Monday, January 29, 2018

Female Genital Cutting: Improving the Care of Women and Girls at Risk

“It is what my Grandmother called the three feminine sorrows: The day of circumcision, the wedding night, and the birth of a baby.” – A Somali poem

Picture yourself as a young teenager, maybe thirteen at most. Perhaps you are getting your first period, you are experiencing the beginnings of womanhood. But then all of that is taken away and replaced with sheer pain and trauma. Your legs are being forced open and the most vulnerable and private part of your body is being mutilated and closed off for no reason other than to appease patriarchal ideals of women and virginity.

Female genital cutting includes procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons. It is most often carried out on females between 0 and 15 years old. Anesthetic is not used during or after the procedure. In takes place in many countries in Africa, Asia, New Zealand, and the Middle East. It is carried out despite the trauma, risk factors, and pain that it causes. It is both a global and inter-generational issue.

Over 200 million women alive today have suffered through FGC. Three million are expected to be cut this year alone. It was estimated in 2013 that 91 percent of women and girls between the ages of 15-49 in Egypt had gone through FGC in their life.

Where there are strong beliefs about what is considered acceptable sexual behavior, FGC aims to ensure premarital virginity and marital fidelity. It is in many communities believed to reduce a woman's libido and therefore believed to help her resist extramarital sexual acts. Many places uphold ideals of femininity and modesty, which include the idea that girls are clean and beautiful after the removal of body parts that are considered unclean and unfeminine.

As a result of the plethora of issues attached to FGC, focus groups were held in March, 2017. There were three focus group sessions of refugee clients who were from practicing or previously practicing cultures. Different age groups were represented from Somalia, Eritrea, and Ethiopia. Lively discussions were held centered on questions about what kind of interest was there among the communities to participate, what people’s concerns were, what new conversations have started surrounding the issue, and what resettlement programs are going to do going forward.

In regards to concerns, some participants shared heart breaking stories of their experiences with health care providers who were not aware of FGC. One participant shared how her first visit to an OB/GYN doctor in a hospital shocked the doctor, who then invited fellow doctors and interns to look at her genitals. The participant stated that she was very embarrassed as a result, and thought that if the doctor had been aware of FGC then he would not have embarrassed her in that way. To think that after all the trauma this woman had already been through, that this doctor would add to that, is disheartening and wrong. Situations like that one have happened to countless women.

These conversations and sharing of personal stories sparked many ideas and proposals for what can be done. That goal being to develop factual, meaningful, and user friendly resources on FGC that are well informed by communities and tailored to specific audiences, like medical professionals. These educational resources were the main desire of women in attendance. For doctors that were not educated, many of the women wanted to have a written description of what occurred and what the cultural reasoning was for FGC, so that they would not have to relive the trauma of FGC in explaining it. The women also wanted parenting support, nutritional aid, and mental health support during the adjustment period in the United States. We have started facilitating parenting, nutritional and hygiene support groups for these women and other refugee clients in the community who have expressed interest through various in house programs in our agency. For example, our Social Adjustment Services program began holding parenting and hygiene support groups for clients needing these types of services.

USCCB/MRS believes that, with well-developed resources combined with the trusted relationship these organizations have with refugee communities, FGC could be properly and sensitively addressed with refugee communities to work towards elimination of FGC. Better care could then be given to women who have already gone through the procedure, because health care professionals could be better informed on the issue. Many sites in the US have agreed to contribute to this project, including San Antonio. These sites, with their efforts, including conversation with refugee communities directly, will provide facts and material that can be used for creating resources.

The women are still talking about the convention and many were pleasantly surprised that this was becoming a broader issue that so many people wanted to be addressed in America. Thanks to the hard work of different communities and survivors of FGC, and their continued efforts in promoting conversation and advocating for women’s sexual rights, there is hope for change. The women in attendance were all passionate to help make change happen. They do not want to keep quiet on this issue nor should they.

For more information on FGC, visit:

This month's guest blogger: Juliana Horn, Non-Projected Arrivals/Extended Care Services Director, Catholic Charities Archdiocese of San Antonio

Monday, December 4, 2017

Managing Trauma: Tips for Supporting Refugee Teens in Schools, Refugee Resettlement, & Other Contexts

As follow-up from today's webinar, please feel free to continue the discussion below!

This webinar builds off of BRYCS previous webinar on Understanding Trauma in Refugee Youth. Hugo Kamya, PhD, Professor and Fulbright Specialist Roster Scholar at the Simmons College School of Social and Lisa Fontes, PhD, Senior Lecturer at the University of Massachusetts encourage you to reflect on your work and relationships with refugee teens. Participants will learn about some of the dilemmas facing refugee teenagers, how to converse helpfully and meaningfully with refugee teens, as well as ways to intervene more effectively with refugee teens, their families, and schools.

