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Query: UMLS:C0277787 (stigma)
 13,352 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although female circumcision is a health condition unfamiliar to most Western obstetrician-gynecologists, immigrants from parts of the world where this procedure is routinely practiced may be encountered. Such women pose unique management problems during labor and delivery. Presented is the case of a 36-year-old Sudanese woman who had undergone pharaonic circumcision, with substantial vulvar scarring, as a young girl in her country of origin. After emigration to the US, she had 2 Cesarean section deliveries. When she presented to the University of New Mexico with a 3rd pregnancy, she requested vaginal birth (to overcome the stigma of moral weakness her family associated with cesarean section) and a female obstetrician familiar with female circumcision. The patient had spontaneous membrane rupture at 39 weeks' gestation. Epidural anesthesia was necessary to examine the patient without severe discomfort. The external genitalia were missing the labia minora, and the clitoral area and external urinary meatus were obscured by bands of scar tissue that had to be cut. The major obstetric problem associated with this profile is prolongation of the 2nd stage of labor due to scar or soft tissue dystocia and the consequent need for deinfibulation. Women who labor unattended with an obstructed introitus are at risk of vesicovaginal and rectovaginal fistulas, laceration of scar tissue with hemorrhage, and fetal asphyxia or death. Incision of the fibrous tissue in this patient allowed sufficient widening of the introitus for expulsion of the fetal head. Delivery was uneventful and occurred after 19 hours. Although some women may desire reinfibulation, this patient sought less discomfort in future vaginal examinations, so the vulvar scars were not reapproximated. The raw surfaces were oversewn loosely after delivery.
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PMID:Female circumcision: obstetric issues. 794 93

True hermaphroditism is a rare intersex disorder in which individuals possess both testicular and ovarian gonadal tissue. A case of true unilateral hermaphroditism presenting with ambiguous external genitalia, right scrotal testis and left pelvic ovotestis is herein outlined Phallic, gonadal and genetic factors were considered before male gender was assigned. Gender assignment procedures have been questioned by intersex activists opposed to early genital surgery. Western societies have a binary perspective on gender and this leads to a stigma being placed on intersex cases. A multidisciplinary approach to this problem involving paediatric specialists in the field, of endocrinology, surgery and psychiatry is necessary, along with educational programmes that promote tolerance in society to variations in gender.
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PMID:Hermaphroditism: cytogenetics, gonadal pathology and gender assignment: a case report. 1769 Dec 40

Female genital cutting (FGC) involves the removal of women's external genitalia for non-therapeutic reasons. An estimated 38,000 women living in Sweden have undergone some form of the procedure. These women often belong to marginalised minorities of immigrant women from countries where FGC is widespread. Clitoral reconstructive surgery following FGC has recently been introduced in Sweden. This study investigates women's perceptions of FGC and clitoral reconstructive surgery with a particular focus on: (1) reasons for requesting reconstructive surgery, and (2) FGC-affected women's expectations of the surgery. Seventeen women referred for clitoral reconstructive surgery at the Department of Plastic and Reconstructive Surgery, Karolinska University Hospital, Stockholm, participated in the study. Findings revealed five factors motivating women's request for clitoral reconstruction (CR): (1) symbolic restitution - undoing the harm of FGC; (2) repairing the visible stigma of FGC; (3) improving sex and intimacy through physical, aesthetic and symbolic recovery; (4) eliminating physical pain; (5) and CR as a personal project offering hope. These factors were highly interconnected, suggesting that the reasons for seeking surgery were often multiple and complex.
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PMID:'I want what every other woman has': reasons for wanting clitoral reconstructive surgery after female genital cutting - a qualitative study from Sweden. 3034 86