Why the U.S. needs to be Concerned About Female Genital Cutting and What is Needed to Stop this Practice

Heather Sipsma, Associate Research Scientist, GHLI

More than 100 million girls and women worldwide have undergone female genital cutting (FGC, also known as “female circumcision”), and more than 3 million female infants and children worldwide are at risk for this procedure annually. FGC is strongly rooted in tradition, culture and religion, and puts young girls and women at risk for extreme pain and infection, as well as other reproductive health and psychological consequences and even death.

In a recent study published in the Bulletin of the WHO, GHLI researchers examined the practice of FGC across 10 countries in West Africa. The prevalence of FGC was high overall but varied across countries -- ranging from 94% in Sierra Leone to less than 3% in Niger. Older age and being Muslim were associated with increased odds of FGC, and higher education was linked with lower odds of FGC. The association between FGC and wealth varied considerably.

Based on data from countries included in the study where the FGC is on the decline, we found four necessary components to effectively reduce FGC practice and support, including 1) community education and awareness, 2) the use of prominent groups to champion the cause, 3) the support of FGC practitioners such as nurses, midwives, and traditional healers, and 4) enforced legislation. Successful community strategies have been documented, including circumcision-free rite-of-passage ceremonies and collective declarations in which villages pledge not to circumcise their daughters. Furthermore, community education and awareness can enable and facilitate affected communities to promote positive attitudes towards discontinuing the practice. Concerted and multifaceted commitments allow for the preservation of a community’s cultural heritage and social values while sustaining attitude shifts away from FGC.

We believe our findings will benefit clinicians and researchers in the US in two important ways: 1) in light of significant migration to the US from West Africa, it is important for US-based physicians and researchers to recognize the potential prevalence of FGC among immigrant groups; and 2) increasing interest in global health means that growing numbers of US physicians travel abroad, therefore, awareness of the FGC practices across cultural contexts can enhance the physicians’ preparation for and effectiveness in international settings.

Future work includes continuing to promote the awareness of FGC both in the U. S. and abroad and providing data for advocacy groups working to prevent FGC in practicing communities.