Psycho-sexual health of FGM survivors

How does FGM affect mental health and wellbeing?

Health is defined by the World Health Organisation (WHO) as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” (WHO, 2018) The WHO also underlines that being exposed to traumatic events during childhood has a crucial importance on mental well-being. It defines mental health as follows:
“A state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community. With respect to children, an emphasis is placed on the developmental aspects, for instance, having a positive sense of identity, the ability to manage thoughts, emotions, as well as to build social relationships, and the aptitude to learn and to acquire an education, ultimately enabling their full active participation in society” (WHO, 2018, p.7)

In studies on the links between FGM and mental health, women having undergone type I and type II FGM and those having undergone type III (infibulation), are often distinguished. WHO includes consequences on mental health and well-being in “FGM sanitary risks” and identify within the psychological risks post-traumatic stress disorder (PTSD), anxious disorders and depression (WHO, 2018).

In 2018, in it’s guidelines on the management of health complications from FGM (WHO, 2018) as well as in it’s clinical guideline (GAMS Belgium, 2020), the WHO emphasized the importance of adopting a holistic approach and bringing psychological support to women in need.

Furthermore, the scarce development of mental health system and psychological support in some countries, above all in Africa, have imposed an important limit to our research and explain why our data and analysis focus more on Europe. Indeed, more studies, therapies and solutions are developed in Europe and the situation is very different in Africa where it is harder to find services and reports on this matter.

The purpose of this thematic note is to discuss the psychological consequences of FGM, present the current solutions and highlight what is at stake. If it is possible to identify psychological consequences directly linked to FGM, it is crucial to understand this event in the larger context of a women’s life path and a broader social, cultural, economic context which also influences mental well-being. This dimension has to be integrated into solutions put in place and / or recommended to cover FGMs psychological complications and resolve a main issue, namely (re)construct a positive self-image and (re)connect with others. Finally, there is still much to be done to enhance psychological support to women and girls affected by FGM and to offer them support which is adapted to their needs.