Female Genital Mutilation (FGM), a persistent human rights abuse rooted in patriarchal traditions, produces lifelong physical and psychological trauma. The pain doesn’t fade over years, but causes ongoing health issues like infections, childbirth complications, and mental health disorders such as PTSD. Key questions continue to be why FGM endures despite advocacy, how to deliver community-level interventions beyond laws, and how to sustain eradication amid a global backlash against women’s rights. The urgency remains for broader socio-economic efforts to protect vulnerable girls.
You can read this website in the language of your choice via Google Translate.
A conversation about FGM today with my friend and colleague Dr Phoebe Abe-Okwonga has raised some quite important questions about ‘Where do we go from here?’. Phoebe has been working in her pro bono London clinic with FGM victims / ‘survivors’ for many years, so she has a massively valuable perspective on what’s happening. Unfortunately, the answer is: We’re not doing enough. People and things to be recorded change over the years, and perhaps the UK approach to FGM hasn’t always kept up?
Twenty Years Of Zero Tolerance Day To #EndFGM: But No End To Gender Debates And Genital ‘Treatments’
The post marks 20 years of the International Day of Zero Tolerance to FGM, celebrating progress but highlighting persistent double standards. Why, for instance, do elective genital surgeries like male circumcision, cosmetic procedures, and especially transgender treatments on minors continue almost unchecked, despite lacking informed consent from children? In particular, there are critiques around the London Tavistock Clinic’s GIDS programmes, rushing youth transitions amid comorbidities. It is important to recognise parallels here with issues like patriarchal control over girls’ bodies. Power imbalances exist in all such practices.
You can read this website in the language of your choice via Google Translate.
February 6 is International Day of Zero Tolerance to Female Genital Mutilation. Begun twenty years ago today (2023), the Zero Tolerance initiative has seen considerable success. But much remains to be done. One major issue is that other forms of elective genital surgery / ‘cutting’ continue unimpeded: male circumcision, genital cosmetic surgery and transgender surgeries are widely accepted, even in some cases for minors unavoidably unable to give informed consent. This is a major problem for #EndFGM.
The Route To End FGM: Moving From ‘Multi-Agency’ Via Multi-Disciplinary To Public Health And Economics
This medical journal paper argues that ending female genital mutilation (FGM) requires a shift from multi-agency efforts to a public health and economic framework, emphasizing patriarchy and financial incentives as overlooked drivers. Central is clinicians’ pivotal role in connecting patients to community influencers and policymakers, while urging quantification of FGM’s massive economic costs—beyond just medical expenses; and to expose benefits to powerful men who support the practice. Vital too are the roles of community members willing to speak out. Challenges include professional silos, funding biases toward large organizations, and personal issues and discomforts. Cross-disciplinary research and evidence-based strategies must be the basis of eradication.
You can read this website in the language of your choice via Google Translate.
Efforts to end female genital mutilation (FGM) have for decades been an important element in promoting the health of women and girls in many parts of the world; but still this gendered harmful practice continues.
Abstract: In this piece, written for the journal EC Gynaecology and primarily as a ‘conversation’ with obstetric and gynaecological clinicians whether in the ‘developed’ or the ‘developing’ world, I seek to
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* Create connections between the clinical treatment/care of women and girls with female genital (‘sexual’) mutilation (FGM) and various of the environments in which the practice continues;
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* Establish that two themes – economics and patriarchy – are critical to a full understanding of this harmful practice**; and
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* Explore ways in which colleague support across disciplinary boundaries, along with a willingness to try new approaches to the problem, may help to enable a Public Health framework leading to the eradication of FGM.
[** For more detailed consideration of critical economic aspects and the wider socio-economic costs of FGM, see The Many ‘E’s Of FGM Eradication – And Why They All Lead Via ‘Economics’ And ‘Epidemics’ To Public Health.]
I also note in the above contexts some of the personal discomforts and very different circumstances which various professionals, amongst them clinicians, may experience as they move towards a wider perspective on FGM; and I explore, in anticipation I hope of further discussion, possible ways forward to resolve these valid potential challenges or problems.
