FGM Warning Signs and Risks

Female genital mutilation (FGM) is a form of child abuse and violence against women and girls. It can cause serious immediate harm, as well as long-term physical and mental health problems. In the UK, the law is clear: FGM is illegal, and safeguarding comes first.

For many families, the hardest part is recognising the warning signs and understanding when concerns may point to risk. For professionals, the challenge is raising concerns early without stereotyping or stigmatising communities. This guide is designed to help with both. It explains warning signs, risk factors, safer ways to talk about concerns, and the steps to take if you think a girl may be at risk.

FGM is also an area where responsibilities can be specific. In England and Wales, regulated health and social care professionals and teachers have a mandatory duty to report ‘known’ cases of FGM in under-18s to the police. This sits alongside wider safeguarding duties and referral routes. 

The aim is to provide practical guidance you can use immediately: what to notice, what to record, who to speak to, and where to signpost for support.

What Is FGM in UK Law?

FGM refers to procedures that intentionally alter or injure female genital organs for non-medical reasons. People may use different words, such as ‘cutting’ or ‘circumcision’. Some families describe it as a ‘special procedure’, ‘initiation’ or a ‘ceremony’. Whatever the label, the safeguarding concern stays the same: the girl cannot consent, and the harm can be severe.

In the UK, FGM is illegal. It is a serious criminal offence to carry out FGM, to assist with it, or to arrange for a girl to be taken abroad for it. The law also covers acts carried out outside the UK in many circumstances, which is why travel planning is a key risk trigger.

A simple way to hold the legal message in mind is this:

• The law focuses on protecting girls from harm.
• The law treats FGM as child abuse when it involves under-18s.
• The law recognises that risk can increase around travel and family pressure.

For a clear summary written for the public, you can use the NHS overview of female genital mutilation (FGM). If you need a legal and prosecution-focused view, the Crown Prosecution Service guidance on female genital mutilation is also useful.

Professionals in education will often link this topic to safeguarding policy and training. In England, the most common reference point is Keeping children safe in education (KCSIE), which includes expectations on identifying and responding to safeguarding concerns, including FGM.

FGM Warning Signs in Children

FGM can be hard to detect because families may keep it secret, and a child may feel frightened or conflicted about speaking out. Some girls do not have the words for what has happened, especially if adults around them describe it as ‘normal’ or ‘good for you’. Even so, there are warning signs that should prompt concern and action.

Potential warning signs can include:

• A girl talking about a ‘special procedure’, ‘ceremony’ or ‘becoming a woman’.
• A girl mentioning an upcoming ‘celebration’ linked to travel or family visits.
• A girl expressing fear or anxiety about an upcoming holiday, without a clear reason.
• A girl saying an older female relative is coming to visit, and she feels worried about it.
• A girl mentioning pressure from family members, even if it sounds indirect or vague.
• A girl asking questions about pain, bleeding or ‘being cut’.

Sometimes a child discloses concerns in an indirect or hesitant way. For example, they might say “My cousin had something done” or “My aunt keeps talking about it”. Treat that as a chance to explore concerns gently and safely, not as gossip.

In school settings, warning signs may also appear through attendance patterns and health complaints. You might notice a child suddenly avoiding PE, refusing to change for sports, or repeatedly asking to go to the toilet.

If you want a professional overview of indicators and context, the GOV.UK information page on mandatory reporting of female genital mutilation explains what ‘known’ means and how reports should be made. 

FGM Risk Factors and Triggers

It is possible to talk about risk factors without stereotyping. The goal is not to label communities. The goal is to recognise patterns that can increase risk and then respond in a child-centred, respectful way.

Risk can increase when:

• There is a family history of FGM, or older sisters have undergone FGM.
• The family has strong expectations about controlling female sexuality or ‘purity’.
• A girl is approaching puberty, or there is talk about ‘becoming a woman’.
• The family is under community pressure, especially from older relatives.
• There is a planned trip to a country where FGM is practised, or where the family has strong community connections.
• The girl’s mother or female relatives have experienced FGM, and the family frames it as a tradition.
• There is talk of a marriage arrangement, engagement or ‘preparing’ a girl.

