Knowledge, attitude, practice, and predictors of female genital mutilation in Degadamot district, Amhara regional state, Northwest Ethiopia, 2018.

BACKGROUND: Female genital mutilation is defined as all procedures that involve partial or total removal of external female genitalia, or other injuries to the female genital organs for cultural and religious purposes. In Ethiopia, the prevalence of female genital mutilation practice was 70.8% according to Ethiopian demographic and health survey 2016. This practice is against females' reproductive health rights with many serious consequences in physical, mental, social and psychological makeup. Therefore, this study aimed to assess knowledge, attitude, practice, and predictors of female genital mutilation in Degadamot district. METHODS: A community-based cross-sectional study design was conducted. Three hundred twenty-five mothers who had under 5 years old female children were selected using systematic random sampling from seven kebeles of Degadamot district. Data were collected using an adapted semi-structured face to face interview questionnaire. Data were entered into Epi-data version 3.1 and then exported to SPSS version 20 for analysis. Logistic regression analysis with 95% confidence intervals was carried out to determine the associations between predictor variables and outcome variables. RESULT: The finding of this study revealed that 56.6% of mothers had good knowledge about female genital mutilation and 54.2% of participants had a favorable attitude about female genital mutilation. 70.8% of under 5 years old female children's had female genital mutilation. Marital status AOR = 7.19(95%CI3.22-16.03), monthly income AOR = 1.97(95% CI 0.26-3.81), custom AOR = 2.13(95% CI 1.20-3.78), belief AOR =2.47(95% CI 1.39-4.39), value AOR = 0.37(95% CI 0.22-0.63), and attitude AOR = 24.4(95% CI 20.01-34.76) towards female genital mutilation had significant association with female genital mutilation practice. CONCLUSION: Prevalence of FGM practices among female children of under 5 years of age was found to be high as compared to the national level (64%). 56.6% of mothers had good knowledge about FGM. The majority of the women had a favorable attitude to keep FGM practice among their under 5 years old daughters. Marital status, monthly income, custom, belief, value, and attitude had a significant association with FGM practice.

Sexual norms and the intention to use healthcare services related to female genital cutting: A qualitative study among Somali and Sudanese women in Norway.

BACKGROUND: Female Genital Cutting (FGC) is a traditionally meaningful practice in Africa, the Middle East, and Asia. It is associated with a high risk of long-term physical and psychosexual health problems. Girls and women with FGC-related health problems need specialized healthcare services such as psychosexual counseling, deinfibulation, and clitoral reconstruction. Moreover, the need for psychosexual counseling increases in countries of immigration where FGC is not accepted and possibly stigmatized. In these countries, the practice loses its cultural meaning and girls and women with FGC are more likely to report psychosexual problems. In Norway, a country of immigration, psychosexual counseling is lacking. To decide whether to provide this and/or other services, it is important to explore the intention of the target population to use FGC-related healthcare services. That is as deinfibulation, an already available service, is underutilized. In this article, we explore whether girls and women with FGC intend to use FGC-related healthcare services, regardless of their availability in Norway. METHODS: We conducted 61 in-depth interviews with 26 Somali and Sudanese participants with FGC in Norway. We then validated our findings in three focus group discussions with additional 17 participants. FINDINGS: We found that most of our participants were positive towards psychosexual counseling and would use it if available. We also identified four cultural scenarios with different sets of sexual norms that centered on getting and/or staying married, and which largely influenced the participants' intention to use FGC-related services. These cultural scenarios are the virgin, the passive-, the conditioned active-, and the equal- sexual partner scenarios. Participants with negative attitudes towards the use of almost all of the FGC-related healthcare services were influenced by a set of norms pertaining to virginity and passive sexual behavior. In contrast, participants with positive attitudes towards the use of all of these same services were influenced by another set of norms pertaining to sexual and gender equality. On the other hand, participants with positive attitudes towards the use of services that can help to improve their marital sexual lives, yet negative towards the use of premarital services were influenced by a third set of norms that combined norms from the two aforementioned sets of norms. CONCLUSION: The intention to use FGC-related healthcare services varies between and within the different ethnic groups. Moreover, the same girl or woman can have different attitudes towards the use of the different FGC-related healthcare services or even towards the same services at the different stages of her life. These insights could prove valuable for Norwegian and other policy-makers and healthcare professionals during the planning and/or delivery of FGC-related healthcare services.

