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Female genital mutilation (FGM)

NSPCC factsheet

May 2014

What is female genital mutilation (FGM)?
How prevalent is FGM?
Who practises FGM?
Why do communities practise FGM?
What does FGM involve?
What are the short and long-term effects of FGM?
Which factors put a child at risk of FGM?
What can we do to prevent FGM and help those affected by it?
What is the FGM policy and campaign context?
Survey
References
Further reading

If you are worried a child may be at risk of FGM call the free 24-hour FGM helpline on 0800 028 3550.


What is female genital mutilation (FGM)?

Female genital mutilation (FGM) is also known as female circumcision or female genital cutting, and in practising communities by local terms such as 'tahor' or 'sunna'. It is a form of child abuse which can have devastating physical and psychological consequences for girls and women.

The World Health Organization describes it as:

"procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons" (WHO, 2013).

Since 1985 it has been a serious criminal offence under the Prohibition of Female Circumcision Act to perform FGM or to assist a girl to perform FGM on herself. In 2003, the Female Genital Mutilation Act tightened this law to criminalise FGM being carried out on UK citizens overseas. Anyone found guilty of the offence faces a maximum penalty of 14 years in prison.


How prevalent is FGM?

FGM is usually carried out on girls between infancy and 15 years of age, with the majority of cases occurring between the 5 and 8 years of age (HM Government, 2011). Because of the hidden nature of the crime, it is difficult to estimate FGM's prevalence, but a study based on 2001 census data in England and Wales estimated that 23,000 girls under the age of 15 years could be at risk of FGM each year and nearly 66,000 women are living with its consequences (Dorkenoo et al, 2007). FGM could be even more prevalent than these figures suggest due to population growth and immigration from practising countries since 2001 (HM Government, 2011).


Who practises FGM?

Data on FGM is only collected in 27 countries in Africa and in Yemen (WHO, 2012), but we know FGM is also practiced in other countries in Africa, the Middle East and in Asia (House of Commons International Development Committee, 2013).

In the UK, FGM tends to occur in areas with large populations of FGM practising communities. The Home Office has identified girls from the Somali, Kenyan, Sudanese, Sierra Leonean, Egyptian, Nigerian, Eritrean, Yemeni, Kurdish and Indonesian communities as most risk of FGM (2014). Areas where girls may be at risk include London, Cardiff, Manchester, Sheffield, Northampton, Birmingham, Oxford, Crawley, Reading, Slough and Milton Keynes, however, FGM can happen anywhere in the UK (NHS Choices, 2013).


Why do communities practise FGM?

There are a number of cultural, religious and social reasons why FGM is practised within communities. These include:

  • social acceptance
  • family honour
  • ensuring a girl is marriageable
  • preservation of a girl's virginity or chastity
  • custom and tradition
  • hygiene and cleanliness
  • the mistaken belief that it enhances fertility and makes childbirth safer for the infant.

(FORWARD, 2013; HM Government, 2011).


What does FGM involve?

The procedure is traditionally carried out by a female with no medical training, without anaesthetics or antiseptic treatments, using knives, scissors, scalpels, pieces of glass or razor blades. The girl is sometimes forcibly restrained (NHS Choices, 2013).

For more information on the procedure, see the World Health Organisation's factsheet on FGM.


What are the short and long-term effects of FGM?

The immediate effects of FGM include:

  • severe pain
  • shock
  • bleeding
  • infections including tetanus, HIV and hepatitis B and C
  • inability to urinate
  • damage to nearby organs including the bowel, and
  • even death.

(NHS Choices, 2013).

Long-term consequences include:

  • chronic vaginal and pelvic infections
  • menstrual problems
  • persistent urine infections
  • kidney damage and possible failure
  • cysts and abscesses
  • pain during sex
  • infertility
  • complications during pregnancy and childbirth.

(HM Government, 2011).

Girls and women who have been subjected to FGM also suffer serious psychological damage. Research carried out in practising African communities found that women who had undergone FGM suffered the same levels of post-traumatic stress disorder (PTSD) as adults who had experienced early childhood abuse. 80% of the women in the study suffered from mood and/or anxiety disorders (Behrendt et al, 2005; HM Government, 2011).

Watch survivors, community leaders and health professionals talk about their experiences of FGM in our video below.




Which factors put a child at risk of FGM?

The most significant risk factor for FGM is coming from a community that is known to practise it. Girls are also at risk if they have a mother, sister or member of the extended family who has been subjected to FGM (HM Government, 2011). See also: Who practises FGM?

A girl who is at imminent risk of being subjected to FGM may be taken back to her family's country of origin at the beginning of the long summer holiday. This allows time for her to heal from the procedure before returning to the UK. Teachers should be alert to a girl talking about a planned visit to her family's country of origin, especially if she mentions a special occasion when she will 'become a woman'. She may be heard talking about FGM to other children, or she may ask a teacher or other adult for help if she suspects she is at immediate risk.

Another warning sign could be the arrival in the UK of an older female relative visiting from the country of origin who may perform FGM on children in the family (HM Government, 2011). Children in this situation may also run away from home or truant (Khalifa, 2013).

Teachers should also be aware of girls who ask to be excused from PE or swimming classes and who spend long periods of time in the bathroom (Khalifa, 2013).


What can we do to prevent FGM and help those affected by it?

If you are worried that a child may be at risk of FGM you can make an anonymous call to our free 24-hour FGM helpline on 0800 028 3550 or email fgmhelp@nspcc.org.uk.

