FGM Aware talk FGM | Jan Macleod, FGM Aware

Tuesday 06 February was International Day of Zero Tolerance for Female Genital Mutilation. After speaking to the NSPCC to get a sense of what FGM is we caught up with Jan Macleod, who works on FGM Aware with the Women’s Support Network to get a bit more insight into the issue.

Just to recap, how would you define Female Genital Mutilation?
Female Genital Mutilation (FGM) comprises all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons. FGM is recognised as a harmful traditional practice which is a serious child protection issue and a breach of human rights.

The World Health Organisation outlines 3 main types of FGM, plus ‘type 4’ which is a variety of different harmful practices.

FGM has no health benefits whatsoever. Type 3 FGM is often most associated with ongoing health problems and childbirth difficulties, but all forms of FGM are wrong and are against the law throughout the UK.

Who does FGM happen to?
FGM is carried out by communities for different stated reasons on girls. It may be carried out at any point from birth to young adulthood or eve of marriage.  The underlying beliefs about the practice will impact on the age at which it is carried out.  For example in cultures where FGM is seen as part of the ritual surrounding entry to adulthood, girls will be cut around puberty.

Where does it happen?
FGM is now an issue for all countries as a result of migration, but it is traditionally concentrated in Africa and the Middle East.  Somalia, Guinea, Djibouti and Egypt are believed to have a prevalence rate of over 90%. In recent years there is a growing awareness of FGM also being carried out in parts of Indonesia, Malaysia, South America and India.

So why should it be on everyone’s radar?
FGM is now an issue for the UK and Europe as a result of migration.  It is important that everyone is aware of this issue so that we can take appropriate action to protect girls at risk and to support those who have experienced FGM.

Is there a correlation between areas with a higher proportion of ethnic minorities and FGM occurrences?
Girls are generally viewed as being at risk if either of their parents come from a family which has traditionally practised FGM, so it follows that the risk of FGM is linked to numbers of people from communities which potentially practice FGM.  It should be remembered though that many individuals and parents no longer support the practice and that the worldwide movement to end FGM has been led by grassroots activists from communities affected by FGM.

But if FGM is so bad, why does it happen? Is it to do with religion or culture? Is it something which is imposed by the men of the household?
The motivations for FGM vary between different ethnic groups and are many and varied, including:

• Preservation of virginity and chastity
• Religion, in the mistaken belief that it is a religious requirement
• Fear of social exclusion
• To ensure the girl is marriageable or to improve marriage prospect
• Hygiene and cleanliness
• Increasing sexual pleasure for the male
• Enhancing fertility
• Family honour
• Social acceptance

It should be stressed that parents do not arrange FGM to be cruel; rather this is seen as good parenting in the context, something that is part of giving your daughter the best start in life.

The overarching reason for FGM is to control women’s sexuality, limit their sexual choices and pleasure and so preserve their honour and the family honour. In many cultures it is the older women in the family who take responsibility for ensuring that FGM is carried out.

What kinds of issues does FGM cause for women and girls?
There is a wide range of possible impacts – not all women will experience all of these. Some women have no health issues associated with the FGM. Some women may not be aware of the extent of what has happened to them, or in the case of girls who were cut shortly after birth, they may not realise that anything has happened.

The short-term health impacts of FGM will vary depending on the type and the conditions in which it is carried out, but may include:

• severe pain and shock
• infection
• injury to adjacent tissues
• sprains, dislocations, broken bones or internal injuries from being restrained
• immediate fatal hemorrhaging
• Infection by blood borne virus

Signs that a girl has recently experienced FGM night include withdrawal, pain urinating, taking a long time to urinate, bleeding and infection.

Long-term health impacts differ depending on type, but can include:

• urine retention and difficulties in menstruation
• uterus, vaginal and pelvic infections
• cysts and neuromas
• complications in pregnancy and childbirth
• increased risk of fistula
• on-going impact of trauma / PTSD

Negative impacts can include additional psycho-sexual and psychological issues and also social consequences such as estrangement from parents / family, and relationship or marriage breakdown.

So how do you normally find out about FGM in the UK?
Family and community members are most likely to know if a parent in the UK is planning to arrange FGM for their daughter, whether by bringing a ‘cutter’ to the UK or by taking their daughter to the home country. This is why empowering communities and community engagement is the key to long terms prevention and an end to FGM.  Members of staff such as midwives, health visitors, teachers, youth workers and GP’s should all be aware of the possibility of FGM and should follow child protection procedures should they suspect a girl is at risk, or that FGM has been carried out.

