Guidance

Female genital mutilation: resource pack

Updated 13 May 2016

1. Aim

This resource was developed in response to requests for clearer direction from central government about the safeguarding responsibilities of local authorities.

It is designed to highlight examples from areas where effective practice has been identified and to emphasise what works in fighting female genital mutilation (FGM).

This resource pack has been updated in November 2015 to reflect recent legislative changes, including the:

  • new mandatory reporting duty for professionals
  • introduction of mandatory recording of FGM cases within the NHS in England
  • publication of new prevalence data

Thereby equipping commissioners with both the data they need to understand the scale of the problem in their area and an insight into some of the tools they can use to effectively fight it.

This pack features:

Disclaimer

External links were selected, reviewed and identified as effective practice on combating FGM when this item was published. However, the Home Office is not responsible for the content of external websites. We do not maintain or update them; we cannot change them; and they may be changed without our knowledge. Other information and effective practice on FGM is freely available and the contents on this website are therefore not exhaustive.

If you have documents or material you would like to be included in this resource, please email FGMEnquiries@homeoffice.gsi.gov.uk

Warning

Some of the content in the links included in this resource pack contain images or accounts which viewers may find distressing.

2. Overview

FGM is illegal in the UK. It is a practice that takes place worldwide in at least 28 African countries and in parts of the Middle and Far East. It also takes place within parts of Western Europe and other developed countries, primarily among immigrant and refugee communities. UK communities that are at risk of FGM include Somali, Kenyan, Ethiopian, Sierra Leonean, Sudanese, Egyptian, Nigerian, Eritrean, Yemeni, Kurdish and Indonesian women and girls.

FGM has been classified by the World Health Organisation into 4 types; these are described on the World Health Organisation website.

FGM is a complex issue - despite the harm it causes, many women and men from practising communities consider it to be normal to protect their cultural identity.

FGM is believed to be a way of ensuring virginity and chastity. It is used to safeguard girls from sex outside marriage and from having sexual feelings. Although FGM is practised by secular communities, it is most often claimed to be carried out in accordance with religious beliefs. FGM is not supported by any religious doctrine.

3. Legislation

FGM is illegal in the UK. In England, Wales and Northern Ireland, civil and criminal legislation on FGM is contained in the Female Genital Mutilation Act 2003 (the act). In Scotland, FGM legislation is contained in the Prohibition of Female Genital Mutilation (Scotland) Act 2005. The Female Genital Mutilation Act 2003 was amended by sections 70-75 of the Serious Crime Act 2015.

Criminal law in England and Wales

Under section 1 of the act, a person is guilty of an FGM offence if they excise, infibulate or otherwise mutilate the whole or any part of a girl’s or woman’s labia majora, labia minora or clitoris. To excise is to remove 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). To infibulate is to narrow the vaginal opening by creating a seal, formed by cutting and repositioning the labia.

Offences of FGM

It is an offence for any person (regardless of their nationality or residence status) to:

  • perform FGM in England and Wales (section 1 of the act)
  • assist a girl to carry out FGM on herself in England and Wales (section 2 of the act)
  • assist (from England or Wales) a non-UK person to carry out FGM outside the UK on a UK national or UK resident (section 3 of the act)

If the mutilation takes place in England or Wales, the nationality or residence status of the victim is irrelevant.

Failing to protect a girl from risk of FGM

If an offence under sections 1, 2 or 3 of the act is committed against a girl under the age of 16, each person who is responsible for the girl at the time the FGM occurred could be guilty of an offence under Section 3A of the act.

FGM taking place abroad

It is an offence for a UK national or UK resident (even in countries where FGM is not an offence) to:

  • perform FGM abroad (sections 4 and 1 of the act)
  • assist a girl to carry out FGM on herself outside the UK (sections 4 and 2 of the act)
  • assist (from outside the UK) a non-UK person to carry out FGM outside the UK on a UK national or UK resident (sections 4 and 3 of the act)

An offence of failing to protect a girl from risk of FGM can be committed wholly or partly outside the UK by a person who is a UK national or UK resident. The extra-territorial offences of FGM are intended to cover taking a girl abroad to be subjected to FGM.

