University College London, UK.
Trauma Violence Abuse. 2024 Oct;25(4):2891-2906. doi: 10.1177/15248380241229744. Epub 2024 Feb 16.
Female genital mutilation (FGM) is a harmful practice that has long-lasting negative impacts on the physical and psychological health of victims. Deemed a global concern, this practice persists in high-income countries (HIC) among certain migrant communities. Given the deleterious effects of the practice, we conducted an updated systematic review of the facilitators and barriers associated with the prevention of FGM in HIC.
A systematic review of published qualitative studies of FGM in HIC was conducted from 2012 to 2022. The search resulted in 276 studies. Of these, the majority were from low- and middle-income countries (LMIC) and excluded. A total of 14 studies were deemed fit for inclusion and none were excluded during quality appraisal. Relevant data were extracted from the studies and thematically analyzed to identify prevalent themes.
A total of 12 themes were identified and the majority reflected barriers to the prevention of FGM including beliefs about female virtue, beliefs about social sanctions, and the preservation of culture, among others. Facilitators to the prevention of FGM were fewer and included memory and trauma from experiencing FGM, knowledge and awareness of the female anatomy, and legislative protection from FGM due to migration. A few themes, such as religious beliefs, acted as both facilitators and barriers.
Findings highlight the importance of shared cultural and social threads among FGM practicing communities in HIC. Interventions can use these findings to guide the development of sociocultural strategies centered on community-level prevention and reduction of FGM in HIC.
女性外阴残割（FGM）是一种有害做法，对受害者的身心健康会产生长期的负面影响。这种做法被认为是一个全球性问题，在某些移民群体中，高收入国家（HIC）也存在这种做法。鉴于这种做法的有害影响，我们对 HIC 中与预防 FGM 相关的促进因素和障碍进行了更新的系统评价。
对 2012 年至 2022 年 HIC 中 FGM 的已发表定性研究进行了系统评价。搜索结果产生了 276 项研究。其中，大多数来自中低收入国家（LMIC）并被排除在外。共有 14 项研究被认为适合纳入，在质量评估过程中没有排除任何研究。从研究中提取相关数据并进行主题分析，以确定普遍存在的主题。
确定了总共 12 个主题，其中大多数反映了预防 FGM 的障碍，包括对女性贞操的信念、对社会制裁的信念以及对文化的保护等。预防 FGM 的促进因素较少，包括经历 FGM 的记忆和创伤、对女性解剖结构的了解和认识，以及因移民而免受 FGM 的立法保护。一些主题，如宗教信仰，既是促进因素也是障碍。
研究结果强调了 HIC 中从事 FGM 实践的社区之间共享文化和社会联系的重要性。干预措施可以利用这些发现来指导以社区为基础的预防和减少 HIC 中 FGM 的社会文化战略的制定。
