Forced genital cutting: Frequently Asked Questions

Forced genital cutting: Frequently Asked Questions

Forced genital cutting refers to any non-consensual cutting or modification of the genitals for religious or cultural reasons, rather than medical reasons. It is commonly known as female genital mutilation (FGM) when performed on girls, and ritual male circumcision when performed on boys.

FGM practices vary. Some forms involve a pinprick or the removal of a small amount of material from the clitoris. Other forms include complete excision of the clitoris and/or labia, and stitching the vulva closed (infibulation). Those from cultures which perform FGM often cite religious obligations as their motivation. FGM is found in some Islamic and pre-Christian African religious traditions. FGM is usually carried out on young girls between infancy and the age of 15, most commonly before puberty starts.

Non-therapeutic male circumcision refers to the removal of the foreskin of male babies and young children. In the UK, this practice is most commonly associated with Jewish, Muslim and some African Christian communities. In Jewish communities, the circumcision is usually performed on a baby boy when he is eight days old. There is no consensus in Muslim communities regarding the age of circumcision. It may be done from soon after birth up to mid-teens.

It is conservatively estimated that 650 million males and 100 million females living today were subjected as children to genital cutting - at least 25% of the world's males and 5% of the world's females. 13 million boys and 2 million girls undergo genital cutting every year.

All forms of FGM, including forms that remove far less tissue than male circumcision, are prohibited under UK law, regardless of whether they are "required as a matter of custom or ritual". FGM is regarded by law as a form of child abuse and violence against women and girls.

In contrast, there is very limited regulation of non-therapeutic male circumcision in the UK. Doctors registered with the General Medical Council must perform the procedure in suitable medical settings with appropriate attention to hygiene, sterility and aftercare. However, there is no requirement for the non-consenting child to have a medical problem for their foreskin to be removed.

Non-doctors performing infant circumcision in the UK have no such regulation and are free to cut boys' penises with unsterilised scissors or knives on kitchen tables or ironing boards.

The High Court ruled in Re B & G (2015) that non-therapeutic male circumcision (including competently performed circumcision) constitutes "significant harm" to a child for the purposes of the Children Act in the context of care proceedings.

The High Court further concluded that to claim male circumcision is less invasive or harmful than some forms of female genital mutilation (FGM) would contradict the evidence and indeed be "irrational".

Circumcision occupies an anomalous exemption from the law of wounding. Under UK law it is illegal to tattoo a child's foreskin but legal to cut it off.

FGM is very painful and can seriously harm the health of women and girls. It can also cause long-term problems with sex, childbirth and mental health. In some cases it is fatal; some girls die from blood loss or infection as a direct result of the procedure.

FGM is often performed by traditional cutters who do not have any medical training. Anaesthetics and antiseptics are not generally used.

Male circumcision is also excruciatingly painful. Even in clinical environments, infant circumcision is usually performed under a local rather than a general anaesthetic. The level of anaesthesia used is rarely sufficient to remove all sensation. Circumcisions performed in non-clinical environments may involve no pain relief at all. Following the procedure, infants continue to experience considerable pain and discomfort while the damage to their genitals heals.

The foreskin is a normal body part with physical, sexual and immunological functions. It is the most sensitive part of the penis to warmth and light touch, containing between 20,000 and 100,000 nerve endings. Surgically removing it from non-consenting children is associated with physical and psychological harms.

Surgical complications resulting from circumcision can include: Scarring, urinary difficulties, meatal stenosis, sinus formation, erection problems, denuding of the skin of the penis, infection, bleeding, psychological problems, amputation of the penis, and even death.

Between 1988 and 2014, there were 22,000 harms recorded by the NHS resulting from circumcision. They included scarring and full penis amputation.

In 2011, eleven boys were admitted to just one hospital with life-threatening complications following circumcision. Three baby boys (Celian Noumbiwe, Angelo Ofori-Mintah, and Goodluck Caubergs) have bled to death post-circumcision in recent years.

In 2014, an NHS whistleblower said religious circumcisions were leaving babies and children "maimed for life".

Complication rates can be even higher overseas. Between 2008 and 2014, more than half a million boys were hospitalised due to circumcision-related complications in South Africa, over 400 of whom died.

We do not have an accurate figure of how many circumcisions are performed annually in the UK, nor the degree of harm as there is no requirement for any follow up or audit and the boys themselves are too young to complain. Additionally, health issues in circumcised adults are likely to be greatly under-reported because people who have experienced sexual harm are often reluctant to reveal it as societal dismissal or stigmatisation may compound the harm.

Aside from the physical harm caused by genital cutting, there is an implicit harm in depriving a person of the chance to retain an intact body, particularly when there is no medical reason to operate.

