De-colonising FGM a paper in BMJ

[Imnobody4]

Harms of the current global anti-FGM campaign

Abstract

Traditional female genital practices, though long-standing in many cultures, have become the focus of an expansive global campaign against ‘female genital mutilation’ (FGM). In this article, we critically examine the harms produced by the anti-FGM discourse and policies, despite their grounding in human rights and health advocacy. We argue that a ubiquitous ‘standard tale’ obscures the diversity of practices, meanings and experiences among those affected. This discourse, driven by a heavily racialised and ethnocentric framework, has led to unintended but serious consequences: the erosion of trust in healthcare settings, the silencing of dissenting or nuanced community voices, racial profiling and disproportionate legal surveillance of migrant families. Moreover, we highlight a troubling double standard that legitimises comparable genital surgeries in Western contexts while condemning similar procedures in others. We call for more balanced and evidence-based journalism, policy and public discourse—ones that account for cultural complexity and avoid the reductive and stigmatising force of the term ‘mutilation’. A re-evaluation of advocacy strategies is needed to ensure that they do not reproduce the very injustices they aim to challenge.

https://jme.bmj.com/content/early/2025/09/25/jme-2025-110961

Excellent article from Nimco Ali.

I have been fighting this argument for decades. When I began campaigning openly against FGM in 2010, the same narrative now being repackaged by the JME was already causing real harm. At the time, I was working in the public sector. Few people knew I was a survivor of FGM, or that I had seen first-hand how so-called cultural sensitivity in schools and social care allowed this abuse to continue unchecked across the UK.
When I spoke publicly and described FGM plainly as violence against women and girls, the backlash was immediate. I was accused of fuelling racism, instructed to stay quiet and told I was betraying my community. I was ostracised and denounced by people who believed they were defending minority rights. My identity was questioned, my motives smeared and my credibility stripped away, often by white, Left-leaning women who believed they were acting in solidarity but whose actions meant girls went unprotected. From day one, I received death threats.
The pattern was always the same. Questioning FGM was framed as racism. Perpetrators and apologists positioned themselves as victims, while professionals and institutions that should have known better retreated in fear. The result was not nuance. It was inaction.

That this paper has been published in BMJ Medical Ethics is appalling. As for IwantToRetire commenting
But equally, even though it gives us hours of entertainment pulling apart papers like this, on one level they are just a self indulgent elite, and just like having a thread about women's groups that are being defunded, we should maybe make an effort to instead start threads about what women's groups and service providers are saying.

I think we should remember what happened with trans ideology. Academia shouldn't be dismissed particularly where medicine is concerned.Look how trans ideology has embedded itself in the NHS.
See how we have a midwife dismissing concerns on this thread.

Non-medical circumcison is the main one the article talks about.

I haven’t actually received any support. I’m doing okay though. Thank you.
I am lucky I survived it, as many children don’t.

The BMJ is not saying it is in favour of FGM. It is an opinion piece in the Journal of Medical Ethics.

The article is not arguing in favour of it. In the introduction the authors specifically state that many of them are against all forms of non-consential genital modification.

This is not an opinion that is “worthy of respect in a democratic society” - to use the test - so anyone who wrote it or signed off its publication needs a hard drive check.

There is a lot of data in the report. But in brief in the 12 months the report covers 41,645 individual women and girls who had FGM attended a medical appointment where FGM was identified by medical staff. That doesn't mean it happened recently, it just means they had it done to them at some point in their life and that it was noted by a doctor or nurse during their appointment.

It is worth noting that over 50% were reported by midwives and around 40% of the rest by Obs/Gyn staff.

Sounds like the UK has a big problem but read on.

Less than 5% of these procedures had been carried out in the UK. Over 80% took place while the person was in Africa and the rest elsewhere in the world.

And of the small number that took place in the UK, more than 80% were genital piercings which people received when over the age of 18 (so presumably they consented to the procedure).

I don't know if these figures accurately reflect the reality or not. But it is probably the best dataset we have.