Any person found guilty of an offence under sections 1, 2, 3 of the act faces up to 14 years’ imprisonment, a fine or both. Any person found guilty of an offence under section 3A of the act, faces up to 7 years’ imprisonment, a fine or both.

Under provisions of the law which apply generally to criminal offences, it is also an offence to:

  • aid, abet, counsel or procure a person to commit an FGM offence
  • encourage or assist a person to commit an FGM offence
  • attempt to commit an FGM offence
  • conspire to commit an FGM offence

Any person found guilty of such an offence faces the same maximum penalty for these offences under the act.

Civil law in England and Wales

Under section 5A and schedule 2 of the act provision is made for FGM protection orders. An FGM protection order is a civil law measure which provides a means of protecting actual or potential victims from FGM.

Applications for an FGM protection order can be made to the High Court or family court in England and Wales with the purpose of protecting a girl or woman against the commission of a genital mutilation offence or protecting a girl or woman where such an offence has been committed.

Other legislative aspects

The act also:

  • guarantees lifelong anonymity for victims of FGM (section 4A of the act)
  • places a mandatory duty on health and social care professionals and teachers to notify the police where they discover FGM has been carried out on a girl under 18 years of age during the course of their work (section 5A of the act)
  • provides for statutory guidance on FGM (section 5C of the act)

4. Case studies

Some examples of good partnership working between voluntary and community sector organisations and local authorities are available to download, including the following FGM case studies:

  • interpreting, awareness-raising and advice
  • multi-agency approach
  • positive working between midwife and GP

5. Questions for local areas to consider

Prevalence of FGM in England and Wales

A 2015 study estimated that:

  • approximately 60,000 girls aged 0 to 14 were born in England and Wales to mothers who had undergone FGM

  • approximately 103,000 women aged 15 to 49 and approximately 24,000 women aged 50 and over who have migrated to England and Wales are living with the consequences of FGM. In addition, approximately 10,000 girls aged under 15 who have migrated to England and Wales are likely to have undergone FGM

The study also reported that:

  • women who have undergone FGM do not only live in urban centres in England and Wales: while many affected women live in large cities where migrant populations tend to be clustered, others are scattered in rural areas
  • no local authority area is likely to be free from FGM entirely: in many areas, the estimated prevalence is low, but there are still some women who may be affected by FGM
  • London has the highest prevalence rate in England and Wales with an estimated 2.1% of women affected by FGM
  • outside London, highest estimates were for Manchester, Slough, Bristol, Leicester and Birmingham

In addition, the Health and Social Care Information Centre (HSCIC) publishes statistics about patients with FGM treated within the NHS in England. This is crucial in understanding the extent of FGM in England as identified through the delivery of healthcare services.

To get an indication of how widespread FGM is in the local area, and what policies or training are in place, local authorities can look at the prevalence data and HSCIC statistics. They can also ask questions such as:

  • which FGM-affected communities live in the area and how many members of these communities are there?
  • is there a policy on FGM, and who is accountable for leading and implementing it?
  • which area does FGM prevention fall under?
  • what training is there for professionals like health, teaching and safeguarding workers?
  • what steps have been taken to use the national multi-agency guidelines on FGM?
  • are designated senior staff for child protection in schools aware of FGM and have they ensured that their staff are aware of the potential risks?

Read more about the worldwide prevalence of FGM.

Working together with voluntary and community sector organisations

A coalition of charitable trusts set up an FGM initiative and funded community projects. As part of this work, the funders carried out an independent evaluation. The summary and final report highlight what works in community engagement activity.

Another group of organisations have produced a guide for local authorities with recommendations for fighting FGM at a local level.

