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Ifechukwu Okpara P, Tekbaş S. Effect of Female Genital Mutilation on Sexual Function in Ibadan, Nigeria. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2024; 36:167-176. [PMID: 38616797 PMCID: PMC11008539 DOI: 10.1080/19317611.2024.2328717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 03/04/2024] [Indexed: 04/16/2024]
Abstract
Objective: Female genital mutilation, which harms women physically and psychologically, also causes serious problems in sexual life that continue throughout life. This study aimed to determine the impact of female genital mutilation on sexual outcomes in Ibadan, Nigeria. Method: This is a cross-sectional descriptive study. A self-administered questionnaire was used to obtain data from 161 women who agreed to participate in the study. After the data were collected, the sample group was divided into two groups those with female genital mutilation (84) and those without (77), and they were compared in terms of sexual outcomes. Results: Type I (77.3%) and type II (22.7%) mutilations were found in women with female genital mutilation. It was determined that women with FGM experienced statistically significantly more pain and bleeding during vaginal penetration than uncircumcised women. At the same time, the orgasm rate was found to be statistically significantly lower in this group. Conclusions: Our study revealed that female genital mutilation and enlargement of the incision area negatively affect sexual health.
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Affiliation(s)
| | - Serap Tekbaş
- Nursing Faculty, Near East University, Nicosia, Turkey
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Hassannezhad K, Asadzadeh F, Iranpour S, Rabiepoor S, Akhavan Akbari P. The comparison of sexual function in types I and II of female genital mutilation. BMC Womens Health 2024; 24:31. [PMID: 38191359 PMCID: PMC10775604 DOI: 10.1186/s12905-023-02860-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 12/21/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Female 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." METHODS In 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. RESULTS Type 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. CONCLUSION Circumcised 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.
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Affiliation(s)
- Kosar Hassannezhad
- Department of Midwifery, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Firouzeh Asadzadeh
- Department of Midwifery, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Sohrab Iranpour
- Department of Community Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Soheila Rabiepoor
- Professor of Reproductive health, Reproductive Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
| | - Pouran Akhavan Akbari
- Department of Midwifery, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran.
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Connor JJ, Abdi C, Chen M, Salad M, Pergament S, Afey F, Hussein I, Robinson BBE. Our Body Our Health (Jirkeena, Caafimaadkeena): Somali Women's Narratives on Sexual Health. JOURNAL OF SEX RESEARCH 2023:1-15. [PMID: 38047877 PMCID: PMC11147957 DOI: 10.1080/00224499.2023.2288077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Women across the globe have been subject to female genital cutting (FGC), with the highest rates in Somalia. FGC can result in sexual concerns, especially sexual pain and lower pleasure. Due to ongoing civil war and climate disasters, there is a large number of Somali immigrants and refugees living in countries where healthcare providers may be unfamiliar with the impact of FGC. In this qualitative study, sixty Somali women between the ages 20 and 45 and living in the U.S. shared their perspectives on how FGC has affected their sexual lives, including how they have coped with any complications attributed to FGC. Participants were recruited through convenience sampling and interviewed by a bilingual community researcher in either Somali or English. Data were analyzed through a participatory analysis process by academic and community researchers. Themes included sexual desire, arousal, and pleasure; sexual satisfaction; sexual pain at first intercourse; coping with sexual pain at first intercourse; long-term sexual pain, coping with long-term sexual pain. Results are discussed with a focus on agency of the participants, role of partners, and implications for healthcare professionals.
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Affiliation(s)
- Jennifer Jo Connor
- Eli Coleman Institute for Sexual and Gender Health; Department of Family Medicine and Community Health, University of Minnesota Medical School
| | - Cawo Abdi
- Department of Sociology, University of Minnesota
| | - Muzi Chen
- Eli Coleman Institute for Sexual and Gender Health; Department of Family Medicine and Community Health, University of Minnesota Medical School
| | - Munira Salad
- Eli Coleman Institute for Sexual and Gender Health; Department of Family Medicine and Community Health, University of Minnesota Medical School
| | - Shannon Pergament
- SoLaHmo, Community-University Health Care Center (CUHCC), University of Minnesota
| | - Foos Afey
- SoLaHmo, Community-University Health Care Center (CUHCC), University of Minnesota
| | - Intisar Hussein
- SoLaHmo, Community-University Health Care Center (CUHCC), University of Minnesota
| | - Beatrice Bean E Robinson
- Eli Coleman Institute for Sexual and Gender Health; Department of Family Medicine and Community Health, University of Minnesota Medical School
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Maya ET, Boamah MO, Agyabeng K, Srofenyoh E, Mumuni K, Samba A. Determinants of sexual dysfunction in pregnancy in a large tertiary hospital in Ghana. PLoS One 2023; 18:e0288456. [PMID: 37471375 PMCID: PMC10358996 DOI: 10.1371/journal.pone.0288456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 06/19/2023] [Indexed: 07/22/2023] Open
Abstract
OBJECTIVE To determine the factors associated with sexual dysfunction in pregnancy. METHODS A cross-sectional facility-based study using quantitative methods was carried out among pregnant women attending antenatal clinic of the Greater Accra Regional Hospital from 14th May to 25th June 2018. Four hundred and twenty-seven married or cohabiting women who were at least eight weeks pregnant and have been living together with their partners for at least four weeks prior to the survey were consecutively recruited. The Female Sexual Function Index (FSFI) tool was used to assess their sexual function. Pearson's Chi Square, Fischer's exact, Mann Whitney and Student's t-tests were used for bivariate analysis where appropriate between sexual dysfunction (dependent variable) and demographic, obstetrics and gynecologic factors (independent variables). Multiple logistic regression was done. Statistical significance was set at p-value of less than 0.05 at bivariate and multivariable analyses. RESULTS The mean age of the respondents was 30.8 ± 4.8 years. Their mean gestational age was 32.3 ± 7.1 weeks. Marital status and duration of stay in marriage or cohabitation were significantly associated with sexual dysfunction with adjusted odds ratios of 1.88 (p-value < 0.05) and 1.08 (p-value < 0.05) respectively. CONCLUSION Cohabiting and increasing length of stay with spouse are significantly associated with sexual dysfunction in pregnancy.
