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FGM

(This information is produced by the MKSCB)

  1. Definition
1.1 Female genital mutilation (FGM) is a collective term for procedures which include the removal of part / all external female genitalia for cultural or other non-therapeutic reasons. Please also see  the Government Equalities Office factsheet on Female Genital Mutilation.
1.2 The practice is not required by any major religion and is medically unnecessary, painful and has serious health consequences at the time it is carried out and in later life.
1.3 The procedure is typically performed on girls aged between 4 and 13, but is also performed on new born infants and on young women before marriage / pregnancy. A number of girls die as a direct result of the procedure, from blood loss or infection.
1.4 Girls are genitally mutilated illegally by doctors or traditional health workers in the UK, or sent abroad for the operation.
  1. Law
2.1 Female genital mutilation is illegal in this country (under the Female Genital Mutilation Act 2003) except on specific physical and mental health grounds.
2.2 It is an offence to:

  • Undertake the operation (except in specific physical or mental health grounds);
  • Assist a girl to mutilate her own genitalia;
  • Assist a non-UK person to undertake FGM of a UK national outside UK (except in specific physical or mental health grounds);
  • Assist a UK national or permanent UK resident to undertake FGM of a UK national outside the UK (except in specific physical or mental health grounds).
  1. Recognition
3.1 Any medical provision for a pregnant woman who has herself been the subject of female genital mutilation provides the opportunity for recognition of risk and preventative work with parents.
3.2 A child may be considered at risk if it is known older girls in the family have been subject to the procedure. Pre-pubescent girls 7 to 10 are at highest risk, though the practice has been reported amongst babies.
3.3 Suspicions may arise if a family is known to belong to a community in which FGM is practiced and is making preparations for the child to take a holiday, arranging vaccinations or planning school absence and the child may refer to a ‘special procedure’ taking place.
3.4 Indications that FGM may have already occurred include:

  • Prolonged school absence with noticeable behaviour change on return;
  • Bladder and menstrual problems;
  • Reluctance to receive medical attention or participate in sport.
  1. Response
4.1 Any suspicion of intended or actual FGM must be referred to Children’s Social Care, in accordance with the Referral and Assessment Procedure.
4.2 Children’s Social Care, must inform the police CAIU at the earliest opportunity and convene a Strategy Meeting within 2 working days if:

  • There is suspicion that a girl or young woman, under the age of eighteen, is at risk of undergoing this procedure;
  • It is believed that a girl or young woman is at risk of being sent abroad for that purpose; or
  • There are indications that a girl or young woman has suffered mutilation.
4.3 A service manager who has attended female genital mutilation training or a child protection adviser / senior manager should chair the Strategy Meeting. Health providers or voluntary organisations with specific expertise should be invited. A legal advisor should be invited or consulted prior to the meeting on the options, which could be considered to protect a child.
4.4 In planning any intervention it is important to consider the significance of cultural factors. FGM is generally performed because of the significance it has in terms of cultural identity. Any intervention is more likely to be successful if it involves workers from, or with a detailed knowledge of, the community concerned.
4.5 Under the Children Act 1989, possible legal proceedings could include a Prohibited Steps Order (s. 8) with or without a Supervision Order (s.35). Removal from home should be considered only as a last resort.
4.6 If the child has already suffered female genital mutilation the meeting will need to consider carefully whether to continue enquiries or whether to assess the need for support services.
4.7 Female genital mutilation is a one-off event of physical abuse (albeit one that may have grave permanent sexual, physical, and emotional consequences), not an act of repeated abuse and organisational responses need to recognise this.
4.8 A 2nd strategy meeting should take place within 10 working days of the first meeting, with the same chair. This meeting must evaluate the information collected in the enquiry and recommend whether a child protection conference is necessary.
4.9 A girl who has already been genitally mutilated should not normally be the subject of a conference or the subject of a protection plan unless additional concerns exist, though she should be offered counselling and medical help. Consideration must however be given to any other female siblings at risk.

Child Protection Conference
4.10 A girl believed to be in danger of FGM may be made the subject of a Child Protection Plan, under the category of risk of Physical Abuse, if the criteria are applicable including the need for the future protection of the child.
4.11 The main emphasis of work in cases of actual or threatened FGM should be through education and persuasion. This approach will be reflected in the Child Protection Plan.
  1. Prevention
5.1 Agencies should work together to promote a better understanding of the damaging consequences to health (physical and psychological) of FGM.
5.2 Wherever possible the aim must be to work in partnership with parents and families to protect children through parents’ awareness of the harm caused to the child.
  1. NHS Actions
With effect from April 2014 NHS hospitals will be required to record the following information:

  • If a patient has had Female Genital Mutilation;
  • If there is a family history of Female Genital Mutilation;
  • If a Female Genital Mutilation-related procedure has been carried out on a patient.
By September 2014 all acute hospitals must report this data centrally to the Department of Health on a monthly basis. This is the first stage of a wider ranging programme of work in development to improve the way in which the NHS will respond to the health needs of girls and women who have suffered Female Genital Mutilation and actively support prevention.

For further information, see Information Standards Board for Health and Social Care, Female Genital Mutilation Prevalence Dataset Standard Specification.

  1. Further Advice
7.1 FGM Helpline

In June 2013, a new helpline was launched, with the aim of protecting children in the UK from FGM. The helpline is open 24 hours a day and can be contacted, by telephone on 0800 028 3550 or by emailing fgmhelp@nspcc.org.uk. The service, which is anonymous, offers support to anyone who has been a victim of FGM or who is worried about a child, For more details please see the NSPCC FGM Helpline website

7.2 Other useful contacts are:

  • Foundation for Women’s Health, Research & Development,
    6th Floor
    50 Eastbourne Terrace,
    London
    W2 6LX

    Tel: 0207 725 2606
    Website: FORWARD

  • The African Well Woman Clinic at Central

University College Hospital, London.

RELATED GUIDANCE

Female Genital Mutilation Resource Pack (HM Government, July 2014) which highlights effective practice from local authorities and partner agencies in tackling FGM.

Female Genital Mutilation Factsheet, NSPCC (2014)

On 27 July 2014, the government announced a series of measures to tackle FGM. (For more information see New measures to tackle female genital mutilation and forced marriage announced at today’s Girl Summit).

Friday 6th February 2015 marked the International Day of Zero Tolerance of FGM (Female Genital Mutilation).