Female Genital Cutting/Mutilation: a Challenge for Patients and Clinicians

Koukoui, Sophia

doi:10.1016/j.jogc.2017.06.027

Cited by 5 publications

(5 citation statements)

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“…Additionally, studies conducted on the 2017 Travel Ban also reveal profound feelings of disempowerment and fear of racist attacks in the Somali community [89]. North American public discourses (i.e., anti-FGM discourses), though well-intentioned, often further 'other' and even defame FGM/ C-affected communities and cultures under the banner of humanrights advocacy, increasing the work such communities must engage in to prepare for encounters with health systems, which they fear will perpetuate the same discrimination [69,[90][91][92]. It is now wellestablished that SDoH are a significant driver of population health inequities [83,93] and that racism is a public health crisis [94,95].…”

Section: Discussionmentioning

confidence: 99%

Health outcomes and female genital mutilation/cutting: how much is due to the cutting itself?

et al. 2023

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While Female Genital Mutilation/Cutting (FGM/C) continues to garner global attention, FGM/C-affected migrant communities, who are often racialized minorities in the U.S., face additional challenges which may impact their physical and mental health and well-being. It has been proposed that an overly narrow focus on the female genitalia or FGM/C status alone, while ignoring the wider social experiences and perceptions of affected migrant women, will result in incomplete or misleading conclusions about the relationship between FGM/C and migrant women’s health. A cross-sectional study was conducted across two waves of Somali and Somali Bantu women living in the United States, (n = 879 [wave 1], n = 654 [wave 2]). Socio-demographics, self-reported FGM/C status, perceived psychological distress, and self-reported FGM/C-related health morbidity was examined against self-reported experiences of everyday discrimination and perceived psychosocial support. In statistical models including age and educational attainment as potentially confounding socio-demographic variables, as well as self-reported FGM/C status, self-reported discrimination, and perceived psychosocial support, self-reported discrimination was the variable most strongly associated with poor physical health and psychological distress (i.e., FGM/C-related health morbidity and psychological distress), with greater perceived psychosocial support negatively associated with psychological distress, when controlling for all the other variables in the model. FGM/C status was not significantly associated with either outcome. Discrimination, more frequently reported among ‘No FGM/C’ (i.e., genitally intact or unmodified) women, was most frequently perceived as linked to religion and ethnicity. Our findings are consistent with views that discrimination drives negative outcomes. In this population, discrimination may include the ‘quadruple jeopardy’ of intersecting relationships among gender, race, religion, and migration status. We find that self-reported experiences of discrimination—and not FGM/C status per se—is associated with adverse physical and mental health consequences in our sample drawn from Somali migrant communities living in the United States, and that social support may help to mitigate these consequences. Our findings thus reinforce calls to better contextualize the relationship between FGM/C and measures of health and well-being among Somali women in the United States (regardless of their FGM/C status), taking psychosocial factors more centrally into account.Clinical Trials.Gov ID no. NCT03249649, Study ID no. 5252. Public website: https://clinicaltrials.gov/ct2/show/NCT03249649

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Section: Discussionmentioning

confidence: 99%

Health outcomes and female genital mutilation/cutting: how much is due to the cutting itself?

et al. 2023

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“…It can be performed before pregnancy, antenatally, in the first stage of labour, and at the time of vaginal delivery [7]. There is little familiarity with this procedure in developed countries and caregivers may not be prepared to treat women with infibulation, especially in emergency situations, which in turn may lead to rupture of the infibulation scar [8,9]. The WHO guideline on the management of complications from FGM/C recommends undertaking defibulation in the antepartum or intrapartum period [1].…”

Section: Introductionmentioning

confidence: 99%

Labour outcomes with defibulation at delivery in immigrant Somali and Sudanese women with type III female genital mutilation/cutting

et al. 2020

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“…Ultimately, politics and power dynamics influence this hierarchy, especially in the western context where FGC is condemned and illegal. As a result, much of the existing literature on FGC is concerned with prevention and intervention rather than treatment, especially in the context of medical professionals' roles (Bedri et al, 2019;Higginbothan, 2015;Johansen et al, 2018;Klein et al, 2018;Koukoui, 2017;Nabaneh & Muula, 2019;Ogunsiji & Ussher, 2021;Payne et al, 2019;Shell-Duncan, 2008).…”

Section: Critical Perspectives On Fgcmentioning

confidence: 99%

“…Previous research on the efficacy of medical training for OB-GYNs in the Canadian context is limited. Johansen et al (2018) and Koukoui (2017) focus on health policy and the relationship between doctors and patients. Their work provides a necessary comparative background to situate my own research on inequalities of power.…”

Section: Critical Perspectives On Fgcmentioning

confidence: 99%

“…Although more recent studies have addressed similar problems of FGC care internationally (Evans et al, 2019;Higginbothan, 2015;Johansen et al, 2018;Vissandjée et al, 2014;Zurynski et al, 2015), Koukoui's (2017) article is one of the few examples from the limited scholarship based in the Canadian context. Drawing from these international studies and especially Perron et al's (2020) "Guideline No.…”

Section: Introductionmentioning

confidence: 99%

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Do No Harm? Discrepancies across Canadian Healthcare Policy and Obstetrics and Gynaecology Training for Treating Women affected by Female Genital Cutting

Johnston¹

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Female genital cutting (FGC) is a flashpoint feminist issue. It is a deeply stigmatized and controversial cultural practice that affects millions of women and girls internationally and is criminalized in Canada. My research set out to answer the questions: To what extent is obstetrics and gynaecology training in Canada structured to provide adequate, effective, and culturally sensitive care for women who have undergone FGC? Does this training reflect the broader framing of FGC as a "barbaric" practice? Through my research into medical education, I find that Canadian healthcare reflects norms and values of nationalism when considering whose bodies represent these standards. With the methodology of transnational feminism, these covert issues of structural violence that mark certain bodies as Other become more clearly recognizable. I challenge predominant knowledge, attitudes, and skills of healthcare practitioners to ultimately recommend four steps toward creating a new benchmark for culturally sensitive training and care. iii Acknowledgements I would like to acknowledge that this work is supported in part by the Canada Graduate Scholarships -Master's (CGS M) from the Social Sciences and Humanities Research Council

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Female Genital Cutting/Mutilation: a Challenge for Patients and Clinicians

Cited by 5 publications

References 4 publications

Health outcomes and female genital mutilation/cutting: how much is due to the cutting itself?

Health outcomes and female genital mutilation/cutting: how much is due to the cutting itself?

Labour outcomes with defibulation at delivery in immigrant Somali and Sudanese women with type III female genital mutilation/cutting

Do No Harm? Discrepancies across Canadian Healthcare Policy and Obstetrics and Gynaecology Training for Treating Women affected by Female Genital Cutting

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