Research participants

The 95 research participants included 65 women and 30 men. Participants were between 16 and 59 years of age. All research participants were first-generation immigrants, born and raised in Somalia, Sudan or a neighboring country, most commonly Kenya, Ethiopia, the United Arab Emirates or Yemen. Some had arrived in Norway in their early childhood, others during their youth, but most as adults. Their times of residence in Norway ranged from six months to thirty years.

Most young participants claimed to be students at a high school or university, whereas few of the adults provided reliable information on their current engagement in education or employment. Educational backgrounds varied extensively, from one year of Koranic School to a PhD. Overall, the Sudanese participants had higher levels of education than the Somali participants, with several of the former having a postgraduate university education.

Most female participants (n = 65) shared information about their personal FGC status (n = 57). Of these, the majority revealed they had undergone FGC (n = 50), mostly infibulation (n = 37). Five women claimed to have undergone sunna circumcision, of which four reported extensive vaginal closure. One woman was unclear about type, and not sure what type of FGC she had, and six participants claimed to have no FGC.

Ethical considerations

The studies followed the ethical considerations required by the Norwegian Centre for Research Data (NSD), which confirmed that the study was in line with the personal data act (reference no. 55641). All the potential participants were provided with a written and oral presentation of the study and the implications of their participation in their selected language (Norwegian, English, Arabic or Somali). All participants gave their informed consent orally (tape recorded) or written according to their choice. In Norway, parental approval is not required for anyone over the age of 16 years; thus, this was not needed. To ensure anonymity and reduce the risk of recognition, details about the study’s participants are left deliberately vague.

Reflexivity

As indicated, most of the interviews were conducted by a research assistant with the same ethnic and/or national background as each study participant, and the author, an ethnic Norwegian, collected some interviews and all ethnographic data. Similarities and differences in personal factors, such as ethnicity, age, education, language proficiency and (perceived) FGC status, between the interviewers and interviewees are likely to affect access, trust and thus data quality. While there were no systematic differences found between the data collected by the author and those obtained by the research assistants in this study, such differences may occur, as described in an earlier paper [37].

Although there were many similarities between the two studies that the data in this paper are drawn from, the second study did not address the conceptualization of sunna circumcision unless it was raised by its participants. Thus, most of the quotes in this paper are from the first study. Quotes and stories drawn from the second study are marked with a star (*). Quotes and stories from Somali participants marked with a star are from the interviews conducted by the author, whereas the rest are from interviews conducted by the research assistants.

Negotiating the abandonment of infibulation

Most study participants grounded their resistance against infibulation in a concern about its negative health consequences. Furthermore, all the health consequences outlined by participants were related to extensive vaginal closure, such as painful and obstructed menstruation, urination, sexual initiation, and childbirth.

Many participants also suggested that these health complications designated infibulation contrary to religion. In contrast, no participants considered sunna circumcision to be haram, i.e. religiously forbidden. There was thus a perception of a religiously right or wrong way to conduct FGC, as formulated by a young Somali woman: “I am not saying the FGC is haram [sinful], but the way people do it is wrong. (…) They don’t do it the way it is described by religion” (IDI). This distinction between a religiously wrong or right way of FGC was also framed in terms of a contrast between tradition and culture, which are manmade and thus changeable, and the eternal values of religion, as expressed by an adult Somali woman:

“Culture is wrong. It is something humans have invented. Religion, in contrast, comes from God, and religion says that FGC [infibulation] is forbidden. This I heard when I grew up in Somalia, when the Koranic School said that FGC is not good, it is only culture” (IDI).

Participants also commonly dismissed infibulation as an outdated and dying practice, which only occurred in rural areas among uneducated and impoverished individuals. This they often contrasted with the practice of educated migrants with an urban background, described as civilized and informed, as in this claim by a middle-aged Somali man:

“Somalis in Norway are more civilized than those in the country of origin. They have got information, and some also have a higher education from before. Those who did pharaonic [FGC] lived in the countryside and did not get the opportunity to move to Norway” (IDI).

