Female Genital Mutilation (FGM)

Female Genital Mutilation (FGM) Female genital mutilation (FGM) involves procedures that include the partial or total removal of the external female genital organs for cultural or other non-therapeutic reasons. The practice is medically unnecessary, extremely painful and has serious health consequences, both at the time when the mutilation is carried out and in later life. The procedure is traditionally carried out by an older woman with no medical training. Anaesthetics and antiseptic treatment are not generally used and the practice is usually carried out using basic tools such as knives, scissors, scalpels, pieces of glass and razor blades. Often iodine or a mixture of herbs is placed on the wound to tighten the vagina and stop the bleeding.

Female Genital Mutilation Act 2003 It is an offence in England, Wales and Northern Ireland for anyone (regardless of their nationality and residence status) to perform FGM in the UK; assist the carrying out of FGM in the UK; assist a girl to carry out FGM on herself in the UK; and assist from the UK a non-UK person to carry out FGM outside the UK on a UK national or permanent UK resident It is also an offence for UK nationals or permanent UK residents to perform FGM on any person overseas; assist FGM carried out abroad by a UK national or permanent UK resident – this would cover taking a girl abroad to be subjected to FGM; assist a girl to perform FGM on herself outside the UK; and assist FGM carried out abroad by a non-UK person on a girl/woman who is a UK national or permanent UK resident – this would cover taking a girl abroad to be subjected to FGM; even in countries where the practice is not a criminal offence. Any person found guilty of an offence under the Female Genital Mutilation Act 2003 will be liable to a maximum penalty of 14 years’ imprisonment or a fine or or both.

Mandatory Reporting Duty ‘Known’ cases are those where either a girl informs the person that an act of FGM has been carried out on her, or where the person observes physical signs on a girl appearing to show that an act of FGM has been carried out Section 5B of the 2003 Act introduces a mandatory reporting duty which requires regulated (qualified) teachers to report ‘known’ cases of FGM in under 18s which they identify in the course of their professional work to the Police. The mandatory reporting should be in line discussing any such case with the school’s DSP and involving Children’s Services as appropriate. While the duty stipulates ‘regulated’ teachers,, non-regulated practitioners also have a responsibility to take appropriate safeguarding action in relation to any identified or suspected case of FGM. Those failing to report such cases will face disciplinary sanctions. Further information can be found at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/469448/FGM-Mandatory-Reporting-procedural-info-FINAL.pdf 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 (see section 2.1a for further information). For the purposes of the duty, the relevant age is the girl’s age at the time of the disclosure/identification of FGM (i.e. it does not apply where a woman aged 18 or over discloses she had FGM when she was under 18).

Who is at risk? In the UK, it is estimated that up to 24,000 girls under the age of 15 are at risk of female genital mutilation (FGM). UK communities that are most (although not exclusively) at risk of FGM include Kenyans, Somalis, Sudanese, Sierra Leoneans, Egyptians, Nigerians and Eritreans. However women from non-African communities that are at risk of FGM include Yemeni, Kurdish, Indonesian and Pakistani women. The age at which the practice is carried out varies.The most common age is between four and ten, although it appears to be falling. Girls are at particular risk of FGM during summer holidays. This is the time when families may take their children abroad for the procedure. Many girls may not be aware that they may be at risk of undergoing FGM.

Consequences of FGM Long-term implications: extensive damage of the external reproductive system uterus, vaginal and pelvic infections cysts and neuromas increased risk of urinary incontinence complications in pregnancy and child birth psychological damage sexual dysfunction difficulties in menstruation Short-term health implications: severe pain and shock infection urine retention injury to adjacent tissues immediate fatal haemorrhaging In addition to these health consequences there are considerable psycho-sexual, psychological and social consequences of FGM.

Justification for FGM Reasons include: custom and tradition religion; in the mistaken belief that it is a religious requirement preservation of virginity/chastity social acceptance, especially for marriage hygiene and cleanliness increasing sexual pleasure for the male family honour a sense of belonging to the group and conversely the fear of social exclusion enhancing fertility Many women believe that FGM is necessary to ensure acceptance by their community; they are unaware that FGM is not practised in most of the world

Indicators of FGM Extended absence from school/college (possibly when siblings are not absent) Truancy Low motivation Excessive parental restriction and control of movements and history of siblings leaving education early to marry Evidence of self-harm Depression Social isolation Eating disorders Substance abuse Evidence of family disputes/conflict Drop in academic performance Talking about a special procedure/ceremony that is going to take place. Domestic violence/abuse Running away from home Request for absence without the following: The precise location of where the pupil is going The purpose of the visit The child/children know and corroborate the purpose of the visit The return date and whether it is estimated or fixed. Knowing that the family belongs to a community in which FGM is practised and that the family are making preparations for the child to take a holiday, arranging vaccinations or planning absence from school

Indicators that FGM may have taken place Prolonged absence from school Noticeable behaviour change on return Long periods away from classes or other normal activities Possible with bladder / menstrual problems. Difficulty sitting still / look uncomfortable Complaint of pain between their legs

Managing risk A child at risk of forced marriage or FGM may also be at risk of honour based abuse. Extreme caution should be taken in sharing information with any family members or those with influence within the community as this may alert them to your concerns and may place the child in danger.

Reminder: Mandatory Reporting Duties Section 5B of the Female Genital Mutilation Act 2003 (as inserted by section 74 of the Serious Crime Act 2015) will place a statutory duty upon teachers11, along with social workers and healthcare professionals, to report to the police where they discover (either through disclosure by the victim or visual evidence) that FGM appears to have been carried out on a girl under 18. Those failing to report such cases will face disciplinary sanctions.

More information available Hertfordshire Safeguarding Children Partnership https://www.hertfordshire.gov.uk/media-library/documents/childrens-services/hscb/professionals/final-fgm-protocol-pathway-hertfordhsire-14.07.2017.pdf National FGM Centre http://nationalfgmcentre.org.uk