• What is FGM?
• What are the consequences of FGM?
• Who is affected by FGM?
• Why is FGM practiced?
• Terminology
• Legal Framework in the European Union

What is FGM?

According to the definition of the World Health Organization (WHO), FGM “comprises all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons” (WHO: Female genital mutilation Fact sheet, updated February 2016).

The WHO classifies FGM into four main types:

• Type I: Often referred to as clitoridectomy, this is the partial or total removal of the clitoris (a small, sensitive and erectile part of the female genitals), and in very rare cases, only the prepuce (the fold of skin surrounding the clitoris).
• Type II: Often referred to as excision, this is the partial or total removal of the clitoris and the labia minora (the inner folds of the vulva), with or without excision of the labia majora (the outer folds of skin of the vulva).
• Type III: Often referred to as infibulation, this is the narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the labia minora, or labia majora, sometimes through stitching, with or without removal of the clitoris (clitoridectomy).
• Type IV: This includes all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping and cauterizing the genital area.

In order to capture more precisely the variety of procedures, several sub-divisions were added to this typology. You can find the complete fact sheet here.

What are the consequences of FGM?

Depending on the type, FGM has various effects on women and girls. It is internationally recognised as a violation of women’s basic human rights and a form of child abuse.

Short-term health risks of FGM:

• severe pain
• excessive bleeding (haemorrhage)
• shock
• infections (e.g. tetanus, HIV)
• urinary problems
• wound healing problems (e.g. pain, fever, infections, abnormal scarring)
• death

Long-term health risks from types I, II and III can include:

• chronic infections and chronic pain (urinary tract, reproductive tract)
• urinary problems
• menstrual problems (painful menstruations, difficulty in passing menstrual blood, etc.)
• sexual problems (pain during intercourse, decreased satisfaction, etc.)
• increased risk of contracting HIV
• need for later surgeries (e.g. deinfibulation)
• psychological problems (trauma, depression, anxiety, etc.)

The fact that FGM is carried out by health care providers (according to UNICEF, “more than half of girls in Indonesia underwent the procedure by a trained medical professional” (UNICEF 2016)) might reduce the risk of immediate complications, but the long-term consequences are equally serious or even worse than when the procedures are performed traditionally. The WHO strongly urges health professionals not to perform such procedures.

For more detailed information, please visit the WHO's website.

Who is affected by FGM?

Prevalence worldwide

Due to a lack of statistical evidence, the exact number of girls and women affected by FGM is still unknown. But according to UNICEF’s most recent publication, there are at least 200 million girls and women alive today who have, at some point in their lives, undergone FGM. Another 3 million girls are estimated to be at risk of being subjected to FGM every year.

The practice of FGM is widespread in large parts of Africa, some countries in the Middle East and Asia, and in some communities in Latin America. As UNICEF’s study shows, more than half of the 200 million women and girls affected by FGM live in only three countries – Indonesia, Egypt and Ethiopia.

However, when talking about prevalence rates, it is important to keep in mind that they may vary considerably - even between neighbouring countries or within a country itself. Besides, it is possible that the prevalence rate declines while the total number of girls and women having been subjected to FGM is increasing. This effect is due to population growth, which is why UNICEF states the following: “If trends continue, the number of girls and women undergoing FGM will rise significantly over the next 15 years”.

For further information about FGM in a global perspective, please refer to these publications:

• UNICEF, New York, 2016: Female Genital Mutilation/Cutting: A Global Concern.
• UNICEF, New York, 2013: Female Genital Mutilation/Cutting: A statistical overview and exploration of the dynamics of change.
  

Prevalence in the EU

FGM is also affecting girls and women living in the European Union, a fact that has long been neglected by European decision-makers. This is why there is still a lack of reliable data that would allow to properly evaluating the total number of girls and women affected by or at risk of FGM within the EU.

So even though there is a growing awareness of the problem at the European level, the exact number of women and girls living with FGM in Europe is still unknown. The European Parliament estimates that there are around 500,000 girls and women currently living in the EU who already have undergone FGM, with another 180,000 at risk of being subjected to the practice every year.

As all Member States differ in their immigrant community profiles, the prevalence rates vary widely between the Member States. Correspondingly, the number of girls at risk of FGM varies, too.

CHANGE Plus targets African diaspora communities from – amongst others – Burkina Faso, Eritrea, Ethiopia, the Gambia, Guinea Bissau, Guinea Conakry, Mali, Sierra Leone, Senegal, Somalia and Sudan in four EU Member States (France, Germany, the Netherlands, Portugal).

If you want to get more specific information about FGM in EU Member States, please consult the reports below:

• European Institute for Gender Equality (EIGE), Vilnius, 2013: Female genital mutilation in the European Union and Croatia
• European Institute for Gender Equality (EIGE), Vilnius, 2013: Study to map the current situation and trends on FGM - Country reports
• European Institute for Gender Equality (EIGE), Vilnius, 2015: Estimation of girls at risk of female genital mutilation in the European Union

Why is FGM practiced?

FGM is practised for a variety of reasons. There are cultural, social and religious factors for the continuation of the practise. While several factors can collude, they can differ from one region to another as well as over time, too.

