The National Female Genital Mutilation Centre (NFGMC) aims to achieve a system change in the provision of services for children and families who are affected by Female Genital Mutilation (FGM) and Harmful Practices (HPs), including breast ironing and flattening, and child abuse linked to faith or belief. \nThe NFGMC project was funded as part of the Department for Education’s Children’s Social Care Innovation Programme to develop a system change in how local authorities respond to cases of FGM. The Tilda Goldberg Centre for Social Work and Social Care undertook the Round 2 mixed methods evaluation.
Female genital mutilation (FGM) remains a critical public health issue and a violation of the fundamental human rights of women and girls, particularly in Africa, where its prevalence is highest. This study examines the prevalence, distribution, and determinants of FGM across the African continent to provide a comprehensive understanding of the factors sustaining the practice. A systematic review approach was adopted, utilizing secondary data from peer-reviewed journal articles, demographic surveys, and institutional reports published between 2012 and 2025. Relevant studies were sourced from databases such as PubMed, Scopus, and Google Scholar using clearly defined inclusion and exclusion criteria. The findings reveal that FGM prevalence in Africa remains alarmingly high, with pooled estimates exceeding 50% in several regions. However, the practice varies significantly across countries and communities, reflecting diverse cultural, social, and economic contexts. Key determinants identified include low levels of education, poverty, rural residence, and deeply rooted cultural and religious beliefs. Social pressure and intergenerational transmission also play a major role in perpetuating the practice. Although there is evidence of a gradual decline in prevalence among younger generations, progress remains uneven and insufficient to meet global eradication targets. Population growth further contributes to the increasing number of affected individuals despite relative percentage declines. The study concludes that FGM is sustained by complex sociocultural and structural factors that require holistic, context-specific interventions. Efforts to eliminate the practice must go beyond legislation to include education, community engagement, and women’s empowerment initiatives.
Female genital mutilation/cutting (FGM/C) is a dangerous practice that predates all religions and perpetrated on children for various reasons in various cultural and global contexts, causing adverse lifelong health consequences including sexual, physical and psychological problems for the survivors. Even so, there appears to be no documented work that brings together the major conceptual blocks on FGM/C, a gap this paper seeks to begin to fill. This paper summarises some major concepts on FGM/C as a resource and evaluates key evidence on the practice. While the practice of FGM/C is highly concentrated in Africa, the practice is spread out globally with a shift towards its medicalization among migrant communities and traditional settings. A focus of this paper is to propagate awareness and polarise debates to bring to an end to the practice of FGM/C globally.
This article reflects on the author’s experiences as a midwife in a super-diverse inner-city team, providing care to women affected by female genital mutilation (FGM). Since qualifying in 2008, the author has learned to navigate the sensitive and complex subject of FGM through personal reflection, education and improved communication. FGM, deeply rooted in cultural traditions, is illegal in the UK but continues in many countries. The article explores the legal context, the cultural significance of FGM, and the challenges healthcare providers face in addressing it. It emphasises the need for culturally sensitive, empathetic care, and highlights the benefits of continuity of care to ensure safer outcomes for affected women and their children.