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Affiliation(s)
| | - Martin Owusu Boamah
- Department of Obstetrics and Gynecology, Greater Accra Regional Hospital, Accra, Ghana
| | - Kofi Agyabeng
- School of Public Health, University of Ghana, Accra, Ghana
| | - Emmanuel Srofenyoh
- Department of Obstetrics and Gynecology, Greater Accra Regional Hospital, Accra, Ghana
| | - Kareem Mumuni
- Department of Obstetrics and Gynaecology, University of Ghana Medical School, Accra, Ghana
| | - Ali Samba
- Department of Obstetrics and Gynaecology, Korle-bu Teaching Hospital, Accra, Ghana
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von Fritschen U, Strunz C, Scherer R, von Fritschen M, Fricke A. Postoperative Course of Reconstructive Procedures in FGM Type III-Proposal for a Modified Classification of Type III Female Genital Mutilation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4439. [PMID: 36901456 PMCID: PMC10002091 DOI: 10.3390/ijerph20054439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 02/26/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Reconstruction after female genital mutilation (FGM) has developed from being merely a therapy for complications to addressing body perception and sexuality. However, evidence regarding a direct correlation between FGM and sexual dysfunction is scarce. The present WHO classification provides an imprecise grading system, which makes it difficult to compare present studies with treatment outcomes. The aim of this study was to develop a new grading system based on a retrospective study of Type III FGM, evaluating operative time and postoperative results. METHODS The extent of clitoral involvement, operative time of prepuce reconstruction and lack of prepuce reconstruction, and postoperative complications of 85 patients with FGM-Type III were retrospectively analyzed at the Desert Flower Center (Waldfriede Hospital, Berlin). RESULTS Even though universally graded by the WHO, large differences in the degree of damage were found after deinfibulation. In only 42% of patients, a partly resected clitoral glans was found after deinfibulation. There was no significant difference in operative time when comparing patients who required prepuce reconstruction and patients who did not (p = 0.1693). However, we found significantly longer operative time in patients who presented with a completely or partly resected clitoral glans when compared to patients with an intact clitoral glans underneath the infibulating scar (p < 0.0001). Two of the 34 patients (5.9%) who had a partly resected clitoris required revision surgery, while none of the patients in whom an intact clitoris was discovered under the infibulation required revision. However, these differences in the complication rates between patients with and without a partly resected clitoris were not statistically significant (p = 0.1571). CONCLUSIONS A significantly longer operative time was found in patients who presented with a completely or partly resected clitoral glans when compared with patients with an intact clitoral glans underneath the infibulating scar. Furthermore, we found a higher, though not significantly significant, complication rate in patients with a mutilated clitoral glans. In contrast to Type I and II mutilations, the presence of an intact or mutilated clitoral glans underneath the infibulation scar is not addressed in the present WHO classification. We have developed a more precise classification, which may serve as a useful tool when conducting and comparing research studies.
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Affiliation(s)
- Uwe von Fritschen
- Department of Plastic and Aesthetic Surgery, Hand Surgery, HELIOS Hospital Emil von Behring, Walterhöferstr. 11, 14165 Berlin, Germany
| | - Cornelia Strunz
- Desert Flower Center, Center of Colorectal and Pelvic Floor Surgery, Hospital Waldfriede, Argentinische Allee 40, 14163 Berlin, Germany
| | - Roland Scherer
- Desert Flower Center, Center of Colorectal and Pelvic Floor Surgery, Hospital Waldfriede, Argentinische Allee 40, 14163 Berlin, Germany
| | - Marisa von Fritschen
- Department of Plastic and Aesthetic Surgery, Hand Surgery, HELIOS Hospital Emil von Behring, Walterhöferstr. 11, 14165 Berlin, Germany
| | - Alba Fricke
- Department of Plastic and Aesthetic Surgery, Hand Surgery, HELIOS Hospital Emil von Behring, Walterhöferstr. 11, 14165 Berlin, Germany
- Department of Plastic and Hand Surgery, University of Freiburg Medical Centre, Medical Faculty of the University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany
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Tammary E, Manasi K. Mental and sexual health outcomes associated with FGM/C in Africa: a systematic narrative synthesis. EClinicalMedicine 2023; 56:101813. [PMID: 36880050 PMCID: PMC9985012 DOI: 10.1016/j.eclinm.2022.101813] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 12/14/2022] [Accepted: 12/19/2022] [Indexed: 01/12/2023] Open
Abstract
UNLABELLED There are gaps in evidence regarding mental and sexual outcomes and associated interventions for women with Female Genital Mutilation/Cutting (FGM/C) living in Africa. This study employed a narrative synthesis to collate evidence on mental and sexual health outcomes. A systematic search of bibliographic databases and websites was performed using appropriate keywords and studies published in English from January 1, 2010 to March 25, 2022. 25 studies were retrieved and reported mental and sexual health complications associated with FGM/C. Most studies, n = 13 studies reported on sexual health outcomes including sexual pain, orgasm and sexual desire problems at sexual arousal and difficulties in lubrication. Mental health outcomes were reported in four studies including depression which was most prominent followed by somatisation and anxiety, Post Traumatic Stress Disorder (PTSD) and sleep disorder. Studies did not highlight combined mental and sexual health interventions. The findings of this narrative synthesis reveal the need to prioritise provision of mental and sexual health care services for women with FGM/C. The study recommends strengthening of health systems in Africa through awareness building, training and capacity building of primary health and specialist health workers in offering mental and sexual health care to women with FGM/C. FUNDING This work was self-funded.
