International continence society white paper regarding female genital mutilation/cutting

Abstract

Female genital mutilation/cutting (FGM/C)—also known as Female Genital Cutting or Mutilation—is defined as the partial or total removal of the female external genitalia for non‐therapeutic reasons. This White Paper, prepared under the auspices of the International Continence Society (ICS), is intended by the ICS as a statement promoting the abandonment of this practice. The ICS also supports the respectful and evidence‐based care or treatment of women and girls already affected by FGM/C, in keeping with the World Health Organization (WHO) Guidelines on the Management of Health Complications from Female Genital Mutilation. Our members specialize in pelvic floor disorders from perspectives within a range of specialties; we encounter and treat women living with FGM/C and its consequences—particularly incontinence, infections, voiding dysfunction, sexual dysfunction, chronic pelvic pain, and obstetric trauma. Understanding the ethical, sociocultural, medical and surgical factors surrounding FGM/C is central to caring for women and girls with a history of FGM/C. The ICS voices herein state strong opposition to FGM/C. We encourage members to apply their skills to improve prevention strategies and the management of those affected.

Do No Harm? Discrepancies across Canadian Healthcare Policy and Obstetrics and Gynaecology Training for Treating Women affected by Female Genital Cutting

“…While the current studies are essential for increasing knowledge and academic literature within FGC discourse, there is still a salient gap in what has been published. With an overwhelming number of publications concerned with human rights debates, elimination and prevention efforts, and changing cultural norms, there is less information focused on: how to appropriately care for women who have already experienced female genital cutting; and, what these approaches should be for healthcare practitioners, especially those outside of high prevalence communities (Abdulcadir et al, 2015;Calvert et al, 2020;Einstein, 2008;Evans et al, 2019;Joseph & Mullen, 2021;Klein et al, 2018;Little, 2015;Lussiez et al, 2020;Marea et al, 2021;Payne et al, 2019;Shahawy & Nour, 2021;Taraldsen et al, 2021). My research aims to build on these existing studies to contribute to this knowledge gap.…”

“…Undergoing FGC has been widely reported to be traumatic due to the circumstances surrounding it, the age of the girls who go through the experience, and the issues surrounding lacking informed consent to the procedure (Adinew & Mekete, 2017;Akinsulure-Smith et al, 2018;Chu & Akinsulure-Smith, 2016;Einstein, 2008;Klein et al, 2018;Obiora et al, 2020;Obiora et al, 2021;Payne et al, 2019). Women who have undergone FGC may experience longterm physical and mental health consequences.…”

“…Women who have undergone FGC may experience longterm physical and mental health consequences. According to Payne et al (2019) "there are significant immediate and long-term risks associated with FGM/C including obstetric, neonatal, urologic, gynecologic, infectious, sexual, and psychological health consequences" (p. 857). Based on the vast array of potential health consequences, there needs to be more distinction in the medical literature on the different types of FGC, and how HCPs must be able to identify the varying physical severity of the four types along with the health consequences that may result (Earp & Johnsdotter, 2021;Ogunsiji & Ussher, 2021;Werunga et al, 2016).…”

“…Ultimately, politics and power dynamics influence this hierarchy, especially in the western context where FGC is condemned and illegal. As a result, much of the existing literature on FGC is concerned with prevention and intervention rather than treatment, especially in the context of medical professionals' roles (Bedri et al, 2019;Higginbothan, 2015;Johansen et al, 2018;Klein et al, 2018;Koukoui, 2017;Nabaneh & Muula, 2019;Ogunsiji & Ussher, 2021;Payne et al, 2019;Shell-Duncan, 2008).…”

“…One major area of the literature discusses the importance of health care providers in preventing and eliminating the practice of FGC, especially through sexual health education for women and girls (Bedri et al, 2019;Nabaneh & Muula, 2019;Ogunsiji & Ussher, 2021;Payne et al, 2019;Perron et al, 2020). HCPs are a strategic source for identifying instances of FGC in adult women along with the continued prevalence of the practice on young girls.…”