Safeguarding

The action we take to promote the welfare of children and protect them from harms such as FGM is everyone’s responsibility. Everyone who comes into contact with children and families has a role to play. More information is available in the following guidance:

6. Effective practice and resources

FGM statutory multi-agency guidance

The Serious Crime Act 2015 amended the FGM Act to provide for statutory guidance on FGM. This will help to further increase awareness of FGM and improve compliance with good practice, and to increase referrals and reports to the police and afford victims and survivors of FGM the greatest possible protection.

The statutory guidance was published on 1 April 2016. The guidance draws on the previous FGM multi-agency practice guidelines and has been updated to capture the legal changes introduced by the Serious Crime Act 2015, new guidance for health professionals, new sources of data on FGM and wider safeguarding responsibilities, duties and resources for professionals. It also includes information on the FGM mandatory reporting duty.

Mandatory reporting of FGM

Since 31 October 2015, regulated health and social care professionals and teachers in England and Wales have been legally required to report ‘known’ cases of FGM in under 18s, which they identify in the course of their professional work, to the police. You can read procedural information on the duty and a factsheet (with translations) for communities.

Local safeguarding children boards

Local safeguarding children boards (LSCBs) play an important role in challenging safeguarding practice and assessing how effective these services are. Every local authority is required to set up an LSCB by bringing agencies like police, probation, youth justice, health, education and social care together, to make sure local safeguarding is happening properly.

As well as co-ordinating each agency’s work, LSCBs have to:

  • develop policies and procedures for how agencies work together
  • develop policies and procedures for the training of those who work with children or in services whose work affects the welfare or safety of children
  • contribute to local plans for children’s services
  • communicate and work with local organisations and communities
  • monitor the effectiveness of local safeguarding
  • undertake serious case reviews as needed

‘Working together to safeguard children’ guidance has been produced for LSCBs which covers the legal requirements and expectations for individual services to safeguard and strengthen children’s welfare, with a clear framework for monitoring the effectiveness of local services.

Local authorities

Some examples of FGM strategies and action taken by local authorities are available to download, including:

  • pictogram showing which professionals and organisations are involved in FGM work in the Bristol
  • subjects covered at the quarterly FGM Delivery and Safeguarding Partnership meetings in Bristol
  • awareness-raising letter sent to school nurses and head teachers by Lambeth Council
  • multi-agency approach to addressing and dealing with FGM issues in Manchester

Police

The POLKA website is only available to police staff. To access it you will need to call 020 7161 2888 first. The POLKA website, run by the College of Policing, houses all FGM training and information guidance for police officers and staff. The College has also published new national police guidance on FGM.

London

Project Azure, set up by the Metropolitan Police Service’s Child Abuse Investigation Command, aims to prevent FGM happening to girls in London. It also gives advice and training to other police forces around the country on how to deal with cases. The team works closely with Met Intel, the counter-terrorism command, and its own pro-active unit for a co-ordinated approach targeting prevalent boroughs to protect London’s women and girls from harm. Their mission is to work together with partners to prevent FGM and to identify and protect victims from harm and identify and prosecute offenders.

West Midlands

Operation Sentinel is a force-wide operation aimed at enhancing the service provided by West Midlands Police and its partners to victims across the force area who are especially vulnerable. A particular focus has been applied to honour-based violence, FGM, domestic abuse, child sexual exploitation, and human trafficking. Sentinel aims to ensure that police, partner agencies (such as local councils, charities and support services) and the community work together more effectively and share information to fight these crimes.

Avon and Somerset

Avon and Somerset police force is involved in promoting education around issues of violence against women and children, helping to increase public awareness and improving relationships with communities where women and girls are at risk of FGM.

Greater Manchester

Greater Manchester Police conduct outreach work among communities who carry out FGM to raise awareness of the practice and encourage more people to report it.

Police and crime commissioners have also undertaken a range of action in their local areas. Get in touch with your local police and crime commissioner to find out more information.

Health in England

FGM has no health benefits and it harms girls and women in many ways.

