Assistant Professor of Economics Lindsey Novak researches topics relating to health and gender norms in low-income countries, including female genital cutting. She spoke with Colby Magazine Staff Writer Kardelen Koldas ’15 about her recent study, published in the Journal of Economic Behavior & Organization.

To start off, what is female genital cutting (FGC)?

So female genital cutting is, really broadly speaking, just the cutting or modification of women’s genitalia for non-medical reasons. Typically girls are cut at very young ages, so it’s a  decision that’s often made on their behalf, not them making the decision. There are some different classifications of FGC, but it’s practiced in 29 countries around the world, and also sometimes practiced in places like the U.S. or the UK, where there is a diaspora of people from countries where it’s typically practiced. And in a lot of places, it’s persisted for over 2,000 years, but in other places, it’s gone by the wayside. A lot of my paper is actually trying to figure out why that has happened. 

FGC and economics—what’s the relationship there? 

There are a couple of reasons that I think economists should and are starting to study FGC. One is that there are a number of health complications associated with the practice. For example, women who undergo FGC are 25 percent more likely to contract sexually transmitted diseases, and more than twice as likely to have really severe birthing complications. All of these health complications combined make female genital cutting an economic problem, because for women who experience these complications—some of them are mental health complications like anxiety and depression and even post-traumatic stress disorder—it’s harder to contribute to the market economy and also to household production. So it can contribute to economic underdevelopment where FGC is widespread as it takes out a working population. 

The other reason is that one thing that economists think a lot about is marriage markets, because marriage really everywhere, but particularly in low-income countries, is an economic institution. It determines how people’s lives are going to play out, how much wealth they are going to accumulate, how healthy their children are going to be. And female genital cutting is important in the marriage formation process—a little bit less important for marriage than people have thought for a really long time, but still a really important component for the marriage market. 

 

So why Burkina Faso?

Burkina Faso is a really interesting case, I think, of female genital cutting because it’s still quite prevalent there. I think right now it’s around 76 percent of adult women who have undergone FGC. But a law passed in 1996 banning FGC. Actually, a lot of countries with FGC have laws against the practice, but Burkina Faso is one of those that actually enforce those laws. But an interesting thing about laws banning FGC is that they’re pretty much ineffective in terms of reducing rates of FGC. Oftentimes what happens is that it drives the practice underground. The girls are often cut at much younger ages because it’s easier to hide effectively. So Burkina Faso’s law not really having a big effect—any effect—on the rate of FGC is definitely not unique but makes that a really interesting case. The other reason I was really interested in Burkina Faso is because it does have this heterogeneity in terms of its communities, wherein some of the rates of FGC are still really high and in others, the rate has fallen a lot. And so that was really the question I wanted to get at: why do some communities hang onto the practice while others don’t? 

Let’s talk about the new paper. What did you investigate? 

One thing that’s helpful is to understand the state of the literature and what people thought about this cultural norm. Sociologist Gerry Mackie has this theory that was published in 1996. It’s pretty old, and he didn’t have the wealth of data that we have now. He proposed this theory that female genital cutting is a social coordination norm. What that means is that FGC is so ingrained in a community that it’s really hard, almost impossible, for an individual or an individual family to deviate from that norm. The idea is that if people are practicing it in the community, then everybody is practicing it because it’s so socially costly to decide, “Oh, I’m not going to cut my daughter.” For instance, they worry that their daughters might not have good marriage prospects, or won’t be accepted into the community as a woman. So these are the reasons that people practice it so that their daughter has positive life outcomes; it’s very much an investment in her future. 

So Gerry Mackie was saying, it’s an all or nothing thing. In order to get people to actually deviate from this norm, you have to convince a bunch of people to come together and say, we’re not going to practice this anymore, and then you can get the rate of FGC to zero. A paper I published in 2015 basically said that’s not the case. In this paper, I propose a new theory for why female genital cutting persists in communities. 

You looked at data for five generations of women and found what?

What I find is that basically every single household has a different preference for FGC or proclivity to practice FGC. That seems a little bit obvious, but here’s the thing. Let’s say that you might need 50 percent of the people in the community to abandon FGC in order for you to decide, “Okay, I’m comfortable with not cutting my daughter,” whereas maybe I need 70 percent of the community to stop practicing FGC before I decide that I’m not cutting. So we have different preferences.

