Genital Mutilation Research Articles

Beyond the surface: unpacking the methodological and ethical challenges of researching into a sensitive female genital mutilation practice

Beyond the surface: unpacking the methodological and ethical challenges of researching into a sensitive female genital mutilation practice

The princess, the witch and the fairy godmother: colonial legacies in ‘FGM’

This article analyses the discursive construction of what has become known as ‘Female Genital Mutilation’ (FGM) in colonial-era debates in the UK Houses of Parliament. The author shows how, in order to bring the topic into the realm of political legitimacy and to be heard in an institution that had only recently allowed women to stand for office, (White) women MPs emphasised their superiority to the African cultures they were talking about. They fought for inclusion as parliamentarians by re-articulating and aligning themselves with Whitely virtues, positioning themselves as noble, respectable and civilised in contrast to the ‘evil’, ‘abhorrent’ and ‘barbaric’ natives. By delineating the moral distance between themselves and non-White men and women, and by (re)stating female parity as the measure of civilisation, they asserted their own right to full inclusion in the nation-state, using the master’s tools to trouble the master’s house. Ultimately, they gained ground for feminism through the re-articulation of racism. Through historicising and deconstructing the narrative as iterated in the seat of government in colonial times, the author furthers the tentative moves towards decolonising the global campaign against FGM. The article sheds light on the coloniality in the present-day hegemonic narrative of ‘Female Genital Mutilation’ and questions whether there might be less harmful ways to articulate opposition to the practice.

The Importance of Incorporating Religious, Cultural and Linguistic Evidence in UK Immigration Procedures: An Analysis of the Semiotic Codes of Asylum Seekers

Asylum seekers who claim asylum in the United Kingdom flee from a diverse range of threats of persecution, particularly in the MENA (Middle East & North African) region. These threats may comprise of war, tribal violence and trafficking to honour-killings, female genital mutilation and witchcraft. Some of these threats may be alien to Western immigration tribunals as they either do not occur in their respective countries or are not understood, particularly because of the intricate religious and cultural nature of the threat in question. For example, a single woman who has had sexual relations outside of marriage would be regarded as having insulted tribal and familial honour in some regions of MENA countries. Here, the word ‘tribe’, which in Arabic is ‘qabilah’, has a distinct historical, cultural and lexical meaning that lawyers, judges and policy-makers may not be aware of; the same may be said of ‘nikah’ (marriage) or ‘Voodoo’ (a type of witchcraft) and many other terminologies. These terminologies are intimately linked to the experiences of immigration applicants and asylum seekers who desire to express their fear of persecution to lawyers, judges and policymakers. Using two real-life case studies involving a Yemeni immigration applicant and Nigerian asylum seeker respectively and my practitioner experience as a country expert having written 140 reports, I will critically explore the value of a primary, semiotic understanding of key religious, cultural and linguistic dimensions in asylum claims (as opposed to secondary source evidence). I argue that the UK’s immigration tribunal system should place more value on how language is embodied within the MENA regions. I do not wish to just highlight this issue but semiotically analyse immigration and asylum procedure, the arguments of the Home Office and tribunals in accepting or rejecting claims and suggest substantive reform by broadening the nature of evidence. Using Peirce’s framework of semiotics, a sign (representamen) is the fundamental entry point to comprehend an object—an object being the referent of a sign. Once we understand a sign and its object, we arrive at the interpretant which is the sense or meaning derived from the object. This triad relationship of sign, object and interpretant constitutes semiois. Here, I argue that analysing the nature of a sign and what it purports to represent can provide us with a theoretical basis by which to reformulate the mechanisms which judges and lawyers use to understand religious, cultural and linguistic evidence in asylum claims. It is through signs that we can arrive at a deeper meaning and the larger picture of the intricate components of an asylum seeker’s claim thereby accessing their semiotic code.

The Role of UK Communities and Leadership in Tackling Female Genital Mutilation

Female Genital Mutilation is the act of removing part or all of a woman's external genitalia, including the act of injuring a woman's genitals without medical reasons. It is estimated that more than 200 million women have undergone Female Genital Mutilation procedures. This is an international problem and concern. The practice of Female Genital Mutilation in England emerged due to the arrival of immigrants who brought this culture. The efforts made by the British government in dealing with Female Genital Mutilation are by enforcing the law in the form of creating anti-Female Genital Mutilation laws and educating the public through campaigns and community empowerment. This research was created to try to see the role of British communities and leadership in dealing with Female Genital Mutilation using comparative feminist political theory and the concept of women's rights. This research will use a qualitative descriptive research methodology. The results of this research are in the form of political policy analysis using four approaches, namely gender; policy; and welfare states, state feminism, policy implementation and making, women's movements. As well as the emergence of obstacles in handling efforts which are influenced by various factors.