Additional resources:

Blanco-Vega, C.O., Castro-Olivio, S.M., & Merrel, K.W., (2008). Sociocultural model for development and implementation of culturally specific interventions. Journal of Latinos and Education, 7(1),43-61.
Boyson, B… & Short, D. (2012). Helping newcomer students achieve success in secondary schools and beyond. Washington, D.C.: Center for Applied Linguistics.
BRYCS. (2017). Collective Voices for Improving the Care & Reducing the Risk of Female Genital Cutting (FGC).
BRYCS. (2010). Child Abuse Issues with Refugee Populations (PART I)- Recognizing Suspected Child Maltreatment in Culturally Diverse Refugee Families
BRYCS. (2010). Child Abuse Issues with Refugee Populations (PART II)- Refugee Resettlement and Child Welfare: Working Together for Child Protection
Chapman, C., Laird, J., Hill, N., & Ramani, A.K. (2011). Trends in High School Dropout ad Completion Rates in the United States: 1979-2009.  Washington, DC: US Department of Education, National Center for Education Statistics.
Fontes, L.A. (2005). Child Abuse and Culture: Working with Diverse Families. New York, NY: Guilford.
Fontes, L.A. (2008). Interviewing Clients Across Cultures. New York, NY: Guilford Press.
Fontes, L.A. (2008). Interviewing Clients across Cultures: A Practitioner’s Guide. New York, NY: Guilford.
Fontes, L.A. (2010). Interviewing immigrant children for suspected child maltreatment. Journal of Psychiatry and the Law, 38, 283-305. 
Fontes, L.A. (2015). Invisible Chains: Overcoming Coercive Control in Your Intimate Relationship. New York, NY: Guilford.
Fontes, L.A. (2017). Building Resilience After Trauma: Lessons from Chile. New York, NY: Psychology Today.
Fontes, L.A. (2017). Helping Refugee Children Cope. New York, NY: Psychology Today.
Fontes, L.A. (2017). Keeping Refugee Children and Teens Safe. New York, NY: Psychology Today.
Fontes, L.A. (2017). Translating Trauma: Foreign Language Interpreting in Therapy. New York, NY: Psychology Today.
Jensen, L. (2005). The demographic diversity of immigrants and their children. In R.G. Rumbaut & A. Portes (Eds.) Ethnicities: Children of immigrants in America ((pp. 21-56). Berkley, CA: University of California Press.
Kamya, H. (2008). Healing from Refugee Trauma: The Significance of Spiritual Beliefs, Faith Community, and Faith-based Services. In  Froma Walsh (Ed.). Spiritual resources in family therapy (286-300).  2rd edition.  New York: Guilford Press. 
Kamya, H. (2009). The impact of war on children: How children make meaning from war     experiences. Journal of Immigrant and refugee Studies, 7, 2, 211-216
Kamya, H. (2011). The impact of war on children:  The psychology of displacement and exile.  In Kelle, B. (Ed.). Interpreting Exile: Interdisciplinary studies of displacement and deportation in Biblical and modern contexts. (pp.235-249). Atlanta: Society of Biblical Literature Press.
Kamya, H.  & Mirkin, M.(2008). Working with immigrant and refugee families. In Monica   McGoldrick and Kenneth Hardy (Eds.). Revisioning Family Therapy: Race, culture and gender in clinical practice. 2nd edition. (pp. 311-326). New York: Guilford Press.(a  revised chapter is coming out 2018 in 3rd edition)
Kamya, H. & White, E. (2011).  Expanding cross-cultural understanding of suicide among immigrants: The case of the Somali.  Families in Society, 92(4), 419-425.
Kamya, H. (2012). The cultural universality of narrative techniques  in the creation of meaning.  In B. MacKin, Newman, E., Fogler, J., & Keane, T. (Eds.) Trauma therapy in context:  The science and craft of evidence based practice. (pp.231-246). Washington, D.C: American Psychological Association.
McBrien, J.L. (2005). Educational needs and barriers for refugee students in the United States: A review of the literature.  Review of Educational Research, 75(3), 329-364.
Muslim Youth Girls Association. (2010). Top 5: Gym Class Hijabi Tips.
National Child Traumatic Stress Network (NCTSN). Types of Trauma.
Mendenhall, M., Bartlett, L., & Ghaffar-Kucher, A. (2017). ‘If you need help, they are always there for us.”: Education for refugees in an International High School in NYC.  Urban Review, 49, 1-25.
Paat, Y. (2013). Working with immigrant children and their families: An application of Bronfenbrenner’s ecological systems theory. Journal of Human Behavior in the Social Environment, 23, 954-966.
Paat, Y. (2013). Understanding the role of immigrant families’ cultural and structural mechanisms in immigrant children’s experiences beyond high school: Lessons for social work practitioners. Journal of Human Behavior in the Social Environment, 23, 514-528.
Presidential Task Force on Posttraumatic Stress Disorder and Trauma in Children and Adolescents. (2008). Children and Trauma: Update for Mental Health Professionals. Washington, D.C: American Psychological Association.  
Schneider, S. & Kamya, H. (in press). Community-Based Services for Refugees and Immigrants: Utilizing Social Capital, Human Capital and Cultural Capital to Improve Family Functioning and Well-Being Among the Somali, Families in Society.
Tseng, V. (2006). Unpacking immigration in youths’ academic and occupational pathways. Child Development, 77(5), 1434-1445.
Watkinson, J.S. & Hersi, A.A. (2013). School counselors supporting African immigrant students’ career development: A case study. The Career Development Quarterly, 62, 44-55.
Yohani, S. (2010) Nurturing hope in refugee children during early years of post-war adjustment. Children and Youth Services Review, 32, 865-873.

