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Testosterone, hormone produced by the male testis that is responsible for development of the male sex organs and masculine characteristics, including facial hair and deepening of the voice.

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Sex booster warning for UAE

Dubai: The Ministry of Health and Prevention (MOHAP) has issued warning against the use of 11 fake pharmaceutical products marketed as food supplements and sexual enhancement products for men.

The products contain undeclared ingredients and pose a high risk to patients with heart disease, diabetes, dyslipidemia, and those taking drugs containing nitrate.

The ministry is committed to monitoring the nutritional supplements that some companies abuse to gain quick profit by giving false promises, said Dr Ameen Hussain Al Amiri, assistant undersecretary for Public Health Policy and Licensing at MOHAP and chairman of the Supreme National Pharmacovigilance Committee. “The Ministry is making efforts to warn the public against the use of such medication, as they threaten lives,” he added.

Dr Al Amiri also urged the authorities concerned to take necessary measures to withdraw these products from the market and prevent them from being imported and circulated in the UAE, as they are not registered with MOHAP’s drug department.

The MOHAP is also warning about the circulation of fake herbal products that are marketed via social media promising enhanced sexual ability in men.

Dr Al Amiri noted that these products can have severe implications on health, as most of them are not registered in the UAE. He urged members of the community to avoid purchasing medication through illicit online pharmacies, and encouraged those who have done such transactions to notify the ministry to take the required measures.

The ministry has received a warning from the US Food and Drug Administration (FDA) on the drugs ‘Man of Steel’ containing sildenafil, and ‘Super Panther 7k’ containing sildenafil as well as tadalafil.

The FDA also issued a warning on several supplements sold by SHH Trading as sexual performance enhancers for men: ‘Macho Man 3000’, ‘Love Zen 3000’ and ‘Monster 1350’ which contain tadalafil; ‘Xzone Gold’ and ‘Triple Miracle Zen Plus 1200’ which contain tadalafil and sildenafil; and ‘XXX Zone Platinum,’ ‘Triple Premium Zen Gold 1300mg,’ and ‘Triple X 2000,’ which include sildenafil, tadalafil and dapoxetine; and ‘Own the Knight 1750,’ which contains tadalafil and dapoxetine.

The authority noted that all these dietary supplements contain undeclared quantities of sildenafil, tadalafil and dapoxetine. Dapoxetine is administered only by prescription while tadalafil and sildenafil can cause a severe drop in an individual’s blood pressure and can be dangerous to those with heart disease or diabetes, dyslipidemia, and those taking drugs containing nitrate.

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Because of these historical connections, the impact of modern physics upon religious ideas has been most enduringly felt and evaluated from the perspective of Western Christian thought.

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The pleasure doctor fighting to restore clitorises after female genital mutilation

Marci Bowers’ clinic in California is famous for those seeking gender-reassignment surgery. Her work as a gynaecological surgeon over the past 25 years has made her one of the leaders in this field – and also in restoring sexual function in clitorises. She is one of only a handful of surgeons who performs this surgery on women who have suffered female genital mutilation (FGM) or cutting.

Reconstructive surgery to repair the physical damage of FGM has been around a long time. But the technique to restore clitoral function began developing only a decade ago, pioneered by French urologist and surgeon Pierre Foldès. His idea was to not only reconstruct the clitoris, but also nerve networks to restore sexual sensation. After training with Foldès, Bowers performed the first clitoral repair surgery in the US in 2009. Since then, she’s operated on around 100 women.

For many women and girls who undergo FGM, it’s a traumatic experience. FGM is the partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons. Up to 140m women and girls live with the consequences of this practice and it is widespread in 29 African countries, but it also occurs in Asia, the Middle East, Latin America and among migrants from these areas.

The clitoris is an important part of a woman’s sexuality and along with the severe medical and psychological consequences that cutting can have, it can also come with psycho-sexual problems.

The clitoris

The clitoris is a complex organ, and when a woman undergoes cutting, only the visible part of the clitoris is cut off. But it is much larger than most people ever assume. It has a root that is about 10cm long that lies beneath the surface, arching around the vagina. It is this that reconstructive surgeons use to rebuild a working organ.

