Female genital mutilation does not usually announce itself loudly in adulthood. It shows up in pauses, in clinics, in routine questions answered a little too slowly. A woman is asked about her menstrual pain, sexual health, or pregnancy history, and there is a brief silence before she responds. Nothing dramatic. Just hesitation. That pause is often the doorway into understanding how female genital mutilation shapes health long after childhood. Long after the event itself. Long after people assume it is over.
Female genital mutilation comprises all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons. That clinical definition doesn’t capture what happens in that pause. The memories of childhood. The pain she’s lived with for years. The complications that only showed up during menstruation, attempts at intimacy, pregnancy. More than 230 million girls and women alive today have undergone female genital mutilation in 30 countries where FGM is practiced, mostly carried out on young girls between infancy and age 15. That pause in the clinic is where silence meets medical reality, where suffering that’s been normalized for generations finally gets named.
When Pain Becomes Your Normal
The pain, shock and use of physical force during the event, as well as a sense of betrayal when family members condone or organize the practice, are reasons why many women describe FGM as a traumatic event. But female genital mutilation doesn’t end with childhood trauma. The health impacts surface years later in ways women often don’t connect to that childhood procedure.
Menstruation becomes agony instead of inconvenience. Obstruction of the vaginal opening may lead to painful menstruation and difficulty in passing menstrual blood, particularly among women with Type III FGM. Imagine your period not just uncomfortable but excruciating. Blood that can’t flow properly. Cramping so severe you can barely function. Month after month, year after year.
Urinary problems including urinary retention and pain passing urine may be due to tissue swelling, pain or injury to the urethra. Going to the bathroom shouldn’t hurt. For female genital mutilation survivors, it often does. Some who experience urinary retention have likened the excruciating pain they feel every time they urinate to the feeling of salt being rubbed into an open wound.
Chronic infections become part of life. Increased risk of repeated urinary tract infections is well documented in both girls and adult women who have undergone FGM. These aren’t occasional infections. They’re recurring, painful, and require constant medical attention that many women can’t access.
Sexual intimacy carries fear instead of pleasure. FGM damages anatomic structures directly involved in female sexual function and can affect women’s sexual health and wellbeing, with removal or damage to highly sensitive genital tissue affecting sexual sensitivity. Extra scar tissue from FGM can cause pain, especially during sex, leading to lack of interest in sex, vaginal dryness, and lower overall satisfaction.
These aren’t abstract medical complications. They’re daily realities. The woman who schedules her life around bathroom access because urination is unpredictable and painful. The woman whose marriage suffers because sex means pain, not connection. The woman who dreads her period starting because she knows the next week will be agonizing.
The Complications Nobody Warns About
Women with FGM are significantly more likely to experience a wide range of complications during childbirth compared to those without. Pregnancy and delivery should be times of joy and anticipation. For female genital mutilation survivors, they’re often times of terror.
Women with FGM have more than double the risk of enduring prolonged or obstructed labour or haemorrhage, while being significantly more likely to require emergency caesarean sections or forceps delivery. Scar tissue may not stretch enough to accommodate a newborn, making delivery even more painful than usual and making it more likely the woman will need a Caesarean section or other emergency interventions.
One doctor working in a region where female genital mutilation is common described meeting women terrified to give birth. Not the normal nervousness of impending labor. Absolute terror based on what happened to their mothers, aunts, sisters. Without timely medical intervention, obstructed labour can cause debilitating obstetric fistula and also puts mother and baby at risk of dying.
Mental health impacts compound physical suffering. Women with FGM have an almost three times greater risk of depression or anxiety, and a 4.4 times higher likelihood of experiencing post-traumatic stress disorder. Studies have shown that girls and women who have undergone FGM are more likely to experience PTSD, anxiety disorders, depression and somatic complaints with no organic cause.
Think about carrying trauma from a childhood procedure you didn’t consent to, experiencing chronic pain and infections, fearing sexual intimacy, and then facing pregnancy complications. All of this while society tells you this was done for your benefit, to make you marriageable, to uphold tradition. The psychological burden is crushing.
The long-term consequences of FGM include chronic vaginal and pelvic infections, painful sexual intercourse, scarring, recurrent cystitis, urethritis, menstrual disorders, infertility, and psychological damages such as low libido, depression, and anxiety. These aren’t rare complications. They’re predictable outcomes of cutting healthy tissue for non-medical reasons.
