Clitoral reconstruction and psychosexual care after female genital mutilation/cutting: Assessment of multidisciplinary care

TL;DR

This study examines how combining clitoral reconstruction with psychosexual care improves satisfaction and well-being in women affected by female genital mutilation/cutting.

Contribution

The study provides evidence that combining clitoral reconstruction with psychosexual care improves outcomes for women affected by FGM/C.

Findings

Women receiving combined clitoral reconstruction and psychosexual care reported higher satisfaction and well-being.

Combined therapy improved sexual response and genital self-image compared to psychosexual care alone.

Minor surgical complications were reported, but overall outcomes were positive.

Abstract

Multidisciplinary care following female genital mutilation/cutting (FGM/C) can consist of surgical interventions such as clitoral reconstruction (CR) in combination with individualized psychosexual care (PC). Evidence on both treatments, alone or in association, is limited.

To investigate the overall satisfaction with PC only or PC in combination with CR.

Cross-sectional study of women who attended the FGM/C outpatient clinic under study and asked for CR between January 2013 and November 2021.

Data were collected through questionnaire-based interviews on motivations for asking for CR, psychological well-being (World Health Organization-Five Well-Being Index), sexual response (Female Sexual Function Index), vulvar pain, genital self-image (Female Genital Self-Image Scale), overall satisfaction with the care received, and, in the case of CR, postoperative complications.

The 20 women included underwent therapy primarily to feel repaired or reconstructed and to improve their sexual function. Mean overall satisfaction with the care was rated 8.95/10 ± 1.39. Twelve (60%) received CR in combination with PC. Eight (40%) received PC only. Women who received combined therapy reported higher overall satisfaction (9.17 versus 8.57), psychological well-being (17.8 versus 9.25), sexual response (31.22 versus 21.56), and genital self-image (25.60 versus 17.60) in comparison with those who only received PC. The main surgical complications were minor postoperative bleeding and one painful wound infection triggering a relapse of posttraumatic stress disorder.

Tailored PC and CR after FGM/C seem to improve psychosexual health, well-being, body image, and pain.

Registration: ClinicalTrials.gov (NCT05026814)

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