“It’s only like losing the visible tip of the iceberg,” Bowers says. The surgery, also known as clitoroplasty, involves removing scar tissue, pulling the remaining clitoris up to the surface, and then stitching it into its natural place.

According to Bowers, the restoration of sexual pleasure is possible because the whole clitoris is sensory, not just the tip. Along with better cosmetic appearance, sensation, and reduction in pain and infection, Bowers says that patients have reported having orgasms for the first time.

But it’s not just about the restoration of sexual sensation. “The number one reason is restoration of identity,” she said. Women who have been cut feel their sense of womanhood has been stolen from them and they want that back. “They want their body back and to feel more normal. It’s about not being different any more.”

The fall out

As good as all this might sound, the procedure is controversial. In 2012, Foldès and colleagues published an article in The Lancet assessing the immediate and long-term outcomes of reconstructive surgery. Over an 11-year period they operated on nearly 3,000 patients, and of the 29% who attended a one-year follow-up consultation, more than half said they were having orgasms and nearly all reported feeling clitoral pleasure.

But a group of British doctors responded in a critical letter to The Lancet. In addition to the lack of a control group, they said the Foldès’ claims were anatomically impossible in cases of type 2 FGM – the partial or total removal of the clitoris and the labia minora. “Where the body of the clitoris has been removed, the neurovascular bundle cannot be preserved … There is therefore no reality to the claim that surgery can excavate and expose buried tissue,” they wrote.

They also said that the campaign against FGM “could be undermined by a false proposition that the ill effects can be reversed”.

Bowers doesn’t agree – both in terms of the surgery and of undermining efforts to fight FGM. “You see the clitoris every single time, 100% of the time. You can’t deny it’s there,” she says. According to Bowers, their response reflects antiquated but persistent notions of female sexuality. The work of NGOs is important, she argues, but if something can be medically fixed, it should be fixed.

And she’s not short of patients. Twice a year she leaves her reported 14-month waiting list for US$21,000 gender reassignment surgery to operate for free on women who come to her for clitoroplasty, although patients still pay a $1,700 admin fee to the clinic.

She’s adamant that she only helps those who want it and who, she says, often come to her unhappy, angry and sad with husbands and partners. “We were only there to help women who found that they were suffering as a result of FGM,” she says. It’s probably fair to say, then, that Bowers is an evangelist for reconstructive surgery.

The pleasure hospital

Bowers became involved in the FGM reconstruction surgeries because of Clitoraid, a private, non-profit organisation that helped fund her training in Paris. The organisation is backed by volunteers of the Raëlian movement – one of the world’s largest UFO religious sects – whose members believe that humans were created by extra-terrestrials. Clitoraid promote free sexuality, sexual freedom and pleasure for all women.

Bowers’ own motivation doesn’t come from a Raëlian perspective, she says, but from her own philosophy that human beings have a sixth sexual sense. “When the sexual sense is taken away, it’s no different than if someone had taken away your sense of smell or your sense of taste.”

It’s clear, though, that her belief runs in parallel with the aims of Clitoraid, which has concentrated its work in the small West African nation of Burkina Faso, recently building a hospital nicknamed the “pleasure hospital” to offer reconstructive operations free of charge. The hospital was supposed to have opened its doors in March 2013 with local medical staff and trained surgeons, but the government stopped the project because of licensing issues. Clitoraid has said its authorisation was revoked following pressure from the Catholic Church and accusations that the group would attempt to convert women to the Raelian movement. The group still intend to open next year.

Ultimately, Bowers claims the enjoyment of sexual activity is a human right. “Sexuality is part of what makes us human beings and what makes life pleasurable,” she says. Before transitioning to life as a woman, she herself was born male. And this, she says, gives her empathy with victims of FGM. “For me, womanhood didn’t come without my own sacrifices and struggle. I empathise with women who have to have surgery to achieve and regain their womanhood. They are struggling to regain their identity, just like I had to do once upon a time myself.”