Among the most commonly cited reasons are:

• FGM as a social norm: Where FGM is the social norm, the pressure on parents to subject their daughters to FGM can be very strong. As they want their children to be respected members of the society they live in, they are more likely to comply with this social norm.
• Tradition: In most practising societies, FGM is considered a cultural tradition.
• The need to preserve this heritage is often used as an argument in favour of FGM. It also increases the social pressure on individuals to conform to what others belonging to the same group have been doing and keep doing.
• Marriageability and economic reasons: This factor is closely related to the preceding ones. Where FGM is a traditionally anchored norm, it is considered a way of increasing a girl’s marriageability, uncircumcised girls often being socially ostracized. Moreover, in communities where the pride price is higher for circumcised brides, economic considerations can play a major role in parents’ decision to have their daughters cut.
• Ideals of virginity and purity: Practising FGM can be motivated by the wish to ensure premarital virginity and marital fidelity by reducing a woman’s libido.
• Medical myths and hygienics: In some communities, it is believed that a circumcised vulva is cleaner than a natural one or that touching a clitoris results in dead or impotence. Others might consider that it is necessary to cut these body parts because they are intrinsically unclean or considered to be male.
• Ideals of beauty, femininity and modesty
• Religious beliefs: Though no religious scripts prescribe the practice, practitioners often believe the practice has religious support. This conviction is also due to the fact that some religious leaders (falsely) promote FGM, whereas others take a stand against it.

In general, we can say that FGM is sustained by social pressure and unequal gender relations. A lack of knowledge about its consequences as well as taboos around sexuality further contributes to its preservation.

Terminology

On this website, we use the term Female Genital Mutilation or FGM to talk about all procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons (WHO 2016). Other terms to describe these practises include – amongst others – “Female Genital Cutting (FGC)” and “Female Circumcision”. It is important to note that none of these terms is completely neutral and that they are not interchangeable.

Especially “FGC” and “Female circumcision” are controversial terms. Some argue that they do not accurately reflect the extent of harm caused by all types of FGM or that they imply equivalent severity with male circumcision. Others prefer “FGC” to “FGM”, because affected women often identify as “circumcised” and not as “mutilated”.

When talking to affected women and girls or when addressing practising communities, we recommend using the terms they are using themselves in order to facilitate communication and to avoid judging.

In the same vein, attributes such as “brutal” or “barbaric” are not appropriate at all, because they depreciate practising communities, reproduce racist stereotypes and reveal a Eurocentric perspective.

Legal Framework in the European Union

FGM is internationally recognized as a violation of the human rights of girls and women. As such, it violates a whole string of fundamental rights: It is nearly always carried out on minors and therefore constitutes a violation of the rights of children. It violates the right to health, physical integrity and life (when the procedure results in death). Furthermore, FGM is conflicting with the right to be free from cruel, inhuman or degrading treatment.

At the European level, FGM has been outlawed, too. There are three decisive documents:

• The Council of Europe Convention on Preventing and Combating Violence against Women and Domestic Violence (also known as the Istanbul Convention), adopted in 2011, was the first treaty to recognise that FGM exists in Europe and that it needs to be systematically addressed. A key feature of this convention is that it requires signatory states to make FGM a criminal offence. The Istanbul Convention’s four ‘Ps’, meaning its four main aspects Prevention, Protection, Prosecution and Policies are generally important to work against gender-based violence, but can also be specifically applied to FGM. Amnesty International describes the convention as a “practical tool to address FGM”.

To see which countries have signed and ratified the Istanbul Convention, please check this list.

• In 2013, the European Commission released an action plan Towards the elimination of female genital mutilation, which stipulates as objective the promotion of effective prevention and victim support measures, including through changing social norms.

• The Victims’ Rights Directive (Directive 2012/29/EU by its official name), passed in 2012 by the European Parliament and the Council of the EU, establishes minimum standards on the rights, support and protection of victims of crime. These standards also apply to every girl or woman who underwent FGM, which means that she is considered a victim and therefore entitled to special protection. Girls have the right to a child-sensitive approach and the child’s best interest is to be the primary consideration.

FGM is at the intersection of different fields of law. Therefore, depending on the context and the national legal framework, prosecution (and prevention) takes place on a different basis.

In some European countries, FGM is legally banned through specific criminal provisions (e.g. in Germany, Italy and the UK) whereas in other states it is banned through provisions in the Penal Code that penalise bodily injury and mutilation (e.g. in France and the Netherlands).

However, a report on FGM related court cases in Europe published in 2015 by the European Commission, identifies a number of trends common to several EU Member States, the first being the application of the principle of extraterritoriality when it comes to FGM. It means in effect that under certain conditions, legal proceedings can be undertaken even if an act is committed outside the country that opens the legal process.

The same applies for the removal of the principle of double incrimination, which makes it possible to take proceedings even in case the act of FGM is not criminalised in the country where it is committed. Given that in most cases, girls and women have been subjected to FGM in their countries of origin before moving to the EU, or are subjected to FGM while travelling outside the EU, this has far-reaching consequences for jurisdiction.