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Affiliation(s)
- Esho Tammary
- Deputy Vice Chancellor, Academic and Student Affairs, AMREF International University, Lang'ata Road. P.O. Box 27691-00506, Nairobi, Kenya
| | - Kumar Manasi
- Senior Implementation Scientist and Mental Health Consultant, Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
- Corresponding author. Brain and Mind Institute, Aga Khan University, Nairobi, Kenya.
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Ozer O, Keles E, Eker HH, Abdi Nor I, Baydili KN. Effect of COVID-19 pandemic on female sexual function in women with female genital mutilation. J OBSTET GYNAECOL 2022; 42:3224-3229. [PMID: 35980853 DOI: 10.1080/01443615.2022.2109954] [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: 01/06/2023]
Abstract
We aimed to evaluate the impact of the COVID-19 pandemic on female sexual function in women with female genital mutilation (FGM) in Somalia. This cross-sectional study was conducted on women with FGM attending the gynaecologic outpatient clinic of our hospital, between March and June 2021, using a validated Female Sexual Function Index (FSFI) questionnaire with a physical examination based on FGM typing. Those women who refused to participate, those with mental illness, uncontrolled systemic disease, drug, alcohol, or khat addiction, pregnant, genital prolapse, gynaecological or urological cancer, previous pelvic surgery, premature ovarian failure, genital skin diseases, drug use that affects sexual function and those with or suspected of having COVID-19 infection were excluded. A total of 201 sexually active women enrolled, with a mean age of 29 (14-55) years. Comparison of FSFI scores and the COVID-19 pandemic, a statistically significant worsening in the mean FSFI scores and all its domains (p<.001, for each). All of the domains of the FSFI were determined higher before and during the pandemic except pain. There is a decline in female sexual functioning during the COVID-19 outbreak in women with FGM. FGM is a major public health concern necessitating urgent response in Somalia.Impact statementWhat is already known on this subject? As it stands, there is a body of research on sexual behaviour during COVID-19 pandemic, but a lack of conclusive evidence. However, our knowledge of the sexual function of women with FGM during the COVID-19 pandemic is largely based on very limited data.What do the results of this study add? There is a decline in female sexual functioning during COVID-19 pandemic in women with female genital mutilation in Somalia.What are the implications of these findings for clinical practice and/or further research? FGM is a major public health problem necessitating urgent response worldwide. There is an urgent need to implement FGM prevention programmes and raise public awareness in order to eradicate this harmful practice.
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Affiliation(s)
- Ozgur Ozer
- Department of Obstetrics and Gynecology, University of Health Sciences Turkey, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, Mogadishu, Somalia
| | - Esra Keles
- Department of Gynecologic Oncology, University of Health Sciences Turkey, Zeynep Kamil Training and Research Hospital, Istanbul, Turkey
| | - Hasan Huseyin Eker
- Department of Public Health, University of Health Sciences Turkey, Hamidiye Faculty of Medicine, Istanbul, Turkey.,Department of Public Health, University of Health Sciences Turkey, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, Mogadishu, Somalia
| | - Ifrah Abdi Nor
- Department of Obstetrics and Gynecology, University of Health Sciences Turkey, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, Mogadishu, Somalia
| | - Kurşad Nuri Baydili
- Department of Biostatistics, University of Health Sciences Turkey, Hamidiye Faculty of Medicine, Istanbul, Turkey
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Somalian women with female genital mutilation had increased risk of female sexual dysfunction: a cross-sectional observational study. Sci Rep 2022; 12:15633. [PMID: 36115897 PMCID: PMC9482632 DOI: 10.1038/s41598-022-19949-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 09/07/2022] [Indexed: 11/09/2022] Open
Abstract
AbstractStudies regarding the impact of female genital mutilation/cutting (FGM/C) on sexual function are scarce. This study is the first to explore the rate of female sexual dysfunction (FSD) among Somalian women who underwent FGM and its association with different FGM types. This study was carried out among women with a history of FGM who visited our clinic for a medical check-up. It relied on data including socio-demographic features, type of FGM determined by an examination, and the Female Sexual Function Index (FSFI) scores. Overall, 255 women were included. While 43.9% (n = 112) of the respondents had a history of Type 3 FGM, 32.2% had Type 2 (n = 82), and 23.9% had Type 1 (n = 61) FGM. Among all patients, 223 had FSD (87.6%). There was a significant association between the FGM type and FSD (p < 0.001). The mean total FSFI score for the patients with Type 1, 2, and 3 FGM was 22.5, 19.7, and 17.3, respectively, all indicating FSD. The FSD is prevalent among mutilated Somalian women. Patients with Type 3 FGM had the lowest mean total FSFI scores indicating that the impact on sexual function was correlated with the extent of tissue damage during FGM.
