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What can I do? Support for professionals

You are a doctor, social worker, childcare worker, teacher or midwife who is asking him or herself: what can I do to help girls and women who have undergone female genital cutting (FGM/C) and to protect girls who are at risk? How can I tell whether someone may have undergone FGM/C? Where can I turn for expert advice on the subject?

Female genital cutting (FGM/C) is a very sensitive issue, and approaching a woman or girl who might be or has been affected by it is not easy. There are no hard and fast rules for professionals to follow here. Every situation is different, every woman and every girl has her own history and her own needs. Below, you will find some general approaches and guidance to help you deal with FGM/C in the course of your daily work.

Adults – interacting with women who have been cut

A recently married woman revealed to me, in my capacity as a social worker, that sexual intercourse with her husband is painful for her.

How can I tell whether a woman has undergone FGM/C and what can I do?

What are the indications that a woman may have undergone FGM/C?

  • The woman comes from a country, community, family that practises FGM/C. Where is FGM/C practised?
  • The woman suffers from health problems that could be associated with female genital cutting. More information on the health consequences.
  • FGM/C is a taboo subject in the communities that practise it, so women will hardly ever raise the topic of their own accord. In addition, many women and girls have never had any sexual education. For that reason, women and girls may not always be aware of the health problems associated with FGM/C, or even whether they have undergone genital cutting (if the genital cutting was performed at a very young age).

What can I do?

Be informed: Find out about FGM/C and get specialist support from the regional or national contact points of the Network against Female Genital Cutting Switzerland.

Broach the issue: Depending on the situation, your role as a professional and your relationship with the woman, you may be able to broach the subject with her. Your primary role in this situation is to listen, and to focus on the needs and desires of the individual in question. Every case is different, and not all people who have undergone FGM/C have problems. In your role as a professional (and ideally one in a trust-based relationship with the person in question), you should signal your readiness to offer support.

Offer support: Point out that there are experts who can help her if she has problems. Arrange access to experienced, specialised female professionals (gynaecologists, midwives, sexual health counsellors, intercultural mediators, peer educators, interpreters etc.). The Network against Female Genital Cutting has a list of contact points.

Minors – identifying and protecting girls who are at risk

I am a childcare professional at a preschool who is concerned that one of the girls might be the subject of female genital cutting during the summer holiday.

How can I tell whether a girl might be at risk, and what can I do?

What are the indications that a girl may be at risk? (This list is not exhaustive).

  • The girl comes from a country, community, family that practises FGM/C. Where is FGM/C practised?
  • FGM/C is practised in the family (the mother, sister or cousin has undergone FGM/C; the father comes from a family that practises FGM/C).
  • A member of the family has explicitly indicated the intention to have the daughter undergo genital cutting.
  • The family has displayed a positive attitude towards FGM/C or played down the subject.
  • They plan to make a trip to her country of origin or another country.
  • The girl has mentioned a special procedure or ceremony (in her country of origin, abroad) and said that she is not allowed to speak about it.

What next?

Be informed: Find out about FGM/C and get specialist support from the regional or national contact points of the Network against female genital cutting Switzerland.

Broach the subject: Depending on the situation, your role as professional and your relationship with the girl and her parents, you may be able to broach the subject with her and/or her parents. Your primary role in this situation is to listen, and not to make a premature judgement. Every case is different. In your role as a professional, , you should signal your readiness to offer support.

Aim of the conversation: The child’s welfare is paramount. For this reason, you should try to build up a relationship of trust with the parents and, in doing so, foster a willingness on their part to cooperate with you. Your aim must be to encourage the parents to protect their daughter from FGM/C. It is also possible that the purpose is to offer help in dealing with pressure from members of the extended family (in Switzerland or in the country of origin) who want the daughter to undergo FGM/C. There are regional contact points that can help.

Content of the conversation: During the conversation, you should communicate...

... that you are concerned for the girl.

... that in Switzerland FGM/C is considered a form of physical injury and dangerous to the welfare of a child.

... that all forms of FGM/C are prohibited by law in Switzerland, as well as in most other countries. Even when FGM/C is performed in another country, it is still a criminal offence in Switzerland.

... that by failing to protect a girl from female genital cutting (e.g. if the girl undergoes the procedure while visiting relatives in the country of origin), parents or guardians are neglecting their duty of care.