It is now mandatory to record FGM in a patient’s healthcare record. Following publication of the Data Standard on 2 April 2014, it became mandatory for any NHS healthcare professional to record (write down) within a patient’s clinical record if they identify through the delivery of healthcare services that a woman or girl has had FGM.

For acute trusts from September 2014, it became mandatory to collate and submit basic anonymised details about the number of patients treated who have had FGM to the Department of Health every month. Monthly reports of this anonymised data, are available on the Health and Social Care Information Centre website.

Below are links to helpful resources and information about FGM for health professionals.

Resources from government:

Resources from other sources:

Psychotherapy and psychosocial services

Case histories and personal accounts taken from women indicate that FGM can be an extremely traumatic experience for girls and women which stays with them for the rest of their lives.

Young women receiving psychological counselling in the UK have reported feelings of betrayal by parents, incompleteness, regret and anger. There is increasing awareness of the severe psychological consequences of FGM for girls and women, which can become evident in mental health problems, drug and alcohol dependency.

Results from research in practising African communities show that women who have had FGM have the same levels of post-traumatic stress disorder (PTSD) as adults who have been subjected to early childhood abuse, and that the majority of the women (80%) suffer from affective (mood) or anxiety disorders.

The fact that FGM is culturally embedded in a girl’s or woman’s community does not protect her against the development of PTSD or other psychiatric disorders. Professionals, particularly those in the health sector, should ensure that mental health support is made available to assist girls and women who have undergone FGM, as well as treatment for any physical symptoms or complications.

Examples of community-based FGM services in local areas include:

Information about mental health services in your area can be found on the NHS website.

Schools in England

It’s up to schools, colleges and universities to decide exactly how they address FGM, taking account of the numbers of pupils from relevant communities. They can, however, create an open and supportive environment. For example by raising awareness through learning in sex and relationship education within personal, social, and health education (PSHE).

Listed below are some helpful resources and information about FGM for schools and teachers.

Resources from government:

Resources from other sources:

  • the film ‘Best of British’ by Values vs Violence looks at personal choices and values and community cohesion issues, and is aimed at sixth form and university students
  • a DVD for secondary school staff on how to tackle FGM issues is available from Integrate Bristol, a charity that works towards equality and integration
  • infant and primary schools ‘Dotcom’ learning programme – a range of resources led by a fun, friendly character called Dot who helps children learn how to value themselves and others, be aware of the choices they make and do the right thing
  • infant and primary schools: effective sex and relationship education within PSHE can help pupils keep themselves safe from harm through building their confidence to ask for help, learning that their body belongs to them and giving them the language to describe private parts of their body. The Sex Education Forum and PSHE Association have advice and guidance on effective teaching and learning in sex and relationship education and PSHE.

Further FGM support materials are also available, including:

  • Key Stage 3 (Y7) lesson plan produced by Islington Council to raise awareness of the practice of FGM and provide information on how and where young people can get help
  • the FGM Fact File: Interactive Teaching Resource: a teaching resource by the Foundation for Women’s Health Research and Development (FORWARD) - see ‘Training’ section below - for use in secondary schools (Y9-11) as part of personal, social and health education. It aims to raise young people’s awareness of FGM, help them realise that it is a form of abuse, and make them aware of who and where they can go to for help. There is also a teachers pack to support the resource.

Children’s social care

All children’s social care professionals should work in accordance with the guidelines in ‘Working together to safeguard children’ (2015) in England and ‘Safeguarding children: working together under the Children Act 2004’ (2004) in Wales.

Local authorities, with their partners, should develop and publish local protocols for assessment. A local protocol should set out clear arrangements for how cases will be managed once a child is referred into local authority children’s social care. The detail of each protocol will be led by the local authority in discussion with their partners and agreed with the relevant LSCB. Such protocols should include clear procedures for handling cases where FGM is alleged or known about, or where there are concerns that a girl may be at risk of undergoing FGM.

