ABSTRACT
European government responses to female genital mutilation (FGM) have focused on protection to the potential detriment of community prevention and survivor support, notably in the UK. We aimed to problematize this approach by exploring the experiences of women affected by FGM engaging with health services. Our multi-method study thematically analyzed EEA literature and 20 in-depth interviews with British Somali women who experienced FGM before migration. Girls were not included due to ethical concerns. We used purposive and snowball sampling to contact and recruit women and analyzed data thematically using inductive coding. Women described obstacles to engaging with health services, including lack of enduring care, difficult consultations, absence of FGM in forms, and limited provider knowledge. Practical services, such as clitoral restoration, were very restricted, limiting women’s agency. Our interviewees proposed practical changes, including provider continuity and “safe spaces,” more nuanced in-service NHS staff education, including FGM in medical school curricula, and involvement of members of communities at risk in health service provision. They must be consulted if government abolition efforts are to achieve success.
