Report on circumcision of girls born in Finland                                                

25.12.2017

Ujuni Ahmed

Emmi Ylispangar

Mahmud Daham

English translation: Siiri Turunen



Contents

1 Introduction. 4

2 The prevention of female circumcision in Finland. 5

3 Background of the interviews. 7

4 Results of the interviews. 8

The purpose of the trip was undisclosed. 9

Related conversations within the family. 9

Lack of support through conversation. 9

Other notes on the interviews. 10

5 Mothers' experiences at child health clinics regarding their own circumcision and the potential circumcision of their child 11

6 Cultural interpreters' experiences on working with the mothers and authorities. 13

7 Discussion on the preventative methods of female circumcision. 14

Sources. 19



1 Introduction

Female circumcision has generated discussion for more than a decade. Various authorities in Finland, such as the Finnish League of Human Rights (Finnish: Ihmisoikeusliitto) and the National Institute for Health and Welfare (Terveyden ja hyvinvoinnin laitos, THL), have frequently expressed concern over the mutilation of female genitalia. Most recently updated on 6 July 2017, THL's report on circumcision is a comprehensive review on the subject (Tyttöjen ja naisten ympärileikkaus, currently available in Finnish only) and indicates the ongoing significance of the topic. Nevertheless, no interviews of circumcised women born in Finland regarding the subject have been previously conducted. While there have been suspicions that girls have been taken from Finland to be circumcised abroad, there has been no previous evidence of it due to the sensitivity of the subject.

For this report, we have interviewed four women who were born in Finland and have undergone circumcision. We have also met with mothers from circumcision cultures who have given birth in Finland and discussed with them the way that Finnish authorities have carried out circumcision-related communication. In addition, we have had discussions with three cultural interpreters on their experiences of the Finnish authorities' concrete attempts to prevent female circumcision. The focus of this report, however, are women who were born in Finland and have undergone circumcision abroad. First, we will discuss the history of the prevention of female circumcision in Finland. In the following part, we will provide the background and the results of the interviews and discussions. Finally, we will discuss ways to utilise these results in the prevention of female circumcision in Finland.

2 The prevention of female circumcision in Finland

In recent years, circumcised women have been coming forward in the media with their experiences. Consequently, several Finnish authorities have expressed their concern regarding the subject. Circumcision is an old tradition that is daily present even in some Finland-based communities. According to THL, the tradition stems from cultural, religious, moral, cleanliness-related, aesthetic, sexual, financial, and social reasons, so preventative methods must be considered in as versatile a manner as possible (THL, Tyttöjen ympärileikkaus).

There have been rumours and suspicions about female circumcision in Finland, but so far, there have been no reports of such incidents to the police by the victims or any other persons. According to research manager Reija Klemetti at THL, while authorities have not been informed of any such cases, social workers and healthcare professionals have expressed suspicions of female circumcision performed in Finland (interview in newspaper Turun Sanomat, 10 February 2017).

Female circumcision has been battled in Finland through both preventative and advisory work for nearly 20 years. The subject has been discussed in various learning materials and related programs. The most long-standing project against female circumcision is the KokoNainen project of the Finnish League for Human Rights which has been active and funded by Finland's Slot Machine Association RAY since 2002. In 2004, the Finnish League for Human Rights also produced a report with instructions for social and healthcare professionals for preventing female circumcision (Tyttöjen ja naisten ympärileikkaus Suomessa: Asiantuntijaryhmän suositus sosiaali- ja terveydenhuollon henkilöstölle, available in Finnish). In addition, several discussion sessions on female circumcision have been organised for girls from immigrant backgrounds at the Helsinki Tyttöjen Talo, a youth centre for girls focusing on sexually and culturally sensitive social work. (Ministry of Social Affairs and Health in Finland, 2012.) The THL report states that all authorities working with families with children have the responsibility to discuss and prevent female circumcision. The legislation on female circumcision should be discussed at least once with patients or clients originating from areas where the operation is practised. Visits to child health clinics are good and natural opportunities for discussion and informing the parents on female circumcision. (THL, Tyttöjen ympärileikkaus.)

As one preventative method, THL also suggests the training of employees about circumcision and the ways to discuss it. Cultural interpreters who share their clients' cultural background are in a key position in informing parents on the Finnish legislation regarding female circumcision. (THL, Tyttöjen ympärileikkaus.)