We can give advice, information and support for anyone concerned that a child's welfare is at risk as well as make a referral on your behalf to the relevant statutory body, where appropriate. Though callers' details can remain anonymous, any information that could protect a child from abuse will be passed to the police or social services.

FGM can happen within families who do not see it as abuse. However, FGM is a criminal act which causes severe physical and mental harm to victims both in the short and long term and for this reason it cannot be condoned or excused. The safety and welfare of the child at risk is paramount and professionals should not be deterred from protecting vulnerable girls by fears of being branded 'racist' or 'discriminatory' (HM Government, 2011).

Professionals need to provide families with culturally competent advice and information on FGM which makes it clear that the practice is illegal. Community and faith leaders can be helpful in facilitating this work with families. This may be enough to stop families practising FGM and protect girls from harm (HM Government, 2011).

If a local authority has reason to believe a child is likely to suffer or has suffered FGM it can exercise its powers to apply to the courts for orders to prevent the child being taken abroad for mutilation. The primary objective of any intervention is to prevent the child from undergoing FGM rather than removing her from her family. If a child has already undergone FGM she should be offered medical help and counselling, and action should be taken to protect any female relatives who are at risk and to investigate possible risk to other children in the practicing community (London Safeguarding Children Board, 2009).


What is the FGM policy and campaign context?

Multi-agency guidelines for dealing with FGM were published in 2011 (HM Government, 2011). In the same year, the UK Government launched a Call to action and Action Plan on Violence against Women and Girls (HM Government, 2013) which included actions to tackle FGM. In February 2014, the Government published an anti-FGM declaration which summarised actions which have been taken so far to combat FGM as well as future initiatives. Actions so far include:

  • the Home Office has used a European Commission grant of £250,000 to promote the NSPCC FGM helpline; provide training for front-line professionals; and part-fund a new prevalence study on FGM in the UK
  • the Crown Prosecution Service (CPS) is putting in place a robust framework to support the prosecution of FGM. In March 2014, the CPS announced the first UK prosecutions over FGM (BBC News, 2014)
  • the Department for Education is investing £700,000 to support programmes led by the Victoria Climbié Foundation and Afruca to address safeguarding issues, including FGM, in minority ethnic communities (HM Government, 2014a).

Planned initiatives include:

  • £100,000 funding for voluntary sector organisations to carry out community engagement work aimed at raising awareness of FGM
  • Department of Health placing a duty on all acute hospitals to report information about the prevalence of FGM within their patient population each month, with the full report from this data return being available in the autumn of 2014
  • the Ministry of Justice seeking views on how a civil prevention order might work alongside the criminal legislation to protect potential victims of FGM (HM Government, 2014a).

In April 2014, the Secretary of State for Education wrote to every head teacher in England alerting them to new safeguarding guidelines and referring them to more detailed information on identifying and responding to specific types of abuse including FGM (HM Government, 2014b). This followed a high profile campaign to increase awareness of FGM in schools which was organised by youth charity, Integrate Bristol. The campaign, led by a 17-year-old student, Fahma Mohamed, included a petition which attracted 250,000 signatures and was backed by the UN Secretary General, Ban Ki-Moon (Guardian, 2014).


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Please fill out our short NSPCC and Home Office FGM survey to help us evaluate and improve this webpage.


References

Behrendt, A. et al (2005) Posttraumatic stress disorder and memory problems after female genital mutilation. American Journal of Psychiatry, 162(5): 1000-1002.

BBC News (2014) FGM: UK's first female genital mutilation prosecutions announced. 21 March. London: BBC.

Department for Education (2014) Michael Gove: letter to headteachers 2 April (PDF). London: The Stationery Office.

Department for Education (2014) Keeping children safe in education: statutory guidance for schools and colleges (PDF). London: The Stationery Office.

Dorkenoo, E., Morison, L. and Macfarlane, A. (2007) A statistical study to estimate the prevalence of female genital mutilation in England and Wales (PDF). London: FORWARD.

Female Genital Mutilation Act 2003.

FORWARD (Foundation for Women's Health, Research and Development) (2013) Female genital mutilation (FGM). London: FORWARD.

Guardian (2014) Michael Gove agrees to write to schools over female genital mutilation. 25 February. London: Guardian.

HM Government (2011) Female genital mutilation: multi-agency practice guidelines (PDF). London: The Stationery Office.

HM Government (2013) Ending violence against women and girls: action plan 2013 (PDF). London: The Stationery Office.

HM Government (2014a) Declaration on female genital mutilation (PDF). London: The Stationery Office.

HM Government (2014b) Letter from Michael Gove to all headteachers in England (PDF). London: Department for Education.

Home Office (2014) Female genital mutilation: resource pack. London: HM Government.

House of Commons International Development Committee (2013) Violence against women and girls: second report of session 2013-14 (PDF). London: The Stationery Office.

Khalifa, S. (2013) How to spot victims of FGM. Children and Young People Now. 20 August-2 September 2013: 31.

London Safeguarding Children Board (2009) London female genital mutilation resource pack (PDF). London: London Safeguarding Children Board.

NHS Choices (2013) Female genital mutilation. London: Department of Health.

Prohibition of Female Circumcision Act 1985.

World Health Organization (WHO) (2012) Female genital mutilation (PDF). Geneva: World Health Organization (WHO).

World Health Organization (WHO) (2013) Female genital mutilation: fact sheet no 241. Geneva: World Health Organization.


Further reading

Search the NSPCC Library Online for publications about female genital mutilation.


Contact the NSPCC's information service for more information on female genital mutilation or any child protection related issue.


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