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Female genital mutilation, or FGM, is practised by some religious and cultural communities, including some in the UK. It’s a form of child abuse and is illegal in the UK, although it does still happen.
The importance of awareness of Female Genital Mutilation cannot be overstated. Those who come into contact with girls and women living in at-risk communities need to understand the practice so that it can be spotted and dealt with correctly.
There is no medical or scientific basis for FGM. It is thought to date as far back as the 5th century BC and there has never been a clearly stated benefit to the woman who is being cut. The practice is being medicalised, with “healthcare professionals” such as doctors carrying out the procedure. This makes it no less wrong and it is still abuse – there is no defence for FGM in UK law.
Latest statistics from NHS Digital show that in the year up to April 2019, 6,415 women and girls had FGM identified during a contact with the NHS. The number of new cases is decreasing over time. In the world, it’s estimated that over 200 million women are living with FGM. It’s important to know the prevalence of cases so that appropriate support can be offered in the right areas.
Here, we are going to look at:
- At what point in her life a woman may experience FGM.
- The language that is used in different communities.
- Cultural reasonings behind the act.
- How to identify women at risk of FGM.
- What to look for in a case of FGM and how it affects the woman.
- Where to turn when you suspect FGM has or will take place.
This will give you the confidence that you need to offer support, coming from a place of understanding and education.
When does Female Genital Mutilation happen?
Female genital mutilation, or the act of cutting or mutilating all or part of a female’s genitals, can happen at different times in the victim’s life. The age of a girl when she experiences FGM, often referred to as cutting, will vary depending on the country she’s in and the culture she’s part of.
In general, most acts of mutilation will occur from a couple of days after birth until around 15 years old. There are other times a woman may be cut during her life, including:
- Before marriage.
- When she first gets pregnant.
- When her first baby has been delivered.
Some reports suggest that the age the act occurs is getting lower.
In the UK, the most common age range for FGM to occur is 5-9 years old, with 44 per cent of cutting happening at this age, out of the cases where the age was known. In the same report, only three per cent of women who were identified as being cut were under 18 when they encountered the NHS. It can take a long time for a case to come to light, often many years after it has occurred.
What other names are used for FGM?
Female genital mutilation is believed to occur in at least 30 countries across the world. With many disparate and geographically separate areas practising this form of abuse, you can expect there to be lots of different language surrounding it.
Firstly, there are different words associated with the procedure itself. You may hear FGM variously referred to as:
- Female circumcision.
- Gashing, cutting, or pricking.
- Female genital cutting.
- Female genital distortion.
- Female sexual mutilation.
However, female genital mutilation, or FGM, is the preferred term since it’s powerful and highlights the gravity of the harm and abuse being perpetrated against women and girls.
- Sunna – Sierra Leone, Soussou
- Gudniin – Somalia, Somali.
- Halalays – Somalia, Somali
- Tahur/tahoor – Sudan, Arabic
- Halalays – Somalia, Somali
- Megrez – Ethiopia, Amharic
- Khitan – Egypt, Arabic.
If you work with communities where FGM is prevalent, it’s worth learning the words the people around you use. This could be invaluable in identifying a girl at risk or offering the right support to a woman who has already been cut.
How do professionals describe FGM?
There are four categories of FGM that are used by medical and social care professionals. This helps to ensure a woman can receive the right support and also to understand the changes in cultures that cut women.
We’re going to give you a description of each type of FGM so that you can understand the terminology you may read or hear from your colleagues.
- Type I, also called a clitoridectomy, describes a procedure that has partially or fully removed the clitoris or prepuce.
- Type II can sometimes be called an excision and is the act of removing the clitoris, labia minora, and sometimes the labia majora.
- Type III is known as an infibulation. The labia minora and/or majora are manipulated to cover the vaginal entrance and sometimes the clitoris is also removed.
- Type IV classification covers all other interreference with a female’s genitals, such as cutting, pricking, cauterising, piercing, or scraping.
Why does FGM happen?
FGM is a common practice in some African countries, as well as in the Middle East and parts of South East Asia. Where there are large migrant communities from countries where it is practised, such as the UK and Australia, FGM is also recorded.
Although often thought to be a religious practice, there is little by way of evidence in any holy scripture that any form of FGM is sanctioned. It is a deeply ingrained cultural practice that is associated with the subjugation of women. Even when a community is aware of the physical risks, the perceived social benefit can win out.
Attitudes towards female sexuality are deeply associated with the practice. Some communities believe a woman who hasn’t been cut is dishonourable and a prostitute. There are also beliefs that the clitoris represents masculinity and it should be removed before the girl reaches maturity. Ideas that female genitals are dirty and ugly also feed into the belief in FGM.
Type III FGM can also be carried out in an attempt to ensure a woman remains a virgin. In cultures where a woman is valued in terms of marriage, families can continue to cut their daughters to ensure they will be taken by a man when they mature.
Misconceptions abound about the link between FGM and Islam. There is nothing in the Koran that endorses FGM. Other communities and religions practise the abusive cutting of women, such as Christians and Jews, making it clearly cultural rather than religious.
Who is at risk of FGM?
It’s hard to say for sure how many women have had their genitals cut or mutilated. NGOs make estimates but there has never been a widespread study on the matter. There is evidence about the countries where it is most commonly practised.
