Savera UK provides support for professionals dealing with Female Genital Mutilation (FGM), Honour Based Abuse and Harmful practices, more information can be found on their wesite.
What is FGM?
Female Genital Mutilation (or cutting) comprises of all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons (World Health Organisation WHO, 2013).
FGM has no health benefits and harms girls and women in many ways. It involves removing and damaging healthy and normal female genital tissue, and interferes with the natural function of girls’ and women’s bodies. The harmful practice causes severe pain and has several immediate and long-term health consequences, including difficulties in childbirth also causing dangers to the unborn (Savera UK, 2024).
As well as being known as Female genital mutilation or FGM the practice is also known under the following pseudonyms
- Female genital cutting
- “The cut”
- Female circumcision
- Initiation
- Sunna (type 1, type 4)
- Khifad
- Khitan
- Khatana
- Bondo
- Pharaonic (type 3)
- As there are a lot of terms – Please refer to National FGM Centre for more information
HM Government - Multi agency statutory guidance on female genital mutilation
Normal female genital anatomy
The 4 different types of FGM
Type 1 Clitoridectomy: Involves removing the fold of skin surrounding the clitoris with or without excision of part or all of the clitoris, a small sensitive and erectile part of the female genitals.
Type 2: Excision: Excision removes the prepuce and clitoris together with partial or total excision of the labia minora
Type 3: Infibulation: This removes part or all of the external genitalia and stitches/ narrows the vaginal opening. (In northwest Nigeria, infibulation is often performed after a clitoridectomy)
Type 4 Other: Unclassified – includes all other procedures such as pricking, piercing or incising of the clitoris and or labia; stretching of the clitoris and or labia; cauterisation by burning of the clitoris and surrounding tissue; scraping of the tissue surrounding the vagina; corrosive substances of herbs into the vagina to cause bleeding.
Other harmful practices
Harmful practices deny children their dignity and integrity whilst violating their human rights. They are grounded in discrimination on the basis of sex, gender, age and other factors.
- Breast Flattening - The process during which young girls’ breasts are ironed or flattened down over a period of time in order for the breasts to disappear or delay the development of the breasts entirely.
- Scarring or Branding – Scarring or branding is a process by which a mark or symbol is cut or burned into the skin of a living person, usually completed as a ritual process.
- Trokosi: Trokosi is a traditional system where virgin girls, some as young as six years old, are sent to shrines as slaves to make amends for wrongs committed by a member of the virgin girl's family
- Menstruation Ostracism – Being asked to isolate during menstruation. Sometimes women and children around the world have to leave their family home during this time.
Profile of cutters
- Elderly women in the community
- Male barbers (Nigeria and Egypt)
- Herbalist
- Female relative
- Medical professionals (23%) +
Instruments used
Female Genital Mutilation is often carried out with unsterilized instruments:
- Special knives
- Scissors
- Scalpels
- Pieces of glass
- Fingernails for babies
- Razor blades main instrument
- Some cutters cut up to 10 girls with same razor
FGM has immediate health implications
- Severe pain
- Shock
- Infection
- Excessive bleeding
- Urine retention
- Haemorrhaging
- Death
- Fracture of bones or dislocation of joints as a result of restraint
- Damage to other organs
A child after having FGM performed.
Long term implications of FGM
- Chronic pain
- Infection
- Cysts
- Menstruation difficulties
- Damage to reproductive system including infertility
- Complications in pregnancy and childbirth
- Sexual Dysfunction
- Psychological damage
- Difficulties in passing Urine & chronic urine infections
- Increased risk of HIV and other STIs
- Renal Impairment / failure
What is the difference between male circumcision and FGM?
- Male circumcision is the surgical removal of the skin that covers the tip of the penis known as the foreskin.
- Male circumcision is legal in the UK if:
- It is performed competently
- It is believed to be in the child’s best interests
- There is valid consent (both parent’s consent).
- In male circumcision the foreskin is removed without harming the penis itself. If male circumcision was carried out in the same way as FGM then most of the penis would be cut off.
