Female genital mutilation (FGM) is sometimes known as female circumcision. The practice is used in many countries as a rite of passage into womanhood. The procedure is usually performed on girls between the ages of four to thirteen, but in some cases, FGM is performed on babies or on young women prior to marriage or pregnancy. FGM is the term used for a range of procedures, which involve partial or total removal of the female external genitalia, and/or injury to the female genitals, for cultural or any other non-therapeutic reasons. These may include the excision of the prepuce, the excision of the clitoris and labia, and the stitching up of the vaginal opening (infibulation), leaving only a small outlet for urine and menses. Long-term health complications may include urine retention resulting in repeated urinary infections; obstruction of menstrual flow leading to frequent reproductive tract infections and infertility; and prolonged and obstructed labour. In addition to the physical complications, there maybe psychological and sexual effects.
The Prohibition of Female Circumcision Act of 1985 made FGM illegal in the UK and the number of women in the UK who seek medical help after undergoing FGM is growing, however, there has never been a successful prosecution under the Prohibition of Female Circumcision Act. Young girls are at risk of undergoing FGM in the UK. They should be offered protection under the 1989 Children’ s Act (Working Together). This states that if a local authority has reason to believe that a child is likely to suffer significant harm as a result of female circumcision, it should consider to what extent it should exercise its investigative powers under Section 47 of the Children Act 1989, (for further details see the BMA web site listed on this page).
Health workers need to use cultural sensitivity when discussing FGM, many women see this procedure as a natural part of their cultural practices. You also need to be especially careful when using an interpreter (do not use a male interpreter, or a family members to interpret unless the client requests this).