Critique of Manifesto to end FGM in the UK by 2030

FGM activists, fronted by Professor Hilary Burrage, recently circulated a manifesto ‘only to those I am pretty sure have a serious interest in issues around female genital mutilation (FGM).’ This patently didn’t include me but others shared it.

She hoped recipients might consider endorsing and adding their name to the Manifesto (which she modestly said she had a hand in writing) and which she hoped reflected the views of most.

‘The intention is to draw attention, via the support of well-known activists and influencers such as yourselves. We feel that the forthcoming International Day of Zero Tolerance for FGM, 6 February, is a good opportunity to bring such a focus to bear.’

“Manifesto to end FGM in the UK by 2030

Female genital mutilation (FGM) constitutes a global health epidemic. It has no place in the 21st century and must be tackled as urgently in the UK as across the world.

The scale of the problem

Defined as a human rights abuse by the UN, FGM constitutes one of the most extreme forms of violence against women and girls, causing trauma and harm that can be lifelong.

UNICEF and the World Health Organisation estimate that over 200 million women and girls alive today have undergone FGM; 30 million more will be subjected to it in the next decade.

According to research published in 2015, a projected 137,000 women and girls in England and Wales live with FGM (though the actual number could be far higher); an estimated 60,000 girls under the age of 15 in the UK are at risk.

FGM and its consequences

FGM is the medically unnecessary partial or total removal of the female external genitalia, infibulation or other injury to the genital organs. The ‘procedure’ is carried out for the first time mostly on minors – usually without anaesthetic or a doctor present – and may be repeated multiple times during a person’s lifetime.

The medical consequences can be severe. They include: haemorrhage, acute pain, difficulties with urination and menstruation, cysts, infections, sexual dysfunction, depression, PTSD, and even death. A survivor may require invasive surgeries throughout her life as a result; chronic illness is not uncommon and mortality of mother and infant during childbirth may also occur.

FGM is part of a continuum of violence against women and girls, which the UK cannot allow to persist. Research shows that FGM survivors are more likely to suffer other forms of violence during their lifetimes, including harmful practices such as breast ironing, forced marriage and related forms of ‘honour-based abuse’ (HBA). Tackling FGM provides the pathway to eradicating these other forms of gender-based violence.

What needs to be done

The law criminalises FGM but with just two convictions, one in England and one in Ireland, since the first enactment of legislation in 1985, this is clearly not enough. Legislation cannot be meaningful without adequate resources to address the wider issues and does little to help survivors.

The state has a fundamental duty to safeguard, and eliminate violence against, women and girls. We view the implementation of the following to be of fundamental importance in the fight against FGM and HBA:

• Explicit inclusion of FGM and HBA in the ministerial portfolios of the Ministry of Health and Social Care, Ministry of Justice and Department for Education to ensure survivor-centred prevention and response across all relevant sectors;
• Mandatory implementation of FGM screening questions by all GPs: female patients should be asked if they have had FGM or have a family history of FGM, regardless of ethnicity or background;
• Mandatory FGM and HBA training for all staff working in environments where safeguarding is an issue, with the prioritisation of education, law enforcement, health and social services;
• Increased investment in specialised social and psychological support services for survivors;
• The provision of a budget to incentivise potential victims/witnesses to report such matters and to reduce the severe risks faced by an individual filing an FGM or forced marriage protection order;
• Standardised data collection and enhanced information sharing across public service providers.The signatories below call on the government to implement these recommendations as a matter of urgency in order meet the UK’s pledge to end FGM by 2030.”

Signatories included Dr. Sharon Raymond MBBS MRCGP, Prof. Hilary Burrage FRSA, Hoda Ali, Dr. Charlotte Proudman and Joy Clarke.

Logos for Dahlia Project, Action:FGM, Savera UK, Magool and The Vavengers were included.

I certainly wouldn’t have endorsed the manifesto despite that I have a deep and longstanding interest in the practice. 

Marge Berer, who was not sent the manifesto directly either, was not impressed by it and quickly penned a devastating critique which she shared with Professor Burrage and published on her blog. I publish it here with her permission. She says:

“Your Manifesto has been shared with me as someone who has written on FGM and published papers on it in the journal Reproductive Health Matters while I was the editor.

I am absolutely not willing to sign your manifesto. Here is why:

First, it is incorrect in a number of places:

1. FGM is not an epidemic. An epidemic is: “the widespread occurrence of an infectious disease”. FGM is a harmful traditional practice. Moreover, its prevalence has been falling internationally since at least 2013, thanks to positive educational campaigns about why it is harmful and also because so many women in the communities where it was traditionally practised have decided themselves to stop the practice. Including in the UK.

2. You have distorted the figures about prevalence in the UK. You seem to be making the false assumption that all the daughters of all the women in the UK who had FGM as children in another country are at risk. There is absolutely no credible evidence to show this. You may believe these figures since so many other anti-FGM groups use them as well. But they are absolutely wrong and all of you should stop bandying them about without checking the source — because you actually do not understand what the source says.

3. Your description of FGM uses gross exaggeration. The severity of the cutting in many countries has been greatly reduced because of educational campaigns, and also because many people are going to medical doctors for it, the same as they are doing with male circumcision. You don’t even mention this. I would very much like to know where you got your information to claim that FGM is done many times, let alone more than once, to the same child. I have never seen any such published, peer-reviewed evidence.

