Understanding Professionals’ Knowledge Regarding Factors Influencing Changes in Attitudes toward Female Genital Mutilation/Cutting in Post-Migration Communities in Geneva, Switzerland
Abstract
:1. Introduction
1.1. Background
1.2. Theoretical Framework Associated with Attitude Changes
1.3. Professionals in the FGM/C Field
2. Materials and Methods
2.1. Study Design and Data Collection
2.2. Interview Guide
2.3. Data Analysis
2.4. Coding
2.5. Ethical Considerations
3. Results
3.1. Social Level of Ecological Model of Behavior Change
Impact and Implementation of Swiss Anti-FGM/C Law
“That’s the difference with countries of origin where, in most cases, the law exists but is not enforced. What deters (FGM/C) in Switzerland is not only the existence of the law but, above all, its enforcement, and it is enforced extremely harshly.”(Participant 6)
“But I think there is pressure from the way the law has been applied because there were (court) appeals, and it didn’t succeed.”(Participant 2)
3.2. Community Level of Ecological Model of Behavior Change
3.2.1. Religious Influence in Context of Migration
“No patient talks to me about religion; she talks about tradition, not religion”(Participant 4)
3.2.2. Multifaceted Examination of Social Aspects
“It was a source of pride to be circumcised. It was also the family’s pride, actually, to say, “Well, yes, I am a circumcised girl, I am a closed girl, of course, who is completely infibulated. Yes, exactly that.”(Participant 5)
“Personally, I don’t feel that they (parents) are under pressure in Switzerland. In Switzerland, they are very clear; they are protected.”(Participant 4)
“Nowadays, it’s about studying, working, having a job. At least, that’s what mothers think these days.”(Participant 5)
3.2.3. Navigating Language Barriers and Awareness Raising
“At the same time, what we also know is that breaking away from expectations is more challenging for a woman who has not been well-educated, thus a less-educated person. Moreover, it is a cultural objective in many situations to keep women in ignorance, as it allows better control over them.”(Participant 1)
“I accompanied a group, engaging in activities like working with modelling clay (representing male and female genitalia). For communities, particularly (with the help of) the intercultural mediators, this experience was foundational.”(Participant 1)
“They knew themself. I don’t have the impression that they knew (the types of excision). I thought I remembered that they discovered a lot of things.”(Participant 2)
“Some women, yes, they know what type of excision they have had, where they had it. Well, I had the pharaonic excision where everything is closed.”(Participant 5)
“When it comes to the potentially affected population in Geneva in general, information is lacking.”(Participant 6)
3.2.4. Cultural Adaptation Process
“It was clear that one had to take into account the length of stay because for them, a person who is not part of an asylum program, whose entire future is uncertain in fact, and who is trying to maintain a cultural link with their country of origin, may still find meaning in circumcision.”(Participant 6)
“I met women, whether they were directly affected, intercultural mediators, or second-generation descendants, who told me that they didn’t know anyone their age who had undergone the practice.”(Participant 6)
“Because the girls who are born here are in their twenties. They are no longer circumcised, even if they have daughters, they do not practice excision.”(Participant 5)
“Therefore, excision itself, I think, no longer has value here in Switzerland.”(Participant 4)
3.3. Interpersonal Level of Ecological Model
Changing Views on Marriage Prerequisite
“They can change the perception, but not change themselves. In fact, she will talk about it, she will discuss it, but she will think to herself, ‘if you take steps, well, it will affect you; that’s it; it will affect your marriage’.”(Participant 5)
“I can’t believe that it’s still a requirement for young girls not to be circumcised, and that it would be the young men who would demand it for marriage. So I can’t conceive of it.”(Participant 6)
“The mothers I meet in consultations often do not share this viewpoint (as a requirement for marriage)”.(Participant 3)
3.4. Personal Level of Ecological Model of Behavior Change
Women’s Experience of and Perspectives on FGM/C
“He (the child) was born with more learning difficulties. A mother hears about this, and it resonates deeply, and she doesn’t want that. So, it was always a quite strong realization”.(Participant 1)
“I think that over all these years, I had one or two cases where there was suspicion that the family had left to perform excision. But it’s not confirmed. Two patients out of the thousands I see each year. It’s very few.”(Participant 3)
“I had mothers where I provoked them a bit. So you will leave (to your country). It (FGM/C) will be done? Patient: Oh no, it’s forbidden here”.(Participant 3)
“But it’s true that deep down, it’s something that hurts, that lingers, even if you’re 70 or 80 years old; it’s something that remains (…) My grandmother used to talk about it. She said, ‘But it was a suffering for us’.”(Participant 5)
“I still have the impression that there is a change in the perception of female circumcision, in mentalities, and in altering the woman’s body; it is changing, especially since people are aware that it causes more problems than anything else.”(Participant 4)
4. Discussion
Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
- I.
