Mental Health Disorders in Circumcised Reproductive-age Women, Legal Dimensions and Prevention Strategies: A Narrative Review.

OBJECTIVE: Female genital mutilation/cutting (FGM/C) can affect women's lives through various physical, psychological, social and even sexual mechanisms. According to the World Health Organization guidelines for managing the health effects of FGM/C, further research into its psychological effects and preventative measures is required. In this study, a comprehensive review of the mental health consequences of circumcised women of reproductive age has been conducted with a special focus on providing preventive solutions. METHODS: A comprehensive search of the Web of Science, PubMed(MEDLINE), Proquest, Scopus and Google scholar was carried outfrom 2000 to 2022. The second stage of search was conducted in grey literature. To facilitate a systematic approach to search the literature, the PECO framework, was adopted. RESULTS: The result of this narrative review study showed that, the most common mental health disorder in reproductive age circumcised women were depression, anxiety and post-traumatic stress disorder. Some studies found a significant relationship between parents' education level and circumcised girls, so that parents of the circumcised women had a low level of education. Two studies considered religious beliefs, tradition, cleanness, sexual desire control and virginity as the reasons for FGM/C. CONCLUSION: All forms of FGM/C may be harmful to one's health. Women, who have undergone widespread forms of circumcision, are more likely to develop mental disorders. As the psychosocial effects of circumcision can affect the sexual experience of circumcised women, addressing this issue, emphasizing its legal aspects, and providing preventative solutions can improve physical, mental, social, and even sexual health in circumcised women.

Mental Health Disorders in Circumcised Reproductive-age Women, Legal Dimensions and Prevention Strategies: A Narrative Review / Distúrbios de saúde mental em mulheres circuncidadas em idade reprodutiva, dimensões legais e estratégias de prevenção: uma revisão narrativa

Abstract Objective: Female genital mutilation/cutting (FGM/C) can affect women's lives through various physical, psychological, social and even sexual mechanisms. According to the World Health Organization guidelines for managing the health effects of FGM/C, further research into its psychological effects and preventative measures is required. In this study, a comprehensive review of the mental health consequences of circumcised women of reproductive age has been conducted with a special focus on providing preventive solutions. Methods: A comprehensive search of the Web of Science, PubMed(MEDLINE), Proquest ,Scopus and Google scholar was carried outfrom 2000 to 2022. The second stage of search was conducted in grey literature. To facilitate a systematic approach to search the literature, the PECO framework, was adopted. Results: The result of this narrative review study showed that, the most common mental health disorder in reproductive age circumcised women were depression, anxiety and post-traumatic stress disorder. Some studies found a significant relationship between parents' education level and circumcised girls, so that parents of the circumcised women had a low level of education. Two studies considered religious beliefs, tradition, cleanness, sexual desire control and virginity as the reasons for FGM/C. Conclusion: All forms of FGM/C may be harmful to one's health. Women, who have undergone widespread forms of circumcision, are more likely to develop mental disorders. As the psychosocial effects of circumcision can affect the sexual experience of circumcised women, addressing this issue, emphasizing its legal aspects, and providing preventative solutions can improve physical, mental, social, and even sexual health in circumcised women.

Mutilación genital femenina: un riesgo incrementado por la indiferencia social / Female genital mutilation: an increased risk by social indifference

Resumen La Mutilación Genital Femenina (MGF) constituye una grave violación a los derechos humanos, de la mujer y de la niñez. Si bien se considera una práctica ancestral en algunas culturas, y es justificada y reproducida bajo el relativismo cultural, es un problema que requiere una mayor atención de las instituciones en general y de la salud pública en particular. Colombia es uno de los pocos países en el continente que reporta casos de prácticas de mutilación; sin embargo, el problema es mundial, no solo por los altos flujos de migración de población en alto riesgo en Europa y Norteamérica, sino porque es un imperativo global erradicar de una de las peores formas de violencia contra la mujer.

Abstract Female genital mutilation constitutes a grave violation of human, women and children rights. It is considered an ancestral practice in some cultures, where it is justified and reproduced under the cultural relativism. It is a problem that requires greater attention of the institutions in general and public health in particular. Colombia is one of the few countries in America that reported cases of mutilation practices. However, the problem is global by large flows of high risk migrants to Europe and North America. Its eradication is a global imperative because it is one of the worst types of violence against women.

