Female Genital Mutilation Global Guide

Cutting Across Borders

Why FGM survives, where the law fails — and what it will take to end it

By Aneeta Prem MBE, Founder of Freedom Charity
Long read | Last reviewed: 16 August 2026

People often discuss female genital mutilation as though the world already understands it. We do not.

Many people still imagine FGM as an African problem. Others wrongly connect it to one religion, assume that a law will end it, or believe that a doctor can make it safe. Each misconception creates a blind spot.

More than 230 million girls and women alive today have undergone female genital mutilation (FGM). In 2026 alone, an estimated 4.5 million girls are at risk, many of them under five. Evidence of FGM now exists in at least 94 countries, yet only 59 of those countries have specific national laws or legal provisions addressing it.

Numbers show scale, but they do not explain survival. To understand why FGM continues, we have to look at power: who controls a girl’s body, what families fear they may lose by refusing the practice, how marriage and economic dependence shape choices, what status or income practitioners may derive from it, and whether the law can reach a child before harm occurs.

One question should sit at the heart of every policy, programme and prosecution:

Is the girl safer?

What FGM is — and what it is not

The World Health Organization defines FGM as procedures involving partial or total removal of the external female genitalia, or other injury to female genital organs, for non-medical reasons.

FGM has no health benefit. International human-rights bodies recognise it as a human-rights violation and a form of violence against women and girls. When adults carry it out on a child, it constitutes child abuse.

Age does not follow one pattern. Families or practitioners may arrange FGM during infancy, childhood or adolescence, around marriage, or sometimes in adulthood. That variation matters because there is no single profile of a girl or woman at risk.

WHO groups FGM into four broad types:

Type I: partial or total removal of the clitoral glans and/or prepuce
Type II: partial or total removal of the clitoral glans and labia minora, with or without removal of the labia majora
Type III: infibulation, which narrows the vaginal opening by creating a covering seal
Type IV: other harmful procedures to female genitalia for non-medical reasons, including pricking, piercing, incising, scraping or cauterisation

These medical categories help clinicians and researchers describe injuries. They must never become a hierarchy in which a less extensive injury appears acceptable.

The health consequences vary. Not every survivor experiences every complication, and we should never reduce a woman to what happened to her. Even so, the established risks include severe pain, haemorrhage, infection, urinary problems, chronic pain, scarring, sexual difficulties, psychological trauma and complications during pregnancy and childbirth.

The economic cost also reaches far beyond individual families. WHO estimates that treating health complications caused by FGM costs health systems at least US$1.4 billion each year.

FGM is therefore not a private family matter. Its consequences reach healthcare, maternity services, mental health, safeguarding, education, justice and public spending.

The map that changes the story

[INSERT PETER’S GLOBAL FGM MAP HERE — FULL WIDTH]

Caption: Researchers have documented female genital mutilation in at least 94 countries. The quality and type of evidence vary: some countries have nationally representative prevalence data, while evidence elsewhere comes from smaller studies, community research, survivor testimony or documented cases. Inclusion on this map does not mean prevalence is the same in every country.

Peter’s map belongs near the beginning because geography is one of the first myths we need to dismantle.

The 2025 global review by Equality Now and partner organisations collated evidence of FGM in 94 countries. That figure matters, but so does the quality of the underlying data. National surveys exist in some countries; smaller studies, indirect estimates and survivor testimony provide evidence in others.

A responsible map must show presence without pretending to show identical prevalence.

This distinction has practical consequences. A teacher, doctor, police officer, immigration official or social worker who associates FGM with only a narrow group of countries may miss a genuine safeguarding risk involving someone from elsewhere.

FGM is global. The evidence is uneven. Both statements can be true at the same time.

Why does FGM continue?

Calling FGM a “tradition” explains almost nothing.

Tradition tells us that people have repeated a practice. It does not tell us why families continue it, what they fear may happen if they stop, who enforces the expectation, or what would make abandonment possible.

Different communities give different reasons. Some connect FGM with marriageability, virginity, femininity, family reputation, adulthood, cleanliness or social belonging. Others invoke religion, even though no single religion accounts for the practice.

