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Please be aware that this blog contains content that may be distressing to read.
There are lots reasons why women and people with a cervix find it hard to go for cervical screening (smear tests). The Hawa Trust work with communities affected by FGM and we spoke with Hawa Sesay, their Executive Director, about the experience of screening for women who have undergone FGM.
Female genital mutilation (FGM) is when parts or all of the female genitals are deliberately cut, changed or removed. It is often done for cultural, religious or other non-medical reasons, usually before puberty begins between infancy and age 15. In the UK, FGM is illegal and is child abuse.
FGM is sometimes called cutting or female circumcision, and some communities may use local terms for it, like sunna, gudniin, halalays, tahur, megrez and khitan.
FGM can cause lifelong emotional difficulties and make attending smear tests extremely hard. The thought of going to the GP or having to disclose FGM can cause a lot of anxiety and be difficult to talk about, especially if you have had a previous bad reaction from a healthcare professional. The position the test requires you to be in, and the fact it involves the lower part of your body, can also trigger bad memories or flashbacks.
Smear tests can physically be very hard, even impossible, for people who have undergone FGM, especially if only a very small hole for urination has been left. This can make it difficult for a nurse to see the cervix and take a sample of cells. It can also make the test incredibly painful.
Cultures that practice FGM are often outside the UK, which can mean there may be additional barriers affecting attendance. This includes language. Having English as a second language can make it even more difficult to talk about FGM and know how to ask for support. In some cultures, pre-marital sex or loss of virginity has a stigma attached to it and cervical cancer itself can be seen as a taboo topic or a disease of promiscuous people. This can lead to misconceptions – for example, that only people who have had sexual contact need smear tests and may mean young or unmarried women feel reluctant to attend.
If you are looking for support or information about your appointment, you might want to call our Helpline on 0808 802 8000.
The below charities are also excellent sources of information and support:
Hawa Trust - information and support to people who have undergone FGM.
FGM National Clinical Group - a charity working with women who have been affected by FGM and other related difficulties
Daughters of Eve - a non-profit organisation working to protect girls and young women who are at risk from FGM.