Comment on: “Health outcomes and female genital mutilation/cutting: how much is due to the cutting itself?”

Essén, Birgitta

doi:10.1038/s41443-023-00667-8

Cited by 4 publications

(5 citation statements)

References 20 publications

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“…So are medical and sexual health consequences (PPAN, 2012 ). It is notable, however, that the question about health outcomes related to FGC is not as intuitive as it might seem from the “standard tale” (see, e.g., Essén, 2023 ). Systematic reviews on health outcomes show that FGC is associated with some health consequences, with type III cutting being associated with more health and sexual complications than type I and II cuttings (Berg et al, 2014 ; Lurie et al, 2020 ; Sylla et al, 2020 ; Johnson-Agbakwu et al, 2023 ).…”

Section: Narratives About Female Genital Cuttingmentioning

confidence: 99%

“…This is probably not a result of all FGC being free of harm but reflects the challenges in conducting methodologically and conceptually sound research on the matter (e.g., representative sampling, adequate control group, accounting for the diversity of FGC practices, using tools that account for local meanings of FGC and capture the complex interplay among culture, health, and sexuality). Despite these reservations regarding existing studies, assertions about long-term health consequences are often presented as “facts” in the standard tale (Essén and Mosselmans, 2021 ; Essén, 2023 ).…”

Section: Narratives About Female Genital Cuttingmentioning

confidence: 99%

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The relationship between dominant Western discourse and personal narratives of female genital cutting: exploring storytelling among Swedish-Somali girls and women

et al. 2023

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IntroductionA dominant narrative, referred to as “the standard tale,” prevails in popular representations about female genital cutting (FGC) that often contrast with how cut women traditionally narrate their FGC experience as meaningful in contexts where FGC is customary. However, scholarship has increasingly highlighted how global eradication campaigns and migration to countries where FGC is stigmatized provide women with new frames of understanding which may lead to a reformulation of previous experiences. This article subjects the storytelling itself to analysis and explores how participants narrate and make sense of their FGC experience in a post-migration setting where FGC is stigmatized.MethodsSemi-structured focus groups (9) and individual interviews (12) with Swedish-Somali girls and women (53) were conducted.ResultsThe article highlights how the participants navigate their storying in relation to "the standard tale" of FGC in their efforts to make sense of their experiences. Navigation was conducted both at an intrapersonal level through continuous identity work, and in relation to the social context in interpersonal encounters, i.e., with service providers and others, among whom the standard tale has become a truth.DiscussionThe article places the analysis within broader discussions about anti-FGC work and considers the implications in relation to efforts to end FGC.

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Section: Narratives About Female Genital Cuttingmentioning

confidence: 99%

Section: Narratives About Female Genital Cuttingmentioning

confidence: 99%

The relationship between dominant Western discourse and personal narratives of female genital cutting: exploring storytelling among Swedish-Somali girls and women

et al. 2023

Self Cite

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“…If there is a difference in health risks currently, this may largely be due to the fact that one set of procedures is illegal in many countries (and so cannot be done openly in a medically controlled way), while the other is not (and so can be done in a relatively safe manner) [77]. As an additional consideration, the question of whether certain negative health outcomes, commonly associated with "ritual" female GGMs, are in fact causally attributable to the cutting itself, as opposed to other factors (e.g., discrimination in healthcare or other settings), is a matter of ongoing debate among experts, as seen in this issue [78][79][80].…”

Section: Two Types Of Female Genital Modification-or Two Perceivedmentioning

confidence: 99%

Child genital cutting and surgery across cultures, sex, and gender. Part 2: assessing consent and medical necessity in “endosex” modifications

Earp

Abdulcadir

Liao³

2023

Int J Impot Res

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“…So are medical and sexual health consequences . It is notable, however, that the question about health outcomes related to FGC is not as intuitive as it might seem from the "standard tale" (see, e.g., Essén, 2023). Systematic reviews on health outcomes show that FGC is associated with some health consequences, with type III cutting being associated with more health and sexual complications than type I and II cuttings (Berg et al, 2014;.…”

Section: Introductionmentioning

confidence: 99%

“…This is probably not a result of all FGC being free of harm but reflects the challenges in conducting methodologically and conceptually sound research on the matter (e.g., representative sampling, adequate control group, accounting for the diversity of FGC practices, using tools that account for local meanings of FGC and capture the complex interplay among culture, health, and sexuality). Despite these reservations regarding existing studies, assertions about longterm health consequences are often presented as "facts" in the standard tale Essén, 2023).…”

Section: Introductionmentioning

confidence: 99%

Navigating Conflicting Norms on Body and Sexuality: Exploring Swedish-Somali Women's and Swedish Welfare Workers' Perceptions of Female Genital Cutting

