Female genital mutilation (known as FGM for short) is a general term to describe a range of intentional damage done to healthy female genitalia, and can include circumcision, excision and infibulation. In females, circumcision may involve removing the head of the clitoris or more extensive damage.
Excision can involve removal of the clitoris, prepuce and labia minora. Infibulation, also known as pharaonic circumcision, is the more drastic procedure. It may be carried out at any age up until marriage, and can involve the amputation of the entire external genitalia. It is a particularly brutal and damaging practice often undertaken without anaesthetic, using primitive and unhygienic equipment. It may be carried out by other female family members or a traditional “circumciser” in the community. Afterwards, the vagina is stitched up, leaving a very small opening to allow passage of urine and menstrual discharge. It scars over and is left closed until marriage, at which time it is cut open to allow penetrative sex. This can take months to achieve and can be painful to the woman and man due to scar tissue which has formed.
Mutilation is a culturally acceptable and very common practise in some parts of the world, with rates of 98% in Djibouti, Guinea and Somalia. Rates of up to 90% are found in Eritrea, Mali, Sierra Leone and Sudan, and 84% in Egypt. The reasons most commonly given for it being done include, custom and tradition, religious demands, hygiene, enhancement of fertility, protection of virginity, prevention of promiscuity, and increasing the husband’s sexual pleasure.
The immediate and short term physical effects of mutilation, depending upon the extent, can result in severe pain, haemorrhage, infection, septicaemia (blood poisoning) and even death. The longer term physical effects include difficulties with sexual, reproductive and general health.
Infections of the urinary tract and pelvis may be recurrent due to the difficulties expelling body fluids. Sexual activity may be limited and difficult even in culturally approved situations due to the extent of mutilation and the scarring which occurs. Mutilation doubles the risk of maternal death during childbirth, and quadruples the chance of the child being stillborn.
In the United Kingdom, in immigrant communities from the countries where this is a common practice, it is estimated that as many as 3,000 to 4,000 new cases of mutilation of varying degrees may take place annually. Dispersal of asylum seekers throughout the country may increase the likelihood of mutilation becoming a local health issue which has to be considered. The age of mutilation in this country tends to be from 7 to 9 years.
The legal position
The World Health Organisation has made it clear that FGM is an unacceptable practice which is damaging to women and that every effort should be made to discourage it.
All female genital mutilation is illegal in the United Kingdom, the Female Genital Mutilation Act came into force on 3rd March 2004. It makes it an offence for the first time for, UK nationals or permanent UK residents to carry out female genital mutilation abroad or to aid and abet, counsel or procure, the carrying out of female genital mutilation abroad even in countries where the practice is legal.
Re-infibulation after childbirth is also illegal. If the procedure is arranged abroad and the child returned to the United Kingdom, action is likely to be taken to ensure the child’s future safety and that of other children in the family.
De-infibulation – the reversal of the procedure – is not illegal, it is in fact to be encouraged in order to prevent ongoing and further health problems.
It is understood that members of a community who accept FGM believe they are acting in the best interests of the child and efforts require to be made to dissuade the continuation of the practise.
However, if it becomes apparent that a child may be at risk of this being done then action must be undertaken to protect the child. This is likely to involve referral to Social Work Services who have a statutory duty to intervene.
If you have undergone this practice and wish to have it reversed then your doctor will arrange the specialist care that this needs. Remember, it is not illegal to have this done and your doctor will be more than happy to assist in its reversal.
If you feel you need to protect someone from this being done to them, including yourself, you can speak to your doctor, a social worker or other health counsellor who will help you. Social pressure to have the mutilation done may be overwhelming and very difficult to resist. Use the support that is available to you to protect yourself and the children affected.