FGM Impact on Women's Health

This research proposal examines the impact of Female Genital Mutilation (FGM) on the psychological and physical health of women aged 18-35 in the UK. It explores the prevalence of FGM, its long-term consequences, factors influencing the practice, and government strategies for prevention. The study utilizes a qualitative approach with interviews and thematic analysis to provide a comprehensive understanding of FGM's impact on women's well-being.

Research proposal: FGM impacted on the
psychological and physical health-wellbeing
of women

TABLE OF CONTENTS
Topic: How has FGM impacted on the psychological and physical health-wellbeing of women
aged 18-35 who have experienced it?..........................................................................................1
INTRODUCTION...........................................................................................................................1
Background of study....................................................................................................................1
Aim..............................................................................................................................................1
Objectives....................................................................................................................................1
Questions.....................................................................................................................................2
Rationale......................................................................................................................................2
Significance.................................................................................................................................2
Scope of study..............................................................................................................................2
LITERATURE REVIEW................................................................................................................2
Theme 1: Prevalence of FGM UK...............................................................................................2
Theme 2: Psychological and physical impact of FGM................................................................3
Theme 3: Factors that influence the practice of FGM.................................................................5
Theme 4: Government strategy that are in place to prevent FGM in UK...................................5
RESEARCH METHODOLOGY....................................................................................................6
Research Philosophy:...................................................................................................................6
Research approach.......................................................................................................................7
Research design...........................................................................................................................7
Research Type.............................................................................................................................8
Sampling......................................................................................................................................8
Data Collection............................................................................................................................8
Data Analysis...............................................................................................................................9
Ethical consideration...................................................................................................................9
Research limitation......................................................................................................................9
TIME PLAN....................................................................................................................................9
REFERENCES................................................................................................................................1

Topic: How has FGM impacted on the psychological and physical health-wellbeing of women
aged 18-35 who have experienced it?
INTRODUCTION
Background of study
Psychological and physical health-wellbeing of individual reflects growth and
development of people on the basis of rewards and challenges of life events. Female Genital
Mutilation is medical practices which aim at partial or total removal of external genitalia of
young women and girls for some specific medical purpose (Ezebialu and et.al., 2017). However,
FGM is considered as traditional practices in some culture where removal of external genitalia of
females is mandatory. The practice is illegal in many countries as it leads to wide range of long-
term physical consequences like formation of cysts, formation of keloid scar, sexual dysfunction,
risk of HIV, etc. The female who undergo FGM suffer from psychological effects like chronic
pain, mood swings, suicidal tendencies, sleeping disorder, depression, etc.
World health organisation articulate about immediate trauma as psychological impact on
wellbeing of women who experience FGM. it is the situation which body undergo acute pain and
shock which results in post-traumatic stress disorder (Kuntner and et.al., 2016). Female Genital
Mutilation is considered as gross violation of human right of girls and women specially in the
communities where is the considered as traditional cultural practice (Female Genital Mutilation
Risk and Safeguarding, 2016). The practice enforces situation like early pregnancies and
marriages (Liang and et.al., 2016). The study will outline physical and psychological impact of
Female Genital Mutilation (FGM) on women health-wellbeing of women aged 18-35. The
research will be beneficial for developing critical understanding over experiences of women who
have undergone FGM. In addition, the project ill be focusing on outlining framework for health
care workers to manage physical and psychological impact of FGM.
Aim
“To investigate the physical and psychological impact of Female Genital Mutilation
(FGM) on women health-wellbeing of women aged 18-35”.
Objectives
 To examine prevalence of FGM in UK
 To investigate the psychological and physical impact of FGM
 To examine the factors that influence the practice of FGM

 To examine the government strategy that are in place to prevent FGM in UK
Questions
 Discuss prevalence of FGM in UK?
 Explain psychological and physical impact of FGM?
 What are the factors that influence the practice of FGM?
 What government strategy can be placed to prevent FGM in UK
Rationale
The motive behind choosing this research topic is to understand the condition and
psychological impact on health of females who under FMG practice. Further, the study is for
academic interest where researcher will aim at gaining knowledge over health care provision and
better management of female victims and their families. In addition, the study is for personal
intertest where focus of scholar will on outlining government strategies which can helps in
preventing FGM as it is an initial cause of chronic illness among women of age group 18 to 35.
Significance
The study is significant as it will helps the research in learning different terms that is
psychological impacts, physical impact, FMG, government strategy, prevention, cultural
perspective, human rights, etc. The study will help in gaining wide knowledge over different
terms and FMG as clinical practice which is illegal but is still practiced regardless of its
Psychological and physical impact on wellbeing of women.
