Lived experiences and impacts of female genital mutilation/cutting (FGM/C): a meta-ethnographic synthesis.

BACKGROUND

This meta-ethnographic review synthesised qualitative evidence on the lived experiences and impacts of female genital mutilation/cutting (FGM/C). By incorporating insights from individuals who have undergone FGM/C, men and healthcare providers caring for affected populations, the study enriches understanding of the practice and its multifaceted consequences.

METHODS

Using Noblit and Hare's seven-stage meta-ethnographic framework, an inductive and interpretive synthesis was conducted. A comprehensive search of electronic databases, including PubMed/Medline, ScienceDirect, Google Scholar, ResearchGate, African Journals Online (AJOL) and the WHO website, identified qualitative and mixed-method studies that captured in-depth perspectives on FGM/C. The Critical Appraisal Skills Programme tool was used to assess the methodological quality of the included studies, and Ames et al's 5-point scale was applied to evaluate the conceptual richness of each study.

RESULTS

Fifty-three qualitative studies spanning diverse geographical and cultural contexts, both in traditionally practising regions and migrant communities, were included. Through rigorous analysis of first-order constructs (participant quotes) and second-order constructs (study authors' themes), five overarching themes were developed: (1) the onset: inherited tradition and gendered expectations; (2) ramifications on health and well-being; (3) inadequate health-seeking behaviours and lack of comprehensive healthcare services; (4) the psychosocial toll and (5) the perceived benefits of FGM/C. Each overarching theme comprises second-order constructs, along with participants' quotes.

CONCLUSION

This synthesis demonstrates how FGM/C is deeply intertwined with sociocultural norms and functions as a bidirectional bridge, presenting a complex dilemma for the health of women and girls, healthcare systems and broader society. On one hand, it serves as a pivotal gateway to sociocultural belonging and a source of social capital, shaping women's and girls' lives long after the practice itself. On the other hand, it inflicts immediate, short-term and long-term health impacts and poses considerable challenges for healthcare systems due to its diverse and interconnected consequences. This complexity makes it challenging to address all related issues within a single setting or with a single specialist, often leaving affected individuals behind in accessing the highest attainable quality of care and support, while simultaneously complicating elimination efforts.

PROSPERO REGISTRATION NUMBER: CRD42023387750.