Women of Underrepresented, Understudied and Underreported (U3) Populations Webinar Series: Female Genital Mutilation and Cutting: Challenges, Research Gaps, and Opportunities in a Hidden Population
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Female genital mutilation/cutting (FGM/C), as defined by the World Health Organization (WHO), comprises all procedures involving partial or total removal of the female external genitalia or other injury to the female genital organs for non-medical reasons. With the passage of the Female Genital Mutilation Act in 1996, performing FGM/C on anyone under age 18 became a felony in the United States. However, recent Centers for Disease Control and Prevention estimates (largely based on prevalence of women and girls affected rather than risk) show a marked increase in women and girls affected by and at risk for this practice, given increases in the populations from regions where this is practiced (as much as 400 percent). Women and girls who have experienced FGM/C present with a range of health challenges including gynecological, obstetrical, and psychological—and there are limited evidence-based guidelines (published by WHO in May 2018) to direct their care. Data are limited, and an evidence-directed approach to the management of the many complications of these procedures is sorely needed. The research gaps and challenges will be presented, as well as the needs of this population of women. Despite the federal law passed in 1996, and a 2013 ruling covering “vacation cutting” (i.e., girls returned to their country on school holiday to visit relatives and undergo FGM/C, in a 2018 court ruling in Michigan a federal judge dismissed six of eight charges against a physician who performed FGM/C, stating the 1996 federal law was unconstitutional.
Dr. Crista Johnson-Agbakwu is an obstetrician/gynecologist at Maricopa Integrated Health System, where she is the Founding Director of the Refugee Women’s Health Clinic. She is also a Clinical Research Affiliate of the Southwest Interdisciplinary Research Center at Arizona State University, where she is Director of the Office of Refugee Health.
She received her undergraduate degree from Johns Hopkins University, medical degree from the Weill Medical College of Cornell University, and completed her residency in Obstetrics & Gynecology at the George Washington University Medical Center. Subsequently, she completed a fellowship in Female Sexual Medicine at the University of California, Los Angeles, and then became a Robert Wood Johnson Foundation Clinical Scholar at the University of Michigan, where she obtained her Master of Health and Health Care Research, examining disparities in reproductive healthcare among refugees/immigrants through mixed-method community-based participatory research.
Her current research focuses on investigating strategies to improve sexual and reproductive health outcomes for newly arrived refugee women, particularly those who have undergone Female Genital Cutting (FGC) as well as Sexual and Gender-Based Violence, with the aim of improving healthcare access and utilization, sexual and reproductive health education, counseling, community engagement, as well as enhancing healthcare provider cultural competency.
Currently, Dr. Johnson-Agbakwu leads a federally funded effort through the Office on Women’s Health to improve the provision of healthcare services, community engagement, and provider cultural competency on FGC across the state of Arizona.