... that FGM/C can result in very serious health problems.

... that you will communicate any further steps or inquiries you plan to make to the parents and/or the girl in a transparent manner.

Bring in a peer educator to provide support:
Whenever possible,  for these conversations seek the support of a peer educator or an intercultural mediator who has been trained in FGM/C. The national contact points can put you in contact with peer educators with appropriate training.

Endangering the welfare of a child: Proceed as you would as a professional encountering another form of child welfare endangerment or domestic violence: if the suspicion of genital cutting is confirmed, contact your local child protection group and/or file a report of possible endangerment with the child and adult protection authority. Find out about requirements relating to the duty of official secrecy and professional confidentiality and the mandatory reporting obligations and reporting rights associated with your employment relationship and in your canton. Further information about the legal situation in Switzerland.

Minors – identifying and supporting girls who have undergone genital cutting

As the form teacher of Y. (15 yrs), I am concerned. She tends to be absent once a month, dislikes taking part in PE and has fainted twice during lessons.

How can I tell whether a girl might have undergone genital cutting, and what can I do?

What are the indications that genital cutting has already taken place? (This list is not exhaustive).

  • The girl comes from a country, community, family that practises FGM/C. Where is FGM/C practised?
  • FGM/C is practised in the family (the mother, sister or cousin has undergone FGM/C; the father comes from a family that practises FGM/C).
  • Health problems resulting from genital cutting. In the case of young children: blood loss, wounds on the vulva, painful urination, pain when changing diapers. In the case of older children or young women: frequent and longer trips to the toilet; pain or absences during menstruation; sudden refusal to take part in certain physical activities due to pain; refusal to see a gynaecologist; problems associated with walking, sitting or standing.
  • The girl is absent or ill for a prolonged period or ill without a doctor’s certificate.
  • The girl is subject to increased supervision/segregation.
  • The girl’s behaviour changes.
  • The girl mentions a special procedure (in her country of origin/abroad) and says that she is not allowed to speak about it.
  • It is common for women or girls affected by FGM/C to avoid mentioning it directly.

What next?

Be informed: Find out about FGM/C and get specialist support from the regional or national contact points of the Network against Female Genital Cutting Switzerland.

Broach the subject: Depending on the situation, your role as professional and your relationship with the girl and her parents, you may be able to broach the subject with her and/or her parents. Your primary role in this situation is to listen, and not to make a premature judgement. Every case is different. In your role as a professional, , you should signal your readiness to offer support.

Aim of the conversation: The child’s welfare is paramount. For this reason, you should try to build up a relationship of trust with the parents and, in doing so, foster a willingness on their part to cooperate with you. Your aim must be to encourage the parents to protect their daughter from FGM/C. It is also possible that the purpose is to offer help in dealing with pressure from members of the extended family (in Switzerland or in the country of origin) who want the daughter to undergo FGM/C. There are regional contact points that can help.

Content of the conversation: During the conversation, you should communicate...

... that you are concerned for the girl.

... that in Switzerland FGM/C is considered a form of physical injury and dangerous to the welfare of a child.

... that all forms of FGM/C are prohibited by law in Switzerland, as well as in most other countries. Even when FGM/C is performed in another country, it is still a criminal offence in Switzerland.

... that by failing to protect a girl from female genital cutting (e.g. if the girl undergoes the procedure while visiting relatives in the country of origin), parents or guardians are neglecting their duty of care.

... that FGM/C can result in very serious health problems.

... that you will communicate any further steps or inquiries you plan to make to the parents and/or the girl in a transparent manner.

Bring in a peer educator to provide support: Whenever possible,  for these conversations seek the support of a peer educator or an intercultural mediator who has been trained in FGM/C. The national contact points can put you in contact with peer educators with appropriate training.

Endangering the welfare of a child: Proceed as you would as a professional encountering another form of risk to child welfare or domestic violence. If the suspicion of genital cutting is confirmed, contact your local child protection group and/or file a report of possible risk with the child and adult protection authority. Find out about requirements relating to the duty of official secrecy and professional confidentiality, and the mandatory reporting obligations and reporting rights associated with your employment relationship and those of your canton. Click for further information about the legal situation in Switzerland.