Many participants suggested that infibulation had been imported from Egypt, with some inferring this from the terminological parallel between pharaonic FGC and the Egyptian pharaohs, others through a reinterpretation of religious texts (Old testament Exodus 1:15–22, Koran (Quran): 28:1–6), such as in this elaboration by an adult Somali man:

“(…) to limit the birth of babies, he [the Egyptian king] decided to control women’s sexual desire or behavior and decided, together with the minister of health, that they should start cutting away female genitalia and stitch it together. Later, this practice was spread to other groups or states around Egypt, with which Egypt had financial, cultural or political connections. After several thousand years, it came to Somalia and became a part of our culture” (FGD).

Similar perceptions of the Egyptian origin of infibulation have been recorded elsewhere [32, 35].

Some of the Somali men used this perception of an Egyptian origin to distance themselves from the practice, framing it as an imported and foreign practice and thus not a genuine Somali tradition. For most Somali women, in contrast, the perceived pharaonic origin did not lead to a similar distancing. None of the Sudanese participants mentioned an Egyptian origin, though it has been a common perception in Sudan as well [38]. For most participants, however, the link to a pharaonic origin placed the practice in the past, and this distant historical origin was used as evidence that the practice is outdated.

The historic origins of infibulation were often contrasted with the newness of sunna circumcision, which some of the participants dated to the 1990s, as a Somali man in an FGD: “Pharaonic [FGC] is ancient, from the Egyptian pharaohs, whereas sunna came about in the early nineties”.

Generally, then, all participants were negative toward infibulation, and most believed the practice to be waning. Most participants, particularly the men, further dissociated themselves from the practice by defining it as distant in terms of time, place (rural areas) and degree of civilization (uneducated, poor, and ignorant).

Perceptions of sunna circumcision

While describing sunna circumcision, most participants used infibulation as a reference. Participants generally described it as a modern procedure, common among educated and urban cosmopolitans, religiously promoted or approved. They also claimed it to be less extensive and harmful than infibulation, though rarely provided any concrete descriptions of its anatomical extent.

Concrete depictions of the physical extent of sunna circumcision, however, varied extensively, both between and among individuals. It was described as anything from a minor pricking to allow some blood to flow to an extensive removal, commonly followed by two or three stitches. Many participants explained this variation as a distinction between an ideal and a real way to perform sunna circumcision. Ideal sunna circumcision was considered a type of FGC that is encouraged, supported or accepted in Islam and was generally described as minor in terms of its physical infringement. Most participants grounded their conception of a religiously correct form of FGC as a procedure with minimal cutting in their broader religious values of avoiding bodily harm. In contrast to ideal sunna, many participants described real sunna circumcision, i.e. as they believed it to take place in reality, as a quite extensive procedure that could include both extensive tissue removal and vaginal closure.

Nevertheless, most commonly, the participants contrasted both ideal and real sunna circumcision with infibulation by referring to vaginal closure. In contrast to the tight vaginal introitus associated with infibulation, all participants described sunna circumcision in terms of a lack of, or less extensive, closure. One example was a Somali woman in her late fifties: “Sunna has an opening, with less cutting. That’s the difference, stitched versus open” (IDI). However, this distinction was often vague and sometimes even contradictory, as indicated in the statement of a Somali woman in her forties:

“Sunni is no cutting or stiches. You can do two stitches, so it’s very little, almost no cutting. Sunni is a small procedure; there is less pain and only two stitches, so the woman will have less pain during sex, periods and childbirth” (IDI).