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Jordal M, Påfs J, Wahlberg A, Johansen REB. "Damaged genitals"-Cut women's perceptions of the effect of female genital cutting on sexual function. A qualitative study from Sweden. FRONTIERS IN SOCIOLOGY 2022; 7:943949. [PMID: 36033981 PMCID: PMC9413146 DOI: 10.3389/fsoc.2022.943949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 07/18/2022] [Indexed: 06/15/2023]
Abstract
Female genital cutting (FGC) is a traditional practice, commonly underpinned by cultural values regarding female sexuality, that involves the cutting of women's external genitalia, often entailing the removal of clitoral tissue and/or closing the vaginal orifice. As control of female sexual libido is a common rationale for FGC, international concern has been raised regarding its potential negative effect on female sexuality. Most studies attempting to measure the impact of FGC on women's sexual function are quantitative and employ predefined questionnaires such as the Female Sexual Function Index (FSFI). However, these have not been validated for cut women, or for all FGC-practicing countries or communities; nor do they capture cut women's perceptions and experiences of their sexuality. We propose that the subjective nature of sexuality calls for a qualitative approach in which cut women's own voices and reflections are investigated. In this paper, we seek to unravel how FGC-affected women themselves reflect upon and perceive the possible connection between FGC and their sexual function and intimate relationships. The study has a qualitative design and is based on 44 individual interviews with 25 women seeking clitoral reconstruction in Sweden. Its findings demonstrate that the women largely perceived the physical aspects of FGC, including the removal of clitoral tissue, to affect women's (including their own) sexual function negatively. They also recognized the psychological aspects of FGC as further challenging their sex lives and intimate relationships. The women desired acknowledgment of the physical consequences of FGC and of their sexual difficulties as "real" and not merely "psychological blocks".
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Affiliation(s)
- Malin Jordal
- Department of Caring Sciences, University of Gävle, Gävle, Sweden
| | - Jessica Påfs
- Department of Social Work, University of Gothenburg, Gothenburg, Sweden
| | - Anna Wahlberg
- Department of Women's and Children's Health, Akademiska Sjukhuset, Uppsala University, Uppsala, Sweden
| | - R. Elise B. Johansen
- Norwegian Centre for Violence and Traumatic Stress Studies, Department of Children and Adolescents, Oslo, Norway
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Gutiérrez-García AI, Solano-Ruiz C, Perpiñá-Galvañ J, Siles-González J, Jimenez-Ruiz I. Female Genital Mutilation as a Social Norm: Examining the Beliefs and Attitudes of Women in This Diaspora. QUALITATIVE HEALTH RESEARCH 2022; 32:1153-1166. [PMID: 35576461 DOI: 10.1177/10497323221097885] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
In this article, we explore the beliefs, values and attitudes about female genital mutilation in the diaspora of sub-Saharan women and how the migration process has influenced these beliefs. Our qualitative analysis of the life stories and lifelines of 10 women in the sub-Saharan diaspora in light of the Social Convention Theory indicated that making public statements about the topic is complex and that the taboo permeating the practice remains intact even outside of Africa. Furthermore, we discovered that, in our context, this practice was not a requirement and did not improve the chances of marriage, with female behaviours considered 'appropriate' instead gaining value. Any interventions based on this theory must consider the broad networks that help shape marriages in this diaspora. This work opened new lines of research regarding the situation of the diaspora of sub-Saharan women and the relationship of the practice of female genital mutilation with marriage.
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Tordrup D, Bishop C, Green N, Petzold M, Vallejo FR, Vogel JP, Pallitto C. Economic burden of female genital mutilation in 27 high-prevalence countries. BMJ Glob Health 2022; 7:bmjgh-2020-004512. [PMID: 35105556 PMCID: PMC8744099 DOI: 10.1136/bmjgh-2020-004512] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 09/17/2021] [Indexed: 11/23/2022] Open
Abstract
Background Female genital mutilation (FGM) is a traditional harmful practice affecting 200 million women and girls globally. Health complications of FGM occur immediately and over time, and are associated with healthcare costs that are poorly understood. Quantifying the global FGM-related burden is essential for supporting programmes and policies for prevention and mitigation. Methods Health complications of FGM are derived from a meta-analysis and stratified by acute, uro-gynaecological, obstetric and psychological/sexual. Treatment costs are calculated from national cohort models of 27 high-burden countries over 30 years. Savings associated with full/partial abandonment are compared with a current incidence reference scenario, assuming no changes in FGM practices. Results Our model projects an increasing burden of FGM due to population growth. As a reference scenario assuming no change in practices, prevalent cases in 27 countries will rise from 119.4 million (2018) to 205.8 million (2047). Full abandonment could reduce this to 80.0 million (2047), while partial abandonment is insufficient to reduce cases. Current incidence economic burden is US$1.4 billion/year, rising to US$2.1 billion/year in 2047. Full abandonment would reduce the future burden to US$0.8 billion/year by 2047. Conclusion FGM is a human rights violation, a public health issue and a substantial economic burden that can be avoided through effective prevention strategies. While decreasing trends are observed in some countries, these trends are variable and not consistently observed across settings. Additional resources are needed to prevent FGM to avoid human suffering and growing costs. The findings of this study warrant increased political commitment and investment in the abandonment of FGM.