Female Genital Mutilation Reconstruction: A Preliminary Report.

BACKGROUND: Female genital mutilation (FGM) is internationally recognized as a violation of human rights. Though rarely discussed, FGM is prevalent, affecting hundreds of millions of females worldwide. OBJECTIVES: We believe that is important for plastic surgeons to be informed and prepared to address the surgical and emotional needs of these women. We present our experience on treatment of women subjected to FGM. METHODS: Three consecutive patients were treated by our clitoral restoration procedure. The procedure involves conscious sedation and involves wide release of scar tissue around the labia majora and clitoris. Labial flaps are elevated and secured down to the periosteum and the clitoris is allowed to remucosalize. RESULTS: Three females with grade II mutilation were treated. The average age was 32.3-years-old and the average follow up was 305 days. All patients self-reported improved sexual function and decreased embarrassment with their partners. And all recommended the treatment to other women subjected to FGM. CONCLUSIONS: FGM is a violation of the basic rights of women and children. Plastic surgeons can help these women restore their physical and psychological sense of well-being by providing effective reconstructive options. Our goal is to raise awareness of this problem and describe a simple yet effective treatment for women that have been subject to FGM. LEVEL OF EVIDENCE: 5.

Frequency-Dependent Social Transmission and the Interethnic Transfer of Female Genital Modification in the African Diaspora and Indigenous Populations of Colombia.

We present a quantitative account based on ethnographic and documentary research of the prevalence of female genital modification (FGMo) in the African diaspora and indigenous populations of Colombia. We use these data to test hypotheses concerning the cultural evolutionary drivers of costly trait persistence, attenuation, and intergroup transmission. The uptake of FGMo by indigenous populations in Colombia is consistent with frequency-dependent hypotheses for the social transmission of the FGMo trait from the African diaspora population in the period following the era of slavery in Colombia. The prevalence and severity of practices related to FGMo decline with level of sociocultural integration into mainstream Colombian culture. Our results provide empirical support for the cultural evolutionary models proposed by Ross et al. (2015) to describe the transmission dynamics of FGMo and other costly traits. Analysis of costly trait dynamics contributes knowledge useful to applied anthropology and may be of interest in policy design and human rights monitoring in Colombia and elsewhere.

[Impact of female genital mutilation on the millennium goals]. / Impacto de la mutilación genital femenina en los objetivos del milenio.

OBJECTIVE: To relate the Female Genital Mutilation as a negative factor for the achievement of the Millennium Development Goals 1, 3, 4, 5 and 6. METHOD: Data collection was through review literature review between in the years 2014 and 2015 in the databases Medline/PubMed, Web of Science, LILACS, SCIELO, Tesis Doctorales TESEO and in the webs of WOK, UNICEF, UNAF and WHO using the descriptors: female circumcision, millennium development goals, rights of women. Articles published between years 2010 y 2015, were included and finally 24 articles were selected. RESULTS: The Female Genital Mutilation is based on gender discrimination, and reinforces and encourages the circle of poverty. This practice causes physical complications that may affect the infant mortality and morbidity, complications in pregnancy and childbirth and there is a relationship between the practice and the transmission of human immunodeficiency virus. CONCLUSION: The fight against Female Genital Mutilation contributes to the achievement of five of the eight Millennium Goals.

Impacto de la mutilación genital femenina en los objetivos del milenio / Impacto da mutilação genital feminina nos objetivos do milênio / Impact of female genital mutilation on the millennium goals

