FGM includes all procedures involving partial or total removal of the female genitalia or any other injury to the female genital organs for non-medical reasons. This practice is illegal in the UK. The girls may be taken back to their countries of origin to undergo FGM but there are also worries that some girls may have FGM performed in the UK. It is usually carried out on young girls between infancy and the age of 15, most commonly before puberty starts. Anaesthetics and antiseptics are not generally used and FGM is usually carried out using knives, scalpels, scissors, razor blades or pieces of glass. Girls may be forcibly restrained and the person carrying out the FGM will usually have no medical training. It is commonly the girl’s parents or extended family who arrange the FGM.

There are four main types of FGM:

• Type 1- clitoridectomy: removing part of or the entire clitoris.
• Type 2- excision: removing part or all of the clitoris and the lips that surround the vagina (the inner labia), with or without removing the larger outer lips (the labia majora).
• Type 3- infibulation: narrowing of the vaginal opening by creating a seal formed by cutting and repositioning the labia.
• Other harmful procedures such as piercing, pricking, scraping, burning or cutting the area.

Removing or damaging healthy and normal female genital tissue interferes with the natural bodily functions of the victim. There are no health benefits of FGM.

Immediate effects:

• Shock
• Severe pain
• Bleeding
• Inability to urinate
• Injury to the tissue surrounding the entrance to the vagina
• Wound infections, including gangrene and tetanus, as well a blood borne viruses such as hepatitis B, hepatitis C and HIV
• Damage to other organs nearby, such as the urethra (where the urine passes) and the bowel
• FGM can sometimes cause death

Long term effects:

• Abnormal periods
• Chronic vaginal and pelvic infections
• Difficulty passing urine and persistent urine infections
• Kidney impairment and possible kidney failure
• Cysts and other formationof scar tissue
• Damage to the reproductive system, including infertility
• Pain during sex and lack of pleasurable sensation
• Complications in pregnancy and newborn deaths
• The need for later surgery to open the lower vagina for sexual intercourse and childbirth

Psychological and mental health problems:

Personal accounts indicate that FGM is a very traumatic experience and it stays with the victim for the rest of their lives. Young women receiving psychological counselling in the UK reported feelings of betrayal by parents, regret and anger.

Other examples of psychological damage caused by FGM include depression, anxiety, low libido, severe psychological trauma and flashbacks during pregnancy and childbirth.

FGM is carried out for cultural, religious and social reasons within families and communities. For example, it is often seen as a way to prepare a girl for marriage and adulthood, and is motivated by the belief that it is beneficial for the girl or woman. Many communities believe that it will reduce a woman’s libido in order to discourage sexual activity before marriage. Other reasons given for FGM include protecting family honour and preserving tradition. However, it causes significant harm and is emotional and physical abuse.

FGM is illegal in the UK, as is arranging for a child to be taken abroad for FGM (whether or not it is lawful in that country). Offenders face a large fine and a prison sentence of up to 14 years. It is considered to be child abuse in the UK and is a violation of the child’s right to life, their bodily integrity and their right to health.

There are a number of situations that might indicate that a child is being prepared for FGM to take place abroad. This can include knowing both that the family belongs to a community in which FGM is practised and is making preparations for the child to take a holiday, arranging vacations or planning absence from school. The child might also talk about a special ceremony/procedure that is going to take place.

Indicators that FGM might have already occurred include prolonged absence from school or other activities with a noticeable behaviour change on return. There possibly might be some menstrual or bladder problems. Some children might find it hard to sit still and look uncomfortable, or may complain about pain between their legs, or talk of something somebody did to them that they are not allowed to talk about.

It is important to talk to the person about your concerns, using straightforward questions. Remember to be sensitive and let them know that they can talk to you again. Then consult a child protection advisor and make a referral to children’s social care or contact the police. It is then their responsibility to carry out an investigation and protect any women or girls involved. You can visit fco.gov.uk/fgm for more information.

Talk to someone you trust, for example, a teacher or a school nurse. They are here to help and protect you. Remember that no one is allowed to hurt you emotionally or physically and FGM is not allowed in the UK. You can get help and information from fco.gov.uk/fgm

It is really important to seek medical advice and help from specialist health services. Some sexual health services will be able to advise you about FGM, but in most cases they will need to refer you to a more specialised FGM clinic.

Foreign and Commonwealth Office

Website: fco.gov.uk/fgm
Telephone: 020 7008 1500

Metropolitan Police

Child Abuse Investigation
Command/Project Azure
Telephone: 020 7161 2888

Child Protection Helpline

Telephone: 0808 800 5000 (advice for adults worried about a child)

Foundation for Women’s Health Research & Development (FORWARD)

Website: forwarduk.org.uk
Telephone: 020 8960 4000

National Society for the Prevention of Cruelty to Children (NSPCC)

Website: nspcc.org.uk
Telephone: 0808 800 5000

Childline

Website: childline.org.uk
Telephone: 0800 1111 (24 hr free helpline for children)