This document summarizes a research paper about female genital cutting (FGC). It discusses how over 130 million women worldwide have undergone FGC, mainly in Africa and Asia, due to cultural and religious beliefs. FGC can cause both immediate and long-term health complications. The paper aims to describe the issue of FGC and its significance for nursing. It reviews literature on FGC, including a primary research article discussing the physical and psychological impacts of FGC and recommendations for culturally sensitive nursing care. The document also summarizes two additional reference articles defining FGC and providing global statistics on the practice.

1. Running head: FEMALE GENITAL CUTTING 1
Female Genital Cutting
Janet Nguyen
Chamberlain College of Nursing: NR 321
May 12, 2015

2. FEMALE GENITAL CUTTING 2
Female Genital Cutting
More than 130 million women worldwide have undergone the practice of female genital
cutting, a procedure most commonly practiced in Africa and Asia, due to their cultural and
religious beliefs (Nour, 2015). Though there are many reasons for the continued practice in these
societies, the World Health Organization has recognized the practice “violates a person’s rights
to health, security and physical integrity, the right to be free from torture and cruel, inhuman or
degrading treatment, and the right to life when the procedure results in death” (Female Genital
Mutilation, 2014). Female genital cutting can be classified into four main types and contains no
health benefits. There are many complications associated with this practice, some being
immediate and others leading up to long-term effects. However with the complications, it is
important to acknowledge and respect these patient’s cultures, religious beliefs and personal
wishes all the while providing beneficence in care, patient teaching and providing autonomy in
their own health care. This paper will describe the problem of female genital mutilation and it’s
significance to nursing, identifying current research on the topic and standards of care, and
recommended practices for nursing.
Scope of Problem
The significant issue behind this practice is due to the amount of females that are affected
and how widespread it is globally, with some focus areas in places like Asia, the Middle East and
Western, Eastern and Northeastern regions of Africa. Most of which are practiced on females
from the time of infancy to the age of 15 (Harris, 2013). An issue that relates to this age group is
the fact that it is done without the consent of the female herself nor is fully capable of
understanding the procedure and what it entails. Her mother or religious leaders determine the
decision of Female Genital Mutilation (FGM) at birth. Primarily, the reasoning behind this

3. FEMALE GENITAL CUTTING 3
practice is encouraged and done due to cultural beliefs, religion and tradition. Some reasons
behind this continuing practice includes rite of passage, preserving chastity, ensuring
marriageability, religion, hygiene, improving fertility, and enhancing sexual pleasure for men
(Nour, 2015).
Topic Important to Nursing
This paper presents an overview of female genital mutilation, the significant amount of
females affected in cultures that are currently practicing this procedure and the effects on female
reproductive health. It is important to understand what female circumcision consists of and how
to recognize this procedure on the affected female population. Understanding this practice and
the complications promote awareness on proper care and assessment of females with this
procedure. Along with nursing care, the paper will show the significance of health education and
importance of psychosocial concerns among these populations.
Methods of Data Collection
For the purposes of this paper, a minimum of one primary research article with one of the
article’s authors as a nurse was required. The Chamberlain College online academic library was
utilized for this search. Published research articles on the topic of “Female Genital Mutilation”
were identified for the literature review by searching the Cumulative Index of Nursing and Allied
Health Literature (CINAHL). The search was limited to full-text, peer-reviewed, research articles
published in the English language with abstracts from the dates of May 2010 to May 2015. The
key words used for this search were “Nursing Care” and “Female Genital Mutilation”. A total of
42 articles were found that met these criteria. The primary research article was chosen based on
recent publication date and sourced from the “Nursing Standard”. From here, two more full-text,
peer-reviewed articles, published in the English language with abstracts from the dates 2010 to

