Factors associated with the support of pricking (female genital cutting type IV) among Somali immigrants – a cross-sectional study in Sweden

Abstract

BackgroundPricking, classified as female genital cutting (FGC) type IV by the World Health Organization, is an under-researched area gaining momentum among diaspora communities. Our aim was to explore factors associated with being supportive of pricking among Somalis in Sweden.MethodsIn a cross-sectional design, attitudes and knowledge regarding FGC, and measures of socioeconomic status, acculturation, and social capital, were assessed by a 49-item questionnaire in four municipalities in Sweden. Data were collected in 2015 from 648 Somali men and women, ≥ 18 years old, of which 113 supported the continuation of pricking. Logistic regression was used for the analysis.ResultsThose more likely to support the continuation of pricking were older, originally from rural areas, and newly arrived in Sweden. Further, those who reported that they thought pricking was: acceptable, according to their religion (aOR: 10.59, 95% CI: 5.44–20.62); not a violation of children’s rights (aOR: 2.86, 95% CI: 1.46–5.61); and did not cause long-term health complications (aOR: 5.52, 95% CI: 2.25–13.52) had higher odds of supporting pricking. Religion was strongly associated with the support of pricking among both genders. However, for men, children’s rights and the definition of pricking as FGC or not were important aspects in how they viewed pricking, while, for women, health complications and respectability were important.ConclusionsValues known to be associated with FGC in general are also related to pricking. Hence, there seems to be a change in what types of FGC are supported rather than in their perceived values.Electronic supplementary materialThe online version of this article (doi:10.1186/s12978-017-0351-0) contains supplementary material, which is available to authorized users.

The Female Genital Mutilation/Cutting Experience in Somali Women: Their Wishes, Knowledge and Attitude

“…All types of FGM/C are seen as violations of children's rights and are thus not allowed [16]. We agree with WHO [3] about FGM/C.…”

“…But, in the studies by Wahlberg et al [16] and by Refaat [17], it was observed to have an important religious aspect by men and women.…”

“…Further, it is also argued that a medically safe pricking (Type IV of WHO classification of FGM/C) would not be physically harmful, as it involves no removal of tissue [16].…”

“…Seventy of the participants refused to be examined, but they described their types of circumcision. As in the study by Wahlberg et al [16], the key interviewers were also responsible for recruiting participants, to make sure they understood accurately the different anatomical forms of FGM/C, and to strive to establish a trusting relationship with the participants, as FGM/C may be a sensitive topic. Further, as it may have been sensitive to disclose positive attitudes toward FGM/C, the key interviewers were individuals who were respected within the community and not associated with any authority.…”

Changes in FGM/C in Somaliland: Medical narrative driving shift in types of cutting

“…While the study was not designed to establish causality, it appears the shift from the pharaonic to the Sunna form of FGM/C is linked to health and well-being issues, specifically attempts to at least minimise any adverse impact upon them. In their study of FGM/C attitudes and knowledge among 648 Somali male and female immigrants in Sweden, Wahlberg et al (2017) reported 113 (17.4%) supported the continuation of pricking, with these more likely to believe it was acceptable religiously, not a violation of children's rights, and does not cause long-term health complications. Moreover, in 1985 Gallo, reporting positive attitudes to FGM/C among respondents, concluded such positivity partly found support in the ignorance of the negative aspects of the practice; given the often-delayed detrimental impact of the cutting years after its occurrence, not all women acknowledged the connection between cause and effect.…”