- It is not performed to preserve virginity or to decrease male sexual desire. It is often done for medical reasons. Male circumcision is not linked to the control of men’s sexual behaviour while FGM is. It causes health problems less frequently, while FGM has serious and more harmful health effects.
- There is a growing movement against male circumcision and it is a controversial subject.
What is Honour Based Abuse and Harmful Practices?
Every year, 5,000 people are killed as a result of ‘honour’-based abuse (HBA) and harmful practices.
Honour Based Abuse of HBA is a broad term used to describe a combination of practices used principally to control and punish the behaviour of a member of a family or social group, in order to protect perceived cultural and religious beliefs in the name of ‘honour’.
Predominantly associated with women and girls, male members of a family can also be victims.
Violence and abuse may occur when it is felt that an individual’s behaviour has broken a code of honour, bringing disgrace to their family or social group. Perpetrators will feel that they need to restore their loss of face and standing within their community. There is often an element of approval and social acceptance from other family members and the community.
There is no statutory definition of Honour Based Abuse (HBA). However, the National Police Chief Council (NPCC) have provided guidance and a definition to Police Forces:
‘any incident or crime involving violence, threats of violence, intimidation, coercion or abuse (including psychological, physical, sexual, financial or emotional abuse), which has or may have been committed to protect or defend the honour of an individual, family and or community for alleged or perceived breaches of the family and / or community’s code of behaviour’.
'Honour'-based abuse, Forced marriage and FGM are all included within the Violence against Women and Girls Strategy (VAWG 2021)
Forced marriage, female genital mutilation and other types of ‘honour’-based abuse are hidden crimes, and to tackle them we need to change attitudes and behaviour.
It is important that everyone knows that these practices are harmful, not sanctioned by any major religion and are in no way ‘honourable’.
What is Forced marriage?
Forced marriage is defined as a marriage conducted without the full consent of both parties and where duress is a factor. There is a clear distinction between forced marriage and an arranged marriage. In arranged marriages, the families may take a leading role in arranging the marriage, but the choice whether or not to accept remains with the prospective spouses. In a forced marriage, one or both spouses do not consent to the marriage. The child could be facing physical, psychological, sexual, financial or emotional abuse to pressure them into accepting the marriage.
Forced marriage affects victims from many communities. The majority of cases reported to date in the UK involve South Asian families, but there have been cases involving families from across Europe, East Asia, the Middle East and Africa. Some forced marriages take place in the UK with no overseas element, while others involve a partner coming from overseas or a British national being sent abroad.
What is the difference between Forced marriage and arranged marriage?
In arranged marriages, the families of both spouses take a leading role in arranging the marriage but the choice of whether or not to accept the arrangement remains with the prospective spouses.
This is acknowledged under the United Nations’ Declaration of Human Rights, article 16(2):
Article 16
(1) Men and women of full age, without any limitation due to race, nationality or religion, have the right to marry and to found a family. They are entitled to equal rights as to marriage, during marriage and at its dissolution.
(2) Marriage shall be entered into only with the free and full consent of the intending spouses.
(3) The family is the natural and fundamental group unit of society and is entitled to protection by society and the State.
Identifying forced marriage
Information about the issue of forced marriage or HBV may have been provided to the victim by a friend, relative or other agency.
The person concerned may not have thought that they were a victim of forced marriage or honour based violence and may have only recently begun to question what has happened to them.
Alternatively the person may be seeking help as they know the intention is for their family to force them into marriage or they may be under threat of HBV.
The primary concern is for the safety of the victim. The nature of forced marriage or HBV is that agencies may have only once chance to respond to the needs of the victim. Ultimately to fail to do so may result in injury or death.
The Forced Marriage Unit - Research
The FMU is a joint Home Office and Foreign and Commonwealth Office (FCO) unit. It was established in 2005 to lead on the Government's forced marriage policy, outreach and casework. The unit operates both inside the UK, where support is provided to any individual, and overseas, where consular assistance is provided to British nationals, including dual nationals. The FMU provides annual reports which contain insight into the extent and of the issue in the UK.
In 2021, the Forced Marriage Unit (FMU) gave advice and support in 337 cases related to a possible forced marriage and/or possible female genital mutilation (FGM).
