Female genital cutting

Domain XVI · Historical, discredited & harmful

What it is

Female genital mutilation (FGM), also called female genital cutting (FGC), "cutting", "circumcision" or "initiation", is a harmful practice, not a therapy. WHO calls it a violation of the human rights of girls and women and of children's rights, and "an extreme form of discrimination". The UK…

Format

• Phase B: Safety, safeguarding and legal duties. Goal: protect any girl under 18 (risk referral; mandatory report of known cases where the duty applies; FGM Protection Order consideration). Format: consultation with the named or designated safeguarding lead; written records. Move on when: the…
• Phase D: Psychological treatment and repair. Goal: treat depression and anxiety with cognitive behavioural therapy and psychological support, as WHO recommends, and address trauma, identity, body image, loyalty to family and community, and grief. Session number and length follow the client's needs…

Who practises it, and how they are trained or regulated

• Phase A: Recognition and enquiry. Goal: notice risk indicators or a history of cutting, and ask safely. Format: within ordinary assessment, with an accredited female interpreter where needed. Move on when: you know whether a child is at risk or known to have been cut, or an adult has disclosed.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Pushing a survivor into a public role; over-identification. Working when her choices, not yours, lead.
• Repeated retelling across agencies; offer to coordinate. Working when she feels informed, not processed.
• Shame, a partner who minimises her pain, coercion. Working when she can set limits and seek help on her terms.
• A partner who sides with relatives; coercive control. Working when the household speaks with one voice on protection.
• Immigration fears deterring families from services. Working when reports follow state procedure and the family stays engaged.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.