Mishaal started masturbating around age 7. Her mother caught her in the act a couple of times and, soon after, decided to have Mishaal's clitoris cut.

"In my late teens, when I talked to my sister [who also underwent genital cutting] and mom about why the cutting happened, the answer was: It is done to reduce women's libido and prevent them from having sex," Mishaal recalled. In their community in Pakistan, she added, "the attitude was: Sex is for [making] babies. Why does it have to be pleasurable? My mom's belief was: You have to have sex to please a man. There was no entitlement to sexual pleasure."

Thanks to years of advocacy and education work, many Americans are now familiar with female genital mutilation or cutting (FGM/C), a practice that involves anything from "nicking" a girl or woman’s clitoris—a vague term that can encompass varied sizes and depths of incisions with a wide range of ultimate effects—to totally removing it and part or all of her labia and suturing shut the vulva. Media coverage often focuses on how widespread FGM/C traditions are, even in the West (FGM/C is usually considered an African, and to a lesser degree an Asian, issue). Reports detail how many (but not all) girls and women subjected to FGM/C undergo the process at young ages, against their will, under extreme social duress, or without full knowledge of what's happening to them. Activists have painted in excruciating detail all the risks associated with the practice, from long-term pain to pregnancy complications to psychological trauma to, in all too many cases, death during or after the procedure.

They have also pointed out that many cultures, like Mishaal’s, have long explicitly or implicitly used FGM/C to control or eliminate women's sexual agency, desire, and pleasure—or enhance those feelings for men.

Yet for all the survivors’ stories out there on the experience of being cut and its subsequent effects on their lives, relatively few accounts in the media have explored how people who've undergone FGM/C experience sex and navigate intimacy. This is somewhat understandable; sex is a tricky-to-taboo subject in most cultures, especially in many in which FGM/C is rampant. Sharing the intimate details of one’s life post-FGM/C can be difficult, embarrassing, or even socially isolating. These stories, though, can be powerful tools for helping outsiders understand, in a visceral sense, how FGM/C can affect people's sex lives, to say nothing of their value for those who have undergone FGM/C and feel isolated in their experiences.

In an effort to bring more stories of the lived experience of sex and intimacy after FGM/C to public attention, VICE recently spoke to Mishaal and her husband Ibrahim, who today live in the U.S. They're both part of the Dawoodi Bohra sect of Ismaili Shia Islam, a minority group of several hundred thousand people, most of whom live in India, Pakistan, Yemen, and along the coast of East Africa, which regularly nicks girls’ clitorises when they're around 7 years old. (In 2017, authorities arrested a Bohra doctor in Detroit for performing FGM/C, the first-ever charge against an individual for cutting girls in the U.S.) Although the Bohra community has been speaking more openly about FGM/C over the past few years, the couple still did not want to share their real names out of concern for social repercussions and general stigmatization. VICE has given them the pseudonyms Mishaal and Ibrahim so they could openly discuss this aspect of their lives.

Mishaal: I didn’t have sex before marriage. But I had multiple people that I was intimate with. I enjoyed foreplay, mostly because of the excitement of it being forbidden where I grew up. But I never orgasmed with anyone but myself. So I knew something was off. But I didn’t figure out that it was tied to the cutting until much later.

When I was young, I was never in a committed relationship, so sexual encounters were few and far between. But after I got married, I found that penetrative sex was painful for a long, long time. That somehow triggered a traumatic reaction I’d never expected. I was almost fearful of it. That was compounded by feelings of, Oh my god, this is awful for our relationship. Or, I don’t feel fully like a woman. I was afraid I would lose our relationship.

Ibrahim: We got married pretty quickly. We met through a common friend and were together for a few weeks [while Mishaal was in the U.S. on vacation from Pakistan] before getting engaged. We were married within eight months, but for most of that time we were physically apart, with her in Pakistan and me coming to visit periodically. We had sexual encounters, but not intercourse. Before we got married, she never said anything; I didn’t realize that she had undergone anything.

We talked about it later, after trying to have sex and finding it to be difficult for her. It was our wedding night the first time we had intercourse, and it was really painful for her, which was an unsettling experience for me. I’d had intercourse before. I’d dated four women prior to marrying Mishaal, and I’d never had an experience where it was so painful for my partner. It was difficult to process what was going on. I understood she was a virgin and the first time is always hard. But my first girlfriend was a virgin as well and she didn’t seem to experience any difficulty.

