Female Genital Mutilation/Cutting: A Systematic Review of Global Patterns, Sociocultural Drivers, and Health Consequences.

STUDY

OBJECTIVE

This review aims to systematically examine the global distribution, health consequences, and sociocultural drivers of female genital mutilation/cutting (FGM/C), with the aim of informing targeted elimination strategies.

METHODS

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched PubMed, Web of Science, and Elsevier Science Direct from inception to July 2025 for studies examining FGM/C prevalence patterns, determinants, and health effects. Eligible studies were in English, addressed at least one of the review's thematic domains, and had ethics approval. Data from 329 articles were extracted and synthesized within the Socio-Ecological Model framework.

RESULTS

FGM/C is mainly practiced in Africa (with national prevalence exceeding 80% in some countries) and persists within immigrant diaspora communities in Europe, North America, and Australia. While prevalence has declined in regions such as East Africa, progress has stalled in parts of West Africa and Sudan. Key drivers include limited education, deep-rooted social and religious norms, marital and economic incentives, and poverty. Legal bans exist in over 80 countries, yet enforcement gaps, cultural resistance, and medicalization hinder elimination. Across all 4 WHO-defined types, FGM/C is linked to acute and chronic physical complications (eg, hemorrhage, urogenital injury, obstetric morbidity), profound psychological sequelae (eg, PTSD, depression, sexual dysfunction), and substantial economic burden on healthcare systems.

CONCLUSIONS

Eliminating FGM/C requires integrated, context-specific strategies that combine strong legislation, community engagement, educational initiatives, and expansion of survivor-centered medical and psychosocial care. Linking these actions to broader Sustainable Development Goals could accelerate progress toward ending FGM/C by 2030.