Our Hidden Shame: FGM in the UK

Female Genital Mutilation (FGM) is often considered to be an abhorrent, but foreign, practice. However, the fact of the matter is that FGM happens here, in the UK, and it needs to be talked about. It needs to be stopped. It is a topic that is unpleasant, both in terms of its violent nature and our cultural discomfort with discussing female genitalia in general. It is also entangled with political discussions about race, religion and cultural sensitivities, so for most people it seems easier just to ignore it. However, shying away from the topic simply shields the perpetrators and leaves their victims unprotected and alone.


A few months ago I was sitting in my garden in cosmopolitan, liberal, twenty-first century London, having dinner with our neighbour, who is a former teacher. Somehow-or-other the conversation turned to the realities of living in a racially and culturally diverse society – something that we concluded was, for the most part, despite the forthcoming anecdote, a very good thing. We discussed the impact this has on the young and how we tackle the uncomfortable realities of social and cultural cohesion. My neighbour then told us the story of teaching a class, in his North London school, about various cultural practices and described FGM and its dangers. It was at this point that one of his female pupils raised her hand and said ‘but sir, I’ve had that done.’ ‘Really?’ he said, masking his shock, ‘who else here, if you don’t mind me asking, has had this done?’ To his horror, half of the girls in his class raised their hands.

This story shook me and, as I went inside, I resolved to do more research. I found out that there are an estimated 137, 000 women and girls in England and Wales living with the effects of FGM. There are 60, 000 girls under 15 at risk of FGM in the UK, 24, 000 of whom are at risk of type 3, the most severe type. 130 million girls and women worldwide have undergone FGM.

My research showed me my own ignorance and misconceptions about FGM and I believe I was, and am, probably not alone in my ignorance, so I feel a simple laying down of the facts is in order.

 

What is FGM?

FGM is sometimes called Female Circumcision or Female Genital Cutting. FGM is its official and legal name under British law.

Female Genital Mutilation refers to any procedure that involves the partial or total removal of the external female genitalia. It is recognised that there are four types:

1 – Clitoridectomy: partial or total removal of the clitoris.

2 – Excision: partial or total removal of the labia minora and occasionally the labia majora (the labia are the ‘lips’ that surround the vagina).

3 – Infibulation: the narrowing of the vaginal opening, sometimes to as small as the size of a match head, by creating a covering seal; this is formed by mutilating the inner or outer labia. This type also often involves the removal of the clitoris.

4 – Other: all other procedures that involve the harming, mutilation or manipulation of the female genitalia for non-medical purposes.

It is usually done on girls before the age of 15, commonly between the ages of 5 and 8, but it is also performed on adult women.

It is often performed against the girls’ wills, while she is physically restrained. It is often performed by an older woman without sterilised tools, anaesthetic or antiseptic.

 This diagram shows the prevalence of FGM in the countries in which it is most frequently practised.  Image source: forwarduk.org.uk/key-issues/fgm

This diagram shows the prevalence of FGM in the countries in which it is most frequently practised.

Image source: forwarduk.org.uk/key-issues/fgm

Who practices FGM?

FGM is practised in more than 28 countries in Africa and the Middle East and in countries that have migrant communities from FGM-affected areas, including but not exclusive to South East Asia, the UK and the USA.

FGM is not a practice exclusive to Islam. It is a cultural practice that predates both Islam and Christianity and is practised by members of many religions in the affected countries. While FGM is often associated with the Muslim community, most Muslims and Muslim countries around the world do not practice FGM.

 

Why is FGM performed?

FGM is performed for many social and cultural reasons; the most simple explanation is that it is done because it is an ancient tradition that has been passed between mothers and grandmothers for centuries.

Some of the social reasons include:

-       To prove that a woman has not had sex before marriage

-       To decrease a woman’s sexual desire and/ or pleasure

-       To increase a male sex-partner’s sexual pleasure

-       To signal that a girl has now become a woman

-       To follow religious beliefs – although there is no doctrinal evidence to show that FGM is required by any religion.

 

What is its medical status and what are its side effects?

There is no medical reason to perform FGM, nor are there any medical benefits.

Effects and side effects of FGM include:

-       Chronic pain,

-       Pain or difficulty having sex,

-       Menstrual blood or urine collecting inside the girl/ woman because the opening is so small,

-       Infections, bleeding, cysts, abscesses,

-       Problems urinating and incontinence,

-       An increased risk of infertility or still-births

-       Life-threatening problems during pregnancy and labour. 

-       Mental health issues such as depression, flashbacks and PTSD.

 

What is its legal status?

Performing or helping to perform FGM has been illegal in the UK since 1985.

Anybody that takes a girl or woman out of the country in order to perform FGM is also legally liable.

Both instances are punishable by up to 14 years in prison.

Performing FGM is internationally considered to be a violation of human rights and a form of child abuse.

 

How different is it to male circumcision?

VERY. Male circumcision involves the removal of the foreskin only, without causing harm to the penis; if it were done in a comparable manner to FGM, most of the penis would be removed.

Male circumcision rarely causes health problems for the individual, whereas FGM causes frequent, painful and sometimes catastrophic side effects.

Male circumcision is an important requirement of both Islam and Judaism and is explicitly mentioned in their doctrines and holy books.

Crucially, male circumcision is not performed in order to control male sexual behaviour, or diminish sexual pleasure. FGM is performed to make sure women remain virgins until marriage and faithful afterwards, furthermore it is done to remove their ability to enjoy sex.

 

Would medical professionals performing FGM in a sterilised environment take away the medical risks?

NO. While having medical professionals perform the procedure would reduce the risk of initial infection and could dull the pain of the actual procedure, the dangers of FGM go far beyond those of the procedure. Having it done in a sterilised environment by professionals would not reduce these future risks, (see list of dangers above).

In addition, in all, bar a very few exceptional, cases the procedure is done against the woman's will. As a result, the performance of FGM by medical professionals would go against two key elements of the Hippocratic oath; to cause no harm and not to perform procedures without the patient's consent (which cannot be accepted if it is believed that consent has been coerced). Some may argue that it will happen either way, so a marginally less damaging procedure is better than one done at home; however, no charities accept this line as they fear that its performance by medical professionals would imply that the procedure is in any way acceptable. Instead, charities, the NHS, the UN and other major national and international organisations agree that efforts must be made to educate people and to eradicate the practice, rather than attempt to make an inherently harmful procedure marginally less harmful.

The "clean procedure vs dirty procedure" argument is frequently used in the discussion of abortions. However, an abortion is a decision made by a woman regarding her own body, which, in most cases, increases her quality of life. In this case, the procedure benefits the patient, however you may feel about the ethical issues surrounding the beginnings of life; so the procedure's medical dangers are annulled by its professional practise. The issues surrounding abortion are, therefore, purely ethical and philosophical. 

FGM, on the other hand, can only decrease a woman's quality of life and there are no medical, emotional or psychological benefits. It only causes harm. It is, therefore, not comparable with the debate regarding abortion and entirely incompatible with the medical profession. 

 

For More Information on FGM:

Forward UK: forwarduk.org.uk/key-issues/fgm

The NHS: www.nhs.uk/Conditions/female-genital-mutilation/Pages/Introduction.aspx

NSPCC: www.nspcc.org.uk/preventing-abuse/child-abuse-and-neglect/female-genital-mutilation-fgm/fgm-facts-statistics/

 

If you are worried that a child is at risk of, or has had, FGM, then call the FGM helpline:

0800 028 3550

It is FREE, ANONYMOUS and 24/7!