Though the term NATIVE SPEAKER/SIGNER is frequently used in language research, it is inconsistently conceptualized. Factors, such as age, order, and context of acquisition, in addition to social/cultural identity, are often differentially conflated. While the ambiguity and harmful consequences of the term NATIVE SPEAKER have been problematized across disciplines, much of this literature attempts to repurpose the term in order to include and/or exclude certain populations. This paper problematizes NATIVE SPEAKER within psycholinguistics, arguing that the term is both unhelpful to rigorous theory construction and harmful to marginalized populations by reproducing normative assumptions about behavior, experience, and identity. We propose that language researchers avoid NATIVE SPEAKER altogether, and we suggest alternate ways of characterizing language experience/use. The vagueness of NATIVE SPEAKER can create problems in research design , recruitment (as participants’ definitions might diverge from researchers’), and analysis (by distilling continuous factors into under-specified binary categories). This can result in barriers to cross-study comparison, which is particularly concerning for theory construction and replicability. From a research ethics perspective, it matters how participants are characterized and included: Excluding participants based on binary/essentialist conceptualizations of nativeness upholds deficit perspectives toward multilingualism and non-hegemonic modes of language acquisition. Finally, by implicitly assuming the existence of a critical period, NATIVE SPEAKER brings with it theoretical baggage which not all researchers may want to carry. Given the issues above and how ‘nativeness’ is racialized (particularly in European and North American contexts), we ask that researchers consider carefully whether exclusion of marginalized/minoritized populations is necessary or justified—particularly when NATIVE SPEAKER is used only as a way to achieve linguistic homogeneity. Instead, we urge psycholinguists to explicitly state the specific axes traditionally implied by NATIVENESS that they wish to target. We outline several of these  and give examples of how to recruit and describe participants while eschewing NATIVE SPEAKER. Shifting away from harmful conventions, such as NATIVE SPEAKER, will not only improve research design and analysis, but also is one way we can co-create a more just and inclusive field. This article problematizes the use of NATIVE SPEAKERThe structure of the article is as follows. In Section “Introduction”, we present background on what the problems are, with regard to both vagueness and harm. Next, we connect these broader concerns with why it is an issue within psycholinguistics research, specifically relating to methodology and theory. In Section “Assessment and Implications of Current Practices”, we discuss implications of alternative approaches that could be taken in response to the big-picture issues detailed in Section “Introduction”, drawing from the literature in other disciplines that already problematize the concept. This section is divided into three stages of the research process: conceptualization, recruitment, task, and survey design, and data analysis. In Section “Actionable Recommendations”, we provide actionable recommendations for how psycholinguistic researchers can move away from NATIVE SPEAKER in their own work at each stage of the research process.To represent a snapshot of the diversity of experiences that cannot be captured by NATIVE SPEAKER, we also provide four example profiles of language users that researchers may encounter (Boxes 1–4). We describe their language profiles  and return to them as examples throughout the paper.The term NATIVE SPEAKER is frequently used in language research. Perhaps precisely because of its frequent use and the assumption that it carries an intuitive meaning, the term is often not explicitly defined and operationalized. In some cases, where NATIVE SPEAKER is operationalized, the definition may be circular in nature and involve unstated, implicit assumptions. For example, according to nativeness-as-history , nativeness-as-proficiency (including continued usage), and nativeness-as-identity. We briefly demonstrate how each of these themes—alone or in combination—are realized in the context of various sub-fields of language research.To exemplify the broad range of definitions for NATIVE SPEAKER, proficiency gained from a very specific “ideal” upbringing: They are the “ideal speaker-listener” with full mastery of a particular language and therefore able to provide authoritative judgments about grammaticality for any aspect of grammar  degree of e” e.g., . Howeverhistory, would include only second-generation deaf signers—that is, deaf individuals growing up with (deaf) signing parents.via a variety of criteria in sign language linguistics , early experience , continued exposure and usage , some indication of grammatical competence , and identification with the Deaf community.In other contexts, though ‘nativeness’ may still be taken for granted, the traditional definition of NATIVE SPEAKER breaks down. In sign language research, for example, the concept of a NATIVE SIGNER has proven to be rather elusive. This stems from the fact that signing individuals’ experiences are highly heterogeneous and idiosyncratic, differing in a number of ways from normative spoken language experiences . The strcs e.g., , involviproficiency) has also been implicated as a part of the definition of a NATIVE SPEAKER. In the context of immigration and language contact situations, continued usage (with links to history), but explicitly excludes the expectation of proficiency at any level.Finally, though much of the previously outlined usages of NATIVE SPEAKER/SIGNER appeals to, or at least brings with it an assumption of, competence cf., , not allidentity and membership. In the case of the Dene Tha community in Chateh, located in Alberta, Canada, among young people, “there is a strong self-identification with one’s heritage language and culture and a deeply rooted personal belief in belonging, as full and rightful members, to this language community”  SPEAKER of a language does not come with connotations of proficiency at all, but instead is used in the sense of mmunity” , p. 22. Box 2via immersion in a preschool setting starting at age 3, but still spoke only Cantonese otherwise.Amy, 23, was born in Hong Kong and lived there until age 2 when her family emigrated to Toronto, Canada. She was first exposed to and began speaking only Cantonese. After moving to Canada, she began to hear English After starting elementary school around age 5, Amy began to spend increasingly more time exposed to English. She continued to hear and speak Cantonese at home with family (including some media like TV and songs), with a couple of family friends, at certain extracurriculars  and in some places in the community that she went to with family . Otherwise, English was heard and spoken at school, with peers and friends outside of school, at most extracurricular activities  and most places in the community. During this time, she gradually became less comfortable using Cantonese to communicate.Currently, Amy uses English for almost everything other than speaking to her parents. She considers herself to not be fluent in speaking or listening to Cantonese. Due to some years of Saturday school as a child, she can read and write a small amount. Based on this, she considers English as her dominant, strongest and effectively only language. She doesn’t fully identify as a native speaker of either language, but she would say Cantonse is her mother tongue, while she speaks more like a (near-)native speaker of English.As we can see, there is no clear, consensus definition of NATIVE SPEAKER/SIGNER or NATIVE LANGUAGE. This multifaceted concept can, but does not always, involve a constellation of factors relating to age, order, and context of acquisition e.g., , continuvia assessments or tasks, and sometimes related to dominance, where the “strongest” language is considered the native language, rather than some measure of “absolute” level of proficiency. Age of acquisition, while often invoked, varies as to the exact ages that matter, for example, birth  As argued in the previous section, it is ambiguous and thus a hindrance to data analysis and rigorous theory construction, and (ii) as we argue in this section, it can be harmful, particularly to minoritized individuals and groups, in that use of NATIVE SPEAKER in academic research reproduces normative assumptions about linguistic behavior, experience, and identity.As illustrated in Section “Vagueness”, the range of its use in research implies that the NATIVE SPEAKER is an “ideal speaker listener”  who has These normative assumptions of NATIVE SPEAKER reinforce hegemonic conceptions of language use, ability, acquisition, and linguistic identity. When researchers use NATIVE SPEAKER in their work, and when participants are excluded from research because they do not fit researcher expectations of a NATIVE SPEAKER, they perpetuate deficit perspectives toward multilingualism and non-hegemonic modes of language acquisition. This can  frame these individuals and their practices as deviating from the norm, thus contributing to racialized conceptions of “nativeness” and feelings of LANGUAGELESSNESS among those whose speech is positioned as abnormal, in which individuals might be categorized (either by themselves or others) as not speaking any language at all . The linadequate sign language input for the child to develop language competence in a natural way” and “do not fall under the strict definition of native speakers or signers” . Limiting sign language research to only include deaf children born to deaf adults would not be representative of the use of signed languages in the world (see example in Box 3), and it is moreover harmful to position the acquisition contexts of the majority of signers as being inadequate, especially without attending to the structural