RESUMEN Objetivo Relacionar la Mutilación Genital Femenina como factor negativo para la consecución de los Objetivos de Desarrollo del Milenio 1, 3, 4, 5 y 6. Métodos Se ha realizado la recogida de datos a través de una revisión integradora de la literatura en los años 2014 y 2015. Se consultaron las bases de datosMedline/PubMed, Web of Science , LILACS, SCIELO, Tesis Doctorales TESEO y en las webs de WOK, UNICEF, UNAF y WHO utilizando los descriptores: circuncisión femenina, objetivos de desarrollo del milenio y mutilación genital femenina. Se incluyeron artículos publicados entre los años de 2010 y 2015, y se seleccionaron finalmente 24 artículos. Resultados La Mutilación Genital Femenina es una práctica basada en discriminaciones de género que refuerza e incentiva el círculo de la pobreza. Provoca complicaciones físicas que pueden repercutir en la mortalidad y morbilidad infantil, así como en complicaciones en el embarazo y el parto y en la adquisición del virus de la inmunodeficiencia humana. Conclusión La lucha contra la Mutilación Genital Femenina contribuye a la consecución de cinco de los ocho Objetivos del Milenio.

RESUMO Objetivo Relacionar a MGF como um fator negativo para a realização dos Objetivos de Desenvolvimento do Milênio 1, 3, 4, 5 e 6. Método Foi realizada a coleta de dados por meio da revisão da literatura nos anos de 2014 e 2015, nas bases de dados Medline/PubMed, Web of Science, LILACS, SCIELO, Tesis Doctorales TESEO e nos sites da UNICEF, UNAF e WHO utilizando-se os descritores: circuncisão feminina, objetivos de desenvolvimento do milênio e mutilação genital feminina. Foram incluídos artigos publicados entre os anos de 2010 e 2015, e selecionados finalmente 24 artigos. Resultados A mutilação genital feminina é uma prática baseada na discriminação de género que reforça e estimula o ciclo da pobreza. Causa complicações físicas que podem afetar a mortalidade e morbidade infantil, bem como complicações na gravidez e no parto e na aquisição de HIV. Conclusão a luta contra a MGF contribui para a realização de cinco dos oito Objetivos de Desenvolvimento do Milênio.

ABSTRACT Objective To relate the Female Genital Mutilation as a negative factor for the achievement of the Millennium Development Goals 1, 3, 4, 5 and 6. Method Data collection was through review literature review between in the years 2014 and 2015 in the databases Medline/PubMed, Web of Science, LILACS, SCIELO, Tesis Doctorales TESEO and in the webs of WOK, UNICEF, UNAF and WHO using the descriptors: female circumcision, millennium development goals, rights of women. Articles published between years 2010 y 2015, were included and finally 24 articles were selected. Results The Female Genital Mutilation is based on gender discrimination, and reinforces and encourages the circle of poverty. This practice causes physical complications that may affect the infant mortality and morbidity, complications in pregnancy and childbirth and there is a relationship between the practice and the transmission of human immunodeficiency virus. Conclusion The fight against Female Genital Mutilation contributes to the achievement of five of the eight Millennium Goals.

A difícil arte de amar: a limitação do conhecimento entre o homem e a mulher: uma interpretação da psicologia simbólica junguiana / Difficulties in the art of loving: the limitation of knowledge among men and women

Baseada na formação da identidade pela elaboração dos símbolos e funções estruturantes coordenados por arquétipos nas incontáveis vivências existenciais, a psicologia simbólica junguiana argumenta, neste artigo, que o amor exige o conhecimento das personalidades dos amantes e que o desconhecimento entre o homem e a mulher, que ainda é muito grande, dificulta sua vivência. A seguir, o autor defende a tese segundo a qual o conhecimento entre o homem e a mulher vem se desenvolvendo lentamente na história da humanidade, mas ainda está no início. Ele afirma também que até mesmo esse pequeno conhecimento acumulado está deformado por projeções defensivas mútuas, oriundas da constituição física, do problema do desenvolvimento diferente de um e de outro e da confusão da identidade do homem e da mulher com os papéis que desempenharam na história. Assim sendo, o autor descreve resumidamente essas deformações e, concluindo, afirma que, para se conhecerem e poderem se amar, o homem e a mulher necessitam antes de tudo elaborar essas deformações milenares que os afastaram e ainda hoje os iludem (AU)

