The Global Online Sexuality Survey: Public Perception of Female Genital Cutting among Internet Users in the Middle East

Female genital mutilation and cutting in the Arab League and diaspora: A systematic review of preventive interventions

OBJECTIVES

Female Genital Mutilation and Cutting (FGM/C) is an act of gender-based violence (GBV) and a global public health issue with well-documented adverse outcomes. With the rise in global migration, there is an increasing prevalence of FGM/C among Arab diaspora living in the West and Global South. What remains unclear is how to reduce the practice. This study was designed to identify interventions exerting an effect on reducing the practice of FGM/C.

METHODS

A systematic review of peer-reviewed articles was conducted on interventions targeting individuals and/or the broader community to prevent FGM/C within the Arab League and its diaspora, up to December 2021. Databases searched included PubMed, Medline, Web of Science, PsycINFO, EMBASE, CINAHL, BIOSIS, ASSIA and Scopus. Quality assessment used the Mixed Methods Appraisal Tool (MMAT) 2018.

RESULTS

Twelve of 896 studies met the inclusion criteria. Eight interventions relied entirely on education with short-term gains but unchanged practices. Three interventions used social marketing and mixed media. Only one study took a multi-sectoral approach.

CONCLUSIONS

At a macro level, opportunities to reduce or to end the practice of FGM/C exist through legislation, policy, a public health approach grounded in gender equality and human rights. Using multi-sectoral actions that consider the social context and challenge social norms at macro, meso and micro levels appears more effective than individual-level interventions. Promoting advocacy and developing supportive environments to reduce GBV, enhance gender equality and empower communities is crucial for interventions to succeed and achieve the Sustainable Development Goal target of FGM/C abandonment by 2030.

Attitudes toward Female Genital Mutilation/Circumcision: A Systematic Review and Meta-Analysis

Background: Understanding the attitudes toward FGM/C held by people who have been involved in this practice can lead to more active interventions to prevent this harmful practice. In order to achieve this, a systematic review was performed on scientific articles. Methods: Electronic databases (PubMed, Scopus, and Science Direct) were examined to identify articles. Results: Our initial search resulted in 3013 articles, of which 40 articles with estimations of attitudes toward FGM/C were reviewed. The results indicate that the random-effects pooled estimation of negative attitudes toward FGM/C practice was 53% (95% CI 47–59; p < 0.001). Furthermore, the pooled estimation of attitudes toward the decision not to circumcise young daughters was 63% (95% CI 46–80; p < 0.001). Conclusion: Despite the increased awareness and efforts to ban FGM/C in many countries around the world, our review demonstrates that positive attitudes toward FGM/C are still far from being eradicated and have hardly changed in the past years. This issue reflects deeply rooted cultural and social concerns of health care professionals with regard to continuing the practice. The authors believe that circumcised women can play a key role in encouraging the abandonment of FGM/C through educational and cultural campaigns.

Female sexual dysfunction in female genital mutilation

Female genital mutilation (FGM), otherwise known as female genital cutting (FGC), is currently very topical and has become a significant global political issue. The impact of FGM on the lives of women and girls is enormous, as it often affects both their psychology and physical being. Among the complications that are often under-reported and not always acknowledged is female sexual dysfunction (FSD). FSD presents with a complex of symptoms including lack of libido, arousability and orgasm. This often occurs in tandem with chronic urogenital pain and anatomical disruption due to perineal scarring.To treat FSD in FGM each woman needs specifically directed holistic care, geared to her individual case. This may include psychological support, physiotherapy and, on occasion, reconstructive surgery. In many cases the situation is complicated by symptoms of chronic pelvic pain, which can make treatment increasingly difficult as this issue needs a defined multidisciplinary approach for its effective management in its own right. The problems suffered by women with FGM are wholly preventable, as the practice need not happen. The current global momentum to address the social, cultural, economic and medical issues of FGM is being supported by communities, governments, non-governmental agencies (NGOs) and healthcare providers. It is only by working together that the practice can be abolished and women and girls may be free from this practice and its associated consequences.