Scope of study
The scope of study is wide as it will boost learning in different perspective with the helps of
which researcher will be able to outline better management female victims who under FGM.
Further, the study will help in deriving appropriate inclusive framework which can be
implemented for health care workers of UK.
LITERATURE REVIEW
Theme 1: Prevalence of FGM UK
As per the view of Bede, (2016) women have experienced Female genital mutilation do
not only reside the urban area of England and Wales. Many are also living in rural areas. London
has the highest national prevalence with an estimated 2.1% women who have been affected by
this unethical practice. Outside London the highest estimates are Manchester, Slough, Bristol,
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Leicester and Birmingham. It has been analysed that women undergoing FGM operations are
often suffering from psychological disorders such as anxiety, depression, guilt and shame.
Mostly this practice is being followed in the name of culture and traditions. Among 9,179 total
attendances 5391, cases of FGM in 2016-2017 were recorded (Annual statistical publication for
FGM shows 5,391 newly recorded cases during 2016-17, 2018). As per NHS digital it can be
articulated that girls and Women born in Somalia are more than one third that is 35 % which is
875 cases newly recorded cases of FGM where 112 involved women and girls were born in the
United Kingdom.
Figure 1: Estimated prevalence of FGM among Women
(Source: Alison and Efua, 2017)
Theme 2: Psychological and physical impact of FGM
In the opinion of Hadid and Dahan, (2015) an immediate psychological trauma can be
suffered by women who have experienced female genital mutilation. Experience of FGM
increases the short- and long-term health risks to women and girls and is unacceptable from a
human rights and health perspective. There is a high risk of adverse health outcomes. Women
can suffer from the severe pain by cutting of the ends of the nerves as cutting of the sensitive
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genital tissue causes intense pain. It can be because during performing of this practice proper
anaesthesia is not been used. Women who have experienced FGM can also face pain which can
be caused due to shock or also may face condition of haemorrhage. Females who undergo
operation of genital mutilation suffers from issues like problem passing in Urine. This may be
due to swelling of tissue or injury to the urethra. women and girls who have experienced FGM
can face the problem of excessive bleeding. This makes their physical health weaker. Excessive
bleeding can be caused if the blood vessel or clitoral artery is being cut down during the
procedure.
Little, 2015, stated that One of the other damages that women who have experienced
FGM can go through is genital tissue swelling. It can be because of inflammatory response or
local infection. This makes the body of Women weak and often leads to adverse conditions like
death. Making use of infected and contaminated instruments in genital mutilation operations can
also lead to other health problem such as HIV Aids. Cutting of genital tissues with the same
surgical instrument without sterilization could increase the risk for transmission of HIV between
girls who undergo female genital mutilation together. Female, girls or women undergoing genital
mutilation operation also faces menstrual problems. It can be because of the barrier in the
opening of vagina. It can lead to pain during menstruation, irregular menses and trouble in
passing menstrual blood.
On the other hand, Gültekin and et.al., (2016) women who have undergone female genital
mutilation also suffers from post-traumatic stress disorder, anxiety and depression. It has also
been analysed that women who have undergone FGM also faces problems in their marital life
that often leads to adverse steps like suicide and divorce. Common issues faced by such women
are emotional or physical pain during sexual intercourse that affects the intimacy of
relationships. In the long term, there may be ‘behavioural disturbances as a result of the
childhood trauma and possible loss of trust and confidence in carers who have permitted, or been
involved in, a painful and distressing procedure’. Females who have experienced FGM also goes
through feeling of guilt, anger and pain. They lose their self-esteem as well as confidence that
makes them unhealthier. Females who have undergone FGM may have the knowledge of
differences in appearance of their genitalia and can feel disgusted during clinical examination or
sexual intercourse. Further not been able to engage in proper sexual intercourse will lead to not
been able to fulfil their desire of bearing a child, due to which many females face depression.
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Theme 3: Factors that influence the practice of FGM
In accordance with Earp, (2015) unethical practices like FGM are performed due to
cultural and social factors. FGM is often motivated by beliefs about what is considered
acceptable sexual behaviour. It aims to ensure premarital virginity and marital fidelity. FGM is in
many communities believed to reduce a woman's libido and therefore believed to help her resist
extramarital sexual acts. Many communities feel that making women undergo the FGM
operation can make them protected from rape and also, they can-not have sex before marriage
and can remain pure for them would be spouse. Often undergoing these drastic practices faces
many emotional and physical issues that makes them unhealthier. They often suffer from
problems like anxiety and depression.
