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Case: Woman is required to present medical certificate about FGM_C to BAMF; has never had a gynaecological examination; is rather reluctant towards getting examined, language/cultural barrier.  

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Case: Woman is required to present medical certificate about FGM_C to BAMF; has never had a gynaecological examination; is rather reluctant towards getting examined, language/cultural barrier.  

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Case: Woman or couple is unhappy with sexuality. Believes that only surgery can help, seems to know little about her sexuality and sex in general , Woman is undecided if she really wants reconstructive surgery.

# data[].attributes.subject
Case: Woman or couple is unhappy with sexuality. Believes that only surgery can help, seems to know little about her sexuality and sex in general , Woman is undecided if she really wants reconstructive surgery.

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Case: Woman presents with signs of having suffered/ or still suffering from sexual/gender-based violence. How to address this topic in a cultural safe way?

# data[].attributes.subject
Case: Woman presents with signs of having suffered/ or still suffering from sexual/gender-based violence. How to address this topic in a cultural safe way?

# data[].attributes.body
- clarify the process and where you are before you start
- giving solutions
- sensitivity
- offering couples therapy
- saying that there is an option to give yourself love and pleasure
-talk openly about sexuality
- explain own position at the beginning and explain the setting!

# data[].attributes.body
- clearly talking
- asking direct questions without being afraid to be able to help and find a solution
- give the opportunity to come back to another consultation
- posibility to get information --> empowering
- respecting the patients position/wish

# data[].attributes.body
During a medical care encounter that was not initially because of FGMC, but eg. lower abdominal pain- you can ask a direct question: Have you undergone FGMC?
if the answer is yes:
Do you have also complications due to the FGMC?
Or Do you have health problems that you think could be related to the FGMC

Share information on FGMC complications if the women does not know them.

Address sexuality as a health care personal. The woman might not bring out the topic by herself. However she might have come for an issue related to sexuality. Question: Do you have pain during sex?

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- pushing
- fear to ask certain questions, be hesistant in the conversation

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- opposing and preaching
- being scared to talk about sex which reinforces the taboo
- Do not be deterred, or persuaded.
- don't be unsure, it makes the person feel that she is in the wrong place

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initiate the discussion in an informal way

Talk about the health of the daughter or the future or using emotion to let her know the importance of the subject

Ask about if there is somme specific activities that will happen in the country

be sensitive about using "FGM/C", be informed about the word that is used in the specific country and use it. sample : Khihat, Sunnat, Sunnah

be patient, have enough time, know your patient

Talk about the law May be use the " shutz brief"

# data[].attributes.body
+ Standard question on medical history forms, whether patient has been "have been cut".
+ Patient wants to be helped, so medical professional can ask all question, but be sensitive and use empathy
--> first appointment can be overwhelming  for patient, be aware you need a foundation of trust,
+ As a medical professional be aware of your own insecurities when talking about FGM_C with a actual survivor.
+ During the consultation on an optional reconstructive surgery, give the option of including the husband. Give the patient the choice of including the husband in the procedure.
+ Cultural empathy

# data[].attributes.body
Directly mention religion some people can frustrated better ask how your community perceive FGM

Not mention FGMC directly

# data[].attributes.body
Not asking if Patient has undergone  FGMC for instance during prolonged labour. Asking the husband instead of the patient

language barrier- allocate a only german speaking midwife to an english speaking patient in the labour ward

indifference of the health care worker: stating a problem without offering a solution - can create fear in the patient
for instance saying that because you have undergone FGMC you might have a complicated pregnancy/delivery without offering the care/information on how to deal with it

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- Don't give judgement
- Don`t cross boundaries or push the patient to answer question, they do not feel comfortable answering ( yet)
- Dont give a woman feeling she is abnormal:
--> Especially regarding the subject on recontruction: Reconstruction is not necessarily on the same level with sexuality. Make sure your patient knows that they not necessarily need a reconstruction to have a wholesome sexuality.
- Don't ask question just out your own curiousity, the patient is not your trainer. If you have question about fmg. Inform yourself.
- Dont talk about something you are not trained in
(like therapy, sexual therapy i.e. )--> always make sure patient knows your limit of expertise.