Articulating and Negotiating Medicalization: Practitioner Perspectives on Female Genital Cutting in Narok County, Kenya

• In Event: Medical Sociology Section Open Call Paper Session

Abstract

Introduction - Medicalization theory has largely been developed in Global North contexts, characterized by consolidated biomedical authority and highly institutionalized health systems. Less attention has been given to how medicalization unfolds in plural health care landscapes where biomedical knowledge and authority may be fragmented, differently organized, or actively negotiated alongside other forms of care. Female genital cutting (FGC) in Kenya provides a particularly revealing case for examining these dynamics. Although criminalized nationally, the practice persists in specific regions, including Narok County, where medical involvement in its performance is reportedly increasing. This study examines how medicalization is articulated and negotiated among practitioners involved in the performance of FGC in Narok County, Kenya.
Method - Drawing on 26 in-depth semi-structured interviews with healthcare professionals and traditional practitioners involved in the performance of FGC, we conducted a reflexive thematic analysis informed by a constructionist epistemology.
Results - Findings show that medicalized framings of FGC are continuously produced and adjusted across technical, moral, legal, and reflexive dimensions. First, medical involvement is framed as technical optimization and harm reduction, emphasizing infection control, anesthesia, and complication management while leaving the normative status of FGC largely intact. Second, medicalization is negotiated through shifting moral and professional boundaries, as actors draw context-dependent lines around consent, age, profit, and responsibility, distinguishing between selective assistance and explicit endorsement. Third, criminalization reshapes medicalization into clandestine arrangements and black-market exchanges, producing fragmented and uneven forms of medical involvement. Finally, some practitioners explicitly problematize medicalization itself, highlighting its potential to generate new iatrogenic risks when biomedical technologies circulate beyond professional oversight.
Discussion - In this context, medicalization does not unfold as full institutional incorporation or professional monopolization. Rather, it emerges as a partial, relational, and situational process, shaped by moral negotiation, legal constraint, and therapeutic plurality.

Authors

• Jolien Inghels, University of Antwerp

• Susan E. Bell

• Samuel Thuo Kimani, University of Nairobi

• Nina Van Eekert, Catholic University of Leuven

• Sarah Van de Velde, University of Antwerp