4. FEMALE GENITAL CUTTING 4
2015 were chosen from the EBSCOhost database for inclusion in this paper. The key words used
for search were “Mutilation” and “Female Genital Mutilation”. The final two articles chosen
were based on credibility of references and date of publication. A summary of each article is
included below.
Primary ResearchArticle
In this literature review (Terry & Harris, 2013), female genital mutilation is defined and
states the associated physical and psychological complications with women who have had this
procedure done. In Terry & Harris’ literature review, they state that women felt that FGM had a
negative effect on their lives psychologically and physically, but lacked the resources or were too
afraid to seek help about the issue. Anxiety plays a big role in women affected by FGM, from the
experience and complications itself to the pressure put upon them as FGM is a status that allows
them to be marriageable. Though these females were circumcised at a young age, those old
enough to question why, had to deal with the pressures of not being “marriage material”.
Females affected by FGM, may experience anxiety and insecurity coming to health care
professionals with fear of being judged or become hesitant to reveal this about themselves at all.
The idea of FGM and it’s affect on females, specifically anxiety can be attributed to the lack of
control they had during this experience as it is something that was pressured or forced upon
them. With this, trust may be lacking and there could be shame or embarrassment if they were
not accepting or understood the rationale of this practice in the first place. These emotions and
feelings these women feel towards FGM must be recognized to allow communication and trust to
be developed in order to aid the affected female emotionally allowing them to seek further
treatment, if desired. The review also covers nursing care for those with female genital
mutilation not solely care through physiological means, but to empathize and understand the

5. FEMALE GENITAL CUTTING 5
cultural reasoning behind this procedure. Nurses should take be culturally sensitive, advocate for
the patient, promote health education and respect patients wishes while promoting a quality of
life and reducing the risks of complications.
This review consists of literature searched through multiple databases such as: CINAHL,
MEDLINE, British Nursing Index, BioMed Centra, Internurse, Trip, PsycINFO and EBSCO
Psychology & Behavioral Science Collection. It contains thirteen studies on female genital
cutting experiences, nursing care, statistics on prevalence and the attitudes towards FGM.
Resources are listed as well as tables that are easy to read and are informational on the subject
matter. The review uses a good amount of statistics on an international level to allow the reader
to visualize the prevalence of this procedure. Also for nurses and nursing students, the review is
helpful in guiding a plan of care for FGM patients holistically and is written by a nurse, Kate
Harris. This review is very well researched, clear and concise.
Second Reference Article
This profession opinion given by the World Health Organization (2014) provides
information on defining female genital mutilation and the different procedures used to alter
female genitalia. It lists the population most at risk for this practice and covers the lack of health
benefits that come along with this procedure. By definition, the World Health Organization
(WHO) defines female genital cutting or FGM as all procedures that involve partial or total
removal of the external female genitalia, or other injury to the female genital organs for non-
medical reasons. There are four categories: clitoridectomy, excision, infibulation and other
procedures that include pricking, piercing, incising, scraping or cauterizing the genital area
(WHO, 2015). These complications could be immediate at the time of the procedure or lead up to
long-term effects. Often these procedures are done without anesthesia or in non-sterile areas with

6. FEMALE GENITAL CUTTING 6
unsterilized equipment. The quality of life and health education is one of the many issues that
must be acknowledged with relation these complications.
WHO (2014) also provides information on the international response of eliminating
female genital mutilation as well as it’s own response and efforts. WHO is a highly respectable
organization with goals of promoting health and work with health systems on an international
level. Along with the promotion of health, they also focus on advocacy, education and
counseling those living with female genital mutilation. This fact sheet is simple to read and
informational, it states the key facts covering female genital mutilation and has reference to
UNICEF, a humanitarian and developmental assistance program for children and mothers, for
it’s statistical overview.
Third Reference Article
This case study by Blanton (2011) provides insight into a personal experience of a
woman who has had a female genitalia circumcision and an example of an ethical dilemma a
patient may have with their healthcare provider. The female genital cutting procedure is defined
and described as well as the sequelae of FGC. Cultural implications are also given with a bit of
backstory as to the rationale and reasoning behind this cultural and religious practice. Legality of
FGC is briefly described in this case study.
Blanton is a DNP, MSN, BSN from the University of Colorado who put together a great
case study of the HCP dilemma of female genital cutting. Blankton includes a case study that
challenges health care professionals in delivering patient care that contraindicates a patients
autonomy and beneficence. She not only explains the four types of FGCs, but the cultural
rationales and beliefs behind this procedure in great detail. She uses information from reputable
organizations such as WHO, UNICEF and UNFPA to name a few. This case study is a good

