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Female genital cutting (FGC) type: proposing a multifaceted, interactive method for FGC self-assessment.

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Area of Science:

  • Medical Anthropology
  • Public Health
  • Women's Health

Background:

  • Self-reporting of female genital cutting (FGC) status and types is often inconsistent and inaccurate.
  • Clinical genital exams are not always feasible or culturally appropriate in community settings.

Purpose of the Study:

  • To determine if integrating self-reflection, visual imagery, and discourse improves FGC status determination by experts.
  • To assess concordance between participant self-reporting and expert classification of FGC type using WHO typology.

Main Methods:

  • Community-based participatory research with 50 Somali women using semi-structured interviews.
  • Participants discussed FGC recollections and used anatomical drawings to identify FGC type.
  • A panel of health and cultural experts independently assessed FGC types, determining interrater reliability and concordance.

Main Results:

  • Developed WHO-informed visual depictions of FGC typology.
  • Created an iterative, self-reflective process for participants to describe their FGC status.
  • Achieved high interrater reliability (kappa=0.64) and 80% concordance between participants and the expert panel.

Conclusions:

  • Integrating FGC visual imagery and self-described status optimizes clinical care and patient education.
  • The proposed patient-informed method guides clinicians in providing culturally sensitive FGC care.
  • This approach is particularly beneficial for patients with limited health and anatomic literacy.