The numbers are a bit of a red herring. The NHS collects data on women who have undergone fgm but that's most likely in their own country.
The question is how you estimate the risk for children. The aim is no child living in UK will undergo fgm. A working assumption is that if the mother has undergone fgm there's a risk to the female child. Calculating that risk is near impossible.
The fact that it's illegal is the best protection.
Papers like this stating "In sum, the horror-inducing ‘mutilation’ stereotype popularised by anti-FGM activist organisations and their supporters in the mainstream media has obscured and significantly distorted the picture of reality." encourage a counter narrative of colonial oppression which in turn can legitimise breaking the law.

Male circumcision (FGM used to be called female circumcision) is done in a lot of cases for medical need, such as if the foreskin is too tight to prevent urination.

Yes there are religious reasons too, but the desperation of people to claim that male circumcision is "barbaric" can make men think that they've been damaged and not realise they required it to be able to urinate.

"Designer vaginas" and clitoral piercings are self-made choices and again shouldn't be lumped together with FGM.

Postmodern Critical Theories

Postmodern Critical Theories are a collection of academic ideologies (most recognizable among them are Critical Race Theory, Queer Theory, and Postcolonial Theory), often associated with the study of race and ethnicity, gender, sex and sexuality, disability, body size, and colonialism, that view societal discrimination primarily through a problematizing lens examining the maintenance of power through systemic oppression. While well-intentioned, postmodern critical theories can undermine Liberal values by promoting divisive identity politics, rejecting the validity of objective truth, suppressing free inquiry, and prioritizing ideological conformity over individual rights.
https://www.theahafoundation.org/female-genital-mutilation-fgm-in-the-us/

Interesting thread, thank you. It’s also an interesting paper with some things to say, though also infuriating. I would rather see cosmetic labioplasty, ‘hymen repair’ and ‘gender affirming surgery’ for transmen renamed as maybe adult FGM than child FGM renamed as something else. The authors are not wrong that cultural trends and pressures are the reasons for all these procedures. I also don’t think they give acknowledgment that the campaigners might have had some influence on the fall in use of the most damaging forms.

A good article in the Mail as well, written by a London GP with previous experience in a London maternity unit.

https://archive.ph/ugmoL

There is weird familiarity about this. A thread where persistent posters crop up to tell us there isn’t a problem and we win in are making a fuss about nothing. Good article in the ”right-wing” press expressing concern about the treatment of vulnerable women and girls, but little from the left. Does the concept of de pcolonising trump the need for child protection?

The BMJ article is abhorrent but the BMA have form.

I can’t get my head round the fact the lead author of the BMJ article chose to have fgm done as an adult! I wonder what level?

Sorry, double posted then.

Janice Turner in the Times:
"These FGM apologists are western privilege personified
Nothing has made me angrier this year than the essay published by the BMJ group attacking the global effort to end the practice
How do you end a hideous form of child abuse? Do you a) strengthen laws, protect victims and prosecute offenders, or b) use abstruse language to muddy the ethical waters, sophistry to turn those fighting abuse into the bad guys so — voilà! — the problem magically disappears?

Nothing has made me angrier this year than the essay published by the BMJ group attacking the global effort to end female genital mutilation (FGM). So angry, I looked up each of the 25 authors and read their other papers, too. From Cambridge to Montreal, Melbourne to Malmo, what privileged self-regard posing as progress.

Questions for these (mainly) white female academics: do you like having a clitoris? Are you entitled to sexual pleasure and giving birth via a vagina that hasn’t been sewn shut? Are you grateful you’ll never hear your daughter scream as she’s pinned down on a bloody table? Then don’t African women deserve the same?

