FGM: In search of a way forwards 

by rootin Uncategorisedon Posted on

Written in collaboration with Betty lliadis, author of The Vagina Chronicles.

In contemporary global scientific and social discourse, female genital mutilation (FGM) is recognised not merely as a medical or public health issue, but as a deeply entrenched social practice that reflects unequal power relations and rigid gender hierarchies.1 FGM is an internationally recognised violation of human rights comprising the partial or total removal of – or injury to – external female genitalia for non-medical reasons1. According to the World Health Organization (WHO), over 230 million girls and women worldwide have undergone FGM in their lifetime, primarily before the age of 151. Although the practice is most concentrated in regions of Africa, Asia and the Middle East, growing migration is increasingly making this a global concern1.

The evidence is clear: FGM is entirely preventable, and so too are the physical, psychological, and reproductive health complications associated with it. From a medical standpoint, FGM provides no health benefits and and is associated with a wide range of complex short- and long-term complications, including haemorrhage, intense pain, infections, urinary and reproductive problems, severe pain during sexual intercourse, and an increased risk of complications during childbirth2. Many also endure profound psychological trauma, depression, anxiety, and post-traumatic stress disorder conditions that often remain untreated due to social stigma and the lack of adequate support services1,2. Decades of research have established the scale and severity of harm across the life course, creating a clear imperative for action.

The scientific community today approaches FGM as an example of how medical realities and social norms intersect. In Betty Iliadis’ book “ Vagina Chronicles”, this practice is examined through psychosocial, scientific, and feminist perspectives, with a focus on lived experience, scientific evidence, and the defence of bodily autonomy and rights.

The systemic gaps in FGM care

The persistence of FGM reflects a knowledge gap and a failure of policy implementation, coordination, and prioritisation. Even in high-income settings such as the UK, findings highlight that FGM continues to occur, with approximately 137,000 women and girls living with its consequences across England and Wales in 2015 (though FGM remains a hidden crisis, so the true prevalence could be higher)3,4.

Despite this, FGM is not a core part of most medical school curricula, leaving clinicians ill-equipped to manage this highly sensitive and complex condition in practice5. Moreover, access to care remains inconsistent, creating a “postcode lottery” in which support depends on location rather than need3. Gaps in prevalence data and surveillance infrastructure further limit the ability of health systems and policymakers to respond effectively and provide adequate services to those in need3. These challenges point to a broader systemic issue: evidence is not being translated into equitable, accessible, and integrated care.

Plugging the gaps to achieve better care

Healthcare systems must play a central role. This includes training clinicians to confidently recognise and manage FGM-related complications with sensitivity, embedding FGM into routine clinical pathways, and expanding access to specialised services, including mental health support3. Consistent data collection and reporting are also essential to inform service provision and policy decisions3.

At a policy level, sustained and targeted funding is critical3. Prevention efforts, community-led education programmes, and grassroots organisations remain under-resourced, despite their recognised role in reducing risk and supporting survivors3,6. Legal and safeguarding frameworks must be not only in place, but actively implemented, with improved coordination across healthcare, education, and justice systems3.

Prevention must be prioritised alongside care. This requires culturally informed engagement with communities, investment in education, and stronger mechanisms to identify and intervene in at-risk cases, both within national borders and across them. Ultimately, eliminating FGM requires alignment across health systems, policy, research, and community action. Without this coordination, even the strongest evidence will fail to translate into meaningful change.

Call to action

The UK system is not currently set up to identify, support and manage FGM effectively; an infrastructure failure that continues to leave women unprotected. 

To address this gap, stakeholders – from medical schools and researchers to community organisations and policy makers – must:

  1. Connect research, policy, and implementation through multisector engagement and education that moves the needle beyond awareness towards meaningful impact
  2. Embed FGM into medical school training and routine clinical pathways, enabling a culturally competent and supportive system
  3. Ensure the active implementation and coordination of legal and safeguarding frameworks
  4. Shift the mindset from reactive to proactive, prioritising prevention alongside care
  5. Call for consistent, long-term funding to drive FGM education and awareness programmes, FGM health services and specialist mental health care

Awareness alone is not enough. By connecting research, education, policy, and implementation, we can move beyond awareness and into action – building a system that not only recognises harm but actively prevents it. 

And we must remember that the fight against FGM is not simply a medical issue, it is a cultural, social, and ethical challenge for the global community and the scientific voices of women within this discourse are indispensable.

The path forward exists; it now depends on whether we choose to act.

References

  1. World Health Organization. (2025, January 31). Female Genital Mutilation. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/female-genital-mutilation 
  2. Pallitto, C., Ruiz-Vallejo, F., Mochache, V., Stein, K., Vogel, J. P., & Petzold, M. (2025). Exploring the health complications of female genital mutilation through a systematic review and meta-analysis. BMC Public Health, 25(1), 1387. https://doi.org/10.1186/s12889-025-21584-z 
  3. Women and Equality Committee. (2025, September 12). Female genital mutilation. House of Commons . https://committees.parliament.uk/publications/49487/documents/263461/default/
  4. Educate Not Mutilate (ENM). (2025, April). Written evidence from Educate not Mutilate [FGM0010]. UK Parliament. https://committees.parliament.uk/writtenevidence/140927/pdf/ 
  5. Bluemel, A. H., & Kinkaid, V. (2023, June 30). Medical students are not equipped with the appropriate education to be able to conduct their mandatory FGM reporting duties. BMJ Sexual & Reproductive Health Blog. https://blogs.bmj.com/bmjsrh/2023/06/30/medical-students-are-not-equipped- with-the-appropriate-education-to-be-able-to-conduct-their-mandatory-fgm-reporting-duties/ 
  6. Matanda, D., Van Eekert, N., Croce-Galis, M., Gay, J., Middelburg, A., & Hardee, K. (2023). What Interventions Are Effective to Prevent or Respond to Female Genital mutilation? a Review of Existing Evidence from 2008–2020. PLOS Global Public Health, 3(5), e0001855–e0001855. https://doi.org/10.1371/journal.pgph.0001855 
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