- Questions générales et données démographiques
- 1.
- Quelle est votre profession?
- 2.
- Depuis combien d’années travaillez-vous dans le domaine des mutilations génitales féminines?
- II.
- Population
- 3.
- Dans votre pratique rencontrez-vous principalement des femmes qui viennent des pays qui pratiquent traditionnellement l’excision?
- 4.
- De quel pays sont-elles principalement originaires?
- 5.
- En moyenne depuis combien d’années sont-elles domiciliées à Genève?
- 6.
- En moyenne ont-elles une bonne compréhension de la langue française?
- III.
- Connaissances
- 7.
- Selon vous, est-ce que les femmes que vous rencontrez ont une bonne connaissance des types d’excision? Si oui, quelle est-elle?
- 8.
- Selon vous, existe-il pour les femmes une/des association-s entre la religion et les pratique d’excision? Si oui, quelle-s est-elle/sont-elles?
- 9.
- Selon vous, existe-il pour les femmes une/des association-s entre le corps, la sexualité et/ou la reproduction et les pratiques d’excision? Si oui, quelle-s est-elle/sont-elles?
- 10.
- Selon vous, existe-il pour les femmes une/des association-s entre les droits humains et les pratiques d’excision? Si oui, quelle-s est-elle/sont-elles?
- 11.
- Selon vous, est-ce que les femmes ont connaissance de la présente d’une législation interdisant les pratiques d’excision en Suisse/à Genève?
- IV.
- Attitudes
- 12.
- Selon vous, existe-il une pression (ou pas) de la famille et/ou de la communauté sur les femmes pour la poursuite ou l’abandon des pratiques d’excision à Genève/ou lors de voyage dans leur pays d’origine?
- 13.
- Selon vous, est-ce que pour les femmes vivant à Genève, l’excision est une condition préalable pour pouvoir marier leur fille?
- 14.
- Selon vous, quelle influence peut avoir le niveau d’éducation d’une femme vivant à Genève sur son attitude face aux pratiques d’excision?
- 15.
- Selon vous, quelle influence peut avoir l’expérience personnelle de leur propre excision sur une femme vivant à Genève sur son attitude face aux pratiques d’excision?
- 16.
- Selon vous, quelle influence peut avoir le nombre d’années passées à Genève sur l‘attitude d’une femme face aux pratiques d’excision?
- 17.
- Selon vous, quelle influence peut avoir, pour une femme vivant à Genève, la présence de législation interdisant l’excision en Suisse/à Genève sur son attitude face aux pratiques d’excision?
