{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T08:38:00Z","timestamp":1767688680049,"version":"3.48.0"},"reference-count":113,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"unspecified","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2025,12,9]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This meta-ethnographic review synthesised qualitative evidence on the lived experiences and impacts of female genital mutilation\/cutting (FGM\/C). By incorporating insights from individuals who have undergone FGM\/C, men and healthcare providers caring for affected populations, the study enriches understanding of the practice and its multifaceted consequences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Using Noblit and Hare\u2019s seven-stage meta-ethnographic framework, an inductive and interpretive synthesis was conducted. A comprehensive search of electronic databases, including PubMed\/Medline, ScienceDirect, Google Scholar, ResearchGate, African Journals Online (AJOL) and the WHO website, identified qualitative and mixed-method studies that captured in-depth perspectives on FGM\/C. The Critical Appraisal Skills Programme tool was used to assess the methodological quality of the included studies, and Ames\n                      <jats:italic>et al<\/jats:italic>\n                      \u2019s 5-point scale was applied to evaluate the conceptual richness of each study.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifty-three qualitative studies spanning diverse geographical and cultural contexts, both in traditionally practising regions and migrant communities, were included. Through rigorous analysis of first-order constructs (participant quotes) and second-order constructs (study authors\u2019 themes), five overarching themes were developed: (1) the onset: inherited tradition and gendered expectations; (2) ramifications on health and well-being; (3) inadequate health-seeking behaviours and lack of comprehensive healthcare services; (4) the psychosocial toll and (5) the perceived benefits of FGM\/C. Each overarching theme comprises second-order constructs, along with participants\u2019 quotes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This synthesis demonstrates how FGM\/C is deeply intertwined with sociocultural norms and functions as a bidirectional bridge, presenting a complex dilemma for the health of women and girls, healthcare systems and broader society. On one hand, it serves as a pivotal gateway to sociocultural belonging and a source of social capital, shaping women\u2019s and girls\u2019 lives long after the practice itself. On the other hand, it inflicts immediate, short-term and long-term health impacts and poses considerable challenges for healthcare systems due to its diverse and interconnected consequences. This complexity makes it challenging to address all related issues within a single setting or with a single specialist, often leaving affected individuals behind in accessing the highest attainable quality of care and support, while simultaneously complicating elimination efforts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD42023387750.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2024-001907","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T08:35:14Z","timestamp":1767688514000},"page":"e001907","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Lived experiences and impacts of female genital mutilation\/cutting (FGM\/C): a meta-ethnographic synthesis"],"prefix":"10.1136","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9112-7191","authenticated-orcid":false,"given":"Asteray Assmie","family":"Ayenew","sequence":"first","affiliation":[{"name":"Department of Midwifery, Bahir Dar University College of Medical and Health Sciences, Bahir Dar, Ethiopia"},{"name":"Obstetrics and Gynaecology, Monash University, Faculty of Medicine, Nursing and Health Sciences, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8337-550X","authenticated-orcid":false,"given":"Ben","family":"Mol","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Monash University, Faculty of Medicine, Nursing and Health Sciences, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9912-8332","authenticated-orcid":false,"given":"Gedefaw Abeje","family":"Fekadu","sequence":"additional","affiliation":[{"name":"Department of Reproductive Health and Population Studies, Bahir Dar University, College of Medical and Health Sciences, Bahir Dar, Amhara, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Billie","family":"Bradford","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Monash Medical Centre, Clayton, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"key":"2026010600350682000_4.1.e001907.1","unstructured":"WHO Guidelines Approved by the Guidelines Review Committee . WHO guideline on the prevention of female genital mutilation and clinical management of complications. World Health Organisation; 2025."},{"key":"2026010600350682000_4.1.e001907.2","unstructured":"Gruenbaum E , Blanton TR , Spieser C . Male and female genital modifications in anthropological perspective. 2023."},{"key":"2026010600350682000_4.1.e001907.3","doi-asserted-by":"crossref","unstructured":"Ahmadu F . Rites and wrongs: an insider\/outsider reflects. In: Female \"circumcision\" in Africa: culture, controversy, and change. 2000: 283.","DOI":"10.1515\/9781685850036-015"},{"key":"2026010600350682000_4.1.e001907.4","doi-asserted-by":"publisher","DOI":"10.1038\/s41443-020-0302-0"},{"key":"2026010600350682000_4.1.e001907.5","first-page":"209","article-title":"What about\" female genital mutilation\"? And why understanding culture matters in the first place","volume":"129","author":"Shweder","year":"2000","journal-title":"Daedalus"},{"key":"2026010600350682000_4.1.e001907.6","unstructured":"World Health Organisation . Eliminating female genital mutilation: an interagency statement. UNAIDS, U., UNECA, UNESCO, UNFPA, UNHCHR, UNHCR, UNICEF, UNIFEM, WHO. Geneva World Health Organisation; 2008. Available: https:\/\/www.who.int\/publications\/i\/item\/9789241596442"},{"key":"2026010600350682000_4.1.e001907.7","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1004061","article-title":"The global prevalence of female genital mutilation\/cutting: A systematic review and meta-analysis of national, regional, facility, and school-based studies","volume":"19","author":"Farouki","year":"2022","journal-title":"PLoS Med"},{"key":"2026010600350682000_4.1.e001907.8","doi-asserted-by":"crossref","unstructured":"Ahmadu FSN , Bader D , Boddy J , et al . Harms of the current global anti-FGM campaign. 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What is female genital mutilation? Everything you need to know about FGM and what UNICEF is doing to stop it. 2025. 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