Elongation of labia minora in Uganda: including Baganda men in a risk reduction education programme

Abstract

Okukyalira ensiko or ‘visiting the bush’ is how, in Uganda, the Baganda people name the practice of elongating the labia minora, which young girls start performing before menarche. As a mandatory rite of passage that identifies membership of the tribe, one of its main purposes is to enhance sexual pleasure for both male and female partners. The conditions in which it is practiced involve certain physical health risks. In this qualitative study carried out in Wakiso district, a semi-structured interview was conducted among 31 Baganda men, in order to understand their perceptions, attitudes and knowledge toward the way in which their daughters practise labia minora elongation. According to our results, men highly value this practice for its capacity to enhance sexual stimulation even though they are aware of its risks. Since genital stretching is likely to endure, the authors discuss the possibility of addressing Baganda men by health workers in an education programme aimed at minimising the risks attached to the procedure and, hence, improving the sexual and reproductive health of Baganda girls.

Okukyalira ensiko ou «visiter le buisson»: c'est ainsi que les Baganda, en Ouganda, appellent l'élongation des petites lèvres que les jeunes filles pratiquent avant leur ménarche. En tant que rite initiatique obligatoire qui confirme l'appartenance à une tribu, un des principaux objectifs de cette pratique est d'augmenter le plaisir sexuel des partenaires sexuels, qu'ils soient masculins ou féminins. Les conditions dans lesquelles l'élongation des petites lèvres est pratiquée exposent à des risques physiques. Dans cette étude qualitative conduite dans le district de Wakiso, des entretiens semi structurés ont été menés avec 31 hommes issus de l'ethnie baganda, afin de comprendre leurs perceptions, leurs attitudes et leurs connaissances, relativement à la manière selon laquelle leurs filles pratiquent l'élongation des petites lèvres. Selon nos résultats, ces hommes accordent beaucoup de valeur à cette pratique, pour sa faculté à renforcer la stimulation sexuelle, même s'ils sont conscients des risques potentiels. Dans la mesure où l'étirement sexuel est susceptible de perdurer, les auteurs discutent de la possibilité que des professionnels de santé abordent ce sujet avec les hommes issus de l'ethnie baganda, dans le cadre d'un programme d'éducation visant à minimiser les risques liés à la pratique et, par conséquent, à améliorer la santé sexuelle et reproductive des filles issues de la même ethnie.

Okukyalira ensiko o ‘visitar el arbusto’ es el modo en que, en Uganda, el pueblo Baganda nombra a la práctica de elongación del labio menor que realizan las chicas jóvenes antes de la primera menstruación. Como rito obligatorio del paso a la madurez que identifica la afiliación a la tribu, una de las principales finalidades de esta práctica es aumentar el placer sexual tanto para los compañeros masculinos como femeninos. Las condiciones en que se practica implica ciertos riesgos para la salud física. En este estudio cualitativo realizado en el distrito de Wakiso, se llevó a cabo una entrevista semiestructurada con 31 hombres Baganda con el objetivo de conocer sus percepciones, actitudes y conocimientos sobre el modo en que se sus hijas practican la elongación del labio menor. Según los resultados, los hombres valoraban mucho esta práctica para su capacidad de mejorar la estimulación sexual aunque estaban al corriente de sus riesgos. Dado que es probable que continúe la práctica de la elongación genital, los autores proponen la posibilidad de que trabajadores sanitarios eduquen a los hombres Baganda a través de un programa educativo destinado a minimizar los riesgos que implica este procedimiento y, por tanto, mejorar la salud sexual y reproductora de las chicas Baganda.

Keywords:

• genital stretching
• elongation labia minora
• female genital modification
• Baganda
• okukyalira ensiko

Acknowledgements

We are greatly indebted to the aid and suggestions given to us by Pia Grassivaro Gallo (University of Padua) and Marian Koster (Wageningen University) who had previously researched genital stretching in Uganda and Rwanda, respectively. We would like to thank Alexander Andrason and Aleksandra Szymanska for their comments on our research. We especially appreciate the effort made by Estrella Lerena (University of Alcalá de Henares) to help us organise the research results.

Notes

^1. On December 9, 2009, a Bill prohibiting Female Genital Mutilation was unanimously passed by the Parliament of Uganda (Namutebi and Kafuuma 2009).