Themes and Codes | Factors Associated with Attitudinal Change |
---|---|
Social level | Local, state, national, and global laws and policies |
Presence of laws prohibiting the practice and sanctions | Knowledge and understanding of legislation and legal sanctions against FGM/C |
Social and economic prospects | Factors that examine the social and/or economic aspects of women or pose obstacles to their engagement in these domains |
Community level | Norms and values shared at the community level |
Awareness and education | Acquisition of linguistic competency Increasing awareness and comprehension regarding the harmful health repercussions of FGM/C National campaigns or healthcare professionals’ educational initiatives |
Migration and cultural adaptation | Gradual adaptation of social, psychological, and cultural aspects over time, as diverse cultural groups align with the prevailing norms of a society Linked with different elements, such as fostering social and economic independence, engaging with other communities, and social contribution Selective migration, involves individuals with higher education, higher incomes, and urban residence, makes them more likely to immigrate |
Religious requirement | Religious dimension connected to the practice and its justifications or the interconnection between cultural and traditional elements associated with the practice |
Social aspect and social pressure from peers | Social pressure for FGM/C in host countries Examination of the community-level dynamics that influence social structures and order within society Control of women’s bodies and sexuality (hygiene, purity, fidelity, etc.) Influence of social or moral values |
Interpersonal level | Influence of family members or cultural traditions |
Social interaction | Accounting for different viewpoints Engaging with other communities Overcoming cultural isolation |
Marriage prospects and perspectives | Marriage perspective Exploring generational differences associated with the practice |
Personal level | Characteristics of the individual such as knowledge, attitudes, behavior, self-concept, skills, and personal experience |
Awareness of health, psychological, legal, and religious aspects | Elements that examine the impact on individuals by considering the experiences related to physical, social, psychological, religious, and legal aspects associated with a particular practice |
Personal experience with FGM/C | Life narrative intertwined with the FGM/C practice, such as physical pain, rituals associated with the practice, and the sexual and reproductive effects, among other aspects |
Relationship with their girls | Elements that explore the connection, perception, and portrayal of girls, as well as the methods through which parents safeguard them |
Social relationships and networking | Social networking (breaking the taboo, advocacy, etc.) Economic and social independence |
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Theme (Dimension) | Sub-Category (Factor) | Quotation Example |
---|---|---|
1. Social level | Impact and implementation of the Swiss anti-FGM/C law | “It’s not really that which will dissuade people. Because in most countries of origin, there is also a law, but that doesn’t prevent people from still committing female genital mutilation. In fact, where it changes, however, is when one knows that the law will be enforced.” (Participant 6) |
2. Community level | Religious influence in the context of migration | “No, there is no patient who talks to me about religion. They talk about tradition, but they don’t mention religion to me.” (Participant 4) |
Multifaceted examination of social aspects | “There is no pressure in Switzerland. However, there can indeed be pressure from the grandmother, from the older generation in fact, and the mother-in-law as well, but these are individuals who do not live in Switzerland.” (Participant 6) “Nowadays, it’s about studying, working, having a job. At least, that’s what mothers think these days.” (Participant 5) | |
Navigation of language barriers and raising of awareness | “The language can remain something difficult.” (Participant 1) “They knew themself. I don’t have the impression that they knew (the different types of excision). I thought I remembered that they discovered a lot of things.” (Participant 2) | |
Cultural adaptation process | “The process of cultural adaptation is such that, the longer one lives in a country where female genital mutilation is no longer a social norm, is no longer obligatory. It is no longer a guarantee of a good future for the young girl, as it holds no value.” (Participant 6) | |
3. Interpersonal level | Changing views on the marriage prerequisite | “The significance attached to this practice is diminishing. In fact, a young girl can marry in Switzerland even if she is not circumcised.” (Participant 6) |
4. Personal level | Women’s experiences of and perspectives on FGM/C | “I had women who said that they do not want their daughters to undergo the same thing, as they themselves had complications such as bleeding and infections.” (Participant 3) “I think that over all these years, I had one or two cases where there was suspicion that the family had left to perform excision. But it’s not confirmed. Two patients out of the thousands I see each year. It’s very few.” (Participant) |
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Salah, N.; Cantoreggi, N.; Petignat, P.; Abdulcadir, J. Understanding Professionals’ Knowledge Regarding Factors Influencing Changes in Attitudes toward Female Genital Mutilation/Cutting in Post-Migration Communities in Geneva, Switzerland. Int. J. Environ. Res. Public Health 2024, 21, 716. https://doi.org/10.3390/ijerph21060716
Salah N, Cantoreggi N, Petignat P, Abdulcadir J. Understanding Professionals’ Knowledge Regarding Factors Influencing Changes in Attitudes toward Female Genital Mutilation/Cutting in Post-Migration Communities in Geneva, Switzerland. International Journal of Environmental Research and Public Health. 2024; 21(6):716. https://doi.org/10.3390/ijerph21060716
Chicago/Turabian StyleSalah, Nasteha, Nicola Cantoreggi, Patrick Petignat, and Jasmine Abdulcadir. 2024. "Understanding Professionals’ Knowledge Regarding Factors Influencing Changes in Attitudes toward Female Genital Mutilation/Cutting in Post-Migration Communities in Geneva, Switzerland" International Journal of Environmental Research and Public Health 21, no. 6: 716. https://doi.org/10.3390/ijerph21060716