Exploring Beliefs and Attitudes Toward Female Genital Mutilation/Cutting Among Healthcare Providers in New York City

Abstract

Given the increase of African immigrants from countries with high female genital cutting (FGC) prevalence, this study explored U.S. healthcare providers’ beliefs and attitudes regarding FGC. A total of 31 professionals who have provided services to FGC-experienced women in New York City were interviewed; data were analyzed using grounded theory. Results indicated that, although a majority of respondents emphasized maintaining a nonjudgmental and open-minded attitude toward clients’ experiences, some only focused on the negative aspects of FGC. Also, multifaceted efforts by providers to understand the cultural meanings of FGC and resolve their own cultural dissonance were identified. The implications for practice were discussed.

Keywords

female genital cutting African immigrants healthcare providers beliefs and attitudes culturally sensitive care

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References

Agar

MacDonald

(1995). Focus groups and ethnography. Human Organization, 54(1), 78–86. https://doi.org/10.17730/humo.54.1.x102372362631282

Akinsulure-Smith

A. M.

Chu

Krivitsky

L. N.

(2018). West African immigrant perspectives on female genital cutting: Experiences, attitudes, and implications for mental health service providers. Journal of International Migration and Integration, 19(2), 259–276. https://doi.org/10.1007/s12134-018-0544-6

Akinsulure-Smith

A. M.

Sicalides

(2016). Female genital cutting in the United States: Implications for mental health professionals. Professional Psychology: Research and Practice, 47(5), 356–362. https://doi.org/10.1037/pro0000079

Anderson

(2017). African immigrant population in US steadily climbs. Pew Research Center. http://www.pewresearch.org/fact-tank/2017/02/14/african-immigrant-population-in-u-s-steadily-climbs/ .

Balk

(2000). To marry and bear children? The demographic consequences of infibulation in Sudan. In B. Shell-Duncan & Y. Hernlund (Eds.), Female “circumcision” in Africa: Culture, controversy, and change (pp. 55–72). Lynne Rienner.

Cappon

L’Ecluse

Clays

Tency

Leye

(2015). Female genital mutilation: Knowledge, attitude and practices of Flemish midwives. Midwifery, 31(3), e29–e35. https://doi.org/10.1016/j.midw.2014.11.012

Caroppo

Almadori

Giannuzzi

Brogna

Diodati

Bria

(2014). Health care for immigrant women in Italy: Are we really ready? A survey on knowledge about female genital mutilation. Annali dell'Istituto Superiore di Sanità, 50(1), 49–53. https://doi.org/10.4415/ANN_14_01_08

Charmaz

(2006). Constructing grounded theory: A practical guide through qualitative analysis. Sage.

Chu

Akinsulure-Smith

A. M.

(2016). Health outcomes and attitudes toward female genital cutting in a community-based sample of West African immigrant women from high-prevalence countries in New York City. Journal of Aggression, Maltreatment & Trauma, 25(1), 63–83. https://doi.org/10.1080/10926771.2015.1081663

10.

Echeverria-Estrada

Batalova

(2019). Sub-Saharan African immigrants in the United States. Migration Policy Institute. https://www.migrationpolicy.org/article/sub-saharan-african-immigrants-united-states .

11.

Evans

Tweheyo

McGarry

Eldridge

Albert

Nkoyo

Higginbottom

G. M.

(2019a). Crossing cultural divides: A qualitative systematic review of factors influencing the provision of healthcare related to female genital mutilation from the perspective of health professionals. PloS ONE, 14(3), e0211829–e0211829. https://doi.org/10.1371/journal.pone.0211829

12.

Evans

Tweheyo

McGarry

Eldridge

Albert

Nkoyo

Higginbottom

G. M. A.

(2019b). Seeking culturally safe care: A qualitative systematic review of the healthcare experiences of women and girls who have undergone female genital mutilation/cutting. BMJ Open, 9(5), e027452–e027452. https://doi.org/10.1136/bmjopen-2018-027452

13.

Figley

C. R.

(1995). Compassion fatigue as secondary traumatic stress disorder: An overview. In C. R. Figley (Ed.), Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized (pp. 1–20). Brunner/Mazel.

14.

Goldberg

Stupp

Okoroh

Besera

Goodman

Danel

(2016). Female genital mutilation/cutting in the United States: Updated estimates of women and girls at risk, 2012. Public Health Reports, 131(2), 340–347. https://doi.org/10.1177/003335491613100218

15.

Goldenstein

(2014). Female genital cutting: Nursing implications. Journal of Transcultural Nursing, 25(1), 95–101. https://doi.org/10.1177/1043659613493441

16.

González-Timoneda

Ros

V. R.

González-Timoneda

Sánchez

A. C.

(2018). Knowledge, attitudes and practices of primary healthcare professionals to female genital mutilation in Valencia, Spain: Are we ready for this challenge? BMC Health Services Research, 18(1), 579. https://doi.org/10.1186/s12913-018-3396-z

17.

Hess

Weinland

Saalinger

(2010). Knowledge of female genital cutting and experience with women who are circumcised: A survey of nurse-midwives in the United States. Journal of Midwifery and Women's Health, 55(1), 46–54. https://doi.org/10.1016/j.jmwh.2009.01.005

18.

Jackson

(2017). Counselling professionals’ awareness and understanding of female genital mutilation/cutting: Training needs for working therapeutically with survivors. Counselling and Psychotherapy Research, 17(4), 309–319. https://doi.org/10.1002/capr.12136

19.

Jäger

Schulze

Hohlfeld

(2002). Female genital mutilation in Switzerland: A survey among gynaecologists. Swiss Medical Weekly, 132(19-20), 259–264. https://doi.org/2002/19/smw-09912

20.