At the centre often lies a harder fear: what happens if our family is the one that refuses?

Control, marriage and reputation

In some settings, FGM forms part of a wider system that regulates female sexuality. UNFPA records justifications linked to virginity before marriage, sexual restraint and fidelity afterwards.

Those ideas turn a girl’s body into evidence of family respectability.

Although the language may sound protective — she will be accepted, marriageable, respectable or safe — the reality is different. Adults make a non-medically necessary decision about her body and may expect her to carry the consequences for life.

Ultimately, the issue is bodily autonomy.

Money matters too

Where marriage determines a girl’s future financial security, anything believed to affect marriageability acquires an economic value. That can make refusal appear risky even to parents who privately question the practice.

Education can alter those choices. UNICEF’s evidence review links education with lower support for FGM and stronger opposition to the practice across generations. Schooling also expands social networks, gives girls access to information and can increase future economic independence.

Education alone will not end FGM. However, a girl with knowledge, qualifications and wider choices has more power than one whose survival depends entirely on fitting a prescribed model of marriage.

Religion is often misunderstood

No single religion explains FGM. The practice exists among communities with different faiths, while many people of those same faiths reject it completely.

UNFPA states that neither Islam nor Christianity endorses FGM, although people sometimes invoke religious beliefs to justify it. Religious leaders can therefore become important allies when they challenge false claims from within their own communities.

In Guinea, for example, Muslim leaders have publicly rejected the claim that Islam prescribes FGM. That approach matters because change is often strongest when credible voices inside a community challenge the justification directly.

The useful question is not “Which religion should we blame?” It is “What belief sustains FGM here, and who can credibly challenge it?”

Medicalisation: the false promise of a safer cut

One of the most troubling developments is medicalisation.

A doctor, nurse or midwife may use sterile equipment, anaesthetic or a clinical setting. None of those things creates a medical reason to injure healthy genital tissue.

WHO reports that health workers performed FGM on around one in four survivors aged 15 to 49 in the available data. In 2025, WHO issued updated recommendations aimed at stopping medicalised FGM and improving clinical care for survivors.

Medicalisation carries an additional danger: legitimacy. If a respected health professional performs FGM, families may interpret that involvement as proof that the practice is acceptable.

Healthcare should protect girls and care for survivors. It should never make FGM respectable.

The law — and its limits

The international legal position sounds stronger than the reality on the ground.

Human-rights treaties and regional instruments require states to tackle harmful practices. The Maputo Protocol contains an explicit obligation to prohibit and condemn FGM. The Istanbul Convention requires participating states to criminalise specified conduct relating to FGM. Sustainable Development Goal 5.3 calls for the elimination of FGM and child, early and forced marriage by 2030.

Yet specific national FGM laws or provisions exist in only 59 of the 94 countries where researchers have documented the practice.

Even that comparison — law or no law — is too simple.

One country may have a strong statute but weak enforcement. Another may rely on general assault or child-protection offences. Some laws provide extraterritorial jurisdiction when families take a girl abroad. Others offer civil protection orders that allow courts to act before the procedure takes place.

The better question is not “Does this country have an anti-FGM law?”

It is:

Can the law protect a girl before she is cut?

Colombia: a new law changes the regional picture

Colombia produced one of the most important legal developments of 2026.

On 27 July 2026, Colombia enacted Law 2609 of 2026, which establishes measures to prevent, respond to and eradicate FGM. The official law is available through the Presidency of Colombia.

The reform matters because it challenges the geography people often attach to FGM. It also shows why affected communities must take part in designing change.

Indigenous women and authorities played a significant role in the work that led to reform. That point deserves emphasis. A harmful practice may exist within a community, but it does not define everyone in that community. Some of the strongest opposition can come from women who understand its pressures from the inside.

Colombia therefore offers two lessons. FGM is not confined to the places where outsiders expect to find it, and lasting reform works best when communities are partners rather than stereotypes.

Liberia: when protection depends on politics

Liberia illustrates a different problem.

