Key Social Norms Take-aways This study reinforces the social coordination norm model of female genital cutting (FGC), showing that decisions around FGC are deeply influenced by the anticipated social benefits of conformity and the costs of deviation. Families often act not purely out of individual preference but in response to the behavior and expectations of their social network. Distinct normative schemas exist between cut and uncut women, shaped by perceptions of social inclusion, moral virtue, and health risk. Notably, the research suggests shifting perceptions—especially increased awareness of health risks or decreased valuation of social benefits—can tip families toward abandonment, even without full community coordination. These findings imply that both social and health messaging may be effective levers for change.
Objectives To test the social coordination norm model of FGC in Senegambia by examining how variation in perceived social advantages and health risks of FGC influences women’s readiness to abandon the practice, and whether patterns of FGC prevalence support the hypothesis of coordinated decision-making within communities.
Methods This mixed-methods study was conducted in Senegal and The Gambia. The first phase involved nine months of qualitative research (interviews and focus groups) with community members and leaders. Findings informed the development of an ethnographically grounded survey administered to 1,220 women aged 18–40 with at least one daughter. Quantitative data included assessments of perceived advantages and disadvantages of FGC and a readiness to change (RTC) framework that categorized women into five groups based on their preferences and expected behaviors. Multilevel logistic and multinomial regressions were used to analyze associations between FGC status, valuation of FGC, and RTC.
Results FGC prevalence strongly clustered by community and ethnicity, consistent with social coordination. Factor analysis of valuation statements revealed two primary constructs: social advantages (e.g., respect for tradition, moral behavior, social inclusion) and health risks (e.g., pain, HIV transmission, childbirth complications). These valuation scores were significantly associated with women’s readiness to change. Women with high perceived social benefits were more likely to support continuation, while those perceiving greater health risks were more likely to support abandonment. Notably, distinct normative patterns were observed among cut and uncut women, reflected in bimodal distributions of valuation scores.
Conclusions Evidence supports the social coordination norm model by demonstrating that FGC decisions are socially interdependent and that normative change is possible even in mixed-ethnicity, mixed-practice communities. While community-level coordination remains a useful approach, the findings suggest that individual or family-level change can occur when the perceived balance of social benefits and health costs shifts. Interventions should therefore target both social norms and individual valuation, emphasizing immediate health risks and fostering new social norms that reduce the perceived necessity of cutting for social inclusion.