Beyond Awareness: Turning Knowledge into Action on Female Genital Mutilation
"Why understanding FGM isn't enough, and how healthcare can truly make a difference."
Female genital mutilation (FGM) affects an estimated 200 million women worldwide, with 44 million being girls under the age of 15. Beyond the immediate trauma, FGM leads to serious medical and psychological complications, impacting women's health and even childbirth. It's a human rights violation that demands attention.
The United Nations has called on member states to protect women and girls from FGM, emphasizing the critical role of healthcare providers. This includes providing supportive services, improving health outcomes, and implementing comprehensive prevention strategies through training.
A recent study in the Emergency Medicine Journal highlights a concerning gap: even when healthcare professionals are aware of FGM, they may miss cases during examinations. This article explores how to move beyond awareness and equip healthcare providers with the tools and training needed to identify, care for, and ultimately help prevent FGM.
Global Scale and Measurement
Female genital mutilation (FGM) comprises procedures involving partial or total removal of the female external genitalia or other injury to the female genital organs for non-medical reasons. UNICEF reports that more than 230 million girls and women worldwide have been cut, with Africa accounting for the largest share and more than 144 million affected there. The UNFPA dashboard draws on the latest Demographic and Health Surveys and Multiple Indicator Cluster Surveys across 17 countries to support analysis of prevalence and practice. The World Bank also provides a dataset tracking FGM prevalence as a percentage.
Evidence-Based Prevention and Care
The WHO guideline treats FGM as a harmful practice with no medical benefit and addresses its physical, psychological, and reproductive health risks. Its revised April 2025 edition expands the scope beyond clinical management to include up-to-date, evidence-informed recommendations for prevention and care. WHO's earlier 2016 publication focused primarily on managing health complications associated with FGM. The Lancet discussion also highlights the need for precision when defining medicalised FGM, which WHO describes as FGM practiced by any category of health-care provider in a clinic, at home, or elsewhere.
Origins and Historical Complexity
Historical scholarship does not establish a single definitive origin for FGM. A 2022 Springer chapter examines the anthropological factors behind the practice, empirical research on its origins, and difficulties in measuring its prevalence and development. A historical overview from Science Insights reports that the practice most likely originated in the Nile Valley, in or around ancient Egypt, while noting that this has not been proven definitively. Other historical research emphasizes that FGM predates modern nations, religions, and legal systems, and that its origins remain debated.
Bridging the Knowledge Gap: From Awareness to Action
The first crucial step is ensuring systematic education about FGM for all healthcare professionals. Given increasing international migration, clinicians everywhere, not just in specific communities, need to be prepared. This includes nurses, physicians, social workers, and advanced practice providers across various specialties like general, emergency, and behavioral health.
- Hands-on Training: Focus on clinical tools for screening and care.
- Patient-Centered Approach: Understanding that cultural contexts vary significantly.
- Trauma-Informed Care: Creating a safe and non-judgmental environment for disclosure is essential.
- Postpartum Intervention: Engaging in conversations with women who have undergone FGM about the potential consequences for their daughters.
Mapping Health Consequences and Responses
Recent research continues to examine FGM/C through global, clinical, and sociocultural lenses. A 2026 systematic review aims to assess the global distribution, health consequences, and sociocultural drivers of FGM/C to inform targeted elimination strategies. A 2025 study in BMC Public Health examines short- and long-term health complications among an estimated 230 million affected women and girls. A Lancet eClinicalMedicine article further identifies barriers to adequate healthcare and support, emphasizing the need for research, comprehensive policies, and evidence-based clinical guidelines.
Awareness Gaps in Healthcare
Evidence indicates that healthcare systems can miss FGM cases because professional awareness remains limited. An EMJ commentary discussing Fawcett and Kernohan's retrospective analysis of 34 potentially missed emergency-department cases describes the health sector as being in the early stages of FGM awareness. WHO reports that more than 230 million girls and women are alive today after undergoing FGM, while more than 4 million girls are estimated to be at risk annually. These figures underscore the gap between the scale of the practice and the capacity to recognize and respond to it.
Shared Drivers and Divergent Contexts
A systematic review covering research from 2009 through March 2020 examined factors associated with FGM/C using Medline, PsycInfo, Web of Science, Embase, and grey literature. A 2026 review compares FGM/C with female genital cosmetic surgery, noting that the practices arise in divergent contexts and have different legal framings while being shaped by a shared factor. An anatomical review by Vincenzo Puppo, published in Clinical Anatomy in 2017, addresses FGM/C classifications, complications, and alternative rites. Together, these sources support comparison that distinguishes social and legal context rather than treating all forms of genital intervention as equivalent.
A Call to Action: Preventing FGM Starts with Prepared Professionals
The study by Fawcett and Kernohan serves as a crucial wake-up call for emergency clinicians, highlighting the urgent need to translate FGM awareness into concrete action.
Accelerating Action Toward 2030
Future efforts are increasingly framed around measurable progress toward ending FGM by 2030. Research published in 2024 examines 30-year trendlines, inequality in prevalence, and the economic burden associated with delay. The UNFPA-UNICEF Joint Programme's 2025 annual report, titled “The Race to 2030: Accelerating Action to End Female Genital Mutilation,” presents the issue against the Sustainable Development Goal deadline. Equality Now's 2025 update likewise calls for coordinated action by 2030 and provides recommendations for governments and advocates.
Fragility, Backlash, and Protection
The 2024 FGM Joint Programme annual report describes growing, systematic, and persistent pushbacks against elimination efforts, linking them to a broader backlash against gender equality and women's rights. A 2026 report on FGM in humanitarian settings argues that the practice becomes a systemic form of gender-based violence when legal, health, and social protection frameworks collapse. These sources place FGM within wider institutional and political conditions rather than treating it solely as a cultural issue. Effective responses therefore depend on functioning protection, health, and social systems.
Lived Consequences and Care
FGM is described as a human rights violation, a public health issue, and a form of interpersonal violence. An emergency-medicine source reports that FGM may be associated with increased caesarean section rates and that some studies have demonstrated increased infant mortality. A 2026 meta-ethnographic review synthesizes lived experiences and impacts by incorporating perspectives from people who underwent FGM/C, men, and healthcare providers. This qualitative perspective complements systematic research examining the practice's global distribution, health consequences, and sociocultural drivers.
By equipping healthcare professionals with the right tools, training, and a patient-centered approach, we can ensure that women and girls affected by FGM receive the compassionate and effective care they deserve.
Ultimately, this proactive stance within the healthcare system can contribute to the prevention of FGM and protect future generations.