What is
Female Genital Mutilation

Female Genital Mutilation (FGM) is any procedure which removes part or all of a girl or woman’s external genitalia for non-medical reasons. It can also be known as female genital cutting or circumcision.

FGM can occur anytime from birth onwards, however it is most commonly done to girls when they are between four and ten years old.

FGM is often practiced seasonally, so the school holidays are when children are most at risk. FGM is often a cultural norm in the communities where it is practiced. The prevalence and type varies between communities even within the same country. However, not all families in FGM practising communities want their girls and women to undergo FGM. It is also important to note that not all women or girls know that they have had FGM performed on them.

Four Types of FGM

There are four types of FGM depending on how much tissue is cut or removed. Type III FGM is the most extreme version and it carries the most risk for women during childbirth. All types of FGM are a human rights violation and all have been illegal in Ireland since 2012.

Type I

Partial or total removal of the clitoris and/or the prepuce. In medical literature this form of FGM/C is also referred to as ‘clitoridectomy’. A number of practising communities also refer to it as Sunna, which is Arabic for ‘tradition’ or ‘duty’.

Type II

This involves the partial or total removal of the clitoris and labia minora with or without excision of the labia majora. The 2007 WHO definition recognizes that although this form of cutting is more extensive than Type I, there is considerable variability in the form or degree of cutting. In English, this type of cutting is often referred to as ‘excision’, although it is important to note that in French the term ‘excision’ generally refers to all forms of FGM/C.

Type III

This involves the narrowing of the vaginal orifice by cutting and bringing together the labia minora and/or the labia majora to create a type of seal with or without excision of the clitoris. In most instances, the cut edges of the labia are stitched together, which is referred to as ‘infibulation’. The adhesion of the labia results in near complete covering of the urethra and the vaginal orifice, which must be reopened for sexual intercourse and childbirth, a procedure known as ‘de-infibulation’. In some instances, this is followed by re-infibulation.

Type IV

All other harmful procedures to the female genitalia for non-medical purposes, for example: pricking, piercing, incising, scraping and cauterization. Pricking or nicking involves cutting to draw blood, but no removal of tissue and no permanent alteration of the external genitalia. This is sometimes called ‘symbolic circumcision’, and some communities have described it as a traditional form of FGM/C. Although symbolic circumcision is still highly controversial, it has been proposed as an alternative to more severe forms of cutting in both African and other countries where FGM/C is performed.

Why is
Female Genital Mutilation Practiced?

The origin of this practice is largely unknown, but it has existed in one form or another in almost all known civilisations throughout history and has not been confined to any one culture or religion. A mix of cultural, religious and social factors within families and communities are the main reasons for developing and continuing the practice. However, the majority of these beliefs are based in myths and misinformation.

A Rite of Passage into Womanhood

In certain FGM-practising communities a girl cannot be considered an adult unless she has undergone FGM. That is, the process is a distinctive element of belonging, of being a member of the group.

Perceived Hygiene

In some cultures there is a belief that female genitalia are unsightly and dirty. In some FGM-practising societies, unmutilated women are regarded as unclean and are not allowed to handle food and water.

Marriageability

FGM is often deemed necessary in order for a girl to be considered a complete woman, and the practice marks the divergence of the sexes in terms of their future roles in life and marriage. Most mothers practise FGM on their daughters to ensure their daughters have a future of respect and well-being.

Women’s Sexuality

In many communities, a girl’s/woman’s virginity is a prerequisite for marriage and central to concepts of family honour. FGM, in particular infibulation, is defended in this context asit is assumed to reduce sexual desire and so lessen a girl’s/woman’s temptation to have premarital sex, thereby preserving her virginity. Infibulation also provides “proof” of virginity.

Religious Misconceptions

FGM predates all contemporary world religions and is not an official religious requirement by any religion. However there are some misconceptions around this issue with many people believing it is a requirement for their faith. It is important to note that FGM is carried out across a number of religious groups.

Prevalence of FGM

n 2017 AkiDwA estimated that 5,790 women and girls living in Ireland had undergone FGM, based on  2016 data collected by Ireland’s Central Statistics Office.

FGM is known to be widely practised in at least 29 African countries, and it has been reported in some countries in the Middle East, Central and South America and Asia. The World Health Organization estimates that between 100 and 140 million women worldwide have undergone FGM.

But it is not isolated to these areas, and the practice is increasing among migrant communities around the world, so FGM is now a global issue.

With migration to  Europe increasing, FGM has become an issue in several countries. The European Parliament estimates  that 500,000 girls and women living in Europe are suffering with the lifelong consequences of female genital mutilation and that 180,000  children are at risk  of FGM every year.

