Bakgrund: Varje år könsstympas fler än 2 miljoner kvinnor. Traditionen att könsstympa kvinnor går så långt tillbaka i historien att ingen historiker i dagsläget kan säga exakt hur, var och varför denna sedvänja uppstod. Det förekommer i ett trettiotal länder. Ingreppet sker ofta utan smärtlindring, sterila instrument och kompetent personal. I Sverige är kvinnlig könsstympning brottsligt, lagen gäller alla svenska medborgare oavsett om det sker inom Sveriges gränser eller utanför. Antalet könsstympade kvinnor i Sverige har ökat i takt med ökad invandring. Kvinnlig könsstympning kan ses som ett övergrepp och kan ge konsekvenser för kvinnor livet ut. Syfte: Syftet var att belysa de fysiska, psykiska och sociala konsekvenserna för kvinnor som genomgått könsstympning. Metod: En litteraturstudie genomfördes enligt Forsberg (2006) och startade med sökningar i databaserna Cinahl och PubMed. Sju kvantitativa och fyra kvalitativa artiklar valdes ut för analys. Resultat: De fysiska konsekvenserna rörde främst miktion, menstruation och sexuellt samliv. Känslomässiga trauman och en känsla av förlust dominerade de psykiska konsekvenserna. Gällande de sociala konsekvenserna berördes kvinnornas identitet till stor del samt deras upplevelser av hur västerlänningar ser på dem. Resultatet visar på övervägande negativa fysiska, psykiska och sociala konsekvenser. Även positiva aspekter har framkommit. Diskussion: I resultatet framgick tre större teman som var gemensamt för de fysiska, psykiska och sociala konsekvenserna. Dessa var kulturkrock, sociala påtryckningar och individ. De kan bidra till att förbättra omvårdnaden av kvinnor som genomgått könsstympning. Diskussionen inspireras av teorin Theory of cultural marginality där fokus ligger på att förklara människors reaktioner då två kulturer kolliderar. / Background: Each year, about 2 million women undergoes genital mutilation. The tradition of genital mutilation of women goes so far back in history that no historians in our time can say exactly how, where and why this practice occurred. The only thing we know is that the practice of female genital mutilation is performed in about thirty countries. The surgery is often done without analgesia, sterile instruments and medically skilled personnel. In Sweden, genital mutilation is a crime and the law applies to all Swedish citizens, regardless of whether it occurs within Sweden's borders or outside. The number of genitally mutilated women in Sweden has increased in line with increased immigration. Genital mutilation can be seen as an assault and may have consequences for women throughout their lives. Purpose: The purpose was to illuminate the physical, psychological and social consequences for women who have undergone genital mutilation. Methods: A literature review was conducted in accordance to Forsberg (2006). The search started out by using two databases, Cinahl and PubMed. Seven quantitative and four qualitative articles were selected for analysis. Results: The physical consequences were related to urination, menstruation and sexual intimacy. Emotional trauma and a sense of loss dominated the psychological consequences. The two largest social consequences that were found were the women's identity and their experiences of how westerners experience them. The result shows predominantly negative physical, psychological and social consequences, although positive aspects also emerged. Discussion: The results showed three major themes that were common to the physical, psychological and social consequences. These were culture clash, social pressures and individuals. They can help to improve the care of women who have undergone genital mutilation. The discussion was inspired by the theory "Theory of cultural marginality" where the focus is on explaining people's reactions when two cultures collide.

Bakgrund: Kvinnlig könsstympning är en gammal sed som är vanligt förekommande i flera länder. Seden innebär att delar av det kvinnliga könsorganet avlägsnas. Det beräknas att två miljoner flickor utsätts årligen. I vilken omfattning ingreppet sker i Sverige är okänt, men det förekommer. I Sverige är alla former av ingreppet förbjudet. Skolsköterskan har möjlighet att möta och hjälpa flickor som riskerar eller har utsatts för kvinnlig könsstympning. Syftet: Syftet med denna studie är att belysa skolsköterskors upplevelser kring kvinnlig könsstympning bland flickor i skolan. Metod: Kvalitativa intervjuer med fyra skolsköterskor i en kommun i Mellansverige samt frågeformulär från sju skolsköterskor i olika delar av Sverige. Kvalitativ innehållsanalys användes som analysmetod. Resultat: Skolsköterskorna upplevde känslor av Kluvenhet, Osäkerhet och Medkänsla. Samt att kvinnlig könsstympning var Känsligt men angeläget att samtala om. Diskussion: Resultatet i denna studie fokuserar på skolsköterskors upplevelser, vilket skiljer sig ifrån tidigare studier i ämnet. I denna studie framkommer det en osäkerhet och rädsla inför att samtala, samt en vilja att hjälpa utan att döma. Detta tyder på att skolsköterskor upplever en utmaning. De behöver stöd och utbildning för att våga möta flickor som utsatts eller riskerar att utsättas för kvinnlig könsstympning. / Background: Female genital mutilation is an old ritual common in several different countries. In female genital mutilation parts of the female genital organ are removed. About two millions girls are exposed every year. Female genital mutilation occurs in Sweden, but to what extent is unknown. All types of genital mutilation are forbidden in Sweden. School nurses have an opportunity to meet and aid girls who are at risk or have been subject to genital mutilation. Aim: The aim of this study is to highlight school nurses´ experience of female genital mutilation among girls in school. Method: A qualitative interview study with four school nurses in a municipality in the central of Sweden as well as qualitative questionnaire from seven school nurses in different parts of Sweden. The material was analyzed using qualitative content analysis. Results: School nurses experienced feelings of Ambivalence, Uncertainty and Compassion. As well as the subject being Sensitive but Vital to talk about. Discussion: The results of this study focus on school nurses experience, which differs from previous studies on the subject. The study shows an uncertainty and fear of talking, and a willingness to help without judging. This indicates that school nurses experience challenges and are in need of support and training in order to meet girls who have been or may be subject to female genital mutilation.

