"I just wanted to be like everyone else…": Qualitative exploration of women's perspectives on female genital mutilation/cutting and its potential abandonment in Somalia.

Somalia has the highest estimated prevalence of female genital mutilation/cutting (FGM/C) globally. However, significant literature gaps exist on associated knowledge and contextual factors within the country, particularly among affected women. This study thus aimed to explore Somali women's perspectives about FGM/C and its potential abandonment in Somalia. We conducted an exploratory qualitative study, informed by critical feminist and social norms theories. Data from 20 semi-structured remote interviews with women in Somalia were analysed thematically using abductive coding. We generated three themes of normative expectations and social control, patriarchal influence and gendered power, and FGM/C support and abandonment. Women demonstrated detailed knowledge of FGM/C procedures and consequences, sharing personal experiences of living with the effects of FGM/C on their physical, mental, and sexual health. Most supported continuation of "milder" 'gudniinka sunnah' FGM/C, rather than abandoning the tradition. However, 'gudniinka sunnah' described several types of cutting, some which fit the World Health Organization typology of Type-IV (pricking, scraping) and others Type-I (removing part/all of the external clitoris), while 'gudniinka fircooniga' (Type-III) - though still occurring - was universally described negatively. While acknowledging potential harms, women expressed the need for more religious and scientific clarity before changing their generally supportive opinions of 'sunnah' FGM/C. Discussing socio-cultural and religious reasons for this preference, women described social norms of femininity and how awareness interventions affected their understanding of 'severe' FGM/C and could help responses against FGM/C in Somalia. While all FGM/C types are negatively associated with women's health and wellbeing, Type-IV is least understood. Although women opposed Type-III, they supported continuing Type-I/Type-IV as 'sunnah' FGM/C. Reasons for this practice are rooted deeply in Somali culture and require active engagement of a range of community stakeholders to enact meaningful changes. Health education can contribute to changing attitudes towards FGM/C in Somalia but is insufficient on its own, potentially benefitting from interventions to change social norms.