Strengthening woman-centred care for pregnant women with female genital mutilation in Australia: a qualitative muti-method study.

Woman-centred care is a collaborative approach to care management, where the woman and her health provider recognise one another's expertise and interact based on mutual respect to provide adequate information and individualised care. However, woman-centred care has not been fully achieved, particularly for women who have experienced female genital mutilation in high-income countries. A lack of clear guidelines defining how to implement woman-centred care may negatively impact care provision. This study sought to explore the quality of point-of-care experiences and needs of pregnant women with female genital mutilation in Australia to identify elements of woman-centred care important to women and how woman-centred care can be strengthened during consultations with health professionals. This multi-method qualitative study comprised two phases. In phase one, we conducted interviews with women with female genital mutilation to explore their positive experiences during their last pregnancy, and in phase two, a workshop was held where the findings were presented and discussed to develop recommendations for guidelines to support woman-centred care. The findings of the first phase were presented under three distinct categories of principles, enablers, and activities following a framework from the literature. In phase two, narrative storytelling allowed women to share their stories of care, their preferences, and how they believe health providers could better support them. Their stories were recorded visually. This study highlights the importance of a comprehensive approach to woman-centred care involving experts, clinicians, community members, and women in designing education, tools, and guidelines.

Prevalence of female genital mutilation and associated factors among women and girls in Africa: a systematic review and meta-analysis

BackgroundFemale genital mutilation (FGM) has zero health benefits. It can lead to short- and long-term risks and complications, including physical, sexual, and mental health and well-being of girls and women. It is a worldwide public health issue with more than 80% prevalence in Africa. It is a global imperative to strengthen work for the elimination, and the United Nations Sustainable Development Goal (SDG) strives to eliminate FGM and monitor the progress made. However, one of a challenge in tracking progress is establishing baseline prevalence data within regions and countries. Therefore, this review aimed to pool the prevalence of FGM in Africa and identify the promoting factors among women and girls.MethodsThis review was conducted according to the PRISMA checklist guideline. Both published and unpublished studies conducted from 2012 onwards were eligible. Studies written in non-English languages were excluded. To retrieve relevant studies; PubMed/Medline, Google Scholar, Science Direct, African Journals Online databases, and African Index Medicus (AIM) were searched using a combination of searching terms. The Newcastle-Ottawa Assessment Scale (NOS) tool was used to assess the quality of each included study. The Cochran’s Q chi-square and I2 statistical tests were used to evaluate the heterogeneity of the included studies. The Funnel plot and Egger's regression test (p value < 0.05) were used to evaluate meh publication bias. We used STATA for analysis and the overall and subgroup pooled effect size was estimated using the random effect model with DerSimonian and Laired pooled effect method. The overall prevalence of FGM and the adjusted odds ratio (AOR) with 95%CI (confidence interval) for contributing factors were calculated and presented using a forest plot.ResultThis study included 155 primary studies conducted on the prevalence and/or factors associated with FGM in Africa. The pooled prevalence of FGM was 56.4% (95%CI 49.7–63.6). The primary factors promoting the practice of FGM were family history of circumcision (AOR = 13.71, 95%CI 9.11−20.62), being a Muslim religion follower (AOR = 3.51, 95%CI 2.61−4.71), poor wealth index (AOR = 1.38, 95%CI1.27−1.51), higher age (AOR = 2.95, 95%CI 2.49−3.38), not attending formal education (AOR = 3.28, 95%CI 2.62−4.12), and rural residency (AOR = 2.27, 95%CI 1.84−2.80).ConclusionThe prevalence of FGM in Africa was found to be high. This study also observed a variation in FGM prevalence across regions and countries and a slight temporal decline over the study period. As the global community enters the final decade dedicated to eliminating FGM, there remains much to be done to achieve the elimination goal.