A web-linked version of my paper, published on 29 September 2022, follows below:
As the Open Letter below states, it is essential that the Dawoodi Bohra Head Priest, Syedna Mufaddal Saifuddin, publicly forbids female genital mutilation (FGM) during his 2022 visit to Britain. FGM is illegal in the UK, and his past statements and support for the practice, plus his influence over an estimated 1.2 million followers, raise concerns that girls could be put at heightened risk. Critics note contradictions between earlier guidance not to perform “khafz” in countries where FGM is illegal and his later insistence that “the act must be done,” and question why the UK granted him a visa when other countries have rejected his applications.
You can read this website in the language of your choice via Google Translate.
The Dawoodi Bohras are a religious sect of the Ismali branch of Shia Islam. Whilst originating in India, Pakistan, SE Asia and nearby Africa, many of the million or more adherents, women and men alike, are well educated, professional people now living in Europe, North America and Australia, For most of them the idea of female genital mutilation (FGM)* in any form is abhorrent, even though some followers of the Islamic faith still insist on it.
And so, between the competing perspectives of ‘modern’ and ‘traditional’ Bohras lies a serious conflict: the modernists, especially in places like the USA and Britain, demand that FGM be forbidden; but the traditionalists, headed up by their Syedna (‘leader’) Mufaddal Saifuddin, are not as yet convinced.
Bohras in Britain have therefore called for a demonstration, demanding that the Syedna declare FGM is forbidden, during his visit to London in August 2022:
🗓 Friday 5 August 2022
📍 Mohammedi Complex, Rowdell Road, Northolt, London, UB5 6AG
⏰ 12.30pm- 3.30pmAnyone nervous about being identified is invited to bring, or ask on arrival for, a mask.
Below is the Open Letter, supported and published by various organisations and individuals, which explains the issues around FGM which Dawoodi Bohras in the UK face:
“Patriarchy incarnate” is not just abstract male dominance, but a spectrum of concrete harms to women’s bodies, minds, and autonomy, often driven by men seeking wealth and influence. It links apparently smaller acts, like sexualized “jokes” or purity rituals, to larger forms of control such as FGM, reproductive coercion, trafficking, and wartime violence, asking who benefits and who is responsible.
You can read this website in the language of your choice via Google Translate.
It was good to receive an invitation from doctoral law student Saarrah Ray to speak at the Oxford University ‘Four College’ event, this time on 20 May 2022, when students from Christ Church, Corpus Christi, Oriel and University Colleges come together, this year to consider female genital mutilation (FGM).
A number of excellent speakers made presentations, and I too contributed, offering my developing perspective on the issues around the economics and politics of patriarchy incarnate and FGM.
Particularly, I am becoming convinced that this patriarchy incarnate arises at a range of levels of severity from the ‘trivial’ to the undeniably atrocious – all of them significant because these ‘levels’ feed into and reinforce each other. Importantly, consideration of patriarchy incarnate invokes whenever it occurs this question: ‘Where (and who) is the agency in this phenomenon?‘.
The answer to this question is generally that the agents of patriarchy incarnate, however it materialises, are men seeking wealth and influence; and the stark realities which lie behind that bald statement are cause for alarm to many of us.
The paper in which I explored this theme follows below. May I suggest that you check out the links here to the various aspects of this topic? You may find them alarming.
Female Genital Mutilation & Child ‘Marriage’, Covid-19, Climate Change – and War: an Economic Perspective (CSW66)
FGM and child marriage should be understood not only as human-rights abuses, but as economic phenomena shaped by poverty, disrupted services, and family survival strategies. Recent relevant factors include COVID-19, climate stress, and war; and school closures, lost income, migration, and insecurity can increase girls’ vulnerability. The main questions are: how much these harms cost societies, how hidden economic pressures drive them, and why “follow the money” matters for prevention? The UN Commission on the Status of Women (CSW66) event offers a policy moment for rethinking eradication efforts through economics as well as law and health.
You can read this website in the language of your choice via Google Translate.
The sixty-sixth session of the Commission on the Status of Women (CSW66), a part of the United Nations organisation, takes place (largely via Zoom) from Monday 14 to Friday 25 March 2022.
