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Female genital alteration: Where do we draw the line?

The last few days have been abuzz with debate on whether the female genital cut should be decriminalised as per the petition filed by Dr Tatu Kamau at the High Court.

The universal agreement is that children must be protected from the cut against all costs, but divergence comes when a mature consenting woman opts to undergo the procedure.

As debate rages on, few are paying attention genital procedures that have been medicalised in Kenya and abroad. Let's have a look at some:


This involves shaving pubic hair, then adorning the pubic region with crystal jewellery stuck on the skin using bonding glue.

It was popularised by the actress Jennifer Love Hewitt in her book The Day I Shot Cupid, and further cemented in popular culture through TV show appearances.

Its promotion was further supported by Amy Child, a beautician from the United Kingdom, where the National Health Service has reported a rise in complications following the procedure, especially those that are done by individuals rather than a trained beautician.

Women who jump onto this trend risk infection, bruising, allergic reactions and trauma during sexual intercourse arising from poorly located crystals.

Genital Piercings

Body piercing is not a new phenomenon; it has been a part of many cultures, and carries underlying meanings. Today it is done for aesthetics, more than anything else, all over the body from the ear lobes to the brow, nose, lips, tongue, nipples and even the genitals. Piercings are done on the clitoris, the labia majora and the labia minora and bullrings and barbells inserted.

The Prince Albert is a male piercing that starts in the urethra at the penile tip and exits on the underside of the penis at the top of the glans (the naked part of the penis after the foreskin) with a curved barbell running through. In the female version - Princess Albertina - the piercing goes through the urethra and comes out of the vagina.

The piercings are done to improve the appearance of the genitals, sexual satisfaction or for the hype. However, they remain largely discouraged by reproductive health authorities, especially the American College of Obstetricians and Gynaecologists (ACOG). Even worse, providers of these piercings remain largely unregulated.

Complications from these procedures abound, though not enough data has been collected to inform their frequency. These include: infections, bleeding, allergic reactions to the jewellery, chronic pain, scarring and keloid formation. In a country where infections transmitted through sharps abound, the possibility of getting HIV, hepatitis B and hepatitis C is real.


Vaginal surgery to repair congenital abnormalities in young adolescents born with genital tract malformations is not a new concept. Repairs for vaginal fistulae in women sustaining them during neglected labour keeps specialists and supporting partners busy all year long.

Repair of perineal tears is a routine procedure done by doctors and midwives for women after childbirth. However, in recent years vaginoplasty has taken a different tangent, with doctors marketing it as a cosmetic procedure, with a promise that it improves appearance, sexual experience and confidence.

Some women want to tighten their vaginas after vaginal births, others want the shape and size of their labia altered, while others want enhancement of the G-spot with collagen injections. These services are available right here at home, provided by our very own gynaecologists.

So far there aren't enough studies to convince the scientific world on the effectiveness of these procedures especially in guaranteeing sexual satisfaction and most international professional bodies remain cautious.

In the face of these procedures, does Dr Kamau have a case in court? Are these procedures the reason women would want decriminalisation of the female genital cut? What is the cost benefit?

One American study showed that most nurses did not have any idea how to deal with genital piercings during emergencies. Yet removing a tongue barbell from an incapacitated patient at the emergency department during surgery is no mean feat!

I can only imagine the trauma a young man with a Prince Albert piercing would go through if he did not realise the importance of mentioning its presence to a radiologist before going for an MRI test. His penile tip will be well and truly fried!

These things are not foreign to us. Five years ago, I had a mum in labour with bilateral piercings on her labia majora complete with a neat row of barbells on either side. Thankfully, my skills for removal were not tested as she ended up needing a Caesarean section!
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Publication:Daily Nation, Kenya (Nairobi, Kenya)
Date:Jan 22, 2018
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