reasons for this .To return to an example from Section “Vagueness”, most conceptions of NATIVE SPEAKER exclude the overwhelming majority of signers from being considered as “native” for research purposes. According to Box 3Angel, 38, is deaf and was born in Manila, Philippines. She moved to San Francisco, CA, in her 30s and now lives in Boston, MA, with her wife, who is also deaf. Growing up, she spoke/signed Tagalog, English, and Filipino Sign Language at home. In school, she used Tagalog and English, as she was integrated into a class of hearing students (“mainstreamed”) on her own, with no interpreters or special support. Now, she primarily uses English and American Sign Language (ASL), and considers English to be her strongest language.Angel attended school from the age of 5; in the 1980s and 1990s there was no organized educational interpreting system in the Philippines, so she was immersed in a spoken language environment. Some of her family is deaf, and they primarily communicate in Filipino Sign Language. At home, her family also used Tagalog, English, Bisaya, and Hokkien. Angel took courses in Nihongo (Japanese) at a language institute and took online courses in Japanese Sign Language, which she signs with a few friends. In college, she took a Castilian Spanish course. She learned ASL from her wife and YouTube videos, as well as from interactions in Deaf spaces in the United States.In informal settings, Angel is most comfortable speaking Taglish , followed by ASL. ASL is the language that she uses the most with her wife, kids, friends, and coworkers at the university where she works. At home, she uses ASL, English, and Tagalog. At work/school, she uses ASL and English. She uses ASL with her friends. Angel uses English with strangers, but uses ASL if the stranger happens to know it. She considers herself a native speaker/signer of Tagalog, English, and Filipino Sign Language.In English Language Teaching (ELT), NATIVE SPEAKERISM and its associated harm have been deeply theorized, with While many studies connecting race and nativeness are situated in the context of ELT, the ideologies that are described are certainly not limited to these contexts. Monolingualism as the norm is often implied in the term NATIVE SPEAKER (see “Vagueness”), and such assumptions have harmful consequences for multilingual  individuals, especially those who are racialized. Box 4Leela, 27, was born in Kerala, India. The first language she was exposed to and spoke was a high contact variety of Malayalam, including elements from Tamil, Hindi, and English. She attended English immersion school, starting at age 4. While she learned to read and write Malayalam in school, Malayalam language classes ended at age 12. She also learned to read and write Hindi in school from ages 8–12.Growing up, she heard and spoke Malayalam mostly at home with her family and in the community at large. She also heard and spoke English and Malayalam in school with peers and friends. She consumed mostly Malayalam and English media, but also sometimes watched Hindi and Tamil movies. Currently, she uses a high-contact variety of Malayalam at home, in social settings, and with greater society. She uses Malayalam and English at work ; English when traveling outside of India; and English and Hindi when visiting family in North India. She also watches Hindi, Malayalam, English, and Tamil movies.She doesn’t consider herself fluent in Malayalam both because she prefers to read and write in English , and because she doesn’t feel like she can speak Malayalam without using English elements, especially depending on the semantic domain. She considers Malayalam her Mother Tongue, which is a locally relevant term, but states that she doesn’t feel proficient in any language.The harm in creating a context in which languagelessness is imputed to  multilinguals must be understood in a historical context in which ascribing languagelessness has been a tool for dehumanization. A well-designed experiment is detailed, makes clear predictions, targets a specific population, and involves a data analysis plan. Given this, the vague and harmful definitions of NATIVE SPEAKER pose significant methodological problems for the field of psycholinguistics.Some psycholinguistic research deals with specific predictions about how “native” and “non-native” speakers process or produce language , we will invariably create theories that fall prey to these same issues. In addition, the hegemony of research conducted in contexts where monolingualism/normative language use is seen as a control or neutral mode structures our fields of inquiry such that multilingualism/non-normative language use is peripheralized, requiring extra theoretical and methodological machinery. This privileges and incentivizes the study of certain, dominant groups over others, and puts research on socially less-powerful groups at an inherent disadvantage. Taking NATIVE SPEAKERS out of the center of our fields will not only sharpen research questions, but also expand the types of research that is done.a priori or in post-hoc examination of the collected data. Groups can include NATIVE SPEAKER, NON-NATIVE SPEAKER, L2 LEARNER, HERITAGE SPEAKER, and countless others. While many researchers use dimensions of language experience, such as age of acquisition, order of acquisition, or continued exposure, often collected via language experience questionnaires, others use proficiency tasks to group participants .When operationalizing concepts, psycholinguists often categorize participants into groups for the purposes of comparison, either These different methods and criteria lead to huge variation in how participants are categorized and treated in analyses across studies. While the use of standardized measures or tasks may appear more objective or consistent, different assessments can often categorize participants in significantly different ways . This poOf course, individual differences will always exist in any sample. However, when using underspecified categories, such as (NON-)NATIVE SPEAKER, there may also exist large systematic “within-group” differences that can affect the linguistic variables of interest, and therefore complicate theoretical interpretation and generalization. Because we often assume homogeneity in such groups, potentially relevant factors of language experience are inconsistently reported. For example, To take one example, MONOLINGUAL NATIVE SPEAKERS in fact vary immensely in experience with other languages or varieties; though researchers do not always take this into account, it can lead to significant differences in linguistic behavior. For instance, lifetime experience with other speech varieties  influences comprehension , while evia an overreliance on factorial design and treating continuous predictors as categorical in analysis. The risks of discretizing continuous measures for analysis and the benefit—or indeed, necessity—of maintaining these continuous measures have also been argued for language research on conceptual and empirical grounds  has been historically inconsistent across the literature and often relies on binary categorization of continuous variables e.g., . Solís-BIn this section, we discuss possible responses to the problems outlined in Section “Introduction”, drawing from the approaches taken by researchers from various fields. These are organized into three (broadly defined) stages of research: conceptualization, recruitment, task, and survey design, and data analysis. We review the effectiveness of these solutions, along with representative examples, leading into our more specific recommendations in Section “Actionable Recommendations”.expertise (linguistic knowledge and ability) and (ii) language loyalty/allegiance . These alternatives allow us to conceptualize two different facets  without appealing to NATIVENESS. For example, Amy (Box 2), a “heritage” bilingual, might consider herself an expert in English with less expertise in Cantonese. At the same time, she holds allegiance to both Cantonese (via inheritance) and English (via affiliation). This distinction on its own, however, does not specifically account for aspects of linguistic history.Although scholars have suggested both narrowing e.g.,  or broadRegardless of the alternative terminology one chooses to use as labels or descriptors, we believe the best practice is to use specific characterizations of particular aspects of language experience . This aligns with recommendations within bilingualism research to increase comparability across laboratories and studies by “provid[ing] detailed descriptions of the populations tested following a consistent approach” , p. 7. BAs discussed in Section “Issues With NATIVE SPEAKER When Constructing Comparison Groups and Conducting Analyses”, even within supposedly MONOLINGUAL NATIVE SPEAKER populations from the same region, literacy and education can vary extensively, not to mention diversity in experience with other languages or language varieties. For example, Ingrid (Box 1) is relatively well-read and thus has consistent exposure to the types of syntactic structures disproportionately represented in written Dutch, such as sentences with multiple embeddings see . HoweverAn additional benefit is that this practice, through increasing deliberate and thoughtful development of inclusion and exclusion criteria, can help to minimize the exclusion of underrepresented groups or individuals who do not fit into normative assumptions, but may in fact match the criteria for a particular research sample. This also potentially expands our participant pool, which may provide the practical advantage of facilitating research recruitment. In a similar vein, although a common practice in psycholinguistic research is the recruitment of ‘native speakers’ to norm or judge stimuli, or ‘native, monolingual speakers’ to record auditory stimuli, we cannot assume that these individuals have “neutral” identities or normative language histories. The same careful consideration of relevant and irrelevant characteristics of individuals under