My interest in Female Genital Mutilation (FGM) began a few years ago.My mother and I 'retraced our roots', and spent some time in the villages of Albreda and Juffureh in The Gambia, West Africa.There was singing, dancing and the drinking up of our newly re-acquainted culture.Amongst the sound of drums and singing voices, we experienced beautifully executed rhythmic movements and I saw two men appear dressed in elaborate frightening costumes brandishing menacing knives.We learnt later that day, that the men in costume were in fact Bondo Devils who play a role in ceremony surrounding the circumcision of young girls.I asked why, how can this happen, how do the women live without an important part of their physical selves?Dr Beatrice Allegranti, a writer on the topic of embodied feminism remarked, 'we re-shape and re-configure our gendered sexual selves during adolescence'.I was curious, what does this mean for the young women who have had part of their sexuality removed, forever unable to experience an important, transforming part of their emotional and physical journeys into womanhood.I was also aware that day, that the experience of female circumcision could have been mine, if not for my ancestors' forced migration, decisions would have been made about how I would forever experience my body without my consent.As a psychotherapist specialising in dance and embodiment, I wanted to ask a question 'Is it possible for women who have undergone female genital mutilation in the UK to gain healing through embodiment and dance when faced with anxiety and depression?' Fran Hosken conceived the term Female Genital Mutilation in 1976 and she was somewhat of a driving force in encouraging western feminists to speak out about the practice of FGM, which perpetrated gendered violence against womxden and girls.Feminism is a political movement that acknowledges the personal as political and what could be more personal than our own bodies.With Ellen Johnson Sirleaf, the former president of Liberia banning FGM on her last day in office in 2017, and politicians in several African countries taking an interest in the practice of FGM, it is also now a political concern, in the sense of governmental policies politics (The Female Genital Mutilation: Dancing through Carol Victoria Jaffier
Medicalisation of female genital mutilation is a troubling development that hinders efforts to abandon the practice, jeopardising the wellbeing of girls and women, write Samuel Kimani and colleagues
Samuel Thuo Kimani, Hazel Rose Barrett, Jacinta Muteshi-Strachan
Despite more than 40 y of discussion and debate regarding female genital mutilation/cutting (FGM/C), this topic remains controversial and emotive, and the practice continues. FGM/C is defined as ‘all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs, whether for cultural or other non-therapeutic reasons’.1 There are four main classifications of FGM/C (Table 1).1 Type III, or ‘infibulation’, is the most severe form and accounts for 10% of cases.2 It is estimated that more than 200 million girls and women worldwide are living with the effects of FGM/C.2 Of these, 44 million are <15 y of age.2 FGM/C is practised mainly in Africa, with the highest prevalence in Somalia, Egypt, Mali and Sudan, where more than 80% of all women between 15 and 49 y of age have undergone FGM/C.2,3 However, FGM/C is also prevalent in other settings including the Middle East, India and Indonesia. The specific type of FGM/C varies within and between countries.4 Classifications of female genital mutilation/cutting1 Classifications of female genital mutilation/cutting1 FGM/C offers no health benefit and causes serious immediate and long-term physical, psychological and sexual harm, including chronic pain, recurrent urinary and vaginal infections, post-traumatic stress and severe pain during sexual intercourse.5 The immediate effects of FGM/C (significant pain and heavy bleeding) recur and are often exacerbated during and after childbirth, especially in women with type III FGM/C.5 FGM/C reflects deep-rooted inequality and constitutes an extreme form of discrimination against women.1 FGM/C is often performed on young girls (before the age of 5 y) and is therefore also a violation of the rights of the child.1–3 FGM/C interferes with normal healthy female genital tissue and sexuality, and is a violation of every girl’s and woman’s right to the highest attainable standard of health.1 Furthermore, FGM/C violates the rights to health, security and physical integrity of girls and women; the right to be free from torture, cruelty and inhuman or degrading treatment and violates the right to life when the procedure results in death.1–3 There are significant social, cultural, traditional and/or religious aspects to consider regarding the practice of FGM/C.6,7 A variety of social and cultural reasons for continuing with FGM/C are reported, including female cleanliness, cultural identity, protection of virginity, prevention of immorality, better marriage prospects, greater pleasure for the husband and improvement of fertility.1,6,7 FGM/C is also often seen as a necessary ritual for initiation into womanhood and is linked to cultural ideals of femininity and modesty.1–3 FGM/C is often believed to reduce a woman’s libido and this is considered to help her resist ‘illicit’ sexual intercourse.1,3 All of these reasons are non-evidence-based. Family pressure to conform to traditional practice is another strong motivation to continue with the practice, and women who depart from the societal norm may face condemnation, harassment and rejection.1 No religious scripts prescribe the practice of FGM/C, although there are variations in how different religious leaders regard FGM/C; some promote it, some consider it irrelevant to religion and others advocate actively for its elimination. This is exemplified by Somalia, a country with a previously reported prevalence of FGM/C of 98%, where respected religious leaders have worked in partnership with community groups to create awareness and openness for discussion, thereby educating the community and ultimately reducing the number of girls and young women suffering FGM/C.3 It is well recognized that local community and religious leaders have pivotal roles and opportunities to either influence change and to help change attitudes and understanding or, conversely, to contribute to and support continuation of the practice of FGM/C.3,4 The international community’s position is that FGM/C violates the choice of a young girl or woman regarding her sexual and reproductive health (Table 2).1 The first joint statement specifically addressing FGM/C was issued by the World Health Organization (WHO) in 1997 in conjunction with the United Nations Children’s Fund (UNICEF) and the United Nations Population Fund (UNFPA).4 Since that time the international response has gained momentum. In 2008, the WHO, together with nine other UN partners, demonstrated increased support for the abandonment of FGM/C across the world.1 