1. Female Genital Mutliation
Introduction to
Female Genital Mutliation
Susan Dobson
Senior Learning & Development Officer

2. Housekeeping House keeping – go over arrangements for course/venue:
Time of break/lunch/end of session – if for any reason you need to leave early, please come and let me know.
Tea and coffee/lunch (if full day)
Fire exit – mention if fire alarm test – also check everyone has signed in
Phones – if required to take call, leave room. If not, switch off phone – also avoid texting/picking up s during session
Toilets

3. Learning Agreement Confidentiality Participation Self care
Before starting, a few words about how the session will run…
Confidentiality : please remember to manage your own personal and professional boundaries and respect the confidentiality of the children and families you are working with. The content of the training session may touch on practice issues or challenges you are experiencing in your case work that you might want to talk through or debrief – if this is the case please feel free to speak to me during a break or at the end of the session.
Participation : It is my hope that the training will give you an opportunity gain knowledge and provide space to reflect on your own practice. This works best when everyone participates at a level they are comfortable with. Feel free to ask questions at any point in the training session, if I don’t know the answer I will endeavour to find out and come back to you
Self Care : We are going to be focussing on child protection processes, which can present challenges and can raise feelings from our own lives as well as issues relating to our work. There are regular breaks scheduled in to today’s session however, if you need more space please let me know. The session may bring issues up for you in relation to your own case work, remember to use appropriate supports, including your line management/supervision to talk through any changes you feel might be appropriate following todays training. If you want to speak to me during a break or after the session, that’s absolutely fine.

4. To gain a better understanding of FGM and the law
Aims
To gain a better understanding of FGM and the law

5. Learning Outcomes By the end of this course, participants will:
Be able to identify different forms of FGM
Understand some of the reasons for practicing FGM
Recognise that FGM is a breach of human rights and against the law in Scotland

6. The right help At the right time In the right way
GIRFEC (make up handout) is the Scottish Government child care strategy,
which is implemented across all services in Scotland working with children.
This link will take you to the Glasgow GIRFEC Practice Guidance.
The concept of the right help at the right time in the right way is key for most
issues but particularly FGM where there may be sensitivities around culture,
family relationships, honour and belonging. Important to be able to
recognise the issues and think about helpful, timely intervention

7. “It is what my grandmother called the three feminine sorrows: the day of circumcision, the wedding night and the birth of a baby.”
From “The Three Feminine Sorrows,” a Somali poem
An estimated 100 million to 140 million women and girls believed to have
experienced FGM, they are predominately in sub-Saharan Africa and the
Arab States. But rates of FGM are increasing, a reflection of global
population growth.
A key challenge is not only protecting girls who are currently at risk but
also ensuring that those to be born in the future will be free from the dangers
of the practice. This is especially important considering that FGM-
concentrated countries are generally experiencing high population growth
and have large youth populations. In 2010, for example, more than 45 per
cent of the female populations in the Gambia, Mali, Somalia and  Uganda were
under age 15.

8. What is FGM?
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
The World Health Organisation
Type 1 – Clitoridectomy; partial or total removal of the clitoris and, in very
rare cases, only the prepuce (the fold of skin surrounding the clitoris)
Type 2 – Excision; partial or total removal of the clitoris and labia minora,
with or without excision of the labia majora (the labia are the “lips” that
surround the vagina)
Types 3 – Infibualtion; narrowing of the vaginal opening through the creation
of a covering seal. The seal is formed by cutting and repositioning the inner,
outer labia with or without the removal of the clitoris
Type 4 – Other; all other harmful procedures to the female gentialia for
non-medical purposes, eg pricking, piercing, incising, scraping and cauterising
the genital area.

10. Why is it practised Psychosexual reasons Societal and cultural reasons
Hygiene and aesthetic reasons
Religious reasons
Socio-economic reasons
Before showing the slide, ask participants in small groups to think of reasons
Why FGM is practiced and perpetuated – it often goes unquestioned as a
Practice by both men and women – what might make women continue
To allow this or practice this on their children?
After going through the following, I ask people to think about where they would,
In a developing country, where access to education is restricted and sex and sexuality
Is shrouded in shame and silence, get access to factual information that would
Contradict some of the myths and beliefs about sex, women and FGM.
Also helpful to draw parallels between attitudes towards domestic violence,
Unmarried teen mothers etc where in our lifetime values would be held and
Perpetuated that violence was OK in marriage and sexually active teenagers
Were mentally ill.
Psychosexual reasons: FGM is carried out as a way to control women’s
sexuality, which is sometimes said to be insatiable if parts of the genitalia,
especially the clitoris, are not removed. It is thought to ensure virginity
before marriage and fidelity afterward, and to increase male sexual pleasure. Sociological and cultural reasons: FGM is seen as part of a girl’s initiation
into womanhood and as an intrinsic part of a community’s cultural heritage.
Sometimes myths about female genitalia (e.g., that an uncut clitoris will
grow to the size of a penis, or that FGM will enhance fertility or promote
child survival) perpetuate the practice. Hygiene and aesthetic reasons: In some communities, the external female
genitalia are considered dirty and ugly and are removed, ostensibly to
promote hygiene and aesthetic appeal. Religious reasons: Although FGM is not sanctioned by either Islam or by
Christianity, supposed religious doctrine is often used to justify the practice. Socio-economic factors: In many communities, FGM is a prerequisite for
marriage. Where women are largely dependent on men, economic necessity
can be a major driver of the procedure. FGM sometimes is a prerequisite for
the right to inherit. It may also be a major income source for practitioners.
FGM tends to be prevalent in communities where there are deeply rooted
issues of gender inequality, and supported by men and women equally and
without question. Anyone departing from the norm can face condemnation,
harassment and ostracism