My colleagues Dr Lori Post, Dr Tobe Levin von Gleichen, Lorraine Koonce-Farahmand Esq and I presented a session moderated by WUNRN manager Lois Herman on Tuesday 15 March at 12 noon EST. Our theme was ‘The Impacts of Climate Change and Covid on FGM and Child Marriage‘.
My own contribution, entitled Female Genital Mutilation & Child ‘Marriage’, Covid19, Climate Change – and War: an Economic Perspective (below) focuses on the economics of these situations – an aspect not often so far examined, but one which I am convinced is critical to all serious endeavours to eradicate FGM, Child, Early and Forced Marriage and other harmful ‘traditional’ practices.
My particular paper follows below:
Female Genital Mutilation In Russia
A just-published (February 2022) Russia Today article about FGM, for which I was interviewed, shows that the practice also exists in Russia, especially in Dagestan and Ingushetia, where it has been reported in some communities and even in a 2019 criminal case involving a 9-year-old girl . Here is more evidence that laws alone are not enough to end FGM; social pressure, secrecy, religion, and community norms are all critical. This article was written at the time of Russia’s invasion of Ukraine, which makes RT a problematic source, even while the FGM information itself is still worth noting
You can read this website in the language of your choice via Google Translate.
Today (24 February 2022) is the first day of the extraordinary military attack by Russia on its neighbour, Ukraine. There is absolutely no ‘reason’ for this assault beyond the fact that the Russian President (Vladimir Putin) wanted to take back control of this sovereign nation, previously – but no more – part of the Soviet Union. I fully understand therefore why the newspaper Russia Today, an English language state controlled reporting vehicle, is now being boycotted by most global readers.
I have however decided to share at this very point in time a Russia Today article which reported on female genital mutilation (FGM) on 6 February, the International Day of Zero Tolerance for FGM. In it the RT journalist Anastasia Safronova writes about the excellent work of #EndFGM campaigners Fatou Mandiang Diatta of Senegal and Dr Carolyne Njue in Australia, and also includes some observations from me. But more significantly at this time Anastasia Safronova shares some little-known information concerning FGM actually in Russia. This is I think important.
Given the inexcusable invasion by Russia of Ukraine, and therefore the current particularly low standing of Russia Today, very unusually I will not just now give a link to the actual article. I hope however that sharing the information which Anastasia carefully collated here reminds us that, as in every other corner of the world, there are always people who really want to help and support those who are vulnerable and in need.
Zero Tolerance For FGM Began With Agitators Like Nawal El-Saadawi
The International Day of Zero Tolerance for FGM (Feb 6), traces its roots to pioneers like Eleanor Rathbone (her 1934 book Child Marriage: The Indian Minotaur) and Nawal El-Saadawi (1931-2021), whose 1969 Women and Sex exposed FGM horrors from her Egyptian childhood and medical practice. El-Saadawi’s radical activism against patriarchy costed her job loss, jail and exile, despite Egypt’s 2008 ban—yet FGM persists. The internet now accelerates global awareness.
You can read this website in the language of your choice via Google Translate.
6 February is the annual International Day of Zero Tolerance for (or to) Female Genital Mutilation. Introduced in 2003 by Stella Obasanjo, the First Lady of Nigeria, during a conference organized by the Inter-African Committee on Traditional Practices Affecting the Health of Women and Children (IAC). Then, in 2012, the UN General Assembly formally designated February 6th as the International Day of Zero Tolerance for Female Genital Mutilation.
But the origins of the demand to #EndFGM came much earlier than that, with fighters such as Dame Eleanor Rathbone in her 1934 book entitled Child Marriage: The Indian Minotaur and Nawal El-Saadawi (seen here in a photograph by my friend and colleague Dr Tobe Levin) whose 1969 publication Women and Sex is one of many she wrote (55 books in all) concerning harmful traditional practices such as those earlier (and independently) addressed by Dame Eleanor.
We have already celebrated here the life and work to end FGM and child marriage in India of the British social researcher and politician Eleanor Rathbone (1872-1946), so now is the time to acknowledge also the huge contribution a generation later of Nawal El-Saadawi (1931-2021), the Egyptian public health physician, psychiatrist, author, and advocate of women’s rights, who died a year ago in March.