Traditional leaders have made significant commitments to abandon FGM, and international partners have supported “initiation without mutilation” alongside alternative livelihoods for traditional practitioners, often known as zoes. These programmes try to preserve non-harmful cultural roles while removing cutting.

The idea deserves serious attention because practitioners may hold status, authority and income as well as technical knowledge.

However, Liberia also demonstrates the fragility of protection when national legislation remains unsettled. In July 2026, the Minister of Internal Affairs announced an intention to lift the moratorium restricting FGM on 15 August 2026 after officials prepared new traditional rules. At the time of this review, I have not found an authoritative government notice confirming that the announced change formally took effect.

That uncertainty is itself revealing.

A girl’s bodily integrity should not depend on whether a temporary restriction survives the next political negotiation.

Community agreement can change behaviour. Durable rights still require clear law.

The Gambia: progress can move backwards

Legal victories are not permanent.

The Gambia prohibited FGM in 2015. Years later, political pressure grew to repeal the ban. In 2024, the National Assembly ultimately rejected the proposed reversal.

The episode matters well beyond The Gambia. Human-rights work does not end when Parliament passes a law. Sometimes the next challenge is defending that protection when political or social pressure turns against it.

A legal gain can become vulnerable if society does not understand why the law exists.

Borders can become loopholes

National law also stops at borders unless states cooperate.

UNFPA has documented concern about cross-border FGM in East Africa, where families may move girls between jurisdictions to evade restrictions or enforcement.

This exposes an obvious weakness. A country has not fully protected a child if those determined to harm her can solve the legal problem by buying a ticket.

Extraterritorial offences, regional cooperation, information-sharing and consistent protection standards therefore matter.

England and Wales: strong law, difficult cases

The Female Genital Mutilation Act 2003 specifically criminalises FGM in England and Wales. The Serious Crime Act 2015 later strengthened that framework.

The law covers the principal offence, assisting FGM in specified circumstances, certain conduct abroad and failure to protect a girl under 16 from a significant risk of FGM. England and Wales also have FGM Protection Orders, which allow family courts to impose measures intended to prevent harm, including travel restrictions or surrender of passports.

Teachers and regulated health and social-care professionals have a separate mandatory reporting duty in specified cases involving girls under 18. That duty concerns known FGM — for example, when a girl tells the professional that FGM has occurred or the professional observes physical signs that appear to show it. Future risk remains a safeguarding concern, but the legal test for mandatory reporting is different.

That distinction matters. Safeguarding professionals need precise information, not slogans.

If FGM is illegal, why are prosecutions so rare?

England and Wales provide a useful case study.

The Crown Prosecution Service had secured three FGM convictions by October 2024. The first, in 2019, concerned FGM committed in the UK. A second conviction in 2023 involved assisting FGM overseas. In 2024, prosecutors secured the first conviction for conspiracy to commit FGM after a man arranged for a girl to travel from the UK to Iraq, where he intended that she undergo FGM and be forced into marriage.

Three convictions do not mean three cases of FGM.

These crimes can be exceptionally difficult to investigate and prove. Families may organise them in private. A victim may be very young, may not understand what happened or may depend on the people involved. The procedure may take place abroad. Years can pass before disclosure. Medical evidence may establish an injury without identifying who arranged it or when.

Prosecution figures therefore cannot measure prevalence.

Nor should conviction numbers become the only test of whether the law works.

Criminal proceedings ask whether the state can prove an offence beyond reasonable doubt. Prevention asks whether professionals could have identified the risk and protected the girl before any injury occurred.

“The measure of a law is not only how many people it punishes. It is whether the person at risk is safer because that law exists.” Aneeta Prem

Education is protection before crisis

Criminal justice usually enters the story late. Education can arrive years earlier.

A child at risk may never use the words “female genital mutilation”. She might say her family is planning a ceremony, that she must become a woman, that relatives are discussing a trip she does not want to take, or simply that she feels frightened.

Giving children age-appropriate language about bodily autonomy, consent, safe adults and asking for help can make the difference between silence and disclosure.

Adults need education too

A professional who misses the warning signs cannot protect even a well-informed child.

