You were born in Florence to a Somali father and an Italian mother, both gynaecologists. How has this background shaped your commitment?

My parents were already working on genital mutilation at a time when it was a completely unknown subject. Even though I wasn't necessarily destined for gynaecology, my interest in this topic caught up with me. After my medical studies in Italy, I applied to Geneva somewhat by chance in 2009 for a six-month contract – that was sixteen years ago! What made me stay: the unique combination of clinical practice, research and teaching. I then specialised in gynaecology, in operative gynaecology and vulvar pathology, and sexual medicine.

How was the FGM consultation at HUG established?

When I arrived, a working group already existed – I was often called by my colleagues to see affected patients. From there, the specialised consultation was created in 2010: two days a month with physicians, psychologists and midwives. We have more than 450 consultations per year for FGM or other vulvar pathologies. For FGM, it is still the only consultation of this type in Switzerland.

Why does this subject remain so marginal?

It's a sensitive subject that concerns violence, people often from minorities, and sexuality. Moreover, the vulva and clitoris remain poorly known and little studied. And these consultations require time: it sometimes takes months for care that also involves cultural changes. But it's so rewarding! We see patients getting better, talking about sexual health with their partners, observing generational change with their children.

On the research side, you've just received Leenaards funding...

Yes, a project conducted with Daniel Huber and his team in Basic Neurosciences that aims to assess the sensitivity of female genital organs in order to improve the diagnostic and clinical, surgical and psychosexual management of patients affected by FGM and, consequently, other vulvar conditions. The question is crucial: patients always ask us whether they feel less than people who haven't undergone genital mutilation, and whether surgery will improve their sensations. We cannot answer precisely. With our research, we want to investigate the neurosensory consequences and understand the different factors, subjective and objective, that can influence genital sensitivity and perception.

You've also developed innovative tools for consultation and teaching...

We created an atlas, then from this atlas watercolours representing different types of mutilation, tested with 80 patients. The idea: a tool that can be used in consultation but also for prevalence studies. We also designed 3D models, introduced into anatomy practical sessions. With Francesca Arena, a historian, and Céline Brockmann, a biologist, we give a course on the history of female genital organs. Geneva offers great openness for this type of educational innovation, for students, but also more broadly for the general public. It's an opportunity.

Thanks to you and your teams, Geneva has indeed become an international reference centre.

We have published extensively, always welcomed colleagues who wished to train, and developed multidisciplinary teams and an international network. Many now come from abroad to learn our methods and share their experiences. Last year, we organised the first international masterclass in post-FGM reconstructive surgery, and we are also producing an e-learning based on this. With a multidisciplinary, trauma informed, culturally sensitive care and around thirty vulvar surgeries per year, we have unique expertise, not only on FGM, but also on the clitoris. Our consultation is becoming well known, even if, unfortunately, we cannot respond to all requests.

Does your personal background play a role with patients?

Certainly. My dual cultural and religious background, my parents' work and training allow me to hold a unique position, with a connection and understanding without judgement, stigmatisation or victimisation. Sometimes, I notice that when a patient sees my surname or learns that I'm of Somali origin, she is reassured.

Why create a dedicated chair?

Firstly, it recognises the academic importance of the subject. Concretely, it would allow us to develop three areas: consolidate and expand an international network of experts with harmonised training, including in high-prevalence countries, standardise our educational tools – watercolours, atlas, videos, 3D models, and strengthen research, particularly through multicentre studies, which do not yet exist. We could thus advance science and recognition and the health of affected women and girls.

FGM obviously concerns women, but it is essential not to consider it only as a women's issue...

Exactly. Men are our therapeutic allies. Their inclusion is also crucial in prevention – they are fathers, partners, brothers. The chair would allow us to formalise what we do, with a multidisciplinary infrastructure: doctoral and postdoctoral students, as well as research nurses. FGM affects more than 230 million women – one in seventeen in the world. With a chair, we could change lives on an incomparably larger scale. And this knowledge also goes well beyond and applies to all women and people with vulvas.

Your expertise extends beyond FGM...

Starting from FGM, we have developed expertise for broader vulvar and clitoral pathologies – accidents, violence, surgical complications, dermatological diseases. I have also been responsible for gynaeco-obstetric emergencies since 2018, with joint responsibility for the care after sexual assault with my colleague forensic physician Tony Fracasso. It's a unique facility in Geneva, accessible 24/7, even without filing a complaint. We conducted a first retrospective study, which informed an intercantonal campaign on the possibility of consulting at A&E after sexual assault. We created an electronic file that can be reproduced by other hospitals, and began a multicentre study with follow-up at three and twelve months of all patients who agree to participate. We assess their physical, mental and sexual health status, substance consumption, and their experience of care. Our report will be released soon, and we then hope to be able to create a permanent observatory.