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Stanford University School of Medicine

Study finds Egyptian doctors are not discouraging female genital cutting

Egyptian signSome women in Egypt are feeling conflicted about whether they should have their daughters undergo female genital cutting and are seeking out the opinions of physicians as to whether they should go through with the procedure. But physicians are giving the women ambiguous information, lending further legitimacy to a practice that is illegal in Egypt and has serious medical risks, including possible infection, hemorrhage and death, a new study finds.

A Stanford researcher and her UCSF colleague surveyed 410 Egyptian women living in and around the capital city of Cairo about their attitudes toward female genital cutting, also known as female genital mutilation.

"We found it's true that some women were planning to do it (cut) anyway and are just going to the doctor for harm reduction," Sepideh Modrek, PhD, the study's lead author, told me. "But others are confused. They have heard mixed messages and don't know what to do and are looking to the doctor for the final decision. And that's the problem with medicalization - it is essentially legitimizing the practice."

The practice of female genital cutting, which is common in sub-Saharan Africa, is thought to have originated in the Nile Valley around the time of the pharaohs, Modrek said. But in recent decades, the World Health Organization has widely promoted abandonment of the practice, which it considers a violation of women's and girls' rights.  In 1997, the Egyptian government outlawed cutting, which has also been a target of national mass media campaigns that highlight the potential harm it can cause.

As a result, the practice has been on the decline in Egypt, though some women still feel compelled by tradition to consider cutting their daughters. In the study, about a third of the women interviewed said they sought out the advice of physicians, with most indicating they would prefer to have the procedure done by a doctor, rather than a midwife, as a safety precaution.

"The women said, 'I'm going to the doctor because I am hearing I shouldn't do this, but my mother says I should do it and my mother-in-law says I should do it. You, the doctor, are the expert. Do we need to do this to our daughter?"" Modrek said.

The women reported that physicians didn't explicitly reject the idea, with some giving the women vague answers about the possible "need" for the procedure, according to the study.

"That's the slippery slope," Modrek said. "The doctor is seen as the more legitimizing voice and the voice of reason. Based on the women we interviewed, the doctors are not coming out and saying, 'You really don't need to do this.'"

The study was published online last week in the journal International Perspectives on Sexual and Reproductive Health.

Previously: Female circumcision: cultural staple, policy nightmare
Photo, of an Egyptian billboard calling for "the beginning of the end" of female circumcision, by Maia Sieverding

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