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Brian D. Earp
@briandavidearp
, 3 tweets, 1 min read Read on Twitter
A. Dawson on preventing FGM/C in "high-income countries." Only 1 peer reviewed paper on efficacy of interventions; most reports are in "gray literature" (e.g., charity websites). Raising awareness seems to be main goal, focus on FGM/C being against human rights + neg. for health
Training on child protection in relation to FGM/C not conducted on a structured, nationwide basis (re: NHS in England). Studies are largely prescriptive or top-down, focused on legal moves & healthcare. Few interventions community-driven, focused on empowering individual women
"We need to improve the evidence and strengthen our evaluations ... there is a dearth of relevant evidence to inform our practice."
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Brian D. Earp
@briandavidearp
N. Van Eekert (Belgium). Strong trends toward medicalization of FGM/C. Does this help or hinder abandonment? Arguments against medicalization: risks "legitimizing" the practice ("If doctors do it, it can't be all that bad, and might be good"). Data from her study suggest that
the higher educated women in areas with high medicalization rates are more likely to NOT cut their daughter; employment, living in a richer household, mothers being involved in household decision making, also associated with less likelihood of cutting. Conclusions?
Seems that increase in medicalization can go hand in hand with the decrease of FGM/C but we don't know if that relationship is causal. Female empowerment seems to be important driver of reducing rates of FGM/C (consistent with them of wider social factors being key)
Read 3 tweets
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Brian D. Earp
@briandavidearp
D. Jacobson on qualitative research in Somali women's 'lived experience' of FGC. Many women described embarrassment at not being cut, feeling jealous of those girls that had. Theme of silence: many women had not shared their stories with anyone but their doctor. Many women said
the fathers were absent from the cutting, often angry w. the women's mothers for allowing them/encouraging them to go through the cutting process (a fairly common theme in the literature). Somali women arriving in Toronto thought all women were cut - it was "normal." But now they
felt abnormal in this new culture. Doctors responded w. shock, asking if genitals were that way "because of cancer" rather than knowledgable, sensitive approach. Another theme: experience of pain, may be context-dependent, not always noticed before migration (cc @LCHeathcote)
Read 3 tweets
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Brian D. Earp
@briandavidearp
G. Heinrichs reporting on new meta-analysis of sexual function following FGM/C. Attempted meta-regression 2 control 4 potential confounding contextual/demographic variables but there was not enough data: those factors not routinely/robustly collected in studies on sexual function
Question: is there a "dose response" w. more severe forms of FGC associated w. greater dysfunction than less severe forms? Control group score about 26 (near sexual dysfunction line on FSFI!); in Type I, score about 25, not far different; but Types II, III trend to lower scores.
Limitations: most data evidence grade is very low to moderate; not all studies had control groups; 5/17 studies did not use exam confirmation of FGM type, demographic factors not routinely collected to allow for controlling of potential confounds.
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