Pronostic obstétrical et néonatal des patientes ayant un antécédent de mutilation génitale féminine

ObjectiveFemale genital mutilation (FGM) covers all procedures involving partial or total removal of the external genitalia for non-therapeutic purposes. The period of pregnancy and childbirth is probably more at risk of complications for these women. The main aim of this study was to compare obstetrical, maternal and neonatal outcomes in patients with a history of female genital mutilation with patients without such a history. MethodsAll deliveries taking place between January 2005 and June 2022 at Besançon University Hospital in patients with a history of FGM were included. This group was compared with a randomly selected group of deliveries of patients with no history of FGM. A total of 87 deliveries with a history of FGM were included and compared with 696 deliveries with no history of FGM. ResultsThere were significantly more instrumental deliveries (27.6% vs. 17.5%, P=0.01), more caesarean sections (23% vs. 14.1%, P=0.01), more episiotomies (9.2% vs. 0.7%, P<0.01), more first-degree perineal tears (30.8% vs. 20.8%, P=0.02), second-degree (13.9% vs. 5.3%, P<0, 01), third-degree (3.1% vs. 0.2%, P=0.02), more anterior perineal tears (23.1% vs. 2.5%, P<0.01), increased duration of pushing efforts (13 min vs. 10 min, P=0.05) and greater blood loss (297 cc vs. 165 cc, P<0.01) in the group with a history of FGM. There was no statistically significant difference in neonatal outcome. ConclusionThe obstetrical prognosis of patients with a history of FGM is significantly poorer. Neonatal prognosis remains unchanged.

The comparison of sexual function in types I and II of female genital mutilation

BackgroundFemale genital mutilation has many sexual, physical, and psychological consequences. The present study aimed to examine the relationship between Female Genital Mutilation/Cutting (FGM/C), and Sexual Function among circumcised women in Sardasht City, Iran.”MethodsIn this present cross-sectional study, 197 women who were mutilated entered the study by simple random sampling from two healthcare centers in Sardasht, Iran. A gynecologist first performed a genital examination to identify the type of female genital mutilation of participants. Subsequently, Socio-demographic and FGM/C-related characteristics checklist and the female sexual function index questionnaire were completed by interview method. Data were analyzed using SPSS 23 software.ResultsType I and II of female genital mutilation were performed in 73.1 and 26.9% of the participants, respectively. The age range of performing female genital mutilation in type I and II of female genital mutilation was 4–10 years old in 67.4% and 71.1% respectively. Traditional practitioners/local women carried out the circumcision in all of the participants, and Sunnah/tradition was reported as the most common reason for doing this procedure. The average total score of FSFI index in type I and II of female genital mutilation was 23.5 ± 2.0 and 17.4 ± 2.39, respectively. In all domains of FSFI, women with type II of female genital mutilation obtained lower scores than women with type I.ConclusionCircumcised women have reduced scores in all domains of FSFI, and the severity of sexual dysfunction is related to the type of FGM/C. Considering the prevalence of female genital mutilation and its adverse effects, it is imperative to initiate cultural improvements through education and awareness. By educating and raising awareness among individuals about this issue, we can foster positive changes and address the problem effectively.

The unbroken chain of female genital mutilation: a qualitative assessment of high school girls’ perspectives

BackgroundFemale Genital Mutilation (FGM) is defined as any procedure that involves damage to the female external genitalia. This practice is majorly prevalent in Sudan, as it is estimated that over 12 million Sudanese women are circumcised. This study uncovers rural females’ knowledge and insights about FGM domestically.MethodsA qualitative, deductive study with thematic analysis was conducted. A total of 42 female high school students were recruited and divided into five focus groups, each of which included girls from four different high school classes in the main school of the study area. A topic guide was prepared and used to lead the focus groups. Thematic analysis was used, and the study data had been categorized into four themes: knowledge, procedure and performance, experience, and practice. The condensed meaning units of each theme were identified, then classified to formulate sub-themes.ResultsAll the participants indicated that FGM is a traditional practice in the village. The vast majority have heard about it from family members, mainly mothers and grandmothers. Regarding the procedure, all the participants agreed that midwives perform FGM, but most of them don’t know what exactly is being removed. According to all participants, mothers and grandmothers are the decision-makers for FGM. The majority of the participants stated that they do not discriminate between the circumcised and uncircumcised women and most of them agreed that circumcision has negative side effects. They have mentioned pain, difficult urination, and walking as early side effects, while psychological impacts and labor obstruction as late ones. Generally, the majority of the participants agreed that circumcision is not beneficial and should stop.ConclusionKnowledge regarding the dangers of FGM among high school girls is better than expected given the high prevalence of the practice. Generally, the process is well understood, the performers are known, the experience is universal, and the side effects are acknowledged. Nevertheless, a majority still showed an intent to circumcise their daughters in the future.

Combating female genital mutilation

Saul Beeson, Holly Vincent and Joe Frankland discuss addressing educational needs to combat female genital mutilation

Female genital mutilation and safer sex negotiation among women in sexual unions in sub-Saharan Africa: Analysis of demographic and health survey data.

