Psychosexual health of women living with female genital mutilation/cutting

Abstract

Female genital mutilation (FGM), also called female genital cutting (FGC), female genital mutilation/cutting (FGM/C) or ritual female genital modification/alteration, is defined by the World Health Organization (WHO) as the partial or total removal of the external genitalia or other injury to the female genital organs for non-medical reasons. FGM/C is a human rights and public health issue with complex historical, anthropological, socio-cultural, legal, political and economic implications. From a health point of view, it negatively affects women's and girls' psychophysical health with possible infectious, uro-gynaecological, obstetric, sexual and psychological complications. Many research gaps exist on the effective care of women living with the complications of FGM/C, especially in case of sexual dysfunction. Psychosexual function after FGM/C depends on the interaction of multiple factors. Some biological and socio-cultural factors are specifically affected by practice. The aim of my research is to improve the available evidence and knowledge about female sexual and reproductive health after FGM/C. This is important to improve and promote women's and couple's healthcare; correctly and honestly inform women, girls and men; and dispel myths, fears and false beliefs that negatively affect women's and girls' lives and FGM/C prevention and care. In this thesis, I will summarize the factors that influence psychosexual health after FGM/C and the evidence and gaps regarding the existing treatments in case of psychosexual dysfunction after FGM/C. I will present a cross-sectional study on sexual anatomy and function after FGM/C, two case studies and a systematic review on clitoral reconstruction associated with psychosexual care before and after surgery. Clitoral reconstruction is a relatively new surgery that is currently debated because of the lack of conclusive evidence on its efficacy and safety. The thesis concludes by discussing my future perspectives of research regarding sexual health after FGM/C, education of healthcare professionals on this topic and health education on female sexual anatomy for women.