UK policy response to female genital mutilation needs urgent rethink
BMJ 2023; 383 doi: https://doi.org/10.1136/bmj-2022-074751 (Published 23 November 2023) Cite this as: BMJ 2023;383:e074751
This article has a correction. Please see:
- Sakaria Ali, consultant paediatrician1,
- Saffron Karlsen, professor of sociology2,
- Hazel Learner, consultant paediatric and adolescent gynaecologist1,
- Natasha Carver, lecturer in international criminology2,
- Christina Pantazis, professor of zemiology2,
- Brian D Earp, senior research fellow3,
- Deborah Hodes, honorary consultant community paediatrician1
- 1University College London Hospital NHS Trust, London, UK
- 2University of Bristol, Bristol, UK
- 3University of Oxford, Oxford, UK
- Correspondence to: D Hodes deborah.hodes{at}nhs.net
Female genital mutilation or cutting (FGM/C) is internationally regarded both as a health and a human rights issue.1 Global prevalence estimates suggest that over 200 million women and girls have had different forms of medically unnecessary genital cutting.2 This figure excludes those with elective genital “cosmetic” surgery,123 which may also count as FGM/C as the WHO definition does not factor in consent (box 1).1 The practice occurs in many societies across the world for a variety of sociocultural reasons, including as a structured rite of passage into adulthood, and it affects women and girls of different ages.2 The increasing migration of people from countries that have higher rates of FGM/C to lower prevalence settings such as the UK has prompted efforts among health professionals and policy makers to understand and reduce the ongoing risk for women and girls with heritage in those communities.
WHO definition and classification of female genital mutilation
The World Health Organization defines female genital mutilation as all practices involving the “the partial or total removal of external female genitalia or other injury to the female genital organs for non-medical reasons.”1 Increasingly it is argued that these practices should be referred to as female genital cutting because of inconsistencies and biases associated with the word “mutilation.”3 We use the abbreviation FGM/C in recognition of this controversy.
WHO classifies four major types1:
Type 1—Partial or total removal of the clitoral glans or prepuce, or both
Type 2—Partial or total removal of the clitoral glans or labia minora, or both, with or without excision of the labia majora
Type 3 …
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