The medicalisation of female genital cutting: Harm reduction or social norm?

Eekert, Nina Van; Buffel, Veerle; Bruyn, Sara De; Velde, Sarah Van de

doi:10.1111/1467-9566.13153

Cited by 6 publications

(3 citation statements)

References 28 publications

(46 reference statements)

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“…WHO and UNICEF have called for the end of medicalization of FGM/C [ 139 , 140 ]. Discussions around the medicalization of FGM/C are beyond the scope of this study, but this has been discussed elsewhere [ 141 , 142 ].…”

Section: Discussionmentioning

confidence: 99%

The global prevalence of female genital mutilation/cutting: A systematic review and meta-analysis of national, regional, facility, and school-based studies

et al. 2022

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Background Female genital mutilation/cutting (FGM/C) is a nonmedical procedure entailing the modification of the external female genitalia. A description of the prevalence and distribution of FGM/C allows the tracking of progress toward ending FGM/C by 2030 (Sustainable Development Goal (SDG): target 5.3). This systematic review aimed to examine FGM/C prevalence and types, by World Health Organization (WHO) region and country. Methods and findings A systematic search using Medical Subject Headings (MeSH) and keywords from 2009 to March 24, 2022 was undertaken in MEDLINE, PubMED, PsycINFO, Web of Science, and Embase to identify studies presenting FGM/C prevalence. Abstract and full-text screening, quality assessment, and data extraction were undertaken by 2 reviewers. Only nationally representative studies were included in the meta-analysis. Pooled FGM/C prevalence was estimated by random-effects meta-analysis using generalized linear mixed models (GLMMs). FGM/C prevalence with 95% confidence intervals (CIs), prediction intervals (PIs), and FGM/C type were presented separately by women aged 15 to 49 years and girls aged 0 to 14 years. A total of 163 studies met the inclusion criteria and 30 were included in the meta-analysis, of which 23 were from the WHO African Region (AFR), 6 from the Eastern Mediterranean Region (EMR), and 1 from the South East Asian Region (SEAR). These studies included data from 406,068 women across 30 countries and 296,267 girls across 25 countries; the pooled prevalence estimate of FGM/C among women aged 15 to 49 years was 36.9% (95% CI: 19.6% to 58.3%; PI: 0.4% to 99.0%), and 8.27% (95% CI: 3.7% to 17.3%; PI: 0.1% to 89.3%) among girls aged 0 to 14 years. Among included countries, this gave a total estimated prevalence of 84,650,032 women (95% CI: 45,009,041 to 133,834,224) and 13,734,845 girls with FGM/C (95% CI: 6,211,405 to 28,731,901). Somalia had the highest FGM/C prevalence among women (99.2%), and Mali had the highest among girls (72.7%). The most common type of FGM/C among women was “flesh removed” (Type I or II) in 19 countries. Among girls, “not sewn closed” (Type I, II, or IV) and “flesh removed” (Type I or II) were the most common types in 8 countries, respectively. Among repeated nationally representative studies, FGM/C decreased for both women and girls in 26 countries. The main limitation of the study methodology is that estimates were based on available published data, which may not reflect the actual global prevalence of FGM/C. Conclusions In this study, we observed large variation in FGM/C prevalence between countries, and the prevalence appears to be declining in many countries, which is encouraging as it minimizes physical and physiological harm for a future generation of women. This prevalence estimate is lower than the actual global prevalence of FGM/C due to data gaps, noncomparable denominators, and unavailable surveys. Yet, considerable policy and community-level interventions are required in many countries to meet the SDG target 5.3. Trial registration Registration: CRD42020186937.

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Section: Discussionmentioning

confidence: 99%

The global prevalence of female genital mutilation/cutting: A systematic review and meta-analysis of national, regional, facility, and school-based studies

et al. 2022

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“…Medicalization is not inevitable, as cases of resistance demonstrate (e.g., to ADHD diagnosis and treatment; Conrad and Bergey 2014). Nor is it uncommon for it to engender controversy, regarding factors such as the nature and scope of medical practice, tensions about universalism, and questions of disparities in patterns of diagnosis and treatment (Bergey et al 2022; Singh et al 2013; VanEekert et al 2021). Additionally, although the term does not imply normativity, medicalization (or demedicalization) can have positive or negative implications for those affected, the professions and industries involved in assessment and intervention, and the health care system more generally.…”