Some triggers are subtle. A girl may not say “FGM”. Instead, she might describe:

• A “women’s event”.
• A “doctor’s visit” abroad that does not sound medically necessary.
• A relative coming to “help” with a ceremony.
• A plan for the girl to stay with the extended family for a period.

It also helps to remember that risk can increase during times of stress. Family conflict, separation or bereavement can increase the influence of extended relatives. Likewise, a family who feels judged may become more secretive. Therefore, an approach that is calm and non-accusatory usually works better.

If you work with families, you can build trust by using reputable, non-stigmatising resources in community languages. The NHS FGM page includes leaflets in several languages via female genital mutilation (FGM), which can support safer conversations.

Holiday Travel and ‘Special Ceremony’

Travel is one of the clearest practical triggers, particularly when a girl is due to travel during the summer holidays, winter break or a family event season. That does not mean every trip signals risk. However, where other risk factors exist, travel can increase urgency.

Red flags around travel can include:

• A trip planned at short notice, especially to stay with extended family.
• A one-way ticket, or unclear return date.
• A girl saying she will miss school for ‘a while’ after the holiday.
• A girl saying she cannot attend a medical appointment or school meeting because of travel.
• A girl expressing fear, distress or dread about going abroad.
• Plans that involve the girl being taken to see an ‘elder’, ‘traditional healer’ or ‘special doctor’.

Also, be alert to language that suggests a rite of passage. A ‘special ceremony’ might be described as:

• A celebration for girls only.
• A gathering of women and older female relatives.
• A party that signals ‘she is ready’ or ‘she will be clean’.
• Something that is ‘private’ and ‘not for outsiders’.

If a girl discloses imminent risk, treat it as urgent safeguarding. In practice, that can mean contacting the DSL immediately, seeking advice from children’s social care, and involving police where needed.

For professionals, it can help to know that protective legal routes exist, including FGM Protection Orders. If you suspect a girl may be taken abroad for FGM, you do not have to wait for harm to occur. There are steps you can take to prevent it, which are covered later in this guide.

Behaviour Changes and School Clues

FGM risk and harm can show up in school through changes that look like ‘ordinary’ wellbeing issues at first. The difference is the pattern, timing and context.

School clues can include:

• A girl becoming withdrawn, quiet or unusually compliant.
• A sudden drop in concentration or attainment.
• Increased anxiety, tearfulness or irritability.
• Requests to leave lessons more often, especially to use the toilet.
• Avoidance of sport, PE or activities involving changing clothes.
• A girl who stops socialising or avoids certain friends.
• Increased absence, particularly around a planned trip or after returning from one.

You might also notice changes in family engagement:

• A parent who becomes hard to reach as travel approaches.
• A caregiver who avoids routine health or safeguarding discussions.
• A reluctance to allow a girl to attend school trips, sports or health sessions.
• Strong resistance to discussing puberty, menstruation or relationships education.

None of these signs prove a risk of FGM on their own. However, when several cluster together – particularly around travel or a ‘ceremony’ – they should raise concern.

If you are a teacher or safeguarding lead, it helps to take an ‘early pattern’ approach. One small concern may not trigger a referral. Three small concerns across two weeks, plus a planned trip, might.

For parents and carers, school clues may show up as reluctance to go in, stomach aches on school mornings, or sudden distress about lessons like PSHE or biology. If your child seems fearful without being able to explain why, ask gentle questions and seek support early.

Physical Health Indicators to Notice

FGM can cause immediate medical risks, and it can also cause long-term issues that affect daily life. Some signs are visible and urgent. Others are indirect and appear as recurring health complaints.

