The Effect of Female Genital Mutilation (FGM) among West African Females in London

Running head: DISSERTATION
The effect of Female Genital Mutilation (FGM) among the west African females age 5 to
21 years living in London, UK
Name of the Student: Nserah Mansaray
Student ID: STU61998
BA Health and Social Care Management
Name of the University: Arden University
Author Note

1DISSERTATION
Abstract
Background- Female genital mutilation (FGM) refers to the ritual circumcision or removal
of all or some portion of the external female genitalia. This practice is prevalent in Africa, the
Middle East and Asia, with particular prevalence in Sierra Leone.
Research question- To determine the effects of FGM amid females from Sierra Leone living
in London, UK.
Methodology- A mixed method research was conducted that was based on both primary and
secondary research design. While the secondary research was reliant on nine pieces of
scholarly evidences, the primary research was based on a one to one interview, conducted
among 10 participants, who were aged between 5-21 years. After obtaining responses from
the participants, four noticeable themes were developed, based on recurrent patterns of
information namely, (i) life experience under the context of cultural and religious view, (ii)
impact on physical and emotional health, (iii) impact on sexuality and fertility menstruation,
and (iv) lack of government support.
Results- Most participants had been forcefully subjected to FGM by their mothers or elder
female family members, on the pretext of citing the procedure as a religious and cultural
obligation. Majority of them stated that FGM created significant physical consequences, with
painful intercourse, loss of sexual desire, sexual dysfunction, infection, cyst development and
excessive bleeding being most common. These directly affected their sexuality and
relationship with partners. Common emotional and psychological consequences were
associated to depression, PTSD, and anxiety.
Conclusion- There is no potential health benefits associated with the process and the
participants are not able to access the available government facilities in the UK.

2DISSERTATION
Table of Contents
1.0 Introduction..........................................................................................................................5
1.1 Background......................................................................................................................5
1.2 Rationale..........................................................................................................................6
1.3 Case Study........................................................................................................................7
1.4 Research Aim...................................................................................................................7
1.5 Research Objectives.........................................................................................................7
1.6 Key-terms.........................................................................................................................8
1.7 Dissertation structure.......................................................................................................8
2.0 Literature Review.................................................................................................................9
2.1 Introduction......................................................................................................................9
2.2 Impact of FGM on the victim’s sexuality........................................................................9
2.3 Impact of the UK policies in relating to supporting these young female.......................10
2.4 Impact of FGM reproduction of women and their life...................................................12
2.5 Summary........................................................................................................................12
2.6 Questions to be answered...............................................................................................13
3. Methodology........................................................................................................................14
3.1 Introduction....................................................................................................................14
3.2 Ontology and Epistemology...........................................................................................14
3.3 Research Questions........................................................................................................14
3.3.1 Sampling methods...................................................................................................14

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3.3.2 Data collection........................................................................................................15
3.3.3 The instrument for data collection..........................................................................15
3.3.4. Validity and Reliability..........................................................................................15
3.3.4 Ethical considerations.............................................................................................16
3.4 Limitations.....................................................................................................................16
3.5 Other areas of consideration...........................................................................................16
3.5.1 Keywords used for data collection in the electronic databases...............................16
3.5.3 The databases used for the literature search............................................................17
3.5.4 Literature review methodology...............................................................................17
4. Results and Discussion.........................................................................................................18
4.1 Introduction....................................................................................................................18
4.2 Response rate.................................................................................................................18
4.3 Results............................................................................................................................19
4.3.1. Life experience under the context of cultural and religious view..........................19
4.3.2 Impact on physical and emotional health................................................................19
4.3.3 Impact on sexuality and fertility menstruation........................................................20
4.3.4 Lack of government support...................................................................................21
4.4 Discussion......................................................................................................................21
5. Conclusion............................................................................................................................25
5.1 Introduction....................................................................................................................25
5.2 General conclusion.........................................................................................................25

4DISSERTATION
5.3 Research question conclusion........................................................................................26
5.4 Recommendations..........................................................................................................26
5.5 Errors and limitation......................................................................................................27
References................................................................................................................................28
Appendix..................................................................................................................................31
Appendix 1: Annotated Bibliography..................................................................................31
Appendix 2: Interview transcript.........................................................................................33