In an emergency

In my capacity as a social worker, I work with a family that is under official investigation to determine whether their six-year-old daughter is in imminent danger of undergoing genital cutting. I’ve just learned that the mother plans to travel abroad with her daughter in the next few days.

What can I do in an emergency situation?

If the girl is in immediate danger, contact your local child protection group, the child and adult protection authority, or the police. However, situations requiring urgent intervention are rare.

Dos & don’ts

I am uncertain and do not know whether or how I should broach the subject of female genital cutting (FGM/C) in my capacity as a professional.

What should I bear in mind when talking about FGM/C with persons (potentially) affected by it?

Orientation in the individual case

On the one hand, professionals should try to reach out to as many individuals who have undergone, or are at risk of undergoing FGM/C as possible, to offer them support and protection. On the other hand, it would not be right to cast a blanket of suspicion over all families that come from certain countries. Not all women or girls from countries where FGM/C is practised have undergone it or are at risk.

FGM/C is taboo

There is a strong taboo surrounding the subject: it relates to sexuality, the female body and violence. This means that addressing it calls for great sensitivity.

The right setting is important

An atmosphere of trust and sufficient time are essential for talking about this issue. If possible, broach the topic of FGM/C in connection with similar topics (e.g. health, sexuality, pregnancy and childbirth, parenting, child protection, violence).

Get informed

It is important for you to know where you can obtain information, support and advice. The national contact points of the Network against female genital cutting Switzerland will be happy to answer any questions. You do not necessarily have to become an expert on FGM/C; what matters is that you assume the role of intermediary and arrange access to support and protection.

Do not take action on your own

It is important that your institution also takes a clear stance on FGM/C and has procedures for dealing with it. Discuss individual cases in your team and with your supervisors.

Reflect on your own attitude and role

The subject of FGM/C can evoke powerful emotions in professionals. These emotions, however, have no place in a conversation with people affected by the practice. Remain objective and professional and engage in the conversation as one among equals with an attitude of respect. Clearly communicate that FGM/C is illegal in most countries, including Switzerland. Further information on the legal situation.

Initiating the conversation

The following examples may make it easier to begin a conversation about FGM/C:

“I have heard that female genital cutting is practised in the country you come from. Is it also a tradition in the community you are from?”

“Were there complications during the birth of your child/children?”

“I am concerned about your daughter...”

Finding the right words

When talking to people from communities that practise FGM/C it is better to stick with the term “female genital cutting”. It is more value-neutral than “genital mutilation”. What’s more, many women who have undergone FGM/C do not see themselves as mutilated. An alternative is to use the term “ritual” or the word used in the language of the person concerned. If necessary, ask an interpreter what the commonly used term is.

Bring in a peer educator to provide support

Whenever possible, seek the support of a peer educator or an intercultural mediator who has been trained in FGM/C for these conversations. The national contact points can put you in contact with suitable peer educators.

Talking about FGM/C in groups

I teach integration courses for refugee women. Many women who may have undergone FGM/C attend these courses.

Should I bring up the topic of FGM/C in the context of instruction?

It is okay to bring up the topic of FGM/C in a group situation as long as you do so in the context of similar topics (e.g. with health, sexuality, sexual education, pregnancy & childbirth, parenting, child protection, violence).

It is essential, however, that no stigma be attached to individual members of the group. A great deal of tact is required if potentially only certain individuals in the group are affected by the issue. Addressing the topic in the context of a school class is particularly tricky, as the wrong approach can have an especially stigmatising effect on the girls or women concerned, due to age and the school environment.

Peer educators can be brought in for prevention events.

Get men involved

I work in the field of HIV/STI prevention and regularly come into contact with men from communities that practise FGM/C.

Should I address the subject of FGM/C with these men?

Men who are members of the practising communities often know only very little about FGM/C; the practice is seen as “women’s business”. Men are affected by FGM/C too, though, in their roles as (future) husbands and fathers. They have an important role to play in the perpetuation or eradication of FGM/C. It is therefore essential that they be brought into the conversation. Only if men are well informed will they be in a position to better understand and support wives who have undergone FGM/C and to keep their daughters safe from the practice.

Peer educators can be brought in to support prevention events aimed at men.