Dyer, (2017) contrasts whether FGM is a matter of custom or traditions or an abuse of
human rights, it is deeply rooted outdated practice that has the drastic impact on the physical and
emotional well-being of women, females and girls. They consider it as the matter of good-deed.
Communities engaged in performing FGM feels that god is being impressed by this act. Author
has analysed that the main reason of such unethical practice is low education and unawareness of
females or women. Local structures of power and authority, such as community leaders, religious
leaders, circumcisers, and even some medical personnel can contribute to upholding the practice.
For making this practice stop, government needs to educate the communities as well as their
leaders on this. Also, some communities believe that the vaginal cut increases the chances of
females getting married. It makes them purer for male.
Theme 4: Government strategy that are in place to prevent FGM in UK
According to Onsongo, 2017, Female Genital Mutilation is illegal in United Kingdom
which is prohibited by Female Circumcision Act 1985. The practice is considered as illegal
because it leads to serious harm to health of females like the individuals undergo complication in
childbirth, sexual dysfunction and depressive disorders. National health services England is
working in partnership with patients and victims by providing them clinical expertise to deal
with the disorders and chronic pain syndrome. As per the views of Hussain and Rymer, 2017,
government of UK shares committee again this practice according to which FGM is considered
as child abuse. The first prevention measure again Female Genital Mutilation by government is
Female Genital Mutilation Act 2003. The act was enforced to protect survivors and to the
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females who are at risk of experiencing FGM. As per act failing to protect girls from FGM
practice is an offense for which the individuals are liable to face penalty or punishment.
In contrast Creighton and et.al., 2016, discussed about national network of Home offices
Border force with 600 trained trafficking and safeguarding officers. The officers of forces aim at
identifying potential survivors at border to order to prevent other people which can be victim of
FMG practice. Further, department of health in UK issue notice for front line clinicians to
remind them responsibility again this practice. Further, Pacho, 2015, articulated about girls’
summit by UK government to end Female Genital Mutilation which is violation of human and
Women rights. In accordance with this, marriage unit is forced in UK where a joint home office
unit and FCO is formed who works together for providing assistance and support to the victims
of forced marriage (THE GOVERNMENT RESPONSE TO THE NINTH REPORT FROM THE
HOME AFFAIRS SELECT COMMITTEE SESSION 2016–17 HC 390, 2016). Further the summit
discussed about eradication of FGM for promoting human rights and providing democratic
values to females of society. Amasanti, Imcha and Momoh, 2016, stated that FGM is considered
as integral part of cross government violence against girls and Women strategy. In this
department of health UK has provided 4 million pounds for prevention of national FGM
prevention programme. This is done to improve social response case for FGM. The grand and
funding helps in safeguarding vulnerable victims and girls who are at risk of experiencing FGM.
Brook and et.al., 2014, discussed about FMG helpline number and email where girls’ vulnerable
survivors can report their concerns and as per FGM protection order the practice is criminal
offence against which the clinicians or families forcing or practicing Genital Mutilation are
sentenced to maximum imprisonment of 5 years (Female genital mutilation (FGM) Preventing
and protecting, 2019).
RESEARCH METHODOLOGY
Research methodology is the tools and techniques that supports the scholar in conducting
investigation in systematic and efficient manner. This is the procedure to find suitable solutions
of research problems.
Research Philosophy:
It is the tool that deals with nature and sources through which knowledge about topic can
be developed. It can be defined as belief through which scholar can collect the data and can
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analysed it effectively. Interpretivism, positivism are the major philosophies that are used in
different studies (Kumar, 2019). Interpretivism is the type of technique that is used in qualitative
studies where’s scholar is required to involve theories and models. On other hand positivism is
another type of method that is generally applied in quantitative types of researches where scholar
is required to use facts, figures and have to make statistical calculations in order to get valid
results.
In the present study on physical and psychological impact of Female Genital Mutilation
(FGM) on women health-wellbeing of women aged 18-35 scholar will take support of
interpretivism philosophy. Use of theories and involvement of human being will help in gaining
better and insight detail about the research problem.
Research approach
This is another tool or a plan that outline the entire research and describe the way in
which entire study will be conducted. Inductive and deductive are two common approaches that
are used in different research projects and dissertation (Fletcher, 2017). Inductive is the type of
method that conducts study from general to specific manner whereas deductive is the method
that conducts investigation from specific to general manner. In inductive approach researcher is
not required to frame hypotheses but in deductive it is essential to frame hypotheses and test
these assumptions in order to find out answers of research problems.
