Use of machine learning methods to understand discussions of female genital mutilation/cutting on social media

Female genital mutilation/cutting (FGM/C) describes several procedures that involve injury to the vulva or vagina for nontherapeutic reasons. Though at least 200 million women and girls living in 30 countries have undergone FGM/C, there is a paucity of studies focused on public perception of FGM/C. We used machine learning methods to characterize discussion of FGM/C on Twitter in English from 2015 to 2020. Twitter has emerged in recent years as a source for seeking and sharing health information and misinformation. We extracted text metadata from user profiles to characterize the individuals and locations involved in conversations about FGM/C. We extracted major discussion themes from posts using correlated topic modeling. Finally, we extracted features from posts and applied random forest models to predict user engagement. The volume of tweets addressing FGM/C remained fairly stable across years. Conversation was mostly concentrated among the United States and United Kingdom through 2017, but shifted to Nigeria and Kenya in 2020. Some of the discussion topics associated with FGM/C across years included Islam, International Day of Zero Tolerance, current news stories, education, activism, male circumcision, human rights, and feminism. Tweet length and follower count were consistently strong predictors of engagement. Our findings suggest that (1) discussion about FGM/C has not evolved significantly over time, (2) the majority of the conversation about FGM/C on English-speaking Twitter is advocating for an end to the practice, (3) supporters of Donald Trump make up a substantial voice in the conversation about FGM/C, and (4) understanding the nuances in how people across cultures refer to and discuss FGM/C could be important for the design of public health communication and intervention. Author Summary Female genital mutilation/cutting (FGM/C) refers to procedures that involve injury to the vulva and vagina for nontherapeutic reasons. At least 200 million women and girls living in 30 countries have undergone FGM/C. In many countries, there is not public perception research on FGM/C. When research is conducted, survey respondents may not answer truthfully about their opinions. We used Twitter data from 2015 to 2020 to better understand how the public thinks about FGM/C. We found that the conversation has generally stayed the same in this time period. Early in the study, users discussing FGM/C were mostly from the United States and United Kingdom, but later in the study, users were mostly from Nigeria and Kenya. Many people posted about stopping FGM/C, especially on the International Day of Zero Tolerance for Female Genital Mutilation and using the hashtag #endfgm. Some people used FGM/C to justify Islamophobia and connected it with other practices like honor killings and acid attacks. We hope that this research can be used to inform communication about FGM/C in different countries to improve understanding about the practice and, design culturally effective campaigns to end FGM/C.