Female Genital Mutilation/Cutting as Grounds for Asylum Requests in the US: An Analysis of More than 100 Cases.

Female Genital Mutilation or Cutting (FGM/C) is a human rights violation used to claim asylum in the US. We sought to understand the nature of these asylum requests. Analysis of 121 FGM/C-focused medical affidavits, and 132 legal case reports. Of 119 eligible affidavits analyzed, 84% were reportedly cut: 4.6% Type I, 84.6% Type II, 16.5% Type III. Average age: 9. Reported acute effects: bleeding (76.3%), infection (27.6%), shock (6.7%), broken bones (2.7%), and hospitalization (2.7%). Reported chronic issues: intercourse difficulty (81.7%), pregnancy complications (54.2%), chronic pain (42.4%), scarring (37.3%), urinary difficulty (31.8%). Psychological consequences included PTSD (72.4%), depression (65.9%), anxiety (51.1%), and lack of trust (10.1%). Co-occurring abuses included domestic violence (62.4%), forced marriage (46%), rape (33.3%), torture (33.3%), child marriage (31.3%), assault due to LGBTQ + status (2.9%). Women claiming asylum based on FGM/C report high rates of chronic health issues. Their histories suggest FGM/C co-occurs with other forms of gender-based violence.

Community Influences on Female Genital Mutilation/Cutting: A Comparison of Four Francophone West African Countries.

Despite long-term efforts to encourage abandonment of female genital mutilation/cutting (FGMC), the practice remains widespread globally. FGMC is situated in specific social and historical contexts, and both prevalence and rates of decline vary widely across practicing countries. However, cross-national comparative research on the determinants of FGMC is sparse. This paper adds to the limited body of rigorous, theoretically grounded quantitative studies of FGMC and takes a step toward advancing cross-national comparative research. We apply an integrated theoretical framework that brings together norms-based and gender-based explanations of community-level influences on FGMC. We test this framework in four francophone West African countries, drawing on comparable nationally representative data from the Demographic and Health Surveys in Burkina Faso (2010), Côte d'Ivoire (2011-2012), Guinea (2012), and Mali (2012-2013). Results show that community-level FGMC norms and community-level gendered opportunities are associated with girls' risk of FGMC, but that the direct and moderating associations vary qualitatively across countries. Our findings highlight the contribution of context-specific social and institutional processes to the decline or persistence of FGMC.

Crime Victimization, Health, and Female Genital Mutilation or Cutting Among Somali Women and Adolescent Girls in the United States, 2017.

Objectives. To examine if exposure to victimization (e.g., homicide, violence, sexual assault, arson, kidnapping) is related to health problems, health care access and barriers, and health needs-beyond the effects of female genital mutilation or cutting (FGM/C)-among Somali women and adolescent girls.Methods. We collected original survey data in 2017 from 879 female Somalis in Arizona.Results. Compared with nonvictims, victims experienced significantly more health problems, were significantly less likely to have a designated place to receive health care, and identified significantly more health care needs and barriers to health care. Victims were 4 times more likely to experience depression or trauma and more than twice as likely to experience sexual intercourse problems, pregnancy problems, and gynecological problems. Among Somalis with FGM/C, victims had a 15% higher predicted probability of pregnancy-related health problems and a 19% higher predicted probability of gynecological health problems compared with nonvictimized Somalis with FGM/C.Conclusions. Somalis exposed to victimization have more health problems, needs, and health care barriers.Public Health Implications. Although more than 98% of Somali women and adolescent girls have undergone FGM/C, crime victimization affects health more than FGM/C alone.

