Sexual and reproductive health

Female genital mutilation and other harmful practices

Health consequences of female genital mutilation

Female genital mutilation may cause mental health problems

This pilot study investigated the mental health of women following genital mutilation [1]. A number of experts have in the past assumed that women undergoing genital mutilation would be more likely to develop psychiatric illnesses than women in the general population but there has been little research to confirm this belief.

The psychological impact of genital mutilation was assessed in 23 Senegalese women in Dakar who had undergone FGM, with 24 uncircumcised Senegalese women serving as comparison subjects. All participants were between the ages of 15 and 40 years, and they had an average length of education of 11.5 years. Twenty-one per cent of the subjects were married and 79% were single. The two groups of circumcised and uncircumcised women did not differ significantly in terms of age, education, marital status, or traumatic life experiences.

A neuropsychiatric interview and other questionnaires were used to assess the traumatization experienced and psychiatric illnesses. More than 80% of the entire group had already faced traumatic life experiences (usually the sudden death of a friend or family member). The age at which the circumcised women experienced FGM ranged between 5 and 14 years (the mean was 8.2 years). In no cases had local analgesics or narcotics been used.

All but one participant remembered the day of her circumcision as “extremely appalling and traumatizing”, the researchers say. More than 90% of the women described feelings of “intense fear, helplessness, horror, and severe pain” and over 80% were said to be “still suffering from intrusive re-experiences of their circumcision”. For 78% of the subjects, FGM was performed unexpectedly and without any preliminary explanation.

The psychiatric diagnoses showed that almost 80% of the women who had undergone FGM met criteria for affective or anxiety disorders, with a high rate (30.4%) of post-traumatic stress disorder (PTSD), while only one of the uncircumcised women fulfilled the diagnostic criteria for an affective disorder.

The researchers conclude that female genital mutilation is “likely to cause various emotional disturbances, forging the way to psychiatric disorders, especially PTSD”. They state that the high rate of PTSD of more than 30% in the FGM group compares to the rate of PTSD of early childhood abuse (which ranges between 30% and 50%).

Although FGM is part of the participants’ ethnic background, the researchers add, “the results imply that cultural embedment does not protect against the development of PTSD and other psychiatric disorders”. Those other psychiatric disorders are said to include “memory dysfunction” which other studies have shown to be present in traumatized persons.

“The alarmingly high rates of psychiatric disturbance among this group of circumcised women provide important evidence that researchers, as well as clinicians, have an obligation to focus more attention on the urgent needs of circumcised women” the researchers state.

References

1. Behrendt A, Moritz S. Posttraumatic stress disorder and memory problems after female genital mutilation. American Journal of Psychiatry 2005; 162:10001002.

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