Title: “YOU MUST CUT THAT LONG AND STINKING THING”: UNCOVERING THE
LIVED EXPERIENCES OF UNCIRCUMCISED POKOT WOMEN IN NORTH-EASTERN
UGANDA
Version: 4 Date: 24 Mar 2022
Reviewer's report:
General comments
The paper, “You must cut that long and stinking thing”: uncovering the lived experiences of
uncircumcised Pokot women in north-eastern Uganda“, addresses an important topic on the
life and experiences of uncircumcised women who live in traditionally female-circumcising
communities. The findings show that women go through a lot of challenges to live in such
settings. However, as cited in the ‘background’ section of the paper, lived experiences among
uncircumcised women in such communities have been extensively studied that the current paper
does not seem to raise anything new. In my view, this is the main drawback of the paper.
Secondly, studying uncircumcised women as “any uncircumcised woman” that the authors could
interview raises a missed opportunity to understand differences in coping abilities between
uncircumcised young and old women, or among married and unmarried women, for that matter.
At this point in time, we can no longer afford a study that examines women (re: uncircumcised
women) in a one-size-fits-all fashion: different women go through the experiences differently,
and it is high time that studies attempted to uncover these differences. The study can be
conducted to explore differences in coping mechanisms, for instance, or to capture views of
men about marrying such women, since most studies have focused on the women. Studies can
also continue to examine the living experiences of circumcised women – because these women
could have been circumcised due to cultural dictates but not because they wanted to undergo
the procedure, and they could be having their own challenges. In my view, a better focus of the
paper could have examined things like:
*Coping mechanisms of uncircumcised women living in traditionally female-circumcising
communities: perspectives from uncircumcised married and unmarried women
*Circumcision experiences, associated challenges, and coping mechanisms of circumcised
women
*Men’s perspectives on sexual enjoyment, marriage and having children with circumcised vs.
uncircumcised women: opportunities for ending female circumcision
*Women’s perspectives on sexual enjoyment, marriage and having children in a traditionally
female-circumcising community: opportunities for using circumcised women as advocates of
change
*Barriers to and facilitators of interventions intended to reduce female circumcision in
traditionally female-circumcising communities, etc.
Specific comments
1. I did not find the text quoted in the title anywhere in the manuscript. Usually, the practice is
to use text from a quotation that has been cited in the paper. This wasn’t the case.
2. The manuscript is not page-numbered
3. The introduction section does not bring out what the knowledge gap is amidst the available
literature on the lived experiences of uncircumcised women in the study area. For that reason, it
is not clear what new findings/insights the current study adds to the existing body of knowledge
on this subject.
4. On the first page of the ‘background’ section of the paper, the authors refer to ‘prevalence
rates’. Please note that prevalence is a one-time measure; so, the use of ‘rates’ is inappropriate.
5. The formatting of the manuscript does not follow standard authors’ guidelines. For instance,
the authors refer to ‘Methodology’ instead of ‘methods’, combine ‘study site’ with ‘sampling’,
and don’t have a sub-section on ‘participant selection’ to describe how the participants were
selected. I would actually separate study site from ‘sampling’, and replace ‘sampling’ with
participant selection as an independent sub-section.
6. The order in which study-related activities were conducted is in reverse order – the authors
present the focus group discussion that they held with key stakeholders last yet this seems to the
activity that they started with. Besides, I don’t think what was done was a focus group discussion
in the typical sense of a focus group discussion; instead, I can see it as a consultative meeting.
I believe that the authors can differentiate between the two.
7. The authors combine data collection with data analysis. I advise that these be kept as
independent sections, and details should be provided on how each was conducted. In the ‘data
analysis’ sub-section, the authors should describe how they followed the steps suggested by
Braun and Clarke, and indicate the level at which they analyzed the data, with reasons why they
analyzed the data at that level. Did the authors use manual or qualitative analysis software or
both?
8. The description of the participants’ characteristics has some mathematical and grammatical
errors.
9. I don’t think ‘knowledge about female circumcision’ is related to the topic. In any case, I
am not sure if this was necessary given that the study was conducted in a traditionally female-
circumcising community.
10. “Denial of sex and basic needs at home”: I did not see any quotation in which women were
denied sex because they were uncircumcised.
11. “Most of the participants stressed difficulty in getting marriage partners…” How many of
the women were unmarried? What does ‘most’ in this case mean?
12. Reporting of results: It would be preferable to refer to the number of interviews in which
the issues reported in the findings were identified, rather than use blanket statements such as
“most”. For example, the authors can write: “In ten of the 15 interviews conducted, women …”
– which is a better representation of the findings than using ‘most’, for instance.