Female genital mutilation explained

Between October and December 2018 new cases of FGM were added to the NHS’ experimental statistics data set. This barbaric and illegal practice is still going on in the UK today. Practices need to understand what FGM is, those at risk and what treatments are appropriate.

In this article, a consultant gynaecologist talks about the dangerous practice of FGM, the risks and treatment involved

This is an edited version of an article which first appeared on Netdoctor.

Female genital mutilation, or FGM as it is commonly known, is a procedure that involves deliberately cutting, damaging or changing the genitalia of young women and girls.

There is no medical reason for FGM to be carried out. It is a form of abuse and is illegal in the UK, but it still happens behind closed doors. Between April 2015, and December 2017, 15,390 patients who had undergone FGM were treated by the NHS.

But what exactly is FGM, why does it occur and can it be reversed? Dr Karen Morton, consultant gynaecologist and founder of Dr Morton’s, discusses the serious health implications of mutilating young girls.

What is female genital mutilation?

FGM is usually carried out on young girls between birth and the age of 15, most commonly before puberty. It is illegal in the UK and the European Union and is child abuse.

Female genital mutilation is a ritual practice originating in certain parts of Africa, Asia and the Middle East whereby young girls are subjected to ‘cutting’ of their genitalia. The degree of mutilation is described on the NHS website being categorised into four main types.

• Type 1 (clitoridectomy) – removing part or all of the clitoris.
• Type 2 (excision) – removing part or all of the clitoris and the inner labia (lips that surround the vagina), with or without removal of the labia majora (larger outer lips).
• Type 3 (infibulation) – narrowing of the vaginal opening by creating a seal, formed by cutting and repositioning the labia.
• Other harmful procedures to the female genitals, including pricking, piercing, cutting, scraping or burning the area.

Why does FGM occur? 

FGM happens without consent and girls are often forcibly restrained. There are no health benefits to FGM and it can cause a huge amount of physical and mental pain.

It is done, one assumes, to ensure chastity in women who may be regarded as property of men within these societies. That said, and almost most shockingly, the ‘cutters’ are frequently female family members.

Female genital mutilation can cause a huge amount of physical and mental pain. Whatever the reasons, there are no health benefits to FGM.

What are the effects of FGM?

FGM comes with a number of serious health risks:

• Extreme physical pain: it is carried out with no pain relief and bleeding may be profuse.
• Mental trauma: one can only begin to imagine the mental trauma experienced by these young girls.
• Difficulty using tampons and having sex: on a practical note it can make using tampons or having sex extremely difficult.
• Difficulty giving birth: special incisions at the vaginal entrance may be needed to allow a baby to deliver.

Can FGM be reversed?

While ‘reversed’ is a strong word to use, as the trauma of FGM can’t be written off, surgery can be performed to open up the vagina. Of course the amputated clitoris cannot be replaced, but the vagina can be made open again by dividing the stitched together labia. This is called deinfibulation and, most often, it’s performed under local anaesthetic in a clinic and patients don’t need to stay overnight. This is offered to all women in the UK once their situation is known about – for example when they register with a GP or come for antenatal care.

Help and support

Help and support is available for patients and practice staff if they are concerned about a patient and worried that they may be at risk of FGM.

• NSPCC: a charity preventing the cruelty of children.
• Daughters of Eve: a non profit organisation working to protect the mental and physical health of young people in FGM practising communities.
• FGM National Group: a charity dedicated to working with women who have been affected by FGM.
• FORWARD: an African diaspora women’s campaign and support organisation with a focus on FGM.

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