1
|
Bhatia A, Lokot M, Kenny L, Mathpati M, Cislaghi B. Honor, violence, and children: A systematic scoping review of global evidence. CHILD ABUSE & NEGLECT 2024; 151:106642. [PMID: 38460273 DOI: 10.1016/j.chiabu.2024.106642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 12/13/2023] [Accepted: 01/09/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND Although the harmful effects of honor-based violence (HBV) against women have been well documented, less is known about how HBV affects children and adolescents. AIMS 1) To describe the contexts, research methods and populations included in research on HBV and children; 2) to outline conceptual and methodological approaches, including definitions of honor; 3) to describe how honor-based practices affect children's experiences of violence. METHODS We searched seven electronic databases using search terms for honor, violence and children which resulted in 7122 unique records. 468 records were selected for full-text review. Articles reporting findings on the effects of honor-based harm or violence against children were included in the final sample for data extraction. We conducted bibliometric and thematic analyses of extracted data. RESULTS In total, 101 articles were included. Most studies were published after 2007, conducted in Europe (n = 46) or in North America (n = 21), and most used qualitative methods (n = 58) followed by quantitative methods (n = 32). In most studies (n = 74) children, especially girls, were included as experiencing HBV or being a victim of homicide related to HBV. A smaller sample of studies (n = 24) included children, especially boys, as perpetrators of HBV. Studies documented the following effects of HBV on children: violence; family rejection and control; homicide or honor killing; forced/early marriage; female genital cutting; gang membership/violence; hymen exam or reconstruction; sex work, or suicide. RECOMMENDATIONS Further research on HBV should be child and youth centered, situated in the Global South, engage with and interview young people directly, and offer recommendations for action.
Collapse
Affiliation(s)
- Amiya Bhatia
- Department of Social Policy and Intervention, University of Oxford, United Kingdom.
| | - Michelle Lokot
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Leah Kenny
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Mahesh Mathpati
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Beniamino Cislaghi
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, United Kingdom
| |
Collapse
|
2
|
Walser SA, Costigan H, Stuckey HL, Berg A, Stephens MB. The Opaque Language of Sexuality: Medical Students' and Providers' Beliefs About Virginity. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:2619-2638. [PMID: 37039944 DOI: 10.1007/s10508-023-02578-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 02/28/2023] [Accepted: 02/28/2023] [Indexed: 06/19/2023]
Abstract
Although virginity is not a medical term and is instead socially constructed, it remains unknown what medical providers believe about the biological basis of virginity. This study explored providers' and medical students' beliefs about virginity and the potential impact of such beliefs on healthcare. This was a concurrent mixed-method survey study of 124 medical students and 216 healthcare providers (Registered Nurse, Physician Assistant, Nurse Practitioner, and Doctor of Medicine) at Penn State Health and The Pennsylvania State University College of Medicine. Participants rated their level of agreement with common misconceptions about virginity on a six-point Likert scale. Open-ended questions gave respondents the opportunity to define virginity and to describe terms like virgin and virginal in the context of sexual experience and the medical lexicon. We identified common themes in the qualitative data using thematic analysis. Frequencies of misconceptions and statistically significant demographic associations were identified in the quantitative data. Definitions of virginity were varied and vague, most with negative connotations. A majority of respondents said that virginity has no biological basis. Many participants identified downsides to use of terms like virgin, virginity, and virginal in medicine. The most prevalent misconceptions about virginity were related to the hymen. Seventeen percent of students and 26% of providers at least somewhat agreed that it was possible to determine whether a person has engaged in vaginal intercourse through a gynecological exam. Misconceptions about virginity persist in medicine and bias, even if unintended, may impact the quality-of-care people with vaginas receive. Language around sexual health should be specific, inclusive, clinically relevant, and free from judgment. Medical education must continue to work to eliminate the concept of a biological basis to virginity.
Collapse
Affiliation(s)
- Sarah A Walser
- The Pennsylvania State University College of Medicine, University Park Regional Campus, 1850 East Park Ave., State College, PA, 16801, USA.
