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Author Notes:


Kathryn M. Yount, Conceptualization, Funding acquisition, Investigation, Methodology, Project administration, Supervision, Writing – original draft

Yuk Fai Cheong, Formal analysis, Funding acquisition, Methodology, Supervision, Validation, Visualization, Writing – original draft

Rose Grace Grose, Formal analysis, Investigation, Methodology, Validation, Writing – original draft

Sarah R. Hayford, Conceptualization, Funding acquisition, Investigation, Methodology, Project administration, Supervision, Writing – original draft

Assistance from Kanghong Shao in data preparation is appreciated.

This manuscript was prepared while Dr. Rose Grose was a post-doctoral fellow in the Hubert Department of Global Health at Emory University.

We thank Dr. Laurie James-Hawkins’s for her contributions to data preparation and comments on earlier drafts.

The authors have declared that no competing interests exist.


Research Funding:

KY, SH, RG, YC, and LJH received support from research grant 1R21HD086762-01/02 (PIs KY and SH) from the Eunice Kennedy Shriver National Institute for Child Health and Human Development

RG also received support from the National Center on HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention; Health Resources and Service Administration in support of the Health Policy Leadership Fellowship in the Satcher Health Leadership Institute at Morehouse School of Medicine

SH also received additional support from the Ohio State University’s Institute for Population Research (P2c-HD058484)


  • Science & Technology
  • Multidisciplinary Sciences
  • Science & Technology - Other Topics

Community gender systems and a daughter's risk of female genital mutilation/cutting: Multilevel findings from Egypt


Journal Title:



Volume 15, Number 3


, Pages e0229917-e0229917

Type of Work:

Article | Final Publisher PDF


We tested a feminist social-ecological model to understand community influences on daughters' experience of female genital mutilation/cutting (FGMC) in Egypt, where over 90% of women ages 15-49 are cut. FGMC has potential adverse effects on demographic and health outcomes and has been defined as a human-rights violation. However, an integrated multilevel-level framework is lacking. We theorized that a more favorable community-level gender system, including stronger gender norms opposing FGMC and expanded extra-familial opportunities for women in the village or neighborhood, would be associated with a daughter's lower risk of FGMC and would strengthen the negative association of a mother's opposition to FGMC with her daughter's risk of cutting. Using a national sample of 14,171 mother-daughter dyads from the 2014 Egypt Demographic and Health Survey, we estimated multilevel discrete-time hazard models to test these relationships. Community gender norms opposing FGMC had significant direct, negative associations with the hazard that a daughter was cut, but women's opportunities outside the family did not. Maternal opposition to FGMC was negatively associated with cutting a daughter, and these associations were stronger where community opposition to FGMC and opportunities for women were greater. Results provided good support for a gender-systems framework of the multilevel influences on FGMC. Integrated, multilevel interventions that address gender norms about FGMC and structural opportunities for women in the community, as well as beliefs about the practice among the mothers of at-risk daughters, may be needed for sustainable declines in the practice.

Copyright information:

© 2020 Yount et al.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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