In this article Jungian symbolic psychology suggests that love requires a good deal of knowledge of the personalities of men and of women and that lack of knowledge, still very pronounced, limits this experience. The theory is based on identity formation by the elaboration of symbols and structuring functions according to archetypes. The author supports that knowledge among men and women is slowly developing in the history of humankind, but is still in the beginning, and even this little knowledge is deformed by mutual projections originated in our physical constitution, in the differences of our process of development and in the confusion between the identity of man and of woman and the roles they have lives through history. Therefore, the author summarily describes these deformations and concludes that, in order to know and to love each other, men and women firstly need to elaborate these millenary deformations which have driven them apart through wounds and illusions (AU)

A difícil arte de amar: a limitação do conhecimento entre o homem e a mulher: uma interpretação da psicologia simbólica junguiana / Difficulties in the art of loving: the limitation of knowledge among men and women

Baseada na formação da identidade pela elaboração dos símbolos e funções estruturantes coordenados por arquétipos nas incontáveis vivências existenciais, a psicologia simbólica junguiana argumenta, neste artigo, que o amor exige o conhecimento das personalidades dos amantes e que o desconhecimento entre o homem e a mulher, que ainda é muito grande, dificulta sua vivência. A seguir, o autor defende a tese segundo a qual o conhecimento entre o homem e a mulher vem se desenvolvendo lentamente na história da humanidade, mas ainda está no início. Ele afirma também que até mesmo esse pequeno conhecimento acumulado está deformado por projeções defensivas mútuas, oriundas da constituição física, do problema do desenvolvimento diferente de um e de outro e da confusão da identidade do homem e da mulher com os papéis que desempenharam na história. Assim sendo, o autor descreve resumidamente essas deformações e, concluindo, afirma que, para se conhecerem e poderem se amar, o homem e a mulher necessitam antes de tudo elaborar essas deformações milenares que os afastaram e ainda hoje os iludem.

In this article Jungian symbolic psychology suggests that love requires a good deal of knowledge of the personalities of men and of women and that lack of knowledge, still very pronounced, limits this experience. The theory is based on identity formation by the elaboration of symbols and structuring functions according to archetypes. The author supports that knowledge among men and women is slowly developing in the history of humankind, but is still in the beginning, and even this little knowledge is deformed by mutual projections originated in our physical constitution, in the differences of our process of development and in the confusion between the identity of man and of woman and the roles they have lives through history. Therefore, the author summarily describes these deformations and concludes that, in order to know and to love each other, men and women firstly need to elaborate these millenary deformations which have driven them apart through wounds and illusions.

Os desafios éticos da mutilação genital feminina e da circuncisão masculina / Los desafíos éticos de la mutilación genital femenina y de la circuncisión masculina / Ethical challenges of female genital mutilation and of male circumcision

O trabalho aborda os desafios éticos concernentes à mutilação genital feminina e à circuncisão masculina, mostrando similitudes e diferenças. A circuncisão masculina é um procedimento médico para determinadas condições clínicas da saúde genital masculina. Os povos que praticam a mutilação genital feminina também praticam a circuncisão masculina ritualística, sendo que há povos e religiões que praticam a circuncisão masculina sem que haja mutilação genital feminina. A mutilação genital feminina se concentra em bolsões de pobreza, sendo atentatória aos direitos humanos, havendo diversos movimentos mundiais em prol de sua erradicação. A circuncisão masculina pode se associar a complicações bastante sérias, de modo que não é aceitável sua realização sem indicação clínica precisa.

Este artículo enfoca los desafíos éticos acerca de la mutilación genital femenina y la circuncisión masculina, demostrando las similitudes y diferencias. La circuncisión masculina es un procedimiento médico para determinadas condiciones clínicas de la salud genital masculina. Los pueblos que practican la mutilación genital femenina también practican la circuncisión masculina ritualista, habiendo pueblos y religiones que practican la circuncisión masculina sin que exista la mutilación genital femenina. La mutilación genital femenina se concentra en zonas de pobreza y ofende a los derechos humanos, habiendo muchos movimientos mundiales en favor de su erradicación. La circuncisión masculina puede estar asociada con complicaciones muy graves, por lo que no es aceptable su realización sin una indicación clínica precisa.

