Background:Female genital mutilation (FGM) is a harmful practice that has long-lasting negative impacts on the physical and psychological health of victims. Deemed a global concern, this practice persists in high-income countries (HIC) among certain migrant communities. Given the deleterious effects of the practice, we conducted an updated systematic review of the facilitators and barriers associated with the prevention of FGM in HIC.Method:A systematic review of published qualitative studies of FGM in HIC was conducted from 2012 to 2022. The search resulted in 276 studies. Of these, the majority were from low- and middle-income countries (LMIC) and excluded. A total of 14 studies were deemed fit for inclusion and none were excluded during quality appraisal. Relevant data were extracted from the studies and thematically analyzed to identify prevalent themes.Results:A total of 12 themes were identified and the majority reflected barriers to the prevention of FGM including beliefs about female virtue, beliefs about social sanctions, and the preservation of culture, among others. Facilitators to the prevention of FGM were fewer and included memory and trauma from experiencing FGM, knowledge and awareness of the female anatomy, and legislative protection from FGM due to migration. A few themes, such as religious beliefs, acted as both facilitators and barriers.Conclusion:Findings highlight the importance of shared cultural and social threads among FGM practicing communities in HIC. Interventions can use these findings to guide the development of sociocultural strategies centered on community-level prevention and reduction of FGM in HIC.

中文翻译：

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“你得到的只是痛苦和悲伤”：高收入国家预防女性生殖器切割的促进因素和障碍

背景：女性生殖器切割（FGM）是一种有害习俗，对受害者的身心健康产生长期的负面影响。这种做法被认为是全球关注的问题，在高收入国家（HIC）的某些移民社区中持续存在。鉴于这种做法的有害影响，我们对与预防高收入国家女性生殖器切割相关的促进因素和障碍进行了最新的系统回顾。方法：对 2012 年至 2022 年已发表的高收入国家女性生殖器切割定性研究进行了系统回顾。产生了 276 项研究。其中，大多数来自低收入和中等收入国家（LMIC）并被排除在外。共有 14 项研究被认为适合纳入，在质量评估过程中没有一项被排除。从研究中提取相关数据并进行主题分析，以确定普遍主题。结果：总共确定了 12 个主题，其中大多数反映了预防女性生殖器切割的障碍，包括对女性美德的信念、对社会制裁的信念和文化保护等。预防女性生殖器切割的促进因素较少，包括经历女性生殖器切割的记忆和创伤、对女性解剖学的知识和认识，以及因移民而免受女性生殖器切割的立法保护。一些主题，例如宗教信仰，既起到了促进作用，也起到了障碍作用。结论：调查结果强调了高收入国家女性外阴残割实践社区之间共同文化和社会脉络的重要性。干预措施可以利用这些发现来指导制定以社区一级预防和减少高收入国家女性生殖器切割为中心的社会文化战略。