Peaceful Protest Should Be Newsworthy Too
My letter published in The Guardian today critiques mainstream media’s neglect of peaceful protests, contrasting it with heavy coverage of disruptive or violent ones. This bias sidelines legitimate grievances, like those in recent UK demos against inequality and policy failures, reducing public awareness and democratic discourse. A key issue is why does the media ignore non-violent action that embodies civil society? Factors include media incentives (spectacle sells), power imbalances favoring official narratives, and implications for activism—peaceful efforts risk invisibility, potentially discouraging participation.
You can read this website in the language of your choice via Google Translate.
Often now people want to make their views known on the difficult issues of the day (or decade, or indeed century..). But to what extent may citizens challenge the law in drawing attention to these views?
Is it ethically – though maybe not legally – okay, say, to cause traffic jams as a protest against climate change?
Or perhaps – a more minority concern – to scale a palace rooftop in support of ‘dads’ rights’?
My letter to The Guardian published today suggests that if a concern is widespread, the media have a duty to report it as news before it becomes a matter of illegal action. Below is the text of the letter. What’s your view?
Covid19 Has Increased Gender And Economic Divides
COVID-19 has widened gender and economic divides globally. Key issues include disproportionate job losses in female-dominated sectors like care and hospitality, increased unpaid care burdens on women from school closures, and rising domestic violence risks. We must ask questions about policy failures to address these gaps, urging targeted support for women’s employment, childcare, and economic recovery to prevent long-term inequality setbacks. You can read this website in the language of your choice via Google Translate
I was pleased to be invited by two colleagues, Lois Herman and Sadia Mir of WUNRN, the Women’s UN Report Network, to liaise as editor with them on this important paper.
It will be a while before full assessments can be made of how Covid19 has impacted on socio-economic and gender divides, but already it is clear that serious efforts are required, right now, to mitigate the already evident damage which this pandemic is inflicting at a global level.COP26, The Future, And Progressive Politics
There were mixed outcomes for COP26; progressive political parties must take multi-level action to address the climate crisis. Three essential spheres for intervention are Political: High-level leadership and legislative decision-making; Policy: Regional and local delivery of environmental strategies; and Parochial: Grassroots engagement to bridge the gap between voters’ daily concerns and climate action. Population growth is also a critical, often overlooked factor in slowing environmental decline. “Green” agendas are essential for political engagement, particularly among young people. Collaboration across progressive parties to deliver sustainable, actionable change is vital, rather than the traditional model of politicians competing about everything; and time is short to get it right.
You can read this website in the language of your choice via Google Translate.
COP26 conference, held in Glasgow (Scotland) in November 2021 was an event with mixed outcomes. I have brought together here some thoughts about how those of us on the progressive side of politics can now move forward. On one hand we need to engage people through the small things which are everyone’s concerns: clean air, recycling plastic etc. And on the other we must all understand that population is a massive issue. One child less per family everywhere would be the biggest thing we could do to slow climate change and other looming environmental dangers.
This note, which I prepared for a presentation, gives some background to the recent COP26 meeting, provides some information on the critical issues around climate change and environmental sustainability, and suggests various levels at which political pressure and action to protect our planet, people and other living things on it may be appropriate.
#FreeNazanin: Every Individual Has Human Rights. It’s Personal.
This is a reflection on the case of Nazanin Zaghari-Ratcliffe and the unbearable pain her prolonged detention caused her family. Hers was not an abstract political issue but a human one, with Richard Ratcliffe’s campaign and hunger strike highlighting the urgency and moral weight of the case. I understand this perhaps as well as can any ‘outside’ observers, given my own experience (so kindly supported and advised in fact by Richard) in securing the safety of a British-Iranian colleague. Everyone is entitled to their human rights and it is our government’s responsibility vigorously to uphold them.
You can read this website in the language of your choice via Google Translate.