The Department for Education has funded a £2 million national programme backed by Barnardo’s and the Local Government Association that will create a programme to bring together experts on FGM to support local authorities.

These are links to helpful resources and information about FGM for children’s social care professionals:

Leaflets

These materials are designed to help classroom teachers and professionals raise awareness of FGM, and explore the stigma and common issues that often surround it.

Resources from government:

The following resources from other sources can be found under FGM support materials:

  • FGM frequently asked questions: a campaigner’s guide for young people, produced by FORWARD
  • ‘I Have Rights’, produced by the Iranian and Kurdish Women’s Rights Organisation (IKWRO)
  • ‘Voices of women’, by Birmingham and Solihull Women’s Aid FGM Project
  • Guidance for schools, produced by Project Azure and the Metropolitan Police Service

Further resources from other sources:

Training

Education and training needs to be provided for all health and social care professionals who may work with affected women and girls, or those at risk, and with their families. Safeguarding is essential and it is also important to consider the issues of ethnicity, custom, culture and religion in a sensitive manner.

LSCBs are responsible for monitoring and evaluating the effectiveness of training, including multi-agency training, to safeguard and promote the welfare of children provided within their area. This is in line with their function to develop policies and procedures in relation to training of those persons who work with children or in services affecting the safety and welfare of children. Such policies and procedures may include specific training in relation to FGM. Further information can be found in the ‘Working together to safeguard children’ resource’.

It is recommended that FGM should be a part of all staff training on safeguarding. Any programme of training around FGM should include the following:

  • overview of FGM (what it is, when and where it is performed)
  • socio-cultural context, including the perception of FGM as a religious obligation
  • facts and figures
  • UK FGM and child protection law
  • FGM complications
  • safeguarding children – principles to follow when FGM is suspected or has been performed
  • roles of different professionals

Professionals should receive training specific to their role. Below are some examples of the types of training available. Particular requirements will need to be assessed according to the professional sector.

Training from government:

Training from other sources:

  • The Foundation for Women’s Health Research and Development (FORWARD) trains professionals and organisations on FGM and child protection issues - their sessions are tailored to the specific needs, issues and concerns of individuals and organisations and include:
  • Birmingham and Solihull Women’s Aid facilitates training on the issues of domestic violence, forced marriage and FGM for frontline professionals, schools and affected communities
  • Values vs Violence provides training to primary and secondary schools using the ‘Cut – some wounds never heal’ DVD. A tool to raise awareness and understanding of FGM issues in schools and communities, ‘Cut’ was commissioned in response to concerns raised by schools who were dealing with victims and disclosure. The film is 13 minutes long. Enter the password vvvuk2010 to view this film. Teachers should follow the lesson plan when viewing this film.
  • Manor Gardens Centre is a North London provider of training to health, social care and education professionals on FGM, as well as to students training in relevant professions. Training is delivered by a specialist FGM midwife and a community facilitator from a FGM-affected community, allowing participants to understand both why FGM is practised, how it affects women and the role of the professionals in preventing it.
  • BAWSO delivers specialist support service in Wales to people from BME backgrounds who are affected by domestic abuse and other forms of abuse, including female genital mutilation, forced marriage, human trafficking and prostitution. In 2010 BAWSO established a female genital mutilation project and an educational booklet for health professionals is available on request.
  • IMKAAN is a UK-based black feminist organisation dedicated to addressing violence against women and girls. It has developed accredited quality standards for working with BME communities and harmful traditional practices, including FGM, forced marriage and ‘honour-based’ violence.
  • Project Azure provides a range of training packages and DVDs on FGM, available to teachers, students and parents, and for outreach work. You can access these from the POLKA website. You will need to call 020 7161 2888 first, as the site is only available to police staff.

DVDs and videos

Ending female genital mutilation

Ending female genital mutilation

To reach communities the Home Office has produced a DVD with interviews with health professionals, survivors and the NSPCC. This DVD will help supported advocates within communities, such as community leaders, to run educational sessions on FGM in trusted environments and to start conversations on the issue. This film is 8 minutes long.