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Diary of paedophile who committed suicide

Cape Town - A convicted paedophile, who committed suicide in police holding cells, will not be taking his secrets to the grave.

The Daily Voice has managed to view the diary of Brian Shofer which is in possession of a source close to him.

In the red Lever arch file, he chronicles how he raped young boys, and was the victim of abuse himself.

Shofer, 58, wrote that he was sexually molested by his uncle as a 13-year-old, and that his father knew about it, but failed to intervene.

In graphic detail, he also noted that during a stint in prison in the 1990s, he was sodomised by prisoners after they heard he was in for molesting children.

Slipped into the file was submission letter for parole, dated May 1, 2008, in which he claimed to feel remorse for his sick crimes, and wanted to ask his little victims’ families, the community, and his father for forgiveness.

The memoirs, in which Shofer documents his troubled life, and contains pictures and accolades, include the 13 psychiatric programmes he “aced” while at Brandvlei and Drakenstein Correctional Facilities.

He claimed the wardens and prison psychiatrists had “enormous respect” for him.

Shofer was found dead in a Mitchells Plain police holding cell on Friday after he hanged himself with a blanket.

He was arrested after his elderly landlord saw him on the front page of the Daily Voice on Monday, and called police. Police took in two young men, aged 25 and 18, the latter admitting that Shofer raped him.

According to the National Prosecuting Authority’s Western Cape spokesperson, Eric Ntabazalila, the teen was repeatedly raped over six years, from the age of 12. Shofer was released from prison six years ago.

The 70-year-old landlord said his tenant claimed the two were his adopted sons.

The teacher made headlines after he advertised tutoring services for kids, from Grades 2 to 11, on Gumtree.

Shofer claimed that he was rehabilitated and that parents were aware of his criminal record.

His convictions date back to 1994. His first victims, mainly from Mitchells Plain, were aged between seven and 14.

He was jailed for several counts of indecent assault, before being released on parole.

Shofer re-offended after setting up a youth centre in Hanover Park.

He was released from prison in 2010.

A parent who has a child at Lourier Primary School in Retreat said he had still been teaching there until last term.

Police say Shofer’s suicide comes as they were formulating more charges against him.

These include: a rape case in Steenberg, a sexual assault case in Mitchells Plain, a sexual assault case in Hanover Park, and 18 cases of sexual assault involving street children in Strand, where he used to reside.

Shofer has also been linked to several Cape Flats schools, including Garlandale High and Tafelsig High.

His diary, written in a neat handwriting, revealed that he studied teaching through Unisa, graduating with six distinctions.

He also had friends who believed he was rehabilitated and took him all over Cape Town, finding him work and places to stay.

On the final page of his submission for parole, he begs for a second chance at life.

“I am truly sorry for my deeds...” he wrote.

“To my beloved father who is still alive and loves and supports me, my chaplain, members of correctional services and the Almighty, [thank you] for transforming me into the being I have become.”

Independent Police Investigative Directorate spokesperson Robbie Raburabu said a post-mortem would be conducted on Shofer’s body.

“It is believed he tore off the edge of his blanket and hanged himself on the door. The results of his autopsy will be released in this week,” he said.

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Ministry ferrets out fake erectile dysfunction, obesity drugs

The Ministry of Food and Drug Safety said Wednesday it identified two compounds commonly used in fake drugs to treat erectile dysfunction and obesity.

According to the ministry, dithiopropylcarbodenafil is the modified chemical structure of the compound found in Viagra called sildenafil. Chlorosipentramine is the chemically modified version of sibutramine, the main compound of obesity drugs.

The ministry has found that illegal and unethical ingredients were mixed into the original compounds through an analysis of the elements of the health products sold.

Through this finding, it said, the government would be able to preemptively prevent people from advertising fake products for increasing sexual performance and weight control.

The National Institute of Food and Drug Safety Evaluation also said that it would continue to improve consumer safety and confidence by identifying chemical structures of other drugs that can be modified to mislead the public.