A key document was developed with evidence collected over the previous decade regarding FGM/C. The 2008 document highlighted human rights and the legal dimensions of FGM/C, and provided more comprehensive data on the prevalence of FGM/C.1 Research regarding the damaging effects of FGM/C on the reproductive and sexual health of girls and young women, and the reasons why FGM/C continues was reported and recommendations for the eradication of FGM/C were made. In 2010, the WHO, in collaboration with the other key UN agencies and international organizations, published a document entitled ‘Global strategy to stop health care providers from performing female genital mutilation’.8 This was followed by action in 2013 when the UN General Assembly adopted a resolution on the elimination of FGM/C.9 This progress was the culmination of efforts of many organizations working together to bring attention to this harmful practice over a long period of time. The UNICEF report in 2013 highlighted that before the intervention of international agencies, there were already well-established local and regional campaigns in Egypt, Burkina Faso, Kenya and Senegal, where organizations were working with religious, political, women’s groups and the medical professional to raise awareness and to advocate for the eradication of the practice of FGM/C.10 Timeline of key international policy drivers Timeline of key international policy drivers The 2008 World Health Assembly resolution emphasized the need for concerted action in all sectors of health, education, finance, justice and women’s affairs, with recommendations that focus on strengthening the health sector response, including guidelines, training and policies to ensure that all health professionals can provide medical care and counselling to girls and women living with FGM/C; building evidence, including generating knowledge and accurate data regarding the prevalence, types, causes and consequences of the practice; and increasing advocacy, including developing publications and advocacy tools for international, regional and local efforts to end FGM/C within a generation.11 Since 1997, great efforts have been made to eradicate FGM/C through culturally sensitive research, the engagement of communities and changes in public policy.4 Progress to stop FGM/C has been made possible because of the establishment of international monitoring bodies, agreements on resolutions that condemn the practice, revised legal frameworks and growing political support to end FGM/C. Of the 29 countries where FGM/C is most prevalent, 24 governments have enacted laws against continuation of the practice. For example, the governments of South Africa and Zambia have banned the practice. In line with this, professional associations such as the International Federation of Obstetricians and Gynaecologists, the International Confederation of Midwives, the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives in the UK condemn the practice of FGM/C and are vocal in calling on all professional associations worldwide to oppose the practice.12 As a result of international combined efforts and legal frameworks being put in place in many countries, an ever-increasing number of women and men in practising communities support eradication of the practice of FGM/C and the overall prevalence is decreasing. However, progress in the eradication of FGM/C is too slow. Challenges include the implementation of recommendations and enforcement of the legal frameworks regarding FGM/C. For example, in Sudan, FGM/C type III was banned in 1946, but continues to be practised, and there have not been any successful prosecutions. Furthermore, there is international concern regarding an increasing trend of medically trained personnel being asked to perform FGM/C.1,5 For example, in Malaysia, FGM/C is carried out legally by health care providers in hospitals. Some health care providers consider the medicalization of FGM/C as a harm-reduction strategy and support the notion that with this approach, some of the risks associated with immediate health complications are reduced and ‘less damage’ is done.1,3 However, this practice is unacceptable, contravenes the essence of the Hippocratic Oath and is against the ethical framework of health care of ‘do no harm’.1,5 More recently, there has been a shift in emphasis from considering FGM/C as a purely health-related issue to adopting a more holistic approach in which the role and sexual and reproductive rights of women in societies are addressed.1,5 However, some communities continue to argue that FGM/C is a traditional and cultural practice and that Western countries should not impose their ‘imperialist’ and ‘colonialist’ views on this long-standing custom.13,14 Increased media coverage and statements by ministers, religious leaders, faith-based groups, celebrities and non-governmental organizations have led to more discussion of the topic both at the international level and in countries where FGM/C is prevalent. However, there is an ongoing need for a stronger coordinated and combined approach in which societal opinion and norms are challenged, community awareness and engagement are mobilized and legal, and medical frameworks supporting eradication are in place and proactively implemented. Often as countries develop and diversify from within, cultural practices do change and there is a realization that condoning acts that contravene human rights has no place within any moral or ethical framework.13,14 Accurate data regarding FGM/C are lacking and greater efforts should be made to address this. Finally, any campaigns or interventions that aim to eradicate FGM/C should be medium to long term (at least 5 y) and should include clear methodologies for implementation and evaluation of the effectiveness (or not) of such interventions to better inform public policy. The eradication of FGM/C can only be achieved through a strong and coordinated approach implemented at local, regional, national and international levels. Supportive education and targeted training are recommended to enable all stakeholders to sensitively and respectfully address this complex and long-standing practice. Health care providers have a duty of care and are in many ways uniquely positioned to support the eradication of FGM/C. It is crucial that all healthcare providers are aware of and meet the requirements of the ethical and legal frameworks that are currently in place to support the eradication of FGM/C. This includes continued promotion of community understanding and objection to FGM/C as a practice that is contrary to human rights, including the right to physical as well as reproductive and sexual health for women. Authors’ contributions: Both authors contributed equally to the writing and drafting of this manuscript. Acknowledgements: The authors would like to thank Jaki Lambert for her contribution to the initial development of this research. Funding: None. Competing interests: None declared. Ethical approval: Not required.
