Female Genital Mutilation (FGM)

In 2013 Coventry became the first authority in the UK to support a full council motion to condemn the practice of FGM.

The purpose of this strategic statement is to further demonstrate Coventry’s commitment to tackling FGM and ensuring that girls and women are protected from the short- and long-term harm caused by such practices.

Female genital mutilation, also known as female circumcision or female genital cutting, is defined by the World Health Organisation (WHO) as "all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for nonmedical reasons".

Female Genital Mutilation (FGM) is an unacceptable and illegal practice, and an extreme violation of human rights. FGM reflects deep-rooted inequality between the sexes and constitutes a severe form of discrimination against women and girls. FGM has no religious foundations but is a deep-rooted cultural practice that differs between communities, ethnic groups and families.

FGM has no health benefits and is an extremely harmful practice that always carries devastating short and long-term health consequences for women and girls.

Classification and definitions

• Type 1: this is the partial or total removal of the clitoral glans (the external and visible part of the clitoris, which is a sensitive part of the female genitals), and/or the prepuce/ clitoral hood (the fold of skin surrounding the clitoral glans).
• Type 2: this is the partial or total removal of the clitoral glans and the labia minora (the inner folds of the vulva), with or without removal of the labia majora (the outer folds of skin of the vulva).
• Type 3: Also known as infibulation, this is the narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the labia minora, or labia majora, sometimes through stitching, with or without removal of the clitoral prepuce/clitoral hood and glans (Type I FGM).
• Type 4:  This includes all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping and cauterizing the genital area.

FGM is highly prevalent in 28 African countries, and in parts of the Middle East and South East Asia. With increased immigration the practice has spread globally including to Europe, North America and Australia. FGM is mostly carried out on young girls sometime between infancy and adolescence, and occasionally on adult women.

FGM and the Law

FGM is an illegal practice in the UK and has been since 1985 under the Prohibition of Female Circumcision Act. This law was extended in the Female Genital Mutilation Act 2003 to address the practice of taking girls abroad to undergo FGM procedures and increased the maximum penalty from 5 to 14 years’ imprisonment.

Female Genital Mutilation Protection Orders (FGMPOs) offer a legal means to protect and safeguard victims of FGM. FGMPOs are granted by a court and are unique to each case. They contain conditions to protect a victim or potential victims of FGM. An order can be applied for by the person who has had or is at risk of FGM, a local authority or any person with the permission of the court (example: teacher or police).

• Guidance on FGMPOs
• FGMPO form

A mandatory reporting duty for FGM  requires regulated health and social care professionals and teachers in England and Wales to report known cases of FGM in under 18-year-olds to the police. The FGM duty came into force on 31 October 2015.

The FGM mandatory reporting duty is a legal duty provided for in the FGM Act 2003 (as amended by the Serious Crime Act 2015). The legislation requires regulated health and social care professionals and teachers in England and Wales to make a report to the police where, in the course of their professional duties, they either:

• are informed by a girl under 18 that an act of FGM has been carried out on her; or
• observe physical signs which appear to show that an act of FGM has been carried out on a girl under 18 and they have no reason to believe that the act was necessary for the girl’s physical or mental health or for purposes connected with labour or birth

Government guidance - FGM: mandatory reporting in healthcare

Professionals also have a duty to report if they suspect anyone under 18 is at risk if FGM. If they think the risk is imminent, they should report to the police and social care as appropriate.

Why the practice continues

The reasons why female genital mutilations are performed vary from one region to another as well as over time and include a mix of sociocultural factors within families and communities. The most cited reasons are:

• FGM is often considered a necessary part of raising a girl, and a way to prepare her for adulthood and marriage.
• FGM is often motivated by beliefs about what is considered acceptable sexual behaviour. It aims to ensure premarital virginity and marital fidelity. FGM is in many communities believed to reduce a woman's libido and therefore believed to help her resist extramarital sexual acts. When a vaginal opening is covered or narrowed (Type 3), the fear of the pain of opening it, and the fear that this will be found out, is expected to further discourage extramarital sexual intercourse among women with this type of FGM.
• Where FGM is a social convention (social norm), the social pressure to conform to what others do and have been doing, as well as the need to be accepted socially and the fear of being rejected by the community, are strong motivations to perpetuate the practice. In some communities, FGM is almost universally performed and unquestioned.
• Where it is believed that being cut increases marriageability, FGM is more likely to be carried out.
• FGM is associated with cultural ideals of femininity and modesty, which include the notion that girls are clean and beautiful after removal of body parts that are considered unclean, unfeminine or male.
• Though no religious scripts prescribe the practice, those supporting the practice of FGM often believe the practice has religious support.
• Religious leaders take varying positions with regard to FGM: some promote it, some consider it irrelevant to religion, and others advocate for its elimination.
• Local structures of power and authority, such as community leaders, religious leaders, circumcisers, and even some medical personnel can contribute to upholding the practice. Likewise, when informed, they can be effective advocates for the abandonment of FGM.
• In most societies, where FGM is practised, it is considered a cultural tradition, which is often used as an argument for its continuation.
• In some societies, recent adoption of the practice is linked to copying the traditions of neighbouring groups. Sometimes it has started as part of a wider religious or traditional revival movement.