Many participants shared this view of sunna circumcision as involving some stitches and hence some vaginal closure. How extensive such closure was perceived to be, however, varied. One Somali woman, for example, distinguished the closure of infibulation from sunna circumcision by pointing at the two ends of a pencil, the writing end indicating the closure in infibulation and the rubber end that in sunna circumcision (*). Following her indication it would imply that in infibulation the vaginal introitus would be only 3–4 mm. in diameter, whereas the vaginal opening left in sunna circumcision could have diameter of 2,5 cm. Another Somali woman claimed that sunna circumcision entailed closure until the urethra, which she illustrated with a drawing (*). However, the most common way of describing the extent of closure in sunna circumcision was a reference to the number of stitches, commonly two or three. No participants specified how this differed from the number of stitches in infibulation. However, as indicated in Table 1, the common number of stitches in infibulation is between four and seven. Most participants did not provide any clear or shared idea of the extent of the closure that the stitches in sunna circumcision would form. The only exception was a Somali midwife I interviewed during my stay in Kenya. She was working at a health center catering to Somali women and claimed that since FGC is performed on small girls with equivalently small genitalia, two to three stitches cause significant vaginal closure. She also claimed that she had never seen a sunna circumcision without closures sufficient to hinder vaginal intercourse. She insisted that circumcision (both infibulation and sunna) has to include closure that effectively makes sexual intercourse impossible without tearing or cutting parts of the infibulated seal. This is in line with findings from a recent study from Somaliland [7].

Some of the participants, however, expressed concerns due to the apparent lack of any substantial difference between infibulation and real sunna circumcision, e.g., these reflections of a young Somali woman:

“I have heard that sunna is a lighter type of cut, but it is not that different from the other type. I feel that nobody follows what the prophet says. Sunna has a larger hole than pharaonic [FGC]. When I left Somalia eight years ago, pharaonic was the most common. But, you could not really see the difference, as girls were cut almost in the same way, whether it was pharaonic or sunna. That means it is all closed and you cannot see any major differences. Even the girls themselves or their parents do not know how to differentiate between the two types. I don’t say that circumcision is sinful, but the way people do it is wrong. They don’t do it the way it is prescribed by religion” (IDI).

In these elaborations, this participant suggests a lack of clarity concerning any difference between infibulation and sunna, both among parents and providers. As she was not a healthcare provider, the basis of her observations is not clear. Nevertheless, as it is common in Somalia for young girls to show each other their circumcision and discuss the size of their vaginal openings [30, 39]. Her observations could have stemmed from such experiences. Nevertheless, she seemed to conclude that severe types of FGC are religiously sinful, whether referred to as infibulation or sunna circumcision, which she distinguishes from an ideal form of sunna circumcision prescribed by religion.

The amount of tissue removal was the other major distinction made between infibulation and sunna circumcision. This was generally described rather vaguely, as in this description by a Somali woman in her early thirties: “(…) you cut (slice/cut with a scissor) some part of the clitoris. You don’t remove everything, but you cut off some part. It is a professional doing it. You cut some of the upper layer, maybe a part of clitoris, it’s so little” (IDI). She then substantiated her description by arguing against closure via infibulation, which she described as “stitching up what God has left open”. Nevertheless, while describing her own circumcision as the sunna type, her claim that she had to “remove the stitches” during childbirth suggests that her sunna circumcision also included vaginal closure.

Some women related differences concerning the extent of cutting in sunna circumcision to anatomical variations. In an FGD for adult women, one participant argued “Bodies differ. [In sunna circumcision] they cut what has grown. Skin that grows”. One of the other participants substantiated this argument, responding that “Sunna implies less circumcision [than infibulation]. There is a difference in the thickness of the skin in women’s genitals. For some women, a clitoris can grow and need to be cut. I suppose this is sunna. But, the labia are still intact.” Such suggestions of a difference in cutting based on anatomical variations among girls have not been previously reported in Sudan or Somalia, although they have been described in other settings [40, 41].

A few of the participants described ideal sunna circumcision as pricking or nicking the genitalia to draw some blood without removing any tissue, e.g., two Somali women, one in her forties and the other in her fifties, who stated, respectively: “sunna is normal, just a tiny prick to cause some bleeding” (IDI) and “No cutting, no stitching and no tying of legs” (IDI*).