Possible physical indicators can include:

• Pain when walking, sitting or using the toilet.
• Difficulty urinating, frequent urinary infections or urinary retention.
• Persistent abdominal pain, pelvic pain or discomfort.
• Unusual bleeding, especially if it does not match a menstrual pattern.
• Difficulty with menstruation, including severe pain or blocked flow.
• Recurrent infections, including genital infections.
• A girl who appears in pain after a holiday, with no clear explanation.

In school, you might notice repeated visits to first aid, requests for pain relief or frequent toilet breaks. In healthcare settings, you might see repeated presentations for UTIs or pain where the underlying cause does not seem to resolve.

If you work in health, use appropriate safeguarding procedures and specialist referral routes. The NHS provides specialist support through National FGM Support Clinics.

A key point for all adults: do not attempt to examine a child yourself unless you are a qualified clinician with a clear safeguarding rationale and correct consent and procedures. Instead, act on concerns through safeguarding routes and seek specialist advice.

How to Talk About FGM Safely

Talking about FGM needs care. The goal is to protect the child without shaming them or attacking their family. You can be clear that FGM is harmful and illegal while still being respectful and culturally sensitive.

Principles that help:

• Use calm, simple language.
• Avoid graphic detail.
• Avoid suggesting the child is to blame or “should have said no”.
• Do not make assumptions about religion. FGM is not required by any major religion.
• Focus on safety, health and rights.
• Give the child control over pace. Let them take breaks.

If you are speaking with a child, phrases that can help include:

• “You can tell me as much or as little as you want.”
• “My job is to help keep you safe.”
• “You are not in trouble.”
• “Some people call this a special ceremony. It can hurt girls. Has anyone talked to you about that?”

If you are speaking with parents, aim for a safeguarding tone rather than an accusatory one. For example:

• “We have a duty to keep children safe, and we ask all families about risks that can increase during travel.”
• “We talk to all families about practices that can cause harm, including FGM.”
• “If a child is at risk, we must act, and we would rather support early than respond late.”

Also, be mindful of privacy. A child may be terrified of the family finding out they spoke out. Therefore:

• Choose a private space.
• Do not use family members as interpreters.
• Use professional interpreters when needed.
• Limit information sharing to those who need to know for safeguarding.

For practical help on sensitive, safeguarding-focused conversations linked to honour-based abuse, you can signpost professionals to the Karma Nirvana helpline, which supports both individuals and professionals.

What to Do if You Are Worried

If you are worried that a girl may be at risk of FGM, act early. You do not need proof. You need a reasonable safeguarding concern.

A practical step-by-step approach is:

1. Listen and reassure
   If a child shares something, stay calm. Thank them for telling you. Reassure them that they are not in trouble.
2. Do not promise secrecy
   Explain that you may need to share the concern with people who can help keep them safe.
3. Record promptly
   Write down what you saw or heard, using the child’s words as closely as possible.
4. Escalate through safeguarding routes
   In a school, go to the DSL immediately. In healthcare, follow your safeguarding lead and local procedures. As a parent, contact the school DSL if the risk links to a pupil community, and contact local safeguarding services if the risk feels urgent.
5. Assess urgency
   If there is imminent risk, especially around travel, treat it as urgent and involve the police or social care quickly.

If you are unsure where to start, the NHS page on female genital mutilation (FGM) explains health impacts and routes to help. For children who want confidential support, Childline can be a safe first step.

Professionals should also align with their local safeguarding partnership procedures. These often sit on local authority websites, typically under ‘MASH’ or ‘child protection’ contact routes.

When to Call the Police 999/101

Police involvement depends on immediacy and risk. A useful rule is:

• Call 999 if there is immediate danger.
• Use 101 if there is serious concern but no immediate emergency.

Call 999 if:

• A child is in immediate danger of being taken for FGM.
• A child discloses that FGM is planned very soon, especially within days.
• A child has severe pain, heavy bleeding, collapse, or signs of urgent medical risk.
• You believe a child is being removed from school or home imminently.

