Readers may recall that I have long been interested in trying to unpick the data on female genital mutilation in the UK. The general standard of debate on this topic is woefully uninformed by actual facts. News pieces and campaign materials have traditionally waved around (almost) meaningless statistics about the numbers of girls being at risk of FGM, without explaining what they mean by “at risk” or how severe that risk might be.
The numbers tend to be horrifying and this has at least two extremely serious consequences. The first is that the practice of FGM among migrant communities in the UK is used as a damning indictment of their failure to integrate, to accede to British law and custom, or more broadly as evidence the uncivilised, backwards ways of immigrants and especially Muslims.
Secondly, for many years there has been a clamorous call to demand explanations why nobody in the UK has been successfully prosecuted for conducting FGM. It has long been assumed (and not just among the spittle-flecked rabble of the Daily Mail comments section) that some sort of political correctness must be the reason why police, prosecutors, social services and child services have all been deliberately averting their gaze from the brutes who continue to cut up the genitals of little girls. But as I have written before, there is another possible explanation as to why these offences are never prosecuted – could it be because in fact these crimes very rarely happen in the UK?
This week the Health & Social Care Information Centre published their latest quarterly bulletin on FGM. This exercise (still described as ‘experimental’) collates reports from Health Trusts around the country which count the numbers of new cases that have come to light within the NHS. The vast majority of cases are adult women (mostly aged 18-39) and typically come to light during obstetrics & gynaecology care in pregnancy and childbirth.
As the headlines explained, this latest quarter found around 1200 new cases of FGM. For the first time, however, the data included some numbers for where the women and girls were born and where the FGM procedure had occurred.
Before I go any further let me stress that the statistics here are patchy and incomplete. We are only considering newly discovered cases, not the total, and there are huge holes in the data sets where the relevant information could not be or was not recorded. Nonetheless the numbers are revealing.
Of the 1242 cases, there were 532 where the country of birth was recorded. Of those, precisely 11 cases were of girls or women born in the UK. That means that 98% of cases of FGM in the UK (from this data set and where the info was logged) were on women born outside of the UK.
Even more usefully, there were 319 cases in which the data recorded where in the world the FGM was undertaken. Of those, seven were reportedly undertaken in the UK. Again, 98% of FGM procedures happened outside the UK.
These numbers 11 cases and 7 cases respectively) are so tiny we should be aware of the risks of data errors and statistical noise. For instance, genital piercings can be classified as Type 4 FGM (in some cases this is legitimate and accurate – piercings are sometimes inflicted upon girls as a form of FGM) but it does create obvious scope for confusion and miscategorisation.
There is one incredibly important question which the HSIC still fails to address or answer: How many of the 1242 new cases of FGM are women who were already resident in the UK before they were mutilated? If we had an answer to that question, everything would suddenly become a lot more meaningful. In the meantime, what is this data telling us? It looks to me like what we are seeing is that relatively large numbers of women who move to the UK from FGM-practising countries such as Nigeria, Kenya and Somalia have already been cut when they move here. This should be a clear and uncontroversial point. There is an obvious and serious need for health professionals to be aware of this and to have the expertise necessary to provide these women with the care and medical treatments they might require to heal the damage.
The other key takeaway from the data is that amongst girls who have been born in Britain, even to communities where it has been traditionally practised, FGM is exceptionally rare. For years we have been told that anything up to 120,000 girls in the UK are “at risk” of FGM, an estimate based on numbers of girls born in the UK to families from the relevant parts of the world. If the true numbers were anything even vaguely on this scale we would expect to see far, far more new cases coming to the attention of the authorities.
To be clear, we cannot be sure from this data that there aren’t lots of girls who are born elsewhere, brought intact to the UK as children, taken out of the country to be cut elsewhere and then brought back again, but this really seems something of a stretch to me. A more credible interpretation of the data would be that FGM remains a huge medical and human rights catastrophe in many parts of the world, but that when people move to the UK, with very few exceptions, they abandon the custom.
We still don’t have the statistics to speak about any of this with authority. As the academic cliché would have it, more research is necessary. If I had one wish on this front, however, it would be that when journalists, campaigners and politicians talk about the thousands of women in Britain who have suffered FGM they explain to people that the vast majority were living elsewhere when it happened. That little nugget of nugget of knowledge entirely transforms the debate and would do so in a much more constructive direction.