Section: Introductionmentioning

confidence: 99%

“Pills Don’t Teach Skills”: ADHD Coaching, Identity Work, and the Push toward the Liminal Medicalization of ADHD

Bergey

2024

J Health Soc Behav

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Despite physicians’ near monopoly over medicalization historically, various stakeholder groups shape an increasingly complex process today. This study examines a relatively new initiative, “health coaching,” within the context of the changing nature of medicalization. Utilizing 51 in-depth interviews with attention deficit hyperactivity disorder (ADHD) coaches, participant observation from seven ADHD symposia, and ADHD coach publications, I examine coaching’s emergence as a partial challenge to medicalization. Findings reveal a field comprised mainly of individuals personally affected by ADHD whose dissatisfaction with institutionalized framings and practices underpins a push for liminal medicalization. Members move between medical and nonmedical discourses to frame ADHD as a paradox of pathology and gift. Additionally, they leverage and commodify personal experience alongside institutional and alternative knowledge into an adjunct or substitute to medication and potential challenge to therapy—one aimed at “self-actualization” versus “treatment.” Such efforts highlight (de)medicalization’s dimensionality, simultaneous medicalization and demedicalization, and a lay-driven enterprise’s role in such processes.

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“…Yet, the opposite occurs in Egypt where medicalization of FGM/C was high despite its ban [55]. WHO and UNICEF have called for the end of medicalization of FGM/C [142, 143].Discussions around the medicalisation of FGM/C are beyond the scope of this study but this has been discussed elsewhere[142,144,145].…”

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confidence: 99%

The global prevalence of female genital mutilation/cutting: A systematic review and meta-analysis of national, regional, facility and school-based studies

Farouki

El-Dirani

Abdulrahim

et al. 2022

Preprint

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Background: Female Genital Mutilation/Cutting (FGM/C) is a non-medical procedure entailing the modification of the external female genitalia. The Sustainable Development Goals aim to end FGM/C by 2030. This systematic review aimed to examine FGM/C prevalence and types, by World Health Organization (WHO) region and country. Methods and Findings: A systematic search using MeSH headings and keywords from inception to March 2, 2020 was undertaken in MEDLINE, PsycINFO, Web of Science, and Embase to identify studies presenting FGM/C prevalence. Abstract and full-text screening, quality assessment, and data extraction were undertaken by two reviewers. Only nationally representative studies were included in the meta-analysis. Pooled FGM/C prevalence was estimated by meta-analysis using random effects models. FGM/C prevalence and types were presented separately by women aged 15-49 and girls aged 0-14. 3,205 articles were identified. 135 met the inclusion criteria and 28 were included in the meta-analysis. Across 27 countries, the pooled prevalence estimate of FGM/C in women aged 15-49 was 40% (95% CI: 26-55%; I2 =100%), and 15% (95% CI: 10-21%; I2 =100%) in girls aged 0-14 across 34 countries. The country with the highest FGM/C prevalence in women was Guinea (97%) and the lowest, Uganda (0.3%). The highest prevalence in girls was in Mali (77%), and the lowest in Ghana (0%). The most common category of FGM/C was flesh removed at 69% (women) and 70% (girls). Limitations include that studies had heterogeneous terminology and relied on recall. Conclusions: There is large variation in FGM/C prevalence, and the lower prevalence in the current generation of girls is encouraging. However, considerable policy and community-level interventions are required to meet the SDG. Future research should consider collecting data on the 15-19 age group in order to accurately assess generational differences in FGM prevalence. The study protocol is available: https://osf.io/ema9j/.

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The medicalisation of female genital cutting: Harm reduction or social norm?

Abstract: Today, female genital cutting is increasingly practised by trained healthcare providers. While opposition to medicalised female genital cutting (FGC) is strong, little is known about the underlying motivation for this medicalisation trend in practising communities. We formulated three

Cited by 6 publications

References 28 publications

The global prevalence of female genital mutilation/cutting: A systematic review and meta-analysis of national, regional, facility, and school-based studies

The global prevalence of female genital mutilation/cutting: A systematic review and meta-analysis of national, regional, facility, and school-based studies

“Pills Don’t Teach Skills”: ADHD Coaching, Identity Work, and the Push toward the Liminal Medicalization of ADHD

The global prevalence of female genital mutilation/cutting: A systematic review and meta-analysis of national, regional, facility and school-based studies

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