Friday, November 10, 2017

Understanding Trauma in Refugee Youth: Pre-flight, Flight, & Post-flight

As follow-up from today's webinar, please feel free to continue the discussion below!

Refugee youth often face multiple traumatic experiences due to forced migration throughout their resettlement journey. With the aim of better understanding refugee trauma and mental health, this presentation offered a foundational knowledge of relevant theories; case vignettes illustrating refugee youth in the community, family, and school; and school-specific considerations.

Thursday, October 26, 2017

The Practice of Female Genital Cutting

Female genital cutting (FGC) has many names around the world. It is known as female genital mutilation (FGM), female circumcision, sunna, khatna, excision, and many others. Regardless of what name you use for the practice, FGC is a human rights violation and a form of gender based violence. This practice is global in scope and cuts across class, race, ethnicity, country, education level, and religion. Worldwide more than 200 million women and girls have been affected by FGC.

The World Health Organization defines FGC as all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons. There are four main types of FGC[1]:

·         Type 1: Often referred to as clitoridectomy; this is the partial or total removal of the clitoris or in very rare cases, only the prepuce (the fold of skin surrounding the clitoris).

·         Type 2: Often referred to as excision; this is the partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora

·         Type 3: Often referred to as infibulation; this is the narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the labia minora, or labia majora, sometimes through stitching, with or without removal of the clitoris (clitoridectomy).

·         Type 4: This includes all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping and cauterizing the genital area.
FGC is performed for a variety of reasons across the world. The practice dates back centuries in some countries and communities. Some cultures and communities perform the procedure to mark a girl’s passage into womanhood and full membership in her community as an adult. Others do it to ensure a daughter’s marriageability, as FGC can be a physical indication and proof of her virginity because Type 3 prevents intercourse without physical preparation. Other communities perform it because they believe it is prescribed by their religion. There are cultures who do it to decrease a girl’s sexual desires and preserve family honor by ensuring their daughter is not being promiscuous. Within individual families, the decision may be based on their community’s beliefs, or they will have the procedure done to their daughters because of extreme pressure from family or friends: they could be ostracized if they do not continue the practice.
There are numerous emotional and physical consequences of the practice. Some immediate and short term impacts could be: severe pain; excessive bleeding; infections; urinary problems; shock; and death. In the long term, consequences can include: infertility; obstructed miscarriage and complications during childbirth; obstructed menstrual and urinary flow; fistulas; and pain and decreased satisfaction during intercourse.
FGC affects almost every country in the world, including the U.S. In 1996, FGC became a crime under federal law (18 U.S. Code § 116) and punishable by up to five years in prison. In 2013, there was an amendment made to the law making it illegal to transport a girl overseas with the intent to perform the procedure, which is commonly known as ‘vacation cutting’. Additionally, there are currently 26 states with their own legislation prohibiting the practice. In late 2015, the U.S. government decided to help combat FGC further and released funding through the Office of Women’s Health for organizations to address the issue in a variety ways and among different communities.

BRYCS, through USCCB/MRS, applied and was granted funding to work on this issue on a national scale, and with an emphasis on refugee communities who have traditionally practiced the procedure. This project, Community Conversations: Collective Voices for Improving the Care and Reducing the Risk of FGC, aims to decrease the likelihood that currently impacted refugee communities will continue this practice and improve the practical response of service providers who may encounter a girl or woman who has undergone FGC or is at risk, such as health and medical practitioners, educators, child and family services, and those working directly in refugee resettlement.
To achieve these goals, BRYCS is partnering with local Catholic Charities resettlement agencies to consult with the impacted communities to better understand the scope of the practice and engage the refugee community in crafting and promoting the messaging and resources designed throughout the project. Additionally, BRYCS will develop interactive educational resources on FGC, for refugee, stakeholder and practitioner audiences, including a dual-generation handbook for mothers and daughters to talk about this subject.
BRYCS believes there are positive alternatives to this practice that communities can use to achieve their desired outcomes for their daughters’ lives and will use this project to promote and encourage these alternatives. BRYCS also believes that women and girls who have undergone the procedure deserve competent, sensitive care throughout their life course.
Stay tuned for a supplemental blog from a resettlement agency who is participating in the Community Conversations project!

Monday, September 25, 2017

Individualized Service Plans


Do you have any assistance for RSIG-implementing agencies that need to create an Individualized Service Plan for its clients? We were asked to create one and I didn't want to make one from scratch if you've seen a well-developed one.

Thank you!

Refugee Youth Project
Baltimore City Community College