Currently there have been no UK convictions for FGM, and only one unsuccessful prosecution to date, when a doctor was charged with re-infibulating a woman following childbirth (closing the vagina as found in type 3 FGM). Whilst there are many anecdotal accounts of girls being cut in the UK or taken abroad for FGM, there are very few police referrals.  The UK and Scottish Governments have recognised the need for more action to engage with communities and protect girls at risk.

What can the average person do to help prevent FGM?
We can all inform ourselves about FGM and share this information with others.  It is particularly important that people who are recently settled in the UK are made aware of the law on FGM and of the services, including health services, which are available for girls and women affected.

It is also helpful to support the local and international organisations working to end FGM and support those affected and this can be done by both donating and volunteering as appropriate.  Women who have difficulty giving birth may develop fistulas, so a donation to a fistula charity in Africa can make a big difference.

Have you witnessed an increase/decrease with number of FGM cases in the last 5 years?
Referrals for FGM have increased slightly over the past 6 or so years, in response to public education, increased media coverage and the introduction of mandatory reporting of FGM in under 18-year-olds by health and social care professionals in England and Wales.

Is there anything you’ve discovered which you think would surprise people?
FGM is a complex issue and I’ve often found myself surprised during my own learning.

I read about a Maasai woman who had refused to let her daughter attend the ceremony where the girls were cut.  When the time for the ceremony came round again a couple of years later the daughter begged her mother to let her be cut.  This really surprised me but on reading further I realised that the girl’s life had basically just stopped. Her friends were now regarded as women whilst she was still seen as a girl.  She had to leave school.  People said she was unclean and wouldn’t let her eat with others.  People said that no man would marry her. That account really made me realise that when FGM is normalised then the consequences of not carrying out FGM can have a very negative impact on the girls as well.

In Scotland I find that many people are surprised to hear that some Christian families carry out FGM, and also to hear that FGM was used in the UK and US to ‘treat’ women with certain conditions as recently as the 1950’s.

What’s the most common misconception you’ve come across?
Perhaps the most common misconception is that FGM is required by certain religions.  In fact FGM is carried out by some branches of a number of religions, but predates both Islam and Christianity and is not required or condoned by any faith.

Surely every day should be a day of zero tolerance to FGM, what is the specific goal of 06 February?
I think that the International Day helps to remind people of the issue and is a focus for activity.  It can be particularly helpful in areas where the numbers at risk are very low but it is nevertheless important to keep the issue on the agenda.

What is FGM Aware?
FGM Aware is an initiative developed and coordinated by the Women’s Support Project to raise awareness about Female Genital Mutilation. Activities include training, public education and community engagement. FGM Aware works in partnership with community organisations and statutory services to help prevent FGM and to improve services to girls and women at risk or affected by FGM. The website provides resources which are aimed at practitioners and services who are in touch with communities potentially affected by FGM.

More information
If you are in the UK and are worried that FGM may happen to you or someone that you know, you can speak to a teacher, doctor, school nurse, social worker, police officer or any health, educational or social care professional. They will be able to help and support you. If it is an urgent situation then call 999 and ask for the police.

You could also call the NSPCC on 0800 028 3550.  This is a 24-hour free helpline for anyone concerned about girls or women at risk of FGM. Or you could contact Childline on the free phone number 0800 1111.

If you are abroad and require help or advice call the Foreign and Commonwealth Office on +44 (0)20 7008 1500 or contact the British High Commission or Embassy in the country you are visiting.

Midwives and health visitors can be a key source of support and information for women survivors of FGM. There are a number of support services at local level, although not every area, by far, has a specialised FGM service. The below national websites provide a starting point:

With thanks to Jan Macleod for her time. Further information on FGM Aware can be found at www.fgmaware.org

More about Jan, FGM Aware

Jan Macleod has been involved in feminist work to tackle gender based violence for more years than she cares to admit, starting out as a volunteer with Rape Crisis.  She has experience of campaigning, support work, developing and delivering training, public education and strategic and policy development. She now works with the Women’s Support Project, based in Glasgow and working across Scotland.

The Women’s Support Project aims to raise awareness of the extent and effects of violence against women and children, and works to improve services for those affected by violence. Key themes in the work has been highlighting links between different forms of male violence and promoting an inter-agency response to the abuse of women and children. Work is informed by a feminist analysis of male violence and an understanding of the links and overlaps between different forms of violence, discrimination and oppression.

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