Violence Against Women

Question 1

What is Female Genital Mutilation (FGM)?

Answer 1

Female Genital Mutilation (FGM) 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

Question 2

What is type 1 FGM?

Answer 2

Clithoridectomy

-Partial or total removal of the clitoris and, in very rare cases, only the prepuce

Question 3

What is type 2 FGM?

Answer 3

Excision

-Partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora

Question 4

What is type 3 FGM?

Answer 4

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, with or without removal of the clitoris.
• Sometimes referred to as Pharaonic circumcision.

Question 5

What is type 4 FGM?

Answer 5

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

Question 6

What is de-infubulation?

Answer 6

• Sometimes known as or referred to as deinfibulation or defibulation or FGM reversal
• The surgical procedure to open up the closed vagina of FGM type 3. (for example for birth)

Question 7

What is re-infubulation?

Answer 7

• Sometimes known as or referred to as reinfibulation or re-suturing
• The re-stitching of FGM type 3 to re-close the vagina again after childbirth

Question 8

What other terms are there for FGM?

Answer 8

• Female circumcision
• Cutting
• Sunna

Question 9

What justifications do people use for FGM?

Answer 9

• Preservation of virginity and chastity
• Religion, in the mistaken belief that it is a religious requirement
• Social acceptance
• Fear of social exclusion
• To ensure the girl is marriageable or to improve marriage prospect
• Hygiene and cleanliness
• Increasing sexual pleasure for the male
• Family honour
• Enhancing fertility

Question 10

When is FGM usually carried out?

Answer 10

• FGM is mostly carried out on young girls sometime between birth and age 15, and occasionally on adult women.
• Most commonly between 4 and 10 years old

Question 11

Who performs the cutting?

Answer 11

• Traditional cutters or circumcisers
• Healthcare workers
• Members of secret societies
• Barbers
• Herbalists
• Relatives

Question 12

How many people have been affected by FGM?

Answer 12

• At least 200 million worldwide
• Approximately 3 million performed per year
• 137,000 thought to have been cut in England and Wales

Question 13

What are the short-term complications of FGM?

Answer 13

• 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 14

What are the long term complications form FGM?

Answer 14

• Urine retention and difficulties in menstruation
• Uterine, vaginal and pelvic infections
• Cysts and neuromas
• Complications in pregnancy and childbirth
• Increased risk of fistula
• On-going impact of trauma / PTSD
• Sexual dysfunction

Question 15

What are the possible social implications of FGM?

Answer 15

• Psycho-sexual and psychological issues
• Estrangement from parent and family
• Relationship and marriage breakdown

Question 16

What are the psychological effects of FGM?

Answer 16

• Post traumatic symptoms
• Anxiety
• Depression
• Fear of Intimacy
• Loss of Trust
• Unresolved Anger
• Nightmares
• Flashbacks – especially associated with sexual intercourse and childbirth

Question 17

What Act criminalised FGM in the Scotland?

Answer 17

Prohibition of Female Genital Mutilation (Scotland) Act 2005

Question 18

What are the risk factors for FGM?

Answer 18

-Mother had FGM
-Older sister or cousins had FGM
-Parents requested rei-infibulation following delivery
Parents express views favouring practice
-Girl is withdrawn from teaching on personal, social or health education

Question 19

What are the signs that a girl is in imminent risk of FGM?

Answer 19

• Withdrawn from school for extended trip of long trip planned during holidays
• Visit from a family elder (particularly from abroad)
• Girl talking about something happening or a big party, or she is becoming a women
• If forced marriage is suspected

Question 20

What is the national guidance for child protection in Scotland (2014)?

Answer 20

• Female genital mutilation should always be seen as a cause of significant harm and normal child protection procedures should be invoked
• Where a child or young person within a family has already been subjected to female genital mutilation, consideration must be given to other female siblings or close relatives who may also be at risk.
• Local guidelines should be in place to ensure a coordinated response from all agencies and highlight the issue for all staff who may come into contact with children who are at risk from female genital mutilation

Question 21

What are the key documents with regard to FGM?

Answer 21

-Scotland’s National Action Plan –to prevent and eradicate Female Genital Mutilation.
Scottish Government 2016
-Tackling Female Genital Mutilation in Scotland. A S
Scottish model of intervention. Scottish Refugee Council and London School of Hygiene and Tropical Medicine, 2014

Question 22

How can support be accessed?

Answer 22

• Health services can provide support and treatment.
• Women can access the help they need by speaking to their doctor, health visitor or midwife or can attend a sexual health clinic.
• Support will be offered in relation to trauma / emotional impact, as well as in relation to any physical treatment.