Purpose The purpose of this paper is to explore the perceptions of and barriers to reporting female genital mutilation (FGM) by victims and survivors of FGM to the police in England and Wales. Design/methodology/approach The paper is based on 14 interviews conducted with adult survivors and victims of FGM. A combination of 1:1 and group interviews were used, based on the preference of the respondents. Respondents were recruited in collaboration with specialist non-governmental organisations and major stakeholders in the area of honour-based violence and black and minority ethnic communities. Findings A key finding in this research was that all victims/survivors the authors interviewed stated that they did not support the practice of FGM, and that they would not follow it for younger women in their own family. Second, the authors found that none of the respondents had reported their experience to the police. Third, they identified key barriers to reporting, which included: their belief that reporting their own experience would not serve any purpose because they had experienced FGM as children, and in another country; and that they did not feel able to report new incidents of FGM in the community because of a lack of trust in the police due to previous negative experiences. Finally, they believed that FGM could be prevented only by work within the community, and not through engagement with the criminal justice system. Originality/value This is, to our knowledge, one of the first papers that is based on victims and survivors’ perceptions that explores barriers to reporting cases of FGM to the police, and offers levers for change.
Geetanjali Gangoli, Aisha K. Gill, Natasha Mulvihill et al.
In many parts of the world, women have made less progress toward gender equality. They face barriers to enter various arenas of growth and development. One of those barriers is Female Genital Mutilation (FGM), which refer to cutting the external female genitalia for any nonmedical reason. The practice is prevalent in some majority Muslim countries and has a tremendous cost: many girls bleed to death or die of infection, most are traumatized. Those who survive can suffer adverse health effects during marriage and pregnancy. According to the World Health Organization, FGM has been documented in 30 countries, mainly in Africa, Middle East and Asia. There is a stereotype that FGM happens just on the African continent, but it’s actually part of the birthing procedure in regions all around the world. The study shows that FGM might be a phenomenon of epidemic proportions in the Arab Middle East and Arab governments refuse to address the problem. UNICEF reports that the practice also occurs to a limited degree in Jordan, Gaza, Oman, and Iraqi Kurdistan. This fall, a United States district judge heard a landmark case. For the first time, the federal government pursued a case of female genital mutilation on American soil. In India, for long, FGM or khatna as the Bohras call it remained a well-kept secret, a subject never to be discussed. But now a few women, victims at the hands of the Bohra tradition, are choosing to speak out and create awareness. FGM violates human rights conventions that protect women and children from cruelty and violence and ensure them "bodily integrity" and access to health care, education, and self-realization.
Female genital mutilation (FGM) includes procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons. To present a case of type III FGM corrected by de-infibulation for treatment of sexual dysfunction. A 31-year-old woman who had FGM reporting unconsummated marriage presented to our clinic clinic. The patient had undergone type III FGM at age 7 in her country. Surgical correction was performed. By de-infibulation, the vaginal and urethral orifices were revealed after incision of scar tissue. The World Health Organization classifies FGM in four types. Type III FGM is narrowing of the vaginal orifice with the creation of a covering seal by cutting and appositioning the labia minora and/or the labia majora, with or without excision of the clitoris (infibulation). De-infibulation surgery is recommended for resolving problems related with sexual dysfunction and child-birth.