| | - Heather Costigan
- Department of Humanities and Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Heather L Stuckey
- Department of Humanities and Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Arthur Berg
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Mark B Stephens
- Department of Family and Community Medicine, The Pennsylvania State University College of Medicine, University Park Regional Campus, State College, PA, USA
| |
Collapse
|
3
|
Familusi OO, Amutah C, Levin P, Andy U, James A. U.S.-Based Obstetrician/Gynecologists' Experiences with Delivering Care to Women with Female Genital Cutting. J Womens Health (Larchmt) 2023; 32:486-493. [PMID: 36857710 DOI: 10.1089/jwh.2022.0294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
Background: There has been an increase of women living in the United States who have experienced female genital cutting (FGC). However, limited research exists evaluating the experiences of obstetrician/gynecologists delivering care to this patient population. This study aimed to assess the overall experiences, including barriers and facilitators, of U.S.-based obstetrician/gynecologists (OBGYNs) with delivering care to patients with female genital cutting at a single academic health center in the United States. Materials and Methods: This is a qualitative study of OBGYNs at a large, U.S., urban, academic health center. OBGYNs participated in a one-on-one semistructured interview. Thematic analysis using a grounded theory approach was conducted to identify predominating themes regarding the overall experiences, barriers, and facilitators to delivering care to patients with FGC. Results: Analysis of 15 study interviews revealed 4 main themes impacting the ability of OBGYNs to deliver care to patients with FGC: (1) limited educational training on FGC, (2) challenges with identifying that a patient had FGC and with using the World Health Organization classification system, (3) questions regarding "normative" anatomy and reinfibulation after vaginal procedures, and (4) navigating affective responses of patient and self when FGC is encountered. Conclusion: The above findings have practical implications, showing that the limited educational experience and lack of a clear policy on how to manage the care of women with FGC lead to variation and even limitations in how care is delivered to these women. We encourage OBGYN professional societies to consider creating education and policy to aid clinicians in caring for patients with FGC.
Collapse
Affiliation(s)
- Olivia O Familusi
- Department of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Leonard Davis Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Christina Amutah
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Pamela Levin
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania. USA
| | - Uduak Andy
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania. USA
| | - Abike James
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania. USA
| |
Collapse
|
4
|
Aljahdali EA, Kurdi MO. Hymen-saving hymenotomy of imperforate hymen in neonates and adolescents: tertiary medical center experience. ANNALS OF PEDIATRIC SURGERY 2022. [DOI: 10.1186/s43159-022-00192-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Imperforate hymen (IH) is the most common obstructive anomaly of female genital tract. Hymen saving has a great importance for both cultural and religious reasons. Conventional surgical treatment for this condition is cruciate incision hymenotomy or hymen-saving central annular hymenotomy (HSCAH). This study aimed to review presentations and management of neonate and adolescents with IH at one tertiary hospital over 12 year’s period. The aim also was to stress upon importance of hymen saving to our Muslim community and improve knowledge, enable targeted education, and reduce unnecessary tests and diagnostic delay for this condition.
Methods
Twenty-five patients with IH were diagnosed and treated in this retrospective cohort study over 12 years, from January 2010 till December 2021. Demographic characteristics of the patients, their symptoms and signs, investigations, type of operations, recurrence, and infections were recorded and analyzed.
Results
Saudi accounted for the majority of IH cases (88%). There were fifteen adolescents, and ten were neonates. Bulging imperforate hymen, pelvic/abdominopelvic mass, constipation, acute urine retention, abdominal discomfort, and lower abdominal distension were among the signs and symptoms. All 25 patients had HSCAH, 21 of whom had primary HSCAH and four of whom had secondary HSCAH due to recurrence. To avoid recurrence, HSCAH was performed with suturing of the inner vaginal mucosa to the exterior vestibular mucosa.
Conclusion
Early diagnosis of imperforate hymen for neonate and adolescent girls and prompt definitive HSCAH could have positive impact on treatment outcome and decrease complications and fulfill integrity of hymen as virginity of high importance in our Muslim community and other similar culture, where hymen-sparing procedure is preferred by most of these patients and families.
Collapse
|
5
|
Min M, Wong T, Akinsulure-Smith AM. Exploring Beliefs and Attitudes Toward Female Genital Mutilation/Cutting Among Healthcare Providers in New York City. Violence Against Women 2022; 28:3174-3193. [PMID: 34817265 PMCID: PMC9423936 DOI: 10.1177/10778012211045710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Given the increase of African immigrants from countries with high female genital cutting (FGC) prevalence, this study explored U.S. healthcare providers' beliefs and attitudes regarding FGC. A total of 31 professionals who have provided services to FGC-experienced women in New York City were interviewed; data were analyzed using grounded theory. Results indicated that, although a majority of respondents emphasized maintaining a nonjudgmental and open-minded attitude toward clients' experiences, some only focused on the negative aspects of FGC. Also, multifaceted efforts by providers to understand the cultural meanings of FGC and resolve their own cultural dissonance were identified. The implications for practice were discussed.