Today around 28 000 women originally from countries where FGM is practised, are living in Sweden. Many of them are at childbearing age which means that knowledge about FGM and its consequences is of outmost importance during delivery. The aim of this study is to describe current research on how to manage the delivery, regarding deinfibulation and the following stitching as well as the risk of complications when the labouring woman is mutilated. This review of literature is based on 12 scientific articles published between years 1989 – 2005. Five different databases have been searched with use of a large number of keywords.The review found that no scientific research has been carried out that describes how deinfibulation and following stitching should be managed when the woman is mutilated. All available articles within this area are referring to best practice only. The review also found that the conclusions of the studies are contradictory. The majority, however, show an increased frequency for prolonged labour that could be related to FGM. The three largest studies also show an increased rate of caesarean section among mutilated women. In the few studies that examine haemorrhage, the majorities show an increased tendency to bleed, that could be related to FGM. Several articles emphasize the importance of good routines for deinfibulation to reduce the risk for complications.In summary it can be established that due to methodological problems in many studies, no reliable conclusion can be made that the researched complications exists to a greater extent when the woman is mutilated

Some cultures have customs against women. The sati tradition in India is one of them. According to sati, if the husband dies the woman is set on fire with his corpse. These women are believed to become immortal saints. A woman who dies burning herself on her husband&rsquo / s funeral fire is considered virtuous, and are believed to go to Heaven. Another tradition is &ldquo / female circumcision.&rdquo / It is performed in African countries. People believing in the necessity of this custom circumcise women by cutting their clitoris. Circumcised women cannot have sexually pleasure. These women are there to satisfy men&rsquo / s desires and give birth to babies. The third tradition is the general name of which is t&ouml / re is performed in the eastern parts of Turkey. According to t&ouml / re, women are put on trial by their families and killed if they have any sexual relationships without marriage bond. In other words, even if a woman is raped, she is found guilty because of having a sexual relationship. In this thesis, these issues and how women are degraded in cultures will be discussed by using the works of famous Indian, Black American and Turkish writers. The books that are discussed in this thesis, Nayantara Sahgal&rsquo / s &ldquo / Rich Like Us,&rdquo / Lakshmi Persaud&rsquo / s &ldquo / Raise the Lanterns High,&rdquo / &ldquo / Possessing the Secret of Joy&rdquo / by Alice Walker and &ldquo / Bliss&rdquo / by Z&uuml / lf&uuml / Livaneli all contribute to this study showing how women are oppressed by different customs in different countries, the common point of which is to serve men&rsquo / s interests.

The swedish law against female genital mutilation (FGM) prohibits procedures that removes parts of the female genitalia and thereby makes permanent changes in the body. The problem with the wording of the law is that it may also apply to the western phenomenon cosmetic genital surgery. This paper therefore examines if cosmetic genital surgery should be covered by the swedish law against FGM, by making a critical comparing analysis. The paper begins with comparing FGM with cosmetic genital surgery to prove that there are more similarities than differences between the procedures. By using the theoretical perspectives universalism and postcolonialism, the paper then examines why, particularly in the West, there is a different approach to FGM than to cosmetic genital surgery, regardless of the similarities of the procedures. Further the paper also examines consent and why consent to FGM is seen as illegitimate while consent to cosmetic genital surgery is seen as legitimate. On basis of the critical comparing analysis the paper then argues: that the procedures cosmetic genital surgery and FGM are very much alike; that cosmetic genital surgery is accepted over FGM because it is more familiar in the West and; that consent should be as illegitimate when given to cosmetic genital surgery as when given to FGM. Thus the conclusion of the paper is that cosmetic genital surgery should be covered by the swedish law against FGM.