study should be applied to perceptual judges and speakers for stimuli.As researchers who have employed a critical approach to understanding research methods in linguistics and related fields have shown, it is imperative to understand how the questions we ask and the ways we ask them will be interpreted in local contexts, because these may differ significantly from researchers’ expectations . All resAs an example, a study of Hindi-Urdu sentence acceptability  asked a range of questions about exposure, comfort, and use of Hindi-Urdu. They also asked participants, at the end of the language experience survey, to indicate if they consider themselves “native speakers” of (a) Hindi-Urdu and (b) English. There were several cases in which participants’ self-identification as “native speaker” did not align with many commonly understood correlates of nativeness: One participant had grown up in Pakistan  and spent the first 35years of his life in regions where Hindi-Urdu were the dominant languages. English and Hindi-Urdu were among the languages he heard growing up, and these were the two languages of instruction in his schooling. He rated himself as being maximally comfortable in reading, writing, listening to, and speaking Hindi-Urdu. And yet, he selected “no” when asked if he considered himself a native speaker of Hindi-Urdu . If that question had been the one used to recruit participants, this person would not have opted in, despite the fact that his language experience, as measured by the other questions, is highly relevant for this study.Conceptions of the term NATIVE SPEAKER vary widely depending on how it is translated and the local context of its use. In many cases, some variant of “native language” is used on government censuses, and understandings of the term are influenced by historical uses and its connection to this survey. For example, in post-Soviet states, Soviet language planning tied languages to national territories, called Soviet Socialist Republics (SSRs), within the USSR. Language became a salient marker of national identity linked to the ability to find employment and access to resources in SSRs, and it was beneficial for people to identify their native language as that of the titular nationality . In the We also must consider that translations are not one-to-one equivalents of meaning, and the categories of NATIVE SPEAKER and its translations, though they will most likely overlap somewhat with understandings of the term in English, will not match completely. The common translation of “native language” in Russian, “rodnoĭ iazik [родной язык],” comes from the root “rod [род]” with associations of “birth” or “tribe” or “natural” and is found in words, like parents (roditeli [родители]) and homeland/motherland , for example, would likely perform “natively” in a Malayalam and English picture naming task, regardless of the comparison group. However, depending on the norms assumed by the researchers, she might not perform “natively” in a phonetic task in English, or a reading comprehension task in Malayalam, because of the contexts in which she learned both of those languages. In addition, Leela now uses solely English at work; when she was a child, she was almost never in English-only contexts. As such, any assessment of her comfort in using English would likely change significantly across her lifespan. Crucially, despite spending her whole life in a Malayalam-speaking region and having an education background that is quite common for people her age, she would show quite different performance across domains. This not only demonstrates the problems with prioritizing certain measures over others, but also could potentially lead to harm by reinforcing deficit perspectives toward multilingualism.Potential histories of oppression and marginalization should also be accounted for. By being explicit about the aspects of language experience that we are concerned with, what assessments we use, and what assumptions our assessments carry, we can help avoid inconsistency. In the same vein, when selecting measures to characterize participants or while performing cross-study comparisons, we suggest researchers pay close attention to how ‘nativeness’ is defined and measured. Keep in mind that the fact that two studies use the term ‘native speaker’ does not guarantee that both studies share the same operationalization. The assessments chosen and how they are reformulated to be more targeted and specific will vary based on the relevant aspects of language experience that the researcher is interested in.Many scholars have noted issues surrounding entrenched “categorical thinking” in psychology and psycholinguistics, marked by sampling few values along a continuum, discretizing continuous measures, and an overreliance on factorial design and ANOVA  homogenous groups, an alternative is to conduct individual differences analyses. Some approaches to language take such individual differences as the norm, even in relatively homogenous populations. For example, Mixed-effects models, in which random effects allow for sub-group differences (as well as stimulus-derived variation), have become the norm in psycholinguistics. In particular, random by-participant intercepts and slopes account for variation at the individual level, which is typical in (psycho)linguistic data see . HoweverOne way to handle large amounts of detailed demographic and language experience data collected from a questionnaire is to use dimensionality reduction techniques, like factor analysis or principal components analysis, to distill the data from many continuous measures into a smaller, more manageable number of relevant, orthogonal continuous factors. These factors can then be used as predictors in a regression model. Especially, when dealing with a sociolinguistic context which might be unfamiliar or understudied, allowing the relevant predictors to be inferred from the data in a principled manner, as opposed to data fishing, might be a desirable approach. This allows researchers to model language experience factors without defaulting to researcher-imposed categories; it could be that categories emerge from the data, but this allows that information to be inferred rather than imposed.For example, An alternative approach to multivariate data, rather than identifying latent variables, is to use clustering techniques to classify individuals and identify emergent groups. According to n-back task to investigate how responsiveness to cognitive control training influences recovery from misanalysis of sentence structure . In other cases, groups can be fully emergent. via the lens of individual differences . In a study of second dialect acquisition, Clustering can be used to identify “natural” groups (in a more informed manner than techniques such as median split) which are applied to test hypotheses or make comparisons. In some cases, groups can be predicted. For example, Like Section “Assessment and Implications of Current Practices”, our actionable recommendations are divided into three sections that correspond to different stages of conducting research: conceptualization of research questions, characterization of language experience in experimental materials, and analysis of data. We begin with suggestions on how to conceptualize research questions and encourage a pause for reflection about the underlying assumptions of experimental constructs. The remainder of the section proposes ways to move beyond NATIVE SPEAKER with regard to various aspects of an experiment, including participant recruitment, stimuli development, task design, and assessment or screening question selection as well as during data processing and analysis. Throughout, we offer concrete actions to take along with illustrative examples to help readers apply these recommendations to their own research. However, not all laboratories or researchers have access to the same resources, whether that be physical space, time, funding, personnel, populations of interest, etc., and may not be able to follow all of these recommendations. We encourage researchers to do the best they can give their constraints. Researchers should prioritize the recommendations that best suit their research questions and experiments .Before designing an experiment, researchers need to take time to think critically about both their own assumptions about NATIVE SPEAKERS and the questions they want to investigate. Understanding one’s own biases before engaging in research will result in more ethical and reproducible science. Throughout this questioning process, we encourage researchers to keep a log of the questions they ask and their answers. This log can help when writing up one’s theoretical viewpoint in a paper, explaining why or why not one included a variable in an experiment, as well as to see how one’s viewpoint has changed over time. See Please note that we are not encouraging researchers to strictly define NATIVE SPEAKER and continue using the term, but instead to think about the more granulated aspects of language experience that they use NATIVE SPEAKER to mean. This is an iterative process, and researchers will benefit from engaging in this process throughout their career.First and foremost, we recommend that researchers ask themselves what their assumptions about NATIVE SPEAKERS are. This will help pinpoint the aspect(s) of language experience they are interested in and which they think are relevant for their overall research. To do this, researchers could start by concretely defining NATIVE SPEAKER in their own terms. For each of the attributes that the researcher lists, they should ask what the attribute implies. For example, if a researcher lists that a NATIVE SPEAKER “learned language X before age Y,” then this attribute implies a critical period. The researcher should evaluate whether or not they agree with this implication, determine if it is an important aspect of language experience, and update their definition accordingly.Researchers should then evaluate the theoretical beliefs that they hold about NATIVE SPEAKERS. One