For French pioneer healers, female genital mutilation is part of the ‘continuum of sexual violence’ – Voxeurop

Report on Female Genital Mutilation (FGM) in Europe: A Challenge to Sustainable Development Goals

Introduction: FGM as a Barrier to Sustainable Development

Female Genital Mutilation (FGM) is a severe violation of human rights and a significant impediment to the achievement of multiple Sustainable Development Goals (SDGs). This practice directly contravenes the objectives of SDG 5 (Gender Equality), particularly Target 5.3, which calls for the elimination of all harmful practices. Furthermore, the profound health consequences of FGM undermine SDG 3 (Good Health and Well-being), while its nature as an act of violence challenges the principles of SDG 16 (Peace, Justice and Strong Institutions). This report examines the prevalence of FGM in Europe, its impact on survivors, and the multidisciplinary responses required to address this issue in alignment with the 2030 Agenda for Sustainable Development.

Global and European Prevalence: A Threat to SDG 5

Statistical Overview

The persistence of FGM represents a global failure to protect the rights of women and girls, a core tenet of SDG 5. Current data indicates a widespread challenge:

• Global Impact: UNICEF data from 2024 estimates that 230 million girls and women worldwide are survivors of FGM.
• European Context: The European Institute for Gender Equality (EIGE) estimates that approximately 600,000 women and girls in Europe live with the consequences of FGM.
• Ongoing Risk: An additional 190,000 girls in Europe are considered at risk of undergoing the procedure, indicating a need for urgent preventative action to meet SDG Target 5.3.

Case Study: The Lifelong Impact on Health and Equality

The experience of Ayan, a 23-year-old Somali refugee in Ireland, exemplifies the devastating impact of FGM on an individual’s life, touching upon SDGs 3, 5, and 16. At age eight, she was subjected to a severe form of FGM, leading to immediate trauma and long-term health complications, including frequent urinary tract infections requiring surgery. This initial act of violence was followed by a forced marriage and further abuse, forcing her to flee her home country. Her story illustrates how FGM is not an isolated event but a starting point for a continuum of gender-based violence that denies women and girls their right to health, safety, and equality.

Holistic Healthcare Models: Advancing SDG 3

The Need for Comprehensive Care

Addressing the health consequences of FGM is critical for advancing SDG 3 (Good Health and Well-being). Surgical intervention alone is insufficient and can re-traumatize survivors. A multidisciplinary approach, as recommended by the World Health Organization (WHO), is essential for providing effective care that aligns with the goal of universal health coverage (Target 3.8).

The Montreuil Model: An Integrated Framework

The ‘Réparons l’excision’ unit at the André-Grégoire Hospital in Montreuil, France, provides a model for comprehensive FGM survivor care. This pilot project integrates various services to address the complex needs of survivors, ensuring that treatment supports both physical and mental well-being.

• Surgical Repair: Reconstructive surgery is offered as one component of a broader healing process.
• Psychological Support: Therapy is provided to help survivors process trauma.
• Sexual Medicine: Consultations are available to address sexual health and well-being.
• Social Assistance: Support is offered to help women navigate administrative and social challenges, particularly relevant for migrants and refugees.

The project’s goal is to have all treatments fully covered by the national health system, establishing a benchmark for holistic care that promotes SDG 3.

FGM as a Continuum of Violence: A Challenge to SDG 16

Connecting FGM to Broader Gender-Based Violence

FGM must be understood within the continuum of sexual and gender-based violence, a key concern of SDG 16 (Peace, Justice and Strong Institutions), which aims to end all forms of violence against children and women. Nina Tunon de Lara, a project coordinator in Montreuil, emphasizes that FGM is often the “starting point” for subsequent violence, including:

1. Forced and early marriages (violating SDG Target 5.3).
2. Domestic violence (physical, sexual, and psychological).
3. Violence experienced during migration and displacement.

Recognizing FGM as part of this continuum is essential for developing effective legal and social frameworks that protect victims and ensure justice, in line with SDG 16.

European Initiatives and Systemic Gaps

Collaborative Efforts Across Europe

Various organizations across Europe are working to combat FGM and support survivors, contributing to the achievement of the SDGs at a local level.

• Ireland: The migrant women’s support group AkiDwA trains professionals to recognize and report FGM.
• Austria: The FEM Süd centre in Vienna provides medical and psychological assistance to survivors.
• Spain: The Dexeus Mujer Foundation in Barcelona performs free genital reconstruction surgery, and a National Health Protocol provides guidance for professionals.

Barriers to Effective Implementation

Despite these initiatives, significant gaps remain. A study by BMC Public Health found that only 3% of women estimated to have undergone FGM have a corresponding medical file, indicating a severe lack of identification and support within healthcare systems. Furthermore, the implementation of national protocols, as seen in Spain, varies regionally, highlighting a need for stronger, more consistent institutional responses to fully realize the ambitions of SDGs 3, 5, and 16.

