Female genital mutilation (FGM) survivors in the UK have been told they have to wait for “more research into the effectiveness” of reconstruction surgery, forcing many to fund their own travel and treatment abroad.
This article contains descriptions of FGM and reconstructive surgery some readers may find distressing.
The World Health Organisation-approved FGM reconstruction surgery is freely available on public health services in European countries like Switzerland.
Professor Jasmine Abdulcadir, one of the world’s leading experts in FGM reconstruction surgery, sees up to 30 survivors a month at Geneva’s University Hospital.
“Not all of them will need or opt for surgery,” she told Sky News.
“There are several types of FGM, so the tissues involved might be diverse. It can be the labia, the clitoris, and the cutting might be more or less severe. So there are different types of surgeries.
“If we talk about clitoral reconstruction, this is for patients that have been cut on the clitoris. And the surgery aims at removing the scar, and making the clitoris more accessible and more sensitive.”
In cases of infibulation, which is when a woman’s vulva has been closed, Prof Abdulcadir described a procedure called deinfibulation, which allows surgeons to open up the scar.
“When the vulva is closed, there are major obstructive complications,” she explained. “It’s difficult to have penetrative sex, to deliver normally.
“Deinfibulation allows us to open the scar. We can also reconstruct the inner labia.”
‘All the girls were crying’
Jamilla, not her real name, is one of Prof Abdulcadir’s patients. She had FGM reconstruction surgery a little over a month ago.
Jamilla is still traumatised about what happened to her as a child in West Africa. Even now, more than 30 years later.
“Every girl who came in came out crying, screaming,” Jamilla told Sky News. “I didn’t want to go in, but they forced me and when I went in, she cut me with a blade. I jumped from the pain. All the girls were crying. I didn’t want to, but they forced me.”
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‘It’s something that never leaves you’
Jamilla’s mother was against her daughter being cut but was tricked by one of her father’s three wives. She was told she was going out to buy some sweets, but was instead forced into the cutter’s house where she was brutalised.
“I was angry because I was just a child. She had already made the decision, but I was angry… furious with her. When I was growing up, she was always around, and I asked her this question: why? She said: ‘No, it’s our culture, we have to do that for the girls.’
“For me, honestly, it was exhausting. I didn’t want to have to heal from it. Afterwards, they said that after one or two weeks they would have a celebration, but I wasn’t feeling well at all.
“Physically, mentally. I always think about it. It’s something that never leaves you. You think about it all the time.”
Read more: Why I stopped carrying out FGM
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137,000 living with FGM in England and Wales
The WHO estimates more than 230 million women and girls alive today have undergone FGM across 30 countries in Africa, Asia, and the Middle East. It’s mostly carried out on girls under 15.
In 2015, it was estimated 137,000 women and girls were living with FGM in England and Wales. And between that report’s publication and 2023, FGM was identified in a total of 87,575 attendances at NHS Trusts and GP practices.
The true numbers are thought to be much higher and the latest government data is expected to be published soon. But even these will not give a true figure of this unimaginable cruelty and violence deliberately perpetrated against young girls.
But while FGM survivors across Europe can access reconstruction surgery through their country’s public healthcare system, it is still not available in the UK.
Growing demand for surgery
Juliet Albert is a specialist midwife who runs a busy FGM clinic in west London. She said demand in the UK continues to grow.
She said: “We do find women coming to our clinic saying they want reconstruction surgery, and we have to say ‘sorry, we don’t offer it here’.
“Some of them will seek it out by going to have it done in another country perhaps, which is obviously very costly, and some of them don’t manage to get any support for that.
“It may be because they’ve got long-term genital pain, or it might be a body image concern. Women say things like, ‘I just want to be whole’, or ‘I want to put back what was taken away’.”
Government agrees to prioritise research
These women now have some hope. Following a highly critical report by the Women and Equalities Committee into inadequate care for FGM survivors, the government has agreed to prioritise research into reconstruction surgery to make it available on the NHS.
Committee chair Sarah Owen MP told Sky News: “In an ideal situation, it would be available to everybody on everybody’s doorstep. But FGM isn’t a problem in every part of our country.
“But it is a problem in certain parts of our country, and I think we need to be able to prioritise those areas where the need is highest to ensure people get the surgery and the support they need as quickly as possible.
“The research isn’t into the merits of reconstructive surgery. The research is into where the need is greatest.”
She hopes it will be available on the NHS “as soon as possible”, and in the meantime that women who are struggling receive support “sooner rather than later”.
“I want GPs to have better understanding of FGM and reconstructive surgery,” she added. “I want people to know that this is still an issue for so many women within our communities.”
The Labour MP thinks it’s an issue the government is now taking seriously, but wants “some action behind the words”.
“It’s been an issue other countries have tackled successfully in the last 20 years,” she said. “I think this country can actually get to grips with this, and this is a very good start.”
But the Department of Health and Social Care told Sky News more understanding of the process was still required.
“The NHS runs FGM clinics which provide healthcare services and emotional and psychological support for victims,” a statement said.
“We are also facilitating further research into the effectiveness of reconstructive surgery for FGM survivors through the National Institute for Health and Care Research.”
FGM reconstruction surgery cannot erase the violence or the pain.
But it can offer something many survivors feared they would never have: the chance to reclaim their bodies after a lifetime of trauma.