The ministry said it would provide the analysis of the illegal ingredients and standards to other related institutions, including the National Forensic Service and Korea Customs Service, to eradicate and manage hazardous food and drug products.

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Nuclear, chemical and biological threats: The terror next time?

IN THE aftermath of the terrorist attacks on New York and Washington, those whose job it is to think the unthinkable were conscious that, for all the carnage, it could have been far worse. Fuel-laden aircraft slamming into buildings was bad enough. But the sight of some among the rescue workers picking over the debris with test tubes, followed by the sudden decision to ground all of America's crop-spraying aircraft for several days, pointed to an even more horrible possibility. Were terrorists with so little calculation of restraint to get their hands on weapons of mass destruction—whether chemical, biological or even nuclear—they would surely use them. How real is that threat?

It is certainly not new. Among one of many warnings from American think-tanks and government agencies in recent years, a report released last December by the CIA's National Intelligence Council concluded baldly that, when it came to chemical and biological weapons in particular, “some terrorists or insurgents will attempt to use [these] against United States interests, against the United States itself, its forces or facilities overseas, or its allies.” Governments in America and Europe worry that Osama bin Laden, the head of al-Qaeda, the terrorist network thought to be behind the September 11th attacks, may already have access to such weapons, and be planning to use them in response to any American military strikes. The World Health Organisation has called on governments around the world to be better prepared for such an eventuality.

For groups prepared to engage in the kamikaze tactics seen on September 11th, the easiest way to spread poisonous or radioactive materials might simply be to fly into repositories of them, or to use lorries full of them as suicide bombs. As Amy Smithson of the Stimson Centre in Washington, DC, observed in a report released last year, there are some 850,000 sites in the United States alone at which hazardous chemicals are produced, consumed or stored. The arrest in America last week of a number of people who were found to have fraudulently obtained permits to drive trucks that carry such hazardous loads looks like a worrying confirmation of such fears.

It is, nevertheless, likely that terrorist groups around the world are working on more sophisticated approaches to mass destruction than merely blowing up existing storage facilities, or hijacking lorry-loads of noxious substances. Mr bin Laden himself has, in the past, called it a “religious duty” to acquire such weapons. He is reported to have helped his former protectors in Sudan to develop chemical weapons for use in that country's civil war, and has since boasted of buying “a lot of dangerous weapons, maybe chemical weapons” for the Taliban regime in Afghanistan that now harbours him.

Even for determined terrorists, however, merely getting hold of chemical, biological or nuclear materials is not enough. Do-it-yourself mass destruction—whether of a nuclear, chemical or biological variety—is far from easy (see article). First, you have to acquire or manufacture sufficient quantities of the lethal agent. Second, you have to deliver it to the target. And third, you have either to detonate it, or to spread it around in a way that will actually harm a lot of people.

The difficulties in doing all these things are illustrated by an attack carried out in 1995 on Tokyo's underground railway. Aum Shinrikyo, a Japanese cult, released a potent nerve agent called sarin on five trains. The intention was to kill thousands. In fact, only 12 people died, and some 40 were seriously injured—bad enough, but no worse than the casualty list from a well-placed conventional bomb.

The cult's researchers had spent more than $30m attempting to develop sarin-based weapons, yet they failed to leap any of the three hurdles satisfactorily. They could not produce the chemical in the purity required. Their delivery mechanism was no more sophisticated than carrying it on to the trains in person in plastic bags. And their idea of a distribution system was to pierce those bags with umbrella tips to release the liquid, which would then evaporate.

The attack, in other words, was not a great success. Yet, of the three classes of weapon of mass destruction, those based on chemicals should be the easiest to make. Their ingredients are often commercially available (see table). Their manufacturing techniques are well known. And they have been used from time to time in real warfare, so their deployment is also understood.

Biological weapons are trickier; and nuclear weapons trickier still. Germs need to be coddled, and are hard to spread satisfactorily. (Aum Shinrikyo attempted to develop biological weapons, in the form of anthrax spores, but failed to produce the intended lethal effects.) Making atomic bombs is an even greater technological tour-de-force. Manufacturing weapons-grade nuclear explosives (“enriched” uranium, or the appropriate isotopic mix of plutonium) requires a lot of expensive plant. Detonating those explosives—by rapidly assembling the “critical mass” needed to sustain a chain reaction—is also notoriously difficult.

