Eugenie Kanzayire, 35, has been in the business of labia elongation and sex counselling for the last 10 years.

Unlike others who use traditional and social media platforms to advertise their work, Kanzayire has a permanent address in CHIC, one of Kigali’s busiest commercial buildings.

Her place of business is unique.

While all the other businesses on her floor use their windows to advertise their work, at ‘Urubohero’, as her business is called, the windows are draped in heavy brown curtains and the doors are firmly shut to accord her clients some privacy.

Clients stroll in and out on appointment, or simply knock on the door to gain access. Inside are a couple of cabinets, boxes of latex gloves, an electric water kettle, bottled green clay, and solid bentonite clay that looks like a sweet potato.

There are also apple cider vinegar and air diffusers that constantly send a sweet aroma around the room. It looks neat but quite small.

As I take my seat, I wonder how she helps her clients since the services that she provides involve spreading their legs and yet, besides the place being small, there is also no sign of a bed.

Kanzayire must have picked on my confusion because quickly, she explained that her clients seek utmost privacy, so some of them prefer to not even set foot at ‘Urubohero’.

Appointments are fixed and she meets them wherever they prefer.

Also a member of the network of Rwandan traditional healers (AGA Rwanda Network), Kanzayire boasts that her ‘medicine’ gets her clients the desired labia length in just a week instead of years as is the norm if done without her assistance.

She won’t share her ‘trade secrets’, including her charges per session or the cost of her products for fear of her competitors.

When seeking services, her clients choose between buying her products and elongating their own labia, or they let Kanzayire do it for them. Most go for the latter, which she highly recommends.

"If you are doing it yourself, you won’t know what to stretch because you can’t see down there,” Kanzayire says.

She adds that labia elongation is not merely about the length, because even their width should be stretched.

"When they (labia minora) are too thin, they look ugly. We also have products to make them look healthy, for those who did it years prior,” Kanzayire adds.

She also discloses that some of her clients are brought to her by their husbands, who wish their partners had done it when they were much younger.

"Most of my clients are married women or those who are getting married,” she notes.

Kanzayire gets her products from neighbouring Uganda, where the tradition is also widely practiced.

But what is labia elongation?

Labia elongation, traditionally known as ‘gukuna’ or ‘guca imyeyo’ is a practice that involves women pulling their labia minora to increase their length to about six centimetres or more.

Although the practice has attracted controversy over the years, it continues to be popular in both rural and urban communities.

Historically, this practice was done by a pair of girls who sat on the floor facing each other as they spread their legs and folded their knees in a hook position. One would pull the other’s labia.

Alternatively, a girl who doesn’t have a partner sits in a hook position, bent over and her arms pass around her thighs to reach her labia. It is believed that if her arms pass between the legs, her labia might grow in the wrong direction.

For lubrication and fast growth, a mixture of ground sodom apple (intobo) and cow ghee is applied to the vulva, an experience that many say is painful but also effective.

Because of how far spread the practice in the region is, many theories of its benefits have also kept evolving. Some say it protects women from vaginal infections and that it eases vaginal birth, among others.

However, the common reason given by its enthusiasts is that labia elongation enhances sexual pleasure for the woman that has done it and her male partner.

Adolescent girls were historically told they would be rejected by their husbands if they didn’t elongate their labia, and that either meant divorce or being cheated on as their spouses sought out other women who had practiced it.

Much has changed especially in terms of tools used and the reasons why it is done, 'gukuna' remains a common practice in urban and rural parts of the country.

One of the other main changes is the required age to do it. Adolescent girls and children were the only ones allowed to, and it was forbidden for a married woman as it was believed that her husband would die if she tried.

Today, any woman of any age can elongate her labia.

Historical practice

In his research slated for publication this year, local journalist and researcher Amani Banzubaze, found that labia elongation is a common practice in the Rwandan community and that not doing so is in fact what would be surprising.

"Although labia elongation is done by women in all economic classes, it is much more common among less educated women, those from rural areas, and those from poor families,” Banzubaze wrote.

