FGM/C: Gendered Silence, Policy Gaps and Hidden Harm

By Ala Nazir, DEJ lead 2025-26

In global health spaces, we are taught ‘Think Global, Act Local.’ It sounds right. It reminds us that meaningful impact begins at home. When I first learned how prevalent female genital mutilation or cutting (FGM/C) is in other countries, my instinct was to check my own region. My local.

What I found unsettled me. Not only because it was present, but because it was present in a way that was almost designed to evade attention. Hidden in plain sight. Written in euphemisms. Sustained by silence. Sometimes even documented as a human rights violation, yet left in a legal grey zone where it can't be named properly, charged properly, or treated as what it is. 

It made me question what else can be hidden in plain sight, not because it is invisible, but because systems are structured not to see. Think global, act local…but what happens when the local was never taught to look?

I did not learn about FGM/C in medical school. Not in a way that prepared me clinically or helped me grasp the weight that it carries beyond its definition. I learnt about it later, through external workshops and international health forums.

What stayed with me wasn’t just the content, but the realisation that something this significant can remain outside formal training, depending on where you study, what your system prioritises, and what it quietly chooses not to name. 

FGM/C is often discussed as though it ends at the act. But it doesn't. In many contexts, FGM/C is performed during childhood or adolescence at an age when a girl is still learning what consent means, still developing her sense of safety, still forming her relationship with her body. It intersects directly with adolescent sexual and reproductive health, where vulnerability is highest, and bodily autonomy should be non-negotiable. 

What complicated the picture further was learning how easily FGM can shift shape when policy is silent. The practice does not disappear; it adapts. It moves into clinics, gets wrapped in medical language, and is sold as safety. Families may say, “a doctor did it”, and communities may even encourage it as the safer option. But in many settings, doctor becomes shorthand for anyone who looks clinical. Medicalisation is not harm reduction, but a disguise. It makes FGM/C easier to repeat and harder to challenge, because it now wears the appearance of legitimacy. 

In many global conversations, I have noticed how quickly FGM/C becomes a performance of condemnation. The language gets loud, the lines get clear, and everyone knows what they are expected to say. But the centre of the conversation can quietly shift away from the survivors and toward the comfort of being seen as against it. Communities become headlines. Survivors become symbols. 

FGM/C is a human rights violation. But outrage alone doesn't build safety. When global attention speaks louder than local trust, it can have unintended consequences. Communities get defensive, the practice moves underground, and what can look like progress may simply be a drop in visibility, not a reduction in FGM/C itself. 

As I type this, I am also struck by how the issue is framed even in global health data systems. When I opened UNICEF's FGM/C dataset, the first indicators presented weren't prevalence or incidence. Instead, it begins with what percentage of men and women think FGM/C should be eliminated. Only later does it turn to the number of women and girls subjected to the practice. 

This order of framing is telling. It exposes how gendered violence can still be treated as negotiable, rather than immediate. Since when did the urgency of protection become conditional on agreement?

And if that wasn't stark enough, FGM/C is not hidden in the global development agenda. It sits clearly under SDG 5 (target 5.3), with a commitment to eliminate FGM/C by 2030. Yet progress remains far too slow. 

According to the UNFPA-UNICEF Joint Programme estimates, meeting that target would require the global rate of decline to accelerate dramatically, by roughly 27-fold. The question, then, is whether we are committed to ending FGM/C, or merely becoming more efficient at documenting it while it continues.

Ending FGM/C requires collective accountability, and men and boys have a critical role in challenging the norms that allow it to persist. But when elimination is framed first as what people ‘think’, it subtly turns protection for women and girls into something that must be socially approved before it can be enforced.

Allyship matters, yes. But protection should never require permission.