female genital mutilation

Question 1

what is FGM

Answer 1

comprises all procedures that involve partial or total removal of the external female genitalia or other injury to the female genital organs for cultural or non-medical reasons

violation of human rights of girls and women

nearly always carried out on minors

Question 2

how many types of FGM are there

Answer 2

4

Question 3

what is type 1 FGM

Answer 3

clitoridectomy - partial/total removal of the clitoris and, in vary rare cases, only the prepuce

Question 4

what is type 2 FGM

Answer 4

excision - partial/total removal of the clitoris and labia minoria, w/ or w/o excision of the labia majora

Question 5

what is type 3 FGM

Answer 5

most radical form

infibulation - narrowing of the vaginal opening through the creation of a covering seal

the seal is formed by cutting and repositioning the inner or outer labia, w/ or w/o removal of the clitoris

aka pharaonic circumcision

Question 6

what is type 4 FGM

Answer 6

other - all other harmful procedures to the femal genitalia for non-medical purposes e.g. pricking, piercing, incising, scraping and cauterising the genital area

Question 7

what is de-infibulation

Answer 7

aka deinfibulation, de fibulation or FGM reversal

surgical procedure to open up the closed vagina of FGM type 3

should be carried out in the latter stages of pregnancy or during pregnancy

Question 8

what is re-infubulation

Answer 8

aka reinfibulation or re-sututing

re-stitching of FGM type 3 to re-close the vagina again after childbirth

illegal in the UK - constitutes as FGM

Question 9

terminology for FGM

Answer 9

legislation, strategic and policy work use the term FGM

FGM is also known as cutting and female circumcision and these may be more used in the community

Question 10

justifications for FGM

Answer 10

preservation of virginity and chastity
religion - mistaken belief that it is a religious requirement
social acceptance, fear of social exclusion
to ensure the girl is marriageable or to improve marriage prospects
hygiene and cleanliness
increasing sexual pleasure for the male
family honour
enhancing fertility

Question 11

prevalence of FGM in Africa and the middle east

Answer 11

carried out by ethnic groups rather than nationalities

> 80% - mali, guinea, sierra leone, sudan, egypt, somalia, eritrea, djibouti

yemen, oman

muslim populations in parts of india and pakistan, malaysia and indonesia

FGM practiced by ethnic minorities in other parts of the world due to migration

important to not exclude countries where prevalence is low as ethnic groups can span geographical boundaries

Question 12

short term health impact of FGM

Answer 12

severe pain and shock 
infection
injury to adjacent tissues
sprains, dislocations, broken bones or internal injuries from being restrained
immediate fatal haemorrhaging 
infection by blood borne virus

Question 13

long term impact of FGM

Answer 13

urine retention and difficulties in menstruation

uterus, vaginal and pelvic infection
cysts and neuromas
complications in pregnancy and childbirth
increased risk of fistula 
on-going impact of trauma/PTSD
sexual dysfunction

Question 14

FGM and the law

Answer 14

offence in the UK since 1985, scotland since 2005

Question 15

prohibition of FGM act 2005 - scotland

Answer 15

offence of FGM

1. person who performs an action mentioned in subsection
2. in relation to the whola or any part of the labia majora, labia minora, prepuce of clitoris, clitoris or vagina of another person is guilty of an offence

actions are:
excision
infibulation
other mutilation

3. aiding and abetting FGM

Question 16

risk factors for FGM

Answer 16

mother has had FGM
older sister/cousin have undergone FGM
mother (+/- father) has requested re-infibulation following delivery
parents express views showing they value the practice
girl is withdrawn from all teaching classes on personal, social or health education

level of integration within UK society is significant - less integrated = more likely to carry out FGM

BUT REMEMBER not all women who have undergone FGM will support it

Question 17

national guidance for child protection in scotland

Answer 17

FGM should always be seen as a cause of significant harm and normal child protection procedures should be invoked

where a child/young person within a family has already been subject to FGM - consideration must be given to other female siblings/close relatives who may also be at risk

local guidelines should be in place to ensure coordinated response and highlight the issue for all staff who may come into contact w/ at risk children