Interviews conducted by Mulki Mölsä as part of the research for the KokoNainen project reveal that circumcision is not only the wish of the parents but that it also concerns the teenage girls' own wishes and their own search for identity. The interviewees said that while the practice of female circumcision could potentially be abandoned within Europe, there might be expectations to reintroduce the traditional practice when returning to the countries of origin. The mothers interviewed by Mulki Mölsä indeed said that they have experienced pressure to circumcise their daughters during their visits to their home countries. The interviews revealed that some interviewees were not aware of the Finnish legislation or did not consider it relevant for the circumcision decision. Considering the grassroots-level training sessions and discussions and the research done for the KokoNainen project, it seems that we cannot rule out the likelihood that girls are being taken abroad to be circumcised. (2004, The Finnish League for Human Rights.)

3 Background of the interviews

Finding interviewees for this report proved to be challenging. Many women would talk about their experiences, but few would agree to be interviewed even anonymously. The fear of the stigma of a "snitch" within the community continues to be significant, and women prefer discussing the subject in a closed and safe environment rather than publicly "admitting" that circumcision is wrong. The reason for this, based on the discussions, is that circumcision is often performed by family members whom the victims wish to protect. While the women are aware that their parents have done them wrong, they also understand the reasons behind the decision. Consequently, even the women who did agree to the interview were concerned about being recognised if their stories would be published in full and word by word.

These grassroots-level discussions have also revealed that parents have no information on the health risks posed by female circumcision or other related matters, but that their actions are based on assumptions and the expectations of the deep-rooted traditions.

Both the individual participants in the discussions and the interviewees emphasised the point that their operations have already happened, and therefore, there is no use being upset about them. In the end, four women between the ages of 18 and 23 agreed to be interviewed. They were circumcised between the ages of 6 and 9 in Egypt, Somalia, Iran, and Syria. One of the women has been to see a gynaecologist in her adult life.

For the purposes of this report, we have had discussions on child health clinics with four mothers who have grown in circumcision cultures and whose children were born in Finland. We have also had discussions with three cultural interpreters who have accompanied circumcised women to child health clinics. We asked about their experiences on how the nurses talk about female circumcision with the children's parents.

4 Results of the interviews

The interviews revealed several troubling points about female circumcision that have a complex effect on the existence of the tradition. In particular, the following three phenomena were repeated in the interviews.

The purpose of the trip was undisclosed

The interviewees' accounts drew particular attention to the matter that nearly none of the women were aware in advance of the purpose of the trip during which the circumcision was performed. One of the interviewees said that the event was only a matter of time but that it still came as a surprise.

Related conversations within the family

Another noticeable similarity in the women's accounts was the lack of conversation on the subject with adults, even though the women were aware of the subject and the positive or at least neutral response to it at home. In one of the cases, the woman's mother had talked about her own experience prior to the event and how girls become women through circumcision. Apart from that, the subject had not been discussed with the woman, so it had mostly been a taboo. Most of the women had had no chance to prepare for the event or ask any circumcision-related questions. Indeed, one of the interviewees told that she had tried to talk about the circumcision with her father after the trip, but the father had told her to keep quiet. This may be a part of the reason why the interviewees have attempted to forget about their experiences.

Lack of support through conversation

The most alarming matter emerging in the interviews was that after the operation, the women were not able to discuss the event with anyone. When asked whether she had talked about it with anyone afterwards, one of the interviewees replied: "No, because I knew that I wasn't allowed to talk about it. And I would have been spanked if I had brought outsiders into a matter in which they might not even have been able to help." The other interviewees also felt that circumcision was a forbidden topic of conversation. Furthermore, it is such an ordinary subject in the community that discussing it is often deemed unnecessary. One of the interviewees said that she just wanted to forget about the event due to the shame caused by the mutilation of her genitals and hence did not want to talk about it with anyone. The forgetting of the incident either consciously or subconsciously was repeated in the interviewees' accounts.

Other notes on the interviews

Three of the four interviewees stated that circumcision is a pointless operation that should be discontinued. One of the women described it in the following manner: "I used to think it was part of the religion, but now that I have looked into it, I have understood that it isn't so, and for me it was an unnecessary and painful operation. I have thought about what it would be like if I hadn't been circumcised, because it's something that I will never know. I only wish that I had been able to make that choice myself and that no one would have made it for me." One of the women described circumcision as a symbol of purity and felt that it was important for girls and their future.

As for reasons for female circumcision, the interviewees listed similar points to those mentioned in THL's report. "People, especially Muslim women, believe that it's some kind of a ritual, that now the girl is a woman and can be married. They are afraid that if a girl is not circumcised, she will have sex before marriage and then no one will want her." This response reflects both the cultural and religious reasons as well as the moral and sexual reasons as it is wished that girls stay virgins before marriage. Socially, it would be shameful for the family if the girl would not be married, and financial worries might also emerge as the unmarried girl would stay in her parents' care. These reasons thus continue to be visible also in the attitudes of some Finland-dwelling families.

The interviewees were also not aware that circumcision is illegal. One of them had suspected it to due to the operation being performed abroad, but otherwise the women had no information on the matter.