FGM Health Consequences

FGM can leave women and girls with many negative health consequences. These can include; infection, bleeding, reduced sensation, increased risk during childbirth, psychological trauma and death. In groups where FGM prevalence is high, certain consequences that are common may be considered ‘normal’ and not associated with the practice.

Short Term Complications

  • Death
  • Haemorrhage
  • Infection and failure of the wound to heal
  • Injury or trauma to adjoining areas, such as the urethra and anus
  • Shock from severe pain and bleeding
  • Surgical mishap
  • Tetanus
  • Transmission of HIV and other viruses

Long Term Complications

  • Decrease or loss of sexual sensation
  • Difficult and complicated childbirth
  • Dysmenorrhoea, difficulties in menstruation including passing menses
  • Dyspareunia (painful intercourse)
  • Incontinence and difficulty urinating
  • Pelvic inflammatory disease (PID) and infertility
  • Psychological trauma
  • Scarring (with or without keloid formation) and hardening of the vaginal tissue, causing constant pain around the genital area
  • Sebaceous cyst development

For all health professionals looking for further information on FGM please see:

Information for Healthcare Professionals in Ireland [2nd Edition].

FGM and the Law

What legislation against FGM exists in Ireland ?

FGM became illegal in Ireland in 2012 when the Criminal Justice (Female Genital Mutilation) Act 2012 was passed.

The 2012 law made it  ILLEGAL to practice or attempt to practice FGM on a woman or girl.

It also became a criminal offence for anyone resident in Ireland to ask someone else to perform FGM or for someone resident in Ireland to take a girl to another country to undergo FGM.

Offenders can be prosecuted when they return to Ireland. The maximum penalty under all sections of this law is a fine of up to €10,000 or imprisonment for up to 14 years or both.

FGM is treated as a form of Child Abuse in Children First National Guidance for the Protection and Welfare of Children, 2011.

The Criminal Justice FGM Act 2012 states:

  • Section 2 – “A person is guilty of an offence if the person does or attempts to do an act of female genital mutilation”.
  • Section 3 – “A person is guilty of an offence if the person removes or attempts to remove a girl or woman from the State where one of the purposes for removal is to have the act of genital mutilation done to her.”
  • Section 4 – “A person is guilty of an offence if the person does or attempts to do an act of female genital mutilation in a place other than the State, but only if it is done or attempted to be done:
    • on board an Irish ship within the meaning of section 9 of the Mercantile Marine Act 1955 ,
    • on an aircraft registered in the State, or
    • by a person who is a citizen of Ireland or is ordinarily resident in the State, and would constitute an offence in the place in which it is done.

FGM as a Human Rights Violation

Female genital mutilation, in any form, is recognised internationally as a gross violation of human rights of girls and women.

The practice of FGM violates:

  • Right to physical and mental integrity
  • Right to highest attainable standard of health
  • Right to be free from all forms of discrimination against women (including violence against women)
  • Right to freedom from torture or cruel, inhuman or degrading treatment
  • Rights of the child
  • Right to life

As it is practiced at very premature age, usually in girls between 4 and 10 years old, the practice of FGM violates children’s rights as defined in the Convention on the Rights of the Child (CRC), in particular the right to be free from discrimination (Article 2), right to be protected from all forms of mental and physical violence and maltreatment (Article 19(1)), the right to highest attainable standard of health (Article 24) and freedom from torture or other cruel, inhuman or degrading treatment or punishment (Article 37).

However, the law is not enough to stop the practice – interventions aimed at providing education and adapting cultural practices and traditions are also needed.

What to do if a child is at risk?

If a child is at risk

If you feel that a girl is at risk of FGM, you should contact your local child protection social worker at Túsla, Children and Family Agency:

Tel: 01 635 2854

Email: info@tusla.ie

Web: www.tusla.ie

If you think a girl is in immediate danger please contact any Garda station or dial 999 or 112.

For professionals working with children it is your legal obligation under Children’s First Guidelines (2011) to report to child protection services and/or the Gardaí if you feel a girl is at risk of FGM or if FGM has already taken place.

 

If FGM has already taken place

If you suspect that FGM has already been performed on a girl, contact the Gardaí and local child protection social work department (Túsla). This will have legal implications for the person(s) who carried out the procedure and it is necessary to report to protect further children at risk in the family or community.

FGM support service

Girls and women can avail of free specialised medical, nursing and counselling services through the FGM support service at the Migrant women’s health clinic. This clinic is offered by the Irish Family Planning Association (IFPA) in its Dublin city centre Every Woman Clinic, Cathal de Brugha St, Dublin 1.

For further details please see: http://www.ifpa.ie/Sexual-Health-Services/FGM-Treatment-Service  or phone/text the designated phone line: 085 877 1342.

