Female genital mutilation

Female genital mutilation (sometimes wrongly referred to as female circumcision) refers to procedures that intentionally alter and cause injury to the female genital organs for non-medical reasons. It is illegal in the UK.

It is estimated over 20,000 young women under 15 are at risk of female genital mutilation (FGM) in the UK each year, and 170,000 women in the UK are living with the consequences of FGM (NHS, 2014). The true extent is unknown due to the ‘hidden’ nature of the crime.

Recent reports identified 5,702 new cases in England in one year.

Young women may be taken to another country to be mutilated during the summer holidays. Some young women may be abused in the UK.

Definition

“Female genital mutilation (FGM) is a procedure where the female genitals are deliberately cut, injured or changed, but where there’s no medical reason for this to be done. It’s also known as “female circumcision” or “cutting”, and by other terms such as sunna, gudniin, halalays, tahur, megrez and khitan, among others.”

NHS Direct, 2019

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Your responsibilities

If you believe there is a risk of FGM you must notify MASH immediately, without seeking consent from the family. The Serious Crime Act 2015 introduced a duty on all teachers and registered health and social care professionals to notify the police of any known cases of FGM in a child (i.e. anyone under the age of 18).  If you fall into one of these categories it is therefore your duty to report it directly to the Police, as well as notifying your designated safeguarding lead.  This notification will not breach any confidence of the child.

FGM is abuse.  Courts may make FGM Protection Orders which aim to protect specific children from being harmed.

More information

FGM is usually carried out on young girls between infancy and age 15, most commonly before puberty starts. The procedure is traditionally carried out by a woman with no medical training. Anaesthetics and antiseptic treatments are not generally used and girls may have to be forcibly restrained.

Countries that have significantly high numbers of cases include Somalia, Eritrea, the Sudan and the Gambia.

FGM can cause severe pain, bleeding, wound infections, inability to urinate, injury to vulval tissues, damage to other organs and sometimes even death. Other complications can arise later with the onset of puberty.

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There are four main types of FGM:

  • type 1 – clitoridectomy – removing part or all of the clitoris;
  • type 2 – excision – removing part or all of the clitoris and the inner labia (lips that surround the vagina), with or without removal of the labia majora (large outer lips);
  • type 3 – infibulation – narrowing the vaginal opening by creating a seal, formed by cutting and repositioning the labia;
  • other harmful procedures to the female genitals, including pricking, piercing, cutting, scraping or burning the area.

FGM is a painful, non-medical, procedure undertaken on girls and young women which can seriously harm their long-term health. It is a form of child abuse and is illegal in the UK. It is also illegal to take a child out of the country or to assist in any way in carrying out FGM on a child.

It is estimated 200 million girls and young women globally have been subject to FGM, of these 44 million are aged under 15.

Spotting the signs

FGM only affects girls and it can take place at any time between infancy and the age of 15 and most commonly before the onset of puberty.

There are no health benefits but there are risks of serious harm both in the short and long term. Signs and symptoms may include:

  • constant pain
  • repeated infections
  • problems passing urine
  • incontinence
  • bleeding, cysts, abscesses
  • pain during sex
  • depression, flashbacks
  • sleep problems
  • self harm

Later in life women may experience difficulty in becoming pregnant and those who do conceive can have significant problems with childbirth.

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Preventing FGM

Girls and young women worried about this issue should have someone to talk to in the school who takes responsibility to listen to them, to talk to family and other teachers, and who can take action to keep them safe. There are a range of leaflets in different languages available from the Department of Health.

We should not rely on young people to identify their own abuse – often they don’t know they are being abused, or are unable to tell us for whatever reason. In the case of FGM they may not even remember it being done if it took place when they were an infant. Look for the following potential indicators of risk:

  • schools should be particularly alert to girls travelling to countries in Africa, the Middle East and Asia during the long summer holiday
  • listen also for information about someone coming to see the child for a special ceremony – sometimes ‘cutters’ come to the victims
  • girls who were born in the UK or are resident here but whose families originate from an FGM practising community are at greater risk of FGM happening to them
  • communities at particular risk are: Egypt, Eritrea, Gambia, Guinea, Indonesia, Ivory Coast, Kenya, Liberia, Malaysia, Mali, Nigeria, Sierra Leone, Somalia, Sudan, Yemen.

What you can do

Ensure young people know the risks – talk about FGM at an age appropriate level from the later years of primary school in the same way we do about drugs and other issues

Ensure your approach to safeguarding against FGM is multi-agency and multi-disciplinary. They should work with partners in social services, health and the police.

Check young people have safe relationships – in their family, with their peers and with your staff. Create the environment where it’s ok to talk even about the most difficult things.

Spot the signs & know what to do – use the checklists above, your safeguarding procedures and be confident in raising FGM as a possibility.

Take action – and keep taking action until you know they’re safe

Resources

  • Home Office Promotional Materials to raise awareness of FGM

    Home Office designed posters to highlight the harmful consequences of FGM. The posters also signpost to the NSPCC’s 24 hour FGM helpline.

  • FGM Guidance for Schools

    The purpose of this guidance is to equip professionals in education settings to respond to concerns regarding girls at risk of FGM.

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  • Training resources for DSLs to use in team meetings
  • Reference documents for additional information
  • Handout for school staff summarising female genital mutilation
  • Quiz to test staff understanding
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