It goes without saying that one of the dominant themes in the interviews was the pain caused by the operation. Two of the four interviewees had received an injectable anaesthetic, but two of them had been undergone the operation without any anaesthesia. One of the women described the pain as so strong that she had feared she might have a heart attack. All interviewees stated that they do not understand causing little children such unnecessary pain that lasts for several weeks.

5 Mothers' experiences at child health clinics regarding their own circumcision and the potential circumcision of their child

Our discussions with the mothers revealed that nurses are often hesitant to bring up circumcision even if they notice that the patient has been circumcised. In one of the cases the nurse had noticed that the mother had been circumcised and had stared and inspected her genitalia for a long period of time without making any comment. The mother had felt confused and asked whether something was wrong. The nurse had replied that it was a routine check. Knowing what the problem was, the mother had continued to feel uncomfortable. She would have hoped for the nurse to ask about it directly rather than have her confusion cause fear for the expecting mother about something being wrong.

The mothers felt that nurses should be more confident in such situations and not be too confused, considering that the mothers may already be feeling uncomfortable in such an intimate situation. In one of the cases, the nurses had not discussed or asked about circumcision during any of the mother's four pregnancies. Many of the mothers felt that the nurses did not know how to act in the situation or how to talk about circumcision. Bringing up the subject seemed to be difficult for the nurses, while the mothers themselves felt that the easiest way to discuss it would simply be direct talk.

One of the mothers stated that circumcision had not been brought up at all during the whole of her pregnancy, but only a few weeks after the birth of her child. She suggested that if a pregnant woman who had only just moved to Finland were not told about Finnish legislation regarding circumcision before giving birth, the new mother might well have time to have her daughter circumcised only because she was not aware that it was illegal. Therefore, it would be imperative that circumcision be discussed already at the maternity clinic. Many of the mothers stated that it is crucial for the prevention of circumcision that nurses be properly trained for talking about circumcision. Currently, there are a lot of differences in nurses' attitudes towards circumcision and their abilities to discuss it.

6 Cultural interpreters' experiences on working with the mothers and authorities

In this report, cultural interpreters are people who have worked both as interpreters and cultural interpreters for several mothers from circumcision cultures. While working with the interpreters, the mothers have either been pregnant or have recently given birth to a daughter in Finland. The cultural interpreters have discussed circumcision and related matters with both the mothers and the clinic nurses. They have also interpreted several clinic appointments during which circumcision has not been brought up contrary to what the interpreters would have deemed necessary. One of the cultural interpreters mentioned a special case in which the interpreter had been interpreting for a mother who had taken her underage daughter abroad for circumcision. The clinic knew about the situation, and the mother justified the decision with both ignorance and religion. No one had discussed the operation itself with her when she had been pregnant. The interpreter was told that only an upcoming circumcision can be interfered with, but if an operation has already taken place, nothing can be done about it. The interpreter did not know how the case had proceeded.

The cultural interpreters who we have had discussions with for the purposes of this project represent three different ethnic groups. Despite this, their experiences on authorities and the mothers have been similar. They also felt that many mothers seemed to be pretending they did not know what the problem was and that the nurses had sometimes not pursued the subject further. One of the cultural interpreters stated that there is no clear policy at the clinics regarding bringing up the subject. It varies between different nurses even in a radical way; one nurse may ask about it hesitantly or feel awkward about asking, while another nurse may take a highly offensive and accusing tone which prompts a defensive response. One of the interpreters described one of the most memorable cases in the following manner:

"I worked as a freelance interpreter for a few years during which I had to interpret highly disturbing subjects. The most memorable and saddest assignments was to interpret a school nurse appointment. What made it sad was that the parents had taken their primary school aged daughter to Kurdistan to be mutilated. The family had lived in Finland for less than five years at the time and were very religious. The mother wore a niqab and even her hands were covered.

The school nurse was shocked and asked them why they had gone through with the operation. The girl's mother answered coldly and surely that it was part of their religion. The school nurse asked whether the mother thought that she had done a good thing for her daughter. The girl's mother only replied that it had to be done."

7 Discussion on the preventative methods of female circumcision

If a girl does not know about the time of the circumcision before it happens, the parents can be sure that the girl does not talk about the operation to her teachers or other adults in advance. However, this can cause stress for the children, not least because they realise that the circumcision will happen at some point. Because it is an unknown monster looming at some point in the future, they are not able to process it. On the other hand, if the operation is mostly described in few words as a transition ritual from a girl to a woman, girls may even look at it with respect and look forward to it. Therefore, girls should be taught about the true nature of circumcision from an early stage. This was also suggested by the interviewees when asked about methods to prevent circumcision.