The practice of female genital mutilation is associated with harmful social norms promoting violence against girls and women. Various studies have been conducted to examine the prevalence of female genital mutilation and its associated factors. However, there has been limited studies conducted to assess the association between female genital mutilation and markers of women's autonomy, such as their ability to negotiate for safer sex. In this study, we examined the association between female genital mutilation and women's ability to negotiate for safer sex in sub-Saharan Africa (SSA). We pooled data from the most recent Demographic and Health Surveys (DHS) conducted from 2010 to 2020. Data from a sample of 50,337 currently married and cohabiting women from eleven sub-Saharan African countries were included in the study. A multilevel binary logistic regression analysis was used to examine the association between female genital mutilation and women's ability to refuse sex and ask their partners to use condom. Adjusted odds ratios (aORs) with a 95% confidence interval (CI) were used to present the findings of the logistic regression analysis. Statistical significance was set at p<0.05. Female genital mutilation was performed on 56.1% of women included in our study. The highest and lowest prevalence of female genital mutilation were found among women from Guinea (96.3%) and Togo (6.9%), respectively. We found that women who had undergone female genital mutilation were less likely to refuse sex from their partners (aOR = 0.91, 95% CI = 0.86, 0.96) and ask their partners to use condoms (aOR = 0.82, 95% CI = 0.78, 0.86) compared to those who had not undergone female genital mutilation. Female genital mutilation hinders women's ability to negotiate for safer sex. It is necessary to implement health education and promotion interventions (e.g., decision making skills) that assist women who have experienced female genital mutilation to negotiate for safer sex. These interventions are crucial to enhance sexual health outcomes for these women. Further, strict enforcement of policies and laws aimed at eradicating the practice of female genital mutilation are encouraged to help contribute to the improvement of women's reproductive health.

Female Genital Mutilation in Bohra Muslim Community: A Conundrum to Muslim Women and Child Rights

Female Genital Mutilation in Bohra Muslim Community: A Conundrum to Muslim Women and Child Rights

Female genital mutilation and urinary incontinence: an analytical comparison with Sudan's prevalent demography.

Female genital mutilation/cutting impacts over 200 million women globally and is linked to obstetric complications as well as long-term urogynecological and psychosexual issues that are frequently overlooked and inadequately addressed. This study aimed to assess the impact of female genital mutilation/cutting on urinary incontinence. This cross-sectional study was conducted in the gynecology department of the Research Hospital located in the Nyala rural region of Sudan. The participants were interviewed to gather socio-demographic and background information. In addition, they received a thorough gynecological examination to evaluate the presence and type of female genital mutilation/cutting. The Incontinence Impact Questionnaire and the Urogenital Distress Inventory were applied to the group with female genital mutilation/cutting and the control group without female genital mutilation/cutting to evaluate urinary incontinence and related discomfort. Subsequently, the scores of both participant groups were compared. The study compared age, weight, height, BMI, gravida, parity, and sexual intercourse averages between groups. The mean Urogenital Distress Inventory-6 and Incontinence Impact Questionnaire-7 scores of individuals who underwent mutilation were higher than those of individuals who did not undergo mutilation (p<0.001). Notably, participants subjected to infibulation exhibited significantly higher average scores on both measures in contrast with the other groups (p<0.001). A higher proportion of mutilated participants, specifically those with infibulation, are afflicted with symptoms of incontinence.

The Traditional Beliefs Inhibiting Uptake of Education in Kajiado Community During the 21st Century

Are there particular cultures that are more adequate than others in the sense that they are perceived relevant during the 21st century of globalization? If so, which are the possible criteria to determine that certain cultures are adequate and have the power to change peoples’ identities? The study sought to address issues on traditional beliefs inhibiting uptake of education in Kajiado community during the 21st century. The objectives were to: establish cultural beliefs affecting education among the Kajiado community members and find out the youths’ attitude towards various cultural practices affecting their contemporary ways of life. The study used survey design with cluster random sampling yielding 90 participants who responded to questionnaires and interview schedules. Female genital mutilation (42%), early marriage (30%) and child labour (23%) were cited as the most retrogressive culture. The study concluded that sensitization of community members against negative cultural beliefs be done through public barazas, community-based organizations, churches, schools, local television and radio stations, socio media and print media platforms. It was recommended that Nyumba Kumi initiative monitor homes under their jurisdiction to prevent female genital mutilation practitioners and consumers of their services from taking place.

What do we know about how children and adolescents conceptualise violence? A systematic review and meta-synthesis of qualitative studies from sub-Saharan Africa.

