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I knew how it feels but couldn’t save my daughter; testimony of an Ethiopian mother on female genital mutilation/cutting.

FREEReprod Health. 2017 Dec 1;14(1):162. doi: 10.1186/s12978-017-0434-y.

I knew how it feels but couldn’t save my daughter; testimony of an Ethiopian mother on female genital mutilation/cutting.

Adinew YM, Mekete BT

ABSTRACT

BACKGROUND: World Health Organization defines female genital mutilation/cutting as all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons. The practice is common in Ethiopia, especially among Somali (99%) ethnic groups. Even though FGM/C is labeled illegal practice according to the revised 2005 Penal Code of the country, the practice is still responsible for misery of many girls in Ethiopia. METHODS: This personal testimony is presented using woman’s own words. Data were collected through in-depth interview with a woman at Gursum health center, Somali regional state, eastern Ethiopia on June 19/2016. The interview was conducted in a private environment and original names were changed to overcome ethical concerns. Informed written consent was obtained from the participant prior to data collection. The interview was audio-taped using a digital voice recorder, later transcribed and translated verbatim from the local language, Amharic to English. RESULTS: The study participant described a range of experiences she had during her own and her daughter’s circumcision. Three themes emerged from the woman’s description: womanhood, social pressure and stigmatization of uncircumcised women and uncertain future. CONCLUSION: Even though the national prevalence may show a decline, FGM/C is still practiced underground. Thus, anti-FGM/C interventions shall take in to account elders influence and incorporate a human rights approach rather than relying merely on the dire health consequences. Further exploration of the determinants of FGM/C on a wider scale is recommended.

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Female genital mutilation: applications of nursing theory for clinical care

Nurse Pract. 2011 Apr;36(4):45-50.

Female genital mutilation: applications of nursing theory for clinical care.

Burke E.

Female genital mutilation (FGM) is a continuing practice among some immigrant groups. As mobility increases among this population, NPs in primary care will continue to see women who have experienced FGM. NPs must gain a better understanding of the practice in order to provide optimal, culturally appropriate clinical care.

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No (wo)man is an island–the influence of physicians’ personal predisposition to labia minora appearance on their clinical decision making: a cross-sectional survey.

J Sex Med. 2011 Aug;8(8):2377-85. 2011 May 19.

No (wo)man is an island–the influence of physicians’ personal predisposition to labia minora appearance on their clinical decision making: a cross-sectional survey.

Reitsma W, Mourits MJ, Koning M, Pascal A, van der Lei B.

Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

INTRODUCTION: Physicians are increasingly presented with women requesting a labia minora reduction procedure.

AIM: To assess the influencing factor of personal predisposition in general practitioners, gynecologists, and plastic surgeons to labia minora appearance in relation to their willingness to refer for, or perform, a surgical labia minora reduction.

METHODS: Cross-sectional self-administered questionnaire survey. Between May 2009 and August 2009, 210 physicians were surveyed. Primary care: general practitioners working in the north of the Netherlands. Secondary care: gynecologists and plastic surgeons working in five hospitals in the north of the Netherlands.

MAIN OUTCOME MEASURES: A five-point Likert scale appraisal of four pictures showing a vulva, each displaying different sizes of labia minora, indicating a physician’s personal predisposition, manifesting as willingness to refer for, or perform, a labia minora reduction.

RESULTS: A total of 164/210 (78.1%) physicians completed the questionnaire, consisting of 80 general practitioners, 41 gynecologists, and 43 plastic surgeons (96 males, 68 females). Ninety percent of all physicians believe, to a certain extent, that a vulva with very small labia minora represents society’s ideal (2-5 on the Likert scale). More plastic surgeons regarded the picture with the largest labia minora as distasteful and unnatural, compared with general practitioners and gynecologists (P < 0.01), and regarded such a woman as a candidate for a labia minora reduction procedure (P < 0.001). Irrespective of the woman’s labia minora size and the absence of physical complaints, plastic surgeons were significantly more open to performing a labia minora reduction procedure than gynecologists (P < 0.001). Male physicians were more inclined to opt for a surgical reduction procedure than their female colleagues (P < 0.01).

CONCLUSIONS: The personal predisposition of physicians (taking account of their specific gender and specialty) concerning labia minora size and appearance influences their clinical decision making regarding a labia minora reduction procedure. Heightened awareness of one’s personal predisposition vis-à-vis referral and willingness to operate is needed.

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Conformity and change: community effects on female genital cutting in Kenya.

J Health Soc Behav. 2005 Jun;46(2):121-40.

Conformity and change: community effects on female genital cutting in Kenya.

Hayford SR.

Population Studies Center, University of Pennsylvania, 3718 Locust Walk, Philadelphia, PA 19104, USA. shayford@pop.upenn.edu

ABSTRACT

In this article, I analyze women’s decisions to have their daughters circumcised based on data from 7,873 women in Kenya collected in the 1998 Kenya Demographic and Health Survey. I use multilevel models to assess the degree to which women s decisions are correlated with the decisions of other women in their community, in addition to studying the effects of socioeconomic characteristics measured at both the individual and community levels. I find some support for modernization theories, which argue that economic development leads to gradual erosion of the practice of female circumcision. However, more community-level variation is explained by the convention hypothesis, which proposes that the prevalence of female circumcision will decline rapidly once parents see that a critical mass of other parents have stopped circumcising their daughters. I also find substantial variation among different ethnic groups in the pace and onset of the decline of female genital cutting.

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