Feminism

Ms Sharawe, who was featured in last year’s BBC list of 100 women for her determination to end FGM, decided to share her journey to Germany and recovery so other women like her could know their options.Yet it has taken years of abuse and the trauma of a second failed marriage for her to find the courage to take on the establishment within the Somali community.Ms Sharawe, now a single mother with a 10-year-old daughter, also feels let down by the NHS.It only offers deinfibulation for FGM survivors - that is surgery that opens up the vagina, but does not replace any removed tissue and will not undo any of the damage.Ms Sharawe decided to look for funds to pay for surgery in Germany.Through online crowdfunding, she managed to raise £25,000 ($32,000) – and underwent a four-and-half hour procedure in December.She was in Germany for three weeks and on her return, the anti-FGM activist and teaching assistant was not able to leave her house for months as she recovered.The childcare costs and other expenses on top of the surgery mean she is still in debt - owing around £3,000 to the hospital.“Paying for damage you didn't choose for yourself, or you didn’t create, is really unfair,” she says.There are four different types of FGM with varying levels of severity:Clitoridectomy: partial or total removal of the sensitive clitorisExcision: partial or total removal of the clitoris plus the inner skin folds surrounding the vagina (labia minora)Infibulation: cutting and repositioning of the outer skin folds around the vagina (labia minora and labia majora).

Often includes stitching to leave only a small gapCovers all other harmful procedures like pricking, piercing, incising, scraping and cauterising the clitoris or genital area.What is FGM, where does it happen and why?In the past couple of decades, medical techniques have been developed to try to repair the damage - pioneered in 2004 by French surgeon Dr Pierre Foldès.

It's complicated and every patient is different,” says Dr Adan Abdullahi, a specialist in Kenya.But he says women with every type of FGM could benefit: “It has a positive effect on childbirth, especially for ‘type three’, which is associated with a narrowing of the vagina.”Other issues, such as pain during sex, can be significantly improved or cured, he says - adding that his patients often experience improved self-esteem “and a sense of completeness”.Ms Bilkisu says she does feel more complete since her surgery, which was covered by the German health system: “Undergoing surgery was really a power move, a way to fight back.”But the 30-year-old recruitment agent encourages others to do their research thoroughly before deciding: "Reconstruction is not only to reconstruct the clitoris.

"I definitely don’t think surgery is the answer for everyone," she tells the BBC.Around half the cases at her clinic, which opened in 2020, are now treated using non-surgical means like injections of platelet-rich plasma which promotes tissue rejuvenation.

"The plasma [can] lead to regeneration and stimulation of increased blood flow and reducing inflammation in the areas where you inject it," she says.However, she cautions that the high cost means such treatments are beyond the reach of many.Her clinic also offers psychological therapies to overcome trauma for women cut at an age when they can remember the experience.For those who do opt for reconstructive surgery, the results can be emotional.“The first time I actually saw my clitoris I was taken aback because for me it was like this doesn't belong to me,” said Ms Bilkisu, who was eight years old when she underwent “type two” FGM.Ms Sharawe agrees it takes some getting used to, plus learning how to deal with things like proper period bleeds.It will take her another six months to completely recover - and she has not been able to afford to go back to Germany for a check-up, which worries her.“But now I know how it feels to be a full woman… I am a very happy woman,” she says.“I can wear underwear without discomfort or pain.

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