(090) Domain-Specific Impact of Type I vs. Type II Female Genital Mutilation on Sexual Function: A Meta-Analysis to Guide Consultation and Empower Orgasmic Potential

Introduction Female Genital Mutilation/Cutting (FGM/C) is a globally condemned practice associated with severe long-term complications, including Female Sexual Dysfunction (FSD). Despite the recognized harm of FGM/C, millions of women worldwide live with its consequences. Understanding the domain-specific impacts of FGM/C types on sexual function is essential for developing targeted clinical interventions to improve sexual pleasure, enhance arousal capacity, and optimize the potential for orgasm in affected women. Objective This systematic review and meta-analysis examines the relationship between FGM/C (Types I and II) and specific domains of female sexual function to inform evidence-based clinical consultations aimed at improving sexual health outcomes. Methods A systematic review and meta-analysis were conducted on published studies examining FSD in women with FGM/C, utilizing the Female Sexual Function Index (FSFI). Eligible studies confirmed FGM/C type by physical examination and reported mean FSFI scores (total and sub-domain) compared to non-cut controls or between FGM/C types. Pooled mean differences (MD) with 95% confidence intervals (CI) were calculated to assess the effect of FGM/C on sexual function, stratified by FGM/C type (Type I vs. Type II), with particular attention to domains most relevant to sexual pleasure and orgasmic capacity. Results Five cross-sectional studies were included in the systematic review and meta-analysis, encompassing 3,059 cases comparing Type I and Type II FGM on sexual function outcomes. The meta-analysis revealed that while overall sexual function, as measured by FSFI total score, showed no statistically significant difference between Type I and Type II FGM (SMD: 6.95; 95% CI: −1.36 to 15.25; P=0.1), domain-specific analysis identified clinically meaningful distinctions relevant to sexual pleasure and orgasmic achievement. Type I FGM was associated with significantly higher scores in the Arousal domain (SMD: 1.11; 95% CI: 0.05 to 2.18; P=0.04) and Orgasm domain (SMD: 1.24; 95% CI: 0.04 to 2.43; P=0.04)-domains directly relevant to sexual pleasure and orgasmic capacity. A statistically significant difference was observed in the Desire domain (SMD: −2.43; 95% CI: −4.78 to −0.08; P=0.04). No significant differences were found between types in Lubrication (SMD: 1.21; 95% CI: −0.23 to 2.64; P=0.1), Satisfaction (SMD: 1.4; 95% CI: −0.86 to 3.66; P=0.22), or Pain domains (SMD: 1.3; 95% CI: −1.15 to 3.75; P=0.3). Conclusions Our results reveal that Type I FGM demonstrates preserved capacity in key psychophysiological processes-arousal and orgasm-compared to Type II FGM. These findings have important clinical implications for women seeking consultation to enhance sexual pleasure and achieve orgasm. Women with Type I FGM who retain greater arousal and orgasmic capacity may benefit from targeted sexual health counseling focused on optimizing these preserved functions and building confidence in their capacity for pleasure. Conversely, women with Type II FGM may require more intensive multimodal interventions addressing the broader spectrum of sexual dysfunction, with particular attention to restoring arousal and orgasmic responses. And this supports domain-specific clinical consultations designed to help women reclaim sexual pleasure, restore sexual function, and achieve orgasm. The findings underscore that sexual health restoration in women with FGM/C is achievable through personalized, evidence-informed approaches that recognize the nuanced variations in sexual dysfunction across FGM/C types. Disclosure No