Female genital mutilation in Britain

doi:10.1136/bmj.310.6994.1590

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J A Black, retired consultant paediatriciana,
G D Debelle, consultant community paediatricianb

^a Victoria Mill House, Framlingham, Woodbridge, Suffolk IP13 9EG
^b Children's Services Unit, South Birmingham Health Authority, Birmingham

Correspondence to: Dr Black.

Accepted 7 February 1995

Much has been written about female genital mutilation in Africa, but little attention has been paid to its existence in Britain. Though it has been illegal in this country since 1985, it is practised secretly or children are sent abroad to have the operation. From the social worker's point of view it is technically a form of child abuse which poses special problems. Black and Debelle review the historical background of female genital mutilation and describe its medical complications. Gallard discusses the problem in France, and Walder considers why such mutilation still continues in Britain.

This article is concerned with female genital mutilation in Britain. The term is preferable to female circumcision, which is inaccurate and implies a minor operation equivalent to male circumcision. In many cultures the operation entails an extensive mutilation, with profound social, sexual, and medical consequences.

Historical background

It is uncertain when female genital mutilation was first practised, but it certainly preceded the founding of both Christianity and Islam. There is no basis for the belief that the procedure was advocated or approved by Mohammed nor is it in any way part of the Islamic faith. Though the operation is largely confined to Muslims, it is also performed in certain Christian communities in Africa. Female genital mutilation is practised in various forms in over 20 African countries and also in Oman, the Yemen, and the United Arab Emirates and by some Muslims in Malaysia and Indonesia1; it is not practised in Iran, Iraq, Jordan, Libya, or Saudi Arabia.

What is female genital mutilation?

There are three types of operation. In the least mutilating form, known misleadingly as the “Sunna” procedure (meaning “following the Prophet's tradition”), the prepuce of the clitoris is removed; this is the only procedure which can be correctly called circumcision. In the most …