Of the cases that the FMU provided advice or support to in 2021:
- 80 cases related to a ‘reluctant sponsor’
- 257 cases related to forced marriages not involving ‘reluctant sponsors’
- 3 cases related to both forced marriage and FGM
- 18 cases related only to FGM
Of the cases that the FMU provided advice or support to in 2021:
- 118 cases (35%) involved victims below 18 years of age
- 120 cases (36%) involved victims aged 18-25
- 53 cases (16%) involved victims with mental capacity concerns
- 251 cases (74%) involved female victims, and 86 cases (26%) involved male victims
Forced marriage is not a problem specific to one country, religion or culture. In recent years, the FMU has handled cases relating to countries across six continents.
In 2021, the FMU handled cases relating to 32 ‘focus countries’, excluding the UK. The ‘focus country’ is the country to which the forced marriage risk relates. This could be the country where the forced marriage (or FGM) is due to take place, the country where it has taken place, and/or the country that the spouse is currently residing in. The ‘focus countries’ (other than the UK) with the highest number of cases in 2021 were:
- Pakistan 159 cases (47%)
- Bangladesh 32 cases (9%)
- Somalia 10 cases (3%)
- Kenya 8 cases (2%)
- Iraq 7 cases (2%)
- Romania 7 cases (2%)
The majority (72%) of victims were in the UK at the time the case was referred to the FMU.
In 2021, 11 cases (3%) had no overseas element, with the potential or actual forced marriage taking place entirely within the UK. This continues to highlight that forced marriages can and do take place in the UK.
During 2021, the North west was the second highest source of referrals to the FMU, with 19% originating in this area
There is a range of Legislation to protect women and girls from FGM
The Female Genital Mutilation Act makes it illegal to practice FGM in the UK or to take girls who are British nationals or permanent residents of the UK abroad for FGM whether or not it is lawful in that country. It also makes it illegal to aid, abet, counsel or procure the carrying out of FGM abroad and has a penalty of up to 14 years in prison and/or a fine.
The Serious Crime Act 2015 protects the anonymity of victims of FGM, and introduceFemale Genital Mutilation Protection Order (“FGMPO”) and creates a mandatory Duty to notify police of female genital mutilation
FGM is recognised as significant harm and Child abuse.
If any child under the age of 18 years, or unborn, is identified at risk of FGM, or known to have undergone FGM, they must be referred to Children’s Social Care.
Be mindful that revealing to parents that enquiries related to FGM may increase the risk to the girl or woman.
Mandatory reporting duty
All regulated Health and Social care Professionals and Teachers have to report direct to the Police on 101 for any child under 18 where:
- As a result of examination, FGM has been visually identified or
- The child has disclosed that they have had FGM
You are not required to ‘verify’ that FGM has occurred in order for the duty to apply and a report to be made.
The duty is personal; i.e. the professional who identifies FGM or receives the disclosure must make the report it cannot be transferred.
This is in addition to a Child Protection referral into Children’s Social Care
Mandatory Reporting does not apply to:
- An adult woman (18+) discloses that she has had FGM
- Parent/guardian discloses that her child has had FGM
- You believe a girl is at risk of FGM
- You think a girl might have had FGM but she has not disclosed, and you have not seen any signs/symptoms
- If you know it has already been reported by a regulated professional in your organisation.
Legal Interventions
- Sec 17 Police and Criminal Evidence Act 1984 (can enter and search in order to protect life or prevent injury)
- Powers Police Protection (Sec 46 Children Act 1989) for up to 72hrs
- Emergency Protection Order (EPO) Sec 44 Children Act 1989 (authorises removal of child to a safe place) An EPO lasts for 8 days, Can be renewed for up to a further 7.
- Interim Care Order (Sec 31 & 38 Children Act 1989)
- Ward of Court Order the young person or an adult friend or advocate can apply for wardship and various injunctions can be attached as required.
- FGM Protection Orders – (Section 73 of the Serious Crime Act 2015)
- FGM Act 2019 made an amendment to children's act to enable family courts to make a Female Genital Mutilation Protection Order (FGMPO) within care proceedings.