Collapse
Affiliation(s)
- Moonkyung Min
- The City College of New York, NY, USA
- University of Calgary, AB, Canada
| | | | | |
Collapse
|
6
|
Moussaoui D, Abdulcadir J, Yaron M. Hymen and virginity: What every paediatrician should know. J Paediatr Child Health 2022; 58:382-387. [PMID: 35000235 PMCID: PMC9306936 DOI: 10.1111/jpc.15887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/22/2021] [Accepted: 12/28/2021] [Indexed: 11/30/2022]
Abstract
Paediatricians may face the notion of 'virginity' in various situations while caring for children and adolescents, but are often poorly prepared to address this sensitive topic. Virginity is a social construct. Despite medical evidence that there is no scientifically reliable way to determine virginity, misconceptions about the hymen and its supposed association with sexual history persist and lead to unethical practices like virginity testing, certificate of virginity or hymenoplasty, which can be detrimental to the health and well-being of females of all ages. The paediatrician has a crucial role in providing evidence-based information and promoting positive sexual education to children, adolescents and parents. Improving knowledge can help counter misconceptions and reduce harms to girls and women.
Collapse
Affiliation(s)
- Dehlia Moussaoui
- Division of General Paediatrics, Department of Woman, Child and Adolescent MedicineGeneva University HospitalsGenevaSwitzerland,Present address:
Department of Paediatric and Adolescent GynaecologyThe Royal Children's Hospital MelbourneParkvilleVictoriaAustralia
| | - Jasmine Abdulcadir
- Division of Gynaecology, Department of Woman, Child and Adolescent MedicineGeneva University HospitalsGenevaSwitzerland
| | - Michal Yaron
- Division of Gynaecology, Department of Woman, Child and Adolescent MedicineGeneva University HospitalsGenevaSwitzerland
| |
Collapse
|
7
|
Mohammed HS, A Sobh AM, Ibrahim ZM, Lotfy M. Evaluation of knowledge and practice of hymenoplasty among Egyptian gynaecologists: a cross-sectional study. EUR J CONTRACEP REPR 2021; 27:180-183. [PMID: 34860141 DOI: 10.1080/13625187.2021.2010039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The aims of the study were to evaluate the knowledge and practice of hymenoplasty among gynaecologists in Egypt. METHODS A cross-sectional study was conducted in January 2020, in which a self-administered questionnaire was completed by 120 gynaecologists at private clinics and hospitals in Ismailia, Egypt. The questionnaire consisted of 19 items relating to participants' sociodemographic characteristics, knowledge and practice of hymenoplasty. RESULTS Eighty-eight (73.3%) participants were not able to give an accurate definition of the hymen; furthermore, 65 (54.2%) were not aware of the different types of hymen. Forty-nine (40.8%) participants were able to define hymenoplasty and 39 (32.5%) knew the different hymenoplasty procedures. Hymenoplasty had been performed by 35 (29.2%) participants. Of these, 26 (74.3%) had carried out the procedure in a private clinic; the median annual number of procedures performed was four. Only two (5.7%) participants reported the occurrence of complications during the procedure. There were no sociodemographic differences between gynaecologists who had and had not performed hymenoplasty. CONCLUSION There is a lack of sufficient knowledge about hymenoplasty among Egyptian gynaecologists; nevertheless, it continues to be practised in private clinics.
Collapse
Affiliation(s)
- Heba Saber Mohammed
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Ahmed M A Sobh
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Zakia M Ibrahim
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Mariam Lotfy
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| |
Collapse
|
8
|
Akinsulure-Smith AM, Wong T, Min M. Addressing Female Genital Cutting among service providers in New York. PROFESSIONAL PSYCHOLOGY-RESEARCH AND PRACTICE 2021; 52:202-212. [PMID: 34556896 DOI: 10.1037/pro0000381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | - Tracy Wong
- Brooklyn College. City University of New York
| | - Moonkyung Min
- The City College of New York, City University of New York
| |
Collapse
|
9
|
Fay KE, Snead CM, Huennekens K, O'Brian CA, Tom L, Simon MA. United States' Obstetrician/Gynecologists' Readiness to Care for Women Affected by Female Genital Cutting. J Womens Health (Larchmt) 2021; 31:431-438. [PMID: 33926232 DOI: 10.1089/jwh.2020.8622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Female genital cutting (FGC) is a form of gender-based violence with obstetrical and gynecological complications that require recognition and care. Data suggest that United States' physicians are not prepared to care for those who have been affected by this practice. This study evaluated the knowledge and practices of United States' obstetricians and gynecologists to care for patients who have undergone FGC. Materials and Methods: This was a cross-sectional confidential survey distributed electronically to a sample of clinically active members of the American College of Obstetricians and Gynecologists. The survey consisted of questions characterizing care of patients who had undergone FGC and barriers to optimal support. Results: Five hundred forty-eight participants representing a wide range of years in practice, geographical locations, subspecializations, and patient demographics participated. Sixty-six percent of participants had cared for patients who had undergone FGC. Participants' description of their patient population racial/ethnic composition did not correlate with likelihood of treating this patient population. Forty percent of participants reported some form of education about FGC, more often among women, younger physicians, and those in practice for fewer years. Thirty-one percent of participants were comfortable counseling about and 20% were comfortable performing deinfibulation; these percentages were higher among those who had received education or had recently cared for an affected patient. Participants reported insufficient training as the largest barrier to providing care to women. Conclusions: While most physicians in this national cohort had cared for women who had undergone cutting, a minority had any form of education. However, prior education correlated with indicators of improved care. Physicians require additional guidance in treating this important and growing patient population.
