Brent JSNA
2015
Female Genital
Mutilation (FGM)
Definition and Types of FGM
Definition of Female Genital Mutilation (FGM)
‘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. It has no health benefits and harms girls and women in many ways.’
Multi Agency Practice Guidelines – Female Genital Mutilation – Page 8
HM Government – 2014
www.gov.uk/government/uploads/system/uploads/attachment_data/file/380125/MultiAgencyPracticeGuidelinesNov14.pdf
‘FGM is not an issue that can be decided on by personal preference – it is an illegal, extremely harmful practice and a form of child abuse
and violence against women and girls.’
Female Genital Mutilation Risk and Safeguarding - Guidance for professionals – Page 1
Department of Health – March 2015
www.gov.uk/government/uploads/system/uploads/attachment_data/file/418564/2903800_DH_FGM_Accessible_v0.1.pdf
Types of FGM
The World Health Organisation has classified four types of FGM
• Type 1 – Clitoridectomy: partial or total removal of the clitoris (a small, sensitive and erectile part of the female genitals) and,
in very rare cases, only the prepuce (the fold of skin surrounding the clitoris).
• Type 2 – Excision: partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora
(the labia are the ‘lips’ that surround the vagina).
• Type 3 – Infibulation: narrowing of the vaginal opening through the creation of a covering seal.
The seal is formed by cutting and repositioning the inner, or outer, labia, with or without removal of the clitoris.
• Type 4 – Other: all other harmful procedures to the female genitalia for non-medical purposes,
e.g. pricking, piercing, incising, scraping and cauterising the genital area.
Multi Agency Practice Guidelines – Female Genital Mutilation – Page 8
HM Government – 2014
www.gov.uk/government/uploads/system/uploads/attachment_data/file/380125/MultiAgencyPracticeGuidelinesNov14.pdf
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Health Impact and Names Used for FGM
NHS Choices makes the following statements about the health consequences of FGM
‘There are no health benefits to FGM. Removing and damaging healthy and normal female genital tissue interferes with the natural
functions of girls' and women's bodies.
Immediate effects
Long-term consequences

Severe pain

Chronic vaginal and pelvic infections

Shock

Abnormal periods

Difficulty passing urine, and persistent urine infections

Kidney impairment and possible kidney failure

Damage to the reproductive system, including infertility; cysts and
the formation of scar tissue


Bleeding
Wound infections, including tetanus and gangrene, as well as bloodborne viruses such as HIV, hepatitis B and hepatitis C

Inability to urinate

Injury to vulval tissues surrounding the entrance to the vagina

Complications in pregnancy and newborn deaths

Damage to other organs nearby, such as the urethra (where urine
passes) and the bowel

Pain during sex and lack of pleasurable sensation

Psychological damage, including low libido, depression and
anxiety (see below)

Flashbacks during pregnancy and childbirth

The need for later surgery to open the lower vagina for sexual
intercourse and childbirth