In the present study on physical and psychological impact of Female Genital Mutilation
(FGM) on women health-wellbeing of women aged 18-35 scholar will apply inductive approach.
This will help in involving theories and generating meaningful valid results.
Research design
Exploratory, conclusive, descriptive etc. are various designs that are used in different
projects. Exploratory design is the method that emphases on gathering insight details related to
subject matter (Ledford and Gast, 2018). It explores the facts and find subjective answers related
to topic. On other hand conclusive is another design that helps in implementing right actions
through which valid conclusion can be drawn on research topic. It is more objective rather than
subjective. Descriptive is the type of tool that describes the relevant facts by involving theories
and models.
In the present study on physical and psychological impact of Female Genital Mutilation
(FGM) on women health-wellbeing of women aged 18-35 researcher will use descriptive
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research design, it would be suitable in order to know more about FGM and its consequences for
women those who suffer from it.
Research Type
Qualitative and quantitative are two types of researches, both these have unique features
and use in different kinds of studies. Qualitative is the type of method in which scholar generally
applies theories and models. In this type of study scholar don’t perform any statistical
calculation’s in order to find out results. On other hand quantitative is the type of technique that
involves facts and perform calculations in order to find out accurate answer of research
problems.
In the present research on physical and psychological impact of Female Genital
Mutilation (FGM) on women health-wellbeing of women aged 18-35 researcher will apply
qualitative research type and there will not calculation’s performed by scholar. Researcher will
emphases on theories related to FGM.
Sampling
It is the procedure of selecting right number of people from the population those who
have knowledge and experience about related subject matter. It is essential for researcher that to
select right people with right number otherwise individual will not be able to reach to end results.
In the current investigation on physical and psychological impact of Female Genital Mutilation
(FGM) on women health-wellbeing of women aged 18-35 scholar will apply random sampling
method. This would be worthwhile technique because by this way investigator will be able to get
actual information without bias. This is also beneficial in order to minimise chances of errors.
Researcher will involve 10 gynaecologists as sample those who are working in hospitals in UK.
They regularly meet with such women those who are suffering from FGM and they have good
knowledge about what kind of consequences face by such girls. Hence, they will be able to give
accurate answers on the research problems.
Data Collection
Primary and secondary are two main sources of collecting information about any topic.
Primary data are fresh and it is not used prior to any study. On other hand secondary data are
another source, such kind of data can be used in many studies. Books, Journals, government sits
are such sources through which scholar can gather secondary details. Whereas in order to gain
primary data researcher can use questionnaire, interview, survey etc.
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In the current investigation on physical and psychological impact of Female Genital
Mutilation (FGM) on women health-wellbeing of women aged 18-35 scholar will apply
interview technique. This would be suitable form to get answers on physical and psychological
consequences of FGM.
Data Analysis
Data analyses is helpful method that aids researcher in reaching to end results. Once data
is being collected by scholar then all these details are converted into meaningful information
through analyses. SPSS is the technique which is used in quantitative studies whereas scholar
put all the raw data into software and statistical calculations are performed to get the results. On
other hand thematic analyses is another technique that is used in qualitative study. In the current
study on physical and psychological impact of Female Genital Mutilation (FGM) on women
health-wellbeing of women aged 18-35 researcher will use thematic analyses tool. Individual
will frame themes on the bases of research questions will interpret these themes by using graphs
and charts.
Ethical consideration
Scholar will give respect to all participants and will not copy any material from many
sites. Individual will be sent consent form to all the respondents and will involve them in
investigation after getting their approval. Furthermore, data will be protected and will not be
shared with any third person. Further, the scholar will ensure asking of proper question in order
to protect belief, morals and practices of participants.
Research limitation
The major limitation of study can be use of words, framing is of question, seeking valid
information and adhering to ethics which can restrict accumulation of information on wide
perspective. Analysis of collected information will be critical as in this it is important for the
researcher to outline specific information to address research objectives and questions.
TIME PLAN
Activities Wee
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Selection of
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Framing aim and
objectives
Conducting
literature review
Selection of
research
methods
Completion of
research
proposal
Collecting data
Analysing the
data
Drawing
conclusion and
framing
recommendation
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Making editions
as per the
requirements
Final submission
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REFERENCES
Books and Journals
Amasanti, M.L., Imcha, M. and Momoh, C., 2016. Compassionate and Proactive Interventions by
Health Workers in the United Kingdom: A Better Approach to Prevent and Respond to
Female Genital Mutilation?. PLoS medicine. 13(3). p.e1001982.