The authors’ big gotcha is that if the West allows labia reduction surgeries, aka “designer vaginas”, we cannot denounce FGM. But the former is done on consenting adults and doesn’t remove a sexual organ — although frankly I’d ban it too.
The verbiage about “blinkered hegemonic narratives” stigmatising “Global South” practices is an insult to women in Ethiopia, Egypt, Kenya (among others) who brought about bans, and to the British-Somalian Nimco Ali who ensured girls at risk of FGM are protected here.
But liberal “feminism” stays high in the intellectual stratosphere, above the messiness of bodies, pain, fear and blood. Never, ever let postmodernists make policy: they disdain the material world. As shown in 1977, when intellectuals successfully lobbied the French government to decriminalise sex with children because consent, in Michel Foucault’s words, was just a “contractual notion”.
How would the authors see suttee, a Hindu practice banned under the Raj, whereby a widow threw herself on her husband’s funeral pyre? They’d condemn “problematic colonial saviour discourse” and say these women had “agency”, so let them burn."

Thanks, s great article from Janice

In Gambia there's been an attempt to repeal the laws against FGM luckily defeated.
FGM: Outrage in The Gambia after one-month-old baby dies - BBC News https://share.google/yleqsT4Fp1EoAvJBv

WILL founder Fatou Baldeh told the BBC that there was an increase in FGM procedures being performed on babies in The Gambia.

"Parents feel that if they cut their girls when they're babies, they heal quicker, but also, because of the law, they feel that if they perform it at such a young age, it's much easier to disguise, so that people don't know," she said.

FGM has been outlawed in The Gambia since 2015, with fines and jail terms of up to three years for perpetrators, and life sentences if a girl dies as a result.

However, there have only been two prosecutions and one conviction, in 2023.

A strong lobby group has emerged to demand the decriminalisation of FGM, but legislation aimed at repealing the ban was voted down in parliament last year.

Regarding Janice Turner's quote that Western FGM, aka "labiaplasty", doesn't remove a sexual organ: yes, it does. The clitoral hood and/or labia minora ARE sexual organs. Both are very sensitive and highly innervated and vascularised. They become engorged with blood, i.e., erect, during arousal. Also, though I couldn't really give a crap about random men's sexual experience, many note that more prominent labia minora enhance their sensation during intercourse as well.

This thread is a depressing snapshot of the simplification and erasure of female genitalia in our culture, and many women's ignorance of their own sex organs: it gets reduced to a "hole" for men and, if you're lucky, a clitoris (which itself is often misunderstood as being just the external glans, when there's a whole structure beneath the surface). The ENTIRE vulva is a sex organ; there are no redundant parts. It's a highly complex and completely interconnected system. You can't go chopping off parts and severing nerves without affecting the whole. You can find many accounts online of women whose sexual function has been permanently damaged or destroyed by this elective FGM.

It's also worth noting that the labia minora are especially dependent on oestrogen, and tend to shrink or even disappear entirely in (peri)menopause, alongside diminishing sexual function and sensation. That isn't a coincidence. Loss of sexual tissue = loss of sensation.

It's truly perverse how young women are driven to pursue what is an effectively menopausal genital appearance: hairless, featureless, sterile. It's the opposite of evolutionary psychology "logic". Abundant pubic hair (and body hair in general) and prominent labia minora are both markers of youth and fertility. If female beauty standards in the West were based on "nature" rather than controlling and castrating women, then both would be idealised. Why should women be chopping off the most female and intimate parts of themselves because many men are deeply sexually dysfunctional, and have a pathological fear of/aversion to the sexually mature female body in its natural state? We're told that men are so sexually driven, that they struggle to control themselves around women, and yet apparently we need to modify ourselves to the point of mutilation to be acceptable to many of them. It's quite the paradox. Not very "animalistic", is it, this supposedly primal male lust? More neurotic, really. Pathetic.

Some young women (in increasing numbers) "choose" to butcher their healthy genitals in the same way that many young women allegedly "choose" to risk death and brain damage by being strangled during sexual encounters. It's not women driving these trends.

To cut a long story short: "labiaplasty" is FGM by another name. And it's all about male control and castration of women.

Big of them.

The article is not arguing in favour of it. In the introduction the authors specifically state that many of them are against all forms of non-consential genital modification.

The implication being that some of them support non-consensual FGM?

I’m failing to understand how that makes them sound less bonkers/evil.