Terrorist groups working from first principles are thus likely to run into formidable obstacles if they want to get into the mass-destruction business. Nevertheless, there may be ways round these. One quick fix would be to buy in the services of otherwise unemployed or ill-paid weapons specialists from the former Soviet nuclear-, biological- and chemical-weapons establishments. At least some of these people are known to have washed up as far afield as Iran, Iraq, China and North Korea, but none has yet been directly associated with any terrorist group.

In an attempt to reduce the risk of this happening, the United States has, over the past ten years, spent more than $3 billion dismantling former Soviet nuclear weapons, improving security at Russia's nuclear storage sites, and keeping former weaponeers busy on useful civilian work. But, as Ms Smithson points out, only a tiny fraction of this money—itself a drop in a bucket when measured against the scale of Russia's sprawling weapons complex—goes towards safeguarding chemical and biological secrets. And even the nuclear side of things has sprung the odd leak.

Over the past ten years there have been numerous attempts to smuggle nuclear materials out of the former Soviet Union. There have been unconfirmed suspicions that Iran, for one, may have got its hands on a tactical nuclear warhead from Russia. So far, though, police and customs officers have seized mostly low-grade nuclear waste. This could not be turned into a proper atomic bomb, but with enough of it, a terrorist group might hope to build a “radiological” device, to spread radioactive contamination around (see article). Fortunately, the occasional amounts of weapons-grade stuff that have been found so far fall short of the 9-15kg of explosive needed for a crude but workable bomb.

Yet even if a group got hold of enough such explosives, it would still face the hurdle of turning them into a weapon. Hence the most effective way for a terrorist group to obtain one would be to find a sponsoring government that is willing to allow access to its laboratories or its arsenal.

After the Gulf war, UN special inspectors discovered that Iraq had been pursuing not one but several ways to produce weapons-grade material, and had come within months of building an atomic bomb. The effort, however, is thought to have taken a decade and to have cost Saddam Hussein upwards of $10 billion. Much of this was spent on acquiring the bits and pieces needed from foreign companies—sometimes through bribery, sometimes through deception.

In similar ways, he amassed the materials and equipment, much of it with legitimate civilian uses in fermentation plants and vaccine laboratories, for his vast chemical- and biological-weapons programmes. Although most of Iraq's nuclear programme had been unearthed and destroyed, along with much of its missile and chemical arsenal, the inspectors were convinced, when they were thrown out of the country in 1998, that important parts of the biological effort remained hidden.

A glance at the list of state sponsors of international terrorism maintained by America's State Department makes troubling reading. Most of the seven countries included—Iran, Iraq, Syria, Libya, Cuba, North Korea and Sudan—have chemical weapons already. Five are suspected of dabbling illegally in the biological black arts, and several have covert nuclear-weapons programmes, too. America's Department of Defence estimated earlier this year that more than two dozen countries have already built weapons of mass destruction, or else are trying to do so.

So far, there is no evidence that any of these governments has helped terrorist groups to acquire such deadly goods. That may, partly, be because of widespread moral revulsion against their use. But self-interest on the part of the states involved is also a significant factor. It is one thing to give terrorist groups financial and logistical support and a place to hide—a favoured tactic of governments on the State Department's list as a deniable way of furthering their own local or regional ends. It is quite another to share such awesome weapons with outfits like al-Qaeda, which no government can fully control.

On top of that, since the September 11th attacks, American officials, from the president down, have gone out of their way to emphasise that not only the terrorists involved in any future assaults, but also the states that shelter them, can expect to find themselves in the cross-hairs.

Iraq has been the worst offender when it comes to wielding any of these weapons. It used chemical weapons in its war with Iran and in attacks against its own Kurdish population. Yet Saddam Hussein's failure to use his chemical and biological-tipped missiles, or the radiological weapons he also had, against western-led coalition forces during the Gulf war showed that, even when morality plays little part, deterrence can still work. America had made clear that, if he had deployed these weapons, he would have brought down massive retribution on both his regime and his country.

