An Insider–Outsider Approach to Understanding the Prevalence of Female Genital Mutilation in Pusiga in the Upper East Region of Ghana
2.1. Background of Practising Community
2.2. Selection Criteria, Population and Sampling Technique
2.3. Data Collection Instruments
2.4. Methods of Analysis
2.5. Ethical Considerations
3.1. Historical and Religious Justifications
“…Female Genital Mutilation started very long ago and is practised in Burkina Faso. Our ancestors used circumcision as a way of differentiating women who were from Burkina Faso from that those from Ghana. So it was a sign of identification between citizens of Burkina Faso and those who were not”.Source (IDI with an Elder, Pusiga-June 2019)
“…Female Genital Mutilation was started by Adam and Eve in the Bible and subsequently Abraham over 2000 years ago. So, female Genital Mutilation did not begin from Pusiga. It was created by our forefathers, who passed the practice to our fathers and passed it to us. You see, the resemblance of the clitoris to that of the penis was something that needed to be curbed. I think this is one reason why our ancestors and the Bible are against it.(IDI with a Christian religious leader, Pusiga-June, 2019)
“…FGM cannot be stopped among Muslims as our previous Muslim leaders practise it in the past; therefore, we cannot stop practising it. We Muslims believe that if you are a female Muslim and are not circumcised, Allah will not accept your prayer. This uncircumcised Muslim woman is considered unclean and dirty; hence, every Muslim woman must undergo circumcision. If non-Muslims decide not to circumcise their females, we do not bother about that, but for us Muslims, we must do it.”(IDI with Islamic Leader, Pusiga-June, 2019)
“… In my clan, it is taboo if any feminine child born is not circumcised, for it is something we grew to see. I have gone through it and do not see why young girls should not be circumcised.source: (IDI with Queen Mother of Pusiga-June, 2019)
3.2. Moral Justifications and the Gendered Dimension
“Yeah, it is a tradition in our country and supported by God. I believe it because I fear punishment from God. I do not have good memories of it because I felt bad pain, and I still get pain during my menstruation, but you know this is what God wants us to do”.
“…Families from the traditional religion choose to circumcise their girls with the belief that it is a religious requirement”.Source: (FGD with Sugidi Assemblyman, Pusiga-June, 2019.)
“… The reason why my fellow girls and I got circumcised, and it will continue with other girls, because they told us that if we are not circumcised, our desire for sex will be too strong to the extent that we cannot control ourselves hence leading us to immoral acts such as promiscuity and adultery in marriage. So, because we do not want to bring disgrace to our families and ourselves, we went through the show—source: (FGDs with survivors of FGM, Pusiga-July 2019)
3.3. Socio-Economic Benefits and Justifications
“Hmmmmm, if you refuse to undergo circumcision, you will be considered somebody who does not properly belong to your people and the society as well. Even if there is a funeral or a social gathering and you appear there, those who know you try to avoid your company because you are uncircumcised. They say when you are not circumcised, it is unholy to pray as a Muslim, and because of that, we young girls undergo the practice of praying and also feel comfortable among our people.(FGDs with Survivors, Pusiga-July, 2019)
“…Uncircumcised women are ridiculed and put to shame by their husbands. They are usually pushed back to their father’s house to undertake the practice even if they do not like it. Men described such women as having a padlock on the door. So, when a man wants to marry, he will first investigate to know if the lady is circumcised or not before he finalised the marriage arrangements”.(Survivors of FGM in an FGD, Pusiga-July, 2017)
“A woman has to undergo FGM or else she may not live in the society, get a job, marry or get a husband; the tradition may be seen as bad, but it is valued by our society and brings honour to families”.(IDI with Queen Mother, Pusiga-June, 2019)
3.4. Intergenerational Dimensions and Power Dynamics Underpinning FGM
“…The burden for the girls to go through circumcision usually comes from their mothers; men do little in that regard. Mothers think that their prospective in-laws and society will respect them if their daughters are circumcised, so they take all the necessary steps to ensure their daughters get circumcised.”Source: (IDI with a father, Pusiga-July, 2019)
“The day I got circumcised, my grandmother told me that today would be a memorable day for me. She told me we have to adhere and that I should be happy and proud because I am now going to become a woman. Finally, she took me to the place (Burkina Faso), and I was asked to lie down. Then, one woman, in addition to my grandmother, held me, and another woman cut my clitoris. Hmm, it was really a painful experience. I was made to stay in that house for one week without any of my relatives, and the woman kept dressing my wound hot until it healed, and I went back home.”(FGDs with Survivors, Pusiga-July, 2019)
“…From my observation, the older people, especially our grandmothers, still strongly support the practice. The only thing I can say apart from the fact that they consider it a tradition, they also lack the knowledge of the harm FGM causes to the survivors.”(IDI with Gender Education Officer, Pusiga-July, 2019.)
“To be honest with you, if I am asked today to under the practice, I will not submit myself to it. I will run away from my father’s house to go live somewhere. The process from cutting to dressing the wound until it gets healed is painful and unbearable. My grandmother told me that if I did not do it, I would not grow to be a responsible woman. However, I see many colleagues who did not do it, living comfortable lives. So, I will not advise anybody to do it”(FGD with survivors of FGM, July 2019)
“My grandmother wanted me to undergo circumcision far away in Burkina Faso, but my father and mother disagreed. My grandmother told me that if I did not do it, I would not grow to become a responsible woman, but that has proven to be untrue. Today, I am married with three children, and all my children are doing well contrary to their claim that I will lose my first born if I do not get circumcised.”(FGDs with Non-survivors, July 2019)
4.1. Part I: Inferring Implications for General Advocacy/Research
4.2. Part 2: Advocating Sexuality Education for Health Promotion
4.2.1. Sexuality Education as a Health Promotion Tool
4.2.2. Sexual and Reproductive Challenges versus Moral Mandate
4.2.3. The Female Sexual and Reproductive Health System
4.2.4. Pleasure as a Theme in Sexuality Education
4.2.5. Chastity as a Non-Invasive Theme in Sexuality Education
4.2.6. Role Modelling
4.3. Implications for Healthcare Professionals Engaged with Survivors of FGM/C
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
The word ‘survivor’ is used to cover women participants in the study who have gone through the cutting process.
In contrast, ‘non-survivors’ refers to participants who have not gone through FGM/C.
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|Types of Interview||Type of Interviewees||Age Group||Place of Interviewees||Number of Interviewees|
|FGDs||Survivors of FGM||12–25||Pusiga||5|
|Non-Survivors of FGM||15–25||Pusiga||5|
|Girl Education Officer||32–50||Pusiga||1|
|Christian Religious Leader||30–45||Pusiga||1|
|Islamic Religious Leader||30–50||Pusiga||1|
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Ocran, B.E.; Atiigah, G.A. An Insider–Outsider Approach to Understanding the Prevalence of Female Genital Mutilation in Pusiga in the Upper East Region of Ghana. Soc. Sci. 2022, 11, 526. https://doi.org/10.3390/socsci11110526
Ocran BE, Atiigah GA. An Insider–Outsider Approach to Understanding the Prevalence of Female Genital Mutilation in Pusiga in the Upper East Region of Ghana. Social Sciences. 2022; 11(11):526. https://doi.org/10.3390/socsci11110526Chicago/Turabian Style
Ocran, Benedict Ekow, and Godwin Agot Atiigah. 2022. "An Insider–Outsider Approach to Understanding the Prevalence of Female Genital Mutilation in Pusiga in the Upper East Region of Ghana" Social Sciences 11, no. 11: 526. https://doi.org/10.3390/socsci11110526