What Makes a Woman? Case Studies Documenting The Reasons for and Circumstances of Female Genital Mutilation/Cutting in Indonesia, Ethiopia and Kenya

Abstract Background: Female genital cutting/mutilation is a harmful traditional practice that violates women’s rights and has adverse health consequences. This paper presents the reasons for and circumstances of female genital mutilation/ cutting (FGM/C) in specific settings of three countries – Indonesia, Ethiopia and Kenya.Methods: Data were collected through a household survey with young people (15-24 years) and through focus group discussions, in-depth interviews and key informant interviews with youth and community stakeholders in 2016 and 2017. Descriptive statistics and thematic content analysis were conducted.Results: The study findings confirm some of the reasons for FGM/C documented by previous studies, noting that these reasons are strongly interconnected, and gender norms are the underlying driver. In all three settings, these reasons drive the alterations of female bodies to result in a ‘cultured’ body that is acceptable to the patriarchal status quo. This results in the ‘pure body’ in Indonesia, the ‘tame’ body in Ethiopia and the ‘adult body’ in Kenya. Health workers and parents play an important role in decision-making around FGM/C in all settings. In Kenya, in particular, young women negotiate their role in decision-making around FGM/C as they are older at the time of circumcision. The study reveals how the changing legal and social contexts in each setting bring about changes in the tradition of FGM/C resulting in medicalization of FGM/C in Indonesia, a lowered age of cutting for girls in Kenya and the increasingly underground practice of FGM/C in Ethiopia.Conclusions: The three cases demonstrate the huge variation in the practice of FGM/C and the social meaning attributed to it by young women and their communities. There is a need to further explore the role of parents in decision-making. Due to the links between the different drivers of FGM/C within each context, the study concludes that context-specific strategies need to be adopted by interventions to create long-lasting change.