Female genital mutilation/cutting and psychological distress among Somali women in the United States

Research on female genital mutilation/cutting (FGM/C) and mental health has largely failed to address the role of disparate experiences of the circumcision event, ongoing health impacts, and unique contexts of western resettlement. This study’s objective was to examine how FGM/C and associated stressors related to mental health outcomes among Somali women living in the US state of Arizona. The Refugee Health Screener (RHS-13) was used to assess clinically significant distress in a survey of Somali women (N = 879). Analysis included bivariate logistic regressions and final adjusted multivariate logistic modeling exploring associations between distress and FGM/C-related variables. Over 81% reported FGM/C (n = 687), most commonly the most severe Type III (n = 243). Approximately 16% met the RHS-13 cut-off criteria for clinically significant distress (n = 118). Women with FGM/C reporting adverse experiences related to the FGM/C circumcision event were more likely to meet cut-off criteria for clinically significant distress (OR = 4.29;95%CI 1.68–10.97). Other potentially traumatic experiences (OR = 8.94;95%CI 3.81–20.98) and perceived discrimination against FGM/C by medical providers (OR = 2.90;95%CI 1.20–7.02) were also associated with distress. Among all women, both with FGM/C and not, having undergone FGM/C was found to be negatively associated with current distress (OR = 0.45;95%CI 0.21–0.98). Treatment of FGM/C not as a singular experience, but as a set of experiences related to an individual woman’s memory of the event, current sociocultural context, availability of psychosocial support, and sense of belonging are potentially vital in the provision of appropriate FGM/C-related care.