Definitions of FGM

 "comprising 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" (HM Government)

The history of FGM is not well documented, and its origins are not known. Thought to date back over 2000 years, it may have been practised in ancient Egypt as a form of distinguishing aristocracy. Other theories include that it originated in Arab countries when black women were employed as slaves, or that it developed independently in sub-Saharan Africa as part of puberty rites.

Although prominent in a distinctive belt across Africa and in Arab countries historically a variety of forms of FGM have been practised by the Scopti sect in Russia to ensure virginity, and in the mid-nineteenth century was practised by Gynaecologists in both the UK and America to cure promiscuity. Somalia has the highest percentage of women and girls who have undergone FGM with ninety eight per cent of the female population having be subjected to a form of FGM (UNICEF 2013), with Egypt having the highest number of victims with twenty seven point two million girls and women having had the procedure.

The most frequently cited reason for FGM to be carried out is for social acceptance and cultural reason. Despite the belief among many women that they must undergo the procedure to ensure that they remain accepted within their culture and society there are a number of countries where this belief is changing, for example in Burkina Faso where seventy six per cent of girls and women have undergone the procedure only nine per cent believe that the ritual should continue.

There is clear evidence that the belief that FGM is carried out for religious reasons is unsubstantiated also with no clear correlation between religious practise and the prevalence of FGM. In Niger fifty five per cent of women who have undergone the procedure described themselves as Christian, while only nine per cent identified with Islamic religion, the opposite is true in Togo with twenty one per cent of women and girls undergoing the procedure describing themselves as Muslim and only one per cent identifying with a Christina religion. Neither the old or new testament writings or the Quran make any reference to FGM.

FGM is illegal in England, Wales and Northern Ireland under the Female Genital Mutilation Act 2003, and in Scotland under the Female Genital Mutilation Act (2005). Under the Female Genital Mutilation Act 2003 it is illegal to excise infibulate or otherwise mutilate the whole or any part of the labia majora, labia minora or clitoris. Section one of the Act makes it illegal to perform FGM, section two makes it illegal to assist FGM and section three makes it illegal to assist a none UK resident to carry out FGM outside of the country on a UK national.  

Section four further strengthens the legislation to extend sections one to three to extra- territorial acts so that it is illegal for a UK national to perform FGM abroad, to assist a girl to perform FGM on herself outside of the country or to assist a non-UK person to carry out FGM outside the UK on a UK national.  Section four addresses the scenario of a UK national or permanent UK resident being taken out of the country to be subjected to FGM abroad.

Any person found guilty of an offence under the Female Genital Mutilation Act 2003 will be liable to a fine or imprisonment of up to fourteen years, or both.

The Female Genital Mutilation Act was further developed and updated by section seventy three of the Serious Crime Act 2015 to incorporate FGM Protections orders. These orders are a civil measure which can be applied for via the family court and are a method of protecting actual or potential victims of FGM.

The International Centre for Reproductive Health estimates that in the UK almost three hundred thousand women have undergone FGM, and approximately twenty two thousand girls under the age of eighteen are at risk each year.

Other sources estimate that twenty four thousand girls under the age of fifteen years have been affected by FGM in the UK.
 

World Health Organisation classifications of FGM

Type one clitoridectomy, partial of total removal of the clitoris
Type two excision which is the partial or total removal of the clitoris and labia minora, with or without he excision of the labia majora
Type three Infibulation involves the narrowing of the vaginal opening through the creation of a seal formed by cutting and repositioning the outer labia with or without the removal of the clitoris
Type four all other harmful procedures to the female genitalia for on medical reasons for example pricking, piercing, incising, scraping and cauterising the genital area

 

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Many men and women in practising communities are unaware of the relationship between FGM and the severe harm it causes to the health of women and girls. All types of FGM are extremely harmful with many short and long term health implications including:

Short-term:

  • Severe pain
  • Emotional and psychological shock (exacerbated by having to reconcile being subjected to the trauma by loving parents, extended family and friends)
  • Haemorrhage
  • Wound infections, including tetanus and blood borne viruses (including HIV and Hepatitis B and C)
  • Urinary retention
  • Injury to adjacent tissues
  • Fracture or dislocation as a result of restraint
  • Damage to other organs
  • Death

The longer-term implications for women who have had FGM Types 1 and 2 are likely to be related to the trauma of the actual procedure, while health problems caused by FGM Type 3 are more severe and long-lasting.

Long-term:

  • Chronic vaginal and pelvic infections
  • Difficulties with menstruation
  • Difficulties in passing urine and chronic urine infections
  • Renal impairment and possible renal failure
  • Damage to the reproductive system, including infertility
  • Infibulation cysts, neuromas and keloid scar formation
  • Obstetric fistula
  • Complications in pregnancy and delay in the second stage of childbirth
  • Pain during sex and lack of pleasurable sensation
  • Psychological damage, including a number of mental health and psychosexual problems such as low libido, depression, anxiety and sexual dysfunction; flashbacks during pregnancy and childbirth;
  • Substance misuse and/or self-harm
  • Increased risk of HIV and other sexually transmitted infections
  • Death of mother and child during childbirth.

It is internationally accepted that FGM is a violation of Human Rights, with the 1993 Vienna World Conference on Human Rights classifying FGM as a form of violence towards women.

Urgent referrals

These should be made, out of normal hours if necessary, if:

  • A child under 18 years shows signs of very recently having undergone FGM. This may allow for the police to collect physical evidence.
  • You believe that there are plans to take the child abroad and there is an imminent risk that she is likely to undergo FGM if allowed to leave your care. 
     

In these cases children's social care and the police will consider what action to take. This could include taking out an FGM Protection Order (Schedule 2 of the Female Genital Mutilation Act 2003) which may include the surrendering of passports. Or if required, an Emergency Protection Order could be made under Section 44 of the Children Act 1989 enabling a child to be removed to a place of safety if there is evidence that a child is in imminent danger.

World wide prevalence

According to the World health Organisations between a hundred and a hundred and forty million girls and women worldwide have undergone some sort of FGM and each year a further 2 million girls are at risk.

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UK Prevalence

The International Centre for Reproductive Health estimates that in the UK almost three hundred thousand women have undergone FGM, and approximately twenty two thousand girls under the age of eighteen are at risk each year.

Other sources estimate that twenty four thousand girls under the age of fifteen years have been affected by FGM in the UK.