Collapse
Affiliation(s)
- Kathryn E Fay
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Carrie M Snead
- Department of Research, American College of Obstetrics and Gynecology Research, Washington, District of Columbia, USA
| | - Kaitlin Huennekens
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Catherine A O'Brian
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Laura Tom
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Melissa A Simon
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| |
Collapse
|
10
|
Darwish AM. A Novel Technique for the Reconstructive Formation of an Annular Hymen in Cases of Postpubertal Imperforate Hymen. Sultan Qaboos Univ Med J 2021; 21:e110-e115. [PMID: 33777431 PMCID: PMC7968913 DOI: 10.18295/squmj.2021.21.01.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 05/28/2020] [Accepted: 07/01/2020] [Indexed: 11/16/2022] Open
Abstract
Objectives Imperforate hymen (IH) is a common genital tract anomaly in women which usually presents after puberty. However, surgical treatment is often considered controversial in religious or conservative communities for sociocultural reasons. This study therefore aimed to assess the efficacy of a novel reconstructive technique involving the preservation of the annular hymen. Methods This prospective interventional study was performed between July 2013 and October 2019 at the minimally invasive surgery unit of a tertiary university hospital in Egypt. A total of 36 women presenting with primary amenorrhoea and haematocolpus were diagnosed with postpubertal IH. A circular hymenotomy was performed on each patient using a 10 mm laparoscopy trocar tip and sleeve to form a new annular hymen under general anaesthesia while preserving the annular hymen. The primary outcome measure was the persistence of hymenal patency and integrity at follow-up. The secondary outcome measure included post-operative patient satisfaction and pain relief. Results The reported technique was feasible in all cases without intraoperative complications. Patency of the reconstructed annular hymen was confirmed at follow-up in all cases; moreover, no intraoperative complications were reported. There was a significant post-operative improvement in pain scores (P <0.001). Both the patients and their parents/guardians reported a high level of satisfaction with the technique. Conclusion This novel technique for the correction of IH involving the reconstruction of an annular hymen was found to be a safe, minimally invasive and effective procedure. This technique should be considered a feasible alternative to a conventional hymenotomy as it allows for the resumption of normal hymenal anatomy without overtreatment.
Collapse
Affiliation(s)
- Atef M Darwish
- Department of Obstetrics & Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt
| |
Collapse
|
11
|
Understanding pre-operative staging and surgical practice in advanced endometriosis: A survey of Canadian gynaecologists. JOURNAL OF ENDOMETRIOSIS AND PELVIC PAIN DISORDERS 2020. [DOI: 10.1177/2284026520924500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Study objective: To determine the pre-operative evaluation, surgical management and referral practices in patients with advanced stage endometriosis by Canadian gynaecologists. Design: A survey of obstetricians and gynaecologists. Setting: The survey was initiated and piloted at an academic centre by general gynaecologists and endometriosis specialists. Intervention: Electronically distributed to 733 individuals by the Society of Obstetricians and Gynaecologists of Canada. This included all members, irrespective of subspecialty and practice patterns. Measurement: Responses were collected using a web-based survey tool and analysed using Excel. Results: The response rate was 15.7% (115 respondents). Pre-operatively, 62.2% of respondents perform a transvaginal ultrasound on all of their patients, while magnetic resonance imaging is reserved for patients with physical exam findings suspicious for advanced endometriosis (26.7%) or in whom the surgeons suspect deep infiltrating endometriosis, bowel, bladder or uterosacral disease (54.4%). Most surgeons (81.4%) report encountering advanced disease that they did not suspect pre-operatively <10% of the time. Although 40% of respondents would refer their patients in whom they suspected deep infiltrating endometriosis, endometriomas, bowel, bladder or uterosacral ligament involvement to an endometriosis specialist prior to any attempted surgery, 54.4% would never refer without previously confirming the diagnosis at laparoscopy. In contrast, only 15% felt comfortable treating advanced endometriosis completely at time of laparoscopy (including deep infiltrating endometriosis, bladder and bowel disease). Post-operatively, 67.8% of respondents refer patients to an endometriosis specialist only if their disease was not appropriately treated surgically, while 23.3% do not refer any of their patients. Conclusion: Our study identified significant variability in the management of advanced endometriosis in Canada. Understanding these patterns will help us formulate a more universal investigation and management plan, which may improve the identification of patients pre-operatively with advanced stage endometriosis that could benefit from treatment by an endometriosis specialist.
