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The abbreviation FGM/C stands for "FemaleGenitalMutilation/Cutting", i.e. female genital mutilation and cutting.

There are many different names for FGM/C around the world. These not only serve as a description of the practice itself, but also reflect the different perspectives on the topic - they are therefore not neutral. For example, the WHO and other international organizations deliberately use the term female genital mutilation to emphasize the severity of the procedure and at the same time avoid drawing analogies to male circumcision. In practicing societies, on the other hand, more positive or more neutral-sounding terms are used, such as cleansing, healing, purity or simply circumcision. The term mutilation is also rejected by many members of these societies.

The choice of the appropriate term leads to a dilemma: on the one hand, FGM/C should (be able to) be named as a serious human rights violation; on the other hand, a sensitive and respectful approach is essential for addressing and counseling. A large number of organizations and contact points therefore now use the combination of female genital mutilation/circumcision (FGM/C) and use the term female genital circumcision (FGC), the corresponding ethnic designation or the individual self-designation of the woman or girl affected when dealing sensitively with the communities.

Female genital mutilation occurs worldwide and cannot be categorized according to countries or national borders. Rather, the classification is based on group affiliation and the respective cultural heritage. More than 200 million girls and women are currently affected by FGM/C. A further four million girls are considered to be at risk (UNICEF 2020).
Members of the practising communities leave their home country through flight and migration, which means that the practised tradition reaches the host country. According to estimates, 104,000 women and girls affected by female genital mutilation live in Germany, and a further 18,000 are considered to be at risk (TERRE DES FEMMES 2022).

For Schleswig-Holstein, this means that more than 3,000 women and girls have already experienced the practice and another 460 are potentially at risk.

The different forms of FGM/C are determined by the respective region and community. The following four types are distinguished:

• Type I (clitoridectomy): Partial or complete removal of the external clitoris and or clitoral hood.
• Type 2 (excision): Partial or complete removal of the outer clitoris and the inner, and sometimes also the outer vulval lips.
• Type 3 (infibulation, also known as "pharaonic circumcision"): The vaginal opening is narrowed by trimming and stitching/stapling together the outer and/or inner vulval lips. Sometimes the clitoris is also partially removed.
• Type 4: All other harmful procedures that injure the female genitalia, e.g. piercing, piercing, cauterizing or stretching the internal and/or external genitalia.

FGM/C has been practiced for thousands of years and has a complex historical and cultural background. The origins of female genital cutting and mutilation are not clearly defined. According to historical texts, female circumcision was documented long before our era. Circumcision was and is carried out worldwide. For example, the removal of the tip of the clitoris was particularly widespread in English-speaking Europe in the 19th century in order to counteract masturbation, female homosexuality, hyper-sexuality and so-called hysteria.

There are a variety of reasons used to explain female genital mutilation, such as

• the traditions of the practising communities
• culturally influenced ideas of sexuality, marriage, family and the role of women
• social norms and cultural affiliation
• aesthetics
• social pressure
• religious arguments
• myths

In summary, FGM/C is the basis for social recognition and belonging in prevalent societies and is therefore essential for securing livelihoods. For the women themselves, FGM/C can be an important part of their identity and cultural affiliation. As a result, they see the continuation of the tradition as parental care, also with regard to their own children, even if this perspective is difficult for outsiders to understand.

FGM/C is usually performed without anaesthetic or painkillers, usually under unhygienic conditions and with the use of massive force. In most cases, it is carried out by a professional circumciser, who often also works as a midwife.
In some countries, the so-called medicalization of FGM/C has been increasingly observed for years: Doctors and other medically trained staff perform FGM/C under clinical conditions. This disguises the practice as an operation and gives it an apparent legitimacy. From a medical ethics perspective and due to the fact that female genital cutting and mutilation is a massive violation of human rights and an invasion of bodily integrity, this altered approach must also be fundamentally rejected.

Many girls and women suffer from the physical and psychological consequences of FGM/C for the rest of their lives.
These can have both short and long-term effects on the health of girls and women, for example in the form of

• psychological problems
• (recurring) infections
• Pain and problems with menstruation and urination
• incontinence
• Fistulas, inflammation, hardened scar tissue and/or growths
• Reduced libido
• Pain during sexual intercourse
• infertility
• Complications during childbirth for mother and child
• pain during gynecological examinations
• Permanent physical pain (including in the genital area, but also headaches and neck pain)

The different forms of FGM/C are determined by the respective region and community. The following four types are distinguished:

• Type I (clitoridectomy): Partial or complete removal of the external clitoris and or clitoral hood.
• Type 2 (excision): Partial or complete removal of the outer clitoris and the inner, and sometimes also the outer vulval lips.
• Type 3 (infibulation, also known as "pharaonic circumcision"): The vaginal opening is narrowed by trimming and stitching/stapling together the outer and/or inner vulval lips. Sometimes the clitoris is also partially removed.
• Type 4: All other harmful procedures that injure the female genitalia, e.g. piercing, piercing, cauterizing or stretching the internal and/or external genitalia.

Female genital mutilation is a human rights violation and is listed as such in various national and international laws, conventions and agreements. FGM/C violates the right of girls and women to physical integrity, sexual self-determination, protection from violence and discrimination.

Due to the severity of the violation, a special criminal offense was created in Germany in September 2013 with Section 226a of the German Criminal Code (StGB), which classifies female genital mutilation as a crime and punishes it with prison sentences of between one and 15 years. Affected women can bring the crime to court up to the age of 41, as the statute of limitations for female genital mutilation only begins at the age of 21 and is 20 years in accordance with Section 78 of the German Criminal Code. Since the beginning of 2015, genital mutilation is also punishable if a girl is mutilated abroad but has her place of residence or habitual abode in Germany (Section 5, No. 9a StGB). Following the Immigration Act of 2005, protection for refugees who are victims of gender-specific persecution has been adapted accordingly.

The Istanbul Convention, the Council of Europe Convention on preventing and combating violence against women and domestic violence, also contains specific recommendations for states on how to deal with gender-based violence - including FGM/C. The threat of female genital mutilation is therefore recognized as a reason for flight in Germany in the Asylum Procedure Act.
The inclusion of the four FGM/C types in the ICD-10-DE 2016 medical diagnosis code means that the follow-up costs of FGM/C can now be billed to health insurance companies.
FGM/C is also considered a risk to a child's welfare, which must be responded to with appropriate measures to prevent it.

When it comes to protecting minors from FGM/C, the protection mandate for youth welfare professionals (Section 8a SGB VIII) and for all other professionals from relevant professional fields applies. The suspicion that a child's welfare is at risk calls for concrete action. The primary goal is to protect the child and avert the danger - ideally with the cooperation of the parents.
In any case, the priority is to protect the girls. Interdisciplinary cooperation is often necessary at short notice to support those at risk. The entire process should be documented in writing and in a comprehensible manner. You can obtain more detailed explanations on the topic of child endangerment from your local youth welfare office or the protection concept of the respective organization.

The letter of protection against female genital mutilation and cutting provides information on the criminalization of FGM/C. It primarily serves to protect against female genital mutilation by helping women and families to stand up to social and familial pressure from the countries of origin. You can find information about the letter of protection here.