Intended for healthcare professionals

Editorials

Tackling female genital mutilation in the UK

BMJ 2019; 364 doi: https://doi.org/10.1136/bmj.l15 (Published 07 January 2019) Cite this as: BMJ 2019;364:l15

Empirical evidence supports concerns about reliability of FGM statistics and negative impact of FGM-safeguarding

The findings from our recent research (1) with Somali families living in Bristol – a group who appear to be particularly targeted by FGM-safeguarding initiatives – provide considerable empirical support for many of the concerns raised by Creighton et al in their editorial (2), particularly the high ‘social cost’ and ‘emotional weight’ borne by innocent people in these contexts. For example, evidence from our focus groups suggests that the requirements of the FGM Enhanced Dataset risk retraumatising women who have been cut with repeated questioning by health professionals about experiences they wish to forget. Participants also voiced a concern that a ‘fixation’ with FGM undermined their receipt of appropriate and effective health care. Our focus group discussions were dominated by stories documenting the myriad ways in which approaches to FGM-safeguarding – whether provided in health care, via children’s schools but particularly through the heavy-handed approaches of social services and police conducting home visits – stigmatised and criminalised families who had done nothing wrong. Participants described how their hopes for ‘normal’ lives – for family holidays, to have their needs accommodated and to be treated with dignity and respect – were undermined by professionals encouraged to see suspicion in everyday, mundane experiences. This led to disillusionment and disengagement, and additional stress when engaging with, statutory services. It also undermined trust within families, the local Somali community and wider British society.

As Creighton et al suggest, this distress was magnified by a sense that the evidence on which these policies were based was inaccurate. There was no question among our participants that FGM was wrong, and should be stopped. Indeed, some of our participants had worked for many years as anti-FGM campaigners in the UK or abroad. Universally, participants described how FGM was no longer something considered part of British Somali culture. They referenced the lack of successful prosecutions but also their own lack of knowledge of UK-based Somali FGM victims, despite sometimes long UK residence. The fact that this lack of evidence was generally treated by officials as a ‘collective professional failure’, as Creighton et al suggest, rather than actual low prevalence was seen, by participants, as testament to the lack of involvement of FGM-affected groups in the policy-making process, and also the Islamophobia inherent in much current policy which treats Muslims unquestioningly as ‘suspect communities’ (3). Improving these policies requires a multi-faceted approach, which examines their development, implementation, as well as impact. But there is a dire need for a more comprehensive examination of the quality of the prevalence statistics on which these policies are based. This will be the focus of a new study funded by the Elizabeth Blackwell Institute at the University of Bristol, beginning in April.

1 Karlsen S, Mogilnicka M, Carver N, Pantazis C Understanding the experiences of FGM-safeguarding services among Somalis living in Bristol Bristol:University of Bristol, forthcoming
2 Creighton SM, Samuel Z, Otoo-Oyortey N, Hodes D (2019) Tackling female genital mutilation in the UK: Current response is disproportionate and should be reconsidered BMJ 2019;364:l15
3 Pantazis C and Pemberton S From the ‘Old’ to the ‘New’ Suspect Community: Examining the Impacts of Recent UK Counter-Terrorist Legislation The British Journal of Criminology 2009;49(5):646–666

Competing interests: No competing interests

11 January 2019
Saffron Karlsen
Senior Lecturer in Social Research
Magda Mogilnicka, Natasha Carver, Christina Pantazis
Centre for the Study of Ethnicity and Citizenship, University of Bristol