Impact of female genital mutilation on sexual function and psychosocial wellbeing among Somali women: a cross-sectional study

BACKGROUND: Female Genital Mutilation (FGM) is associated with significant physical, psychological, and sexual health consequences. This study sought to examine the impact of FGM on sexual function and psychosocial well-being among women in Somalia compared to those without FGM. METHODS: A total of 753 women were consecutively enrolled, including 707 with FGM and 46 without. Data collected included age, type of FGM (Types I-IV), decision-maker, and setting of the procedure. Participants completed the Female Sexual Function Index (FSFI) and the Brief Symptom Inventory-18 (BSI-18) to evaluate sexual function and psychosocial well-being. RESULTS: The prevalence of FGM was 93.9%, with Type II being the most common (47.1%), followed by Type III (28.1%), Type I (18.9%), and Type IV (5.9%). Mothers were the primary decision-makers in 60.0% of cases. Sexual dysfunction was significantly more prevalent among women with FGM (64.6%) compared to those without (34.8%) (p < 0.001). The incidence of dysfunction increased with FGM severity: Type I (52.2%), Type II (60.2%), Type III (74.9%), and Type IV (90.5%) (p < 0.001). Women with FGM demonstrated significantly decreased sexual desire, arousal, lubrication, orgasm, satisfaction, and higher pain, anxiety, depression, and somatization (p < 0.001). Regression analysis revealed a strong inverse association between FGM and all domains of sexual and psychological health, with odds ratios increasing with the FGM type (Type I: OR = 2.1; Type II: OR = 2.8; Type III: OR = 5.6; Type IV: OR = 17.8). CONCLUSION: Our findings suggest that women in FGM experience significantly greater psychosexual and psychosocial impairments compared to their non-FGM counterparts.