Effects of Female Genital Mutilation/Cutting on the Sexual Function of Sudanese Women: A Cross-Sectional Study

Female genitalmutilation/cutting (FGM/C) for nonmedical reasons is a cultural practice that has been going on for centuries and affected hundreds of millions of women, primarily in Africa and the Middle East. Female genital mutilation/cutting is medically classified into 4 types by the extent of the procedure. The rates of these procedures are declining, but because of population growth, the actual numbers of women at risk is increasing. Population movement also means these practices are moving to Europe and North America. The health impacts of FGM/C have been widely studied, have no known benefits, and have immediate and long-term medical consequences. However, few of these studies looked at the effect of FGM/C on sexual functioning. This study couples data from the Arabic Female Sexual Functioning Index (ArFSFI) and physical examination to assess the sexual impacts of FGM/C. There were 107 Sudanese women recruited for the study between 2014 and 2016 at a hospital in Saudi Arabia. Selection criteria included age (18-50 years), an FGM/C procedure, married and sexually active, and literate in Arabic. Exclusion criteria included being postmenopausal or pregnant or having chronic mental/medial illnesses. Data were collected through a voluntary survey covering a period of 4 weeks and a clinical examination. Summary scores ranged between 2 and 36, and the ArFSFI recommended value of 28.1 was used as the delimiter between normal and dysfunctional sexual function. Statistical correlations between FGM/C types were made with ArFSFI scores. Results are presented comparing the 4 types of FGM/C with the 6 ARFSFI variables. Mostwomen had either FGM/C type I (39%) or type III (36%). No one had type IV; 92.5% of the women scored below the ArFSFI cutoff value. Women who had undergone more severe FGM/C procedures had lower scores, and women with the least mutilations had higher scores across all areas. Other studies that have been done support this conclusion, but few of them differentiated between FGM/C types or independently confirmed them. Physical examination revealed most women underreported the extent of their FGM/C. It is also noted that sexual health has been shown to be connected to overall health and thus should be addressed in normal gynecological examinations.