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being: The article extensively discusses the severe physical and psychological health consequences of Female Genital Mutilation (FGM). It details Ayan’s experience of frequent urinary tract infections and the need for surgery. Furthermore, it highlights the importance of comprehensive healthcare, including reconstructive surgery, psychological support, and sexual medicine, as provided by the André-Grégoire Hospital. The discussion on the need for treatments to be covered by national health systems directly relates to ensuring healthy lives and promoting well-being.
• SDG 5: Gender Equality: FGM is presented as a fundamental issue of gender inequality and a violation of human rights. The article explicitly frames FGM as “a specific phenomenon in the fight against violence against women” and part of a “continuum of sexual violence against women,” which also includes forced marriages and domestic violence, as experienced by Ayan. The core theme is the elimination of harmful practices and violence targeted at women and girls.
• SDG 10: Reduced Inequalities: The article touches upon the vulnerabilities of specific populations, such as refugees and migrants. Ayan is a Somali refugee in Ireland who is a survivor of FGM. The work of support groups in Dublin for migrant women and the challenges faced by these women in accessing consistent healthcare across different European regions (as noted in Spain) point to inequalities in services and outcomes based on origin and status.
• SDG 16: Peace, Justice and Strong Institutions: The practice of FGM is a form of violence and abuse, particularly against children, as Ayan was only eight years old when she was subjected to it. The article discusses the need for national protocols and frameworks, like the one in Spain, to ensure professionals can identify and respond to FGM. This reflects the goal of ending abuse and violence against children and promoting just and inclusive societies through effective institutions and policies.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. SDG 3: Good Health and Well-being

   • Target 3.7: Ensure universal access to sexual and reproductive health-care services. The article highlights the specialized care provided at the André-Grégoire Hospital, which includes “sexual medicine, psychology, discussion groups, and social assistance” for FGM survivors. This comprehensive approach is a direct example of providing specialized sexual and reproductive healthcare.
   • Target 3.8: Achieve universal health coverage, including financial risk protection and access to quality essential health-care services. The article mentions the goal that “all treatments to be covered by the national health system” and that the entire process at the Montreuil unit is “free of charge for those who access the service.” This directly addresses the aim of universal health coverage and removing financial barriers to essential care.

2. SDG 5: Gender Equality

   • Target 5.2: Eliminate all forms of violence against all women and girls. The article explicitly defines FGM as the “starting point” in a “continuum of sexual violence against women,” which also includes “forced marriages, domestic violence of any kind (physical, sexual, psychological).” Ayan’s story of being forced to marry and suffering abuse after FGM exemplifies this target.
   • Target 5.3: Eliminate all harmful practices, such as child, early and forced marriage and female genital mutilation. This is the most central target addressed. The entire article is focused on the practice of FGM, its consequences, and efforts to support survivors. Ayan’s experience of undergoing FGM as a child and being forced into marriage directly relates to both components of this target.

3. SDG 16: Peace, Justice and Strong Institutions

   • Target 16.2: End abuse, exploitation, trafficking and all forms of violence against and torture of children. The article describes Ayan’s ordeal at the age of eight, a clear case of violence and abuse against a child. The mention that FGM is “usually performed on girls between the ages of five and eight” reinforces the relevance of this target, which aims to protect children from such violent practices.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. For SDG Target 5.3 (Eliminate FGM)

   • Indicator (related to 5.3.2: Proportion of girls and women who have undergone FGM): The article provides specific statistics that serve as direct measures of the prevalence of FGM, which is the basis for this indicator. These include:
     • The global estimate from UNICEF of “approximately 230 million girls and women worldwide who have undergone genital mutilation.”
     • The European estimate from EIGE that “around 600,000 women and girls live with the consequences of genital mutilation.”
     • National and regional data for France, where “139,000 women have undergone FGM” and “7.2% of women living in this department [Seine-Saint-Denis] have undergone FGM.”

     These figures can be used to track the prevalence of FGM among different populations over time.

2. For SDG Target 3.8 (Achieve universal health coverage)

   • Indicator (related to 3.8.1: Coverage of essential health services): The article implies a way to measure the gap in healthcare coverage for FGM survivors. The study by BMC Public Health, which found that “only 3% of women estimated to have undergone female genital mutilation have a medical file” in Vienna, serves as a powerful proxy indicator for the lack of access to and coverage of essential health services for this specific population. A low percentage suggests a significant failure in providing universal health coverage to these women.

4. Summary Table of SDGs, Targets, and Indicators

Source: voxeurop.eu