Attitudes towards female genital cutting among adolescents in rural Burkina Faso: a multilevel analysis.

OBJECTIVE: Despite decades of abandonment efforts, female genital cutting (FGC) prevalence rates in Burkina Faso remain high. We present updated prevalence data from rural adolescents and examine factors associated with FGC receipt and attitudes, testing predictions of social convention and modernisation theory regarding the abandonment process. METHODS: We interviewed 1644 adolescents aged 12-20 years from 10 villages and one sector of Nouna town in the Nouna Health and Demographic Surveillance site in late 2017. Response-weighted prevalence for self-reported FGC receipt, beliefs about religious requirements, and attitudes about abandonment were calculated. We used bivariate regression and two-level hierarchical models to test whether social convention or modernisation theory-related factors predicted current FGC attitudes. RESULTS: 43% of women in our sample reported having undergone FGC; 74% of women and 76% of men believed FGC should be abandoned. The strongest predictors of FGC receipt were religion, ethnicity, the village's FGC rate and mother's education. The strongest predictors of FGC abandonment attitudes were religion, ethnicity, belief that FGC is religiously required, and own FGC status.  Males' attitudes were less determined by community factors than females'; females' attitudes were more strongly influenced by factors linked to modernization, such as maternal education and household wealth. CONCLUSIONS: FGC continues to be common in rural and small-town Burkina Faso, and our analysis suggests that social conventions play an important role in its continuation. However, modernisation-related factors were stronger predictors of abandonment attitudes than of FGC status, particularly in adolescent women. The changes these relationships suggest may benefit the next generation of girls.

OBJECTIF: Malgré des décennies d'effort pour l'abandon, les taux de prévalence de l'excision génitale féminine (EGF) au Burkina Faso restent élevés. Nous présentons des données de prévalence mises à jour sur les adolescents vivant en milieu rural et examinons les facteurs associés à la réception de l'excision et aux attitudes liées, en testant les prévisions de la théorie des conventions sociales et de la modernisation concernant le processus d'abandon. MÉTHODES: A la fin de 2017, nous avons interrogé 1.644 adolescents âgés de 12 à 20 ans de 10 villages et d'un secteur de la ville de Nouna sur le site de surveillance démographique et de santé de Nouna. La prévalence pondérée des réponses pour la réception de l'EGF auto-déclarée et les croyances relatives aux exigences religieuses ont été calculées ainsi que la question de savoir si la pratique devrait continuer. Nous avons utilisé une régression à deux variables et des modèles hiérarchiques à deux niveaux pour vérifier si des facteurs liés à la théorie des conventions sociales ou de la modernisation prédisaient les attitudes actuelles sur l'excision. RÉSULTATS: 43% des femmes de notre échantillon ont déclaré avoir subi une EGF. 74% des femmes et 76% des hommes pensaient que l'excision devrait être abandonnée. Les prédicteurs les plus puissants pour la réception de l'excision étaient la religion, l'ethnie, le taux d'excision dans le village et l'éducation de la mère. Les prédicteurs les plus puissants des attitudes pour l'abandon de l'excision étaient la religion, l'ethnie, la croyance que l'excision était une obligation religieuse et son propre statut d'excision. La richesse, la résidence en milieu urbain et l'exposition aux médias n'étaient pas associées à la réception de l'excision ou aux attitudes liées. CONCLUSIONS: L'excision continue d'être courante dans les zones rurales et les petites villes du Burkina Faso, et notre analyse suggère que les conventions sociales jouent un rôle important dans sa poursuite. Cependant, les facteurs liés à la modernisation étaient des prédicteurs plus forts des attitudes d'abandon que le statut d'excision, en particulier chez les adolescentes, ce qui pourrait profiter à la prochaine génération de filles.

A Spatial Analysis of the Prevalence of Female Genital Mutilation/Cutting among 0-14-Year-Old Girls in Kenya.

