Female Genital Cutting/Mutilation: An Exploratory Study of the Psychological Health Outcomes in Tanzania

Background and Purpose: Female Genital Cutting/Mutilation (FGC/M) is a practice that involves the partial or total removal of various portions of the external female genitalia for non-medically necessary reasons.  While FGC/M is practiced in more than 28 countries in Africa and the Middle East, there are women with FGC/M living around the globe including the U.S. with little to no access to resources.  While the physical and sexual outcomes of FGC/M have been examined, very little research has examined the psychological impact.  Little is known among health care professionals including social workers about these effects of FGC/M and  little is understood about how this impacts women emotionally both in the country where FGC/M is a social norm and countries where FGC/M is not a common practice. This paper helps narrow the gap in the research by examining the mental health and emotional outcomes of FGC/M with women in Tanzania.

Method: Forty in-depth, semi-structured interviews were conducted with adult women (ages 18 to 80) from the Maasai tribe of Tanzania who have undergone FGC/M. Participants were selected by a snowball sampling method and interviewed in either English, Swahili or Maasai language  with the help of a female Maasai translator fluent in each language.  Given that mental health is not a developed field in Tanzania, this study sought to elicit participants’ feelings toward the practice including how the practice made them feel emotionally at the time of the procedure and at present time.  Interviews were transcribed verbatim and coded thematically using qualitative software NVivo version 10. An initial review and coding process suggested multiple thematic findings.

Findings: Preliminary analysis reveals that women underwent FGC/M by force and with little preparation about what the procedure entailed leading to their accounts of associating FGC/M with pain, stress and fear. The data suggest this is a traumatic procedure and is commonly associated with forced and early marriage in which women report initial feelings of unhappiness and fear of leaving their childhood home and being married to men significantly older than them.  Using the biopsychosocial framework, participants report knowing very little about how FGC/M affected them biologically and psychologically but many reported understanding the social implications of the practice within their culture.  Moving forward, many women felt the practice should not continue. 

Conclusions and Implications: The findings highlight the mental and emotional challenges that women endure as young girls in the face of culture and the societal desire to uphold tradition, oftentimes seeing no direct benefit of going through the experience. On a global level, social workers can provide advocacy for women and girls in the area of policy as well as provide support for women who migrate to countries where this is not a common practice to help ease the transition to a foreign country.  Current interventions should seek to include mental and emotional health as an educational component so that women can understand not only how this practice affects them physically and sexually, but also make sense of it at a psychological level.