FGM Reconstruction Surgery in the UK

FGM reconstruction surgery UK: Why women in the UK are travelling abroad for FGM reconstruction surgery

By Aneeta Prem MBE, Founder of Freedom Charity

For Freedom Charity’s current overview of female genital mutilation, safeguarding, prevention and routes to support, see our main FGM guide.

Specialised surgery to restore clitoral sensation after FGM is not routinely commissioned by NHS England. This is different from deinfibulation, which the NHS does provide. Some survivors seek specialised reconstruction abroad and pay privately. Suitability, benefits and risks require individual specialist assessment. Freedom Charity believes survivors should have clear information and equitable access to appropriate care.

A recent  excellent report by Sky News health correspondent Ashish Joshi highlighted the experiences of UK women forced to travel to Switzerland. Although his coverage brought important visibility, the wider reality deserves careful explanation. This article sets out the evidence, the policy barriers and the urgent action needed.

The scale of FGM in the UK

FGM is one of the most severe forms of harm inflicted on girls. The World Health Organisation estimates that more than 230 million women and girls live with its impact worldwide. A study published in 2015, using 2011 population data, estimated that 137,000 women and girls affected by FGM who were born in countries where it is practised lived in England and Wales in 2011. This is a historical modelled estimate, not a current count of survivors. NHS attendance data measure recorded healthcare contacts and are not a measure of prevalence.

The historical population estimate and NHS service records measure different things and should not be added together. People who never disclose FGM or access a service may be absent from clinical records. Current needs cannot be calculated reliably from either figure alone.

What reconstruction surgery aims to achieve

Specialised clitoral reconstruction is one possible procedure offered by some services. It does not replace tissue removed by FGM or guarantee restored sensation. Evidence on benefits and harms remains uncertain, and a person’s symptoms, anatomy, preferences and trauma-informed counselling should guide specialist assessment.

Importantly, reconstruction does not erase trauma. Even so, for many it offers a sense of control and dignity. Because choice is central to trauma-informed care, survivors should have access to full information and safe options.

Why specialised clitoral reconstruction is not routinely commissioned

NHS FGM services offer assessment, deinfibulation and other support, while some specialist teams also provide surgery for FGM-related complications. Specialised reconstruction to restore clitoral sensation is not routinely commissioned by NHS England. The evidence and commissioning questions are set out below.

1. Limited long-term evidence

RCOG guidance notes that current studies are too small and too short-term to support reconstruction as routine NHS care. Reviews funded by the National Institute for Health and Care Research highlight the need for stronger long-term data. Since techniques differ between surgeons and centres, comparing outcomes is difficult.

Evidence update (2025): The World Health Organization guideline conditionally suggests clitoral reconstruction for selected women living with FGM, while rating the supporting evidence very low certainty. This calls for specialist assessment, counselling and shared decision-making; it does not itself create an NHS commissioning pathway.

2. Safety considerations

Some women experience positive outcomes. However, possible complications include bleeding, infection, pain or emotional distress. Because reconstruction is intimate and complex, clinicians emphasise the need for safe protocols, specialist training and careful follow-up.

3. Capacity and commissioning pressures

Introducing reconstruction would require investment in trained teams, theatre sessions and multidisciplinary support. Given the current pressures facing the NHS, commissioning such a service has not yet been prioritised.

4. Communication barriers within services

Many healthcare staff feel unsure how to discuss sexual function after FGM. Consequently, survivors often receive inconsistent or incomplete advice. Better communication would support informed decisions.

Why survivors are travelling abroad

Some European centres, including Geneva University Hospitals, provide FGM reconstruction within established specialist services. Swiss residents can access treatment through compulsory health insurance. However, UK survivors must usually pay privately.

Fees and eligibility vary by clinic, procedure, country and individual circumstances. Anyone considering treatment abroad should request a written, itemised quote and ask about clinical assessment, complication management, travel, follow-up care and how their UK team would coordinate any treatment. No single indicative price should be treated as reliable for all patients.

Nevertheless, women still travel because they live with daily pain, numbness, or long-standing loss of function. Their motivation comes from a desire for relief, dignity and the possibility of regaining something taken from them as children.

The pressures women face when travelling

Travelling for surgery creates new risks and challenges. For example:

• Financial pressure from private medical fees and travel

• Interrupted continuity of care when UK clinicians did not perform the procedure

• Emotional strain, because travel may trigger traumatic memories

• Community pressure, especially where disclosure is difficult

These challenges sit on top of the original trauma of FGM.

A human rights and equality issue

The UK has strong laws against FGM and a duty to protect survivors. Prevention work is vital, and many NHS practitioners provide excellent support. However, when reconstruction is unavailable, a new form of inequality emerges. Women with savings or supportive networks can seek treatment abroad. Women without those resources cannot.

This divide demands national attention.

“FGM is a deep violation of a girl’s body and her trust. No survivor should need to raise thousands of pounds or travel overseas to explore options for healing. If we want to end FGM, we must also support survivors to rebuild their lives safely and fairly.” Aneeta Prem MBE 

What the UK needs to do next

To build a fair and evidence-based approach to FGM reconstruction surgery UK, the following steps are essential.

1. Fund national research programmes

The UK should develop controlled trials in specialist centres. Research must assess surgical outcomes, safety, long-term effects and psychological impacts. Survivors should help shape this work.

2. Update clinical guidance regularly

Professional bodies should review new global evidence and update guidance each year to reflect current practice.

3. Improve access to balanced information

Every woman attending an NHS FGM clinic should receive clear, accurate and sensitive information about reconstruction, including potential benefits and risks.

4. Plan for fair access to treatment

If research supports reconstruction, the NHS must ensure safe, equitable access so survivors are not dependent on private funds.

5. Strengthen prevention and education work

Reconstruction must never be seen as a remedy for FGM. Instead, prevention and education remain vital. Freedom Charity’s school programmes and our books But It’s Not Fair and Cut Flowers, continue to help protect children across the UK.

Freedom Charity’s position

Freedom Charity works daily with survivors seeking clarity, safety and compassionate support. Some want counselling, others need medical care, and many simply want someone to listen. Every survivor deserves options rooted in evidence and dignity.

The UK has made progress in preventing FGM. Now we must match that progress by strengthening support for survivors.

Healing should never depend on a passport or a bank balance.

Freedom Charity’s commitment

Freedom Charity works to prevent FGM, safeguard children and support survivors. Our work includes school education, community training, helpline support and donating safeguarding books such as Cut Flowers and But It’s Not Fair.

But prevention alone is not enough. Women who were harmed as children must not face barriers to healing as adults.

You can learn more about our mission at:
https://freedomcharity.org.uk