I’d heard this was practiced in Africa. But I wasn’t aware that the practice took place within our community, and I don’t think most men are. As far as how it affected intimacy for women, I hadn’t a clue. I felt like it was a brutal practice and really unfair, but I didn’t think about it beyond that.

Mishaal: By then, I’d realized the effect that FGM had on my ability to derive sexual pleasure from any experience. I understood how much you would enjoy intercourse would depend on how much you’d been aroused and how into it you are. I knew the FGM was a part of not being able to get even sufficiently aroused to enjoy sex. But I hoped it would get better. You’re only a virgin once.

Ibrahim: We didn’t just have one conversation about this. It happened over a series of experiences.

Mishaal: Our difficulty having conversations about this made us realize how much bad messaging we’d soaked up—difficulties talking about sex, viewing sex as something almost dirty. That subtext had been embedded in us from childhood.

Ibrahim: We tried having sex more regularly. We tried different ways of having sex, different positions and activities that might make it easier. I think for a long time, part of the problem was that Mishaal would get really tense when a sexual encounter started and that would remove any pleasure she might have been able to have. To be honest, it wasn’t until we had our first kid that she started to have, not necessarily comfort—but that she didn’t initially recoil during sex.

Mishaal: It is hard to know [how much of my difficulty having sex is the result of physical issues caused by FGM and how much of it is the psychological expectation of pain]. That’s always been a question in my mind. I think for me it’s some combination of both things.

Physically, if I’m able to have an orgasm through masturbation, though, then that should be able to happen through partnered sex as well. But that has just never happened. The presence of another person just affects me now. But sex did evolve from being downright painful to tolerable [after I gave birth for the first time]. That eased a lot of the stress around sex and made it a lot better.

Ibrahim: I only learned later in our marriage that Mishaal was masturbating. It was news to me that she actually had experienced orgasm before. But that hasn’t really influenced [how we have sex]. I have not learned what it is that would allow her to achieve orgasm through masturbation.

Mishaal: Still, it has been an evolution of: Okay, do I just accept defeat like most women in my culture and that I am just never going to feel pleasure from this? Or do I try to find other ways around it? And to be honest, I don’t think I have. I haven’t done enough. I know things like sexual counseling could benefit me. Or we could be more experimental with gadgets or whatever. Other things could help. But it is really hard for me to even rouse up the desire [to try these things.]

Ibrahim: Unfortunately, most of our energy is tapped by the time we end up in bed [as we work full-time and are the parents of young children.] We still have sex, but it is not frequent.

Mishaal: But there are a lot of things that bind us besides sex. I’m very physical in terms of hugging and kissing, so it is not like we don’t physically connect.

Ibrahim: We also might not have intercourse, but oral sex happens. There are ways we help each other.

Mishaal: In my mind, there’s sexual closeness, which I still don’t have, unfortunately—with Ibrahim or anyone. Then there is every other level of closeness, which does exist in our relationship.

But, while it’s always shifting, for me there is still a lot of guilt. I think he could have an active relationship with someone who was initiating, or who wanted, sex. I feel terrible that this is one aspect where I am not a good partner. There has always been a shadow in my life about this.

Ibrahim: I think I still show Mishaal affection too, though.

Mishaal: You do. The guilt for me is totally self-inflicted.

Ibrahim: On some level, there is even trauma for me in our experiences, too. Sex was so painful—why would I want you to feel this way?

Mishaal: He has been weaned off sex. I try to address that, but it is becoming harder. As the years go by, the libido goes. I was telling Ibrahim the other day that even when I didn’t enjoy sex, at least there would be times when I wanted to masturbate. I haven’t even wanted to do that in a long time.

Ibrahim: I think recently, though, meeting people who’ve gone through the same experience—and even just talking to your sister and mother openly about this and how painful it has been—has been helpful. If that had happened earlier, I think things would have been different.

Mishaal: A lot of this is the result of not having those conversations earlier, and of carrying shame and guilt for so long that it paints how you view sex.

Ibrahim: This is never going to happen to our daughter.

Mishaal: The hardest part of coming to terms with FGM for me is that it didn’t prevent the one thing my parents thought it would. I had relationships with multiple men prior to getting married, and my decision not to have sex with them had nothing to do with being cut, but everything to do with how I’d been raised, what I believed. But the marriage—which is supposed to be a sacred relationship—it created a lifelong taint on that.