Female genital mutilation/cutting (FGM/C), also known as female circumcision, is a global public health and human rights problem affecting women and girls. Several concerted efforts to eliminate the practice are underway in several sub-Saharan African countries where the practice is most prevalent. Studies have reported variations in the practice with some countries experiencing relatively slow decline in prevalence. This study investigates the roles of normative influences and related risk factors (e.g., geographic location) on the persistence of FGM/C among 0-14 years old girls in Kenya. The key objective is to identify and map hotspots (high risk regions). We fitted spatial and spatio-temporal models in a Bayesian hierarchical regression framework on two datasets extracted from successive Kenya Demographic and Health Surveys (KDHS) from 1998 to 2014. The models were implemented in R statistical software using Markov Chain Monte Carlo (MCMC) techniques for parameters estimation, while model fit and assessment employed deviance information criterion (DIC) and effective sample size (ESS). Results showed that daughters of cut women were highly likely to be cut. Also, the likelihood of a girl being cut increased with the proportion of women in the community (1) who were cut (2) who supported FGM/C continuation, and (3) who believed FGM/C was a religious obligation. Other key risk factors included living in the northeastern region; belonging to the Kisii or Somali ethnic groups and being of Muslim background. These findings offered a clearer picture of the dynamics of FGM/C in Kenya and will aid targeted interventions through bespoke policymaking and implementations.

Geographical variation in the prevalence of female genital mutilation in the Kurdistan region of Iraq.

BACKGROUND: Female genital mutilation is practised in the Kurdistan Region of Iraq but the reasons for this are not well understood. AIMS: This study aimed to determine the geographical clustering of female genital mutilation in the Kurdistan Region of Iraq. METHODS: A secondary analysis of data from the Iraq Multiple Indicator Cluster Survey 2011 was done. The sample included 11 384 women of reproductive age who reported having undergone genital mutilation. The prevalence of female genital was analysed according to Iraqi governorate including the three governorates of the Kurdistan Region of Iraq, district of the Kurdistan Region of Iraq, and age group (15-30 and 31-49 years). RESULTS: The prevalence of female genital mutilation was highest in Erbil (62.9%) and Sulaimany (55.8%) governorates in the Kurdistan Region of Iraq. The prevalence was highest in the districts of Pishdar (98.1%), Rania (95.1%), Choman (88.5%), Dukan (83.8%) and Koya (80.4%). In 20 of the 33 districts, the prevalence of female genital mutilation was significantly lower in the younger age group (15-30 years). The difference between the two age groups was small and not statistically significant in the districts of Pishdar, Rania and Dukan. The main cluster of districts with a high prevalence of female genital mutilation is located in the eastern part of the Kurdistan Region of Iraq along the border with the Islamic Republic of Iran. CONCLUSIONS: Further research is needed to explore the determinants of the continued high prevalence of female genital mutilation in this area.

Survey on female genital mutilation/cutting in Jeddah, Saudi Arabia.

OBJECTIVES: The objective of this study was to determine whether female genital mutilation/cutting (FGM/C) exists in Jeddah, Saudi Arabia. DESIGN: A cross-sectional study. SETTING: King Abdulaziz University Hospital, Jeddah, Saudi Arabia. PARTICIPANTS: Between December 2016 and August 2017, women attending the obstetrics and gynaecology clinics were asked to participate in a cross-sectional survey. This included questions on demographics, FGM/C status and type and attitudes towards the practice. RESULTS: In a convenience sample of 963 women aged 18 to 75 years, 175 (18.2%) had undergone FGM/C. Compared with women without FGM/C, women with FGM/C were older, married, non-Saudi and had a lower monthly income. Thirty-seven (21.1%) women had had FGM/C with some cutting of body parts (type I or II), 11 (6.3%) with suturing (type III), 46 (26.3%) with no cutting of body parts (type IV) and 81 (46.3%) did not know their type of FGM/C. There was also a significant association between nationality and age at which FGM/C was performed, with Saudi women undergoing the procedure earlier than Egyptian, Somali, Yemeni and Sudanese women. CONCLUSIONS: FGM/C is prevalent in Jeddah, Saudi Arabia, among immigrant women from other countries, and it is practised among Saudi women. Further research is needed to determine its prevalence.