should ask themselves what theories they do or do not support and list the assumptions that those theories make about language experience. Then, the researcher can determine if they agree with those assumptions. The researcher may notice a trend among the assumptions that they agree with. For example, a researcher may support theories that imply that someone is a NATIVE SPEAKER of X if X was the language of instruction at school. This indicates that the researcher views language of instruction as an important aspect of language experience. Crucially, a researcher should then ask “Would including a participant with a different language profile change my theoretical predictions?” If the answer is “Yes,” then the researcher should consider what aspect of a participant’s language profile would have to be different (and how different) for the researcher to see a change in their predictions. Once a researcher has completed this line of questioning, they will be more equipped to determine the aspects of language experience they consider to be important for their research as a whole. Identifying one’s underlying assumptions can then inform recruitment, experiment design, and data analysis.During this reflection, some may feel resistance to shifting away from NATIVE SPEAKER, which may have been a functional or central concept in their past research. We do not deny that certain commonalities may be observed among those broadly considered NATIVE SPEAKERS (or L1 speakers) by researchers. However, these communalities may be more precisely captured by factors of language history, proficiency, and/or identity, meaning that a move away from fuzzy categories is a move toward clarity of mechanisms. Given this context, we ask that researchers consider carefully whether the implicit and explicit exclusion of marginalized and minoritized populations through the usage of this term is necessary or justified for their particular research program or questions. It is crucial for researchers to be explicit about the types of language experience which are important to their research questions in order to avoid reproducing normative assumptions about who gets to be a NATIVE SPEAKER. By pulling away from the term NATIVE SPEAKER as a proxy variable, researchers can reduce harm and begin to better align their research and theory with non-normative contexts of language learning and use.After researchers have analyzed their own beliefs, they can begin designing experiments that take into account their assumptions. Researchers often begin the research conceptualization process with a general question that they translate into a specific, operationalized hypothesis. If researchers have gone through the initial reflection process, then they already know what aspects of language experience are relevant for their research, and what aspects are important for specific questions. However, it is important to ask follow-up questions for each new experiment. Researchers should engage in this process for each new experiment that they design.The first question a researcher should ask is as follows: What aspect of language experience is important for this specific research question? If they are not able to identify an aspect, they should go through the self-exploration process in Section “Reflection” again. Once researchers have identified what aspect of language experience is important for their question, they should identify why it is important. This question has two goals: (1) It situates the work in a theoretical context, and (2) it ensures that the construct is relevant. When researchers tie their experiments to broader theories, they should again evaluate what these theories imply about NATIVE SPEAKERS and whether or not they agree. If researchers are not able to identify why a construct is important, then they should consider using a different aspect of language experience . At this stage, it is also beneficial to determine what predictions come from a researcher’s chosen aspect of language experience. While this should be a standard part of experiment design, thinking through possible results is particularly beneficial in the case of research derived from the concept of NATIVE SPEAKER because it can indicate whether existing constructs are informative and relevant.One should also consider whether including speakers with different language profiles would affect the data, and if so, how. Similar to whether a different language profile would impact theoretical predictions, this question evaluates both the scope of the empirical question and how susceptible the experiment design is to heterogeneity within speaker groups. If slight variations in speaker profile change the predictions, then the natural heterogeneity of participant groups will lead to differences in results. Exploring how one’s data would change by including participants with different language profiles may reveal relevant aspects of language experience the researcher had not previously considered.excluding and why? If researchers are excluding a group due to a specific aspect of language, we encourage researchers to tailor their screening questions to measure that aspect of language instead of blanket-eliminating a widely heterogeneous group of subjects . Researchers should consider what their data and predictions would look like if they did include these speaker groups and contexts.Considering how language profiles affect data leads nicely to the next important question: Who is the researcher Lastly, researchers should dedicate a considerable amount of time to evaluate how they structure their research questions and situate them in a theoretical framework. As discussed previously, many existing theories make assumptions about NATIVE SPEAKER and inherently imply other debated frameworks. By carefully examining the assumptions underlying theory, researchers can avoid vagueness and enhance replicability. Assumptions about NATIVE SPEAKER as a concept may also exclude certain participants from research, perpetuating harmful stereotypes and deficit models. We call on researchers to establish their research in explicit theories of language learning, exposure, and usage. Within this solid framework, researchers can then clearly state what they are testing and how it relates to the variables within the theoretical framework. The participants’ explicit, specific, and measurable language experience should be the driving variables in theory development and experiment design.Various aspects of an experiment may use the term NATIVE SPEAKER or assume the construct as given. In this section, we provide best practices to move beyond this when designing materials for participant recruitment, experimental tasks, and surveys, as well as when reporting methodological details in a publication.First and foremost, we recommend that researchers actively avoid describing participants as ‘(non-)native speakers’ in any part of the experiment, including the use of this concept as a criterion for assigning participants to target and comparison groups. Instead, the best practice is for researchers to, based on their specific research question, specify targeted aspects of linguistic experience in detail . These concrete characteristics can then be used in recruitment and analysis, promoting clarity and transparency.For example, when asking about the effect of language experience on acceptability of resumptive pronouns in Egyptian Arabic, one might construct comparison groups differently based on one’s particular assumptions about the role of language experience. If a researcher thinks that speaking Egyptian Arabic as the primary language is what matters, that would be one way of recruiting and characterizing a comparison group. Alternatively, if a researcher thinks age of acquisition is what matters, recruitment could take place based on whether participants had grown up speaking Egyptian Arabic. Crucially, these different hypotheses would result in potentially different groups of participants, and asking about ‘native speaker’ status would result in a third, less-specified group.Some of this information can be collected after the experiment is completed, in a post-experiment questionnaire, but, when possible, conducting norming studies , looking to census data, or making hypotheses based on ethnographic or sociolinguistic research is also a good practice . In the case of recording auditory stimuli, some relevant elements to report are (i) whether the person is from the same community as the participants, (ii) how their language experience might match or deviate from that of the participants, and (iii) when possible, any information about whether and how that might be perceived by the participants.Crucially, we are not asking that researchers necessarily report any and all information they might have ; rather, we ask that researchers aim to have clear, For example, if a researcher is conducting a study on constituent ordering preferences in Hindi-Urdu speakers living in the United States, rather than reporting that ‘a native speaker of Hindi-Urdu was recorded for auditory stimuli,’ a better practice would be to report details, including the location and linguistic context in which the speaker grew up and currently resides, the speaker’s regional/cultural variety of Hindi-Urdu, and their language usage practices, including potential multilingualism. Similarly, for a researcher conducting a study on processing of ‘foreign-accented’ speech, rather than reporting that ‘ten non-native speakers of English recorded sentences,’ it would be better practice to report details (in the main text or in a table) about each speaker’s regional background, linguistic history, and perceived degree of accentedness.When choosing assessments to characterize participants, researchers should keep the following question in mind: Is this assessment measuring ‘nativeness’ as I operationalize the term, or is this assessment capturing others’ ideologies about what a ‘native speaker’ is? When we ask participants to self-report their “native” status, in reality, the