Female Genital Mutilation (FGM)

What is FGM?02 (1in4-3776)

Female genital mutilation (FGM), also referred to as ‘cutting’, generally describes the partial or total removal of the external female genitalia for non-medical reasons. It is a form of abuse designed to constrain and control a woman’s sexuality. FGM is against the law.

 

FGM is a global practice and happens all over the world. Practising communities originate from parts of the Middle East, Asia and Africa. FGM is a crime in the UK. It’s also illegal to take a British national or permanent resident abroad for FGM or to help facilitate this. The maximum sentence for carrying out, or facilitating FGM is 14 years in prison. FGM is recognised internationally as a gross violation of human rights of girls and women.

How FGM might affect your body

FGM can impact on your physical health. Some of the physical consequences can include:

  • Damage to the reproductive system, including infertility
  • The increased likelihood of undergoing later surgery – in some cases, to open the lower vagina if a woman wants to engage in penetrative sexual intercourse, or chooses vaginal childbirth
  • Complications in pregnancy and during labour including increased risk of death of mother and new-born baby
  • Pain during sex and lack of pleasurable sensation
  • Persistent urinary tract infections
  • Difficulty urinating
  • Kidney damage
  • Chronic vaginal and pelvic infections
  • Odour caused by infection, retention of menstrual blood or urine leakage
  • Abnormal periods – increased pain and/or prolonged blood flow due to reduced vaginal opening

Periods

Some women experience pain during their monthly period as a result of FGM. If blood is unable to escape easily through the vaginal opening because it is closed, the uterus may try to push the blood out – which might result in pain and discomfort. If this is a problem you experience, speak to a healthcare professional who will be able to talk you through your options.

Pregnancy, childbirth and FGM

If you are pregnant and have had FGM, it is important that you tell your doctor or midwife so they can ensure you are able to give birth as safely and comfortably as possible. Unless you are having a caesarean section delivery, your vagina must be able to open in order to allow you to give birth. For some women the scar tissue they have as a result of having experienced FGM can make this difficult. Having a reduced vaginal opening may also cause complications during birth and create additional risks for you and your baby. Whilst it is possible to have a vaginal birth after having experienced FGM, you may need to have an episiotomy.

“The first time I encountered FGM was about 10 years ago with a service-user from Ethiopia. I remember she was pregnant and we were not aware of her FGM until she went to hospital. She had type 3 FGM and had problems giving birth. She had to have a caesarean. Now we ask women about FGM so that they can be prepared.’’

Mary, a Refuge staff member

Psychological consequences

FGM can have a range of psychological impacts, including:

  • Self-harm
  • Addiction – use of drugs or alcohol to try to escape thoughts and feelings associated with FGM
  • Anxiety, anger and panic attacks
  • Low self-esteem
  • Flashbacks and nightmares
  • Depression

It is both normal and understandable to experience many of the above after FGM. If you are experiencing any negative consequences as a result of FGM, please remember that you are not to blame and you are not alone.

Sex, relationships and FGM

 Many women who have experienced FGM find sex difficult. This can be for physical and/or psychological reasons. Every woman’s experience of sex after FGM is different. Some women who have experienced FGM have a positive experience of sex. Others may experience a lack of sensation, low libido (not feeling the urge to have sex), or find sex very painful. Whatever your experience, you are not alone and Refuge is here to support you.

It is important to remember that sex must be your choice. If you are unable or unwilling to have sex, your partner must respect that decision. If you are being pressured or forced to have sex please speak to your key worker, or if you are in immediate danger of sexual assault dial 999.

For some women, sex is more difficult because of the emotional – rather than the physical – impacts of FGM. Medical professionals can prescribe a range of different psychological therapies depending on your specific needs and circumstances and you can also approach your key worker about this too. Remember – a fulfilling sexual relationship is possible after FGM.

‘‘When I had sex with the man they forced me to marry it hurt. But when I met my daughter’s father, we fell in love. It hurt at first, but I loved him so much, I began to enjoy it. Before I didn’t think that would be possible.’’

Mamakoh, a Refuge service-user

You could be at risk of FGM if:

  • You have family members who have experienced FGM
  • Your partner/husband’s family has experienced FGM
  • Your family or your partner/husband’s family come from an FGM practising country
  • Family or friends are talking about a ‘special procedure’, ‘special occasion’ or ‘becoming a woman’
  • Your family is planning a long holiday
  • A female elder is coming to visit

When does it happen?

FGM is usually carried out on girls between the ages of one and 15, but younger babies, older girls and women can be victims too.

Why does FGM happen?

  • FGM is a harmful traditional practice; multiple reasons and excuses for its continuation are given. These include: to control sexuality, , hygiene reasons and to initiate a girl into adulthood
  • Although some claim FGM is carried out for religious reasons, FGM actually predates Islam, Christianity and Judaism and is not a requirement of any religion. It is also claimed that FGM is cultural and cannot be changed, FGM is a dangerous tradition, not a culture. It is a crime, and we are all responsible for stopping it

‘‘Scarification (cutting or branding designs onto the skin) used to be part of our culture in Sierra Leone but that culture changed. The culture of FGM will change too. This will not happen to my child.’’

Fatu, a Refuge service-user

How is Refuge helping to support women who experience FGM?

We have been providing expert specialist support to survivors of FGM in our refuges and outreach services for many years. As well as providing services to women, we are raising awareness amongst professionals working in communities. We are also taking the voices of the women and children we support to the policy tables. Alongside these services, we run awareness-raising programmes of work for professionals who support women affected by FGM. We also campaign for the eradication of FGM, by lobbying the Government and taking the voices of the women and children we support to the policy tables. Click here to read our most recent consultation on FGM and mandatory reporting.

Get help

If you feel you may be at risk of, or have experienced, FGM, Refuge is here to support you. There are also other ways to access help:

  • If you or someone you know is at immediate risk of harm dial 999 immediately
  • If you are abroad and require help or advice or you are worried about being taken abroad call the Foreign and Commonwealth Office on +44 (0) 20 7008 1500
  • If you believe a child is at risk please contact your local Children’s Social Care or the Police
  • To report crime anonymously contact Crimestoppers on 0800 555 111
  • If you need information or support: NSPCC FGM helpline 0800 028 3550 or email fgmhelp@nspcc.org.uk; Forward +44 (0)20 8960 4000 or email forward@forwarduk.org.uk; Iranian and Kurdish Women’s Rights Organisation +44 (0)207 920 6460
  • If you have experienced FGM and require medical attention speak to your GP or local NHS specialist FGM clinic directly
  • If you need a safe place to stay call the Freephone 24-Hour National Domestic Violence Helpline (run by Refuge and Women’s Aid) on 0808 2000 247
  • If you are abroad and require help or advice, or you are worried about being taken abroad, call the Foreign and Commonwealth office on +44 (0) 20 7008 1500 (available 24 hours)

“I hadn’t considered my FGM until my key worker helped me to increase my knowledge and referred me to a specialist doctor. Through Refuge, I’ve been able to escape my situation and have been supported to get my life back on track.”

Julie, a Refuge service-user

Source: FGM booklet created by Refuge, in partnership with Rosa, the UK fund for women and girls