The countries where you’re likely to find Female Gential Mutilation occurring, broken down by region, are:
|Africa||Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Cote d’Ivoire, Democratic Republic of Congo, Djibouti, Egypt, Eritrea, Ethiopia, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone, Somalia, Sudan, Tanzania, Togo, Uganda and Zambia.|
|Asia||India, Indonesia, Malaysia, Pakistan and Sri Lanka.|
|Middle East||Oman, the United Arab Emirates, Yemen, Iraq, Iran, the State of Palestine.|
|Europe||Georgia and the Russian Federation.|
|South America||Columbia, Ecuador, Panama and Peru.|
In countries like the UK, USA, New Zealand, Australia and EU countries, the practice has been reimported in migrant communities.
Being aware of the nationalities that commonly practise FGM will help you know who may be at risk of abuse. It’s not just about where a girl comes from, though. The community her family is in and whether there is a history of FGM in her family will increase the risk to a girl.
What are the signs of Female Genital Mutilation?
As someone who comes into contact with young girls and women, you need to know the signs of FGM. Unless you’re a health practitioner, you’re not going to see a girl’s genitals, but there are other things that you can watch out for.
A little earlier, we covered some of the different words used to talk about FGM. Hearing these in conversation should pique your interest to have a deeper talk with those who said it.
There may be times where you have the chance to prevent FGM, whilst more often you will need to identify when it has happened and ensure the woman or girl gets the right support.
Identifying potential FGM
Having a professional relationship with young girls in at-risk communities can give you privileged information. There are certain things that you might get told. It’s your responsibility to report any potential abuse under your safeguarding obligations.
Some actions and conversations to look out for include:
- Listen for language such as “special procedures” and ceremonies about “becoming a woman”.
- You may learn of a long trip planned to her home country or country of origin when she’s at a vulnerable age.
- There may be conversations about FGM between her and her peers.
- Her family may disengage from general healthcare practices or withdraw her from PSHE lessons.
- She directly tells you that she thinks she is at risk of FGM.
Identifying when FGM has already taken place
You may be approached by a girl or woman who tells you that she’s been a victim of FGM. You need to make sure that you follow your professional safeguarding procedures and ensure that she gets the support she needs.
It’s not always going to be that simple to spot. Here are some other indicators that you should look out for when working with women and girls from high risk communities:
- A new discomfort when she sits down.
- Not being comfortable sitting for long periods.
- She spends more time in the bathroom trying to pee.
- Problems urinating or with periods are frequent.
- Avoiding sports and PE classes.
- An aversion to medical procedures, care, or examination.
- Her behaviour changes drastically and she becomes withdrawn.
What are the effects of FGM?
The effects of Female Genital Mutilation are wide reaching and are not confined to physiological problems. Mental health issues and social problems can also arise, causing massive harm to a child’s development and a woman’s future happiness.
When a woman has been subjected to a type III mutilation, she could face a lifetime of cutting. It is a ritual in some cultures that her restricted vaginal opening is cut open on her wedding night to allow for consummation. Further, if she gets pregnant, more cuts may be necessary and later on she may face further mutilation to restrict her vaginal opening again after childbirth. The physical and mental effects of this cannot be overstated.
Studies have also shown a decrease in fertility in women who have been cut. Due to a lifetime of urinary tract and vaginal infections, it can become difficult for a woman to conceive a baby.
The physical effects of FGM
- Severe, constant pain.
- Lots of bleeding during or after the procedure.
- Swelling of the genital tissue.
- Infections and problems healing.
- Increased risk of infection with HIV.
- Bladder and urinary tract infections and possible kidney failure.
- Vaginal infections such as bacterial vaginosis.
- Painful periods and retained menstrual blood.
- Cysts and abscesses.
- Formation of scar tissue.
- Painful sex.
- Complications in childbirth.
The mental health effects of FGM
- Inability to enjoy sex
- Post-traumatic stress disorder
- Low self-esteem
- A child losing trust in adults.
Where can I find support for Female Genital Mutilation?
If you suspect a girl or woman in your professional setting is at risk of FGM, you can make a report to the police on the non-emergency 101 line. If there is imminent danger, you should call 999. Everyone is responsible to make a report – you cannot pass the responsibility along to your line manager or safeguarding lead.
The NSPCC also has a 24-hour helpline dedicated to helping girls at risk or who have been a victim of FGM. The phone number is 0800 028 3550, and the contact email address is email@example.com.
The NHS also has publications across a range of languages about FGM. The languages covered include some of those of the at-risk communities so you should be able to offer support on the woman’s terms.
Female genital mutilation is abusive, abhorrent, and illegal in the UK and many other countries. The practice of removing a young girl’s clitoris and/or labia, sewing her labia to reduce her vaginal opening, or in any other way cutting, pricking, or manipulating their genitals serves no medical purpose and has no prescription under any religion.
Children are more likely to face being cut, but a vaginal opening that has been sewn closed may need to be cut open and then mutilated again, depending on the woman’s culture. A woman can face a lifetime of abuse along with physical problems such as repeated vaginal and urinary infections.
Health and social care professionals like yourself need to be aware of what FGM is and what you can do to prevent it. By raising your awareness of FGM you are going to be more effective in your role and offer better safeguarding to the vulnerable girls and women you come into contact with.