Male participants were generally even less specific than women in their outline of the anatomical extent of sunna circumcision. One example is the description by a Somali man in his late twenties: “Sunna circumcision is common and normal. The girl doesn’t lose any part of her body” (IDI). An even younger man described sunna as the removal of “very little tissue” (IDI). For this reason, he considered it significantly less dangerous than pharaonic FGD, although not necessarily totally harmless.

Overall, while there were extensive variations in the depictions of the anatomical extent of sunna circumcision, there was a general agreement that the procedure was significantly less extensive than infibulation, included less or no vaginal closure and often entailed less tissue removal.

Deemed less physically infringing than infibulation, sunna circumcision was commonly depicted as harmless. Its lack of health complications was commonly explained by a larger vaginal orifice. Even those who depicted sunna circumcision as including some vaginal closure believed this closure to be less tight and hence not obstructive of women’s natural functions of urination, menstruation or sexual relations; at least, not to the same extent. This became clear when we probed for the perceived differences between the health problems caused by sunna and infibulation. A Somali woman in her forties, for example, described, during an interview, how sunna was the removal of “Just a little piece. The girls don’t get so much damage”. A Somali man in his early thirties claimed that “Sunna circumcision is less dangerous and good for the girl’s health. Sunna is easier and less dangerous. I support sunna” (IDI). A Somali man under 20 years of age similarly claimed, during an interview, “Sunni is to cut a small piece of the girl’s genitalia. It is accepted religiously. It is the type where you just cut a little, and it is less dangerous than the pharaonic [FGC]. I have not heard that sunni circumcision gives any health risks or affects her sexual drive”.

These quotes illustrate that while most Somali participants presented sunna circumcision as harmless, they simultaneously perceived the practice to typically be physically extensive. Although some participants revealed that sunna circumcision could cause some harm, this was considered rather less severe than the harm caused by infibulation and thus better. Accordingly, when participants suggested that sunna circumcision is “good for the girl’s health”, they seem once again to use infibulation as a reference, i.e. that sunna is better for their health than infibulation, and not that it is good for female health per se.

Only one participant mentioned concrete experiences with health complications caused by sunna circumcision. This was a Sudanese woman with infibulation, whose youngest sister had undergone sunna circumcision, causing her immediate and long-term health problems*. A few of the men also suggested that sunna circumcision might cause some harm, although they did not report any personal experiences. This included a man of approximately 50 years of age who, after studying the subject in preparation for his planned interview had concluded that sunna destroys an important body part for women. Another Somali man, approximately 30 years younger, concluded that while he did not consider sunna circumcision dangerous, he thought it could cause some harm.

Furthermore, there was an almost uniform view that sunna circumcision has no negative consequences for women’s sexuality. This was often specified in terms of the absence of pain during sexual initiation, which is common with infibulation. This focus on the absence of pain, however, disregards other aspects of sexual encounters, including sexual desire, pleasure and satisfaction for women. This was striking; most participants described sunna circumcision, in both its ideal and real form, to include removal of clitoral tissue, and both Somali and Sudanese migrants shared the perception that the clitoris is the physical site for women’s sexual desire and pleasure [9, 26, 30]. Hence, a depiction of sunna circumcision as lacking consequences for women’s sexuality may reflect a limited appreciation of women’s sexual desire and pleasure. It may even reflect a generally negative perception of female sexual desire and pleasure due to its perceived link to sexual immorality, as other studies have found [26, 30, 34]. This is linked to the traditional perception that a lack of FGC is associated with promiscuity, not sexual pleasure [5, 20, 21, 23]. This interpretation is affirmed by many of the stories of participants, which described the change from infibulation to sunna circumcision as a means to reduce any associated health risks while maintaining the meanings that associate FGC with sexual control and virtue. A Sudanese woman in her fifties recalled, during an interview, how her sister in Sudan had tried to convince her to have her daughter cut by referring to a medical doctor’s argument that sunna is “a small thing, just to minimize lust”*. A Somali woman in her forties was told that sunna circumcision “it helps, because when a girl has her clitoris, she will desire” (IDI). A Somali woman in her thirties, claiming to have been subjected to sunna circumcision with stitches, after which her legs were bound, laughingly expressed how she had told Somali friends that she has no FGC to see their reactions: “We friends, we touch each other, right. (…) There is a girl who touched my breasts and bum—they laugh and think I get so horny since I am not stitched”.* Another allusion to the notion that the removal of the clitoris is a way to reduce sexual energy was articulated by a few participants who likened FGC to the castration of male camels; both procedures are believed to be calming.

