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The UN set a target of eradicating FGM 🔑 by the end of this decade, and impressive advances have been made in some countries. But overall, progress has stalled 🔑 or reversed. In 2024, 200 million girls and women worldwide had undergone FGM. Since then, 30 million more women have 🔑 endured it. Most FGM cases – 144 million – have happened in Africa, with a reported 80 million in Asia 🔑 and 6 million in the Middle East. The rate of decrease has been slower than population growth in communities where 🔑 the practice persists, and Unicef says that girls are also being cut at a younger age, reducing the opportunities to 🔑 intervene.

In Sierra Leone – where FGM remains legal – three girls have died in 🔑 cutting ceremonies this year. There are no health benefits to the practice, which involves the partial or total removal of 🔑 the external female genitalia. All forms are associated with increased long- and short-term health risks. Alarmingly, MPs in the Gambia 🔑 initially approved an attempt to overturn a ban on FGM this summer. Almameh Gibba, the legislator responsible, said he wanted 🔑 to "uphold religious loyalty and safeguard cultural norms and values". The country would have been the first to reverse protective 🔑 legislation, setting an alarming precedent: it took determined activism by campaigners to see off the threat. According to UN estimates, 🔑 as many as three-quarters of Gambian women between 15 and 49 have undergone the practice. The rate in Sierra Leone 🔑 is believed to be even higher.

The growing concern is that FGM is increasingly being 🔑 medicalised in some places – performed by trained staff rather than traditional practitioners, with some communities apparently seeing this as 🔑 a safer way to continue the custom despite the risks that exist even in a hospital setting. The mistaken belief 🔑 that this is necessarily less severe, and prevents complications, may make parents more willing to go ahead. It is also 🔑 less visible, with families and staff often claiming that a girl is undergoing a different procedure. Training healthcare workers about 🔑 the damage it causes can help them not only to resist pressure to carry out FGM, and report it, but 🔑 to shift attitudes. One study found that clients of antenatal clinics with staff trained to prevent FGM were themselves less 🔑 supportive of the practice.

Men as well as women 🔑 need to be addressed and involved in anti-FGM activism. Promoting gender equality more broadly is essential, as is engaging with 🔑 traditional, political and religious leaders to raise awareness of the harms: even families who disapprove of the practice may still 🔑 subject their daughters to it for fear that they will otherwise be stigmatised. Such work is best led by local 🔑 campaigners with external support. Survivors also need help in dealing with psychological damage and accessing reconstructive surgery. While several European 🔑 countries have specialist clinics, the NHS does not provide it. Though prevention is the priority, those who have endured FGM 🔑 need support too.