Review Article

Psychological consequences of female genital mutilation: A mixed-method systematic review

Tara Reman, Valerie Balligand, Benoit Schoefs, Veronique Feipel, Jeanne Bertuit
South African Journal of Physiotherapy | Vol 79, No 1 | a1877 | DOI: https://doi.org/10.4102/sajp.v79i1.1877 | © 2023 Tara Reman, Valerie Balligand, Benoit Schoefs, Veronique Feipel, Jeanne Bertuit | This work is licensed under CC Attribution 4.0
Submitted: 30 January 2023 | Published: 07 July 2023

About the author(s)

Tara Reman, School of Health Sciences (HESAV), Lausanne, Switzerland; and, Laboratory of Functional Anatomy, Faculty of Medicine, Université Libre de Bruxelles, Brussel, Belgium
Valerie Balligand, Department of Health, Haute Ecole Libre de Bruxelles Ilya Prigogine, Bruxelles, Belgium
Benoit Schoefs, CHU St-Pierre, Clinique du Périnée, Brussel, Belgium
Veronique Feipel, Laboratory of Functional Anatomy, Faculty of Medicine, Université Libre de Bruxelles, Brussel, Belgium
Jeanne Bertuit, School of Health Sciences (HESAV), Lausanne, Switzerland

Abstract

Background: Female genital mutilation (FGM/C) defined as ‘all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons’ is a cultural practice having several consequences on women’s health. Medical and sexual consequences have been documented, but the link between FGM/C and the development of psychological symptoms is not clearly established. The influence of contextual factors is poorly understood.

Objectives: To evaluate the psychological impact of FGM/C and how victims experience it.

Method: A mixed method systematic review was conducted. The inclusion criteria were observational primary studies involving women who had undergone FGM/C and had experienced psychological symptoms. Publication bias was assessed by using the Mixed Methods Appraisal Tool. A configurative strategy that involved a comparison of quantitative and qualitative data was used, followed by an analysis of causal link between FGM/C and induced psychological disorders.

Results: Fourteen studies were included. Post-traumatic stress disorder (PTSD), depression, anxiety and somatisation showed a significantly higher prevalence in women who have experienced FGM/C versus non-mutilated women. Female genital mutilation type II or III were identified as predictors of disorder severity. Qualitative studies showed a significant difference in the perception of FGM/C between immigrant and non-immigrant women, as well as the multidimensional nature of the factors influencing disorders’ onsets.

Conclusion: Our study showed a high association of FGM/C (and its degree of severity) with psychological disorders such as PTSD, depression, anxiety and somatisation. It also illustrates contextual factors, including socio-cultural factors that may influence the intensity of these psychological disorders.

Clinical implications: It is important for health professionals to be aware of the psychological consequences of FGM/C and the different factors influencing FGM/C perception. Indeed, a feeling of ‘Being abnormal’ can be awakened among patients because of health professionals’ incorrect behaviours.


Keywords

female genital mutilation; cutting; mental health; psychological symptoms; mixed method systematic review

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