But social coordination norm theory assumes the opposite.

So social coordination norm theory effectively assumes everybody’s preferences are the same. If all of us need, let’s say, 10 percent of the population to stop practicing FGC, then if we get those 10 percent to stop, then everybody is going to stop. So that would mean that 10 percent, or 90 percent, is the tipping point. But my paper actually says some communities don’t have a tipping point. Some communities are going to have let’s say, 50 percent of the population practicing FGC. If 50 percent of the population are like, “It’s not worth it to me to cut my daughter if only 50 percent of my community is practicing,” the other 50 percent says, “No, this is still really important to me.” And so you might have what I call a stable equilibrium, where you have this really persistent rate of FGC for decades or long periods of time.

“And in a lot of places, [FGC has] persisted for over 2,000 years, but in other places, it’s gone by the wayside. A lot of my paper is actually trying to figure out why that has happened.”—Assistant Professor of Economics Lindsey Novak

A tipping point or a stable equilibrium—is that what makes the distinction of how you should approach the community to lower FGC?

Yeah, so if there is a tipping point, then these public declarations would be helpful. You just get a few more people to stop practicing, then you’re going to see rates decline quickly. But if you have a stable equilibrium let’s say at 40 percent, then you’re going to have a really hard time getting those 40 percent to actually decide to stop practicing based on the fact that a whole swath of their community doesn’t practice FGC. So I think it becomes a much harder problem when there’s a stable equilibrium.

And this is a different way of thinking about FGC? 

Yes, I basically propose a new theory and test that theory with this really huge dataset. 

Would your theory have other applications? 

The method I created for testing this theory is really useful for studying a lot of other social phenomena. One of the biggest social phenomena that have been studied in the tipping point in literature is racial segregation in neighborhoods, particularly in the U.S. There’s all this very disheartening literature that shows that when a certain number of people of color move into communities, then there’s white flight. They basically show that there’s this tipping point, I think around 15 percent of people of color, then white people start to leave at really high rates. Previous to my paper, we had the tools to identify tipping points, but we didn’t have the tools to identify stable equilibria in social phenomenon. So my method would be really interesting to study other social phenomena that maybe don’t necessarily have tipping points but have stable equilibria. Rioting is another really interesting example, where you see the people around you and either decide to join in or not. It might be like if four people are rioting, I’m not going to riot, but if 10 people are, then I’m going to join in. For phenomena that are dependent upon the behaviors of people around you, this method would be very useful. 

What impact do you hope your paper has? 

The first thing is I hope that this paper is a nail in the coffin for the social coordination norm theory. I think there’s a body of evidence that’s accumulated saying that the social coordination norm theory does not play out in the data. A corollary to that is one of the most common interventions to reduce the rate of FGC is these public declarations—bring a bunch of people together, have them publicly declare that they’re not going to cut their daughters anymore. And this is very much predicated on that social coordination norm theory that all we need is for people to talk about it and collectively decide to abandon FGC. It’s actually more complicated than that.

What this paper says is that it might work in some communities, but in a lot of communities, that’s not going to be effective at all. And so you’re wasting time and money. We should think about other interventions that are actually going to change preferences, not just the coordination mechanism—the coordination mechanism being this public declaration. I think we just don’t understand FGC very well at all. I think it’s a really interesting topic because there’s just very little comprehensive understanding of the practice. 

So something that is often talked about is really understudied? Why?

It’s interesting because female genital cutting is, according to the U.N., a violation of the rights of children and a human rights violation. And there certainly is research on it, but the majority of the research is done by these really diligent and very smart, typically ethnographers or anthropologists who do these deep dives into one or two communities. Cooper Bussberg [’21] and I are writing a paper that basically takes an overview of all of the literature about female genital cutting and then proposes a research agenda for understanding the practice and designing interventions that encourage abandonment of FGC. We’re looking at 25 countries, all in sub-Saharan Africa and the Middle East.

Which is aimed at adding what to the literature? 

A comprehensive understanding of why FGC persists so that we can better design and target policies that will encourage people to stop the practice.