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Affiliation(s)
- David Tordrup
- WHO Collaborating Centre for Pharmaceutical Policy and Regulation, Utrecht, The Netherlands.,Triangulate Health Ltd, Doncaster, UK
| | | | | | - Max Petzold
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | | | - Joshua P Vogel
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Christina Pallitto
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and ResearchTraining in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Awareness, clinical experience and knowledge of female genital mutilation/cutting among female pelvic medicine and reconstructive surgeons in the United States. Urology 2021; 159:59-65. [PMID: 34758373 DOI: 10.1016/j.urology.2021.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 10/19/2021] [Accepted: 10/24/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To promote the recognition and care of patients with female genital mutilation/cutting (FGM/C), we aimed to evaluate the awareness, clinical experience and knowledge of FGM/C among female pelvic medicine and reconstructive surgery (FPMRS) specialists. FGM/C is a cultural practice whereby there is removal of external female genitalia for non-therapeutic reasons. Despite the high prevalence of urogynecologic complications, there is a paucity of literature discussing FGM/C from the lens of urologists and urogynecologists. METHODS By cross-sectional design, we distributed a 27-item survey via email to members of the Society of Urodynamics, Female Pelvic Medicine and Reconstructive Surgery. We collected variables pertaining to previous FGM/C education, clinical confidence, cultural and medical knowledge, and desire for future education. RESULTS A total of 54 US-based, mostly urologists and FPMRS specialists, completed the survey. All providers had heard of FGM/C; however only 13% received formal education during medical training. Over 50% had encountered a patient with FGM/C in clinical practice. Only 19% and 13% felt completely confident recognizing and discussing FGM/C, respectively. Seventy percent believed religious doctrine informed FGM/C practice and 24% correctly identified FGM/C type on clinical representation. Finally, only 17% of respondents were aware of FGM/C guidelines, and providers expressed a desire for increased availability of multimodal resources. CONCLUSIONS Education regarding FGM/C remains sparse and variable for US FPMRS specialists. Cultural and clinical knowledge is also lacking, which is a detriment to patient care. In order to strengthen awareness and knowledge, we must develop high-quality FGM/C educational resources for urologists and gynecologists.
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Mohammed G, Hassan H, Hassan A. Egyptian female genital “norm” and female genital self-image. SEXOLOGIES 2021. [DOI: 10.1016/j.sexol.2021.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Connor JJ, Brady SS, Chaisson N, Mohamed FS, Robinson BBE. Response to Commentaries: Understanding Women's Responses to Sexual Pain After Female Genital Cutting. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:1907-1912. [PMID: 34100144 DOI: 10.1007/s10508-021-02047-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 05/07/2021] [Accepted: 05/10/2021] [Indexed: 06/12/2023]
Affiliation(s)
- Jennifer Jo Connor
- Program in Human Sexuality, Department of Family Medicine and Community Health, University of Minnesota Medical School, 1300 South Second Street, Suite 180, Minneapolis, MN, 55454, USA.
| | - Sonya S Brady
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Nicole Chaisson
- Smiley's Clinic, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | | | - Beatrice Bean E Robinson
- Program in Human Sexuality, Department of Family Medicine and Community Health, University of Minnesota Medical School, 1300 South Second Street, Suite 180, Minneapolis, MN, 55454, USA
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Shafaati Laleh S, Maleki A, Samiei V, Roshanaei G, Soltani F. The comparison of sexual function in women with or without experience of female genital circumcision: A case-control study in a Kurdish region of Iran. Health Care Women Int 2021; 43:194-206. [PMID: 33797319 DOI: 10.1080/07399332.2021.1887193] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Studies on the sexual consequences of female genital circumcision are controversial. In this article, we intend to compare the sexual function in women with or without experience of circumcision in the Kurdish region of Mahabad in Iran. In this case-control study 550 women completed the demographic and Female Sexual Function Index (FSFI) questionnaires. Female genital circumcision was associated with reduction of lubrication and sexual satisfaction as well as increasing dyspareunia compared to the uncircumcised women. However, there was no significant difference between two groups regarding to arousal, desire and orgasm of women.
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Affiliation(s)
| | - Azam Maleki
- Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Vida Samiei
- International Affairs and Academic Relations, Deputy of Education, Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Farzaneh Soltani
- Mother and Child Care Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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16
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Nzinga AM, De Andrade Castanheira S, Hermann J, Feipel V, Kipula AJ, Bertuit J. Consequences of Female Genital Mutilation on Women's Sexual Health - Systematic Review and Meta-Analysis. J Sex Med 2021; 18:750-760. [PMID: 33618990 DOI: 10.1016/j.jsxm.2021.01.173] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 12/15/2020] [Accepted: 01/04/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Female genital mutilation (FGM) can leave a lasting mark on the lives and minds of those affected. AIM To assess the consequences of FGM on women's sexual function in women who have undergone FGM compared to women who have not undergone FGM. METHODS A systematic review and meta-analysis were conducted from 3 databases; inclusion and exclusion criterions were determined. Studies included adult women having undergone FGM and presenting sexual disorders assessed by the Female Sexual Function Index (FSFI). RESULTS Of 129 studies, 5 that met the criteria were selected. The sexual function of mutilated women, based on the FSFI total score and its different domains, was compared to the sexual function of non-mutilated women. There was a significant decrease in the total FSFI scores of mutilated women compared to non-mutilated women. However, the results obtained for the different domains were not the same for all authors. The meta-analysis highlighted a high heterogeneity with inconsistency and true variance in effect size between-studies. CONCLUSION Analysis of studies showed that there is a significant decrease in the total FSFI score, indicating that FGM of any type may cause impaired sexual functioning. But a firm conclusion on this topic is not yet achievable because the results of this analysis do not allow to conclude a cause and effect relationship of FGM on sexual function. Nzinga A-M, De Andrade Castanheira S, Herklmann J, et al. Consequences of Female Genital Mutilation on Women's Sexual Health - Systematic Review and Meta-Analysis. J Sex Med 2021;18:750-760.
