Rising Rates of Female Genital Mutilation in the Netherlands Raise Concerns

The number of women in the Netherlands who have undergone female genital mutilation (FGM) has increased in recent years, rising from 40,994 in 2018 to 43,428 in 2023, according to new figures from Pharos, the Dutch Centre of Expertise on Health Disparities. Pharos presented these findings during a symposium on FGM, with a detailed study commissioned by the Ministry of Health expected to be published in April.

Beyond those already affected, an estimated 29,000 girls in the Netherlands could be at risk of FGM in the next two decades, particularly those originating from countries where the practice is prevalent. Researchers estimate that around 2,600 girls face a “real risk” in the coming years, often due to FGM being practiced within their families.

FGM, defined as the partial or complete removal or damage of the external genitalia without medical justification, is rooted in beliefs about femininity and sexuality, with the practice often seen as a prerequisite for cleanliness, chastity and marriageability.

The Netherlands has prohibited and criminalized FGM for over thirty years, with a maximum prison sentence of sixteen years for perpetrators. It is also illegal to perform FGM abroad on Dutch residents.

‘Tip of the Iceberg’

The increase in FGM cases is linked to migration patterns, with a growing number of women in the Netherlands originating from countries where FGM is common. Approximately two-thirds of women in the Netherlands who have experienced FGM come from Somalia, Ethiopia, or Eritrea. Girls from Egypt, Iraq, and Ghana are also identified as being at risk. Pharos contributes to reducing these health disparities by stimulating and supporting an integrated approach.

This includes women who were subjected to FGM before arriving in the Netherlands and girls born in the country who remain vulnerable, particularly during visits to their countries of origin.

While there are indications of FGM being performed in other European countries like France, Italy, Switzerland, and the United Kingdom, concrete evidence is lacking in the Netherlands. However, gynecologist Wendela Kolkman, who treats circumcised women weekly at the Haga Hospital, believes it is “naive” to assume the practice doesn’t occur within the Netherlands, stating, “It’s the tip of the iceberg.”

Kolkman notes that discussing FGM remains challenging within migrant communities and among healthcare professionals, often due to shyness, fear of crossing cultural boundaries, or concerns about damaging patient trust. This reluctance can lead to missed signals and a lack of discussion about FGM.

healthcare providers may lack sufficient knowledge to recognize the connection between recurring health issues, such as bladder infections, and underlying FGM-related complications.

Focus on Prevention

The rise in the number of women with FGM doesn’t necessarily indicate increased awareness of the issue. Many women, particularly recent arrivals or those with limited language skills, struggle to navigate the Dutch healthcare system. Women in asylum seeker centers often prioritize basic survival needs, making them less receptive to information about FGM.

Senait Tekie, a ‘key figure’ for the GGD in The Hague, highlights that girls, particularly those from Somalia, are often at risk during holidays when they are sent to stay with family in their country of origin. Pharos indicates that most girls are circumcised between the ages of four and twelve, though this varies by country.

FGM can lead to severe physical and psychological consequences, including complications during childbirth. Kolkman emphasizes that women are often unaware that their health problems are linked to FGM, and surgical interventions can prevent complications or alleviate symptoms.

The Dutch approach prioritizes prevention and care, with a focus on engaging key individuals from communities like Somalia and Ethiopia to educate parents and girls about the dangers of FGM.

Protective Measures in the United Kingdom

Research from the Scientific Research and Data Center (WODC) revealed that potential victims are not adequately protected and are often identified too late, or not at all. The WODC recommended additional legislation and protective measures.

In the United Kingdom, authorities can issue court orders to prevent potential victims from traveling if there are concerns they may be subjected to FGM during a holiday abroad. This measure is rarely used in the Netherlands, and there have been no criminal cases related to FGM since the practice was outlawed.

Kolkman believes that the figures from Pharos underscore the necessitate for continued attention, not only within healthcare but also in education. She stresses that providing care to circumcised women is important, but true prevention begins with raising awareness, both in the Netherlands and in countries where FGM is common.