The social context and boundaries of medical practices: what Critical Frame Analysis teaches us about medical handbooks on Female Genital Mutilation

This paper addresses the question of how medical handbooks treat the topic of female genital mutilation, and what this involves in terms of the context and boundaries they set to inclusive intersectional feminist politics. Female genital mutilation (FGM), also referred to as circumcision or cutting, has been on the political agenda for decades, including in the Global North. The naming itself indicates the complexity of the topic, displaying tensions on how to perceive the practice and who is entitled to address it in what way. In the Global North, the practice is widely condemned, and various support services are offered to those affected or at risk. These include social consultations, as well as medical interventions ranging from therapeutic to surgical treatments. As points of contact for those affected, medical personnel are important actors in the implementation of state measures against FGM. To this end, handbooks are developed to guide professionals in dealing with FGM. This paper discusses the broader findings of the analysis of such a handbook. More particularly, we present the results of a Critical Frame Analysis (CFA) of “Female Genital Mutilation. Medizinische Beratung und Therapie genitalverstümmelter Mädchen und Frauen (Medical Counselling and Therapy for Genitally Mutilated Girls and Women)” (Fritschen, Strunz and Scherer (eds.), 2020). It was announced as a book in which leading experts present the background, social context, and all therapy-relevant aspects of FGM. Communication strategies are taught, and an overview of surgical treatment options are given. Further topics are psychological and socio-medical counselling, legal issues, financing, prevention and contact points for those affected. The book, which is primarily aimed at surgeons, gynaecologists, and paediatricians, is considered the first and most comprehensive reference work on medical counselling and therapy on the German-speaking market. CFA is a method to detect the frames underlying a (policy) document, by unpacking what the problem or issue at stake is and why, who causes and/or faces it, and what the possible solutions are, including who is meant to undertake what action or to benefit from those solutions. This allows the frames contained to be (re)constructed, including their normative dimensions. It’s the latter we’re interested in. Medical handbooks, while considered to be practical tools, contain normative frames guiding such practice and our argument is that they, therefore, set the social context and boundaries within which medical practice takes place. Unpacking the normative dimensions contained in a work seen as the standard for the field allows us to discuss the political dimension of medical practice in relation to FGM. Our paper comprises four sections: We first discuss the theoretical underpinnings of CFA and how discursive constructions set the symbolic space and generate the boundaries for social practices. Subsequently, we present the findings of the CFA of “Female Genital Mutilation. Medizinische Beratung und Therapie genitalverstümmelter Mädchen und Frauen”. In the third section, we discuss these findings from the perspective of inclusive intersectional feminist politics. The conclusion wraps up the main findings and suggests venues for further research and political practice.