Blog Original research

Counselling professionals’ awareness and understanding of female genital mutilation/cutting: Training needs for working therapeutically with survivors.

FREECouns Psychother Res. 2017 Dec;17(4):309-319. doi: 10.1002/capr.12136. Epub 2017 Jul 20.

Counselling professionals’ awareness and understanding of female genital mutilation/cutting: Training needs for working therapeutically with survivors.

Jackson C


Background: There is a dearth of literature that has looked at the psychological  impact of female genital mutilation/cutting (FGM/C), and little is known about the understanding and awareness of FGM/C amongst counselling professionals. Method: An online survey was completed by 2073 BACP members. The survey covered four broad themes: demographics; awareness and understanding of FGM/C; experience of working therapeutically with survivors; and FGM/C training. Descriptive and inferential analyses were undertaken on quantitative data, and thematic content analysis was undertaken on qualitative data. Results: Only a small proportion of respondents (10%) had knowingly worked with survivors of FGM/C. Overall, respondents lacked confidence in their awareness and understanding of FGM/C, including their safeguarding duties. Having cultural respect, knowledge and understanding was perceived as the most helpful factor
when working with this client group. Less than a quarter of respondents had undertaken any training with regard to FGM/C, although the vast majority expressed a desire to do so. Discussion: This research has highlighted the importance of improving signposting to existing training and educational resources around FGM/C, as well as the need to develop new resources where appropriate. The importance of embedding cultural competency into core practitioner training, not just training specific to FGM/C, is paramount.

This article can be accessed in this LINK.

Archives Blog Review

Psychological and counselling interventions for female genital mutilation.

Int J Gynaecol Obstet. 2017 Feb;136 Suppl 1:60-64. doi: 10.1002/ijgo.12051.

Psychological and counselling interventions for female genital mutilation.

Smith H, Stein K.


Women and girls living with female genital mutilation (FGM) are more likely to experience psychological problems than women without FGM. As well as psychological support, this population may need additional care when seeking surgical interventions to correct complications of FGM. Recent WHO guidelines recommend cognitive behavioral therapy for women and girls experiencing anxiety disorders, depression, or post-traumatic stress disorder. The guidelines also suggest that preoperative counselling for deinfibulation, and psychological support alongside surgical interventions, can help women manage the physiological and psychological changes following surgery. This synthesis summarizes evidence on women’s values and preferences, and the context and conditions that may be required to provide psychological and counselling interventions. Understanding women’s views, their own ways of coping, as well social and cultural factors that influence women’s mental well-being, may help identify the types of interventions this population needs at different times and stages of their lives.

This article is available in this LINK

Archives Blog Original research

When cultures collide: female genital cutting and U.S. obstetric practice.

Obstet Gynecol. 2009 Apr;113(4):931-4. doi: 10.1097/AOG.0b013e3181998ed3.

When cultures collide: female genital cutting and U.S. obstetric practice.

Rosenberg LB, Gibson K, Shulman JF.

Mount Sinai School of Medicine, Department of Obstetrics, Gynecology & Reproductive Science, The Mount Sinai Medical Center, New York, New York, USA.


CASE: A 28-year-old primigravida at 41 weeks of gestation, previously unregistered, presented to a tertiary care Labor and Delivery unit reporting painful uterine contractions 7 minutes apart. The patient, a recent immigrant from a Northeastern African country, was accompanied by her extended family. She promptly disclosed that as a 10-year-old she underwent genital cutting in her country of origin.

Physical examination revealed the results of Type III female circumcision, or total removal of the clitoris and labia minora, and infibulation, or sewing together, of the labia majora. The prepuce and body of the clitoris were completely absent. In addition, the external urethral orifice was not visible due to extensive scar tissue overlying the infibulation. The scar tissue was pale gray, avascular, and extended almost the entire length of the labia majora, leaving a relatively small opening. As active labor continued, it became clear that the constricted opening would not allow for fetal descent. The obstetrician in attendance subsequently performed a midline episiotomy through the perineal body. A healthy male neonate was delivered. During the postpartum examination, the obstetrician identified extensive lacerations as well as an almost total separation of the previously fused labia majora.

The obstetrician explained the reasoning for midline episiotomy repair to the patient and her sister, who was continuously at the bedside. The obstetrician also informed the patient that the infibulation separated. As the obstetrician began repairing the internal lacerations, the patient insisted that the labia majora be sewed back together (reinfibulation). Although the obstetrician explained the risks of poor wound healing and infection from suturing a devascularized tissue plane, the sister emphasized the importance of infibulation in their culture and the need to have the circumcised anatomy restored. After careful consideration, the obstetrician performed a repair of the lacerated tissue, including a partial reinfibulation.

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