When Silence Perpetuates Suffering
Many female genital mutilation survivors didn’t know something was medically wrong until pain became unbearable. They assumed everyone’s periods were that painful. That sex always hurt. That urination was supposed to cause discomfort. The immediate or long-term health complications are overlooked as the perceived social benefits of the practice are deemed higher than its disadvantages.
This normalization thrives on silence. When women don’t talk about their bodies, when reproductive health remains taboo, when cultural practices can’t be questioned, suffering continues unchallenged. Female genital mutilation is driven by social norms rooted in traditional beliefs passed on through generations, often unquestioned and enforced by societal approvals such as marriage prospects and sanctions such as ostracism.
Challenging female genital mutilation isn’t about attacking culture. It’s about naming a health issue that harms women and girls. FGM is a violation of the human rights of girls and women with no health benefits and devastating consequences. The practice has no health benefits and can result in severe bleeding, problems urinating, cysts, menstrual difficulties, infections, complications in childbirth and increased risk of newborn deaths.
Since 2004, the American Heart Association’s Go Red for Women initiative has addressed awareness and clinical care gaps of women’s greatest health threat, cardiovascular disease. The Heart Truth’s Red Dress campaign was designed to emphasize that heart disease is not just a man’s disease, delivering a wake-up call about women’s health risks often overlooked or dismissed.
Wearing red for women’s health awareness connects to this broader need for visibility. Female genital mutilation, like heart disease, reproductive health issues, and maternal mortality, thrives in silence. Red becomes the color of visibility. Of refusing to whisper about women’s bodies while they suffer. Of demanding that women’s health be taken as seriously as men’s.
When we wear red, we signal that women deserve healthcare that sees them completely. That acknowledges their unique health needs. That doesn’t dismiss pain as hysteria or normal discomfort. Female genital mutilation exists in that same space of normalized suffering where women’s pain gets minimized until it becomes catastrophic.
Healing Looks Different for Everyone
Treatment costs for health complications from female genital mutilation are estimated at about 1.4 billion dollars every year. But healing isn’t just about medical procedures. It’s about being believed, supported, and given options tailored to individual needs.
Medical care for female genital mutilation complications includes treating infections, managing pain, addressing scar tissue, and sometimes surgical reconstruction. Some women benefit from procedures that improve function and reduce pain. Others need ongoing management of chronic conditions. There’s no one-size-fits-all approach.
Counseling helps address trauma. Psychological impacts can range from a girl losing trust in her caregivers to longer-term feelings of anxiety and depression. Therapy provides space to process childhood trauma, current pain, and ongoing impacts on relationships and wellbeing.
Pelvic floor therapy helps some women regain function and reduce pain. Sexual health counseling addresses intimacy issues. Support groups connect survivors with others who understand their experiences. Community programs work to prevent female genital mutilation while supporting those already affected.
UNICEF provides access to medical and psychological care for girls at risk of FGM and FGM survivors, supporting health workers who provide such treatment. We know what works: health education, engaging religious and community leaders, parents and health workers, and use of traditional and social media are effective strategies to end the practice.
Progress is happening. After decades of slow change, progress against female genital mutilation is accelerating, with half of all gains since 1990 achieved in the past decade, reducing the number of girls subjected to FGM from one in two to one in three. But 230 million survivors still need care, and millions of girls remain at risk.
This connects to broader women’s health protection. Healthcare systems must adapt to meet women where they are. Must ask the right questions. Must create safe spaces where women can disclose female genital mutilation without judgment. Must train providers to recognize and treat complications.
Wearing red isn’t just awareness. It’s a signal that women deserve care that adapts to them, that cardiovascular disease is the leading cause of death for women yet often goes unrecognized. The same system that fails to adequately screen women for heart disease often fails to ask about female genital mutilation, fails to provide trauma-informed gynecological care, fails to believe women when they report pain.
Female genital mutilation will only end when we stop whispering. When we name it clearly as a harmful practice with devastating health consequences. When we support survivors openly. When we educate communities about real impacts. When we demand that women’s bodies be treated with the same medical seriousness as men’s. The uncomfortable truths need speaking. The silence needs breaking. The suffering needs ending. That’s what 2026 demands from all of us.
