Female Genital Mutilation (FGM)

1. What is FGM?

Female Genital Mutilation (FGM) is a procedure where the female genitals are deliberately cut, injured or changed without a medical reason for doing so. It is also known as female circumcision or cutting, and by other terms, such as sunna, gudniin, halalays, tahur, megrez and khitan, among others.

There are 4 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 (the lips that surround the vagina), with or without removal of the labia majora (the larger outer lips).
Type 3 - Infibulation Narrowing the vaginal opening by creating a seal, formed by cutting and repositioning the labia.
Type 4 Other harmful procedures to the female genitals, including pricking, piercing, cutting, scraping or burning the area.

The age at which FGM is carried out varies enormously according to the community in which it is taking place. The procedure may be carried out on new-born infants, during childhood, adolescence, just before marriage or during a woman's first pregnancy. 

Need to know

In the UK, FGM is recognised as a form of domestic abuse.

For further information about domestic abuse, see: Domestic Abuse (including MARAC).

Need to know

Across the world, FGM is a deeply rooted practice, widely carried out among specific ethnic populations in Africa and parts of the Middle East and Asia, where it serves as a complex form of social control over women's sexual and reproductive rights. There is no Biblical or Koranic justification for FGM and religious leaders from all faiths have spoken out against the practice. The exact number of girls and women alive today who have undergone FGM is unknown; however, UNICEF estimates it to be over 200 million.

2. The Impact of FGM

Regardless of the age in which FGM is carried out, the practice can cause severe pain, and in some cases, death. There may also be immediate and/or long-term consequences for health and wellbeing.

These may include:

  1. Enduring pain and discomfort;
  2. Pain and difficulty having sex;
  3. Repeated infections, which can lead to infertility;
  4. Bleeding, cysts and abscesses;
  5. Incontinence;
  6. Mental health issues (depression, flashbacks and self-harm);
  7. Problems during labour and childbirth.

3. FGM and the Law

3.1 The Female Genital Mutilation Act 2003

Under the Female Genital Mutilation Act 2003, it is illegal for anyone to:

  1. Perform FGM (including taking a girl/woman abroad for FGM);
  2. Help a girl/woman perform FGM on herself in or outside the UK;
  3. Help anyone perform FGM in the UK;
  4. Help anyone perform FGM outside the UK on a UK national or resident;
  5. Fail to protect a girl/woman for whom you're responsible from FGM.

Anyone found guilty of these offences could be sentenced for between 7 and 14 years in prison.

Note: Under Section 6 (1) of the Female Genital Mutilation Act 2003, the term ‘girl’ includes a woman.

3.2 The Serious Crime Act 2015

Offences

The Serious Crime Act 2015 amended The Female Genital Mutilation Act 2003 so that the offences (as set out above) apply to habitual as well as permanent UK residents.

The Act also introduced a new offence of failing to protect a girl/woman from the risk of FGM, meaning that family members and others failing to take protective action can now be prosecuted.

Other measures

As well as the impact on offences, the Serious Crime Act 2015 also:

  1. Grants lifelong anonymity to victims;
  2. Introduced FGM Protection Orders; and
  3. Places a duty on health, education and social care professionals to notify the police when they know that FGM has been carried out on a girl under the age of 18.
Need to know

An FGM Protection Order (FGMPO) is a legal means to protect and safeguard victims and potential victims of FGM. The order will contain conditions unique to each case, which could include measures such as surrendering a passport.

The FGMPO application can be made by the adult, the local authority or anyone else to whom the court gives permission (for example the police, a charity or a family member).

For further information see GOV.UK Guidance: FGM protection orders: factsheet.

4. Safeguarding Response

Current concerns

If the adult appears to be at immediate risk of harm, the situation should be treated as an emergency and the police alerted using 999.

If FGM has taken place, the adult is also likely to require medical attention.

Going through FGM is a traumatic experience. Responses from a trauma informed perspective should always be considered, and the adult made central to the safeguarding process and any decisions that are made.

FGM can often be part of a wider pattern of abuse, rather than a one-off incident. The adult may be experiencing controlling or coercive behaviours and other efforts to control and monitor them. For example, physical, psychological or financial abuse.

FGM can also be a precursor to forced marriage – the safeguarding response should endeavour to establish from the adult whether this is a risk for them.

For further information, see: Forced Marriage.

The safeguarding response should be mindful that engaging with family and community members could increase risk of ongoing harm to the adult. In particular, if the FGM procedure has not yet occurred, there is a risk it could be expedited if a family becomes aware that action is being taken to prevent it. Where the adult at risk needs support to engage in the safeguarding process, including an interpreter, this may be best provided by an independent advocate or specialist organisation.

Disclosure of historical FGM

If an adult makes a historical disclosure of FGM, this must be referred to the police for investigation and redress.

The adult should be provided with the medical and emotional support they need to support their recovery.

5. Concerns that a Child may be at Risk of FGM

Any concerns should be raised to the police and local authority child protection services.

6. Training

Training should be available to enable professionals to discharge their safeguarding duties with regard to FGM.

This should include:

  • An overview of FGM (what it is, when and where it is performed);
  • The UK law on FGM;
  • The potential consequences of FGM;
  • What to do when FGM is suspected or has been performed; and
  • The role of different professionals and the importance of multi-agency working.

Online training has been developed for the Home Office by Virtual College. See Female Genital Mutilation: Recognising and Preventing FGM.

In partnership with other organisations, NHS England also provides a free online course. See: FGM E-learning to improve awareness and understanding of FGM.

7. Statutory Guidance and Further Information

Statutory guidance and duties

GOV.UK: Multi-agency statutory guidance on female genital mutilation

GOV.UK: Mandatory reporting of female genital mutilation: procedural information

Other guidance and resources

GOV.UK Guidance: Female genital mutilation: resource pack

GOV.UK Guidance: FGM protection orders: factsheet

National FGM Centre: FGM Assessment Tool for Social Workers (best practice guidance and tool

National FGM Centre: Knowledge Hub and Resources

NHS: National FGM Support Clinics