Female Genital Mutilation (FGM) is a global public health concern with no evidence-based medical justification. It involves the intentional injury or removal of healthy female genital tissue and can result in severe, sometimes life-threatening consequences. Beyond the immediate physical trauma, FGM shapes the entire trajectory of a girl’s or woman’s life affecting her right to physical, mental, and sexual good health, education, socioeconomic security, and personal autonomy.

This article explores who performs FGM, how and when it occurs, the recognised types, and the health implications across the life course.

Who performs FGM and how is it undertaken

FGM is commonly performed by lay ‘cutters’ within practising communities. It can include using non-medical instruments to cut skin and without providing anaesthetic for pain relief. Many women and girls do not consent, are not told what will happen, and are forcibly restrained during the procedure.

A growing concern is the medicalisation of FGM. An estimated 25% of FGM procedures are now carried out by healthcare providers, sometimes in clinics, creating a misleading perception of safety and legitimacy. However, medicalisation does not diminish harm. Two widely reported cases in Egypt where a 17-year-old girl (2016) and a 12-year-old girl (2020) died during medicalised FGM procedures starkly illustrates this danger.  

Professional and regulatory bodies remain unequivocal: All forms of FGM, including medicalised FGM, are unethical, illegal and a breach of professional codes.

The End FGM European Network (2025) has issued a clear position statement opposing medicalisation. 

When is FGM performed?

The age at which FGM occurs varies widely between countries, reflecting the differing societal norms and beliefs. UNICEF (2024) reports:

• Nigeria 93% of cases occur in infancy or early childhood
• Sierra Leone: 50% occur during adolescence
• Indonesia: 51% occur in adulthood

FGM Types

The World Health Organisation identifies four types. All have consequences that unfold across the lifetime.

Type 1: Partial or total removal of the clitoral glans (the external and visible part of the clitoris), and/or the clitoral hood (the fold of skin surrounding the clitoral glans).
Type 2: Partial or total removal of the clitoral glans and the labia minora (inner folds of the vulva), with or without removal of the labia majora (outer folds of the vulva).
Type 3 (Infibulation): Narrowing of the vaginal opening by creating a covering seal - cutting and repositioning the labia minora, or labia majora, sometimes with stitching, with or without removal of the clitoral clitoral hood and glans. May partially or fully close the vaginal opening and is associated with the highest risk of complications 
Type 4: All other harmful procedures to the female genitalia for non-medical reasons, such as pricking, piercing, incising, scraping and cauterization.

Health Impact Across the Life Course

FGM impacts health from infancy through to older age. An infographic produced by the National FGM Centre and FGM Sunflower Clinic (2022) illustrates how different FGM Types link to immediate, short-term, and long-term consequences. FGM and Health Consequences Infographic 2022

Immediate Consequences

At the time of the procedure individuals may experience:

• Severe pain
• Haemorrhage
• Shock
• Infection
• Trauma
• In some cases, death

Long-Term Consequences

Damage to genital tissue and obstruction of the urethral or vaginal openings can lead to:

• Chronic inflammation
• Recurrent infections
• Difficulties with urination and menstruation
• Painful sexual intercourse
• Complications in childbirth
• Potential kidney failure
• Increase risk of malignancy
• Long-term mental health problems 

Infancy and childhood

FGM is the fourth leading cause of child mortality in 15 countries where it is widely practised (Flowe et al., 2025). An estimated 44,000 girls and women die annually, and a girl dies every 12minutes because of FGM-related complications.

As a severe Adverse Childhood Experience (ACE), FGM inflicts profound physical and psychological trauma, disrupts child development and contributes to life-long adversity.

Puberty and adolescence

Girls with Type 3 FGM often struggle with menstruation due to partial or complete blockage of the vaginal opening. Menstrual blood can become trapped, causing:

• Severe pain
• Repeated infections
• Pelvic inflammatory disease
• Infertility

These complications can significantly impact mental health. Girls may miss school and eventually drop out of education (NSPCC, 2021). 

Pregnancy and childbirth

In the reproductive years, women with Type 2 and Type 3 FGM and their babies face heightened risks during pregnancy and childbirth. Those with Type 3 FGM are:

• 70% more likely to experience pre-eclampsia, eclampsia, prolonged labour and haemorrhage
• Twice as likely to die in childbirth

Babies are at increased risk of:

• Foetal distress
• Forceps delivery
• Caesarean section
• Stillbirth

In cases of miscarriage, FGM may obstruct essential medical procedures (Pallitto et al., 2025). 

Adulthood and older age

Complications often persist and worsen into adulthood and older age.

• Chronic inflammation and recurrent infections increase risk of abnormal cell changes and cervical cancer.
• Pain, stigma and trauma can deter women attending screening
• Altered anatomy impedes clinical examinations and smear testing delaying early detection and treatment of gynaecological cancers and other conditions.  
• Vaginal cysts and abscesses may develop.
• Ongoing urinary problems may compromise kidney function.
• Chronic inflammation disrupts sleep, and exacerbates long-term mental health problems, including anxiety, depression and post-traumatic stress
• During menopause falling oestrogen and progesterone levels exacerbate and pain and discomfort from scar tissue and the anatomical damage caused by FGM.
• Chronic pelvic infections may cause some women to have an earlier menopause.

Research on the health impact and needs of women at menopause and in older age living with the consequences of FGM remains limited. 

Conclusion

FGM causes a cascade of serious, lifelong health complications that undermine the wellbeing and life chances of girls and women. To meet their complex needs, dedicated, specialist and trauma-informed health and social care services must be commissioned across the life course.

Further Resources 

• World FGM prevalence map – National FGM Centre
• FGM and Health Consequences Infographic 2022

Advice

• Talk to your GP: you can talk them about the feelings you are having, and they may refer you to specialist services if they feel it will help you.
• Health care professionals may have access to support resources through their professional bodies and employing organisations.
• Students will have access to support resources on their university website.