Reman Tara, Balligand Valerie, Schoefs Benoit, Feipel Veronique, Bertuit Jeanne
School of Health Sciences (HESAV), Lausanne, Switzerland.
Laboratory of Functional Anatomy, Faculty of Medicine, Université Libre de Bruxelles, Brussel, Belgium.
S Afr J Physiother. 2023 Jul 7;79(1):1877. doi: 10.4102/sajp.v79i1.1877. eCollection 2023.
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.
To evaluate the psychological impact of FGM/C and how victims experience it.
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.
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.
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.
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.
女性生殖器切割（FGM/C）被定义为“出于非医疗原因，涉及部分或全部切除女性外生殖器或对女性生殖器官造成其他伤害的所有手术”，这是一种对女性健康有多种影响的文化习俗。医学和性方面的后果已有记录，但FGM/C与心理症状发展之间的联系尚未明确确立。对背景因素的影响了解甚少。
评估FGM/C的心理影响以及受害者的体验方式。
进行了一项混合方法的系统评价。纳入标准为涉及接受过FGM/C且有心理症状的女性的观察性原发性研究。使用混合方法评估工具评估发表偏倚。采用了一种配置性策略，包括对定量和定性数据进行比较，然后分析FGM/C与诱发的心理障碍之间的因果关系。
纳入了14项研究。与未受切割的女性相比，经历过FGM/C的女性中创伤后应激障碍（PTSD）、抑郁、焦虑和躯体化症状的患病率显著更高。II型或III型女性生殖器切割被确定为疾病严重程度的预测因素。定性研究表明，移民女性和非移民女性对FGM/C的认知存在显著差异，以及影响疾病发作的因素具有多维度性质。
我们的研究表明，FGM/C（及其严重程度）与PTSD、抑郁、焦虑和躯体化等心理障碍高度相关。它还说明了背景因素，包括可能影响这些心理障碍强度的社会文化因素。
卫生专业人员必须意识到FGM/C的心理后果以及影响对FGM/C认知的不同因素。事实上，由于卫生专业人员的不当行为，可能会在患者中引发一种“异常”的感觉。
