Background

It was 1985 and I was running a workshop for health professionals on the frontline of delivering cervical smear tests. A woman rose to give an impassioned plea that genital examinations should “offer respect and compassion to cut women like myself”. We listened attentively to her words, nodded courteously; the discussion then moved on.

Later, as participants were leaving, I overheard the comments: “What does she mean ‘cut women’?”, “Surely that's not a problem in Britain?” and “What should you do?” To my shame, I felt the same – ignorant, confused and unsure of my ground. ‘Female circumcision’, as it was then called, was an alien idea. If we did grasp the concept it was taken to mean the equivalent of male circumcision – a process that while invasive, was likely to be acceptable in its cultural context and was in many ways none of our business.

Fast forward three decades and what is now known as female genital mutilation (FGM) – note the change in terminology – is a high-profile issue and illegal in the UK. Are we any clearer, more informed or more resourced? I asked ten UK-based health professionals, from varying sexual health fields and cultural backgrounds, to offer opinions – often based on their knowledge of colleagues’ attitudes as well as their own. The results make for interesting reading.

Change, no change

There was agreement among respondents that we are now both more aware and more outraged. Many respondents drew the parallel with child abuse, saying that while health professionals have always seen the problem, now it seems to be “managed, reported and supported” as never before. There is a sense of “a real will to change”.

The bad news is that with the awareness and outrage comes a raft of difficulties. Respondents reported that the issue feels “scary”, …