5DISSERTATION
1.0 Introduction
1.1 Background
Female genital mutilation (FGM) is a procedure that intentionally change or cause
injury to the female genital organs for no specific non-medical reasons and this procedure
that no specific health benefits for the girls. The procedure can lead to severe bleeding and
complications in urinating and in the later stages of life lead to the generation of cysts, genital
infection along with complications during pregnancy and child births. FGM also said to
increases the risk of preterm birth (WHO, 2019). This custom is popular in Africa, Middle
East and in Asia. Nearly 200 million girls and women are victims of FGM worldwide. It is
regarded as a religious ritual that is mostly carried out over young girls during their infancy
up to the age of 15. There are four different types of FGM. Type 1 FGM is classified as
clitoridectomy. This is regarded as total or partial removal of the clitoris or the prepuce (the
fold of the skin over the clitoris). Type 2 FGM is regarded as excision. It is a type of total or
partial removal of the labia minora (inner folds of the vulva) and clitoris either in presence or
absence of labia majora (outer fold of the skin present over the vulva) (WHO, 2019). Type 3
FGM is referred as infibulations that deals with narrowing of the vaginal opening by insertion
of the covering seal. The seal is formed by cutting followed by repositioning of the labia
minora or labia majora or by stitching with or without clitoridectomy. Type 4 FGM
encompasses all the life threatening procedures execute over the female genitalia for no
specific medical reasons and it mainly involves incising, pricking, piercing, scarping and
cauterizing the genital area (WHO, 2019).
The reason why FGM is conducted over girls varies in different geographic locations
and is guided by a mix of sociocultural factors within different communities. For example, in
the majority of the communities FGM is considered important for raising a girl and prepare

6DISSERTATION
her for marriage and adulthood. I some places it is done to ensure pre-marital virginity or
marital fidelity. In some places FGM is conducted to reduce the women’s libido and
extramarital acts (WHO, 2019).
According to the NHS (2019), girls who are born in UK or are residents of UK but
from FGM practising origin are at a greater risk of FGM. The communities from Egypt,
Eritrea, Ethiopia, Gambia, Africa, Indonesia, Malaysia, Sudan and Yemen residing in UK
mainly practice this brutal ritual. Bjälkander et al. (2013) stated that there is high level of
agreement between the reported and the observed type of FGM in the Sierra Leone. The
study also showed that there is no direct co-relation between demographic, health surveys,
and the FGM in the Sierra Leone. In the majority of the cases flesh is removed (87.1%) and
these are followed by pricking (2.7%) and sewn closing of the genitalia (1.1%).
1.2 Rationale
FGM is internationally considered as a procedure that violates the human rights of
female. The procedure reflects deep-rooted inequalities between the two genders and
constitutes a significant from of sexual or physical discrimination against women. The
practice also violates person’s rights to health, physical integrity and security along with the
right to be free from torture or cruel yet inhuman activities or degrading treatment and the
basic right of live health away from fatal threats (NHS 2019). Apart from violation of the
human rights, FGM also leads to significant impairment of health as it damages the female
genital organs and hampers the normal functioning of the human body. The short term
consequences include pain, excessive bleeding, fever infection and trauma. The long-term
consequences include urinary problems, vaginal problems, menstrual problems, and problems
during child birth and numerous other psychological complications (WHO 2019).

7DISSERTATION
The custom of FGM is more popular among the African communities residing UK
with a special mention to the communities hailing from Sierra Leone. According to the
research conducted by WHO in the year 2018, activities in the West Africa are of the opinion
that mass literacy campaigns along with education are the best possible manner to stop the
brutal tradition prevalent in Sierra Leone however, the current statistics of African population
indicates that there is a gap in educational awareness and health literacy campaigns. Thus
designing of the person specific health education and literacy program might prove to be
helpful in overcoming the situations. Thus this dissertation aims to examine the perspectives
of the Sierra Leone women residing on London UK about their experiences and thought
process of FGM. Depending on their understanding and analysis of the physical harm based
on their lived experience might prove to be helpful in designing targeted policies by the
stakeholders in UK, London.
1.3 Case Study
The study will be conducted under the organisational support of Hawa trust for the
extracting the primary research data from the affected individuals. Hawa trust is a local
organisation that works with women and young girls who are the victims of FGM. Hawa trust
is a charity that is based in Hackney, UK. This charity works together with the other charities
or organisations in order to support the local communities in order to reduce the FGM among
the vulnerable women residing in UK London but are from different origin. The main target
group of this Hawa trust in order to eradicate FGM include the women from the African,
Asian and Arab origin.
1.4 Research Aim
To examine the impact FGM among female from Sierra Leone living in London