To medicalize or not to medicalize : is that the question? Exploring medicalization of female genital cutting in Egypt and Kenya

Abstract

Today, medicalization is one of the major shifts within the practice of female genital cutting (FGC). Medicalization, as defined by the WHO, refers to any situation in which the practice is performed by a trained health professional, at a public or private clinic, at home, or elsewhere. The question “to medicalize or not to medicalize” is a hot topic in the debate on FGC, typically answered by policy makers through the implementation of an anti-medicalization discourse. Yet, in this Ph.D. dissertation, we argue that the discussion on medicalization is often built on moral and ethical arguments, with little empirical grounding. More specifically, we argue it is essential to incorporate the view of practicing communities themselves in the debate. The overarching research questions within this Ph.D. dissertation are “Why do mothers opt to medicalize their daughters’ cut and how does this decision relate to her social position within her community?”. In this dissertation we aim to identify the social correlates of the shift towards medicalization, and the meaning and motivation behind them. In Egypt, we examined the association between mothers’ social position, social norms surrounding the practice, the mothers’ daughters’ risk to be cut and the possible medicalization of this cut. In Kisii County, Kenya, we explored the mothers’ motivation to medicalize their daughters’ cut and we discussed the shift towards medicalization in relation to other shifts in the practice. The first important conclusion of our research is that increasing medicalization and decreasing FGC prevalence can coexist. Increasing medicalization percentages do not necessarily increase girls’ risk to be cut. Moreover, we indicated three major drivers behind mothers‘ choices to medicalize their daughters’ cut. Firstly, mothers argue that they opt for a medicalized cut to reduce the health risks related to the cut. They seek a less harmful but still culturally acceptable alternative. Secondly, the medicalization of FGC is socially stratified. Thirdly, medicalization may act as a social norm itself. In conclusion, we state that the debate about medicalization should be more nuanced and that the general discourse on medicalization should be challenged and empirically grounded. Before we are able to answer the question “to medicalize or not to medicalize”; many more questions lay before us