Nazanin Zaghari-Ratcliffe, a British-Iranian citizen and wife of British Richard Ratcliffe (holding her picture here), has now been detained for almost six years by the Iranian authorities since, about to return to the UK after a visit to her parents with her infant daughter, she was arrested in Tehran. Her husband Richard has not seen Nazanin even once since that time. Instead, Richard has spent innumerable days, weeks and months seeking ways to bring Nazanin back home but – despite heroic efforts – to date without success. (Happily, she did eventually return to her family on 16 March 2022.)
There is for me, however, also a backstory: on Christmas Day 2020 I received a phone call from a person in the Foreign Office. His message was brief: ‘Your friend is safe in our care.’
This message concerned another British-Iranian, mentioned below, who had been wrongly detained in Iran. Whilst by no means the end of the story, that phone call marked the fundamental, essential and critical step in lifting the burden – much, much less for me than Richard and Nazanin’s – of getting matters resolved. I know very many of us hope every day that the British Government will now, immediately, secure the same outcome for Nazanin and her family.
Child ‘Marriage’ Has No Fit With The International Day Of The Girl: Eleanor Rathbone (1934), Iranian and Global Laws
Child marriage (under age 18) is fundamentally incompatible with the International Day of the Girl and should be understood as a human-rights abuse, not a cultural exception. We can link Eleanor Rathbone’s 1930s campaigning with present-day evidence from the US, Britain, and especially Iran, where the law still permits very early marriage with judicial and parental approval. Stronger action is essential to protect girls’ (and sometimes boys’) education, safety, and future prospects.
You can read this website in the language of your choice via Google Translate.
11 October 2012 was the first annual date of the International Day of the Girl. This date, confirmed by the United Nations on 19 December 2011, arose from the work of Plan International in Canada, focusing on issues faced by girls around the world and how to resolve them.
One such critical issue is Child Marriage, a practice which has for at least a century been acknowledged to cause enormous harm (especially to girls and babies). But still it continues in South Asia, Sub-Saharan Africa, the Middle East and North Africa, and, yes, even in some modern first world nations.
There are various views about what constitutes ‘child’ marriage, but the general consensus is that it comprises marriage before the age of 18. Let’s start our consideration of it with the suffragist Eleanor Rathbone. From there we shall move to reports of child marriage in the USA and in Britain, and on to continuing overt Iranian judicial justifications for it in 2020-21.
Writing About Health Education In ‘The New Social Curriculum: A Guide To Cross-curricular Issues’ (1990) – and The ‘Gillick Competence’
Have we moved on in the three decades since Barry Dufour as editor published The New Social Curriculum: A Guide To Cross-Curricular Issues? The book, published by Cambridge University Press in 1990, was then a fairly ground-breaking initiative to bring together various aspects of the school curriculum which might otherwise have been ‘squeezed out’ by the introduction of the English National Curriculum in 1987-9.
As his helpful Introduction to the book (pp. vii-ix) explains, Prof Dufour offered ways to incorporate via a cross-curricular approach several aspects of subject learning which many of us regard as essential, but were not then accorded by the Government the statutory requirement of ‘core’ delivery.
My task was to propose such incorporation for Health Education, a particularly delicate aspect of any school’s curriculum both because it is dependent on the knowledge, skills and willingness of teachers to deliver, and because it embraces such thorny issues as drugs and ‘sex education’, the latter set at that time in the context of ‘Section 28‘ (homosexuality, AIDS – and the related unarticulated suicidal fears of and for some young men) along with the moral panic about ‘teenage pregnancy’. (An aside: the ‘Gillick competence‘ test had then only recently arisen as an issue, perhaps ironically after Victoria Gillick unsuccessfully challenged any provision of contraception advice to under-16s. The Gillick consent concept as applying to a range of largely health and medical provisions – including in 2021 Covid-19 vaccinations in English schools – was not yet fully established when Barry Dufour’s book was published.)
Below is what I wrote as Chapter 4 of The New Social Curriculum.
Child, ‘White’ And Other Forms Of ‘Marriage’ In Iran And Afghanistan (And Child Brides As Baby-Production Machines)
The withdrawal of Western armed forces from Afghanistan has brought brutally into focus how women and girls are treated in some Middle Eastern countries which adhere to strict Sharia (Islamic) law, via which their rights are eroded – not least by concepts of ‘marriage’ which few in the West know or understand. And now we learn that the horrifying practice of child ‘marriage’ is actually becoming more common in adjoining Iran, a nation which may also benefit from current military manoeuvres and the subsequent reinforcement of Islamic law.
