Medical narrative and religious norm driving cut type and medicalization changes in female genital mutilation/cutting in Somaliland

Abstract

The authors’ aim was to examine if the nature of female genital mutilation/cutting (FGM/C) in Somaliland is changing and any contributing factors. In this mixed method qualitative study the researchers used 24 focus groups, 20 key informant interviews and 28 in-depth interviews with multiple stakeholders. We found a shift from the pharaonic to Sunna cut, an age decrease at which FGM/C is performed and an increase in its medicalization. Shift in cut type and medicalization appears to be partly a response to the medical narrative of anti-FGM/C campaigns, partly an intertwining of messaging regarding health risks and religious norms. We recommend a need to consider programs that reflect upon the utility and appropriateness of moving the dominant narrative to issues around the right to bodily integrity and bodily autonomy, and melding that messaging with the Islamic discourse on protecting health that focuses on collective welfare.

Disclosure statement

The funder played no role in the preparation of the article nor in the study design, the collection, analysis and interpretation of the data, the writing of the report and the decision to submit the article for publication.

Data availability statement

The datasets generated and analyzed during this study are available from the Population Council upon reasonable request.

Ethical approval

Ethical approval was obtained from the Population Council’s Institutional Review Board (Ref: Protocol 775) and Somaliland’s Ministry of Labor and Social Affairs (Ref: W/SH/AB/02/28/016).

Notes

1 First, a move from Type II or III toward Type I or IV cuts, in which the skin around the genitals is ‘nicked’ rather than deeply cut or removed, resulting in a drawing blood so the family and girl can declare she has undergone FGM/C, and with a reduced likelihood of immediate or long-term health complications; second, a shift from infibulation to a more vaguely defined ‘Sunna’ cut among Muslim populations, that could constitute Types I, II or IV nicking.

2 The community generally uses the term “Gudninka gabdhaha” (i.e. female circumcision), which was translated as FGM/C; some used the abbreviation of FGM.

Additional information

Funding

The study was funded by UK Aid from the UK Government under the DFID research project “Evidence to End FGM/C: Research to Help Girls and Women Thrive”, which is coordinated by the Population Council. All content is the sole responsibility of the authors and does not represent the opinions of the UK Government or the Population Council. We thank all who participated in this study and shared their feelings, views and experiences.