Teachers, doctors, nurses, police officers, social workers and others need to understand both FGM and the wider pattern around it. Travel, family pressure, marriage expectations, unexplained absence or changes in behaviour may matter when viewed together.

Professional curiosity should never become racial or religious profiling. Good safeguarding asks proportionate questions because of evidence of risk, not because of someone’s ethnicity.

Parents and communities also need accessible information. A statute written for lawyers is not the same as a mother knowing what protection exists for her daughter tomorrow morning.

Boys and men belong in the prevention effort

When families justify FGM through ideas about future marriage or what men supposedly expect, male rejection of the practice can weaken those expectations.

Freedom Charity’s Not in My Name campaign brings boys and young men into education about FGM, forced marriage and dishonour abuse. Its purpose is not to shift responsibility away from women and girls. It challenges the social permission that allows abuse to continue.

A future husband should never become the imagined reason for harming a child.

What happens to the women who once performed FGM?

This is one of the least explored questions.

Traditional practitioners can hold more than an income. Their role may carry status, authority, specialist knowledge and a place within rites of passage.

Ending cutting without understanding that role can leave the surrounding social system untouched.

Liberia’s work with zoes offers one model: alternative livelihoods combined with “initiation without mutilation”. The approach asks whether culture can retain meaning while abandoning injury.

We need stronger evidence about what happens next.

Do alternative livelihoods remain viable when external funding ends? Can former practitioners become trusted educators or protectors? Does the community abandon FGM, or simply find a different practitioner? Which forms of transition actually last?

“Give cutters another job” is not a policy.

Understanding how status, economics and social norms interact could be.

Stories can give children words

Facts matter. Stories can make difficult facts understandable.

Freedom Charity uses Cut Flowers to help young people understand FGM through characters, choices and consequences rather than through a clinical lecture.

That method has a safeguarding purpose.

Children often disclose indirectly. They may recognise a character’s danger before recognising their own. A pupil may understand what a friend is describing before either child knows the formal language of abuse.

A book cannot replace safeguarding. It can begin the conversation that makes safeguarding possible.

The Red Triangle: making opposition visible

Public symbols do not replace law, education or protection. They can, however, make a social norm visible.

Freedom Charity created the Red Triangle Badge against FGM as a public statement that FGM is child abuse and should not happen in anyone’s name. The heart-of-gold motif adds a second message: protection must combine courage with care.

A symbol becomes useful only when people understand what it means.

Imagine a Red Triangle recognised in schools, clinics, airports, police stations and community centres. For a young person, its most important message would be simple:

This person understands. I can speak to them.

We cannot simply announce global recognition into existence. Organisations must earn it through consistent safeguarding, trusted partnerships and education.

That is what would give the symbol power.

6 February: one day, 365 days of responsibility

Every 6 February, the world marks the International Day of Zero Tolerance for Female Genital Mutilation.

The date creates a valuable global moment. Governments make commitments, schools teach, survivors speak, organisations campaign and journalists examine progress.

In 2026, UN leaders used the day to warn that 4.5 million girls remain at risk this year.

Awareness for 24 hours is not enough.

The real test begins on 7 February.

Freedom Charity uses the international day to connect awareness with education, FGM information, Cut Flowers, the Red Triangle and routes to safeguarding support.

The opportunity is larger than an annual campaign. A global day can become a global teaching moment whose effect continues throughout the year.

What we still do not know

Credibility requires more than repeating what research has established. We also need to identify the gaps.

Global prevalence data remain uneven

The 94-country evidence map is important, but researchers do not have equally strong data everywhere. Some countries conduct nationally representative surveys; elsewhere, evidence may come from small studies or individual accounts.

Better mapping should reduce blind spots without creating false precision.

Hidden cases remain difficult to count

Families and practitioners frequently carry out FGM in private. Some children are too young to report it, while other survivors disclose only years later.

Official figures therefore cannot tell us the full scale.

Attitude change is not the same as behaviour change

Education programmes can improve knowledge and reduce support for FGM. Researchers still need to know whether those improvements result in fewer girls undergoing the practice and whether change lasts into the next generation.