Kathleen Stock in Unherd has their measure

https://archive.ph/3RnLu

https://unherd.com/2025/12/theres-no-silver-lining-to-fgm/

This bit

And so our co-authors — the majority of whom work in Europe, Australasia, and North America — tell us that anti-FGM initiatives in Africa cause material harms. Supposedly, they siphon off money and attention that could be better spent in other health campaigns, and they undermine trust in doctors.
They also cause young women to consider genital cutting as “traumatising” in retrospect, we are told, where they would not otherwise have done so.

rang a bell. I've seen similar arguments put forward by people trying to justify sex with children.

I haven't bother to check who the authors of this paper are, but what is reeks of is privilege.

So long as, which it is at the moment, a procedure that is inflicted on women through culture or religious pressure it is highly offensive to sit down and dabble at a sort of whatabouterry.

If the authors has for instance been part of a campaign that had rid the world of imposed FGM, only then MIGHT it be okay to indulge in this speculation.

Obviously in the current circumstances of campaigns and services being delivered or funded by countries that are not part of that cultural practice, those agencies should work closely and be informed by local women (ie not any partriarchal system).

That would have been a better target of these political dilettantes.

It is offensive that they wrote it. It is offensive that it was published.

There are any number of groups based in the UK offering support and advise to women who have suffered FGM who could have been asked to write an article.

For a journal that has ethics in its title they clearly dont apply that to their own work.

If it wasn't so insulting it would be absurd.

What is also insulting is people who have no back ground in anything other than dabbling and posturing their queer radicalism, just dont understand history thinking they can postulate armchair theories.

Efua Dorkenoo who virtually single handed started awareness in the UK of the suffering of women who had undergone, at a time when people were actually embarrassed to talk about anything as intimate as this, and not sure how to think (long before woke) about accepting a woman from a culture they didn't know or understand, could challenge and recognise that they shouldn't stay silent as women in this culture needed help that the west could give via funding etc..

I have actually met her, and she was not only determined but strong as so many just snubbed her, mainly because she didn't fit into their pigeon hole idea of people. She was so dignified and determined.

It is such an insult to her dedication and the trail blazing work she did, to have some dumb queer influenced nobodies walk all over the reality of her campaign, and all the women who came after her.

Without her much of the current work and support around FGM would not be happening.

Please read her obituary.

https://www.theguardian.com/society/2014/oct/22/efua-dorkenoo

@McSilkson 👏👏👏 100%!

I haven't read the entire thread, but did read the link to the article on teenagers who have had elective labial surgery- and thought a summary might be useful.

In that study, the writers noted out of 427 females who had this type of surgery, 12 were under 18. All those who had the surgery, had it for reasons of severe discomfort- it wasn't because they fancied a different look. And this was undertaken in hospitals.

The 12 children were looked at in this report, because it is recognised that they are unusual, and the doctors questioned if the surgery would be of more benefit to them after those children had grown into adulthood. They didn't say if there would be any further follow-up on that.

Re adults: Personally, since going into surgical menopause over 10 years ago, my genitals have changed shape, which is causing significant discomfort and chafing. For that reason I would consider labiaplasty - if I could afford it - plus I'm too embarrassed to talk about this IRL to anyone. I'd hate to lose what sexual function/pleasure I have though!

From the links that have been shared, the vast majority of labiaplasty is carried out for reasons of severe discomfort- although it is medically categorised as cosmetic. I think that often causes confusion, because cosmetic surgeries are usually elective, and so we think non-essential, although they can improve quality of life eg surgery on burns/scarring to ease pain/mobility. Yet these should not be seen in the same way as surgeries to beautify eg face lifts.

FGM is not cosmetic in any way shape or form. It is child abuse.

According to a new article in the Journal of Medical Ethics, we should rebrand this as the less alarming “genital practices”.

As though that euphemism makes it sound better.

Kathleen Stock:

"The usual strategy is to take the most benign example of the practice possible, then make that the central paradigm. ... Perpetually gloomy about human behaviour in other areas, when it comes to sex and death the mood becomes positively Pollyanna-ish."

Nail on head.