results capture their ideologies of what a ‘native speaker’ is and whether they fit into that definition. The same reflection question must be used when considering apparently objective measures. Take, for example, ‘nativeness’ accent ratings. In this type of assessment, speech samples from the participants are given to raters  who then judge how “native” a speaker sounds. While accent ratings appear to be collecting objective data, in reality, this measure too is capturing the rater’s subjective ideologies about what a ‘native speaker’ should sound like and whether their perception of the speaker matches their ideologies of nativeness.’To avoid assessing ideologies about NATIVENESS and leaving room for interpretation of what this term means, we recommend that our assumptions as researchers about NATIVENESS be made explicit in the assessments we select. If, for example, a researcher were to be interested in determining whether participants grew up speaking the “native” language at home and at school during early childhood, rather than asking an ambiguous question, such as “Are you a native speaker of German?” one could ask more targeted and explicit questions, such as “Did you grow up only speaking German and spoke it at home and school?” , and we urge that proficiency be properly contextualized, taking language access and structures of oppression into account. Much like The questions in Whether or not one’s study design involves explicit predictions or analyses based on participants’ language experience, the sociolinguistic context should inform how researchers choose questions for recruiting and characterizing participants and how they interpret and report responses. Norms of multilingualism and schooling in the local context may affect to what degree a given question about language experience will generate a homogeneous sample. The desirability of homogeneity will depend on the purposes of the study, but be cautious of the trade-off between the homogeneity of a given sample and the generalizability of an observed effect. We caution against making broad claims about language organization and behavior based on studies drawing on samples from relatively homogenous (and WEIRD) speech communities. However, precisely, reporting the language and cultural background of one’s participants (as discussed in “Participants and Groups” and “Stimuli and Norming”) can help inform directions for expansion in the future research.Here, we give some suggestions for the types of information which might be relevant to take into account when contextualizing results, and therefore the types of information which researchers can ask about and report in publications. For example, is the language or variety stigmatized, either locally or by the larger society? Is the community minoritized (even if the language/variety is not stigmatized)? Are the speakers (and perhaps by extension particular linguistic features) racialized? What is the incidence of multilingualism in the community? How does schooling look typically, and what are the associated language policies? What counts as being multilingual for the local context? Are the language boundaries which linguists can perceive relevant for the speakers themselves cf. ? Lookingpost-hoc analyses connecting those patterns with information about language experience. Finally, even in contexts where there might be qualitatively separable groups, researchers can examine how relevant language experience factors might contribute to how individuals do or do not map on to group-level patterns.Rather than comparing groups of participants based on NATIVE SPEAKER status, we recommend that researchers compare response measures based on more transparent and targeted variables of language experience relevant to their research question. As part of this move away from categorical analyses, we encourage researchers to take an individual differences perspective to foreground individual-level patterns in their data. There are several ways this could be implemented. In a context where researchers recruit from the same pool of participants, expecting heterogeneity of experience but not expecting qualitatively separable groups, one could examine data for apparent outliers and attempt to interpret these based on language experience factors. Alternatively, one could examine whether the dependent variables are multimodally distributed, and conduct We briefly direct the reader to methods of analysis which align with the theoretical moves we are advocating to accurately and fairly represent our research populations, namely, using continuous variables instead of categories in linear regression and taking into account individual differences using mixed-effects modeling , as well as using dimensionality reduction techniques on many continuous variables and using clustering techniques to split the data into observed rather than predetermined groups (Multivariate Data). We recognize that these statistical tools may not be available or applicable to all researchers, particularly those who work with smaller sample sizes ; in such cases, it might be necessary to consider whether non-parametric statistical methods or qualitative analyses are more appropriate.Regression analysis is widely used in psycholinguistics, and it allows us to account for continuous predictors. To take a concrete example, let us say Dr. A is interested in differences in lexical processing based on language experience . Dr. A may recruit participants who are all currently residing in Germany and have either German or English as their L1. Along with a German lexical decision task, they ask their participants about their age of acquisition and self-rated language usage and proficiency in a post-experimental questionnaire. One or more of these variables can be added as continuous predictors into a regression model.Statistics for Linguists: An Introduction Using R, Analyzing Linguistic Data: A Practical Introduction to Statistics using R, and Data Analysis Using Regression and Multilevel/Hierarchical Models  can cause adverse consequences for analysis. This is something to keep in mind when dealing with many language experience variables, because we may expect several variables of language experience to correlate with each other, in addition to being correlated with the response measure. For example, age of acquisition is often correlated with measures of proficiency . So, Dr.Dimensionality reduction techniques include factor analysis (FA) and principal components analysis (PCA). These techniques are similar, but different in their approaches and assumptions. PCA is usually preferred when the goal is simply to reduce correlated observed variables to a smaller set of composite variables, whereas FA is preferred when the goal is to detect underlying factors influencing the responses on the observed variables  may not always be evenly distributed across a continuous range. Data may instead be multimodal such that certain participants are particularly similar to each other, representing groups who are qualitatively different, at least in that particular context or participant sample. In this case, participant groups could be identified in a data-driven way Before clustering, diagnostics should be used to confirm that the data indeed are multimodal. There are various types of cluster methods, including the broad classes of hierarchical methods, where each individual begins as its own cluster and is grouped with progressively more clusters  and partitioning methods, where number of clusters are prespecified and individuals are assigned to a particular cluster . For more information about cluster analysis, It is clear that the concept of NATIVE SPEAKER can be harmful to both psycholinguistic research and the populations we study. The term NATIVE SPEAKER has been problematized in different fields, and some solutions have been to repurpose the term. However, these approaches simply redefine NATIVE SPEAKER to include or exclude certain populations  and manyAs we reflect on these recommendations, recall the point made in Section “Actionable Recommendations”—as researchers may not be able to practically implement all of these all at once, they should prioritize the changes which are most relevant for their research questions and the contexts in which they work. However, individuals and individual laboratories cannot on their own be responsible for shifting away from this concept and the associated baggage. We recognize there are structural barriers to implementing some of these recommendations, such as expectations of reviewers, access to funding to collect requisite data, and necessarily small sample sizes when working with certain populations. Of course, we psycholinguists are part of these structures to different degrees and can work within our spheres of influence to make a difference. This could look like advocating for less harmful ways of characterizing and recruiting participants as part of local/institutional ethics boards, program committees, journal editorial boards, and in classroom or other training contexts. Structural changes are necessary and must accompany the individual-level changes which are the focus of this paper. We hope these recommendations will not only improve research design and analysis, but also contribute to the co-creation of a more just and inclusive field.NATIVE SPEAKER at the Stages of Conceptualization and Design, Issues With NATIVE SPEAKER When Constructing Comparison Groups and Conducting Analyses, Complicating NATIVENESS in Conceptualization, Continuous Variables and Linear Regression, Multivariate Data and Dimensionality Reduction, Emergent Groups and Clustering, Participants and Groups, Stimuli and Norming, Tasks, and Assessments, Regression Analysis, and Multivariate Data. DB: Issues With NATIVE SPEAKER When Constructing Comparison Groups and Conducting Analyses, Continuous Variables and Linear Regression, Individual Variation and Mixed-Effects Modeling, Multivariate Data and Dimensionality Reduction, Emergent Groups and Clustering, Surveys and Recruitment, preparation of All authors contributed to the conceptualization and writing of this paper. The most substantive contributions of each individual are listed as follows. LC: Vagueness, Issues With The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


