FGM

Global Support Is Growing to End Female Genital Mutilation

A new study analyzed Twitter conversations about the practice that is widely regarded as a violation of human rights, and found that public perception has shifted from advocating against FGM/C to ending it entirely.

An estimated 200 million girls and women worldwide have undergone female genital mutilation and cutting (FGM/C), a practice that involves partial or complete removal of female genitalia for nonmedical reasons. This violent procedure is illegal in many nations, but still widely practiced in several countries, primarily those in Eastern, Northeastern, and Western Africa.

While world leaders have declared FGM/C as a violation of human rights and an extreme form of gender-based discrimination, there is limited research on the public perception across nations and cultures of this practice, which can perpetuate stigma and social exclusion among the women and girls who have received it.

Now, a new study led by researchers at the School of Public Health has analyzed social media conversations to gain insight into public knowledge and beliefs about FGM/C.

Published in the journal PLOS Global Public Health, the new study suggests that public sentiments about FGM/C have become increasingly politicized, but also largely focused on ending the harmful practice that can cause excruciating pain, chronic infections, sexual dysfunction, psychological trauma, and other health complications.

Social media posts, in particular, can reveal traditionally private thoughts about sensitive or stigmatizing issues. The researchers say this insight can help inform effective and culturally sensitive communication, education, and interventions that aim to reduce the global prevalence of FGM/C.

“The perceived anonymity that social media provides inspires candid conversations about sensitive topics such as FGM/C, so analyzing social media posts made us uniquely positioned to understand perceptions of and sentiments toward the practice. Much of the research on this topic has used primary data collection and is therefore subject to social desirability bias” says Sarah Weber, a first-year epidemiology PhD student.

The study arose from a class project in senior author Elaine Nsoesie’s class Topics in GH: Applications of Machine Learning in Global Health (PH795). For the analysis, Weber and colleagues from SPH utilized machine learning methods to characterize English-language discussions of FGM/C on Twitter, identifying and tracking the volume of tweets, as well as discussion themes and knowledge about FGM/C from 2015 to 2020.

FGM/C conversations were primarily concentrated among Twitter users in the United States and United Kingdom through 2017, but then shifted to Twitter users in Nigeria and Kenya in 2020.

For all years in the study period, the team observed tweets associating FGM/C with anti-Islam sentiment, despite the fact that FGM/C occurs across multiple religions. Many tweets also connected FGM/C to other gender-based violent acts or situations, such as child marriage, female infanticide, and gang rape. “MAGA,” “Trump,” and “conservative” were among the most common descriptions listed in the user profiles of people tweeting about FGM/C, suggesting that conservative Trump supporters comprise a significant portion of the Twitter community talking about this subject in English.

“People who have experienced FGM/C have long experienced stigma that could prevent them from seeking out healthcare or disclosing that they’ve undergone FGM/C to their providers, says study co-lead author and SPH alum Gray Babbs (SPH’21), currently a PhD student studying health services research at Brown University. “Our study adds additional context that FGM/C was a common Islamophobic talking point in politically conservative rhetoric during this time period. This additional stigmatization could exacerbate trends of healthcare avoidance or provider nondisclosure.” 

Notably, #endfgm was the most commonly used hashtag in the team’s dataset, unifying public health messaging with general advocacy tweets emphasizing the need to support FGM/C survivors. The #endfgm conversations increased 17-fold during the annual International Day of Zero Tolerance for FGM/C on February 6, which suggests that days of observance can help raise awareness and action around ending this practice.

“This study underscores that tackling FGM requires a nuanced approach,” says study coauthor Salma Abdalla, assistant professor of global health and epidemiology. “It is vital that we continue to address this harmful practice but it’s also crucial not to stigmatize those who’ve experienced it. We also need to invest in similar research in countries where the practice is prevalent to better understand the public discourse in settings where it is needed the most.” 

The study was also coauthored by Nina Cesare, research scientist for the Biostatistics and Epidemiology Analytics Center at SPH.