He added that the exact origins of this practice in Rwanda are not known, but unverifiable information that he managed to gather is that labia elongation spread to the whole country during the reign of King IV Rwabugiri who ruled Rwanda from 1853 to 1895.

It is believed that Rwabugiri had sexual relations with foreign women from one of his military expeditions in the Bushi Region (present-day Eastern DR Congo) who had elongated their labia. He liked it and had to carry one of the women back to Rwanda, henceforth declaring it mandatory for adolescent girls across the kingdom to heed the practice.

If authentic, this would mean that the practice is more than a century old in Rwanda and could explain why it is common in all parts of the country.

Labia elongation is not only confined to Rwanda. It is a centuries-old practice that is also popular in Uganda, Burundi, Zambia, Malawi, Zimbabwe, and in some places as far as the Marquesas Islands in the Pacific Ocean.

Overrated practice

Emma Claudine Ntirenganya, a former radio host with more than 18 years of experience in reproductive health discussions, refutes claims that elongated labia enhance sexual pleasure.

"No, that’s a lie! Sexual pleasure comes from female sex hormones, how ready you are mentally, and whether you are attracted to your partner among others. Elongated labia is not a factor at all,” Ntirenganya says.

However, she adds that strong beliefs in the practice may build confidence and enhance pleasure since it may partly contribute to their psychological preparation for sex.

She added that the most important thing is to give women the right information so that they can make informed choices on whether to go through with it or not.

"I don’t encourage or discourage anyone about the practice. However, I tell them how it doesn’t have any scientific benefits, and going forward, they can then choose what works for them,” Ntirenganya explained.

Unnecessary pressure

Rwandan feminists and other rights groups have on several occasions called for the ban of the practice on young girls.

Cecile Umuhoza, a women’s rights activist, says that there is no point in preserving the labia elongation practice because the world now knows better.

"It should be a matter of preference. No one should be forced or manipulated into doing it. Some adult women decide to elongate while others are going through surgery to remove them. Labia elongation should join the list of the things that are optional, like tattoos and piercings,” she says.

Umuhoza adds that the labia elongation concept sends a message that women are not complete or enough as they are.

"It means that women need painful, time-demanding, and privacy-invading manipulations to be deemed acceptable for men’s pleasure. That’s completely outrageous in today's world,” she says.

The Director of Community Outreach at Health Development Initiative (HDI), Jocelyne Ingabire says that while labia elongation is often portrayed as something that girls must do to please their future husbands, it is unfair that young girls who haven’t even experienced their first menstruation period are pressured or even coerced into practicing it before they understand sexuality or marriage.

"I find it quite unfair that our society pressures young girls into this practice. As HDI, we are concerned that there is a lack of clear measures to discourage this practice that may expose girls and women to sexual abuse and gender-based violence,” she said.

Currently, HDI is currently in the process to conduct research on the community perception of labia elongation in Rwanda, with hopes that it will inform the adoption, adaptation, and implementation of gender transformative/youth inclusive policies and laws.

Health concerns

Stephen Rulisa, a professor of obstetrics and gynaecology with 20 years of experience, says currently, there is no scientific research indicating that labia elongation has negative implications on the health of women.

"Labia elongation does not have any known negative implication physiologically. I haven’t heard of any report of discomfort because of elongated labia, even during pregnancy and birth. When people ask me, I tell them there is no difference, clinically speaking,” he says.

However, the World Health Organisation says if hygiene is not maintained, infections are likely during the process.

In a past interview on labia elongation, Dr Magnifique Irakoze, a gynaecologist, pointed out the need for adult women to have full information before engaging in the practice.

For instance, he said, one of the reported complications for those engaging in labia elongation is an irritation that might result in a small wound on the vulva that can be a point of entry for infection.

"If someone delays seeing a doctor, the infection might ascend and attack the internal female organs, including the tubes and ovaries. Those untreated chronic pelvic inflammatory diseases may cause infertility in some women. If women choose to do it, let them do it in a setting with proper hygiene,” he added.

The World Health Organization classifies labia elongation as type 4 Female Genital Mutilation (FGM) which includes all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping, and cauterising the genital area.