1. FEMALE GENITAL MUTILATION

2. What is FGM Comprises all procedures that involve partial or total removal of female external and/or injury to the female genital organs for cultural or any other non-therapeutic reasons (WHO 1995).

3. WHO CLASSIFICATION Type I : Partial or total removal of the clitoris and/or the prepuce (clitoridectomy). Type II:Partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (excision). Type III:Narrowing of the vaginal orifice with creation of a covering seal by cutting and appositioning the labia minora and/or the labia majora, with or without excision of the clitoris (infibulation). Type IV: All other harmful procedures to the female genitalia for non-medical purposes, for example: pricking, incising, scraping and cauterization.

4. ESTIMATED PREVALENCE OF FGM Globally 100 – 140 million girls and women affected 91,5 million girls and women above 9 years old in Africa are currently living with the consequences of FGM 3 million girls in Africa at risk of undergoing FGM annually

5. Where ? In more than 28 countries in Africa and parts of the Middle East. High prevelence especially in Sudan, Somalia, Eritrea, Djibouti, Egypt, Ethiopia, Mali, Burkina Faso, Gambia, Guinea,Sierra Leone Iraq Kurds, Yemen. FGM reported amongst Bohra Muslims in India, Pakistan and East Africa, Malaysia and Indonesia. Immigrant Population in Western countries including the UK.

6. Indicators of risk Girls from FGM practising communities Girls born to women who have undergone FGM Any girl who has a sister who has already undergone FGM Girls from FGM practising communities taken out of school for long periods

7. Indicators that FGM has occurred Sudden behaviour change Urination and menstrual problems Recurrent urinary tract infections Disclosure

8. Impact : Health risks Short term - severe pain, bleeding, shock, acute urine retention, infections and death. Long term – failure of wound to heal, cysts, keloid scarring, clitoral neuroma, recurrent urinary tract infections, menstrual problems, lack of pleasurable sexual sensation, pain during sexual intercourse, child birth complications, psychological consequences

9. UK Legislative Framework FGM illegal since the 1985 Female Circumcision Prohibition Act. The new FGM Act (2003) updates and extends the original Act. An offence to: take UK nationals/residents overseas for FGM; aid and abet, counsel or procure FGM; to perform FGM on women or children for cultural or non-medical reasons; maximum penalty - 14 years imprisonment.

10. What to do if concerned about a child or young person Refer to TSCB procedures online (Procedures tab followed by ‘children in specific circumstances’ tab followed by ‘female genital mutilation’) Refer to MARAT

11. Support available for victims/survivors NSPCC National FGM Help Line 0800 028 3550 and emails sent to fgmhelp@nspcc.org.ukfgmhelp@nspcc.org.uk St Mary’s Sexual Health Centre 0161 276 6515 NESTAC (New Steps for the African Community): 01706 868993 or mobile 07862 279289