Think again

‘Think again’

‘Think Again’ is a thought-provoking film which follows a 12-year-old’s struggle between family hope and safeguarding her rights. On discovering her mother wants to take her back to be ‘cut’, she explores the implications of FGM and the traditions and myths that persist in the 21st century. ‘Think Again’ depicts the cultural context in which FGM is practised and the inter-generational conflict of holding to traditions in Europe. It addresses a complex issues with sensitivity and creativity, breaking the silence and inspiring change. The film is 8 minutes long and was produced by FORWARD.

Silent scream

‘Silent scream’

‘Silent Scream’ is a film about FGM made by young women in Bristol with the support of Integrate Bristol and Zed Productions. The film is 12 minutes long.

The cutting tradition

‘The cutting tradition’

‘The Cutting Tradition’ is a 47-minute film, narrated by Meryl Streep, commissioned by FIGO - the International Federation of Obstetricians and Gynecologists. Filmed in Ethiopia, Egypt, Djibouti, Burkina Faso and the UK, it looks at the reasons for female genital mutilation in Africa today. The film was produced by SafeHands for Mothers and FIGO.

True story

‘True story’

UNFPA (the United Nations Population Fund) and UNICEF are working towards the elimination of female genital mutilation or cutting in the Afar region of Ethiopia. ‘True Story’ is a film made for the UNFPA/UNICEF joint programme by SafeHands for Mothers. It is 27 minutes long.

FGM is child abuse

FGM is child abuse’, by NHS Choices

A 5-minute film produced by NHS Choices about what FGM is and where to find help if you or someone you know is at risk of FGM.

For honour and love

Produced by the Kurdish and Middle Eastern Women’s Organisation in Britain, this DVD covers 4 themes:

  • ‘Lost in translation’ – a scene about control in relationships
  • ‘The holiday’ – a scene about female genital cutting
  • ‘A family affair (part 1)’ – a scene about forced marriages
  • ‘A family affair (part 2)’ – a scene about ‘honour’ killings

Each DVD is supplied with a booklet, which gives a summary of the message of each scene, a number of discussion points for use with groups of young people and suggestions for further discussion.

For copies of ‘For honour and love’, please contact the Kurdish and Middle Eastern Women’s Organisation, Caxton House, 129 St John’s Way, London N19 3RQ Telephone: 020 7263 1027; mobile: 07748 851 125; fax: 020 7561 9594; email: info@kmewo.org

‘Cut – some wounds never heal’

Produced by Values vs Violence, this is a tool to raise awareness and understanding of FGM issues in schools and communities. Resource commissioned in response to concerns raised by schools dealing with victims and disclosure. The film was produced by Sharon Evans and is 13 minutes long.

Enter the password vvvuk2010 to view this film. Teachers should follow the lesson plan when viewing the film.

‘Now that you know, say no to FGM

These 3 short films, by SafeHands for Mothers, offer insight into reactions to FGM and can be used by facilitators working with young people in communities to highlight, inform and educate on FGM.

7. Contacts, helplines and clinics

Helplines

FGM support services

To find FGM support near you, try the FGM help and advice postcode finder.

Home Office FGM unit

The unit:

  • provides outreach support to local areas to support them in developing their local response to fighting FGM and to raise awareness of the unit
  • identifies and highlights examples of effective practice across local areas and professional groups
  • promotes available FGM resources
  • works with the police, Border Force, the Crown Prosecution Service and the College of Policing to improve the identification and prosecution of offenders
  • has an overview of all government work to fight FGM and works closely with the voluntary and community sector, survivors and professionals to develop cross-cutting policies and processes

If you are interested in receiving any outreach support or have any other queries, please email the FGM unit at fgmenquiries@homeoffice.gsi.gov.uk.

General contacts

Other organisations

FGM clinics

A list of specialist FGM clinics in the UK is available on the NHS website.