FGM can sometimes cause death
Psychological and mental health problems
Case histories and personal accounts taken from women indicate that FGM is an extremely traumatic experience for girls and women,
which stays with them for the rest of their lives.
Young women receiving psychological counselling in the UK report feelings of betrayal by parents, as well as regret and anger.’
www.nhs.uk/Conditions/female-genital-mutilation/Pages/Introduction.aspx
FGM is practiced in many parts of the world and consequently it is known by many names, including:Cutting; Gudiniin; Halalays; Qodiin; Bondo; Sonde; Thara; Khifad; Xatna; Kutairi; Megrez; Niaka; Ibi; Ugwu; Khifad; Tahoor; Absum.
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Legislation
Legislation
FGM has been a specific criminal offence in the UK since 1985 when the Prohibition of Female Circumcision Act was passed. This Act
was updated by the Female Genital Mutilation Act 2003, which was itself amended by the Serious Crime Act in 2015.
For detailed information about FGM legislation, go to the UK Government ‘Serious Crime Act 2015 Factsheet – female genital mutilation’
www.gov.uk/government/uploads/system/uploads/attachment_data/file/416323/Fact_sheet_-_FGM_-_Act.pdf or
www.cps.gov.uk/legal/d_to_g/female_genital_mutilation/
Female Genital Mutilation Act 2003
•
It is an offence to perform FGM
•
It is an offence to aid, abet, counsel or procure a girl to perform FGM
•
It is an offence for someone in the UK to aid, abet, counsel or procure FGM outside of UK that is carried out by a person who isn’t
a UK national or resident
•
Any FGM act done outside the UK by a UK National or resident is an offence
The Serious Crime Act 2015 made new provisions to tackle FGM by:
•
extending the extra-territorial reach of the offences in the Female Genital Mutilation Act 2003 so that they apply to habitual as
well as permanent UK residents
•
introducing a new offence of failing to protect a girl from risk of FGM
•
granting lifelong anonymity to victims
•
bringing in a civil order (‘FGM protection orders’) to protect potential victims (From 17th July 2015)
•
•
Introducing a duty on healthcare professionals, teachers and social care workers, to notify the police (by calling 101) of known
cases of FGM carried out on a girl under 18 (From 31st October 2015)
www.gov.uk/government/uploads/system/uploads/attachment_data/file/469448/FGM-Mandatory-Reporting-procedural-info-FINAL.pdf
The maximum penalty for any of the FGM offences increased to 14 years’ imprisonment and /or a fine
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Key Facts and Where FGM is Practiced
Key Facts about FGM
 125 million women and girls worldwide have undergone FGM.
 3 million girls are subjected to FGM every year.
 170,000 women and girls are living with FGM in the UK.
 65,000 girls aged 13 and under are at risk of FGM in the UK. House of Commons Home Affairs Committee
Female genital mutilation: the case for a national action plan Second Report of Session 2014–15 - 25th June 2014
www.publications.parliament.uk/pa/cm201415/cmselect/cmhaff/201/20102.htm
Where is FGM Practiced?
FGM is an international issue which effects people across the world, the international diversity and age demographic of the Brent
population would indicate that it is a significant issue for girls and women as well as boys and men in Brent.
‘FGM is a deeply rooted tradition, widely practised mainly among specific ethnic populations in Africa and parts of the Middle East and
Asia, which serves as a complex form of social control of women’s sexual and reproductive rights’
Multi Agency Practice Guidelines – Female Genital Mutilation – Page 9
HM Government – 2014
www.gov.uk/government/uploads/system/uploads/attachment_data/file/380125/MultiAgencyPracticeGuidelinesNov14.pdf
‘In the UK, FGM tends to occur in areas with larger populations of communities who practise FGM, such as first-generation
immigrants, refugees and asylum seekers. These areas include London’
www.nhs.uk/Conditions/female-genital-mutilation/Pages/Introduction.aspx
The maps and charts on the following three pages illustrate the prevalence of FGM in the global context and provide an indicator of the
potential experience of FGM in the diaspora communities in Brent.
The fourth page indicates the estimated numbers of girls born in Brent to women who have themselves experienced FGM compared with
the other London Boroughs.
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Map indicating international prevalence of FGM - 1
Female Genital Mutilation/Cutting: A statistical overview and exploration of the dynamics of change - July 2013
www.unicef.org/esaro/FGCM_Lo_res.pdf
Map indicating international prevalence of FGM - 2
including the countries where FGM is known to occur in certain communities but where the numbers are not verifiable and
those countries where FGM is reported among the migrant population.
UNICEF – FGM Data Set 2014
http://data.unicef.org/child-protection/fgmc.html
Recent research from the United States would suggest that in some countries there has been a generational change in the Prevalence of FGM.