Half of the world's children experience violence every year, but the meaning of violence is not universally agreed. We may therefore risk failing to measure, and address, the acts that matter most to children and adolescents. In this paper, we describe and synthesise evidence on how children and adolescents in sub-Saharan Africa conceptualise different behavioural acts which are deemed violence in childhood under WHO and UN CRC definitions. We conducted a systematic review of qualitative studies. We searched PsychINFO, CINAHL, Embase, Global Health, Medline and ERIC for all publications released prior to March 2023. 30 papers met inclusion criteria. We synthesised primary data from children and adolescents and drew upon theoretical and contextual interpretations of authors of included studies. Only 12 of more than 45 sub-Saharan African countries were represented with relevant research. Of the 30 included papers, 25 came from three countries: South Africa, Uganda and Ghana. Only 10 of 30 papers reported data from young children (pre-adolescence), and 18 of 30 papers primarily focused on sexual violence. 14 studies used child friendly and/or participatory methods. From this limited evidence, we identified six overarching themes in how children and adolescents conceptualised their experiences of acts internationally recognised as violence: 1) adults abusing or neglecting responsibility; 2) sexual violence from peers, family and community members; 3) violence in established intimate relationships; 4) emotional violence surrounding sex from peers and community members; 5) fighting and beating between peers; 6) street and community dangers. No studies meeting our inclusion criteria specifically examined children or adolescents' conceptualisations of homophobic or transphobic violence; violence against children with disabilities; boys' experiences of sexual violence from male perpetrators; trafficking, modern slavery or conflict; child labour; or female genital mutilation. We found that three dimensions were important in how children and adolescents constructed conceptualisations of violence: their age, relationship to the perpetrator, and the physical location of acts they had experienced. These dimensions were interrelated and gendered. The current limited evidence base suggests children and adolescents' conceptualisations of violence overlapped with, but were also distinct from, the WHO and UNCRC definitions of violence. Currently international survey tools focus on measuring types and frequencies of particular acts and neglect to focus on children's understandings of those acts. Relationship to perpetrator, age of child, physical location are all important in how children conceptualise their experiences of acts internationally recognised as violence, and therefore might be important for their health and social outcomes. Those developing measures should account for these dimensions when developing items for testing.

Role of Social Norms and Culture in Gender Violence

Gender violence is a complex issue deeply woven into the fabric of many societies. Norms and culture play a significant role in perpetuating and justifying this violence by shaping societal expectations, gender roles, and power dynamics. Rigid gender norms can create a climate where men are expected to be dominant and aggressive, while women are expected to be submissive and passive. This creates an uneven playing field where violence against women is often seen as acceptable, even expected, behavior. Cultural beliefs and traditions can further reinforce these norms, for example, through practices like child marriage, female genital mutilation, or honor killings. These harmful practices not only directly violate women’s rights and safety but also normalize the idea of male control and female subordination, creating a breeding ground for further violence. Understanding the intricate interplay between norms, culture, and gender violence is crucial for dismantling these harmful structures and building a society where all individuals can live free from fear and discrimination. Gender norms are the cultural messages we all get about the way men and women are “supposed” to be. Tropes like boys will be boys. Take it like a man. A woman’s place. Act like a lady. Sometimes these messages are indirect, implied, or invisible; others, direct, specific, and overt. These norms affect us all consciously or otherwise. Therefore is study focused on analyzing the prevalence of gender violence and also to find out the role of social norms and culture in abetting gender violence? Objectives of the study To find out the role of social norms in abetting gender violence. To find out the views of women on already established social norms.

The Female Genital Mutilation (FGM) Prosecutions: Exploring Legal Approaches to Combat Gender-Based Violence and Protect Women's Rights Across African Nations

The Female Genital Mutilation (FGM) Prosecutions: Exploring Legal Approaches to Combat Gender-Based Violence and Protect Women's Rights Across African Nations

Evaluating the long-term impact of large-scale trainings: an exposure based cross-sectional study on female genital mutilation-related knowledge, attitudes and practices among Sudanese midwives in Khartoum State

ObjectivesTo examine the long-term impact of large-scale training targeting midwives in a setting where they are the main female genital mutilation (FGM) practitioners. We hypothesised that trained midwives would have...

Urological Complications of Female Genital Mutilation: A Case Report of 15 Patients

Urological Complications of Female Genital Mutilation: A Case Report of 15 Patients

Examining the Types and Consequences of Female Genital Mutilation in Somalia: A Cross-Sectional Study on the Burden and Impact of Acute and Long-Term Complications

Examining the Types and Consequences of Female Genital Mutilation in Somalia: A Cross-Sectional Study on the Burden and Impact of Acute and Long-Term Complications