"Stage of Change" Theory and the Practice of Female Genital Cutting: Research Findings from Senegal and the Gambia

Bettina Shell-Duncan, University of Washington
Ylva Hernlund, University of Washington

Female genital cutting (FGC) involves the partial or complete removal of the external genitalia, and affects an estimated 132 million women worldwide. Despite decades of intervention efforts, scholarly consensus finds that there has been greater success at raising awareness of adverse health consequences than in eliminating the practice, motivating interest in theoretical models of behavior change. Drawing on extensive qualitative data collected in Senegambia, the research reported here explores whether and how the “Stage of Change” model (aka Transtheoretical Model) can be applied to FGC. Our findings suggest that individual readiness to change is a complex construct, simultaneously capturing behavior, motivation, and features of the environment in which the decision is being made. Consequently stages identified in this research reflect the multidimensional nature of readiness to change the practice of FGC. Limitations of this model as applied to FGC and its utility in quantitative population research will be discussed.