FGM Additional Information from Health Safeguarding Team

1. Why FGM Happens

FGM is carried out for a number of cultural, religious and social reasons. Some families and communities believe that FGM will benefit the girl in some way, such as preparing them for marriage or childbirth.

But FGM is a harmful practice that isn't required by any religion and there are no health benefits of FGM.

FGM terms: what they mean.

You might have heard some FGM terms that you're not familiar with, including:

• 'Cutter'
  A 'cutter' is somebody who carries out FGM. They might use things like knives, scalpels, scissors, glass or razor blades to carry out the procedure;
• 'Cutting season'
  This refers to the summer months – often July, August and September – when many girls are on break from school. This is often the period when girls have time to undergo FGM. Girls might be flown abroad during this time, so it's important to be aware of this risk.

28 Too Many, a charity working to end FGM in Africa, has a list of other FGM-related terms.

We know:

• There are no medical reasons to carry out FGM;
• It's often performed by someone with no medical training, using instruments such as knives, scalpels, scissors, glass or razor blades;
• Children are rarely given anesthetic or antiseptic treatment and are often forcibly restrained;
• It's used to control female sexuality and can cause long-lasting damage to physical and emotional health.

2. Who's at Risk

Girls living in communities that practice FGM are most at risk. It can happen in the UK/Jersey or abroad.

The Home Office has identified girls and women from certain communities as being more at risk:

• Somali;
• Kenyan;
• Ethiopian;
• Sierra Leonean;
• Sudanese;
• Egyptian;
• Nigerian;
• Eritrean;
• Yemeni;
• Kurdish;
• Indonesian.

Children are also at a higher risk of FGM if it's already happened to their mother, sister or another member of their family.

FGM can happen at different times in a girl or woman's life, including:

• When a baby is new-born;
• During childhood or as a teenager;
• Just before marriage;
• During pregnancy.

3. Signs FGM Might Happen

• A relative or someone known as a 'cutter' visiting from abroad;
• A special occasion or ceremony takes place where a girl 'becomes a woman' or is 'prepared for marriage';
• A female relative, like a mother, sister or aunt has undergone FGM;
• A family arranges a long holiday overseas or visits a family abroad during the summer holidays;
• A girl has an unexpected or long absence from school;
• A girl struggles to keep up in school;
• A girl runs away – or plans to run away - from home.

4. Signs FGM Might Have Taken Place

• Having difficulty walking, standing or sitting;
• Spending longer in the bathroom or toilet;
• Appearing quiet, anxious or depressed;
• Acting differently after an absence from school or college;
• Reluctance to go to the doctors or have routine medical examinations;
• Asking for help – though they might not be explicit about the problem because they're scared or embarrassed.

5. Effects of FGM

There are no health benefits to FGM. It can cause serious harm, including:

• Severe and/or constant pain;
• Infections, such as tetanus, HIV and hepatitis B and C;
• Pain or difficulty having sex;
• Infertility;
• Bleeding, cysts and abscesses;
• Difficulties urinating or incontinence;
• Organ damage;
• Problems during pregnancy and childbirth, which can be life-threatening for the mother and baby;
• Mental health problems, such as depression, flashbacks and self-harm;
• Death from blood loss or infections.

6. If a Child Reveals Abuse

A child who has faced, or is worried about FGM, might not realise what's happening is wrong. And they might even blame themselves. If a child talks to you about FGM it's important to:

• Listen carefully to what they're saying;
• Let them know they've done the right thing by telling you;
• Tell them it's not their fault;
• Say you'll take them seriously;
• Don't confront the alleged abuser;
• Explain what you'll do next;
• Report what the child has told you as soon as possible.

IF YOU SUSPECT OR RECEIVE A DISCLOSURE OF FGM IMMEDIATE RESPONSE IS REQUIRED

1. Telephone Police on 612612;
2. Telephone MASH on 519000, followed by a MASH enquiry form.

FGM is a criminal offence upheld within the Jersey Sexual Offences Law (2018).

It is a criminal offence to:

• Carry out female genital mutilation;
• Assist female genital mutilation;
• Fail to protect a child aged 15 or younger from risk of genital mutilation.

Part 8 of the Law directs professionals in their duty to notify police of apparent female genital mutilation of child. A regulated professional must notify the Police if she/he is informed by a child that female genital mutilation (however described) has been carried out on the child; or observes physical signs on a child that appear to show that female genital mutilation has been carried out on the child.

One survivor's story

"My Aunt cut my genitals when I was seven years old. The culture of silence surrounding this FGM/C means laws alone won't stop it. I was seven years old.

"My parents had sent my brother and me to visit family in India for two months. On a humid mid-summer afternoon, my dad's sister decided to throw a party for my brother, celebrating his completion of the Qur'an. At the party, she pulled me aside, wielding a jumbo-sized Toblerone. She said that if I stayed on my best behavior, I wouldn't have to share it with anyone, including my brother. I was overjoyed.

"My aunt was a doctor. So when she led me downstairs to her clinic and instructed me to lie flat on my back on her operating table, I didn't think to question her authority. With no anesthetic and very little warning, she performed the ritualized cut. After it was over, we headed back to the party in silence. I remember sitting in a corner by myself, unable to open the chocolate bar bribe and feeling sick to my stomach. I blocked out the memory, until the day when I discovered that what happened to me had an acronym that could be found in the glossary of a medical anthropology textbook.

"When I confronted my parents, they were stunned. My aunt had carried out the ritual without their consent. My father felt a unique betrayal. This was the same little sister he encouraged to pursue medicine in the first place. He had no idea that female genital mutilation or cutting (FGM/C) was even practiced within the Dawoodi Bohra community, a Shia subsect from India's coastal state of Gujarat.

"As I learned more about the practice, I discovered that more often than not, men are oblivious and may not even know it is happening - or has happened - to their daughters, sisters and mothers. I learned that FGM/C dates back thousands of years, predating Islam and Christianity. It is a cultural practice that is neither rooted in religion nor bound by geography nor restricted to a socioeconomic class. Like other forms of gender-based violence, FGM/C is a manifestation of power and means of controlling the sexuality of women and girls.

"In recent years, many countries have passed laws to criminalize the practice of FGM/C. Yet, it is an extraordinarily difficult crime to prosecute. Laws alone are not enough. For there to be a sustainable end to this practice, there has to be a radical culture change from the ground up, that promotes zero tolerance to any and all forms of excision.

"As I have engaged with friends and family members who support the ritual, some will argue that it is not technically mutilation. They even go as far as asserting that "mutilation is what is done in Africa", as though our community practices a more civilized, humane version. According to the World Health Organization, all versions of FGM/C cause harm, both physical and psychological, which renders the "good FGC v bad FGM" debate meaningless.

"One of the greatest challenges in raising awareness on FGM/C is that many survivors are shamed into silence. If they voice dissent, their communities might socially ostracize them.

"Within the last few years I have noticed a shift. More and more FGM/C survivors are courageously speaking out. Male relatives who may have never even been aware of the practice are also taking a stand. From a recent Change.org campaign launched by over a dozen Dawoodi Bohra survivors in India, to Safe Hands for Girls "a youth-powered movement in Gambia", communities are movement-building and speaking out against FGM/C in greater numbers.

"I encourage you to break the culture of silence around FGM/C by sharing this video containing testimonials of fellow survivors and advocates, and joining the global conversation to #endFGM.

7. Further Learning

• Above information taken from: NSPCC - Female Genital Mutilation (FGM);
• Home Office online FGM training, free to register, one hour long, can be used for CPD: Virtual College - Recognising and Preventing FGM.