FGM (female genital mutilation) is a type of domestic abuse and it involves the cutting, injuring or modification of a female’s genitals without a medical basis for the procedure. It is also known as female circumcision. It has been illegal in the UK since 1985, but in the period 2016-17 there were over 5,300 new recorded cases of FGM, the greatest number of which concerned women born in Somalia.
What are the types and effects of FGM?
It is usually carried out on girls under the age of 15, but the effects are often long-lasting and so can affect a woman for her whole life.
Types of FGM include:
- Clitoridectomy – removal of all or part of the clitoris
- Excision – removal of all or part of the clitoris and the inner labia, sometimes with the removal of the larger, outer labia or lips (labia majora)
- Infibulation – a procedure which narrows the vagina by cutting and repositioning the inner labia
Other types include harm such as pricking, piercing, scraping or burning parts of the genitals.
Effects of FGM include:
- Chronic pain
- Anxiety, depression and PTSD relating to the procedure
- Pain during sex
- Lack of pleasure during sex
- Chronic gynaecological infections which can result in infertility
- Urinary incontinence
- Abnormal genital bleeding
- Problems during childbirth which can endanger the lives of the mother and baby.
In severe cases, uncontrolled blood loss during the procedure can be fatal.
How can someone get help or treatment relating to their FGM?
There are many charities (some of which are linked in the signposting section of this page) which can provide confidential advice for victims, or people who are worried they may be at risk, of FGM.
These charities are also involved in raising awareness of FGM to aim to eradicate it in the UK in accordance with the law. FGM has continued despite its outlawed status as it is a cultural or religious practice carried out by some groups, particularly in parts of Africa and South Asia. Some members of these communities believe that it preserves the woman’s virginity and that therefore wrongly view it as a necessary procedure.
However, there is no advantage to FGM. It is a crime, whether against the woman’s will or perceived not to be and whether a person living in the UK has the procedure carried out in the UK or they are forced to travel to have it done.
From a medical point of view, surgery called deinfibulation may be able to open up the vagina. This is often recommended if a victim of FGM has difficulty having sex or urinating. It is also important to disclose FGM to a midwife or health professional during pregnancy as the pregnancy is considered high-risk. Deinfibulation surgery may be appropriate in this instance also.
A GP will also be able to someone who is experiencing mental health issues such as PTSD or depression as a result of their FGM. They may refer them to a counsellor, psychologist or psychiatrist through whom the person can receive therapy, such as cognitive behavioural therapy (CBT).
UK Says No More is an organisation which supports pharmacies across the country to provide safe spaces for people experiencing domestic abuse (including FGM) and who are seeking support – a service which is all the more crucial during the pandemic.
Someone can report FGM to the police on 999. There is also a silent call function for people who are not safe to make a verbal call. This can be activated by ringing 999, then pressing 55.
There are a few ways to confirm what sort of reasonable adjustments should be made for someone who may be subject to FGM:
Employers are being increasingly encouraged to help employees who are, or may be, experiencing a form of domestic abuse, such as FGM.
A Public Health England toolkit was published in 2018, outlining guidance for employers on helping tackle domestic abuse among their employees.
Statistics published in the introduction to the toolkit state that over half of medium and large employers surveyed saw increased rates of absenteeism in employees experiencing forms of domestic abuse, as well as reduced performance.
As employers are legally obliged to provide a safe working environment as part of their duty of care to employees, they should encourage employees to disclose FGM and following this, implement reasonable adjustments or seek to help in other ways.
How can employers respond to employees experiencing FGM?
The Public Health England toolkit recommends that employers take the following three-step approach with regard to potential instances of domestic abuse:
- Acknowledge the abuse by encouraging employees to disclose and discuss it
- Respond by reviewing workplace safeguarding policies and ensuring that employees are given the support they need in the workplace
- Refer the employee(s) to charities who can help advise them on how to deal with their FGM in the short and longer terms (see signposting section).
Reasonable adjustments should also be made in accordance with the employee’s need for support if their situation is covered by the Equality Act – including long-term mental health difficulties such as anxiety or PTSD, physical injuries, etc.
Some reasonable adjustments to allow an employee experiencing FGM to work as effectively and comfortably might include:
- Flexible working hours to accommodate an employee’s medical/therapy appointments if they are seeking help to improve their mental or physical health linked to their FGM.
- Adjustments to duties depending on the extent of the impact of a FGM-related condition on the employee. If an employee is struggling with stress or anxiety, they may be best taking on lighter, less taxing duties, for example.
- Working from the office as opposed to from home which is especially relevant during the Covid-19 pandemic when many people are working from home. If this will be difficult for the employee, an employer may wish to offer an alternative workspace away from the family home or family members involved in the FGM procedure. This also applies to staying away from work while having to self-isolate with Covid-19 or symptoms – people experiencing FGM do not have to self-isolate if this would prevent them from escaping an abusive home situation.
- Raising awareness so that colleagues understand the importance of FGM awareness and indicators that someone may be a victim of this crime.
Daughters of Eve – charity advocating for equal treatment of women in FGM-practising communities and protecting these women’s mental, physical, sexual and reproductive health in conjunction with policy makers.
Halo Project – charity supporting victims of honour-based violence, forced marriage and FGM, as well as partner organisations who provide interventions and services to protect the people at risk from these practices (01642 683 045).
Women’s Aid – charity working to create and curate resources relating to domestic abuse more generally and to improve the response to people who require help to escape from, or recover from the effects of domestic abuse. The charity campaigns for greater awareness of domestic abuse and educates people on how to identify the signs of an abuse victim, etc.
Other Research Resources