Use 101 if:

• You have credible information that a child is at risk, particularly around travel.
• You need advice about protective steps and safeguarding coordination.
• There is concern about planning, arranging or facilitating FGM.

If you are a professional in England or Wales and you have a ‘known’ case involving an under-18, you must follow mandatory reporting rules as well. This is covered in the mandatory reporting section below.

For context and thresholds used by criminal justice agencies, you can refer to the College of Policing overview of female genital mutilation.

How to Report FGM to Social Care

Children’s social care plays a central role when a child may be at risk of significant harm. A referral is not about punishing families. It is about protecting a child and mobilising support and protective action.

You should consider a social care referral when:

• A girl is at risk due to travel plans, alongside other indicators.
• A girl discloses pressure, fear or a planned ceremony.
• There is evidence or strong suspicion that FGM has occurred.
• The family refuses to engage in safety planning, or the risk remains high.
• There are wider safeguarding concerns, such as honour-based abuse, forced marriage risk or domestic abuse.

In many areas, the referral route is through the local authority’s Multi-Agency Safeguarding Hub (MASH). If you are a professional, follow your local safeguarding partnership procedures. If you are a parent and you cannot get through quickly, you can also contact the police for urgent risk, or seek advice from specialist services.

If you are worried about community pressure and honour-based harm, the Karma Nirvana helpline can help you think through risk safely, including how to avoid increasing danger for the child.

Mandatory Reporting Duty: England and Wales

In England and Wales, regulated health and social care professionals and teachers have a legal duty to report ‘known’ cases of FGM in under-18s to the police. This duty sits alongside normal safeguarding responsibilities, not instead of them.

Two points matter for clarity:

• The duty applies to known cases, not suspected risk.
• A ‘known case’ usually means the professional either sees physical signs during their work or the child directly discloses that FGM has been carried out.

The duty came into force on 31 October 2015 and is set out in procedural guidance on GOV.UK. 

If you are a professional and you are unsure whether the duty applies in your scenario, use the GOV.UK guidance on mandatory reporting of female genital mutilation and seek advice from your safeguarding lead. Many unions and professional bodies also provide summaries, such as the National Education Union guidance on FGM mandatory reporting.

Even when the mandatory duty does not apply, you still must act on risk. Suspected risk and contextual concerns should be managed through safeguarding referral routes, including social care and police where appropriate.

Recording Concerns and Evidence

Good recording protects children. It also protects professionals by showing the decision-making path. When FGM risk is present, small details can become critical, especially around travel timelines, who is involved, and what the child said.

A strong record should include:

• Date and time of the concern or disclosure.
• Who was present.
• The child’s words, written as closely as possible to what they said.
• Any mention of travel, ceremonies, family pressure or specific relatives.
• Your observations, separated from your interpretation.
• Actions taken immediately, including who you spoke to and when.
• The rationale for decisions and next steps agreed.

If you are a school or college, ensure you store records securely and share information only on a need-to-know basis. If you are a parent, keep your own notes too. Write down dates, what your child said, and any relevant messages about travel or ceremonies.

Avoid common pitfalls:

• Do not ‘soften’ the language to make it feel more polite. Use the words the child used.
• Do not delay recording until the end of the week.
• Do not investigate in ways that could increase risk, such as confronting family members without a safeguarding plan.
• Do not ask leading questions. Keep it open and factual.

If you need a structured approach for staff, build a short recording template into your safeguarding system so adults can record consistently under pressure.

FGM Protection Orders Explained

FGM Protection Orders (FGMPOs) are civil court orders designed to protect a person at risk of FGM or to protect someone against whom FGM has been committed. The court can impose restrictions and requirements to prevent harm, including in travel contexts. 

