It’s nineteen years since the Female Genital Mutilation Act of 2003 became  law, and seven years since mandatory reporting of cases was introduced in 2015. So how are we doing? – and is FGM still an issue? – short answer, we are making some progress but it is still very much an issue affecting thousands of girls living here in the UK on the same streets as us, and millions of girls globally.

February 6^th  will mark the 10^th anniversary of  the International Day of Zero Tolerance of Female Genital Mutilation (FGM) with all UN agencies moving towards elimination by 2030 by ‘collective abandonment’ of this ancient but cruel cultural practice which is carried out on 2-3million girls every year, thousands of them  here in the UK.

It is worth reiterating that there is no religious obligation or reason, in any religion for this practice, it is purely cultural.

It is estimated that globally 100-200 million women survivors are living with the consequences of FGM, which has devastating effects on their lives, health and well-being. For comparison, approximately 40 million people are living with HIV/AIDS.

Last weekend I attended a medico-legal conference on the multidisciplinary approach being taken to Female Genital Mutilation in the UK, and here is what I learned.

There has now been a successful prosecution in England (2019) resulting in a lengthy prison sentence for the perpetrator. A handful of other cases are currently under investigation, but it is increasingly clear that we cannot prosecute our way to elimination, we were told by a police specialist. Successful prosecutions are likely to remain few and far between, although they do send a very strong signal.

The complexities of investigation and reaching the required level of proof for a court to return a guilty verdict are extremely challenging with FGM-practising communities, whose awareness is variable that this practice is illegal as well as cruel and amounts to torture,  and whose trust in the police remains low. Girls will have to give evidence against their families or are too young to communicate what has happened to them. Successful prosecutions will result in the break-up of the family with the affected child and siblings being taken into care. The maximum jail term for FGM is 14 years.

Mandatory reporting is working and casting light on a hidden problem, 6590 cases were reported in the last year (to March 2020) of which 145 we carried out here in England. The majority of newly reported cases each year are historical, and come to light many years after perpetration when women present to mainly Obstetric or Gynaecology services and are living with the consequences of previous FGM. But a minority of acute reports do occur, often when something has gone wrong, for example life-threatening bleeding.

The National FGM Centre which opened in 2015 and is jointly run by Barnardo’s and the Local Government Association work with FGM-practicing communities and have safeguarded 742 girls and supported 3412 survivors so far, using community awareness and education programmes and FGM Protection Orders. More than 700 orders are currently in place.

So some good news, but why is progress so slow? This is mainly due to a general lack of awareness, with at risk children hiding in plain sight. The majority of cases are now occurring in under-fives, I think we know why, but it means that the focus of case-finding probably needs to change. The inclusion of FGM in secondary school sexual health teaching has certainly raised awareness in older pupils.

Professionals who need to be asking the questions (teachers, doctors, nurses, nursery workers, social workers, community leaders and others ) either don’t think about it or are too embarrassed or even intimidated to ask the question? There is a serious shortage of specialist paediatricians able to examine victims and collect forensic evidence. The other reason is lack of funding and government commitment, with domestic and international budgets slashed, these so-called ‘softer services’ have been savaged or cut completely, that’s part of why we need the International Day of Zero Tolerance. There is also a bit of complacency, it can’t really be that bad, can it?

But do you think we would all be sitting so patiently waiting for collective abandonment of this hideous practice by 2030 if thousands of little boys were having their penises cut off? I doubt it.

* Catherine Royce is a retired medical doctor, a former member of the Federal Policy Committee and a member of LibDem Women and Liberty Network.