Collapse
|
12
|
Crosby SS, Oleng N, Volpellier MM, Mishori R. Virginity testing: recommendations for primary care physicians in Europe and North America. BMJ Glob Health 2020; 5:e002057. [PMID: 32133175 PMCID: PMC7042604 DOI: 10.1136/bmjgh-2019-002057] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 11/24/2019] [Accepted: 11/30/2019] [Indexed: 01/14/2023] Open
Abstract
Virginity testing is a complex, culturally mediated practice that is poorly understood by Western clinicians. While advocating for global elimination of the practice of virginity testing as a human rights violation, clinical practice is often more complicated and ethically nuanced, and the clinician must act in the best interest of her patient. Upholding human rights does not have to be incompatible with providing a needed service to a patient, which should never include an invasive exam if not medically necessary, but should include education and safety assessments.
Collapse
Affiliation(s)
- Sondra S Crosby
- Medicine, Boston University, Boston, Massachusetts, USA.,Schools of Medicine and Public Health, Boston University, Boston, MA, USA
| | | | | | - Ranit Mishori
- Department of Family Medicine, Georgetown University, Washington, DC, USA
| |
Collapse
|
13
|
Atkinson HG, Ottenheimer D, Mishori R. Public Health Research Priorities to Address Female Genital Mutilation or Cutting in the United States. Am J Public Health 2019; 109:1523-1527. [PMID: 31536414 DOI: 10.2105/ajph.2019.305259] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Female genital mutilation or cutting (FGM/C), an age-old tradition that is still widely practiced around the world, is gaining recognition as an important public health issue in the United States. Increasingly, because of migration, women and girls affected by FGM/C have become members of host communities where the practice is not culturally acceptable.According to recent conservative estimates, more than 513 000 immigrant women and girls living in the United States have undergone or are at risk for FGM/C, a significant increase from the 1990 estimate of 168 000. The arrests of physicians in Michigan in 2017 for performing FGM/C on minors underscores the fact that cutting is happening in the United States.We have identified numerous gaps in our understanding of the magnitude of the problem in the United States and in the availability of scientific data informing a variety of interventions (preventive, clinical, educational, legal). We catalog these major gaps and propose a research agenda that can help public health experts, researchers, clinicians, and other stakeholders to establish priorities as we confront FGM/C as an important health issue affecting hundreds of thousands of women and girls in the United States.
Collapse
Affiliation(s)
- Holly G Atkinson
- Holly G. Atkinson is with the City University of New York School of Medicine, New York, NY. Deborah Ottenheimer is with the Icahn School of Medicine at Mount Sinai, New York, NY. Ranit Mishori is with the Georgetown University School of Medicine, Washington, DC
| | - Deborah Ottenheimer
- Holly G. Atkinson is with the City University of New York School of Medicine, New York, NY. Deborah Ottenheimer is with the Icahn School of Medicine at Mount Sinai, New York, NY. Ranit Mishori is with the Georgetown University School of Medicine, Washington, DC
| | - Ranit Mishori
- Holly G. Atkinson is with the City University of New York School of Medicine, New York, NY. Deborah Ottenheimer is with the Icahn School of Medicine at Mount Sinai, New York, NY. Ranit Mishori is with the Georgetown University School of Medicine, Washington, DC
| |
Collapse
|
14
|
Atkinson HG, Geisler A. Developing Physician Educational Competencies for the Management of Female Genital Cutting: A Call to Action. J Womens Health (Larchmt) 2019; 28:997-1003. [DOI: 10.1089/jwh.2018.7163] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Affiliation(s)
- Holly G. Atkinson
- Department of Medical Education, CUNY School of Medicine, New York, New York
| | - Amaris Geisler
- Department of Medical Education, CUNY School of Medicine, New York, New York
| |
Collapse
|
15
|
Connect the Dots—March 2019. Obstet Gynecol 2019; 133:579-581. [DOI: 10.1097/aog.0000000000003151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|