However, a few participants, mainly young women, expressed concerns that sunna circumcision could also have negative sexual effects on women, such as a Somali woman of approximately 20 years of age: “I don’t think there are any sexual consequences of circumcision if one is open. When it comes to sunna, it depends how much is removed” (IDI).

There thus seemed to be an apparent inconsistency in the participants’ views regarding the motivation for and effect of sunna circumcision, i.e., sunna circumcision was perceived to have no effect on women’s sexuality while simultaneously reducing women’s sexual desire.

This shifts our focus back to the ideal of virginity, which is a central aspect of infibulation. Sunna circumcision in its ideal form should not include (extensive) vaginal closure and thus may not function of constructing, protecting and proving virginity as infibulation is considered to do. Thus, below, we explore how the participants expected the transition from infibulation to ideal sunna circumcision to affect virginity ideals and ideas of marriageability.

Most participants claimed that FGC was not important for marriageability in the diaspora. This claim implied that no Somali or Sudanese man living in Europe would demand that his wife be infibulated. Furthermore, several participants suggested that many men preferred their wives not to be infibulated to avoid painful sexual initiation. Meanwhile, however, there was a common perception that unmarried women without infibulation, including women who had undergone defibulation, would be deemed promiscuous and immoral. Defibulation is a minor surgery to open the infibulation seal to expose the vaginal and urethral openings and may thus ease any health consequences caused by closure [42]. The general view of such procedures as socially unacceptable if conducted premaritally could be considered a contradiction to the uniform consensus against infibulation.

Thus, while participants grounded the change from infibulation to sunna circumcision in a concerns over health, sexual problems, and the perceived backwardness of infibulation, some of the cultural values associated with FGC, particularly virginity and virtue, seemed to obstruct the speed and extent of this change. In the following section, I thus elaborate on the meaning making that dominates the participants’ discourses of the change from infibulation to sunna circumcision.

From tradition to religion

Many informants explained their own shift from supporting infibulation to supporting or accepting sunna circumcision as a part of their religious education and awakening. They had come to view infibulation as not required by Islam and even contradictory to their faith, i.e., as haram. Islamic jurisprudence issues the term haram to refer to any act forbidden by God, typically in the Quran. While infibulation is not mentioned in the Quran, the participants’ perceptions that it is haram were grounded in its severe health consequences. Regarding their religious views on sunna circumcision, many participants were aware of various hadiths and of some of the controversies in terms of their interpretations. Furthermore, while the Quran does not mention FGC, some participants thought that it does and thus deemed the practice obligatory.

Many participants framed the abandonment of infibulation as a change from tradition and culture, which are dictated by humans, and thus could be defied. In contrast, as religion was perceived as God-given, those who perceived sunna circumcision as a religious practice, thought this could not be challenged. As indicated by an adult Somali man in an FGD: “There are two types of FGC in Somalia; the one, pharaonic is cultural, and the other, sunna, is religious”. A Somali woman expressed a similar view during an interview: “Before, with infibulation, this was done to control women [sexually]. But, nowadays, with sunni, it is done for religious reasons”.

