Experts criticize Netherlands' approach to female genital mutilation care, prevention
Proper care for women who have undergone female genital mutilation is the most effective way to ensure they do not have their daughters circumcised, experts say. However, Dutch insurance does not always reimburse operations to reverse the circumcision and medical schools do not provide enough training for how to deal with women who have undergone the procedure, according to Nederlands Dagblad.
The Netherlands is invested in preventing the practice of female genital mutilation, according to the state secretary. "Youth doctors pay extra attention to girls from high-risk countries," State Secretary Van Ooijen told Nederlands Dagblad. "We [prevent genital mutilation] by, among other things, providing information and punishing the perpetrators."
However, Emily Allwood of health interest group Pharos noted that ensuring care for women who have already undergone genital mutilation is an important piece of the puzzle that is largely missing from the Netherlands' strategy. Researcher Annemarie Middelburg agrees.
"Recovery is the best prevention," Middelburg, who advises the government and United Nations on policy, told Nederlands Dagblad. "If a circumcised woman can lead a full life again, she will protect her daughter from the same suffering that was inflicted on her."
But experts observed the Dutch healthcare system has several roadblocks for women who need such care. There are around 41,000 circumcised women in the Netherlands, according to Nederlands Dagblad. However, Allwood said the standard medical school curriculum does not have information about female genital mutilation.
"GPs often have insufficient knowledge about genital mutilation or do not dare to discuss it," Allwood said.
In addition, reconstructive surgery –– which involves removing scar tissue and bringing the clitoral stump back to the surface –– is often not covered by basic health insurance if a woman is having psychological or sexual problems caused by genital mutilation.
Many other European countries do not differentiate between psychological, sexual and somatic complaints when it comes to reimbursing the surgery, Middelburg told Nederlands Dagblad. "Other European governments based their decision on scientific literature that shows that a repair operation can also be healing for psychological and sexual complaints."
On the other hand, Van Ooijen said it was "unclear" whether the "disadvantages outweigh the advantages" if female genital mutilation has caused no physical complaints. Women who are having sexual or psychological problems from genital mutilation are more likely to be sent to a psychologist than a surgeon in the Netherlands.
In 2023, the government will begin researching the effectiveness and safety of reconstructive surgery. Women with psychological complaints from genital mutilation can then receive surgery in the context of the study, Van Ooijen told Nederlands Dagblad.