Articles on Shifting Sands
FGM data is misinterpreted and misunderstood
A recent Committee of cross-party MPs discussed the need to deal with an anomaly in the 1989 Children Act that would allow family courts to issue FGM Protection Orders. This was unanimously supported.
It however became apparent during MP’s contributions that the Department of Health’s FGM statistics were being used incorrectly by MP’s in justifying the need for the Bill. Members seemed to believe, incorrectly, that FGM is still widely practised on girls born in the UK.
Helen Whateley: NHS data tells us that FGM is happening in not insignificant numbers, so we must do whatever we can.
Carolyn Harris: The true number of women and girls affected by FGM is difficult to ascertain, given the secrecy around the practice. In July 2017, NHS Digital published experimental statistics for England that showed that between April 2016 and March 2017 there were 9,179 NHS attendances where FGM was identified or a medical procedure for FGM was undertaken.
Gloria de Piero: Despite being illegal since 1985, statistics published by NHS Digital show that between April 2015 and March 2016, FGM was identified in 9,223 attendances at NHS trusts and GP practices, 6,080 of which were new cases. In the following year, 9,179 attendances included 5,391 new cases. The most recent statistics show 2,320 attendances in the first three months of 2018, of which 1,030 were newly recorded women or girls. However, given the known obstacles associated with reporting and recording FGM—the act is likely to be committed by a family member or an established and respected member of the community, for example—the real figure is likely to be even higher. Female genital mutilation is occurring, yet prosecutions of those committing it are not.
Michael Tomlinson: My hon. Friend the Member for Richmond Park mentioned that around 137,000 women and girls in this country have been affected by FGM. Will the Minister anticipate how many of those cases may go before the family courts?
In the brief Public Bill Committee discussion that followed on 5 April 2019, nobody raised questions about, nor was a discussion held in regard to the dominant FGM narrative. Yet there was a general acceptance that ‘more needs to be done’.
Gloria de Piero Shadow Minister (Justice) asked for a progress report in regard to a number of areas, including whether the government had plans ‘to take a greater look at the numbers affected, to provide a more accurate indication of how many people are affected across the UK.’
Alison Macfarlane, Professor of Perinatal Health and a statistician had anticipated this and sent the Committee members the following explanation in advance of the discussion. Perhaps they hadn’t had a chance to read and absorb it? Had they, it would have helped illustrate that data supporting the widespread belief that FGM is being carried out on British born girls does not actually exist.
I am writing to you as a member of the Committee on the Children Act 1989 (Amendment) (Female Genital Mutilation) Bill [HL] 2017-19. I am a statistician working at City, University of London. I worked with a leading anti-FGM campaigner, the late Efua Dorkenoo and was responsible for producing estimates of the numbers of women in England and Wales with FGM which have been widely quoted in discussion of the subject.
In that capacity, I am writing to draw your attention to the misleading ways in which they, along with the Department of Health’s statistics, were used in the second reading debate on the Bill currently in the House of Commons to create the impression that FGM is still widely practised on girls born in the UK.
1. We estimated that approximately 137,000 women born in the countries where FGM is practised and living in England and Wales in 2011 had undergone FGM. Our report made it clear that these were migrant women who had undergone FGM before moving to the UK, so there is no way that they could be the subject of cases in family courts or of prosecutions.
We explicitly said that we could not estimate numbers of women and girls born in England and Wales who had undergone FGM. This was because recent research showed that most families had dropped the practise on migration and the numbers are now likely to be very low. Although it is important to try to prevent these small numbers of occurrences, there was no basis for producing statistics. You will find our report on the University website.
2. The Department of Health’s statistics, produced by NHS Digital, were misquoted in support of statements that FGM is still widespread. While it is correct that ‘in 2016-17, the NHS reported 9,179 cases of FGM, of which 5,391 were newly recorded’, ‘newly recorded’ simply means that the FGM was recorded in the FGM dataset for the first time, not that the FGM was recently undertaken. The majority of women may have undergone FGM many years earlier in their country of origin. Only four per cent of these women and girls for whom trusts reported a country of birth were born in the UK and only four per cent of these reported having FGM undertaken in the UK, with 89 per cent of them reporting that the FGM was a vaginal piercing. So these data do not show that FGM is widespread in England or that the practise is increasing.
3. Members quoted low numbers of FGM protection orders, again suggesting low numbers of cases. Even these numbers may be too high, as we are now hearing from FGM activists of cases where these have been used inappropriately.
The fact that we have reached this situation is a result of considerable preventive work since the 1980s by campaigners and community groups. They include women who had survived FGM themselves and wanted to ensure it did not happen to their daughters. This is why legislation based on the assumption that FGM is widespread and increasing is inappropriate to a changed situation where numbers are low but not yet zero.
Please let me know if you would like any clarification or further information about these statistics.
Alison Macfarlane BA, Dip Stat, C Stat, FFPH, Professor of Perinatal Health.
A similar letter by her Misleading use of FGM statistics compounds concerns about their reliability was published in the British Medical Journal 5 March 2019.
Update: The Bill was read the Third time 11 March 2019 and passed without amendment.
About the Author - Bríd Hehir
Bríd is a retired health professional. She started her career as a (volunteer) nurse and midwife in Africa, in Ethiopia and Botswana, where she worked for almost four years. She encountered FGM/C in Ethiopia. She then moved to London where she worked in the National Health Service as a midwife, community nurse, health visitor, reproductive and sexual health nurse and manager over a period of 30 years. She did not encounter FGM/C during that time despite working with immigrant communities who are reported to practice it still. She is puzzled by the current reported prevalence of the practice, the official response and associated activism. And is worried that they might cause more harm than good.
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@JonathanPieNews Having worked in the NHS for 30years and seen how both parties play politics with it, I wouldn't trust either in regard to it. But agree that a full & honest debate needs to be had around the type of healthcare provision we need and deserve. Maybe #TheBrexitParty will start one?
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