Kaplan-Marcusán

del Rio

N. F.

Moreno-Navarro

Castany-Fàbregas

M. J.

Nogueras

M. R.

Muñoz-Ortiz

Monguí-Avila

Torán-Monserrat

(2010). Female genital mutilation: Perceptions of healthcare professionals and the perspective of the migrant families. BMC Public Health, 10(1),193. https://doi.org/10.1186/1471-2458-10-193

21.

Kaplan-Marcusan

Torán-Monserrat

Moreno-Navarro

Fàbregas

M. J. C.

Muñoz-Ortiz

(2009). Perception of primary health professionals about female genital mutilation: From healthcare to intercultural competence. BMC Health Services Research, 9(1), 11. https://doi.org/10.1186/1472-6963-9-11

22.

Lane

J. L.

Johnson-Agbakwu

C. E.

Warren

Budhathoki

Cole

E. C.

(2019). Female genital cutting: Clinical knowledge, attitudes, and practices from a provider survey in the US. Journal of Immigrant and Minority Health, 21(5), 954–964. https://doi.org/10.1007/s10903-018-0833-3

23.

Leye

Ysebaert

Deblonde

Claeys

Vermeulen

Jacquemyn

Temmerman

(2008). Female genital mutilation: Knowledge, attitudes and practices of Flemish gynaecologists. European Journal of Contraception & Reproductive Health Care, 13(2), 182–190. https://doi.org/10.1080/13625180701780957

24.

Mather

Feldman-Jacobs

(2016). Women and girls at risk of female genital mutilation/cutting in the United States. Population Reference Bureau. https://www.prb.org/resources/women-and-girls-at-risk-of-female-genital-mutilation-cutting-in-the-united-states/ .

25.

Mehta

P. K.

Saia

Mody

Crosby

S. S.

Raj

Maru

Piwowarczyk

(2018). Learning from UJAMBO: Perspectives on gynecologic care in African immigrant and refugee women in Boston, Massachusetts. Journal of Immigrant and Minority Health, 20(2), 380–387. https://doi.org/10.1007/s10903-017-0659-4

26.

Moaddab

McCullough

L. B.

Chervenak

F. A.

Stark

Schulkin

Dildy

G. A.

Raine

S. P.

Shamshirsaz

(2017). A survey of honor-related practices among US obstetricians and gynecologists. International Journal of Gynecology & Obstetrics, 139(2), 164–169. https://doi.org/10.1002/ijgo.12294

27.

Nour

N. N.

(2004). Female genital cutting: Clinical and cultural guidelines. Obstetrical & Gynecological Survey, 59(4), 272–279. https://doi.org/10.1097/01.OGX.0000118939.19371.AF

28.

Ogunsiji

(2015). Female genital mutilation (FGM): Australian midwives’ knowledge and attitudes. Health Care for Women International, 36(11), 1179–1193. https://doi.org/10.1080/07399332.2014.992521

29.

Ormrod

(2019). The experience of NHS care for women living with female genital mutilation. British Journal of Nursing, 28(10), 628–633. https://doi.org/10.12968/bjon.2019.28.10.628

30.

Pavlish

C. L.

Noor

Brandt

(2010). Somali immigrant women and the American health care system: Discordant beliefs, divergent expectations, and silent worries. Social Science & Medicine, 71(2), 353–361. https://doi.org/10.1016/j.socscimed.2010.04.010

31.

Relph

Inamdar

Singh

Yoong

(2013). Female genital mutilation/cutting: Knowledge, attitude and training of health professionals in inner city London. European Journal of Obstetrics & Gynecology and Reproductive Biology, 168(2), 195–198. https://doi.org/10.1016/j.ejogrb.2013.01.004

32.

Sureshkumar

Zurynski

Moloney

Raman

Varol

Elliott

E. J.

(2016). Female genital mutilation: Survey of paediatricians’ knowledge, attitudes and practice. Child Abuse & Neglect, 55(May), 1–9. https://doi.org/10.1016/j.chiabu.2016.03.005

33.

Surico

Amadori

Gastaldo

L. B.

Tinelli

Surico

(2015). Female genital cutting: A survey among healthcare professionals in Italy. Journal of Obstetrics and Gynaecology, 35(4), 393–396. https://doi.org/10.3109/01443615.2014.960826

34.

Tamaddon

Johnsdotter

Liljestrand

Essén

(2006). Swedish Health care providers’ experience and knowledge of female genital cutting. Health Care for Women International, 27(8), 709–722. https://doi.org/10.1080/07399330600817741

35.

UNICEF (2016). Female Genital Mutilation/Cutting: A global concern. https://data.unicef.org/resources/female-genital-mutilationcutting-global-concern/.

36.

Vangen

Johansen

R. E. B.

Sundby

Træen

Stray-Pedersen

(2004). Qualitative study of perinatal care experiences among Somali women and local health care professionals in Norway. European Journal of Obstetrics & Gynecology and Reproductive Biology, 112(1), 29–35. https://doi.org/10.1016/S0301-2115(03)00313-0

37.

Widmark

Leval

Tishelman

Ahlberg

B. M.

(2010). Obstetric care at the intersection of science and culture: Swedish doctors’ perspectives on obstetric care of women who have undergone female genital cutting. Journal of Obstetrics and Gynaecology, 30(6), 553–558. https://doi.org/10.3109/01443615.2010.484110

38.

World Health Organization (2016). WHO guidelines on the management of health complications from female genital mutilation. https://www.who.int/reproductivehealth/topics/fgm/management-health-complications-fgm/en/.