7. FEMALE GENITAL CUTTING 7
example of ethical dilemmas and possible solutions to satisfy both the patient and HCP to the
best of it’s abilities.
Related Standard of Care
 Health Education
 Advocacy
 Evidence based practice
According to WHO, since 1997, there has been a push to counteract the practice of FGM
through research, work in the communities and changes in public policy on international and
local levels. In 2008, WHO decided to focus on eliminating this practice by increasing advocacy,
building evidence to expose the causes and consequences of this practice and teaching health
care professionals on treating and counsel females who have experienced female genitalia
mutilation. Along with these steps towards eliminating unnecessary harm of female genitalia
they are strongly urging health professionals not to perform such procedures through building
evidence (WHO, 2014). These are main concepts that are showing a decrease in prevalence, as
evidenced based practice and awareness is significant in eliminating this practice especially with
an organization as global as the World Health Organization. Harris’ believes in treating affected
females holistically, but also stresses the importance of increasing advocacy for females,
promoting health education to promote a better quality of life for this population.
Recommendations for Nursing Practice
Nursing care of the affected women include the need to identify and develop guidelines
and training for health care workers to care for those affected with FGM (Harris, 2013). Health
care workers need to be able to identify FGM and all of its complications: physically and
psychosocially. Nurses can provide quality care through an open line of communication,

8. FEMALE GENITAL CUTTING 8
encouraging health- seeking behavior, respecting the needs and wishes of the woman, providing
support, tending to the physical and psychosocial needs, increasing the autonomy of women
affected by FGM and most of all being an advocate. With these aspects of quality care in mind
nurses need to bear in mind their own beliefs, culture and judgments to assure a neutral approach
to give the best care possible. We must assess the female’s feelings towards their experience,
physical complications they are currently experiencing and the best possible way to treat them
without overwhelming them with our beliefs. As health care workers, it is also our duty to be
educated about this practice according to their cultural views and appropriate ways to care for
these individuals without causing further harm.
Conclusion
In conclusion, efforts in public policy, further research and a push for female autonomy
regarding their health care give a fighting chance of eliminating this practice. First, identification
of one’s own values and beliefs must occur in order to provide an unbiased way of caring for
FGM affected patients. Though educating these populations on the cons of female genital cutting
and related consequences we must acknowledge their cultural and religious beliefs all the while
promoting health on all levels and promoting patient safety. Successful approaches to ending
FGM in order to be effective include: being community-led, changing the social norms at a
community level and empowering women as cultural absolutism and anti-FGM legislation were
ineffective in the past (McChesney, 2015).
Female genital mutilation is not beneficial in anyway, but has many complications that
outweigh the pros. It is important to approach the care of FGM affected women with sensitivity,
give care with physical changes in their anatomy limiting pain and discomfort and treating them
without judgment of their cultural beliefs. The best advances to eliminating this practice are

9. FEMALE GENITAL CUTTING 9
through bringing about awareness to these communities, advocating and empowering women.
With the push of cultural absolutism and anti- FGM legislations they retract our advances in
elimination and prevent trust and communication to falter with these communities. It is a fine
balance to achieve, but it is promising as long as there is a push for advocacy, health education,
treatment through care and respect for these communities.

10. FEMALE GENITAL CUTTING 10
References
Blanton, K. (2011). Female genital cutting and the Health Care Provider’s Dilemma: A case
study. Clinical Scholars Review, 4(2), 119-124.
World Health Organization. (2014). Female Genital Mutilation. Retrieved June 18, 2015, from
http://www.who.int/mediacentre/factsheets/fs241/en/
Nour, N.M. (2015). Female genital cutting: Impact on women’s health. Seminars in
Reproductive Medicine, 33(1). 41-46. doi: 10.1055/s-0034-1395278
Seven Things to Know about Female Genital Surgeries in Africa. (2012). Hastings Center
Report, 42(6), 19-27. http://dx.doi.org/10.1002/hast.81
Terry, L., & Harris, K. (2013). Female genital mutilation: A literature review. Nursing Standard,
28 (1), 41-47. doi: 10.7748/ns2013.09.28.1.41.e7750
McChesney Young, K. (2015). Successful approaches to ending female genital cutting. Journal
of Sociology & Social Welfare, 42(1), 3-24.