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Changing cultural attitudes towards female genital cutting

Abstract

As globalization brings people with incompatible attitudes into contact, cultural conflicts inevitably arise. Little is known about how to mitigate conflict and about how the conflicts that occur can shape the cultural evolution of the groups involved. Female genital cutting is a prominent example1,2,3. Governments and international agencies have promoted the abandonment of cutting for decades, but the practice remains widespread with associated health risks for millions of girls and women4,5. In their efforts to end cutting, international agents have often adopted the view that cutting is locally pervasive and entrenched1. This implies the need to introduce values and expectations from outside the local culture. Members of the target society may view such interventions as unwelcome intrusions1,2,3,6,7,8,9, and campaigns promoting abandonment have sometimes led to backlash1,7,8,10,11 as they struggle to reconcile cultural tolerance with the conviction that cutting violates universal human rights1,9. Cutting, however, is not necessarily locally pervasive and entrenched1,3,12. We designed experiments on cultural change that exploited the existence of conflicting attitudes within cutting societies. We produced four entertaining movies that served as experimental treatments in two experiments in Sudan, and we developed an implicit association test to unobtrusively measure attitudes about cutting. The movies depart from the view that cutting is locally pervasive by dramatizing members of an extended family as they confront each other with divergent views about whether the family should continue cutting. The movies significantly improved attitudes towards girls who remain uncut, with one in particular having a relatively persistent effect. These results show that using entertainment to dramatize locally discordant views can provide a basis for applied cultural evolution without accentuating intercultural divisions.

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Figure 1: Treatment effects for unnormalized implicit association scores.

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Acknowledgements

We thank the Gezira State government, the Sudan Nation Council for Child Welfare, the Gezira State Council for Child Welfare, and local authorities in Umalgoura and East Gezira for supporting the study. We acknowledge the efforts of the Gezira State Council for Child Welfare, our many facilitators and participants, and the national field office of UNICEF in Khartoum. We thank O. A. A. Abdalla, W. O. B. Alalfi, and A. Al Shibli for their contributions to the materials for the IAT, W. O. B. Alalfi for his screenplays and M. Banaji, P. Biroli, A. Elhadi and R. Winkelmann for valuable feedback. This study was funded primarily by the Swiss National Committee of UNICEF. It is also part of a European Research Council grant on the Foundations of Economic Preferences. Funding agencies played no role in the design of the study, data collection, data analysis and interpretation, or the writing and submission of the paper.

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Authors and Affiliations

Authors

Contributions

S.V., E.F. and C.E. initiated the study. S.V. and C.E. designed the experiments with input from E.F. S.V. and C.E. contributed to the writing and production of the movies and developed the implicit association test for measuring attitudes. N.A.M.Z. pre-tested the movies. S.V., N.A.M.Z., H.E.F.A. and C.E. recruited participants and liaised with government and community officials. S.V., N.A.M.Z., H.E.F.A. and C.E. planned and conducted the experiments. C.E. analysed the data with input from S.V. and E.F. S.V., E.F. and C.E. interpreted the results and wrote the paper.

Corresponding authors

Correspondence to Sonja Vogt, Ernst Fehr or Charles Efferson.

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The authors declare no competing financial interests.

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Reviewer Information

Nature thanks N. Christakis, B. Shell-Duncan and the other anonymous reviewer(s) for their contribution to the peer review of this work.

Extended data figures and tables

Extended Data Figure 1 Correlation between attitudes and cutting practices at the community level.

The relationship between estimated cutting rates and average scores for each of 45 communities in the state of Gezira, Sudan14, from the implicit association test (Pearson’s correlation, ρ = −0.423, one-sided P = 0.0008, based on a two-dimensional weighted bootstrap explained in the Supplementary Information Section 1). The unweighted least squares line is shown as a reference.

Extended Data Table 1 Experiment 1, regression results for the implicit association test
Extended Data Table 2 Experiment 2, intention-to-treat effects estimated by difference-in-difference
Extended Data Table 3 Experiment 2, the effects of the treatments on the movie-goers
Extended Data Table 4 Experiment 2, intention-to-treat effects for subjects with a baseline implicit association score at or below the median
Extended Data Table 5 Experiment 2, the effects of the treatments on the movie-goers for subjects with a baseline implicit association score at or below the median
Extended Data Table 6 Experiment 2, intention-to-treat effects for subjects with a baseline implicit association score above the median
Extended Data Table 7 Experiment 2, the effects of the treatments on the movie-goers for subjects with a baseline implicit association score above the median

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Supplementary Information

This file contains Supplementary Text and Data, Supplementary Figures 1-6, Supplementary Tables 1-24 and additional references. (PDF 3148 kb)

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Vogt, S., Mohmmed Zaid, N., El Fadil Ahmed, H. et al. Changing cultural attitudes towards female genital cutting. Nature 538, 506–509 (2016). https://doi.org/10.1038/nature20100

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