On February 6, UN International Day of Zero Tolerance for Female Genital Mutilation (FGM), the international community will condemn FGM. Who would disagree that FGM (the partial or total removal of female external genitalia or injury to female genital organs for cultural reasons) is not a great harm, violence against women and violation of human rights?
On this day, there will also be publicly renewed political commitment to the Sustainable Development Goal target to eliminate the practice by 2030. The drive towards ending FGM is commonly framed in a penal context. Prosecution of cutters and parents sends an unequivocal message. But criminalisation and legal reform are not enough. FGM is deeply embedded in culture. Criminal laws against this traditional practice already exist in at least 24 countries where FGM is highly prevalent- with few prosecutions and little evidence of significant diminution of the practice.
As articulated in an excellent Editorial “Changing Culture to End FGM” in the Lancet this week, local chiefs, religious leaders and community elders have far greater influence that any law. FGM is culturally, and often religiously, important to the people who seek to continue it. Legal reform may demonstrate political will but when made in response to pressure from the international community, may carry with it an unacceptable whiff of cultural imperialism. Disregard for indigenous cultural beliefs risks alienating and entrenching beliefs that FGM should continue.
There must be commitment both to meaningful engagement with communities and robust enlisting of grassroots expertise. We need to be humble enough to realise that people living within those communities are well-placed to challenge culture practices such as FGM. They will inform law and policy-makers of what will and won’t work. We also need to recognise that FGM will not end until other inequalities in health, education and reproductive rights are also addressed.
We should use February 6 as a time for reflection on what is happening on our own shores to tackle FGM in diaspora communities. The lack of prosecutions for FGM under the FGM Act (2003) makes for easy headlines and renewed wringing of hands that we are abjectly failing to tackle FGM in the UK. But talk to women from these communities in the UK and they will say that this law acts as a deterrent and gives a legal stronghold to reject calls from back home to have a girl cut.
We may be going too far in a drive to secure prosecution, by passing additional laws including one recently that mandates reporting by doctors (and other regulated professionals) of under 18s with FGM directly to the Police. This legislation was well-intentioned. The more investigations, the greater than chance of (finally) finding a case that can be successfully prosecuted. This legislation was however passed after an inadequate consultation process. There have been numerous unintended consequences which the government are reluctant to hear. With only a few exceptions, reports to date relate to children who underwent FGM prior to arrival in the UK. This mandated disclosure of FGM in a health consultation demands a breach of patient confidentiality without consent of the child or parent. There are no benefits over and beyond established safeguarding regulations. This disproportionate response which involves police, seriously impacts on the individual, her family and her community. Moreover, it attacks trust – the very cornerstone of the doctor-patient relationship. Communities are already indicating that girls with FGM are deterred from seeking help for complications or even engaging with health on unrelated matters for fear that their FGM will be “outed” and police will get involved.
On Feb 6, we need to honestly appraise where the fight to end FGM is now, locally and internationally. We need to be well-informed and move beyond hasty implementation of legislation. We need to recognise the tremendous ongoing work in communities, health, education, police and social care towards ending FGM. We need to work to rebuild trust and engage with communities to find the solutions. Above all, we need to remember that slow progress is still progress.
This blog is the 1stin a series capturing discussions in the context of a British Academy project, Working Together: Human Rights and the Sustainable Development Goals, which explores the potential of human rights to realize the SDGs. The project is being led by Professor Sandra Fredman, Fellow of the British Academy.
Thank you Dr Brenda Kelly for a thought provoking piece. I had thought that getting the police involved was a good thing but you’ve rightly pointed out that this may well prove detrimental to the people it was designed to protect. I would still like to see the right case come to trial and a successful prosecution follow with a stiff custodial sentence to show the legislation has teeth. FGM is very much out there for discussion now with procedures professionals in the healthcare system and police are obliged to follow, which as you highlight has it’s plusses and minuses. I hope those at risk or survivors of FGM feel there are professionals they can approach for their medical, emotional and psychological needs as well as providing a place of safety if necessary. The current situation ain’t perfect but you’ve reminded me that progress has been made and one should acknowledge ones successes, large and small.
Thank you for your reflection. I think the key observation in the UK (and this may be relevant to other diaspora communities, is that the vast majority of women and girls we are seeing with FGM, had it done prior to coming to the UK. To involve police when the act was clearly outwith our jurisdiction, sends the wrong message to those who are already vulnerable and possibly needing medical assistance. I think the law most certainly has a role, but it needs to be applied in a proportionate manner in order not to alienate women and communities. We do not want to drive this practice underground.