This article is about the ethical challenges related to female genital mutilation and male circumcision, by showing similarities and differences. Male circumcision is a medical procedure to some clinical conditions of male genital health. The peoples that carry out the female genital mutilation also carry out together the ritual of male circumcision, but there are peoples and religions that carry out male circumcision without female genital mutilation. Female genital mutilation occurs concentrated in very poor regions and it is against Human Rights, so there are several worldwide movements for its eradication. Male circumcision can be associated to seriously dangerous complications, so that it is not ethically acceptable to be carried out without a precise clinical indication.

Caring with difficulty: Brazilian nurses' experiences of gynaecological surgery care.

This study was made by a qualitative approach based on symbolic interactionism and grounded theory. The subject was defined as what mutilation means for nurses who take care of women submitted to gynaecological surgery. The aim was to identify the interaction relationship of nurses as female with the phenomenon of mutilation in gynaecological surgeries and how it affects their relationship with female patients in this situation. Data were obtained by interviews with 16 nurses who work in gynaecology units. The findings present two core categories: speaking as a professional and speaking as female. When they spoke as professional nurses they defined mutilation technically. As females they verbalized their conflict and difficulty in working with mutilation and redefined it as being the loss of something very important for themselves. We conclude that female nurses when confronting female surgery distances themselves behind the professional nurse and performs nursing care as a daily routine. It means that these nurses live a personal conflict that influences directly on how they supply care. They care for, but do not care about; the ethos of biomedicine leads carers on to a technical path from which it is difficult to get off.

Quiste de inclusión epidérmico vulvar como complicación tardía de circuncisión ritual / Vulvar epidermoid inclusion cyst as a late complication of ritual circumcision

Presentamos un caso de quiste de inclusión epidérmico, como complicación tardía, en una mujer africana con antecedente de mutilación genital tipo II o clitoridectomía total, durante su infancia.

We report a case of epidermal inclusion cyst as a late complication in an African woman with history of ritual genital mutilation type II or total excision during childhood.

Egypt demographic and health survey 2008

Health for all is the main health objective of the Egyptian government. To monitor and evaluate progress toward the achievement of this goal, reliable data are needed. These data come from two primary sources: the health service delivery system (service-based data) and the community (household-based data). The two types of data complement each other in enhancing the information available to monitor progress in the health sector. Beginning in 1980, a number of household surveys have been carried out in Egypt to obtain data from the community on the current health situation, including a series of Demographic and Health Surveys of which the 2008 EDHS is the most recent. The results of the 2008 EDHS show that several key maternal and child health indicators including antenatal care coverage, medical assistance at delivery, and infant and child mortality have improved. The survey also found that family planning use is rising and fertility is continuing to decline although at a slow pace. In addition, the 2008 Egypt DHS collected information relating to other health issues that Egypt is facing including knowledge and practices relating to avian influenza and the prevalence of high blood pressure among the adult population. By collecting and testing blood samples for the hepatitis C virus from respondents, the survey also provides the first nation-wide data on the prevalence of infection with the hepatitis C virus among the Egyptian population age 15-59 years. The findings of the 2008 EDHS together with service-based data are very important for measuring the achievements of the health program to date as well as for planning future interventions to address Egypt’s health challenges. Based on the above-mentioned considerations, it is very important that the results of the 2008 EDHS should be widely disseminated at different levels of health management, in the central offices as well as local governments, and to the community at large

Sierra Leone demographic and health survey 2008

One of the mandates of Statistics Sierra Leone (SSL) is to collect, collate, process, analyse, publish and disseminate population census and survey data at all levels. Statistics Sierra Leone has the additional mandate of being the focal point for policy formulation and coordination of population activities in the country. By this mandate, Statistics Sierra Leone occupies the leadership position in the population sector and the major provider of information on the Sierra Leone population. The successful conduct of the 2008 Sierra Leone Demographic and Health Survey (SLDHS) and the production of this report, within a reasonably short time frame, undoubtedly underscores Statistics Sierra Leone’s leadership role. The compilation of the report has been borne out of the need to meet the yearnings of policy makers, programme implementers, and researchers, who require timely data for their day-to-day operations. The report contains detailed information on the demographic, health, and social indicators that will enable us measure progress in the Sierra Leone Society