An examination of the medicalization trend in female genital cutting in Egypt : how does it relate to a girl's risk of being cut?

Abstract

Female Genital Cutting (FGC) is increasingly being performed by trained health professionals. International, national, and local institutions strongly oppose this medicalization trend, arguing that the involvement of health-care providers in the performance of FGC will counteract efforts to eliminate the practice. However, no empirical research to date has confirmed or refuted this claim. Therefore, it remains unclear how the medicalization of FGC relates to changes in the prevalence of the practice. In the current paper, we aim to fill this gap in the literature by examining the association between this medicalization trend and the risk of FGC. We focus on Egypt because of its high medicalization and prevalence rates and its unique history of FGC legislation. We performed a discrete-time event-history regression analysis combined with governorate fixed effects using the Egyptian Demographic Health Surveys from 2005, 2008, and 2014 (N = 49,273 daughters clustered within 29,810 mothers). Our results show that increasing medicalization rates coexist with decreasing prevalence rates. This effect is particularly pronounced in a context where a substantial number of cuts were medicalized (estimated at 40% and above). This effect is significantly more pronounced in higher educated mothers. Our study thus shows that the medicalization of FGC can coincide with decreasing prevalence rates of FGC. Medicalization of FGC may take place in a context where an awareness of the health hazards related to FGC is more pronounced, thereby also discouraging the practice as a whole. In addition, the medicalization of FGC may make the practice more individualized and therefore reduce the incentives for FGC.