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Affiliation(s)
- Andy-Muller Nzinga
- Pelvic floor Re-education Unit, Department of Physical Medicine and Rehabilitation, University Clinics of Kinshasa, Faculty of Medicine, University of Kinshasa (UNIKIN), Kinshasa, Democratic Republic of Congo (DRC)
| | | | - Jessica Hermann
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
| | - Véronique Feipel
- Laboratory of Functional Anatomy, Faculty of Motor Sciences, Université Libre de Bruxelles, Brussels, Belgium; Laboratory of Anatomy, Biomechanics, and Organogenesis, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Augustin Joseph Kipula
- Pelvic floor Re-education Unit, Department of Physical Medicine and Rehabilitation, University Clinics of Kinshasa, Faculty of Medicine, University of Kinshasa (UNIKIN), Kinshasa, Democratic Republic of Congo (DRC)
| | - Jeanne Bertuit
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland.
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17
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Pérez-López FR, Ornat L, López-Baena MT, Pérez-Roncero GR, Tajada-Duaso MC, Chedrau P. Association of female genital mutilation and female sexual dysfunction: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2020; 254:236-244. [PMID: 33011507 DOI: 10.1016/j.ejogrb.2020.09.031] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 09/15/2020] [Accepted: 09/21/2020] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To meta-analyze possible associations between female genital mutilation (FGM) and female sexual dysfunction, dyspareunia and pelvic pain. METHOD A systematic literature search was performed in PubMed, EMBASE, Scopus, Web of Science, African Index Medicus and Cochrane Library. The PICO protocol included Population: Studies evaluating girls or women; Intervention/Exposure: participants with FGM; Comparison: participants without FGM; Outcomes: female sexual function, dyspareunia or pelvic pain using validated tests. Random effect models were used for meta-analyses, and standardized mean differences (SMDs) and their 95 % confidence intervals (CIs) for any of the measured continuous outcomes were calculated when possible. Risk of bias was assessed with the Newcastle-Ottawa Scale. RESULTS Fifteen studies (n = 6672 participants) reported on the outcomes of the 19-item Female Sexual Function Index (FSFI). The meta-analysis of the total FSFI score showed a SMD of -1.43 (95 % CI -2.17, -0.69) suggestive of female sexual dysfunction. In addition, scores for the six FSFI domains were significantly lower in women with FGM: SMDs for desire -0.62 (95 % CI -1.01, -0.22), arousal -0.88 (95 % CI -1.41, -0.35), lubrication -0.95 (95 % CI -1.45, -0.46), orgasm -1.07 (95 % CI -1.63, -0.50), satisfaction -0.96 (95 % CI -1.52, -0.41) and pain -0.48 (95 % CI -0.91, -0.05). Estimation of the prevalence of female sexual dysfunction with the FSFI was not possible since different cut-offs values were used in those studies that reported for this outcome. No other searched outcomes using other tools were reported. CONCLUSION FGM seriously alters female sexual function as assessed with the FSFI, globally and per domain.
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Affiliation(s)
- Faustino R Pérez-López
- Department of Obstetrics and Gynecology, University of Zaragoza Faculty of Medicine, Zaragoza, Spain.
| | - Lía Ornat
- Department of Obstetrics and Gynecology, University of Zaragoza Faculty of Medicine, Zaragoza, Spain
| | | | | | - Mauricio C Tajada-Duaso
- Department of Obstetrics and Gynecology, University of Zaragoza Faculty of Medicine, Zaragoza, Spain
| | - Peter Chedrau
- Instituto de Investigación e Innovación en Salud Integral, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
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18
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Siles-González J, Gutiérrez-García AI, Solano-Ruíz C. Leadership among Women Working to Eradicate Female Genital Mutilation: The Impact of Environmental Change in Transcultural Moments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165996. [PMID: 32824774 PMCID: PMC7460365 DOI: 10.3390/ijerph17165996] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/13/2020] [Accepted: 08/14/2020] [Indexed: 11/16/2022]
Abstract
The study of cultural moments can identify the level of acceptance of female genital mutilation and the visibility of the involved health problems in a globalized world. AIMS To describe the transcultural process through which immigrant women who have experienced female genital mutilation become leaders against this practice. METHOD Descriptive research with cross-cultural principles and a qualitative approach. A semi-structured interview was the chosen technique for data collection. A total of 18 women participated in the preliminary observation and analysis unit, and only 8 women (38.8%) were ideologically against female genital mutilation (FGM). INCLUSION CRITERIA The selected women had undergone FGM and were fully prepared to discuss it. RESULTS Staying in a different country and the associated social relations reduce cultural pressure and promote critical thinking. Cultural moments reflect the different situations that affect the perception and practice of female genital mutilation. Health problems associated with female genital mutilation (sexual, reproductive, and psychological) become visible at transcultural moments. CONCLUSIONS Environmental country change affects the cultural pressure that sustains this practice in individual minds, institutions, structures, and bodies. These changes produce transcultural moments. The practice of female genital mutilation constitutes a significant segment of gender-based violence.