FGM Support Service

Girls and women can avail of free specialised medical, nursing and counselling services through the FGM support service at the Migrant women’s health clinic. This clinic isoffered by the Irish Family Planning Association (IFPA) in its Dublin city centre Every Woman Clinic, Cathal de Brugha St, Dublin 1.

For further details please see: http://www.ifpa.ie/Sexual-Health-Services/FGM-Treatment-Service  or phone/text the designated phone line: 085 877 1342.

Community Health Ambassador Programme

AkiDwA has been raising awareness on the issue of FGM since 2001. Providing information on FGM is key in assisting families in their decision to abandon the practice. Awareness raising of professionals working with children who are at risk of FGM is also extremely important in preventing FGM before it occurs.

AkiDwA has a network of volunteer community health ambassadors throughout Ireland raising awareness on FGM in their local communities.

AkiDwA’s work on FGM

2019 —   AkiDwa celebrated the second  Zero Tolerance for FGM Day with Action Aid on February 6th at the Irish School of Ecumenics, Trinity College Dublin.  Triona Pender of Action Aid explained how the AFTER project is tackling FGM in  Cork.

2018 — AkiDwA recruited 13 active Community Health Ambassadors and provided  them with training in Dublin.  After being trained by Akidwa to raise awareness  of the damaging  effects of FGM, Community Health Ambassadors Memory Mangava and Sitshenisiwe Nondo began working   in Carrick-on-Suir to educate the community about FGM, the law against it and the impact it has on women and children in terms of physical and mental  health.

Their work as  Akidwa Community Health Ambassadors was featured in the local newspaper.

2015 — AkiDwA reconvened the National Steering Committee on FGM to make recommendations for the 2nd National Action Plan on FGM (2015-2020).

2014  AkiDwA became a founding member of the European End FGM Network. This involves 11 organisations from across Europe working together to advocate for European action on FGM.

May 2014 — AkiDwA collaborated with the IFPA and the HSE   to plan  the opening of the first specialised support service for FGM survivors

2013 —  Akidwa collaborated with  Ireland’s Royal College of Surgeons  (RCSI), Pobal and the HSE’s Social Inclusion Unit  to   revise and update the 2nd Edition of the FGM handbook Information for Healthcare Professionals working in Ireland. The first handbook  to helpfor Irish healthcare professionals identify and tret women with FGM was produced by Akidwa in 2008.

2012 — After a decade of campaigning and lobbying by organisations like Akidwa, Ireland’s Criminal Justice (Female Genital Mutilation) Act 2012 was signed into law.  One of the innovative aspects of this law is that it became a criminal offence to take children outside the country  to subject them to FGM.

2012  — AkiDwA published an information leaflet for the public- Female Genital Mutilation and the law in Ireland.

2012  — AkiDwA lobbied to have Female Genital Mutilation (FGM) included as a Risk Factor in the new Irish national standardized maternity hospital chart. The new hospital charts are used for all women looking for maternity care.  This marked the first time that  FGM was officially highlighted  at a national level as a risk factor in obstetric care.

2010 — An Bord Altranais Practice Standards for Midwives, which is sent to all registered midwives in Ireland, came into force in July 2010 and now includes a section on FGM.

2010  AkiDwA established two community forums for dialogue on FGM in Cork and Galway.

2009 — AkiDwA and the IFPA made representations to the Joint Oireachtas Committee on Health and Children on the need for legislation to prohibit FGM and for the promotion of health services related to FGM.

2009 — AkiDwAi  joins the European END FGM campaign led by Amnesty International as the official Irish partner organisation .

2008 — Both Organisations agreed to develop a National Plan of Action to address FGM in Ireland. This was supported by a steering committee of diverse stakeholders including children’s advocacy groups, women and human rights organisations.

2008 —AkiDwA produced the first initial statistics of the prevalence of FGM in Ireland.

2008 — AkiDwA and the Royal College of Surgeon’s published an information handbook – Female GenitalMutilation: Information for Healthcare Professionals Working in Ireland – to raise awareness among healthcare professionals.

2005 — Consultations with women from communities where FGM is practiced led to a partnership with the Irish Family Planning Association (IFPA).

2001 — Commenced awareness raising on FGM, promoting migrant women’s health, and campaigning for legislation to prohibit the practice.

Further information and eLearning on FGM

United to End FGM free online learning tool provides information on FGM. It has the options of a health, asylum or combined stream modules. This is a free eLearning module and you will receive a certificate of completion. www.uefgm.org

World Health Organisation Factsheet on FGM http://www.who.int/mediacentre/factsheets/fs241/en/

UNICEF Report 2013 “FGM/C A statistical overview and exploration of the dynamics of change” http://www.unicef.org/esaro/FGCM_Lo_res.pdf

End FGM European Network http://www.endfgm.eu/en/

© AkiDwA 2019
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