In practical terms, an FGMPO can be used to:

• Prevent a family from taking a girl abroad for FGM.
• Require the surrender of passports.
• Set conditions around contact with certain individuals.
• Require a family to disclose travel details.
• Put other protective measures in place tailored to the risk.

You do not need to wait until FGM happens to seek protection. Prevention is the point.

If you want an official overview written in plain English, GOV.UK provides guidance on FGM protection orders. For a legal rights-focused explanation, Rights of Women publishes a guide on female genital mutilation and the law.

Professionals should discuss the suitability of an order with safeguarding leads and legal services. Families and individuals can seek legal advice and specialist support, especially where community pressure is strong.

Support Services and NHS Clinics

Support should be trauma-informed and non-judgemental. Girls and women affected by FGM may carry shame, fear, anger, grief or numbness. Some may also fear consequences at home if they speak out. Therefore, confidential and specialist support matters.

NHS routes include:

• Your GP, who can refer to specialist services.
• Local safeguarding and paediatric services for under-18s.
• Specialist clinics that understand FGM and related trauma.

A key national resource is the list of National FGM Support Clinics, which offers information on community-based support in different regions.

Other support and advice routes include:

• Confidential support for children via Childline.
• Specialist advice linked to honour-based abuse via the Karma Nirvana helpline.
• Clinical and maternity information for women via the Royal College of Obstetricians and Gynaecologists resource on female genital mutilation (FGM).

If a child is in immediate danger, always use 999. If you are supporting someone after harm, encourage medical support even if the FGM happened years ago. Health complications can appear later, and mental health support can be life-changing.

Training and Policy Checklist for Schools

Schools play a vital role because they see children daily. They can spot patterns, notice travel triggers, and provide a trusted adult for disclosure. A school does not need to become an expert medical service, but it does need a confident safeguarding system.

A practical checklist for schools includes:

• Policy clarity
  • A safeguarding policy that explicitly references FGM and related honour-based abuse risks.
  • A clear flowchart for staff: who to tell, what to record and what happens next.
• Staff training
  • Training that covers warning signs, travel risk and safer conversations.
  • Specific clarity on the mandatory reporting duty in England and Wales for ‘known’ cases. 
  • Guidance on avoiding stereotyping while still responding to risk.
• Pupil support routes
  • A visible reporting route that pupils trust.
  • Named trusted adults and quiet spaces for disclosure.
  • Age-appropriate education about bodily autonomy, consent and where to get help.
• Attendance and travel monitoring
  • A process for flagging prolonged leave requests and vague travel plans.
  • A system to link travel concerns with safeguarding reviews, not just admin approval.
• Information sharing
  • Strong links with school nursing, local safeguarding partners and early help.
  • Clear internal information sharing so patterns do not sit in silos.
• Recording and review
  • Consistent recording expectations.
  • Regular DSL review of low-level concerns that may cluster into a risk pattern.
• Community-sensitive practice
  • Use of professional interpreters when needed.
  • Communication that focuses on child safety and legal duties, not blame.

Where possible, schools should also signpost to official information, such as the NHS guidance on female genital mutilation (FGM) and the GOV.UK page on mandatory reporting of female genital mutilation. That keeps messaging consistent and reduces confusion.

Conclusion

FGM is child abuse. It can cause severe physical harm, lasting health problems and deep psychological trauma. Because it is often hidden behind family pressure, secrecy and travel plans, early warning signs matter. So do calm, skilled conversations that protect the child without stigmatising communities.

If you are a parent or carer, trust your instincts when something feels wrong, especially around a ‘special ceremony’ or upcoming travel. If you are a professional, record concerns clearly, involve your safeguarding lead early and follow local referral routes. In England and Wales, remember the mandatory duty to report ‘known’ cases in under-18s to the police. 

Most importantly, you do not have to handle this alone. Use safeguarding systems, seek specialist advice, and signpost to NHS and specialist support. Early action can prevent harm, and it can give a child the safety and support they need to move forward.