Psychological Health Outcomes of Female Genital Mutilation/Cutting among Women of Reproductive Age in Southeast Nigeria

Abstract

<title>Abstract</title> Background Female Genital Mutilation/Cutting (FGM/C) remains a deeply entrenched, harmful cultural practice with well-documented physical consequences; however, its psychological health outcomes remain underexplored in many settings, including Southeast Nigeria. Existing evidence suggests that FGM/C constitutes a traumatic experience with enduring implications for women’s mental health, emotional wellbeing, and psychosocial functioning. This study examined the psychological health outcomes of FGM/C among women of reproductive age in Southeast Nigeria. Methods A multisite cross-sectional quantitative design was used. The study involved 300 women aged 18 years and above drawn from rural communities in Ebonyi and Imo States, comprising 150 women who had undergone FGM/C and 150 women without FGM/C. Data were collected using a structured questionnaire and standardized psychological instruments: the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), PTSD Checklist (PCL-5 short form), and an adapted Emotional Intimacy Scale. Independent samples <italic>t</italic> -tests and chi-square tests were conducted using Stata version 17, with statistical significance set at <italic>p</italic> ≤ 0.05. Results Women who had undergone FGM/C reported significantly higher levels of psychological distress compared with non-FGM women. Mean depression scores were higher among the FGM group (17.2 ± 5.1) than the non-FGM group (11.3 ± 4.6; <italic>p</italic> &lt; 0.01), while anxiety scores were similarly elevated (14.9 ± 4.8 vs. 9.8 ± 4.2; <italic>p</italic> &lt; 0.001). More than half of women with FGM/C exhibited moderate-to-severe depressive and anxiety symptoms. Emotional intimacy was significantly lower among women with FGM/C, with greater emotional disconnection reported ( <italic>p</italic> &lt; 0.001). Among women with FGM/C, 56.7% exhibited moderate-to-severe PTSD symptoms. Conclusions FGM/C is strongly associated with adverse psychological health outcomes, including depression, anxiety, post-traumatic stress symptoms, and reduced emotional intimacy. These findings demonstrate that beyond its physical harms, FGM/C imposes a substantial and enduring psychological burden on affected women. Integrating culturally sensitive, trauma-informed mental health services into reproductive and community health programmes is essential for addressing the psychological sequelae of FGM/C and improving women’s overall wellbeing in Southeast Nigeria.