4. Can you also provide published, peer-reviewed evidence that “A survivor may require invasive surgeries throughout her life as a result”. Do you have any evidence that this happens in the UK, since your call for action is about the UK?

5. Can you also provide published, peer-reviewed evidence that “FGM is part of a continuum of violence against women and girls”?

6. And again, what is your evidence regarding this claim: “Tackling FGM provides the pathway to eradicating these other forms of gender-based violence.” It’s a completely spurious claim, not least because you don’t define what you mean by “tackling FGM”.

It is highly irresponsible to make these claims without evidence. People’s lives are put at risk, children are being taken away from their parents for no reason, and whole communities are affected.

As regards “What needs to be done“:

7. You call for more convictions and yet if you look at the number of times the police and the DPP have sought convictions and failed, because they arrested people without credible evidence, because they were overly keen to prosecute, you might want to think again. Has it ever crossed your minds that the reason there have been next to no convictions is because FGM is not being done much in the UK? It’s not possible ethically or legally to assume risk exists because of ethnic origin or, for example, to treat everyone in an airport with suspicion, arrest them and put their children into care just because they are going abroad (which has happened).

8. You call for every female patient in the country to be questioned by GPs, thus criminalising all of us??? This is absurd and unethical.

9. You mention the recent conviction in Ireland. Are you aware that when the police were unable to identify anyone who could have carried out the alleged cutting, they said it must have been a witch? And are you aware that in the conviction here in London last year, the mother who was sent to prison was also accused of witchcraft, and false claims were made in court that FGM and witchcraft are linked, and that this successfully demonised her? Do you actually think this represents justice? Or do you yourselves believe in witches?

10. You want to pay people to report cases? Welcome to the Stasi in East Germany. Or don’t you know that people will lie for money.

I recommend you withdraw this manifesto because it contains unsubstantiated information, proposes nothing of value, discredits you and your groups, and if taken seriously, can do serious harm to innocent people because it calls for criminalising large numbers of people because they are women, and due to their ethnic and racial background. I think it’s shameful.”

Let’s see what transpires. A follow-up to this piece can be accessed here.

Problematic examples of the Zero Tolerance approach for FGM will be discussed at this Hidden Voices UK event on Feb 8th.

Update 9 Feb 2020

The manifesto was published here 6 Feb 2020 and included a number of changes e.g.

• Female genital mutilation was no longer an epidemic but a global health problem affecting millions
• Estimated numbers were changed from ‘research based’ in 2015 to ‘an estimated 137,000 women and girls with FGM were living in England and Wales in 2011; 60,000 girls under the age of 15 had been born to mothers with FGM

That the girls were ‘at risk’ had been removed. But it still doesn’t say that the estimated number of women were migrants.

‘What needs to be done’ also contained a number changes. The original for each is italicised followed by the change.

The law criminalises FGM but with just two convictions, one in England and one in Ireland, since the first enactment of legislation in 1985, this is clearly not enough. Legislation cannot be meaningful without adequate resources to address the wider issues and does little to help survivors.

Became

The law criminalises FGM but with just four prosecutions and one successful conviction in the UK, since the first enactment of legislation in 1985, this is clearly not enough. Legislation cannot be meaningful without adequate resources to address the wider issues, does little to help survivors and does not address the general lack of awareness of FGM and its consequences.

Mandatory implementation of FGM screening questions by all GPs: female patients should be asked if they have had FGM or have a family history of FGM, regardless of ethnicity or background;

Became

All women and girls to be asked about FGM and family history of FGM at every GP surgery across the UK – regardless of ethnicity or background. This will help identify survivors, individuals at risk and avoid the unintentional stigmatisation of particular communities or ethnic groups;

Mandatory FGM and HBA training for all staff working in environments where safeguarding is an issue, with the prioritisation of education, law enforcement, health and social services;

Became

Mandatory FGM and HBA training for all staff with a responsibility to safeguard children and vulnerable adults, with the prioritisation of education, law enforcement, health and social services;

Increased investment in specialised social and psychological support services for survivors;

Became

Increased investment in specialist healthcare, social and psychological support services for survivors;

The provision of a budget to incentivise potential victims/witnesses to report such matters and to reduce the severe risks faced by an individual filing an FGM or forced marriage protection order;

Became

A budget to aid and protect potential victims/witnesses who might not otherwise report such matters and to reduce the severe risks faced by an individual filing an FGM or forced marriage protection order;

It ended with;

The signatories below call on the government to implement these recommendations as a matter of urgency in order meet the UK’s pledge to end FGM by 2030.

The ‘signatories’ were logos for the following organisations, some  with little – no presence in the UK.

They include; Equality Now, The Royal College of Midwives, Humanists UK, 28 Too Many, AHA Foundation, Dahlia Project/Manor Gardens/Magool, Unite the Union, Savera UK, HJS, Quilliam, IKWRO, The Vavengers, Keep the drum, lose the knife, Karma Nirvana, WHFS, MWNUK, Orchid Project, IPPF, FORWARD Germany, We Speak Out and of course Action:FGM ‘the coalition of organisations that are working to end FGM and other harmful practices that undermine the well-being of women and girls.’

March 2022

Action:FGM appears to have a Twitter presence only and hasn’t posted since 2020.