A House with Open Door, the recent book by British-Iranian anthropologist Kameel Ahmady, provides an important source of information about Islamic legal and socio-economic modes of ‘marriage’ in Iran (and other Islamic states). Marriages may endure from one hour to 99 years, a man may have several wives, and children may be contracted into matrimony. The age at which adult Iranians formally marry by informed mutual consent is rising for largely economic reasons but many tensions exist within this arrangement, and there are numerous other versions of ‘marriage’, some to very young girls and all of them based on patriarchal power and interests. Nor are things much different in places like Pakistan or, in some respects, other countries in that general region, such as Egypt.
A House With Open Door (Kameel Ahmady, 2021): My Foreword
We in the English-speaking parts of the world may be aware that life is different in various ways beyond our experience, but little is known by most of us about how family and domestic matters are conducted in the Middle East. I was the adviser and editor for the English language version of A House with Open Door, a book about ‘informal’ or ‘white’ marriage, written by the British-Iranian anthropologist Kameel Ahmady.
In my editorial capacity I learned a lot about a culture and customs very different from my own, where the focus is on upholding what are considered to be Shi’a Islamic constraints and requirements in regard to marriage.
Below is the Foreword I wrote for that book.
Social Science At 16+ (Published in SOCIOLOGY, Vol.20, No 3)
Social Science at 16+ is a paper I published in Sociology in August 1986*. At that time there was considerable concern about the future of the Social Sciences as subjects in schools and colleges, this being the focus of my paper here.
And now, some 35 years later, we are again facing fears for the future of the Social Sciences and other non-STEM subjects such as the Arts. Perhaps then this is a good point at which to revisit the original discussions about intended reductions in the breadth and scope of the curriculum in secondary and higher (tertiary) education.
*When I wrote this piece I was Hon. Secretary of ATSS, the Association of Teachers of Social Science (and Founding Hon. Secretary / Co-ordinator of FACTASS: The Forum of Academic and Teaching Associations in the Social Sciences). Since then ATSS has conjoined with the British Sociological Association, of which I was also an Executive member.
The Social Science at 16+ paper follows below:
Patriarchy Incarnate
‘Patriarchy Incarnate’ is a term I first used in the context of FGM (female genital mutilation) almost a decade ago. I saw it then, and I still see it, as the literal imposition of some men’s will on women’s bodies. But since that time I have begun to understand how the term can also be applied to other aspects of patriarchal imposition, both physical and psychological. In the end little distinguishes soma and psyche; harm to either is harm to both, especially when the harm is inflicted knowingly by fellow human beings.
Long-Covid, Data, Confidentiality And Scientist-Citizens
I recently had a modest involvement in a study concerning the use of clinical data in health care. The enquiry is wide-ranging but I hope I had something to contribute in terms of public confidence in the use of ‘their’ data for medical research. I suggested that most people have scant idea of how such research works, and that it might be a good idea, along with the increasing engagement of ‘citizen-scientists’ (‘lay’ people who help to generate data) to have ‘scientist-citizens’ – science professionals who actively explain how the data is anonymized and used, and why they need it.
Below is the gist of my submission to the enquiry. The commentary focuses to a degree on Long-Covid – a very topical issue just now – and the UK National Health Service (NHS) but also has a wider take on medical science and on matters such as approaches to the eradication of female genital mutilation (FGM) and, in fact, my own long experience of auto-immune conditions. I don’t usually write about myself, but maybe, given my own auto-immune conditions, it makes sense to do so just now, as we all recognise the need to know more about Long-Covid and similar conditions?
It was in the 1980s that my mother (now a centenarian) first told me about female genital mutilation (FGM). She was active as a Quaker and as a member of Amnesty International (UK), and somehow this awful practice had come up in a discussion. Could these stories of FGM be true, she asked? I promised, with my medic sister, to do my best to find out.
How could I know way back then that this earnest question by my Mum would come to expand my horizons, extend my networks and friendships, and shape my life? Read more…
Hilary Burrage 