Proponents of FGM have argued the procedure has hygienic benefits. But both the World Health Organisation and the NHS stress that FGM has no health benefits and is harmful.

Throughout history, male circumcision has been advocated as a pseudo-medical cure for a variety of ailments ranging from epilepsy to excessive masturbation. However, any marginal health claims are extremely contested. The NSS is unaware of any national medical, paediatric, surgical or urological society in the world that recommends routine circumcision of all boys as a health intervention. If the benefits of the operation outweighed the risks, NHS doctors would recommend it for every child – regardless of the parents' religion – and they do not.

Supposed medical benefits of circumcision are increasingly under question in the UK. The proportion of boys in England circumcised for medical reasons had fallen from 35% in the early 1930s to 6.5% by the mid-1980s. An estimated 3.8% of male children in the UK in 2000 were being circumcised by the age of 15. The researchers stated that too many boys, especially under the age of 5, were still being circumcised because of a misdiagnosis of phimosis.

The National Secular Society believes that the right to bodily autonomy is fundamental, and that no-one, regardless of age, sex or religious/cultural background, should undergo nontherapeutic surgery without their express consent. For this reason, we campaign for both girls and boys to be fully protected from non-consensual genital cutting.

Article 9 of the European Convention on Human Rights does provide for a right to freedom of thought, conscience, and religion which includes the freedom to manifest a religion or belief in practice and observance.

However, this aspect of Article 9 is a qualified right, which means that limitations on this right can be justified in certain circumstances. We maintain that the right of the individual to bodily autonomy provides such a justification.

Arguments similar to those made to justify the imposition of circumcision are also made to justify other non-therapeutic surgery of children. But UK courts have not accepted that religious/cultural reasons justify any form of assault on children in other contexts, including FGM, facial scarification, religious flagellation, religious deprivation of medicine, or religious starvation.

The act of forced genital cutting violates the child's right to religious freedom. It irrevocably deprives the child of the right in future to associate or dissociate from certain practices and customs of his birth community.

In 2010, the Royal Dutch Medical Association (KNMG) in association with all the major Dutch medical colleges released a policy statement asserting that: "non-therapeutic circumcision of male minors is a violation of children's rights to autonomy and physical integrity. Contrary to popular belief, circumcision can cause complications – bleeding, infection, urethral stricture and panic attacks are particularly common. KNMG is therefore urging a strong policy of deterrence. KNMG is calling upon doctors to actively and insistently inform parents who are considering the procedure of the absence of medical benefits and the danger of complications."

In 2016 the Danish Medical Association also called for an end to male circumcision, arguing that the procedure should only ever be performed with "informed consent". This follows the joint statement in 2013 by all the Scandinavian children's ombudsmen that children should be allowed to choose for themselves and that non-therapeutic childhood circumcision "violates fundamental medical-ethical principles".

In September 2017 the Belgium federal government's Committee for Bio-Ethics ruled that bodily integrity was more important than religious faith.

In its 2018 report the Child Rights International Network (CRIN) called the ritual circumcision of infant males for non-medical reasons a "violation of bodily integrity" which "unnecessarily" exposes children to risks.

The UN Convention on the Rights of the Child (UNCRC) recommends respect for the right of the child to freedom of thought, conscience and religion, and advises that traditional practices prejudicial to the health of children should be abolished. In a 2013 report, the UN Committee on the Rights of the Child included non-therapeutic circumcision in it the 'harmful practices' section.

The Committee's 2016 report on the UK recommended: "Ensure that no one is subjected to unnecessary medical or surgical treatment during infancy or childhood, guarantee bodily integrity, autonomy and self-determination to children".

In April 2018 a proposal to the Danish government to create a gender-neutral age of consent of 18 for all forms of non-therapeutic genital cutting stalled, despite considerable public support.

A draft bill was put before the Icelandic government in 2018 to ban non-consensual ritual circumcision for boys, which has not been progressed following heavy lobbying from religious groups.

In a 2018 YouGov survey, 62% of people in the UK said they would support a law prohibiting the circumcision of children for non-medical reasons. Only 13% would oppose it.`

FGM is is illegal in the UK. It's also illegal to take abroad a British national or permanent resident for FGM, or to help someone trying to do this. Contact the police if you or someone you know is in immediate danger of FGM.

You should also contact the Foreign and Commonwealth Office if you know a British national who's already been taken abroad.

If you're abroad you can contact the nearest British embassy, commission or consulate.

Contact the NSPCC anonymously if you're worried that a girl or young woman is at risk or is a victim of FGM.

NSPCC FGM Helpline
Telephone: 0800 028 3550
From overseas: +44 (0)800 028 3550

The UK government has a list of organisations which can give you help and advice, including details on NHS specialist clinics for FGM.

If you are affected by male circumcision 15 Square is a charity which can provide information and advice.