The big distinction between the dangers of states obtaining such weapons and the danger of terrorists getting their hands on them, argues Gary Samore of the International Institute for Strategic Studies, in London, is precisely that, however hostile they may be, states are more “deterrable”. Mr bin Laden's network has shown that it will stop at nothing. But are states such as Iraq and North Korea, which operate in other ways largely outside international law, deterrable enough to prevent them lending a secret helping hand to a group like Mr bin Laden's?

America's defence secretary, Donald Rumsfeld, argued this week that it takes no “leap of the imagination” to expect countries harbouring terrorists to help them get access to weapons of mass destruction. Testimony from the trial of four bin Laden operatives convicted earlier this year for the August 1998 bombing of America's embassies in Kenya and Tanzania revealed that their past military interest in Sudan went beyond helping the regime make chemical weapons for its own war. In one case, Mr bin Laden was attempting to purchase uranium via intermediaries.

Meanwhile, intelligence officials trying to assess the range of threats they now face worry that Iraq's past military links with Sudan may have been no coincidence either. In 1998 America bombed a Sudanese pharmaceutical plant which it said showed traces of a precursor chemical for VX, a highly potent nerve gas that inspectors believe Iraq had put into weapon form. Some observers speculate that, even if Sudan's denials that it was manufacturing any such stuff are true, the country may have served as a trans-shipment point for supplies to Iraq. Might some weapons assistance have flowed the other way, possibly reaching Mr bin Laden's network? Iraq denies it has had anything to do with Mr bin Laden, but there have been unconfirmed reports that one of the New York hijackers met a senior Iraqi intelligence official earlier this year in Europe.

Yet even if no direct link is ever proved between a reckless foreign government and last month's terrorist attacks on America, western officials have long fretted that groups such as Mr bin Laden's will be able to exploit emerging new patterns of proliferation to gain access to nuclear, chemical and bug bombs. Despite attempts by western-sponsored supplier cartels—the Missile-Technology Control Regime, the Nuclear Suppliers Group and the Australia group, which tries to track the trade in worrying chemicals or biological agents—the number of such suppliers has expanded over the past decade. Countries that were once entirely dependent on outside help for their covert weapons programmes, mostly from Russia and China, are now going into business themselves.

This is particularly disturbing in the context of the third obstacle to the use of these weapons: delivery. Working from original Russian Scud missile designs, North Korea has created a thriving missile- and technology-export business with Iran, Pakistan, Syria and others in the Middle East. Iran, in turn, has started to help Syria and possibly Libya (which had past weapons ties with Serbia and Iraq) to improve their missile technology. Egypt is still building on the expertise developed by a now-defunct missile co-operation programme with Argentina and Iraq.

It is unlikely that such ballistic-missile technology would find its way into terrorist hands any time soon. But two things are true of almost all technologies: as the years pass, they get cheaper, and they spread. Even if there is no immediate threat, it may eventually not be just hijacked aircraft that are flying into places that terrorists have taken a dislike to. And their “warheads” may consist of something even worse than aviation fuel.

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What It's Like to Have Sex After Undergoing Female Genital Mutilation

Mariya Karimjee has had sex once in her life — sort of. When she was a senior in college, Karimjee, now 27, decided it was finally time to do the deed with her boyfriend of a year, even though he had repeatedly said he was willing to wait until she was ready. Though she never felt pressured to engage in more physical intimacy, she felt like she needed to have sex anyway — to "get the act over with," as she later described it.

So, Karimjee had sex. And, as she feared and expected, it was excruciating.

"The pain was everywhere; I couldn't figure out what hurt and where," Karimjee wrote of the experience in an essay for the Big Roundtable last year. "... I sat in the bed, allowing myself to cry for the first time since we'd begun talking about sex. For the first time since I'd admitted to him that I might never be able to enjoy a sexual experience. That when I was younger, someone had taken a knife to my clitoris and cut out a small but significant part of me."