The Legal Framework for the Fight against Female Circumcision: From Cultural Indulgence to Human Rights Violations. The French Example.

The harmful consequences of female circumcision for women's health have been demonstrated and are regularly recalled by the World Health Organisation. Whereas in the past, the cultural dimension of the practice was emphasised, which result in impunity or absence of guilt, it is now considered by the United Nations as a violation of human rights, especially of the right to health. In 2012, the General Assembly asked States for a total ban on the practice. Despite the consensus on the punishability of female circumcision, its enforcement diverges, in particular in Western Europe. France is considered as a model in this area, that's why this study focuses on it. Yet, under French law, there is no special legislation criminalising the practice: female circumcision is punishable on grounds of mutilation. However, the French success is not complete: the prevention of such acts could be improved.

A qualitative assessment of women's perspectives and experience of female genital mutilation in Iraqi Kurdistan Region.

BACKGROUND: Female genital mutilation (FGM) is prevalent in Iraqi Kurdistan Region, but there is a lack of adequate knowledge about how the practice is perceived by the women population who are the direct victims of the practice. This study aimed to assess the knowledge, beliefs, and attitude of a sample of Kurdish women of FGM and identify the main enabling factors for performing this practice and the barriers to ending it. METHODS: This qualitative study was based on six focus groups involving a sample of 51 women. We used a topic guide to lead discussions, which included questions on women's perspectives of different aspects of FGM such as the reasons for practicing it, the positive and negative consequences, the continuation of the practice and tackling this problem in the community. Content analysis was used for the qualitative analysis of the data. RESULTS: The women had poor knowledge about different aspects of FGM particularly concerning the procedure and the consequences. The mutilated participants revealed the devastating experience of the pain and the psychological effects they have experienced. Reducing sexual desire, having halal (permissible by Allah) hands, and religious requirement were the main reasons for practicing FGM. Reduction in women's sexual desire and the related social problems with the husband were the main problems identified to be associated with FGM. Most women did not support the continuation of FGM practice, but some women still think that FGM should be left to the people's preference. The participants identified raising people's awareness, active involvement of religious leaders in prevention efforts and the issuance and enforcement of legislation against FGM as the primary measures to reduce FGM practice. CONCLUSION: Passing through FGM at childhood is an overwhelming experience with long-term effects for women. There is still a significant segment among the women population that do not oppose the continuations of FGM and need religious and scientific evidence against FGM. Some reasons for practicing FGM are deeply embedded in the culture and traditions, and there is a need for extensive efforts to raise the awareness of the population and change their thoughts and behavior about FGM.

Factors associated with the support of pricking (female genital cutting type IV) among Somali immigrants - a cross-sectional study in Sweden.

BACKGROUND: Pricking, classified as female genital cutting (FGC) type IV by the World Health Organization, is an under-researched area gaining momentum among diaspora communities. Our aim was to explore factors associated with being supportive of pricking among Somalis in Sweden. METHODS: In a cross-sectional design, attitudes and knowledge regarding FGC, and measures of socioeconomic status, acculturation, and social capital, were assessed by a 49-item questionnaire in four municipalities in Sweden. Data were collected in 2015 from 648 Somali men and women, ≥ 18 years old, of which 113 supported the continuation of pricking. Logistic regression was used for the analysis. RESULTS: Those more likely to support the continuation of pricking were older, originally from rural areas, and newly arrived in Sweden. Further, those who reported that they thought pricking was: acceptable, according to their religion (aOR: 10.59, 95% CI: 5.44-20.62); not a violation of children's rights (aOR: 2.86, 95% CI: 1.46-5.61); and did not cause long-term health complications (aOR: 5.52, 95% CI: 2.25-13.52) had higher odds of supporting pricking. Religion was strongly associated with the support of pricking among both genders. However, for men, children's rights and the definition of pricking as FGC or not were important aspects in how they viewed pricking, while, for women, health complications and respectability were important. CONCLUSIONS: Values known to be associated with FGC in general are also related to pricking. Hence, there seems to be a change in what types of FGC are supported rather than in their perceived values.