Humanitarian settings remain under-researched

Conflict, displacement and disrupted education can increase vulnerability while weakening safeguarding systems. UNICEF Innocenti research published in July 2026 found a shortage of rigorous evidence about FGM and child-marriage prevention programmes in humanitarian settings.

An intervention that works in a stable community may not work during war or displacement.

Alternative livelihoods need long-term evaluation

Programmes that support former cutters may be promising, but the important question is whether they lead to permanent abandonment rather than simply moving the practice elsewhere.

Survivor care must remain part of the answer

More than 230 million girls and women are already living with the consequences of FGM. Prevention protects the next girl; good healthcare, dignity and justice must support those already affected.

Ending FGM has both responsibilities.

Six myths that still cause harm

“FGM is an African problem.”

Evidence now exists in at least 94 countries. Prevalence and evidence quality vary widely, but the practice is not confined to one continent.

“FGM is required by Islam.”

It is not. Communities of different faiths practise FGM, while religious leaders across affected countries actively oppose it.

“A small cut does not count.”

WHO recognises several forms of non-medically necessary injury to female genitalia. Less extensive does not mean harmless or acceptable.

“A doctor can make FGM safe.”

Medical training and sterile equipment do not create a medical justification for injuring healthy tissue.

“Once Parliament bans FGM, the problem is solved.”

The experience of cross-border FGM, weak enforcement and attempts to reverse existing laws shows why legislation is necessary but insufficient.

“Mothers who allow FGM simply do not care about their daughters.”

Families can operate under intense pressure involving marriage, reputation, social exclusion, gender expectations and intergenerational authority. Understanding those pressures does not excuse child abuse. It helps us identify what must change.

What actually ends FGM?

No single intervention works everywhere.

Law establishes a boundary. Courts and police must make that boundary credible. Health professionals need the knowledge to care for survivors and refuse medicalisation. Teachers need to recognise risk. Children need age-appropriate education and safe routes to disclosure. Families need alternatives to social exclusion. Communities need trusted people who can challenge harmful norms from within.

Economic opportunity matters where dependence reinforces the practice. Men and boys matter where marriage expectations help sustain it. Former practitioners may need new livelihoods and new social roles. Researchers need better data. Governments need to fund what evidence shows works.

Survivors must have a meaningful voice throughout.

These approaches do not compete with one another. They form a protection system.

If you are worried about FGM

If someone faces immediate danger in the UK, call 999.

If you are worried that a child or adult may be at risk, seek specialist safeguarding advice before confronting relatives or suspected perpetrators. Confrontation can increase danger or prompt a family to move the person at risk.

Freedom Charity provides confidential information and safeguarding support through its 24-hour helpline.

Professionals should follow their safeguarding procedures. In England and Wales, teachers and regulated health and social-care professionals also have a specific mandatory reporting duty when the statutory conditions concerning known FGM in a girl under 18 apply.

An FGM Protection Order may help protect a girl or woman at risk, including through restrictions on travel or arrangements for FGM.

Outside the UK, laws and safeguarding systems differ. Contact the relevant police, child-protection, health or specialist FGM service in the country concerned.

The final test

Colombia shows how law can change. Liberia demonstrates why protection becomes fragile when statute does not secure it. The Gambia reminds us that even established rights can face political reversal. Across East Africa, cross-border FGM exposes the limits of national law. Britain’s prosecutions show both the reach of criminal justice and the difficulty of proving hidden abuse.

No country provides the complete answer.

Together, however, these examples reveal something hopeful.

Communities can change their expectations. Men can reject practices once justified in their name. Traditional leaders can become protectors. Former practitioners can take different roles. Teachers can recognise risk earlier. Children can learn that what adults plan for them is not inevitable.

The world does not need another generation of girls to prove that FGM causes harm.

It needs the courage to apply what we already know, the honesty to investigate what we still do not know, and the determination to reach a child before the harm occurs.

The final measure is not how loudly we condemn FGM.

It is whether the girl is safer today than she was yesterday.