A survivor once told me she remembered being cut.
She remembered the pain. The blood. The humiliation. She told me her mother paid for it. She was seven years old.
Now, as a woman, she lives with the consequences. She told me she urinates one drop at a time. She has constant infections. She has needed repeated antibiotics. She has known sexual pain, not sexual pleasure. Her anger was not abstract. It was precise. It was directed at the adults who allowed it, the systems that missed it, and the society that now asks survivors to keep explaining why this matters.
She said she felt we had all failed her.
What answer do we give to that?
FGM is not culture. It is not religion. It is not honour. It is not a private family matter. It is violence against a girl’s body. It is child abuse. It is a human-rights violation.
For years, I have campaigned to stop female genital mutilation through Freedom Charity’s work on FGM, school education, safeguarding training, the Red Triangle Badge Against FGM, the Not in My Name message for boys and young men, and my novel Cut Flowers.
I did not write Cut Flowers to describe FGM from a distance. I wrote it through the lives of two girls so children, teachers, parents and boys could understand the danger before another child was harmed.
The story follows Katie and Sophia, two girls whose summer holidays run side by side. One remains in the UK, doing what children do: laughing, arguing, dreaming, being ordinary. The other is taken to Africa on what should have been a family trip, only to discover that adults she loves and trusts have planned something that will change her body and her life.
That is why fiction can be powerful. Policy speaks to systems. Stories reach children.
FGM cannot be prevented if children do not understand danger, if friends do not know when to speak, if teachers miss warning signs, or if boys grow up believing this is not their issue.
That is why Cut Flowers was created with PSHE lesson plans. It was not only a novel. It was a safeguarding tool for classrooms, teachers and professionals. It gave schools a way to talk about FGM before another girl was taken, cut and silenced.
The Not in My Name campaign carried the same message to boys and young men: do not demand it, do not excuse it, do not stay silent. FGM is not love. It is not purity. It is not marriageability. It is not family honour.
The Red Triangle badge, with its heart of gold, gave people a visible way to stand together. It said: we see you, we believe you, and we will not look away.
That work was prevention.
But prevention is not the whole duty.
A country that says FGM is a grave violation of human rights must also care properly for the women already living with its consequences.
That is where the UK still has work to do.
The NHS records thousands of women and girls each year attending services where FGM is identified. These are not just figures. They are women in GP surgeries, maternity units, sexual-health clinics, mental-health services and hospital rooms trying to describe pain, fear, infection, trauma, sexual difficulty or childbirth anxiety to professionals who may or may not know what to do.
Some survivors know exactly what happened to them. Others do not. Some were cut as babies. Some remember every second. Some carry shame that was never theirs to carry. Some have never told anyone. Some have told people and were still not helped.
That should trouble every policymaker in Britain.
The evidence supports this concern. NHS Digital continues to record thousands of FGM-related attendances in England each year. NHS specialist FGM clinics exist, but Parliament’s Women and Equalities Committee has raised concerns about inconsistent access, unclear referral routes, limited counselling provision and the need for proper research into reconstructive surgery.
That is why this is not only a personal or charitable concern. It is a national policy failure that needs a national response.
The UK does have specialist NHS FGM support clinics. That should be recognised. Many clinicians, midwives, counsellors and health advocates are doing serious, compassionate work.
But specialist care still depends too much on geography, local knowledge, referral routes and whether the survivor meets the right professional at the right moment.
That is not a pathway.
That is luck.
FGM survivors should not need luck to receive proper care.
A national NHS pathway should be clear enough for every GP, midwife, sexual-health nurse, mental-health practitioner, safeguarding lead, social worker and teacher to understand. It should set out where to refer a survivor, what support exists, what language to use, what safeguarding duties apply and how to ensure that she receives care without shame.
That pathway must include specialist counselling. Not generic sympathy. Not a leaflet. Not a rushed conversation at the end of an appointment. Survivors need counselling that understands trauma, family betrayal, sexual harm, fear, cultural pressure, silence and anger.
It must include trained interpreters. A woman should never have to rely on a relative, community member or unsafe interpreter to discuss the most private injury of her life.
It must include proper clinical assessment, sexual-health support, maternity care, pain support and deinfibulation where clinically appropriate.
It must also include honest information about reconstructive surgery.
This is where the debate becomes difficult, and it must be handled responsibly.
Reconstructive surgery is not magic. It cannot erase what happened. It will not be right for every survivor. No woman should be pressured into surgery. No one should make false promises about outcome, sensation, pain or trauma.
But caution must not become neglect.
Some survivors want to know whether reconstructive surgery could help them. Some want to understand their own anatomy. Some want assessment because they live with pain, sexual dysfunction, body distress or the feeling that something was stolen from them. Others do not want surgery at all.
Both choices deserve respect.
The point is not to push surgery. The point is to give women evidence, safety, information and choice.
FGM took choice away. Survivor care must give it back.
