Understanding the forces underpinning female genital mutilation/cutting (FGM/C) is a necessary first step to prevent the continuation of a practice that is associated with health complications and human rights violations. To this end, a systematic review of 21 studies was conducted. Based on this review, the authors reveal six key factors that underpin FGM/C: cultural tradition, sexual morals, marriageability, religion, health benefits, and male sexual enjoyment.
There were four key factors perceived to hinder FGM/C: health consequences, it is not a religious requirement, it is illegal, and the host society discourse rejects FGM/C. The results show that FGM/C appears to be a tradition in transition.
Key findings:
- In sum, the findings show that like other socially entrenched practices with benefits and sanctions anchored in a broad system of collective behavior, FGM/C derives from a complex belief set, in which reasons are at once ideological, material, and spiritual. Important factors materialise at multiple levels: intrapersonal (e.g., health consequences), interpersonal (e.g., sexual enjoyment), meso (e.g., cultural tradition), and macro level (e.g., religion, legislation). Despite the grouped presentation of factors, the mutually reinforcing connections among the conditions influencing the practice should be recognized.
- This demonstrates a migrant perspective of living in two worlds, where the multiple contexts and discourses surrounding FGM/C are negotiated and there is a cultural accommodation taking place. It also illustrates that FGM/C among exile communities is a tradition in transition with, in time, a likely transfer of relative weight to discontinuing the practice. The results are in agreement with Mackie (1996), who suggests that FGM/C as the “natural” way has become a belief trap. FGM/C is a self-enforcing belief, in which the cost of testing it has become so high that it traps people. Outside the realm of doxa, however, it seems that people are in a state of transition, which stimulates and enables them to reflect on values of home and host communities.
- The results suggest that anti-FGM/C laws and actual court cases showing the effects of the law can be used as a deterrent within the communities concerned. The relevance of continuously and consistently informing citizens about the fact that FGM/C is prohibited by law and a human rights violation is indicated. While laws in themselves are not enough, they signal expectations by a government regarding the practice and they can work in a complementary fashion with prevention strategies, such as awareness, and educational intervention approaches by creating enabling environments for change.
- Future approaches should target stakeholders at the intrapersonal through to the macro levels. What is crucial is that information, messages, and activities are tailored to their audiences. Specifically, the results show that programs can also build upon existing beliefs about detrimental consequences from FGM/C and that the practice is not a religious obligation.
- The findings indicate advantages in establishing an alliance with religious leaders, who often function as norm authorities. Health promotion professionals can also aim to modify or remove continuance factors identified, such as correcting women’s misperceptions regarding male sexual pleasure and informing community members of the greater likelihood of sexual problems with FGM/C.
- Regarding the other factors, findings showed that parents wanting their daughters to be successful in marriage and material opportunity chose the strategy of FGM/C. When migration removes pressure, and alternative options for social and economic survival other than FGM/C seem possible, parents and other community members will consider refraining from FGM/C.
Policy implications:
