In November 2008, the Norwegian Knowledge Centre for Violence and Traumatic Stress Studies (NKVTS) commissioned the Norwegian Knowledge Centre for the Health Services (NOKC) to conduct a systematic review about the consequences of female genital mutilation/cutting (FGM/C). The review would answer the question: What are the psychological, social and sexual consequences of FGM/C?
We searched systematically for relevant literature in international scientific databases, in databases of international organisations that are engaged in aspects related to FGM/C, and in reference lists of relevant reviews and included studies. We also communicated with professionals working with FGM/C related issues. We selected studies according to pre-specified criteria, appraised the methodological quality using checklists, and summarized the study level results using tables and calculated effect estimates (risk ratio and mean difference) in addition to performing meta-analyses to estimate effect. We applied the instrument GRADE to assess the extent to which we could have confidence in the effect estimates.
We included and summarized results from 17 comparative studies with a total of 12,755 participants from communities where FGM/C is practiced. All studies compared women with FGM/C to women without FGM/C. The evidence base was insufficient to draw conclusions about the psychological and social consequences of FGM/C. The effect estimates show that compared to women without FGM/C women with FGM/C are more likely to experience 1) pain during intercourse, 2) reduced sexual satisfaction, and 3) reduced sexual desire. However, the quality of the evidence was too low to draw conclusions about a causal relationship between FGM/C and psychological, social and sexual consequences.
There is a paucity of high quality evidence regarding the consequences of FGM/C. While the evidence base is insufficient to draw causal conclusions about the consequences of FGM/C, our results show that women with FGM/C experience pain and reduction in sexual satisfaction and desire compared to women without FGM/C.