Government cannot keep pointing to an evidence gap while failing to close it. If the evidence is not strong enough, fund the research. If pathways are unclear, build them. If professionals are not trained, train them. If survivors do not know where to go, publish the routes clearly. If services are patchy, make them national in standard and local in access.
An evidence gap should lead to research, not silence.
This is not a demand for reckless medicine. It is a demand for serious policy.
Freedom Charity has already set out why many UK survivors are asking questions about FGM reconstruction surgery in the UK. That technical debate matters, but this article makes the wider human-rights point: women should not be left to navigate pain, infection, trauma, sexual difficulty and uncertainty without a clear NHS pathway.
We cannot claim to lead the world on ending violence against women and girls while leaving FGM survivors to navigate pain, infection, sexual trauma and shame through a system that too often depends on postcode and chance.
Survivors need more than awareness days. They need more than statements of concern. They need trained professionals who do not flinch, judge or dismiss. They need specialist care that recognises the whole woman, not only the injury. They need NHS services that understand that the trauma of FGM does not end when the cutting stops.
The survivor who spoke to me was seven years old when adults failed her.
Seven-year-old children do not consent. Seven-year-old children do not protect themselves from organised abuse. Seven-year-old children cannot challenge mothers, relatives, cutters, communities, secrecy or fear.
That is our job.
It is the job of government. It is the job of schools. It is the job of health services. It is the job of safeguarding professionals. It is the job of every adult who claims to believe in the rights of girls.
And when prevention fails, care must not fail too.
I want the UK to be braver.
I want a clear national NHS pathway for FGM survivors.
I want mandatory practical training for professionals who are likely to meet survivors.
I want specialist counselling to be treated as essential, not optional.
I want trained interpreters who understand trauma, privacy and safeguarding.
I want proper research into reconstructive surgery, so women can make informed choices based on evidence rather than uncertainty.
I want clear public information so survivors know where to go.
I want every survivor to be believed the first time.
Above all, I want us to stop speaking about FGM as though the crime ends on the day a girl is cut.
For many survivors, that day is only the beginning.
FGM is illegal. FGM is abuse. FGM is a violation of human rights. But if we stop there, we leave women alone with the consequences.
My position is simple.
No girl should be cut.
No woman should be left alone with the pain.
No survivor should have to beg for care.
FGM took her choice away. The least we can do now is give choice back.
ix FAQ / AEO Section
FGM survivors need a clear NHS pathway, specialist counselling, trained professionals, appropriate interpreters, clinical assessment, sexual-health and maternity support, and honest information about treatment options.
Yes. NHS National FGM Support Clinics exist in England and provide support for women with FGM. However, access and referral routes can still be unclear, which is why a national pathway is needed.
Yes. FGM is child abuse, a form of violence against women and girls, and a human-rights violation. Professionals must understand both the safeguarding duties and the long-term impact on survivors.
FGM can cause long-term physical, emotional, sexual, psychological and maternity-related harm. Prevention is vital, but survivors also need care, dignity, specialist support and choice.
Cut Flowers is Aneeta Prem’s novel about FGM, told through the lives of two girls, Katie and Sophia. It was created as a story-led safeguarding resource to help young people, schools and professionals understand FGM and prevent harm.
The Red Triangle Badge is Freedom Charity’s symbol against FGM. It is worn to show solidarity with girls at risk and survivors, and to support prevention through education and the Not in My Name message.
Freedom Charity: Female Genital Mutilation
https://freedomcharity.org.uk/female-genital-mutilation/
Freedom Charity: Cut Flowers
https://freedomcharity.org.uk/cut-flowers/
Freedom Charity: Red Triangle Badge Against FGM
https://freedomcharity.org.uk/red-triangle-badge-against-fgm/
Freedom Charity: FGM reconstruction surgery UK
https://freedomcharity.org.uk/fgm-reconstruction-surgery-uk/
NHS Digital: Female Genital Mutilation Annual Report, April 2024 to March 2025
https://digital.nhs.uk/data-and-information/publications/statistical/female-genital-mutilation/april-2024-to-march-2025
This is the strongest statistics source: NHS Digital records 6,980 individual women and girls and 16,300 attendances where FGM was identified in 2024–25.
NHS: National FGM Support Clinics
https://www.nhs.uk/conditions/female-genital-mutilation-fgm/national-fgm-support-clinics/
Use this for survivor support. NHS says the clinics provide physical assessment, deinfibulation if required, emotional support, counselling, FGM Health Advocates and specialist referral.
Women and Equalities Committee: Female Genital Mutilation report
https://publications.parliament.uk/pa/cm5901/cmselect/cmwomeq/714/report.html
Use this for the policy criticism, especially inconsistent access, referral pathways, counselling and reconstructive surgery research.
RCOG: Female Genital Mutilation and its Management, Green-top Guideline No. 53
https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/female-genital-mutilation-and-its-management-green-top-guideline-no-53/
Aneeta Prem London 29 June 2026
FGM prevention matters, but survivor care must not be the unfinished part of UK policy. Aneeta Prem calls for a clear NHS pathway, specialist counselling, trained professionals and research into reconstructive surgery.
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