An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.
Medical complications of female genital mutilation
Epstein D, Graham P, & Rimsza M
More than 130 million women are subjected to genital mutilation. Despite increasing efforts to reduce the practice, there are many obstacles to eliminating this 2,000-year-old practice, which is based on strong cultural traditions. As college health clinicians provide care to more international students from countries where female genital mutilation is performed, increased awareness and knowledge of the procedure will enable clinicians to understand and manage its complications. We report a case of obstructive uropathy resulting in hydronephrosis secondary to female genital mutilation and review the medical literature regarding this and other complications of genital mutilation “surgery.”
HIV/AIDS and female genital mutilation in the Somali’s nomads of eastern Ethiopia: a discussion paper.
Omar M, Mohamed K.
Institute of Health Sciences and Public Health Research, University of Leeds, United Kingdom.
Female Genital Mutilation (FGM) is widely practised among the Somali nomads in Eastern Ethiopia. It may be categorized as one of many harmful traditional practices such as uvula cutting, gum piercing, cauterization and blood letting, which are conducted by unskilled traditional healers in unhygienic conditions, and which potentially increase the risk of HIV transmission. Other factors also play a significant role in the perpetuation of the HIV/AIDS epidemic in the region, such as lack of awareness, misconception about the routes of HIV transmission and ways of prevention, the practice of polygamy, and window inheritance. Pervasive poverty and recurrent famine also fuel the epidemic. Lack of official pastoralist-specific policy and strategy on HIV and FGM further complicates the problem. This paper discusses the possible relationship in terms of health risk between HIV/AIDS and FGM in the Horn of Africa and calls for more concerted efforts, including further research in order to address this potential risk.
Behavioural and biological determinants of human sex ratio at birth.
The Galton Laboratory, Department of Genetics, Evolution and Environment, University College London, UK.
The human sex ratio SR (proportion male) at birth has been reported to vary with many variables. The explanation of this variation is not established, but I have hypothesized that it is partially caused by the hormonal concentrations of both parents around the time of conception. The present note suggests how this hypothesis might accommodate recent sex ratio findings relating to ‘psychosexual restriction’, female genital cutting, sexes of prior sibs, finger length ratios, the autism spectrum disorder, parental occupation and maternal eating disorders. Tests of such suggestions are offered, and it is hypothesized that: (a) in women, Manning’s R (the ratio of the lengths of the 2nd and 4th digits) is positively correlated with offspring sex ratio (proportion male); (b) women who have undergone female genital cutting (FGC) have high androgen levels; (c) offspring sex ratio correlates positively with ‘masculinity’ of parental occupation, the correlation being mediated by testosterone levels. It is noted that the lines of evidence for three hypotheses (James’, Manning’s and Baron-Cohen’s) are mutually supportive.
Paediatricians should resist its medicalisation Female genital mutilation is defined by the World Health Organization as any procedure that involves partial or total removal of the external genitalia or other injury to the female genital organs for non-medical reasons.1 Worldwide, 100-140 million girls and women are estimated to live with the consequences of such practices…
Genital trauma in prepubertal girls and adolescents.
Department of Obstetrics and Gynecology, Pediatric and Adolescent Gynecology, Washington University School of Medicine, Barnes Jewish Hospital, St Louis Children’s Hospital and Missouri Baptist Medical Center, St Louis, Missouri 63110, USA. firstname.lastname@example.org
PURPOSE OF REVIEW: To look critically at recent research articles that pertain to children and adolescents who present with genital injuries. RECENT FINDINGS: Emerging evidence supports links to long-term psychological sequelae of child sexual abuse. Parents should be educated to instruct their children regarding types of child abuse and prevention. ‘Medicalization’ of female genital mutilation (FGM) by health providers, including ‘cutting or pricking’, is condemned by international organizations. SUMMARY: Genital injuries whether accidental or intentional need to be reported with standardized terminology to allow for comparisons between reported outcomes. Motor vehicle accidents associated with pelvic fractures may result in bladder or urethral trauma. Adverse long-term psychosocial behaviors may be sequelae of child sexual abuse. FGM is willful damage to healthy organs for nontherapeutic reasons, and a form of violence against girls and women. Healthcare providers should counsel women suffering from the consequences of FGM, advise them to seek care, counsel them to resist reinfibulation, and prevent this procedure from being performed on their daughters.
[Psychological factors of genital automutilation and medico-ethical interest in emergency vulvoplasty]. [Article in French]
Fayad S, Srom V, Delotte J, Bafghi A, Sorci K, Bongain A.
Service de Gynécologie-Obstétrique, Reproduction et Médecine Foetale, Hôpital Archet-II, CHU de Nice-Sophia-Antipolis, BP 3079, 151, route de Saint-Antoine-de-Ginestière, 06202 Nice cedex 03, France.
The genital self-mutilation is not rare in women. Risk factors found in these cases are: mood disorders, food behavior anomalies and antecedents of sexual aggression. However, surgical repair is not done in emergency: we find no similar report to our clinical case describing an added up bilateral reduction nymphoplasty carried out in emergency after hemorrhagic genital self-mutilation. We discuss psychological risk factors, psychiatric diagnosis and optimal treatment, studied from medico-ethical point of view, for this surgical emergency.
What’s “normal”: female genital mutilation, psychology, and body image.
Department of Obstetrics and Gynecology, Oregon Health and Sciences University, USA.
Despite international efforts to halt the practice of female genital mutilation (FGM), the number of African girls and women undergoing the procedure is not declining as rapidly as international observers had hoped when the World Health Organization began focusing attention on the practice in the 1960s. This article focuses on the psychological effects of FGM through the example of a patient who had undergone the procedure in childhood and now felt that her closed appearance was “normal” and that to be opened would be “abnormal.” Western advocates must educate themselves about the various cultural forces that lead to FGM in order to help women who have undergone the procedure heal psychologically, thereby breaking the pattern of abuse from generation to generation.
[Need for more research on female circumcision. Lack of communication between women and men conserves the traditional practice]. [Article in Swedish]
Almroth L, Almroth-Berggren V, Bergström S.
Barnkliniken, Centralsjukhuset i Kristianstad. email@example.com
Several studies in cultures in which FGM is widely performed have shown an emerging questioning of the value of performing the procedure, especially among the younger generations. Traditionally the practice has been said to be carried out by women in order to satisfy men. Recent research findings, however, indicate that men may have attitudes and preferences strikingly different from what has been ascribed to them in the literature. Thus men may play an important and positive role in future work to counteract the practice. Reinfibulation after delivery implies repeated genital mutilation. Despite this, reinfibulation has attracted little research, and not very much is known about the practice. There is a need for systematic research about the extent of complications of FGM, especially long-term effects including effects on pregnancy, delivery and the newborn child. Our experiences from research on FGM in Sudan indicate that research findings might be very useful in intervention programs.
Thousands of girls in the UK are at risk of female genital mutilation. A multi-agency safeguarding group in Bristol, established after a school nurse became concerned that pupils were at risk, is preventing girls from being taken out of the country to have the procedure. It raises awareness among professionals and supports families in the Sudanese and Somalian communities to speak out against the practice.