Centre for the Study of Ethnicity and Citizenship, University of Bristol, Bristol, United Kingdom
School for Policy Studies, University of Bristol, Bristol, United Kingdom.
BMJ Open. 2020 Jun 16;10(6):e035039. doi: 10.1136/bmjopen-2019-035039.
This research documents the experiences of people with Somali heritage with female genital mutilation (FGM)-safeguarding services in healthcare and whether such services are considered appropriate by the people who encounter them.
Six focus groups conducted with ethnic Somalis living in Bristol, during the summer of 2018, divided by gender and whether people had experienced FGM-safeguarding as adults or children.Participants experienced FGM-safeguarding in primary and secondary care.
30 people (21 women and 9 men), identified through local organisations or snowball sampling. All participants were of Somali heritage and aged over 18.
Government priorities to support those who have experienced female genital cutting/mutilation (FGC/M) are being undermined by their own approaches to protect those considered at risk. Participants argued that approaches to FGM-safeguarding were based on outdated stereotypes and inaccurate evidence which encouraged health and other service providers to see every Somali parent as a potential perpetrator of FGC/M. Female participants described providers in a range of healthcare settings, including Accident and Emergency Departments (A&E), antenatal care and general practice, as 'fixated' with FGC/M, who ignored both their health needs and their experience as victims. Participants felt stigmatised and traumatised by their experience. This undermined their trust in health services, producing a reticence to seek care, treatment delays and reliance on alternative sources of care. Associated recommendations include developing more accurate evidence of risk, more appropriate education for healthcare providers and more collaborative approaches to FGM-safeguarding.
All the participants involved in this study are committed to the eradication of FGC/M. But the statutory approaches currently adopted to enable this are considered ill-conceived, unnecessarily heavy-handed and ultimately detrimental to this. Recognising these common aims can enable the development of services better able to protect and support those at risk of FGC/M in ways which are culturally competent and sensitive.
本研究记录了具有索马里血统的人在医疗保健中接受女性生殖器切割（FGM）保护服务的经历，以及遇到这些服务的人是否认为这些服务合适。
2018 年夏天，在布里斯托尔，按性别和是否有成年人或儿童经历过 FGM 保护服务，对 6 个焦点小组进行了划分。参与者在初级和二级保健中经历了 FGM 保护服务。
30 人（21 名女性和 9 名男性），通过当地组织或滚雪球抽样确定。所有参与者都有索马里血统，年龄均超过 18 岁。
政府支持那些经历过女性生殖器切割/切割（FGC/M）的人的优先事项，正在受到他们自己保护那些被认为处于危险中的人的方法的破坏。参与者认为，FGM 保护服务的方法基于过时的刻板印象和不准确的证据，这鼓励卫生和其他服务提供者将每一位索马里父母视为 FGC/M 的潜在实施者。女性参与者描述了包括急症室（A&E）、产前护理和全科医生在内的一系列医疗保健环境中的提供者，他们“专注”于 FGC/M，忽略了他们的健康需求和他们作为受害者的经历。参与者感到自己因经历而受到污名化和创伤，这破坏了他们对卫生服务的信任，导致他们不愿寻求护理、治疗延迟和依赖替代护理来源。相关建议包括开发更准确的风险证据、为卫生保健提供者提供更适当的教育以及更协作的 FGM 保护方法。
参与本研究的所有参与者都致力于消除 FGC/M。但是，目前为实现这一目标而采用的法定方法被认为考虑不周、过于强硬，最终对这一目标不利。认识到这些共同目标，可以使服务得到更好的发展，能够以文化上胜任和敏感的方式保护和支持那些面临 FGC/M 风险的人。
