An Institutional Ethnography of the Social Relations that Shape Reproductive Health Care Experiences for Women with Female Genital Mutilation/Cutting/Circumcision (FGC) in Toronto, Ontario, Canada
Bibliographic record
Abstract
In recent social science research, it has been reported that women with female genital mutilation/cutting/circumcision (FGC) often experience stigmatization during reproductive health care. However, there has not been investigation into how these experiences come to take place. To address this gap in knowledge, the social relations that shape the reproductive health care experiences of women with FGC were investigated using Institutional Ethnography. Qualitative interviews were conducted with eight women with FGC, seven obstetrician/ gynecologists, and two general practitioners. Interviews revealed a set of social relations that organized women with FGC’s experiences of feeling “different” during care, which included anti-FGM discourse, organization of obstetric/gynecological work, and legislation. Immigrant women with FGC learned they were “different” in Canada from anti-FGM discourse in public conversations that opposed FGC. Women worked to mitigate this stigmatization before entering the clinic by engaging in “emotional health work”. This work carried over into the appointment itself and was shaped by the organization of doctors’ work, which was surgically focused. Finally, aspects of the Canadian legal and health care systems disproportionately disadvantaged women with FGC since the Criminal Code of Canada (Bill C-27) guarantees women their rights, but limits such rights to what is “normal” in the west through the dictation of surgeries to which women have access. This dissertation highlights how the ruling discursive knowledge of the “normal” reproductive body holds women’s bodies up against western ideals. These ideals have a normalizing function that shaped women with FGC’s reproductive health care experiences, as they learned how “normality” was inaccessible to them. Women also viewed their racialization as overlooked within medical training and by health care personnel. Racialization has not often been explicitly discussed in the broader FGC literature. It is imperative to actively make space for the perspectives of Black women with FGC in strategies that work toward their protection and to also modify the focus in FGC research and advocacy from gendered discrimination instead onto intersectional stigmatization. By better addressing the intersectional stigmatization to which women with FGC are exposed, they may not have to work so hard to navigate reproductive health care.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.028 | 0.012 |
| Scholarly communication | 0.004 | 0.001 |
| Open science | 0.002 | 0.005 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".