Now that the storm has calmed, let me say it was necessary to expose the hidden nature of Female Genital Mutilation Type 4 within our Black Minority and Ethnic  Community here in UK. We are all accustomed to Female Genital Mutilation/Cutting but as evidenced by backlash myself and others faced after BBC aired the documentary,  communities think one form of abuse is more acceptable than the other and in this case, it would appear as if  pulling is more acceptable than cutting . There is a general feeling in BME communities that cutting is FGM and pulling is not. Throughout my research, I insisted that pulling is Female Genital Mutilation Type 4 and is harmful to girls.

In 2014, I enrolled at Royal Holloway University to pursue MSc in Social Work.  I am finally graduating in July 2017. Studying gave me quality time to renew my knowledge, reflect and rejuvenate myself. But like always I like to take risks.

 

But like always I like to take risks. After much debating within me and sometimes with others, I took the risk to choose a topic on Female Genital Mutilation Type 4. In my community, this is a taboo topic. When BBC aired it on like and when my community saw me testifying, daggers were drawn against me. Insults were hailed against me. I do not remember which part of my body was not insulted or ridiculed. But well, there is a price activist students pay. What I was simply trying to do by understanding this research was to get policy makers, parliamentarians, media, social workers and all professionals be aware of this hidden type of FGM as some children in the UK may be trapped. I went through it and so were 90% girls when we were growing up. I was concerned about safeguarding.
Previously media focus had been on cutting but now pulling was brought under the microscope too. In any case, no harmful cultural practice should be permissible because it benefits men. Children are innocent and any touch on such delicate parts of their bodies which be considerate to physical and emotional damage in their lives.

Doing a research on Female Genital Mutilation Type 4 especially labia pulling was risky but necessary 

Excerpt from my disseration

This study sought to explore social workers` attitudes, views and feelings towards FGM Type IV in as far as safeguarding and child protection issues are concerned. The approach took a deductive hypothesis that scholarly researchers, the media, policymakers and FGM campaigners have created FGM hierarchy by focussing more on FGM/ Cutting.

A sample of thirty-five social workers from forty Local Authority Children`s Services and six voluntary organisations working on FGM around UK were randomly selected to participate in this qualitative study. The questionnaire was used as the research instrument. However, this exploratory research study did not necessarily produce final and conclusive evidence.

The key themes that emerged from this study were social workers’ mixed views, thoughts, and feelings on FGM hierarchy, lack of harmonised training and information, loopholes in policy and legal frameworks and role of girls, communities, and families in combating FGM Type IV.

The results of the study clearly demonstrate that social workers have mixed views on FGM Type IV.  The implications of the findings are significant for social work practice. Knowledge gaps and information disharmony on FGM Type IV in terms of prevalence, practising communities, statistics and consequences on children could jeopardise child protection and safeguarding assessments and interventions. Further to that, social workers are of the view that whereas FGM hierarchy impacts on practice, there is not much they can do since they are guided by legal and policy frameworks which this study revealed as lacking information on FGM Type IV and its hidden nature.

This study lays the foundation for future research targeting some FGM Type IV practising communities. Social workers recommended that legal and policy frameworks, training and dissemination of information be reviewed and harmonised.  Future research was highly recommended with a larger sample on consequences on children, the prevalence in the UK, children who may be at risk and link between FGM Type IV and early sexual activity and consequently teenage pregnancies in practising communities in the UK.

Why Female Genital Mutilation Type 4 and is pulling harmful to children?

This study is coming at a time when Female Genital Mutilation (FGM) (Appendix 1) is a topical issue in the United Kingdom (UK).  However, it would appear that there is an implicit denial that non-cutting forms of FGM are not as important. Like previous policy documents on FGM, the most recent policy guidelines for professionals by the Department of Health on “Risk and Safeguarding,” still fall short on FGM Type IV prevalence, practising communities and consequences of this harmful cultural practice on children (DOH, 2016). Despite the laws being in place, FGM is still underreported by many professionals even though they encounter such cases on a daily basis (Royal College of Midwives, 2013). It is estimated that 20 000 children are at risk of mostly FGM/Cutting also known as FGM Types I, II, III (FORWARD UK, 2007). There is no official estimate for FGM Type IV in the UK. There have been endless efforts by government and voluntary sector to eliminate FGM/Cutting as it violates children`s rights. Currently, the UK government is more focused on prosecuting anyone who performs FGM on children (Leye, et al., 2007).

In addition to deficits in policy guidelines on FGM Type IV, the study to explore social workersviews, thoughts and feelings on FGM Type IV was also influenced by personal experiences of the researcher who comes from one of the communities that practises FGM Type IV. Media reports of her experiences of FGM Type IV generated debate in practising communities’ majority who argued that FGM Type IV is not a form of FGM because of its supposedly many benefits to girls when they eventually get married (Metro, 2013).  On the other hand, a national charity working to protect and safeguard black children in the UK, Africans United against Child Abuse (AFRUCA), recently released a report from a study that took place between July and December 2014. There were 110 participants from 12 FGM practising communities in Greater Manchester. AFRUCAs findings confirmed the hidden nature of FGM Type IV. The AFRUCA report of 2015 stated that some children who may be at risk of FGM Type IV were being overlooked in the child protection and safeguarding systems because FGM Type IV was not considered a type of mutilation. During this study, it was noted that participants from Zambia, Zimbabwe, Burundi, Ethiopia, Malawi, Uganda and Rwanda did not consider labia elongation as a form of FGM but part of their culture. They argued that there was no crime in a culture that ensured girls pull their labia because doing this rite of passage would then ensure their future husbands derive pleasure from sexual intercourse and stay in the marriage (AFRUCA, 2015).

