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Introduction
As migrants and refugees cross borders, they carry deeply rooted traditions and cultural practices such as female genital mutilation. Female genital mutilation/cutting (FGM/C) comprises “all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs whether for cultural or other non-therapeutic reasons” (World Health Organization (WHO), 2014).
FGM/C is a major public health concern. This practice has been performed on approximately 125 million girls, sometime between infancy and age 15 years, mostly concentrated in Western, Eastern and North-Eastern regions in Africa, some countries in Asia and the Middle East, as well as in some immigrant communities in North America and Europe (WHO, 2014). An estimated three million female children continue to be mutilated each year in Africa with approximately 30 million girls worldwide who are at risk (WHO, 2014). FGM/C can be classified into four categories, according to the World Health Organization (WHO), depending upon the severity of the procedure. These types are described in Table I.
FGM/C causes both physical and psychological devastation, even death, for women around the world and yet continues to be performed (Andro et al., 2014; Bacquet-Walsh et al., 2012; Berg et al., 2010; Brown et al., 2013; Goldenstein, 2014; Hill et al., 2012; Jensen, 2010; Macready, 1996; United Nations Population Fund, 2013a). Numerous physical complications both immediate and long lasting due to unhygienic conditions and inadequate health care have been reported for all types of FGM/C including gynecological and urinary infections, intense pain, increased rates of HIV, tetanus, obstructed labor, tearing due to scar tissue, vaginal-rectal fistulas, caesarean sections, post-partum bleeding, stillborn deliveries and infant death among those who had FGM/C (Andro et al., 2014; Brown et al., 2013; Hill et al., 2012; Straus et al., 2009; World Health Organization (WHO), 2008, 2011). Although there are additional reasons for maternal and infant mortality, such rates are highest in the world in countries where FGM/C is practiced (Berg and Underland, 2013; United Nations Children’s Fund, 2014).
Psychological wounds such as shame, embarrassment and isolation following this procedure can plague women their entire lives. Many women suffer from sleep disorders, difficulties in daily life, symptoms of anxiety and/or depression, low self-esteem and/or...