11. Terminology Female Circumcision Female Genital Mutilation
Female Genital Cutting
Female Genital Mutilation/Cutting (FGM/C)
·The terminology used for this procedure has gone through various changes.
When the practice first came to international attention, it was generally
referred to as “female circumcision.” (In Eastern and Northern Africa, this
term is often used to describe FGM type I.) However, the term “female
circumcision” has been criticized for drawing a parallel with male circumcision
and creating confusion between the two distinct practices. Adding to the
confusion is the fact that health experts in many Eastern and Southern African
countries encourage male circumcision to reduce HIV transmission; FGM, on
the other hand, can increase the risk of HIV transmission.
It is also sometimes argued that the term obscures the serious physical and
psychological effects of genital cutting on women. UNFPA does not
encourage use of the term “female circumcision” because the health
implications of male and female circumcision are very different.
The term “female genital mutilation” is used by a wide range of women's health
and human rights organizations. Use of the word “mutilation” also emphasizes
the gravity of the act and reinforces that the practice is a violation of
women's and girls’ basic human rights. This expression gained support in the
late 1970s, and since 1994, it has been used in several United Nations conference
documents and has served as a policy and advocacy tool.
In the late 1990s the term “female genital cutting” was introduced, partly in
response to dissatisfaction with the term “female genital mutilation.” There is
concern that communities could find the term “mutilation” demeaning, or
that it could imply that parents or practitioners perform this procedure maliciously.
Some fear the term “female genital mutilation” could alienate practicing communities,
or even cause a backlash, possibly increasing the number of girls subjected to the practice.
Some organizations embrace both terms, referring to “female genital mutilation/cutting” or FGM/C.

12. Risks and Impact Physical health Mental health Psychosexual
Psychological
Social consquences
severe pain and shock
infection
injury to adjacent tissues
sprains, dislocations, broken bones or internal injuries from being restrained
immediate fatal haemorrhaging
urine retention and difficulties in menstruation
uterus, vaginal and pelvic infections
cysts and neuromas
complications in pregnancy and child birth
increased risk of fistula
on-going impact of trauma / PTSD
sexual dysfunction
Negative impacts can include additional psycho-sexual and psychological issues
and also social consequences such as estrangement from parents / family, and
relationship or marriage breakdown.

13. Sara’s Story http://www.fgmaware.org/
After showing Sara’s story, ask the participants in small groups to think
About how they might assess the possibility of FGM, or offer support
Where FGM has been practiced or is a risk
Highlight the need for
Multi-agency working and assessment
Good, consistent relationships
An understanding of trauma and the impact on service users
An understanding of fear of authority and trusted relationships –
FGM is often carried out by community leaders, female family
members or trusted adults – professionals presenting as trusted
Authority figures may be mistrusted and feared, need to work consistently to
Overcome previous experience

14. Legislation Unlawful since 1985
An offence if carried out in Scotland or overseas
An offence for habitual and permanent UK residents
FGM has been unlawful in Scotland since The Female Genital
Mutilation (Scotland) Act 2005 re-enacted the Prohibition of Female
Circumcision Act 1985 and extended protection by making it a criminal
offence to have FGM carried out either in Scotland or abroad by
giving those offences extra-territorial powers.
The Scottish Government has worked collaboratively with the UK
Government to close a loophole in the Prohibition of Female Genital
Mutilation (Scotland) Act 2005.  This extends the reach of the extra-territorial
offences in that Act to habitual (as well as permanent) UK residents. 
This strengthening of legislation is included in the Serious Crime Act (2015)

15.
Further information including links to guidance, training materials,
support organisations and Scotland’s National Action Plan – to
Prevent and Eradicate FGM can be found at