As she went on to explain in recent episodes of This American Life and The Heart, when Karimjee was 7 and growing up in Karachi, Pakistan, she had part of her clitoris removed, in accordance with the beliefs of the Dawoodi Bohra sect of Islam. She is one of at least 200 million people around the world to undergo female genital mutilation, a practice the World Health Organization defines as "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."

Also referred to as female genital cutting or female circumcision, FGM is widely considered an act of gender-based violence as well as a human rights violation, a practice typically performed on young girls (and, occasionally, female infants or teenagers) in a variety of cultures. WHO asserts that the practice "has no health benefits, and it harms girls and women in many ways."

WHO classifies the procedure into four primary types, each of which can have different effects on survivors' sexual health and comfort: clitoridectomy, which results in at least partial removal of the clitoris; excision, or a clitoridectomy plus removal of the labia minora; infibulation, which involves narrowing the vaginal opening by cutting and repositioning the labia (sometimes by stitching) with or without removing the clitoris; and all other harmful treatment of the female genital area, including but not limited to piercing, incising or cauterizing.

FGM is, in many societies, a long-standing cultural practice, which continues for reasons that vary from place to place and heritage to heritage. But, according to WHO, the procedure is generally tied to beliefs about acceptable sexual behavior, meant to deter promiscuity and strip women of erotic desire — or, potentially, enjoyment.

As Karimjee and millions of others have found, it can be extremely effective at doing just that.

"Sex did not go the way popular culture or anecdotal evidence told me it would go," Karimjee said in a phone call with Mic on Thursday, explaining the lasting effects her first experience had. She has not attempted to have sex since she first tried in 2010, primarily because of continuing anxiety about the experience.

"I gear myself up, but for me, the fear is so great that in the moment, I don't know if I feel anything but afraid," she explained. "I am not able to get out of my own head long enough to be able to be like 'I'm turned on.' That happens very rarely for me, and it takes months to feel comfortable enough."

In a phone call with Mic this week, Dr. Doris Chou, medical officer for the Department of Reproductive Health and Research at WHO, said research suggests women who are living with FGM "are more likely to experience pain or reduction in sexual satisfaction and desire," and, in addition to significant pain during intercourse, might face reductions in arousal, decreased lubrication during sex, limited capacity for orgasm or even anorgasmia.

Though people who undergo clitoridectomies, excision or infibulation can (and often do) still experience some amount of sexual pleasure, a majority have reported lower rates of arousal or sexual fulfillment — in studies, at least. Anecdotally, there's less information available about the realities of having sex — or not — after FGM, not to mention what that means for individual women's overall wellbeing.

"[There] are actually quite physical consequences, but there's also the psychological," Chou said. "We do know women and girls who have undergone FGM suffer anxiety or post-traumatic stress disorder. In the context of a sexual relationship, we are concerned that women might have difficulty really actually having any kind of sexual life."

The implications of that difficulty can be devastating, as illustrated by a growing number of women like Karimjee, who have begun to share their (often traumatic) experiences of developing, maintaining or even wanting sex lives with parts of themselves missing.

"I've spoken to women in my sect who have also been cut, who never, ever, ever want to have sex because they're so traumatized by what happened to them, and other women who have very vague memories but say they never get turned on, so it clearly worked," Karimjee said.

Indeed, much of the struggle with desire is due not only to the intense physical pain women who have been cut might experience during intercourse. Natalie Kontoulis, advocacy and communications officer for the organization End FGM, has found that for many people, it has to do with deeper, more complicated feelings about sexuality and personal autonomy.

"If a person who has undergone FGM is not in severe physical pain, she might not feel much — sensation might be gone," Kontoulis said via Skype on Thursday. "It can feel like you're a vessel, doing this to serve your partner, making sex less of a partnership. Some survivors feel they're not fully women. I think when you've literally had a part cut out of you, you cannot feel whole for those reasons."

There can also be lifelong trauma associated with being cut in childhood, Kontoulis added, which might be compounded by a lack of opportunity to talk about "how you were, potentially, betrayed at a young age by those you trusted most."

