PSYCHO-SEXUAL HEALTH

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.” (OMS, 2018) The WHO also underlines that being exposed to traumatic events during childhood have 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” (OMS, 2018, p.7)

In studies on the links between FGM and mental health, women
having undergone type I and type II FGM and those haing undergone type III (infibulation), are often distinguished. W.COPFGM.ORG

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 (OMS, 2018).

In 2018, in its guidelines on the management of health complications from female genital mutilations (OMS, 2018) as well as in its clinical guideline (GAMS Belgique, 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, solutions are developed in Europe and the situation is very different in Africa where it is far more difficult 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 currently at stake. If it is possible to identify psychological consequences directly linked to FGM, it is crucial to understand this event into women’s life path and a broader social, cultural, economic context also influencing mental well-being. This dimension has to be integrated into solutions put in place and / or recommended to cover FGM 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 adapted to their needs.

Adelufosi et al., 2020, Cognitive behavioural therapy for post‐traumatic stress disorder, depression, or anxiety disorders in women and girls living with female genital mutilation: A systematic review, Access here

Ahmadu F., 2007,  Challenging Myths of sexual dysfunction in circumcised women, Access here

Coho C., Sepulveda R. P., Hussein L. and Laffy C., 2019, Female Genital Trauma: Guidelines for Working Therapeutically with Survivors of FGM, Access here

Ferenczi S., 2006, Femmes, excision et exil – Quel accompagnement thérapeutique possible ?, Access here

GAMS Belgique, – Femmes, excision et exil – Quel accompagnement thérapeutique possible ?, « Partie IV : L’accompagnement thérapeutique des femmes concernées par les MGF et le mariage forcé »

International Center for Research on Women, 2017, Mental Health and Ending Female Genital Mutilation and Cutting: Opportunities in U.S. Foreign Policy and Programs, Access here

Johnsdotter, Sara (2019): “The growing demand in Europe for reconstructive clitoral surgery after Female Genital Cutting: A looping effect of the dominant discourse?” Forthcoming, in Droit et Cultures. Access here

Köbach et al., 2018, ‘Psychopathological sequelae of female genital mutilation and their neuroendocrinological associations’, Access here

Knipscheer et al., Mental health problems associated with female genital mutilation, Access here

Lansana Gberie, “Mental illness: Invisible but devastating. Superstitution often blamed for acute mental health diseases”, Africa Renewal, December 2016 – March 2017. Access here

OMS, 2013, Plan d’action global pour la santé mentale 2013-2020, Access here

OMS, 2020, page de présentation sur les MGF, Access here

OMS, 2018, Lignes directrices de l’OMS sur la prise en charge des complications des mutilations sexuelles féminines, Access here

OMS, 2018, Chapitre 7 : Santé mentale et MGF,  Access here

Osman S., Sevalie S., Weston M., 2018, Mental Health in Africa, Access here

Nawal M. Nour, Karin B. Michels, Ann E. Bryant, “Defibulation to Treat Female Genital Cutting: Effect on Symptoms and Sexual Function”, in Journal of Obstetrics & Gynaecology, Vol.108, No.1, July 2006, pp.55-60. Access here

Norwegian Knowledge Centre for the Health Services, 2010, Psychological, social and sexual consequences of FGM/C: a systematic review of quantitative studies,  Access here

Peyton N., 2019, FGM Survivors Across Africa Call for Mental Health and Trauma Support”, Access here

Sharif Mohamed, F., Wild, V., Earp, B. D., Johnson-Agbakwu, C., & Abdulcadir, J. (2020). Clitoral reconstruction after female genital mutilation/cutting: a review of surgical techniques and ethical debate. Journal of Sexual Medicine, 17(3), 531–542. Access here

Smith H. and Stein K., Psychological and counselling interventions for FGM, Access here

Venoranda R. K., 2020, Long-term mental effects of FGM not addressed enough, Access here

Vloeberghs E., Knipscheer J., Van der Kwaak A., Naleie Z., Van Den Muijsenbergh M., 2011,  Veiled pain. A study in Netherlands on the psychological, social and relational consequences of FGM, Access here

28 Too Many, 2016, The psychological effect of FGM, Access here

« The Community of Practice on Female Genital Mutilation » is part of the « Building Bridges between Africa and Europe to tackle FGM » project, supported by the « UNFPA-UNICEF Joint Programme on the Elimination of FGM ».
The project is coordinated by AIDOS in partnership with GAMS Belgium.

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