Addressing female genital mutilation in Europe: a scoping review of approaches to participation, prevention, protection, and provision of services

Abstract

BackgroundPublic and policy attention to female genital mutilation (FGM) in diaspora communities has increased in Europe, but research remains limited and misinformation abounds. As a first step to addressing these issues, this study explored FGM prevention and response interventions in Europe, using a scoping literature review and key informant interviews.MethodsA scoping study design was selected, using Arksey and O’Malley’s six-stage scoping framework to review identified sources. Key informant interviews were used to inform and add depth to literature findings. Findings were summarised thematically, guided by the Scottish Government’s ‘4Ps’ framework for tackling violence against women (i.e. participation, prevention, protection, providing services).ResultsSeventy literature sources, of 1095 screened, plus 16 individual and 3 group interview sources were included. Several countries have developed promising interventions supporting FGM resistance and recovery. However, gaps remain including community participation, professional knowledge and linkages, and evaluation of approaches.ConclusionsThis scoping review is an initial attempt to describe available primary evidence on European initiatives responding to FGM. Further research is required to determine whether interventions are effective, while policy and practice development must be shaped and driven by the experiences, needs, and views of affected communities.

Children on the move in Europe: a narrative review of the evidence on the health risks, health needs and health policy for asylum seeking, refugee and undocumented children

“…People arriving by sea are particularly susceptible to injury and illness; a recent survey of rescue ships found that dehydration and dermatological conditions associated with poor hygiene and crowded conditions were common, as well as new and old traumatic injuries from both violence and accidents 31. The risk of female genital mutilation is high in girls from certain regions and is a recognised reason for seeking asylum 32…”

Missing from the debate? A qualitative study exploring the role of communities within interventions to address female genital mutilation in Europe

“…A qualitative study design was selected, drawing on data from a scoping literature review 21 and interviews (ie, individual and group) with Europe-based academics, legal professionals, statutory and voluntary service providers, community activists and representatives from potentially affected communities. The research question was ‘ What is the role of potentially affected diaspora communities in interventions that respond to and challenge FGM in Europe?…”

“…Individual interview participants were recruited purposively to include academics, policy-makers, police officers, NGO staff and community activists in EEA member countries with recognised FGM responses. Initially, interview participants were identified through the literature review 21 (ie, conference presenters and lead authors and other authors appearing in more than one article were invited by email). Additionally, heads of relevant government departments, NGO programme staff and community activists known for their FGM expertise related to one or more of the ‘4P’ focus areas were contacted by phone or email.…”

Sculptors of African Women’s Bodies: Forces Reshaping the Embodiment of Female Genital Cutting in the West

“…Furthermore, it is also critically important to distinguish the ethical debate surrounding genital alterations performed on minors, and consider the human right to bodily integrity and genital autonomy of all minors regardless of gender (Brussels Collaboration on Bodily Integrity, 2019; Earp, 2016bEarp, , 2020. This must be further contextualized by the sociopolitical discourse around gender and race which are pivotal to the development of truly unbiased policy (Atallah et al, 2016), failing to do so further "others" non-White migrant women's bodies (Baillot, Murray, Connelly, & Howard, 2018;Johansen, 2017).…”

“…Discomfort with genital appearance post-defibulation is further complicated by the fact that re-infibulation is criminalized throughout much of the west. In those nations where legislation does not explicitly outlaw re-infibulation, it is strongly denounced by professional organizations who admonish providers to refuse such patient requests, considering it a form of "medicalized female genital mutilation"; while concomitantly oblivious to the moral double-standard that condones female genital cosmetic surgery (FGCS) among consenting, wealthy women (Ahmadu, 2017;Baillot et al, 2018;Earp, 2016a;Johansen, Ziyada, Shell-Duncan, Kaplan, & Leyed, 2018;Perron, Senikas, Burnett, & Davis, 2020), despite the lack of long-term safety and efficacy data (Barbara et al, 2017;Magon & Alinsod, 2017;Perron et al, 2020;Serati, Salvatore, & Rizk, 2018). Since both reinfibulation and FGCS are primarily performed on consenting adults, we argue that "partial" re-infibulation/"partial" defibulation 5 should be reconsidered as FGCS rather than FGC among women with otherwise healthy sexual function and autonomy in requesting vulvar reconstructive procedures (Shahvisi & Earp, 2019).…”