Midwives' experiences of providing contraception counselling to immigrant women.

OBJECTIVE: To describe midwives' experiences of providing contraception counselling to immigrant women. METHODS: The study was conducted with a qualitative design, based on interviews followed by inductive content analysis. Ten midwives were interviewed, working at midwife-led prenatal clinics in immigrant-dense areas in southern Sweden. RESULTS: Midwives require knowledge and understanding of cultures and religions in order to provide contraception counselling to immigrant women. It is important for the midwives to be aware that women have different values regarding sexual and reproductive health. The challenge for the midwives is to understand and to be curious about every woman's lifeworld perspective, culture and religion. The midwives knowledge and understanding of cultures and religions is acquired through experience and shared between them. Knowledge makes a midwife confident in her role as the contraception counselling provider to immigrant women. CONCLUSION: Cultural and religious factors affect contraception counselling. According to the midwives, knowledge and awareness of these factors is crucial and leads to improved understanding of midwives providing contraception counselling, better compliance, fewer unwanted pregnancies and improved sexual and reproductive health among women.

Knowledge and attitudes toward female genital cutting among West African male immigrants in New York City.

In this project, we explored knowledge and attitudes toward female genital cutting (FGC) in a survey of 107 West African immigrants, including 36 men. Men in this study were as knowledgeable about the health consequences of FGC as women, though with a less nuanced understanding. They also rejected the practice at rates comparable to women. Despite this knowledge and rejection of FGC, most men did not express a personal preference for women with or without FGC in intimate relationships. Future research and interventions must explore men's opposition to FGC and emphasize the impact of FGC on their partners' gynecological and reproductive health.

Dismantling the man-made myths upholding female genital mutilation.

Female genital mutilation (FGM) is internationally considered an affront to human rights and an act of violence against women and young girls. Furthermore, it hierarchizes and perpetuates inequality and denies women and girls the right to physical and psychosexual integrity. The aim of this study is to detect the weak points and false premises underlying male justification of FGM and to present demythologization as a health education tool. We used a qualitative methodology with an ethonursing focus via semistructured individual and group interviews in 25 men associated with FGM. Our results found that nine myths and their mythologization are presented through the masculine voices of those associated with this tradition. These myths are used as justification by men and women in order to uphold the practice of FGM. Demythologization as a nursing intervention based on reorienting or restructuring models of cultural care allows us to work against the false premises making up the myths which act to protect this tradition.

Female genital mutilation in children presenting to Australian paediatricians.

OBJECTIVE: The WHO reports that female genital mutilation/cutting (FGM/C) is an ancient cultural practice prevalent in many countries. FGM/C has been reported among women resident in Australia. Our paper provides the first description of FGM/C in Australian children. DESIGN: Cross-sectional survey conducted in April-June 2014. SETTING: Paediatricians and other child health specialists recruited through the Australian Paediatric Surveillance Unit were asked to report children aged <18 years with FGM/C seen in the last 5 years, and to provide data for demographics, FGM/C type, complications and referral for each case. PARTICIPANTS: Of 1311 eligible paediatricians/child health specialists, 1003 (76.5%) responded. RESULTS: Twenty-three (2.3%) respondents had seen 59 children with FGM/C and provided detailed data for 31. Most (89.7%) were identified during refugee screening and were born in Africa. Three (10.3%) were born in Australia: two had FGM/C in Australia and one in Indonesia. All parents were born overseas, mainly Africa (98.1%). Ten children had WHO FGM/C type I, five type II, five type III and six type IV. Complications in eight children included recurrent genitourinary infections, menstrual, sexual, fertility and psychological problems. Nineteen children (82.6%) were referred to obstetrics/gynaecology: 16 (69.9%) to social work and 13 (56.5%) to child protection. CONCLUSIONS: This study confirms that FGM/C is seen in paediatric clinical practice within Australia. Paediatricians need cultural awareness, education and resources to help them identify children with FGM/C and/or at risk of FGM/C, to enable appropriate referral and counselling of children, families and communities to assist in the prevention of this practice.