^2. The following Luganda words can be found in the paper: Buganda: kingdom of Baganda tribe in Uganda; Baganda: name of the largest tribe in Uganda; also means ‘men’ or ‘women’; Bulange: Parliament of Buganda located in Mengo (Kampala); Kabaka: the King of Buganda; Kiganda: traditional culture of the Baganda; Luganda: language spoken by the Baganda; Muganda: ‘a man’ or ‘a woman’ (member of Baganda tribe); Nabagereka: Queen mother, or wife of the Kabaka of Buganda; Okukyalira ensiko: ‘visiting the bush’ (the practice of stretching labia minora); Okusika: ‘stretching’, ‘pulling out’ (the practice of stretching labia minora); Ssenga: paternal aunt.

^3. Throughout this paper, we will refer to genital stretching as practised by the Baganda as okukyalira ensiko because of all the cultural connotations attached to the Luganda expression.

^4. Gruenbaum (2005) on FGM researching methods says that ‘When time does not allow for extensive participant observation, individual in-depth interviews are highly desirable’ (432).

^5. Ages and lengths as indicated by the ssengas and by the adolescents consulted.

^6. These reasons described by Tamale (2005) and Grassivaro, Villa and Pagani (2006) were confirmed by the ssengas and the adolescent girls consulted during this research.

^7. According to Grassivaro Gallo and Villa (2006b). Nevertheless, the girls in the workshops attended by the authors just named the bush.

^8. Also named ‘black jack’, a herb used as well for genital stretching in Rwanda (Koster and Price 2008).

^9. No botanical names were found for the last four. All these were herbs cited by the ssengas and adolescent girls consulted. Neubinger (1994, 846) quotes ntengotengo. Tamale (2005) quotes mukasa, ntengotengo and oluwoko. Grassivaro Gallo and Villa (2006a) quote namirembe, ntengotengo, kabbo ka kabyala and mukasa.

^10. Grassivaro Gallo and Villa (2006b) state that herbs may be substituted by crèmes, e.g. Tropical Belt manufactures ‘Sangoma Twin Towers’, a moisturising crème that can be purchased in http://tropicalbelt.com/products.html. ‘Twin Towers’ refers to the concept of elongated labia minora as ‘twins’, as described by Grassivaro Gallo and Villa (2006a).

^11. Described as stinging by both the ssengas and the adolescent girls consulted.

^12. As related by the girls participating in the COFCAWE Workshops.

^13. The word ssenga was only used by men in the interviews conducted in Luganda. When answering in English, the interviewees used the word ‘auntie’.

^14. This fact was denied by the staff at the Nabagereka Foundation, with its headquarters in Bulange, the Kabaka Parliament (Mengo, Kampala).

^15. Quoted from the interviewed. Interview conducted in English.

^16. Unsalted cow butter. Its use for this purpose was denied by all the ssengas consulted.

^17. Neither the ssengas nor the bibliography consulted confirms the use of tweezers for stretching.

^18. Quoted from the interviewed. Interview conducted in English.

^19. Tamale (2005) claims that it is a cultural taboo for a Muganda father to discuss sexual issues with his daughters.

^20. Quoted from the interviewed. Interview conducted in English.

^21. Christofferesen-Deb (2005), who researched the perceptions of AbaGusii towards Female Genital Modifications in Kisii (Kenya), observed that men preferred circumcised women: ‘circumcised women were preferred on account of their ‘sexual coolness’, which seemed to offer the promise of faithfulness that husbands seek’ (411).

^22. The Baganda prefer wet rather than dry sex (Tamale 2005). Furthermore, Koster and Price (2008) write about Rwandese's perceptions towards elongating labia minora; ‘All of our informants were of the opinion that elongated labia minora aid in the production of vaginal secretions’ (198).

^23. This is explained by Koster and Price (2008): ‘Since the labia minora swell during sexual excitement, there is a larger surface area for penile friction during coitus. Since the swelling partly takes place inwards, the entrance to the vagina may also become tighter, thus creating more pleasurable friction for the man’ (196). Gruenbaum (2005), on female genital cutting, states that ‘narrowing of the vaginal opening with infibulation is believed to make intercourse more pleasurable for men’ (431).

^24. Further explanation on labia minora described as ‘doors’ can be found in Grassivaro Gallo and Villa (2006a).

^25. According to Tamale (2005): ‘When touched and manipulated in the correct manner during foreplay or mutual masturbation, they may be the source of immense pleasure to the couple’ (27).

^26. See footnote 19.