For quite some time that was true for Karimjee, who felt extreme rage toward her mother, in particular, for allowing her to be cut. After her family moved to the United States when she was 11, Karimjee went on to struggle with her parents' justification for the decision, which she believes was based on harmful cultural views about desire.

But those views were not necessarily unique to her sect of Islam or other groups that practice FGM. Karimjee has found that spending her adolescence in a conservative, predominantly Baptist Texas suburb contributed to her complicated feelings about her own sexuality.

"It's hard for me personally to reconcile the fact that my parents were fundamentally responsible for having me cut, but at the same time these were the same people who never made me feel sex was bad," Karimjee said. "My parents never made me feel like sex was something I needed to be ashamed of. But my peers in high school definitely got that from their churches and their parents, and transferred that on to me."

The combination of physical and psychological trauma from the overall experience of FGM can lead some women to pursue therapeutic options ranging from sex therapy (something Karimjee says she's looking into) or even clitoral restoration surgery.

According to Dr. Marci Bowers, a gynecological surgeon who works for the organization Clitoraid, restoration can be life-changing, but it's usually not enough. It's also not always an option: As Bowers said in a previous interview with Mic, although FGM is practiced around the world — including in the U.S. — a significant proportion of people who have been cut lack access to medical services like restoration.

"It's a tremendous thing if you're able to restore — it's like giving sight to a blind person," Bowers said by phone this week. "But anything associated with that part of the body, people remember that pain. Even where there's sensation, in an area where someone had pain before it's hard to retrain the brain to see any [non-painful] sensation as a positive sort of thing. It's hard to trust again."

And while FGM opponents like Kontoulis note it's still crucial to consider the practice an act of violence, it's also important not to tell someone she shouldn't feel good about sex if she never felt bad about it before.

"I've heard survivors say [their FGM] doesn't bother them, they still get pleasure from sex," Kontoulis said. "That might be physically absolutely true, or it might be that they just don't expect to have pleasure. It doesn't bother them. In that sense, it's difficult, because you don't want to impose your own kind of pleasure system or cultural system or sexual system on another person. But the problem with that is there's a line between trying to be culturally diplomatic and treating FGM as a human rights violation, and it's difficult to not cross it."

It's an issue that leaves Karimjee with complex feelings as well. She, too, has spoken with many women who have been cut but have not faced her same struggles with sex, yet still have lingering questions about whether they should feel satisfied.

"I personally have never spoken to anyone — even women who are married and having sex who've been cut, who say 'I don't know if I'm orgasming, but I do enjoy having sex with my husband' or 'I enjoy the act of sex, it doesn't hurt' — who doesn't also say, 'But I still wonder what it would be like,'" Karimjee said. "It's an ever-present question for them."

"In some way, they feel something was taken away from them — something intangible," she added. "As long as that feeling is still out there, there's definitely still a problem."

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Would You Inject Your Penis With This? (Hint: It Will Make It Bigger)

Some men would try anything to increase the size of their member, from penis stretching to enlargement surgery. Now, one doctor claims that a patient can increase their penis size by having it injected with blood. Would you go to this length (pun intended) for a bigger bulge?

How injecting the penis works

Forget the little blue pill, there’s a new remedy in town. Dr. Norman Rowe, a certified surgeon in New York, told the Daily Mail he can increase penis size by 1.5 inches in just 10 minutes. The Botox-style procedure involves injecting the penis with a patient’s own blood for immediate results.

The method of injecting platelet-rich plasma (blood plasma enriched with platelets) is commonly used in sports medicine in order to rejuvenate muscles and fix injuries. That’s precisely where the doctor got his inspiration for this unusual size-boosting method. And unlike painful surgeries, “There is no recovery period,” said Rowe. “You come in, get the injection, 20 minutes later you’re walking out.”

In addition to increasing size, Rowe says he’s been able to cure erectile dysfunction for some patients. What do you think — would you try this method to increase the size of your penis and fix erectile dysfunction? If not, try these foods and let us know how it goes.

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