Department of Gynaecology and Obstetrics, University Hospital Maggiore Della Carità, Corso Mazzini, 18, 28100, Novara, Italy.
School of Gynaecology and Obstetrics, University of Eastern Piedmont, Novara, Italy.
Arch Gynecol Obstet. 2023 Oct;308(4):1067-1074. doi: 10.1007/s00404-023-06929-6. Epub 2023 Jan 27.
Female genital mutilation/cutting (FGM/C or FGM) are procedures that involve partial or total removal of external female genitalia and other injuries to the female genital organs for non-medical reasons. Over 4 million girls are at risk of FGM annually. Since urogynecologic and obstetric complications of FGM have been extensively described and characterized, the aim of this review is to shift the focus on other aspects like perception of women, awareness of community, and knowledge of health workers. Our purpose is to highlight those aspects and understand how their grasp might help to eradicate this practice.
Self-perception of women with FGM changes when they emigrate to western countries; awareness of complications and awareness of their rights are factors that make women reject the practice. Women from rural areas, already circumcised, or without a secondary level education are more likely to have a circumcised daughter. Women with at least a secondary education are more likely to agree with the eradication of the practice. Lack of education and poor wealth index are factors associated with men's support of FGM. Although aware of FGM, healthcare professionals need to be trained on this topic. General practitioners play a central role in addressing patients with FGM to the right path of diagnosis and treatment and psychologists in helping them with psychological sequelae.
These findings point out the future area of intervention, stressing the need of higher standard of care and global effort to eradicate this practice.
女性外阴残割(FGM/C 或 FGM)是指出于非医学原因部分或全部切除女性外生殖器和其他女性生殖器官的创伤。每年有超过 400 万女孩面临 FGM 的风险。由于 FGM 的尿生殖妇科和产科并发症已经得到了广泛的描述和特征化,本综述的目的是将重点转移到其他方面,如女性的感知、社区的意识和卫生工作者的知识。我们的目的是强调这些方面,并了解其掌握程度如何有助于消除这种做法。
已经移民到西方国家的女性,对 FGM 的自我认知会发生变化;对并发症的认识和对自身权利的认识是女性拒绝这种做法的因素。来自农村地区、已经接受过割礼的或没有接受过中等教育的女性更有可能让女儿接受割礼。接受过中等教育的女性更有可能同意消除这种做法。教育程度低和贫困指数差是与男性支持 FGM 相关的因素。尽管了解 FGM,但卫生保健专业人员仍需要接受这一主题的培训。全科医生在引导接受过 FGM 的患者进行正确的诊断和治疗方面发挥着核心作用,心理学家在帮助他们处理心理后遗症方面也发挥着重要作用。
这些发现指出了未来的干预领域,强调需要提高护理标准和全球努力来消除这种做法。