 According to a 2015 systematic review there is little high-quality information available on the psychological effects of FGM.Several small studies have concluded that women with FGM suffer from anxiety, depression and post-traumatic stress disorder.Feelings of shame and betrayal can develop when women leave the culture that practises FGM and learn that their condition is not the norm, but within the practising culture they may view their FGM with pride, because for them it signifies beauty, respect for tradition, chastity and hygiene.