Whereas the use of the sunna term to designate a type of FGC provides the practice with a religious grounding or framing [43], the link between FGC and Islam was differently perceived by the participants. Some saw the practice as obligatory, others as beneficial and still others as merely accepted. These views were not always based on a clear or strong conviction but rather on an insecure deduction, as expressed by an adult Somali man during a FGD: “Sunna is, as the name indicates, associated with religion. At least, they say it is more in accordance with religion”.

The overall impression was thus that while most participants reinterpreted infibulation as contrary to Islamic teaching, they perceived sunna circumcision to be a replacement that was religiously encouraged, supported or at least accepted.

From outer to inner sexual control

The second aspect of changes in meaning relates to the perceived sexual significance of FGC. Whereas the meaning of infibulation is intimately tied to closure, constituting a physical hindrance to and evidence of a lack of sexual engagement, the reduction or absence of closure said to be characteristic of ideal sunna circumcision suggests a change in meaning. Often, participants described a transition from infibulation to sunna circumcision as a change from outer to inner sexual control. Thus, to replace the physical closure endured through infibulation, they emphasized the importance of inner control, which could be ensured through improved parenting, religious education and reduced sexual desire through sunna circumcision. One example was an explanation provided by a Somali man in his thirties:

“In our parents’ time, they thought to circumcise and stich the labia together, so that girls could not have sexual intercourse. So, they thought that this was the solution to stop girls from having sex. But, they didn’t think about giving the girls information and knowledge about how not to do it [premarital sex]. You see? They just thought about closing it [physically] to prevent sexual activity” (IDI).

References to clitoral removal as a measure to reduce women’s sexual urges, and thus their sexual self-control, were also often alluded to. One example is the recollections of a Sudanese woman in her fifties about her sister’s suggestion to at least subject her daughters to sunna circumcision:

“Your daughters are still young, so you don’t know how girls would survive the teenage period; are we going to run behind them all the time? It is just a small thing! Just to minimize their sexual desires so they won’t make troubles. Girls also start to wear jeans, and friction can stimulate them too” (IDI)*.

While statements such as this were commonly presented in terms of arguments from others, the participants rarely disclaimed their validity. In general, discourses of the change from infibulation to sunna circumcision were intertwined with a discursive change towards increased privatization and internalization of sexual control. In contrast to infibulation, which is performed, checked, and broken by others, sunna circumcision in its ideal form was perceived to be a procedure that contributes to sexual virtue by reducing sexual desire. This discursive shift seems to have begun in parallel with an increased focus on religious teaching of sexual morality.

These blurred discourses of a change from outer to inner sexual control trough a change of type of FGC, were counteracted by the limited extent to which this was perceived to have taken place in practice. That is, sunna as it was perceived to be commonly practiced in reality, often included sufficient closure so as to ensure also external control. Furthermore, was there a simultaneous discourse of increasing other forms of external control, particularly in the form of pressure to follow a modest dress code and socialization- and movement pattern. This suggests that the discourse of transition is complicated and remains primarily at a discursive and ideal level.

From old-fashioned to modern

The third major change in meaning is the discursive framing of the shift in the type of FGC as a civilizing process. Participants commonly associated infibulation with the past, with rural areas, and with a lack of education, as indicated by a Somali man in his thirties:

“People in Somalia are now beginning to leave this bad culture behind. They are enlightened. They know how it is not good for girls when they marry, for their husbands, or when they are giving birth or for their sexual life. So, people who have information and are enlightened are abandoning this. But, people in the rural areas, those who we call baadiya, they continue to practice the pharaonic type” (IDI).

Similar perceptions were expressed by another Somali man:

“If we talk about the old times, then pharaonic circumcision was common among Somalis. But, nowadays, it is different. It seems people have become more civilized now, particularly in large cities. They use sunni circumcision. I think we should continue to practice circumcision, but not the pharaonic type” (IDI).

Many participants shared similar reflections by framing the change in FGC type as a result of modernization, education, civilization, and migration. Thus the shift was described as a result of new insights gained through education, religious enlightenment, and exposure to international impulses through travel or discussions with returned or visiting migrants.