European healthcare systems are increasingly being challenged to respond to female genital mutilation (FGM). This study explores the FGM experiences of migrant women coming from FGM-practicing countries residing in a European host country. A qualitative phenomenological study was carried out and 23 participants were included. Data were collected through 18 face-to-face open-ended interviews and a focus group and were analysed using Giorgi’s four-step phenomenological approach. Three main themes were derived: “FGM consequences”, “healthcare received” and “tackling FGM”. Participants highlighted obstetric, gynaecological and genitourinary consequences such as haemorrhages, perineal tears, caesarean delivery, risk of infection, dysmenorrhea, urinary tract infections and dysuria; consequences for sexuality, mainly, dyspareunia, loss of sexual interest and decreased quality of sexual intercourse; and psychological consequences such as loss of self-esteem, feelings of humiliation and fear of social and familial rejection. Women perceived a profound lack of knowledge about FGM from health providers and a lack of sensitive and empathetic care. Some women perceived threatening and disproportionate attitudes and reported negative experiences. Participants highlighted the importance of educating, raising awareness and improving prevention and detection strategies. The findings disclose the need to improve training and institutional plans to address structural and attitudinal barriers to health equity across migrant families in their host countries. Violence against women is one of the most pervasive gender-based inequalities that creates inequalities in many areas of the life of women and girls. These disadvantages pose serious threats to their welfare and the fulfilment of their rights . The praAccording to the latest United Nations Children’s Foundation (UNICEF) data, the exact number of girls and women affected by FGM globally remains unknown. However, at least 200 million of women and girls have undergone FGM and it is estimated that 68 million girls will undergo FGM before 2030 if action against this practice is not intensified ,5.FGM is mainly concentrated in 130 countries in the western, eastern and north-eastern regions of Africa, along with the Middle East and is practised in some countries of Asia and Latin America with wide variations in prevalence . NeverthThus, although the practice is originally characteristic of certain areas, this local phenomenon has been globalised and spread around the world through the different migratory movements. Therefore, FGM and its harmful consequences are affecting a growing number of women and girls among migrant communities in Europe, North America and Australia . AccordiIt is expected that the number of women with FGM in Europe will rise at quite a fast rate and future flows are expected to be strongly geographically selective, involving mainly France, Italy, Spain, the UK and Sweden . This faThe practice is painful and traumatic and its performance is often unhygienic or carried out by non-expert practitioners who have little knowledge of the anatomy of the genitourinary system of women and lack the ability to respond to adverse events. FGM has consequences that undermine the health and well-being of girls and women, revealing a remarkable situation on the global women’s public health agenda ,13. The Immediate complications include severe pain, shock, haemorrhage, tetanus or infection, urine retention, ulceration of the genital region and injury to adjacent tissue, wound infection, urinary infection, fever and septicaemia. Haemorrhage and infection can be severe enough to cause death. Long-term consequences include complications during childbirth, anaemia, the formation of cysts and abscesses, keloid scar formation, damage to the urethra resulting in urinary incontinence, dyspareunia , sexual dysfunction, hypersensitivity of the genital area and increased risk of HIV transmission, as well as psychological effects .In addition to the physical and psychological impact of FGM, the associated complications are usually not the primary problems for women who arrive as refugees or migrants. They are very likely to come from conflict zones where they experience poverty, malnutrition, health problems, lack of educational opportunities and restricted access to health care services . This faEvans et al. suggests that care and communication around FGM can pose significant challenges for women and other healthcare providers . SeveralNonetheless, limited research has examined how women and men experienced the practice of FGM and its consequences, as well as the healthcare received within the Spanish national public health system ,20,21,22To address this need and considering that FGM may act as an element of discrimination and a condition for health inequalities in contexts where the practice of FGM is unknown and ignored, the aim of this study was to gain in-depth experiential knowledge about the experiences regarding FGM of migrant women coming from FGM-practicing countries residing in their European host country.A qualitative study design with a phenomenological approach was chosen. Phenomenology was selected on the basis of its relevance to research individual lived experiences, meaning-making and interpretation of one’s experience or perception. This method, developed by Husserlian philosophy , aims toA total of 23 participants were included in the study. For the selection of the participants a purposeful sampling strategy was used, which implies identifying and selecting individuals or groups of individuals that are especially knowledgeable about or experienced with a phenomenon of interest . The samContact with the target population was made through key informants. Key informants were local community leaders who were located via community health agents, local associations of migrants and social organizations and services. Key informants were asked if they wanted to participate in the study if they met the inclusion criteria. Key informants also served as gatekeepers since they were trusted sources that controlled access to the target population. Using the snowball sampling technique, they contacted potential participants and asked them for the first time if they would agree to the study. This technique was chosen because its suitability provides forms of contact with populations or groups characterised as difficult to access or, meant in the literature, as hard-to-reach populations ,27 or hiAll eligible participants who were approached agreed to be part of the study. Data were collected through 18 face-to-face open-ended semi-structured interviews and a focus group. The study was carried out in two stages: the first stage was carried out in London (United Kingdom) in January of 2017 and the second stage was carried out in Valencia (Spain) from February to May 2017. The focus group was conducted in April 2017 in Valencia. The study was carried out in two stages based on the criteria of convenience-relevance and the sufficiency of the sample, which were also considered to facilitate the research process and the scope of the saturation principle.First, a few questions exploring the sociodemographic characteristics of the sample were undertaken. The following general questions included women’s experiences on FGM, its consequences and the healthcare received. The participants chose the times and locations for the interviews: participants’ home, workplace or a cafe or a garden close to their homes. Two researchers were involved in carrying out the interviews. The researcher’s credentials, occupation and training were informed to participants prior to data collection. All narratives were, after obtaining consent, recorded in audio format. Field notes were written after each interview to detail observations that could not be captured via the audio recording. The duration of interviews sessions ranged between 11 and 58 min.The focus group was conducted to stimulate the interaction between the participants and to explore the discourse in certain social context, capturing the social experience and the different opinions and contractions following Berenguera approach . The focAll participants received oral and written information about the purpose of the study, voluntary participation, guaranteed confidentiality and the right to discontinue at any time without any adverse effects. All participants signed a written informed consent prior to each interview. All interviews were coded prior to their transcription to guarantee the confidentiality of the participants. Approval was obtained from the Ethics Committee in Human Research of the University of Valencia, Spain.Data analysis was conducted according to the four-step phenomenological approach of Giorgi  and tookTo assess the rigour of the research process developed in the framework of qualitative research, we have based ourselves on the general criteria described by Guba and Lincoln: credibility, transferability, dependency and confirmability . SpecifiThis study has been reported in line with the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines to enhance the quality and transparency of the study .From the 23 experiences collected, 20 women had undergone FGM, of whom 14 had been mothers. The mean age of the men interviewed was 50 years, while that of the women was 31.8 years. All the participants came from countries affected by FGM: Mali, Somalia, Nigeria, Burkina Faso, Senegal and Cameroon, except for one participant who came from Equatorial Guinea and was included in the study since she had close contact and knowledge about FGM. The detailed sociodemographic characteristics and the FGM status of the study participants are shown in Three main themes were derived from narrative data: (a) FGM consequences, (b) healthcare received and (c) tackling FGM. From these, several sub-themes emerged, which are described below . RepreseIn this category, the following subthemes were derived: “obstetric consequences”, “genitourinary consequences”, “pain”, “sexual complications”, “psychological and social consequences”, “men’s consequences” and “lack of insight”. In general terms, both short and long-term consequences were described. The severity of complications depends on the type of FGM that has been performed, types II and III being the most intrusive: “The bigger the grade is, the more complications are” (I1LW). Other factors, such as the girls’ prior health or the conditions in which the practice is carried out, also influence the consequences of the procedure.Regarding obstetric consequences, the most frequently mentioned were postpartum haemorrhage, perineal tears, pain, caesarean delivery and the risk of infection. Infertility, preterm birth, shoulder dystocia and even death were also mentioned . SeriousMultiple allusions were also made to bleeding secondary to FGM itself, also associated with the significant risk of traumatic wound infection.