Bede, F., 2016. Female genital mutilation. InnovAiT. 9(7). pp.395-403.
Birge, O., and et.al., 2015. Vulvar epidermoid cyst and type 2 radical genital mutilation. Case
reports in obstetrics and gynecology, 2015.
Creighton, S.M. and et.al., 2016. Multidisciplinary approach to the management of children with
female genital mutilation (FGM) or suspected FGM: service description and case
series. BMJ open, 6(2), p.e010311.
Dyer, O., 2017. US doctors are charged with female genital mutilation for first time. BMJ:
British Medical Journal (Online), 357.
Earp, B.D., 2015. Sex and circumcision. The American Journal of Bioethics. 15(2). pp.43-45.
Ezebialu, I., and et.al., 2017. Surgical and nonsurgical interventions for vulvar and clitoral pain
in girls and women living with female genital mutilation: a systematic review. International
Journal of Gynecology & Obstetrics. 136. pp.34-37.
Fletcher, A.J., 2017. Applying critical realism in qualitative research: methodology meets
method. International Journal of Social Research Methodology.20(2). pp.181-194.
Gültekin, İ.B., and et.al., 2016. Surgical reconstruction in female genital mutilation. Turkish
journal of urology. 42(2). p.111.
Hadid, V. and Dahan, M.H., 2015. A case of chronic abdominal neuropathic pain and burning
after female genital cutting. Case reports in obstetrics and gynecology, 2015.
Hussain, S. and Rymer, J., 2017. Tackling female genital mutilation in the UK. The Obstetrician
& Gynaecologist. 19(4). pp.273-278.
Kumar, R., 2019. Research methodology: A step-by-step guide for beginners. Sage Publications
Limited.
Kuntner, M. and et.al., 2016. The evolution of genital complexity and mating rates in sexually
size dimorphic spiders. BMC evolutionary biology. 16(1). p.242.
Ledford, J.R. and Gast, D.L., 2018. Single case research methodology: Applications in special
education and behavioral sciences. Routledge.

Liang, M., and et.al., 2016. Demographic perspectives of female genital mutilation. International
Journal of Human Rights in Healthcare. 9(1). pp.3-28.
Little, C.M., 2015. Caring for women who have experienced female genital cutting. MCN: The
American Journal of Maternal/Child Nursing. 40(5). pp.291-297.
Onsongo, N., 2017. Female Genital Cutting (FGC): Who Defines Whose Culture as Unethical?.
IJFAB: International Journal of Feminist Approaches to Bioethics. 10(2). pp.105-123.
Pacho, T.O., 2015. Complexity of Female Genital Mutilation/Cutting. Journal of Social work
Values and Ethics. 2(2). pp.63-76.
Brook, G. and et.al., 2014. 2013 UK national guideline for consultations requiring sexual history
taking. Clinical Effectiveness Group British Association for Sexual Health and
HIV. International journal of STD & AIDS, 25(6), pp.391-404.
Online
Female genital mutilation (FGM) Preventing and protecting. 2019. [Online]. Available through: <
https://www.nspcc.org.uk/preventing-abuse/child-abuse-and-neglect/female-genital-
mutilation-fgm/preventing-protecting/ >.
Female Genital Mutilation Risk and Safeguarding. 2016 [Online]. Available through:
<https://assets.publishing.service.gov.uk/government/uploads/system/uploads/
attachment_data/file/525390/FGM_safeguarding_report_A.pdf>.
THE GOVERNMENT RESPONSE TO THE NINTH REPORT FROM THE HOME AFFAIRS
SELECT COMMITTEE SESSION 2016–17 HC 390. 2016. [Online]. Available through:
<https://assets.publishing.service.gov.uk/government/uploads/system/uploads/
attachment_data/file/573776/57751_Cm_9375_FGM_accessible.pdf>.
Annual statistical publication for FGM shows 5,391 newly recorded cases during 2016-17. 2018.
[Online]. Available through: <
https://digital.nhs.uk/news-and-events/news-archive/2017-news-archive/annual-
statistical-publication-for-fgm-shows-5-391-newly-recorded-cases-during-2016-17>.
Alison, M. and Efua, D., 2017. Prevalence of Female Genital Mutilation in England and Wales:
National and local estimates. [Online]. Available through: <
https://beta.ukdataservice.ac.uk/impact/case-studies/case-study?id=228>.
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