Media publicity of the documentary film, “The Cruel Cut” had the huge impact on British Society on FGM/Cutting (Docson4, 2013). However, it reinforced the idea that FGM involves Cutting only. This must have contributed to FGM hierarchies of abuse also. Based on this background information, this study, therefore, sought to explore social workers’ views, attitudes and feelings towards FGM Type IV to gather information that would inform policy on safeguarding and child protection as children who live in practising communities may be at risk.

Legislators, media, scholars, professionals in the health sector have given more attention to FGM/Cutting (Leye et al, 2007). The extensive attention to FGM/Cutting seems to have undoubtedly created FGM hierarchy. FGM definition by WHO has been singled out as a major contributing factor to many perceiving FGM Type IV as less harmful (AFRUCA, 2015). To make matters worse, WHO has been reluctant to explicitly define or classify FGM Type IV like the case with Types I, II and III. FGM Type IV is lumped together under the umbrella term “others” and constitutes pricking, excision, pulling and stretching which are unrelated types of mutilation/modification (WHO, 2008). The lack of specific definition of FGM Type IV has led to a long-ranging debate on whether it is mutilation or modification. This has consequently justified myths and beliefs that FGM Type IV benefits girls when they eventually become married women. Therefore, this research was undertaken to explore views and attitudes of social workers towards FGM Type IV, hierarchies on such forms of abuse and consequently how this affects safeguarding and child protection by social workers.

The literature review provided evidence that scholars, policymakers, voluntary sector, and media have paid most attention to FGM /Cutting thereby creating FGM hierarchy. Lack of information on statistics and consequences of FGM Type IV on children from practising communities overlooks the risk children face. A significant number of children may be going through FGM Type IV without proper safeguarding and child protection policies and procedures in place.  It is against this background that this research sought to explore attitudes, thoughts, and feelings of social workers on FGM Type IV in as far as safeguarding and child protection are concerned about seeking to answer the question, “What are social workers` perspectives on Female Genital Mutilation (FGM) Type IV within Black Minority Ethnic (BME) communities in the United Kingdom?”

Link to trauma, HIV and AIDS, early sexual activity and teen pregnancies

FGM has a serious psychological impact on children and evidence has shown how people get affected emotionally and physically (Roger, 2011). Girls begin to pull their labia from age 6. For instance, children who are forced to do labia elongation may feel anxiety because of stretching that may end up unsuccessful. As a result of this, girls may feel bullied, isolated, rejected and stereotyped as a result of a negative result. There is anxiety, fear, and desperation to be like others.  There are no easy access clinics to support victims to build their resilience and deal with post traumatic disorder (Dustin and Davies, 2007).

One young Zambian woman shared how the pulling and stretching can take several months resulting in behavioural challenges for some girls (BUWA, 2012)).  She highlights how girls who did not perform FGM Type IV were ostracised by their families and communities. She further states that in Zambia girls who did not stretch or pull their labia are constantly mocked and threatened that they will never get married. She argues that FGM Type IV is forced on girls and the practice is a way to police their bodies. In her case, she realised that her family made decisions for her much earlier in her life, some of which had serious consequences for early sexual activity and consequently teenage pregnancies (Katongo, 2014). However, most girls are forced to do it as a way to avoid backlash from family and society. The girls fear to be psychologically isolated and losing their identity. They have no choice but to conform to what is considered the norm (Toubia, 1994).

FGM Type IV, with specific reference to stretching, which is done to children under 12 years and before menstrual cycles is also performed with no anesthetic and has the same traumatic impact on children as with FGM Types I to III. The pain has been described as severe at the beginning but less severe as girls get used to it. However, the pain of whatever form causes distress on the body. There is the greater risk when children, for instance, from Western and Central Uganda pull using weights, threads and pegs given the fact that vaginal tissue is soft (WHO, 2008). Experts on sexual health have argued that women do not derive sexual pleasure due to their labia pulled out. In fact, reaching sexual climax has been refuted though Zambian women have argued otherwise (Fekit, 1996).

Health risks of FGM Type IV have not received the attention of scholars. However, a survey revealed a link between HIV and AIDS and FGM Type IV called Labia Minora Elongation due to damage to the female sexual organs as a result damage to the tissue (Martinez et al,2013). Herbs that are used during the procedure aid laceration, swelling, hypersensitivity to the genitalia, wound infection and HIV transmission. Research is still limited on how FGM Type IV causes girls to be sexually active and consequently get exposed to early sexual activities and pregnancy.

The above is not the full research. The academic paper will be produced in future and this is still work in progress.  The researcher will be raising awareness on all forms of harmful cultural practices and not just one here in the UK and worldwide to safeguard.