“In my country  they usually do FGM to babies of a week or days of life. There are not so many means to do it. Likewise, they cut 20 girls using the same knife, so there are many infections. There are also girls who die from hemorrhages…”(I14VW)“There are many complications (…) first, there are plenty hygienic infections”(I8VW)“Bleeding... Her family was healing her, at home! Not in a hospital”(I9VW)In addition, to wound infections caused by FGM, women also refer us to other genitourinary complications such as repetitive urinary tract infections: “Yes, many (urine infections), as a child and now” (I12VW)Moreover, the pain is a symptom that appears associated with most complications’ secondary to FGM. We have found references to it both when urinating (dysuria), having sex (dyspareunia), related to menstruation (dysmenorrhea) or related to birth or gynaecological examination .Regarding the consequences on sexuality, dyspareunia, the decrease or absence of erotic desire, the decrease in the quality of sexual relations and anorgasmia were mainly mentioned: “Then, when you get married it is very difficult to feel pleasure” (I1LW), “She is suffering because she does not have the desire to have sex” (I9VW).Regarding psychological consequences, the participants did not explicitly describe suffering from anxiety and depressive disorders, post-traumatic stress, or reminiscences of the moment of the cut. However, we can find verbatims of clear components of psychosocial affectation such as loss of self-esteem, feelings of humiliation and fear of social rejection and dishonour of the family.“I had to please my parents, I had to please everyone. I was given plenty of gifts, gold, jewellery, which is hardly praised in our culture”(I1LW)“Because a girl who is not mutilated, people call them ‘bilákoro’, it’s like… if you are dirty, you are not welcomed…”(I15VM)“It is a party, the day of FGM comes and then the whole family gets prepared. It is said that the girl’s crying defines the courage of the family”(I15VM)Finally, we have also found different testimonies from women affected by FGM who report not having suffered any associated complications. Two participants expressed: “There are no complications after female circumcision” (IG); “It didn’t affect my sex life and it didn’t affect my pregnancy. I would have loved to have my clitoris hanging, but it’s not there which is fine, no problem! Sex life it’s OK! I cannot complain! (Laughs…)” (I1LW)Many women do not perceive the consequences and complications as a cause of FGM, since they understand that they are “common and normal in women”. Therefore, they do not perceive the need to seek support, help or assistance in the face of a problem, since they consider it as something intrinsic to the nature of women.“If they have severe FGM types, they have lots of problems such as infection, difficulty with bleeding like periods problems. However, they do not seek much help because they think that is normal for every woman, the more they are educated the more help is seek. Yes, but I do not think they will be coming in numbers. Only the ones who knows better”(I1LW)There is also a belief in some communities that if something bad happens, the existence of a “higher being” is what determines the final result as reported by one participant:”It is something normal in life. For example, when girls die during the FGM procedure, people think that God has made the decision and it happens because it must happen. It is the same for women who die giving birth. They do not associate it with mutilation” (I14VW)Some of these consequences also affect men. For I2LW interviewee, men do not suffer any consequence: “I don’t know the men, I don’t think they have problems” (I2LW). However, other participants suggest the opposite: coping with the fear of losing virginity on their wedding night, frustration, or decreased quality of sexual relationships.“A lot of pressure comes also from men, but I think in my culture lots has changed, and men are stepping back, and they don’t want to go through that trouble (…), when a woman who is FGM type III comes to them, and they have to open their vagina with their own genitalia”(I1LW)“There are men who do not want to sleep with the woman that day, but there are others who force her wives because they have to do so (…)”(I14VW)“Women do not have pleasure when they have sex and this generates many frustrations, for men too, so they do not feel satisfied in bed and then the problem begins. They go with other women…”(I14VW)From this theme, four subthemes were derived: “unacquainted professionals”, “lack of detection and information”, “stigmatizing and over-inquisitive attitudes” and “offering reversal or deinfibulation”.The lack of knowledge about FGM of different professionals perceived by women emerged, for example, when they underwent gynaecological examination or received childbirth care.“I knew that the way they looked at me meant that they had no knowledge of what had happened to me (…) When we talk between us, the ignorance of professionals comes up”(I14VW)The interviewee I8VW experienced an unpleasant situation in consultation, when the midwife made an unfortunate comment, thus demonstrating a lack of sensitivity and information about FGM and its approach: “The midwife found it very rare that performing a cervical smear would hurt so much and she told me: ’if the penis has fit there, it shouldn’t hurt so much’. I explained to her why it was so painful for me. Ashamed she apologised” (I8VW)Participants reported that healthcare providers failed to detect FGM and its consequences. Practically all the women interviewed in Valencia reported that no professional asked them if they had undergone FGM at any time during their pregnancy or any other health visit: “No, no... they didn’t tell me anything about it, nobody” (I11VW), “No, no one has never asked me this” (I12VW). Some participants suggested that although some professionals may be knowledgeable about the practice, they do not ask because of embarrassment and a lack of skills to handle the situation: “I think they do know but they don’t ask, they may be ashamed…” (I17VW). This fact has an impact on the information provided and, consequently, the quality of care for these women, girls and families. On the contrary, all women who gave birth in a hospital in the British Health Care System were asked during pregnancy about FGM: “But when I was doing my booking, they asked me if I had FGM done” (I1LW), “During my first pregnancy they kept asking me if I had been circumcised” (I4LW).Another important aspect to highlight is the stigma. To avoid stigmatization of different cultures and groups, professionals should demonstrate respect for different cultures and their ritual practices, which is wholly compatible with showing a frontal rejection of FGM. Professionals should avoid issuing blaming judgments to these women, since, as I1LW interviewee described, “she did not choose to be mutilated”. Statements from healthcare providers such as, “we have to refer you to social services” during the first pregnancy consultation were construed as very offensive, even more so for this specific interviewee, who as a midwife knew the action plan perfectly, but did not agree with the way in which the professionals had decided to act and communicate. This participant stated:“But when I was doing my booking, they asked me if I had FGM done. I said yes, and they said that if I had a girl, they would have to refer me to social services… for child protecting issues. This was quite offensive because I don’t want anyone else what I have been through” (…). “It wasn’t my choice; it wasn’t me going to the doctor and saying: ‘I want FGM to be done on me’ (…). Instead of judging women, professionals should raise awareness, provide education and emotional support if women’s been traumatised”(I1LW)Four of the participants were offered a reversal of FGM intrapartum which was accepted by two of them. These women who were offered a reversal attended the British healthcare service.“I was in labour and the doctor came and told me that he will open before the baby came. I refused because I didn’t want it. But at the end I had caesarean not because pf the FGM but because the baby was stuck somewhere. With my second baby I also had caesarean”(I2LW)“They said to me: ‘You can’t deliver your baby unless we open you’. And I chose to be opened the day of delivery. I didn’t want to have a reversal in pregnancy, I wanted everything at the time of delivery, all together”(I4LW)None of the Spanish participants were offered a reversal during pregnancy. One Spanish participant requested surgical reconstruction, but she found that professionals did not always know the procedure to follow. Information on the possibility of undergoing reconstructive surgery was obtained in this case by friends, women in the same situation and the media (internet): “I requested it. I heard of it from a friend (…) I looked it up in ‘YouTube’, I looked for information so I found out what could be done (…) After asking different professionals, I found a midwife who referred me to the specialist doctor” (I14VW)Under this main theme, the subthemes “education and awareness”, “speaking up”, “improving prevention” and “penalization” were derived.Participants emphasised the education and awareness of women and men -as a fundamental component in the practice maintenance-, both in current countries of residence and in countries of origin with prevalence of FGM.