Exploring Female Genital Cutting Among Survivors of Torture.

Though the practice of female genital cutting (FGC) has been framed as a form of gender-based torture, few studies have examined the prevalence and impact of the practice among documented survivors of torture. This article presents a secondary analysis of data from 514 African-born women at an interdisciplinary clinic for survivors of torture. Results indicate few demographic differences between those who experienced FGC and those who had not, though a larger proportion of the FGC group were West African and identified as Muslim. Many with FGC were in the process of applying for asylum, reported sexual and psychological torture, and cited gender as a basis for their persecution. The FGC group evidenced unique correlates related to immigration status and psychological and sexual torture experiences that the non-FGC group did not. Findings indicate that female survivors of torture with FGC represent a distinct group with specific mental health needs.

Changing cultural attitudes towards female genital cutting.

As globalization brings people with incompatible attitudes into contact, cultural conflicts inevitably arise. Little is known about how to mitigate conflict and about how the conflicts that occur can shape the cultural evolution of the groups involved. Female genital cutting is a prominent example. Governments and international agencies have promoted the abandonment of cutting for decades, but the practice remains widespread with associated health risks for millions of girls and women. In their efforts to end cutting, international agents have often adopted the view that cutting is locally pervasive and entrenched. This implies the need to introduce values and expectations from outside the local culture. Members of the target society may view such interventions as unwelcome intrusions, and campaigns promoting abandonment have sometimes led to backlash as they struggle to reconcile cultural tolerance with the conviction that cutting violates universal human rights. Cutting, however, is not necessarily locally pervasive and entrenched. We designed experiments on cultural change that exploited the existence of conflicting attitudes within cutting societies. We produced four entertaining movies that served as experimental treatments in two experiments in Sudan, and we developed an implicit association test to unobtrusively measure attitudes about cutting. The movies depart from the view that cutting is locally pervasive by dramatizing members of an extended family as they confront each other with divergent views about whether the family should continue cutting. The movies significantly improved attitudes towards girls who remain uncut, with one in particular having a relatively persistent effect. These results show that using entertainment to dramatize locally discordant views can provide a basis for applied cultural evolution without accentuating intercultural divisions.

Between Moral Relativism and Moral Hypocrisy: Reframing the Debate on "FGM".

The spectrum of practices termed "Female Genital Mutilation" (or FGM) by the World Health Organization is sometimes held up as a counterexample to moral relativism. Those who advance this line of thought suggest the practices are so harmful in terms of their physical and emotional consequences, as well as so problematic in terms of their sexist or oppressive implications, that they provide sufficient, rational grounds for the assertion of a universal moral claim--namely, that all forms of FGM are wrong, regardless of the cultural context. However, others point to cultural bias and moral double standards on the part of those who espouse this argument, and have begun to question the received interpretation of the relevant empirical data on FGM as well. In this article I assess the merits of these competing perspectives. I argue that each of them involves valid moral concerns that should be taken seriously in order to move the discussion forward. In doing so, I draw on the biomedical "enhancement" literature in order to develop a novel ethical framework for evaluating FGM (and related interventions--such as female genital "cosmetic" surgery and nontherapeutic male circumcision) that takes into account the genuine harms that are at stake in these procedures, but which does not suffer from being based on cultural or moral double standards.