Co-designing sensitive, non-confrontational methodologies for gaining insight into ongoing sexual trauma for those living with FC/FGM

How can academic researchers and community partner organisations explore multiple creative methodologies to overcome the barriers to seeking therapeutic intervention for victims of FC/FGM?

Women who have had female circumcision/female genital mutilation (FC/FGM) often experience life-long consequences in relation to health, wellbeing, and sexual functioning. However, current policy in the UK tends to ignore these needs in favour of policies which seek to protect potential future victims. In so doing, the policy also constructs women with experience of FC/FGM primarily as perpetrators of future violence rather than people with their own support needs. This oversight directly contributes to the trauma experienced by those in FC/FGM-affected communities and undermines their sense of belonging to wider society (Carver et al, 2022). Moreover, there is a clear need that any services developed to address these needs must be mindful that constructions of the self in relation to historical and ongoing sexual trauma are culturally and socially specific.

It is estimated that there are 137,000 women with FC/FGM living in the UK. Research by the applicants (Karlsen et al, 2019) indicates that the provision of ‘support’ by general health services is typically inappropriate, stigmatizing and problematic. While National FGM Support Clinics (NFGMSCs) have been established at locations across the UK, including one in Bristol, use of these centres has primarily been limited to surgical de-infibulation. A 2022 co-produced Bristol study by the applicants (BFCRG with Caafi Health) indicates that there are major unmet needs among individuals with experience of FC/FGM and their families. Participants in the study spoke of an urgent need to address the issue of ongoing sexual trauma from living with FC/FGM, which they see as being responsible for marital disharmony, familial trauma and marital breakdown. Services to address issues such as sexual pleasure for those living with FC/FGM and men’s roles in providing emotional support would also be welcomed.

This research and previous research have revealed that there is major stigma and embarrassment in talking about and seeking support for sexual relationships in many affected communities (Carver, 2021). Further, analysis shows that people from ethnic minorities are considerably less likely than people who identify as White to self-refer to Sexual Assault Referral Centres (Mattison et al, 2022). A strong distrust of health practitioners and services has also been detected among affected community groups, as well as a general feeling that counselling and support services are designed for the White majority and therefore irrelevant or not culturally appropriate for those with FC/FGM experience (Karlsen et al, 2019, 2020; Pantazis et al, forthcoming).

What will the project involve? 

This project seeks to inaugurate productive research relationships with experts in the delivery of care to sexual trauma survivors and key community partners and thus initiate a much-needed examination of how living with FC/FGM can be re-imagined for individuals and society.

The project will bring together an interdisciplinary team of researchers from the University of Bristol with two local community partner organisations: a grassroots organisation which provides support to local communities to overcome health barriers (Caafi Health) and a Sexual Assault Referral Centre (The Bridge) which as well as providing medical care for victims of sexual assault, also provides expert counselling on trauma and sexual relationships. The aim is to exchange ideas on co-designing a research project to explore how to address the major gap in services for people living in the UK who have had FC/FGM in a culturally appropriate and trauma-informed way.

This will involve a 1-day workshop in which the researchers will seek to learn from invited experts on creative approaches to “difficult conversations” (Watson et al, 2020). They will then discuss these methods with a view to designing a co-produced study (incorporating one or more of the methods) which will explore what it means for sexual relationships to live with FC/FGM in the UK, and how might therapeutic interventions be re-imagined in order to become accessible, relevant and meaningful for such women and their partners. The workshop will also explore multiple creative methodologies that might overcome the barriers to seeking therapeutic intervention.

Who are the team and what do they bring?

  • Natasha Carver (Policy Studies, University of Bristol) is a researcher in international criminology, her research looks at the legal constructions of racialised and gendered identities and how these identities are negotiated by those who are subject(ed) to their force. She has been involved in multiple research projects investigating the harms of safeguarding policies relating to female genital cutting, inaugerated by her and her colleagues ground-breaking report When Safeguarding Becomes Stigmatizing.
  • Christina Pantazis (Social Sciences and Law, University of Bristol) is a researcher in zemiology and is Head of the Centre for the Study of Poverty and Social Justice. Her research focuses on two broad areas: social harm and criminalisation; and poverty, social exclusion and inequality, particularly concerning issues related to gender and ethnicity.
  • Saffron Karlsen (Social Sciences and Law, University of Bristol) is a sociologist whose work explores the ways in which ethnicity and religion inform group identities and experiences of inequality. It is motivated by the need for more effective engagement of marginalised groups in the co-production of research. Her research has been instrumental in establishing empirical evidence regarding the role of racism in the development of ethnic inequalities in health in the UK.
  • Magda Mogilnicka (Social Sciences and Law, University of Bristol) is a sociologist with research interests in the fields of ethnicity, lived diversities, migration, everyday racism. She has been involved in an interdisciplinary project documenting the experiences of local Somalis with female genital mutilation safeguarding services.
  • Merle Patchett (Geographical Sciences, University of Bristol) is a cultural-historical geographer by training, whose research broadly focuses on theories, histories, and geographies of practice with a particular interest in experimental geographical methods that seek to problematize methodological assumptions pertaining to rigour, reliability and representation.
  • Nilu Ahmed (Health Sciences, Bristol Dental School) is an advanced qualitative research practitioner with a multidisciplinary academic training in Psychology, Sociology, Gerontology, and Human Geography. Her work is rooted in an antiracist and intersectional framework, and she brings these lenses to all her work. She has extensive experience of successful Patient and Public Involvement (PPI) and community engagement expertise. She is active in community work and her research uses coproduction with community members and students as coresearchers. She has interests and experience in working with adverse childhood experiences and with adults with childhood trauma.

What is to come?

The outcome of the workshop would be a funding bid for a fully co-produced creative methodology research project about what living with FC/FGM in the UK means for sexual relationships for women and their partners, and what therapeutic methods are best suited as counselling interventions in this area. This will also create opportunities, career development and partnership development for the four UOB ECRs involved particularly in the realm of creative methodologies.