Palm

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Female genital cutting (FGC), sometimes referred to as female genital mutilation, is the subject of intense debate, exposing tensions between varying cultural values about bodies and sexuality. In Sweden, FGC is framed as a social problem designed to control female sexuality, and national efforts have long aimed to prevent it from being perpetuated. Welfare workers have a key role in interpreting and implementing FGC politics, making the welfare encounter a site where sometimes divergent cultural understandings about FGC, bodies, and sexuality converge. In this thesis, I explore how sexuality and sexual health are constructed in relation to FGC through welfare work and from the perspectives of different generations of Somali women in the Swedish setting of immigration. Based on individual interviews (16) and focus groups (3) with welfare workers (24) in social care, healthcare, and education, I investigate how FGC, sexuality, and sexual health, is approached in counseling and information targeting young women potentially affected by FGC. Through individual interviews (12) and focus groups (9) with Swedish-Somali women of different generations (53), I examine how women relate to and make sense of their own FGC experiences in light of changing social norms and discourse of FGC post-migration to Sweden. I discuss how concepts of FGC, body, sexuality, and sexual health are navigated and negotiated by investigating meanings ascribed to FGC by the various actors. I also consider the ways in which the understandings of these notions are changing depending on a complex interchange between individual experience, social interaction, and global discourse on FGC. The thesis consists of four papers. The first two papers explore the complexity of how to counsel and address FGC in welfare encounters while having a difficult dual role – working to protect future generations from the practice, while simultaneously encouraging and empowering those for whom it has already been done, without undermining body image or sense of sexual capacity. The first paper found that a key problem is the over-reliance on medical models of sexuality that tend to result in a reductionist focus on the genitals for sexual function, perhaps under-emphasizing the role of the mind, emotions, and sociocultural factors. This approach often led welfare workers to conclude that FGC inevitably negatively interferes with sexuality and sexual health. It was also primarily within a biomedical discourse that solutions and strategies to promote young women’s sexual wellbeing were sought. The second paper investigate how welfare workers understand and respond to health discourse about FGC, using counseling on menstrual pain as an empirical example. The study found that welfare workers navigate their various sources of knowledge, where acquired FGC-knowledge worked as a lens through which young women’s situations were understood. Medical discourse, and menstrual pain in particular, was also used as a starting point for discussing drawbacks of FGC, in order to deter young women from forwarding the practices to future generations. The third paper highlights how women navigate dominating discourse of FGC in their efforts to make sense of their experiences. The study found that imageries and dominant framings of FGC affect how women are perceived by others, or how they expect others to perceive them, also affecting women’s selfunderstanding. Women “talked back” to and talked through expected categorizations and elements of dominant discourse that put women with FGC in a stigmatized position. Doing this, they reinforced categorizations of the most extensive form of FGC (type III, pharaonic cutting) as stigmatized and harmful, while less extensive forms of FGC (type I-II, IV, sunna cutting) were disconnected from some of the stigma attached to FGC. The fourth paper examines subjective experiences and perceptions of sexuality in relation to FGC. The study found that while FGC has been seen as a means to mold a tempered female sexuality in line with cultural standards for proper gendered behavior, both gender standards and means to achieve them have changed under influence of migration and global FGC politics. The findings suggest that while premarital virginity remains as an important value, the external regulation of sexuality through FGC to protect female chastity has been replaced by increased emphasis on inner control and self-discipline. Women disqualified previous rationales for the practice by unsettling the connection of FGC to reduced sexual responsiveness. Many described sexual responsiveness as inherent and not necessarily adversely affected by FGC, although experiences varied. While most expressed positive expectations on sexual desire and pleasure, emerging was also more mixed understandings among some older and younger women. These were associated with notions of the clitoris as significant for sexual responsiveness, causing women to question their bodily and sexual adequacy. Such understandings shall be seen in light of previous cultural ideas about FGC as contributing to reduced sexual responsiveness, which is reinforced in the Swedish context which emphasizes the negative impact of FGC on sexuality. In conclusion, this thesis sheds light on the complex nature of FGC in a context of immigration, particularly highlighting FGC in relation to individual care and counseling in welfare encounters. In Sweden, FGC is framed as a social problem, shaping how women with FGC are perceived and understand themselves. Welfare workers predominantly address FGC from a health perspective, often adopting a genital reductionist approach. Medical discourse plays a dual role: empowering women through knowledge while also exerting control over their bodies, drawing boundaries of some bodies as normal, and others as pathological. Interviews with Somali women shed light on their interactions with FGCconstructs in the Swedish context, illustrating a complex interplay of sociocultural, individual, and global influences.

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Comment on: “Health outcomes and female genital mutilation/cutting: how much is due to the cutting itself?”

Cited by 4 publications

References 20 publications

The relationship between dominant Western discourse and personal narratives of female genital cutting: exploring storytelling among Swedish-Somali girls and women

The relationship between dominant Western discourse and personal narratives of female genital cutting: exploring storytelling among Swedish-Somali girls and women

Child genital cutting and surgery across cultures, sex, and gender. Part 2: assessing consent and medical necessity in “endosex” modifications

Navigating Conflicting Norms on Body and Sexuality: Exploring Swedish-Somali Women's and Swedish Welfare Workers' Perceptions of Female Genital Cutting

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