DEFINITION OF FGM
Comprises all procedures involving partial or total removal
of the external female genitalia or other injury to the female genital
organs for non medical reasons.
World Health Organisation 2014
A RIGHTS-BASED APPROACH
Female genital mutilation (FGM) violates the following human rights
The right to be
free from gender
discrimination
The right to life
and physical
integrity
The right to
health
The rights of
the child
All children shall enjoy special protection, and shall be given opportunities
and facilities, by law and by other means, to enable them to develop
physically, mentally, morally, spiritually and socially in a healthy and
normal manner and in conditions of freedom and dignity
Declaration of the Rights of the Child 1959
Prevalence of Female Genital Cutting
Scaled 2011
KEY COUNTRIES OF ORIGIN
Countries with the highest prevalence
are:
• Somalia (98%)
• Guinea (96%)
• Djibouti (93%)
• Egypt (91%)
• Eritrea (89%)
• Mali (89%)
• Sierra Leone (88%)
• Sudan (88%)
• Gambia (76%)
• Burkina Faso (76%)
• Ethiopia (74%) - UNICEF
WHEN AT RISK OF FGM
At birth
Infancy
Malaysia
many under 1
year
Neonatal
period
In Nigeria,
Eritrea and
Mali, most girls
undergo FGM
be-fore the age
of 5
Teenagers
After birth of
a child
In Somalia
and Chad, most
girls undergo
FGM between
the ages of 5-9
years
In Kenya
and Egypt,
most girls
undergo FGM
after the age of
10
Childhood
Before or
at marriage
In 50% of cases FGM is carried out before the age of five
MISCONCEPTIONS
• Social obligation/ acceptance/ rite of passage
• Reducing sexual desire, fear of clitoris and sexuality, keeping
virginity
• Religious requirement
• Readiness for marriage and adulthood
• Purify the body/clean, aesthetics
• Protects against material want
FGM TYPES
Normal Female Genital Anatomy
WHO FGM Classification: Type IV
UNICEF: cut/nicked, no flesh removed
UNICEF: Cut and flesh
removed with or without
stitching
UNICEF: Cut and flesh removed
UNICEF : Cut, flesh removed and sewn closed
COMPLICATIONS OF FGM
• Haemorrhage
• Sepsis
• Death
• Urinary retention
• Tetanus and gangrene
• Infections (e.g., HIV, Hepatitis)
Immediate/short-term consequences
Long-term consequences
• Recurrent urinary infections • Keloid scarring and cysts
• Complications in pregnancy
• Painful menstruation
• Infertility
• Pain during intercourse
THE UK LAW
Female Genital Mutilation Act 2003 makes it a criminal offence for any
UK national or permanent
resident to mutilate the
whole or any part of a girl
or woman’s genitalia
Or to aid, abet, counsel
or procure the carrying
out of FGM in the UK
As well as to have it carried out
abroad, even in countries where
the practice may be legal
BROACHING THE TOPIC
Using the term mutilation may be upsetting to some patients
Try to be sensitive and use value-neutral terms
• Have you been cut down there?
• Were you circumcised?
• Have you been closed?
Safeguarding women with FGM and girls at risk of undergoing FGM is everyone’s responsibility
What can YOU do?
Prevention and Support
Suspicion of FGM
Liaise with local support/communities
e.g. FORWARD charity
Identify girls at risk
Empower and support affected girls and
young women
(both those at risk
and survivors)
Treat as Child Abuse - Follow MultiAgency Practice Guidelines: Female
Genital Mutilation (2011).
Implement awareness
campaign/passport
Document and collect information and
share it systematically