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Debating medicalization of Female Genital Mutilation/Cutting (FGM/C): learning from (policy) experiences across countries

BACKGROUND: Although Female Genital Mutilation/Cutting (FGM/C) is internationally considered a harmful practice, it is increasingly being medicalized allegedly to reduce its negative health effects, and is thus suggested as a harm reduction strategy in response to these perceived health risks. In ma...

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Autores principales: Leye, Els, Van Eekert, Nina, Shamu, Simukai, Esho, Tammary, Barrett, Hazel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6823951/
https://www.ncbi.nlm.nih.gov/pubmed/31675972
http://dx.doi.org/10.1186/s12978-019-0817-3
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author Leye, Els
Van Eekert, Nina
Shamu, Simukai
Esho, Tammary
Barrett, Hazel
author_facet Leye, Els
Van Eekert, Nina
Shamu, Simukai
Esho, Tammary
Barrett, Hazel
author_sort Leye, Els
collection PubMed
description BACKGROUND: Although Female Genital Mutilation/Cutting (FGM/C) is internationally considered a harmful practice, it is increasingly being medicalized allegedly to reduce its negative health effects, and is thus suggested as a harm reduction strategy in response to these perceived health risks. In many countries where FGM/C is traditionally practiced, the prevalence rates of medicalization are increasing, and in countries of migration, such as the United Kingdom, the United States of America or Sweden, court cases or the repeated issuing of statements in favor of presumed minimal forms of FGM/C to replace more invasive forms, has raised the debate between the medical harm reduction arguments and the human rights approach. MAIN BODY: The purpose of this paper is to discuss the arguments associated with the medicalization of FGM/C, a trend that could undermine the achievement of Sustainable Development Goal 5.3. The paper uses four country case studies, Egypt, Indonesia, Kenya and UK, to discuss the reasons for engaging in medicalized forms of FGM/C, or not, and explores the ongoing public discourse in those countries concerning harm reduction versus human rights, and the contradiction between medical ethics, national criminal justice systems and international conventions. The discussion is structured around four key hotly contested ethical dilemmas. Firstly, that the WHO definition of medicalized FGM/C is too narrow allowing medicalized FGM to be justified by many healthcare professionals as a form of harm reduction which contradicts the medical oath of do no harm. Secondly, that medicalized FGM/C is a human rights abuse with lifelong consequences, no matter who performs it. Thirdly, that health care professionals who perform medicalized FGM/C are sustaining cultural norms that they themselves support and are also gaining financially. Fourthly, the contradiction between protecting traditional cultural rights in legal constitutions versus human rights legislation, which criminalizes FGM/C. CONCLUSION: More research needs to be done in order to understand the complexities that are facilitating the medicalization of FGM/C as well as how policy strategies can be strengthened to have a greater de-medicalization impact. Tackling medicalization of FGM/C will accelerate the achievement of the Sustainable Development Goal of ending FGM by 2030.
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spelling pubmed-68239512019-11-06 Debating medicalization of Female Genital Mutilation/Cutting (FGM/C): learning from (policy) experiences across countries Leye, Els Van Eekert, Nina Shamu, Simukai Esho, Tammary Barrett, Hazel Reprod Health Review BACKGROUND: Although Female Genital Mutilation/Cutting (FGM/C) is internationally considered a harmful practice, it is increasingly being medicalized allegedly to reduce its negative health effects, and is thus suggested as a harm reduction strategy in response to these perceived health risks. In many countries where FGM/C is traditionally practiced, the prevalence rates of medicalization are increasing, and in countries of migration, such as the United Kingdom, the United States of America or Sweden, court cases or the repeated issuing of statements in favor of presumed minimal forms of FGM/C to replace more invasive forms, has raised the debate between the medical harm reduction arguments and the human rights approach. MAIN BODY: The purpose of this paper is to discuss the arguments associated with the medicalization of FGM/C, a trend that could undermine the achievement of Sustainable Development Goal 5.3. The paper uses four country case studies, Egypt, Indonesia, Kenya and UK, to discuss the reasons for engaging in medicalized forms of FGM/C, or not, and explores the ongoing public discourse in those countries concerning harm reduction versus human rights, and the contradiction between medical ethics, national criminal justice systems and international conventions. The discussion is structured around four key hotly contested ethical dilemmas. Firstly, that the WHO definition of medicalized FGM/C is too narrow allowing medicalized FGM to be justified by many healthcare professionals as a form of harm reduction which contradicts the medical oath of do no harm. Secondly, that medicalized FGM/C is a human rights abuse with lifelong consequences, no matter who performs it. Thirdly, that health care professionals who perform medicalized FGM/C are sustaining cultural norms that they themselves support and are also gaining financially. Fourthly, the contradiction between protecting traditional cultural rights in legal constitutions versus human rights legislation, which criminalizes FGM/C. CONCLUSION: More research needs to be done in order to understand the complexities that are facilitating the medicalization of FGM/C as well as how policy strategies can be strengthened to have a greater de-medicalization impact. Tackling medicalization of FGM/C will accelerate the achievement of the Sustainable Development Goal of ending FGM by 2030. BioMed Central 2019-11-01 /pmc/articles/PMC6823951/ /pubmed/31675972 http://dx.doi.org/10.1186/s12978-019-0817-3 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Review
Leye, Els
Van Eekert, Nina
Shamu, Simukai
Esho, Tammary
Barrett, Hazel
Debating medicalization of Female Genital Mutilation/Cutting (FGM/C): learning from (policy) experiences across countries
title Debating medicalization of Female Genital Mutilation/Cutting (FGM/C): learning from (policy) experiences across countries
title_full Debating medicalization of Female Genital Mutilation/Cutting (FGM/C): learning from (policy) experiences across countries
title_fullStr Debating medicalization of Female Genital Mutilation/Cutting (FGM/C): learning from (policy) experiences across countries
title_full_unstemmed Debating medicalization of Female Genital Mutilation/Cutting (FGM/C): learning from (policy) experiences across countries
title_short Debating medicalization of Female Genital Mutilation/Cutting (FGM/C): learning from (policy) experiences across countries
title_sort debating medicalization of female genital mutilation/cutting (fgm/c): learning from (policy) experiences across countries
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6823951/
https://www.ncbi.nlm.nih.gov/pubmed/31675972
http://dx.doi.org/10.1186/s12978-019-0817-3
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