut. I had no say in the matter,” says Sencho.
She enjoyed school and her teacher had high hopes for her. But she had to leave to be married. “My dream was to become a nurse and live up to my teacher’s wishes,” she says.
“Now I sell vegetables … I feel I am nothing. The cut condemned me to a life of hopelessness. Kidonda kilipona lakini uchungu bado uko (the wound healed but the pain remains).
“Let our generation be the last one to undergo the cut,” she says. “The trauma ends here.”
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In the UK, advice and support for those who fear they are at risk of FGM and for survivors can be found by emailing Forward, or calling 0208 960 4000, or contacting the NSPCC on 0800 028 3550, the Dahlia Project on 0207 281 9478 and Childline on 0800 1111. In the US, Sahiyo and the Asian Women’s Shelter have a support line for those who fear they are at risk of FGM and survivors. Call 1 877 751 0880, operating Monday to Friday 9am to 5pm PT