Short-term health implications can include:

• urinary retention
• injury to adjacent tissues
• fracture or dislocation as a result of restraint
• damage to other organs
• severe pain
• emotional and psychological shock
• haemorrhage
• wound infections including Tetanus, and blood borne viruses (including HIV and Hepatitis B and C)
• death

Long-term implications for a girl or woman’s health and welfare can include:

• chronic vaginal and pelvic infections
• difficulties in menstruation
• difficulties in passing urine and chronic urine infections
• renal impairment and possible renal failure
• damage to the reproductive system, including infertility
• infibulation cysts, neuromas, abscesses and keloid scar formation
• complications in pregnancy and delay in the second stage of childbirth
• maternal or foetal death
• psychological damage; including a number of mental health and psychosexual problems including depression, anxiety, and sexual dysfunction
• increased risk of HIV and other sexually transmitted infections
• increased risk of vaginal fistula
• sexual dysfunction.

In addition, there are also psycho-sexual, psychological and social consequences of FGM.

In Coventry, the FGM Steering Group continue to oversee and take forward a range of work to prevent and eradicate  FGM. This means challenging the norms and ideas that perpetrate it, raising awareness of the dangers of the practice, and sending a strong message that FGM  will not be tolerated.

Key Objectives

Prepare

To provide high quality services that are shaped around the needs of victims and survivors at all levels of risk and ensure that their voices are heard and responded to.

Prevent

Coventry City Council and its partners are committed to improving awareness raising and understanding of FGM. Girls and women will be empowered to report, and professionals will be given the skills and confidence to support them. We will also focus on men in their roles as fathers, husbands, community and religious leaders who can play a pivotal role in changing attitudes and beliefs concerning the continuation of FGM.

Protect

There will be effective information sharing and referral pathways between key agencies. The safety of victims and survivors will remain central to all support and services offered; safeguarding procedures will be robustly implemented to ensure that girls and women are protected. Opportunities to identify FGM for instance, when a child is going on a holiday to a country of high prevalence or if a family/child leaves with no notice, should be maximised and appropriate safeguarding procedures followed. Interventions will be tailored to victims and survivors with a range of needs.

Pursue

FMG is a crime; justice and positive outcomes for victims and survivors is a priority. There are a number of laws concerned with ending FGM including the Female Genital Mutilation Act 2003 and the mandatory reporting duty for FGM which requires regulated health, social care professionals and teachers in England and Wales to report known cases of FGM in under 18 year olds to the police. Coventry will use FGM Protection Orders (FGMPO’s) to protect girls and women and raise awareness regarding how these can be used to safeguard individuals. We will develop effective referral pathways working effectively with but not exclusively with the police and health services to understand how the wider partnership can support activity to achieve justice and a reduction in this crime.

Services in Coventry

We have an FGM community-based service delivered locally by Coventry Haven Women’s Aid.

This service offers:

• Specialist practical and emotional support for women, children and girls whom are victims, or at risk of, genital mutilation and abuse
• Safe refuge accommodation
• Awareness raising of FGM within practicing communities
• Training to professionals in statutory and voluntary services, including schools, doctors’ surgeries and hospitals and midwives
• Recruitment of Community Champions to extend our reach to all affected communities
• Promotion and publication of the 'Ending FGM' message
• Working at a strategic level to ensure a good policy response

Safeguarding

Children and Young People

We all have a responsibility to make sure children and young people are safe from harm or abuse. If you have any suspicion, or information, suggesting a child is being harmed, it should not be ignored.

If there is no immediate danger or you need advice or information, you can call the Multi-Agency Safeguarding Hub on 024 7678 8555.

Professionals can also complete the Multi-agency Referral Form.

Remember, if it's an emergency, dial 999.

Adults

It is important to understand that safeguarding is everyone's responsibility. If you have any suspicion, or information, suggesting an adult is being harmed, it should not be ignored.

If there is no immediate danger or you need advice or information, you can call Adult Social Care Direct on 024 7683 3003 or email ascdirect@coventry.gov.uk. 

Professionals can also complete the Adult Social Care Referral Form

Remember, if it's an emergency, dial 999.

Resources

NOTE; the Petal's app is under review.

Coventry’s Petals Web app

The web app targeted at young people gives advice on how to get support and deal with FGM. It can also be used by people who want to find out more about Female Genital Mutilation and how it might affect them and others they may know.

Young people’s Web app

Petals for Professionals is an online resource which explains the legal responsibilities of professionals and provides information on where to get further help and advice.

Professionals Web app

Government Publications

• FGM resource pack (including posters)
• Multi Agency Practice Guidelines FGM
• Mandatory reporting process
• Mandatory reporting fact sheet
• Mandatory reporting of FGM: Procedural information
• Government Statement Opposing FGM