De senaste årtiondena har flyktingströmmar från länder som praktiserar kvinnlig könsstympning (FGM) kommit till länder i västvärlden. I mötet med den nya vården riskerar kvinnorna att få fel diagnos, omvårdnad och bemötande. Syftet var att belysa könsstympade kvinnors möte med vården i västvärlden, utifrån följande frågeställningar: hur erfar kvinnorna mötet med vårdpersonalen? Hur erfar vårdpersonalen mötet med kvinnor som genomgått FGM? Studien genomfördes som en litteraturstudie, baserad på 15 artiklar av kvalitativ design. Analysen resulterade i sju teman utifrån de två frågeställningarna. Resultatet visade att kvinnorna upplevde mötet med vårdpersonalen som diskriminerande, ångestfullt och oroande. Brist på stöd ledde till känslor av ensamhet och kvinnorna kände sig annorlunda i den nya kulturen. Vårdpersonalen upplevde mötet med kvinnor som genomgått FGM som stressande och såg kvinnorna som okunniga och outbildade. Språkbarriärer var en försvårande faktor i kommunikationen. En god kommunikation och förståelse är viktigt för att skapa ett tryggt vårdmöte. Sjuksköterskan bör ta hänsyn till såväl kroppsliga som kulturella faktorer. Undervisning om FGM bör inkluderas i samtliga grundutbildningar för sjuksköterskor och övrig vårdpersonal. Vidare forskning bör belysa interventioner om ökad kunskap om FGM, fokusera på de könsstympade kvinnornas möte med olika vårdprofessioner, samt den åldrande gruppen som genomgått FGM och är i behov av vård. / The last decades a large number of refugees from countries where female genital mutilation (FGM) is practiced have come to countries in the West. The risk in the health care meeting is that the woman gets the wrong diagnosis, therapy and treatment. The aim was to highlight genitally mutilated women's encounters with the health care in the Western world, based on the following questions: how do the women experience the meeting with the caregivers? How do the caregivers experience the meeting with women who have undergone FGM? The study was conducted as a literature study, based on 15 articles with qualitative design. The analysis resulted in seven themes based on the two questions. The results showed that women felt the meeting with caregivers as being discriminatory, anguished and upsetting. Lack of support led to feelings of loneliness and the women felt different in the new culture. The nursing staff felt that meetings with the women were stressful and saw the women as unexperienced and uneducated. Language barriers were an aggravating factor in communication. Good communication and understanding is important in order to create a safe care meeting. The nurse should take into account both physical and cultural factors in order to build a good relationship. Education about FGM should be a part of the basic education of nurses and other health care professionals. Further research should shed light on interventions of increased knowledge about FGM, focus on the mutilated woman's encounter with various health care professions, as well as the aging group who have undergone FGM and is in need of care.

Female genital mutilation, or FGM, is a harmful traditional practice that was brought to Europe by immigrants from practising regions in Africa. Despite numerous approaches to the eradication of FGM, the tradition perpetuates within the immigrant communities in several European countries. Drawing on the available literature, film and interviews, this thesis presents a comparison of the French and Dutch strategies to tackling the problem of FGM. The thesis argues that the Dutch preventative approach could benefit from adopting particular features of the French punitive approach. The thesis concludes by proposing that strong legislative measures that apply to the discovery, investigation and prosecution of FGM cases have contributed significantly to the decline of FGM among practising communities in France, and as such, would have similar results if incorporated into the Dutch strategy for the eradication of FGM.

Background: More than 200 million females worldwide live with some form of female genital mutilation [FGM]. While reinforcing social and cultural values for those, to whom the practice is normative, FGM also envelops psychological as well as physical lifelong consequences. Aim: This literature study aimed to describe women's experiences of living with female genital mutilation from a physical, psychological, social and cultural perspective. Method: A literature study was performed through collecting and analysing ten qualitative articles. The data consisted of narratives of migrant women that had undergone FGM and lived in Western societies. The analysis was performed according to Friberg's five-step-model. Results: Feelings of honour and shame were expressed in connection to FGM. FGM was understood to fortify belonging to cultural identities and establish social acceptance linked to cultural ideals of femininity. Emotional and physical pain made women feel incompleteness, challenging their social relationships, including sexual intimacy. Additionally, it was noted that healthcare professionals lack specific knowledge needed while caring for those women, leaving them hesitant in further seeking healthcare. Women's perception of FGM changed after migration. They experienced larger control over their lives but also insecurity towards the discontinuation of the practice. Conclusion: FGM and its implications were complex and resulted in consequences that affect women's life. Greater knowledge and understanding of FGM were identified as necessary on the healthcare system, strengthening and furthering the required support and information for women's health.

Magister Legum - LLM

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