Definition of Female Genital Multilation (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).
- It 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, 2022).
- Female genital mutilation
- Female genital cutting
- “The cut”
- Female circumcision
- Initiation
- Sunna (type 1, type 4)
- Khifad
- Khitan
- Khatana
- Bondo
- Pharaonic (type 3)
- There are a lot of terms – 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.
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.