“Oh God! Education, education, education. I can’t say it enough! And also educating men here but also back home”(I1LW)“To avoid this practice, women must go to school (…) When a woman is not educated, she cannot think, she cannot defend herself (…)”(I9VW)Furthermore, many of the participants emphasised the idea of speaking up about the practice and showing support for its eradication. Two of the interviewees described that after several years in Spain, they returned to their places of origin to publicise the consequences of FGM and work with the community towards its eradication, trying to generate action for social change.“I explained to my mother the inconveniences and I have succeeded to prevent my daughter and nieces from FGM. It is possible! If there is a will, there is a way. I didn’t know that I could convince my mother either”(I14VW)“When I went back to my country, I gave a talk about FGM (…) at first, I looked as if I was no longer African, my mind had changed a lot”(I14VW)“I have also held a meeting with all the women in my town (…) Now I can say that 80% of the women in my town have abandoned the practice”(I15VM)Another aspect that emerged during the interviews was the prevention of FGM in girls. Several quotes demonstrate that girls, despite residing in Europe, continue to be at risk of FGM when they travel to their country of origin: “One day I was talking to my mother, and she told me that she was waiting for my daughter to cut her clitoris with the others…” (I14VW).Some interviewees proposed dealing with FGM by penalizing and prosecuting the practice. However, they also state that this is not always effective because although the performance of FGM may be punishable by law, the law is not always fulfilled: “Yes, yes, in my country it is prohibited. They do it, but it is prohibited. But it may be that one day it will end” (I11VW).In the present study, the experiences of women and men from FGM-affected countries were investigated via qualitative analysis and assigned to three main themes. As discussed in the interviews, the consequences of FGM are complex and affect different spheres of women’s and men’s lives along with their families. With regards to the consequences for women’s health which are described in our study, participants highlight both obstetric and gynaecological consequences and complications such as postpartum haemorrhage, perineal tears, completion of caesarean delivery, infertility, risk of infection and dysmenorrhea; genitourinary complications such as urinary tract infections and dysuria; consequences for sexuality, mainly dyspareunia, decreased or absent erotic desire, decreased quality of sexual intercourse and anorgasmia; and psychological consequences such as loss of self-esteem, feelings of humiliation, fear of social rejection and family disgrace, which coincide with several synthesis studies ,35,36,37Although the consequences for women’s health appear to be the most predominant, socioeconomic consequences and those affecting men were also described by interviewees. Direct economic consequences on women and their families can originate fundamentally from the development of infections secondary to FGM that require expensive treatment, or the development of other complications that can lead to disability. In the long run and in certain contexts, this situation could lead to direct economic dependence on the husband or father . In addiIn many communities, FGM is a cultural requirement for girls who go into adulthood to acquire a certain social position and belong to a group. FGM is an important brand of social identity and not conforming to this can lead to social consequences, such as bullying, ridicule, social stigma, exclusion from the adult community, community events and social support, discrimination by peers, social rejection, loss of social status, increased isolation due to lack of marital capacity and family shame, as well as exclusion of the whole family from the social acceptance and welfare system of the community, as demonstrated by participants ,39.Regarding the consequences for men, those most mentioned included the pursuit of pleasure outside of the relationship, the fear of causing pain with penetration, or unsatisfactory sexual intercourse, as described previously ,40,41.Notwithstanding the health and social consequences acknowledged by most participants, we also found reports of women who did not associate any complications with the practice. In this way, Reig-Alcaraz  demonstrRegarding the healthcare received, the experiences of the respondents are varied. However, we observe clear differences between those residents in London and those interviewed in Valencia. For many of these women, their first contact with the health services in their host country is when they are pregnant . During In Spain, the study participants perceived a profound lack of knowledge about FGM by healthcare providers as evidenced in regional studies ,47 that Similarly, when requesting information on reconstructive surgery in Spain, there were severe difficulties in locating the appropriate information and referrals, as described in previous research . This faOn the other hand, women residing in the United Kingdom emphasised the high level of awareness and knowledge of healthcare providers. Based on the interviews with the participants, the professionals who attended them during their antepartum visits, labour and postpartum period, were fully aware of the established protocols and guidelines for action. Moreover, all women who gave birth in a hospital in the British Health Care System were asked during pregnancy about FGM. Despite this, women still felt discriminated against at times due to the stereotyping of healthcare providers and their insensitivity toward FGM. Interviewers also described a lack of understanding of cultural differences, perceiving the concerns of health professionals in relation to FGM as disproportionate. For example, some women perceived shaming and even threatening attitude in relation to the continuity of the practice of FGM for future newborns, without even having explored maternal intention in relation to the continuity or abandonment of the practice. In this sense, the experiences of migrant women collected by qualitative studies in countries with a large migrant population from countries affected by FGM reinforce a worrying lack of empathic care and sensitivity ,46.Finally, throughout the participants’ discourse, different strategies and actions to improve healthcare for women and girls affected by FGM as well as the prevention and eradication of the practice of FGM emerged. Participants highlighted the importance of educating and raising awareness among women and men both in their hosts countries and countries of origin ,51,52,53Our findings also support a previously demonstrated need to improve prevention and detection strategies ,47,50,54This study has certain limitations that require to be acknowledged. Firstly, one of the major limitations was searching for the study participants. When using the “snowball” technique, one of the possible biases involves the oversampling of a network of peers . In addiSecondly, because the nature of the subject can be very sensitive, it is possible that some of the interviewees have not been able to express their feelings and experiences with total spontaneity and freedom. Finally, it was also considered that participants may not have been completely truthful in some of the aspects discussed, because, among other reasons, FGM is a harmful practice punished both in the United Kingdom and in Spain.The current study identifies health and social issues in migrant women and men affected by the practice of FGM from their own perspective. Migrant women residing in Spain perceived a profound lack of knowledge about FGM from healthcare providers and consequently stressed that the information received was insufficient. The findings also illustrate that sometimes participants encountered negative attitudes when accessing healthcare services in their host countries and for certain participants the language used by health care providers was seen as frightening or humiliating. Some women’s experiences suggest a concerning absence of sensitive and empathetic care and a more woman-centred and human rights-based approach is recommended.Our findings disclose the need to improve training and institutional plans to address structural and attitudinal barriers to health equity across migrant families in their host countries. This study may contribute to making visible this unknown practice among health providers and may serve as a basis to formulate strategies aimed at strengthening the care of women and girls affected by FGM from a comprehensive, respectful, cultural and gender perspective, while also being effective in eliminating the physical and psychological consequences of FGM and reducing health inequalities for migrant women and girls.Trying to deal with the crisis of violence against women this study provides insights from the perspective of women who have been affected directly by the issue, through the discussion of personal experiences related to the provision of care. It also offers a broad and holistic understanding about the phenomenon studied, which can inform professionals about the realities of the practice of FGM. Such insights are vital to provide women-centred care, particularly for women and girls from vulnerable groups whose voices are often unheard.