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19
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Maya ET, Boamah MO, Agyabeng K, Srofenyoh E, Mumuni K, Samba A. Prevalence of sexual dysfunction among prenatal women attending the Greater Accra Regional Hospital, Ghana. Int J Gynaecol Obstet 2020; 151:49-56. [PMID: 32682333 DOI: 10.1002/ijgo.13314] [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] [Received: 01/25/2020] [Revised: 05/24/2020] [Accepted: 07/15/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To estimate the prevalence and types of sexual dysfunction in pregnancy. METHODS A cross-sectional facility-based descriptive study among pregnant women attending the prenatal clinic of the Greater Accra Regional Hospital, a large tertiary health facility in Accra, Ghana, from May to June 2018. The inclusion criteria were 18 years or older, singleton pregnancy of 8 gestational weeks or more, and residing with their partner for at least 4 weeks before the study. Face-to-face interviews were conducted among consecutively enrolled women by using the Female Sexual Function Index (FSFI) tool. RESULTS Overall, 425 women were enrolled. The mean age was 30.8 ± 4.8 years. The mean gestational age was 32.3 ± 7.1weeks (range 9.7-42.0 weeks). The prevalence of sexual dysfunction in pregnancy was 64.9% (95% confidence interval [CI], 60.3%-69.4%) but only 32 (7.5%) women self-reported sexual problems. The predominant types of sexual disorder were desire disorder (377 [88.7%; 95% CI, 85.3%-91.4%] women) and arousal disorder (320 [75.3%; 95% CI, 71.0%-79.2%]). CONCLUSION Sexual dysfunction in pregnancy was found to be common, but most pregnant women were not aware that they had it.
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Affiliation(s)
- Ernest T Maya
- School of Public Health, University of Ghana, Accra, Ghana
| | - Martin O Boamah
- Department of Obstetrics and Gynecology, Greater Accra Regional Hospital, Accra, Ghana
| | - Kofi Agyabeng
- School of Public Health, University of Ghana, Accra, Ghana
| | - Emmanuel Srofenyoh
- Department of Obstetrics and Gynecology, Greater Accra Regional Hospital, Accra, Ghana
| | - Kareem Mumuni
- Department of Obstetrics and Gynecology, University of Ghana Medical School, Accra, Ghana
| | - Ali Samba
- Department of Obstetrics and Gynecology, University of Ghana Medical School, Accra, Ghana
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20
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Van Rossem R, Meekers D. The decline of FGM in Egypt since 1987: a cohort analysis of the Egypt Demographic and Health Surveys. BMC WOMENS HEALTH 2020; 20:100. [PMID: 32393248 PMCID: PMC7216476 DOI: 10.1186/s12905-020-00954-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 04/16/2020] [Indexed: 11/22/2022]
Abstract
Background Female genital mutilation (FGM) has been a longstanding tradition in Egypt and until recently the practice was quasi-universal. Nevertheless, there are indications that the practice has been losing support and that fewer girls are getting cut. This study analyzes the prevalence of FGM in different birth cohorts, to test whether the prevalence declined over time. The study also examines whether such a decline is occurring in all segments of society or whether it is limited mostly to certain more modernized segments of society. Methods This study pooled data from the 2005, 2008 and 2014 waves of the Egypt Demographic and Health Surveys (EDHS). The women participating in the EDHS provided data on 62,507 girls born to them between 1987 and 2014, including whether they were cut and at what age. Kaplan-Meier and Weibull proportional hazard survival analyses were used to examine trends in the prevalence and hazards of FGM across birth cohorts. Controls for region, religion and socioeconomic status of the parents were included in the Weibull regression. Results The results show a steady decline in FGM across the birth cohorts studied. The base hazard for the 2010 birth cohort is only 30% that of the 1987 one. Further analyses show that the decline in FGM occurred in all segments of Egyptian society in a fairly similar manner although differences by region, religion and socioeconomic status persisted. Conclusions This study confirms that FGM is declining in Egypt. The proportion of girls getting cut has declined rapidly over the past few decades. This decline is not limited to the more modernized segments of society, but has spread to the more traditional segments as well. The latter increases prospects for the eventual eradication of the practice.
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Affiliation(s)
- Ronan Van Rossem
- Department of Sociology, Universiteit Gent, Korte Meer 3-5, 9000, Ghent, Belgium.
| | - Dominique Meekers
- School of Public Health & Tropical Medicine, Department of Global Community Health and Behavioral Sciences, Tulane University, 1440 Canal Street, Suite 2200, New Orleans, LA, 70112, USA
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21
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Al Awar S, Al-Jefout M, Osman N, Balayah Z, Al Kindi N, Ucenic T. Prevalence, knowledge, attitude and practices of female genital mutilation and cutting (FGM/C) among United Arab Emirates population. BMC WOMENS HEALTH 2020; 20:79. [PMID: 32321503 PMCID: PMC7178722 DOI: 10.1186/s12905-020-00949-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 04/15/2020] [Indexed: 11/26/2022]
Abstract
Background Female genital mutilation/cutting (FGM/C) is a common practice in developing countries, including the UAE, and presents a major health problem. Methods A questionnaire-based cross-sectional study was conducted among 1035 participants: 831 (80.3%) females and 204 (19.7%) males. Results The number of women with FGM/C was 344; hence the prevalence of FGM/C in our study was 41.4%. Type I was the most prevalent (62.8%), followed by Type II (16.6%) and Type III (5%). FGM/C was less prevalent among educated and employed women (p-value < 0.001) and was mostly performed during infancy and childhood. Among the participants, 13.7% reported that their daughters had undergone FGM/C, with Type I being the most common, and 25% of them planned to have their future daughters undergo Type I FGM/C. While FGM/C was mostly performed by ritual circumcisers (74.4%), in 25 and 36.7% of the cases, it was performed by health professionals and in the clinic setting, respectively. About 69% of the participants considered FGM/C a custom, 72.8% were against the practice, and only 17.4% believed in its legality. Complications occurred in 30% of cases. The type of FGM/C was associated with the occurrence of complications: bleeding, difficulties in sexual life, and delivery-related problems (p-value < 0.05). One-fifth of the male participants expressed plans to circumcise future daughters (p-value < 0.001). Conclusion FGM/C remains a prevalent practice in the UAE and has a negative association with the general health of Emirati women. The lack of clear legislation to criminalize this practice is a problem to be addressed. In this context, national-level educational and legal strategies should be a priority.