Evidence of how this apparent trend is impacting traditional cutting communities in the UK is yet to be researched.
Source: Charlotte Feldman-Jacobs and Donna Clifton, Female Genital Mutilation/Cutting: Data and Trends Update 2014 (Washington, DC:
Population Reference Bureau, 2014).
www.prb.org/Publications/Datasheets/2014/fgm-wallchart-2014.aspx
The Context of FGM in Brent
Between 2005 and 2013 it is estimated that 2,171 girls born in Brent families had mothers who had experienced FGM
This equates to 9.39% of the girls born in Brent during this time period.
Estimated percentage of girls born (between 2005 and 2013) to women with FGM in London,
Published July 2015
12
Percentage (%)
10
9.4%
8
6
London average, 5.25%
4
2
0
Female Genital Mutilation in England and Wales: Updated statistical estimates of the numbers of affected women living in England and Wales and girls at risk - Interim report on provisional estimates
City University London – July 2015
www.city.ac.uk/__data/assets/pdf_file/0020/266033/FGM-statistics-report-21.07.14-no-embargo.pdf
Human Rights and Expected Action to be Taken in Cases
or Suspected Cases of FGM
Human Rights
‘FGM is internationally recognised as a violation of women’s human rights and a form of child abuse…‘it constitutes a breach of the
fundamental right to life, liberty, security, dignity, equality between women and men, non-discrimination and physical and mental
integrity’. It also violates the rights of the child as defined in the United Nations Convention on the Rights of the Child.’
‘Many women who have survived FGM may also experience other forms of violence, such as early, child or forced marriage or
domestic violence. As migrants, sometimes dependent on their husbands, fathers or wider family, they may be particularly vulnerable.
Communication from the commission to the European Parliament and the European Council
Towards the elimination of female genital mutilation – November 2013
http://ec.europa.eu/justice/gender-equality/files/gender_based_violence/131125_fgm_communication_en.pdf
Expected Action
‘FGM is not a matter that can be left to be decided by personal preference – it is an extremely harmful practice. Professionals should
not let fears of being branded ‘racist’ or ‘discriminatory’ weaken the protection required by vulnerable girls and women..’
‘IN ALL CASES: If you are worried about a child under 18 who is at risk of FGM or has had FGM, you have a legal obligation to share
this information with social care or the police. It is then their responsibility to investigate, safeguard and protect any girls involved.
Other professionals should not attempt to investigate cases themselves.’
Multi Agency Practice Guidelines – Female Genital Mutilation HM Government – 2014
www.gov.uk/government/uploads/system/uploads/attachment_data/file/380125/MultiAgencyPracticeGuidelinesNov14.pdf
In Brent referrals about a concern should be made via the ‘Brent Family Front Door’
which incorporates our Multi Agency Safeguarding Hub - MASH) on 020 8937 4300 or via [email protected]
If risk to the child is imminent then you should call the police on 999
If you are not in Brent you may Call the 24/7 National FGM Helpline on 0800 028 3550 or via [email protected]
Regulated professionals’ (e.g. Teachers, Health and Social Care Workers) should inform the police via the non-emergency phone line
– 101 in cases of confirmed FGM in under 18 year olds
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Training, support organisations and information on FGM
Free training in Brent about FGM.
Free training about FGM is available for anyone works (paid or voluntarily) with children, young people or families in Brent. It can be
accessed by registering with the Brent Local Safeguarding Children Board training website –
http://brentlscb.learningpool.com
Support and campaigning organisations for women who have been cut, include
NHS African Well-Women’s Clinics, for de-infibulation and other clinical and therapeutic support
www.nhs.uk/NHSEngland/AboutNHSservices/sexual-health-services/Pages/fgm-health-services-for-women.aspx
FORWARD (Foundation for Women's Health Research and Development) an African diaspora women’s campaign and support
organisation. www.forwarduk.org.uk
Daughters of Eve works to protect girls and young women who are at risk from female genital mutilation (FGM).
www.dofeve.org
The Dahlia Project is a therapeutic support group and individual counselling service for women who have undergone FGM
www.manorgardenscentre.org/dahlia-support-fgm-survivors
Support and guidance for professionals, includes
The UK Government multi-agency practice guidelines to support front line professionals to prevent FGM.
www.gov.uk/government/publications/female-genital-mutilation-guidelines
The London Safeguarding Children Board, Child Protection Procedures – FGM Guidance
www.londoncp.co.uk/chapters/sg_ch_risk_fgm.html
The National FGM Centre
www.nationalfgmcentre.org.uk
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