Female genital mutilation (FGM) is a procedure where the female genitals are deliberately cut, injured or changed, but where there's no medical reason for this to be done.
It's also known as "female circumcision" or "cutting", and by other terms such as sunna, gudniin, halalays, tahur, megrez and khitan, among others.
FGM is usually carried out on young girls between infancy and the age of 15, most commonly before puberty starts. It's illegal in the UK and is child abuse.
It's very painful and can seriously harm the health of women and girls. It can also cause long-term problems with sex, childbirth and mental health.
Help and support is available if you've had FGM or you're worried that someone may be at risk.
Types of FGM
There are four 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 (lips that surround the vagina), with or without removal of the labia majora (larger outer lips)
- type 3 (infibulation) – narrowing of the vaginal opening by creating a seal, formed by cutting and repositioning the labia
- other harmful procedures to the female genitals, including pricking, piercing, cutting, scraping or burning the area
FGM is often performed by traditional circumcisers or cutters who don't have any medical training. However, in some countries, it may be done by a medical professional.
Anaesthetics and antiseptics aren't generally used, and FGM is often carried out using knives, scissors, scalpels, pieces of glass or razor blades.
FGM often happens against a girl's will without her consent and girls may have to be forcibly restrained.
Effects of FGM
There are no health benefits to FGM and it can cause serious harm, including:
- constant pain
- repeated infections, which can lead to infertility
- bleeding, cysts and abscesses
- problems passing urine or incontinence
- depression, flashbacks and self-harm
- pain and/or difficulty having sex
- problems during labour and childbirth, which can be life-threatening for mother and baby
Some girls die from blood loss or infection as a direct result of the procedure.
FGM and sex
FGM can make it difficult and painful to have sex. It can also result in reduced sexual desire and a lack of pleasurable sensation.
Talk to your doctor or another healthcare professional if you have sexual problems that you feel may be due to FGM, as they can refer you to a special therapist who can help.
In some cases, a surgical procedure called a deinfibulation (see below) may be recommended, which can alleviate and improve some symptoms.
FGM and pregnancy
Some women with FGM may find it difficult to become pregnant, and those who do conceive can have problems in childbirth.
If you're expecting a baby, your midwife should ask you at your antenatal appointment if you've had FGM. It's important to tell your midwife if you think this has happened to you, so they can arrange appropriate care for you and your baby.
FGM and mental health
FGM can be an extremely traumatic experience that can cause emotional difficulties throughout life, including;
- flashbacks to the time of the cutting
- nightmares and other sleep problems
In some cases, women may not remember having the FGM at all, especially if it was performed when they were an infant.
Talk to your doctor or another healthcare professional if you're experiencing emotional or mental health problems that may be a result of FGM. Help and support is available.
Treatment for FGM (deinfibulation)
Surgery can be performed to open up the vagina, if necessary. This is called deinfibulation.
It's sometimes known as a "reversal" although this name is misleading, as the procedure doesn’t replace any removed tissue, and will not undo the damage caused. However, it can help many problems caused by FGM.
Surgery may be recommended for:
- women who are unable to have sex or have difficulty passing urine as a result of FGM
- pregnant women at risk of problems during labour or delivery as a result of FGM
Deinfibulation should be carried out before getting pregnant, if possible. It can be done in pregnancy or labour if necessary, but ideally should be done before the last 2 months of pregnancy. The surgery involves making a cut (incision) to open the scar tissue over the entrance to the vagina.
It's usually performed under local anaesthetic in a clinic and you won't normally need to stay overnight. A small number of women need either a general anaesthetic or spinal anaesthetic (injection in the back), which may involve a short stay in hospital.
Getting help and support
All women and girls have the right to control what happens to their bodies and the right to say no to FGM.
Help is available if you've had FGM or you're worried that you or someone you know is at risk.
- if someone is in immediate danger, contact the police immediately
- if you're concerned that someone may be at risk, contact the NSPCC helpline on 0800 028 3550 or firstname.lastname@example.org
- if you're under pressure to have FGM performed on your daughter, ask your doctor, health visitor or other healthcare professional for help, or contact the NSPCC helpline.
- if you've had FGM , you can get help from a specialist NHS gynaecologist or FGM service – ask your doctor, midwife or any other healthcare professional about services in your area
If you're a health professional caring for a patient under 18 who has undergone FGM, you have professional responsibilities to safeguard and protect her. Guidance and resources about FGM for healthcare staff are available on the GOV.UK website.
Why FGM is carried out
FGM is carried out for various cultural, religious and social reasons within families and communities in the mistaken belief that it will benefit the girl in some way (for example, as a preparation for marriage or to preserve her virginity).
However, there are no acceptable reasons that justify FGM. It's a harmful practice that isn't required by any religion and there are no religious texts that say it should be done. There are no health benefits of FGM.
FGM usually happens to girls whose mothers, grandmothers or extended female family members have had FGM themselves or if their father comes from a community where it's carried out.
Where FGM is carried out
Girls are sometimes taken abroad for FGM, but they may not be aware that this is the reason for their travel. Girls are more at risk of FGM being carried out during the summer holidays, as this allows more time for them to "heal" before they return to school.
Communities that perform FGM are found in many parts of Africa, the Middle East and Asia. Girls who were born in the UK or are resident here but whose families originate from an FGM practising community are at greater risk of FGM happening to them.
Communities at particular risk of FGM in the UK originate from:
- Ivory Coast
- Sierra Leone
The law and FGM
FGM is illegal in the UK.
It is an offence to:
- perform FGM (including taking a child abroad for FGM)
- help a girl perform FGM on herself in or outside the UK
- help anyone perform FGM in the UK
- help anyone perform FGM outside the UK on a UK national or resident
- fail to protect a girl for whom you are responsible from FGM
Anyone who performs FGM can face up to 14 years in prison. Anyone found guilty of failing to protect a girl from FGM can face up to 7 years in prison.