Female Genital Mutilation

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Overview

Click here to watch a short film about female genital mutilation, produced by the Royal College of Midwives. 

Female genital mutilation (FGM) is a procedure where the female genitals are deliberately cut, injured or changed, but there’s no medical reason for this to be done.

It’s also known as female circumcision or cutting, and by other terms, such as sunna, gudniin, halalays, tahur, megrez and khitan, among others.

FGM is usually carried out on young girls between infancy and the age of 15, most commonly before puberty starts.

It’s illegal in the UK and is child abuse. It’s very painful and can seriously harm the health of women and girls. It can also cause long-term problems with sex, childbirth and mental health.

The NHS website provides a useful overview of female genital mutilation; the parts of the NHS guidance that are relevant to fostering are included here. 

Getting help and support

All women and girls have the right to control what happens to their bodies and the right to say no to FGM.

If someone is in immediate danger, contact the police immediately by dialling 999.

Inform your supervising social worker and/or the children’s social worker about any incidents linked to FGM (or any other safeguarding issues). 

Children who have been subject to FGM can get help from a specialist NHS gynaecologist or FGM service via a GP.

Types of FGM

There are 4 main types of FGM:

  • Type 1 (clitoridectomy) – removing part or all of the clitoris,
  • Type 2 (excision) – removing part or all of the clitoris and the inner labia (the lips that surround the vagina), with or without removal of the labia majora (the larger outer lips),
  • Type 3 (infibulation) – narrowing the vaginal opening by creating a seal, formed by cutting and repositioning the labia,
  • Other harmful procedures to the female genitals, including pricking, piercing, cutting, scraping or burning the area,

FGM is often performed by traditional circumcisers or cutters who do not have any medical training. But in some countries it may be done by a medical professional.

Anaesthetics and antiseptics are not generally used, and FGM is often carried out using knives, scissors, scalpels, pieces of glass or razor blades.

FGM often happens against a girl’s will without her consent, and girls may have to be forcibly restrained.

Effects of FGM

There are no health benefits to FGM and it can cause serious harm, including:

  • Constant pain.
  • Pain and difficulty having sex. 
  • Repeated infections, which can lead to infertility.
  • Bleeding, cysts and abscesses.
  • Problems peeing or holding pee in (incontinence).
  • Depression, flashbacks and self-harm.
  • Problems during labour and childbirth, which can be life threatening for mother and baby.
  • Some girls die from blood loss or infection as a direct result of the procedure.

FGM and mental health

FGM can be an extremely traumatic experience that can cause emotional difficulties throughout life, including;

  • Depression.
  • Anxiety.
  • Flashbacks to the time of the cutting.
  • Nightmares and other sleep problems.

In some cases, children may not remember having FGM at all, especially if it was performed when they were an infant.

Treatment for FGM (deinfibulation)

Surgery can be performed to open up the vagina, if necessary. This is called deinfibulation. It’s sometimes known as a reversal, although this name is misleading as the procedure does not replace any removed tissue and will not undo the damage caused, but it can help many problems caused by FGM.

The surgery involves making a cut (incision) to open the scar tissue over the entrance to the vagina. It’s usually performed under local anaesthetic in a clinic and you will not normally need to stay overnight. A small number of women need either a general anaesthetic or an injection in the back (epidural), which may involve a short stay in hospital.

Surgery may be recommended for:

  • Girls or women who are unable to have sex or have difficulty peeing as a result of FGM. 
  • Pregnant women at risk of problems during labour or delivery as a result of FGM. Deinfibulation should be carried out before getting pregnant, if possible. It can be done in pregnancy or labour if necessary, but ideally should be done before the last 2 months of pregnancy.

Why FGM is carried out

FGM is carried out for various cultural, religious and social reasons within families and communities in the mistaken belief that it’ll benefit the girl in some way (for example, as a preparation for marriage or to preserve her virginity).

But there are no acceptable reasons that justify FGM. It’s a harmful practice that has no health benefits.

FGM usually happens to girls whose mothers, grandmothers or extended female family members have had FGM themselves, or if their father comes from a community where it’s carried out.

Where FGM is carried out

Girls are sometimes taken abroad for FGM, but they may not be aware this is the reason for their travel. Girls are more at risk of FGM being carried out during the summer holidays, as this allows more time for them to “heal” before they return to school. Communities that perform FGM are found in many parts of Africa, the Middle East and Asia. Girls who were born in the UK or are resident here but whose families originate from an FGM-practising community are at greater risk of FGM happening to them.

Communities at particular risk of FGM in the UK originate from: Egypt, Eritrea, Ethiopia, Gambia, Guinea, Indonesia, Ivory Coast, Kenya, Liberia, Malaysia, Mali, Nigeria, Sierra Leone, Somalia, Sudan, and Yemen.

The law and FGM

FGM is illegal in the UK. It’s an offence to:

  • Perform FGM (including taking a child abroad for FGM). Anyone who performs FGM can face up to 14 years in prison.
  • Help a girl perform FGM on herself in or outside the UK.
  • Help anyone perform FGM in the UK.
  • Help anyone perform FGM outside the UK on a UK national or resident.
  • Fail to protect a girl for whom you’re responsible from FGM. Anyone found guilty of failing to protect a girl from FGM can face up to 7 years in prison.

Download the Statement Opposing FGM

The summer holidays are when many young girls are taken abroad, often to their family’s birth country, to have FGM performed.

The FGM statement, also known as the FGM health passport, highlights the fact FGM is a serious criminal offence in the UK.

If you’re worried about FGM being carried out on a child being taken abroad, print out this statement, ask the child to take it abroad and the child’s social worker should discuss it with the child’s family.

If possible, the child should be asked to keep the declaration in their passport, purse or bag, and carry it with them all the time.

Download the statement opposing FGM: It is available on the GOV.UK website in various languages.

Leaflets to download

The Department of Health and Social Care has published leaflets for patients who want to know more about FGM.

These are available in the following languages:

Virginity testing and hymenoplasty

NSPCC guidance ‘Protecting children from FGM‘

Virginity testing and hymenoplasty (a surgical procedure to reconstruct the hymen) are illegal in the UK. Click here for further information.