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Affiliation(s)
- Shamsa Al Awar
- Department of Obstetrics and Gynecology, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 15551, Al Ain, Abu Dhabi, United Arab Emirates.,Department of Obstetrics and Gynecology, Tawam Hospital, Al-Ain, United Arab Emirates.,Al Ain Hospital, Al Ain, United Arab Emirates
| | - Moamar Al-Jefout
- Department of Obstetrics and Gynecology, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 15551, Al Ain, Abu Dhabi, United Arab Emirates. .,Department of Obstetrics and Gynecology, Tawam Hospital, Al-Ain, United Arab Emirates. .,Al Ain Hospital, Al Ain, United Arab Emirates. .,Department of Obstetrics and Gynecology, Faculty of Medicine, Mutah University, Mu'tah, Jordan. .,Department of Obstetrics and Gynecology №1, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
| | - Nawal Osman
- Department of Obstetrics and Gynecology, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 15551, Al Ain, Abu Dhabi, United Arab Emirates
| | - Zuhur Balayah
- Department of Obstetrics and Gynecology, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 15551, Al Ain, Abu Dhabi, United Arab Emirates
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Abstract
Clitoral reconstructive surgery is not sufficient to restore women's sexual pleasure after excision. If the surgical technique aims at reconstructing the cut clitoris after type 2 female genital mutilation, the surgery alone cannot reconstruct other dimensions invoked by women in their requests for the procedure. In France, where clitoral reconstructive surgery since 2004 has been entirely covered by national insurance, a multidisciplinary approach precedes the surgery. Ethnographic fieldwork in one public hospital contributes a wider comprehension of the entire process of clitoral reconstruction, as well as the tools elaborated by the medical team. In particular, analysis of the assessments of the psychologist and sex therapist compiled in the medical folders shows how the multidisciplinary medical team developed specific tools. These tools are oriented at reconstructing the patient's sexual sensibility, at breaking through psychological blocks such as self-esteem and body image, and/or at addressing abusive intimate relationships.
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Affiliation(s)
- Michela Villani
- Department of Social Sciences, University of Fribourg, Fribourg, Switzerland
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Buggio L, Facchin F, Chiappa L, Barbara G, Brambilla M, Vercellini P. Psychosexual Consequences of Female Genital Mutilation and the Impact of Reconstructive Surgery: A Narrative Review. Health Equity 2019; 3:36-46. [PMID: 30805570 PMCID: PMC6386073 DOI: 10.1089/heq.2018.0036] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Purpose: We aim to provide a comprehensive overview of the health consequences of female genital mutilation/cutting (FGM/C), with a particular focus on the psychosexual implications of this practice and the overall impact of reconstructive plastic surgery. Methods: A MEDLINE search through PubMed was performed to identify the best quality evidence published studies in English language on long-term health consequences of FGM/C. Results: Women with FGM/C are more likely to develop psychological disorders, such as post-traumatic stress disorder, anxiety, somatization, phobia, and low self-esteem, than those without FGM/C. Most studies showed impaired sexual function in women with FGM/C. In particular, women with FGM/C may be physiologically less capable of becoming sexually stimulated than uncut women. Reconstructive surgery could be beneficial, in terms of both enhanced sexual function and body image. However, prospective studies on the impact of reconstructive surgery are limited, and safety issues should be addressed. Conclusion: Although it is clear that FGM/C can cause devastating immediate and long-term health consequences for girls and women, high-quality data on these issues are limited. Psychosexual complications need to be further analyzed to provide evidence-based guidelines and to improve the health care of women and girls with FGM/C. The best treatment approach involves a multidisciplinary team to deal with the multifaceted FGM/C repercussions.
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Affiliation(s)
- Laura Buggio
- Gynaecology Unit, Fondazione IRCCS Ospedale Maggiore Policlinico, Milan, Italy
| | - Federica Facchin
- Faculty of Psychology, Catholic University of Milan, Milan, Italy
| | - Laura Chiappa
- Health Director, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giussy Barbara
- Department of Obstetrics and Gynecology and Service for Sexual and Domestic Violence (SVSeD), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Massimiliano Brambilla
- Plastic Surgery Unit, General Surgery Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Vercellini
- Gynaecology Unit, Fondazione IRCCS Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Sciences and Community Health, Università degli Studi Milano, Italy
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Johnsdotter S. The Impact of Migration on Attitudes to Female Genital Cutting and Experiences of Sexual Dysfunction Among Migrant Women with FGC. CURRENT SEXUAL HEALTH REPORTS 2018. [PMID: 29541003 PMCID: PMC5840240 DOI: 10.1007/s11930-018-0139-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Purpose of Review The purpose of this review was to explore current research on the impact of migration on issues related to female genital cutting and sexuality. Recent Findings There is growing evidence that migration results in a broad opposition to female genital cutting among concerned migrant groups in western countries. In addition, after migration, affected women live in the midst of a dominant discourse categorizing them as "mutilated" and sexually disfigured. There is also, in contrast to what is shown by most research, a public discourse saying that female genital cutting (FGC) leads to lost capacity to enjoy sex. Concurrently, a vast body of research demonstrates a strong correlation between a negative body image or body shame and sexual dysfunction. Summary Care for women with FGC needs to be holistic and, while offering medical care when needed, the health care providers should avoid feeding into self-depreciatory body images and notions about lost ability to enjoy sexual life.
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Affiliation(s)
- Sara Johnsdotter
- Faculty of Health and Society, Malmö University, 205 06 Malmö, Sweden
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