Violence Against Women and Girls

Question 1

define FGM

Answer 1

Female genital mutilation 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

type 1 FGM

Answer 2

Clitoridectomy

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

Question 3

type 2 FGM

Answer 3

Excision

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

Question 4

type 3 FGM

Answer 4

Infibulation
o 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 o

Question 5

type 4 FGM

Answer 5

Other
o 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-infibulation

Answer 6

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

Question 7

define re-infibulation

Answer 7

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

Question 8

“justifications” for FGM

Answer 8

• 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 9

when is FGM carried out?

Answer 9

FGM is most commonly carried out on young girls sometime between birth and age 15, and occasionally on adult women. The age at which FGM happens is different in different communities and areas, and is linked to the reasons for carrying it out. The most common age is between 4 and 10, although reports suggest that the average age is falling in some areas.

Question 10

who performs the cutting in FGM?

Answer 10

Most often this is carried out by traditional cutters or “circumcisers”. These women will often have a very respected role within the community. The role is often passed down from mother to daughter. Some of these women will have other important role e.g. childbirth attendants. More than 18% of all FGM is performed by healthcare providers. There is an increasing trend towards medicalisation appearing (including in countries where there are laws against FGM).

Question 11

short term health impacts of FGM

Answer 11

1. Severe pain and shock
2. Infection
3. Injury to adjacent tissues
4. Sprains, dislocations, broken bones or internal injuries from being restrained
5. Immediate fatal haemorrhage
6. Infection by a BBV

Question 12

long term health impacts of FGM

Answer 12

1. Urine retention and difficulties in menstruation
2. Uterine, vagina and pelvic infections
3. Cysts and neuromas
4. Complications in pregnancy and childbirth
5. Increased risk of fistula
6. On-going impact of trauma/PTSD
7. Sexual dysfunction

Question 13

psychological effects of FGM

Answer 13

1. PTSD
2. Anxiety
3. Depression
4. Fear of intimacy
5. Loss of trust
6. Unresolved anger
7. Nightmares
8. Flashbacks – especially associated with sexual intercourse and childbirth

Question 14

describe the Prohibition of Female Genital Mutilation (Scotland) Act 2005

Answer 14

Offence of female genital mutilation
(1) A person who performs an action mentioned in subsection (2) in relation to the whole or any part of the labia majora, labia minora, prepuce of the clitoris, clitoris or vagina of another person is guilty of an offence.
(2) those actions are:
Excising it
Infibulating it or
Otherwise mutilating it
(3) Aiding and abetting female genital mutilation
A person who aids, abets, counsels, procures or incites:
• A person to commit an offence under section 1;
• Another person to perform an action mention in section 1(2) in relation to the whole or any part of that other person’s own labia majora, labia minora, prepuce of the clitoris, clitoris or vagina; or
• A person who is not a United Kingdom national or permanent United Kingdom resident to do a relevant act of genital mutilation outside of the United Kingdom, commits an offence

Question 15

risk factors for FGM

Answer 15

• Mother has had FGM
• The girl should be viewed at increased risk if:
o An older sister or cousins have undergone FGM
o The mother (and/or father) has requested reinfibulation following delivery
o The parents express views which show that they value the practice
o The girl is withdrawn from all teaching classes on PSHE

Question 16

possible signs of imminent risk of FGM

Answer 16

• A girl is withdrawn from school to allow for an extended holiday, or a girl talks about a long trip planned during the school summer holidays
• There is no evidence to date that FGM takes place in Scotland but it may be possible that families will arrange for FGM to happen in the UK. It is thought that a visit from a female family elder is an indicator of risk, particularly if she is visiting from the country of origin
• A girl may talk about “something special” happening, or that there will be “a big party” or she is going to “be a woman soon”
• If forced marriage is suspected or known then risk of FGM should also be addressed where the girl comes from a group that traditionally practices FGM

Question 17

national guidance for child protection in Scotland (2014)

Answer 17

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 relative 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 18

key documents for FGM

Answer 18

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