One of the women considered the problem to be that girls are given the false information that circumcision is a part of religion rather than culture-based, which would make it easier to refuse the operation. She believes that if religion's true take on circumcision was more frequently and clearly discussed, girls could muster up the courage to refuse the trips or to talk about the subject with a reliable adult. Another interviewee suggested similar methods and added that parents should be more clearly informed of the consequences of circumcision: "I think that parents should be told that if they do this, even abroad, they will be deported. Maybe they would stop then. Girls must also be taught at school that this is not appropriate or even based on religion. This could also have been taught to us at Quran school." One of the interviewees suggested that if girls have recently travelled to countries where circumcision is performed, they could be checked after returning to make sure that circumcision has not taken place. This interviewee also felt that informing girls about circumcision in advance would be a good step in the right direction.

Once circumcision has been performed, the child will suppress it from her mind consciously, partly pressured by the community. Such a painful and confusing event will, however, easily cause traumas that will continue to disturb the child if she is not able to process the incident. Additionally, considering the environment, like the child's school where most peers have not undergone the operation, the child may be feeling out of place and defiled. This may also have a connection to the fact that girls from immigrant backgrounds are restricted from participating in PE and swimming lessons by their families already at primary school.

It is important to note that one of the interviewed women has been to see a gynaecologist in Finland, and the healthcare professional did not interfere or ask about the circumcision at all. None of the interviewees had been to see a gynaecologist before reaching the age of majority. Gynaecologist's appointments are seen to concern only married women, which also makes it difficult for girls to find out and understand that they have been mistreated. Acknowledging this as early as possible would surely help the girls to pursue professional help and to process the event at an early stage, as well as simplify their sexual life in the future.

The discussions also raised the important question of how efficiently healthcare professionals are actually trained in the prevention of female circumcision. According to many of our sources, preventative methods are taught in different areas of healthcare, but at least our discussions with the mothers and the cultural interpreters reveal clear deficiencies in the matter.

Based on this report, it can be presumed that circumcision education and prevention do not have concrete consequences for as long as the members of the communities exclude themselves from the communication and these problems are not regarded as problems within the communities. The interviewed women were in a contradictory position considering that they were unwilling to oppose their parents by discussing their matters and development stages as children while still mostly being of the opinion that the circumcision tradition should be discontinued. Cultural awareness is extremely important, as the roles of a parent and a child (especially a female child) are more strongly defined in the cultures of many of the girls' parents than in a traditional Finnish society. Consequently, the participation of cultural interpreters is particularly important, as regular interpreters' own attitudes towards the subject and their positions within the community may have an effect on building the trust relationship. A clear message was expressed by nearly all of the participants in our discussions and interviews: This should not be allowed to happen in Finland.

Even though the women interviewed in this report represent different nationalities that have partly very large cultural differences, the interviewees' ideas, experiences, and attitudes towards female circumcision are very similar. This is a positive matter and clearly represents the ideas of a younger generation. However, considering how uncomfortable the women felt about being interviewed, it is clear that positive attitudes towards female circumcision continue to be deeply rooted in even some families living in Finland. For as long as this continues, the preventative work against female circumcision should not be carried out with too much cultural sensitivity. For example, it is best to be clear and explicit with parents and mothers about the gravity of circumcision to avoid misunderstandings about its legality and damage to both girls' physical and mental well-being.


Sources

Tiilikainen, Marja, ed. 2004. Tyttöjen ja naisten ympärileikkaus Suomessa. Asiantuntijaryhmän suositukset sosiaali- ja terveydenhuollon henkilöstölle. Helsinki: The Finnish League of Human Rights (Ihmisoikeusliitto), source in Finnish

National Institute for Health and Welfare (Terveyden ja hyvinvoinnin laitos THL), Maahanmuuttajien terveys- ja hyvinvointitutkimus. https://www.thl.fi/fi/web/maahanmuuttajat-ja-monikulttuurisuus/maahanmuuttajien-terveys-ja-hyvinvointi/maahanmuuttajien-seksuaali-ja-lisaantymisterveys/tyttojen-ja-naisten-ymparileikkausten-fgm-ehkaisy/tyttojen-ja-naisten-ymparileikkaus accessed 22 August 2017, article in Finnish

Akimo, Minna. Turun Sanomat. https://www.ts.fi/uutiset/kotimaa/3393024/Tyttojen+ymparileikkaukset+pelkona+myos+Suomessa++Tyksissa+tehty+avausleikkauksia accessed 21 August 2017, article in Finnish

Action plan for the prevention of circumcision of girls and women 2012-2016 (FGM), accessed in Finnish at www.julkari.fi/handle/10024/112458

Action plan in English: https://www.julkari.fi/handle/10024/111768