Female genital mutilation

Also called FGM, Female genital cutting

Illegal in the UK, including taking a girl abroad for it. Health professionals have a mandatory duty to report it in under-18s.

What it is

The partial or total removal of the external female genitalia, or other injury to them, for non-medical reasons. It has no health benefits and causes lifelong harm.

It is illegal in the UK under the Female Genital Mutilation Act 2003. It is also an offence to take a girl abroad for it, or to fail to protect a girl at risk. It is child abuse, and it is a form of violence against women and girls.

**There is a mandatory reporting duty.** Regulated health and social care professionals and teachers in England and Wales must report known cases in a girl under 18 to the police, personally, by ringing 101. That duty is not discretionary and does not depend on the person's own judgement about the family. For adults, and for girls at risk rather than known cases, the route is local safeguarding rather than mandatory reporting.

The health consequences are lifelong: chronic pain, recurrent urinary and vaginal infections, difficulty passing urine and menstruating, painful or impossible intercourse, infertility, complications in childbirth, and significant psychological harm including post-traumatic stress disorder.

Deinfibulation, a surgical procedure to open the scar, is available on the NHS and can be done before or during pregnancy. Specialist FGM clinics exist and take self-referrals in many areas.

Re-infibulation, closing again after childbirth, is illegal.

Signs you might notice

In a girl: difficulty walking, sitting or standing; spending a long time in the bathroom; frequent urinary infections; withdrawal, anxiety or depression; a prolonged absence from school, especially over a summer holiday, with a change afterwards; or talk of a special ceremony or becoming a woman.

In a woman: chronic pelvic or vulval pain; difficulty or pain passing urine, and a very slow stream; prolonged or painful periods; painful or impossible intercourse; repeated infections; anxiety about examinations and childbirth; and flashbacks.

Risk indicators: family from a practising community, an older sibling affected, a planned trip abroad, or a relative visiting who is known to perform it.

Urgent: acute bleeding, severe pain, inability to pass urine, or signs of infection after a recent procedure. That is a medical and a police emergency.

How it can affect day-to-day life

Women who have experienced FGM often avoid healthcare entirely, particularly cervical screening, sexual health services and antenatal care, because examinations are painful and re-traumatising and because they fear judgement or police involvement.

That fear is the main barrier. Explaining clearly what will and will not be reported, and that adults are not reported without their consent unless a child is at risk, is what allows people to come forward.

Trained interpreters are essential, and family members should never interpret for this.

Girls at risk are frequently identified through a mother already affected, which makes the antenatal booking conversation a genuine safeguarding opportunity rather than an intrusion.

Communities that practise it are not monolithic, and many individuals within them oppose it. Approaching it as a safeguarding and health issue rather than as a cultural accusation works better and is more accurate.

Supporting someone well

Know the mandatory duty: a known case in a girl under 18 must be reported personally to the police on 101 by a regulated professional or teacher.

For an adult, or for a girl at risk rather than a known case, follow local safeguarding procedures and take advice.

Ask sensitively, in private, with a professional interpreter, never a family member.

Explain clearly what will happen with the information; fear of the unknown is the main barrier.

Offer referral to a specialist FGM clinic, and explain that deinfibulation is available and can transform urinary and menstrual symptoms.

Raise it in pregnancy early, so deinfibulation can be planned rather than done during labour.

Never perform or arrange re-infibulation; it is illegal.

Offer trauma-informed psychological support alongside physical treatment.

For an urgent risk, such as an imminent trip abroad, act immediately through the police and children's social care.

Where to get help

999 for immediate risk to a child; 101 for the mandatory report.

The NSPCC FGM helpline on 0800 028 3550, free and anonymous, 24 hours.

A specialist NHS FGM clinic, which takes self-referrals in many areas, and a GP practice or midwife for referral.

Local safeguarding teams for adults and for children at risk.