The Weaponization of FGM Terminology in US Political Debate

The World Health Organization defines female genital mutilation (FGM) as “a traditional harmful practice that involves the partial or total removal of external female genitalia or other injury to female genital organs for non-medical reasons.”¹ This practice, affecting over 230 million women and girls globally, is recognized as a violation of human rights with no health benefits.² Although illegal at the federal level in the US since 1996, and banned in forty-one states, a concerning trend has emerged: the misuse of the term “genital mutilation” to target transgender individuals and restrict access to gender-affirming care.

The Blurring of Lines: FGM and Gender-Affirming Care

Despite the existence of the Stop FGM Act, designed to protect victims, several studies estimate around half a million women and girls in the US are either survivors or at risk of FGM-C.¹ Recently, Republican lawmakers have begun employing the term “genital mutilation” to describe gender-affirming healthcare, particularly for minors, as part of a broader strategy to mobilize opposition to transgender rights.

In 2022, Texas lawmakers introduced a bill that removed the definition and the word “female” from the state’s definition of “female genital mutilation,” with the intent of criminalizing certain gender-affirming care procedures. ³ Although that specific bill failed to pass, a similar measure was enacted in Idaho the following year and is currently facing legal challenges.

The Reality of Gender-Affirming Care for Minors

It’s crucial to understand the scope of gender-affirming care received by minors in the US. The vast majority of support for transgender youth is social affirmation – changes in clothing, hairstyles, names, and pronouns. Access to bathrooms aligned with gender identity is also a key component.

Gender-affirming hormone therapy and surgical procedures are far less common. Researchers analyzing data from 2016 to 2020 found fewer than 3,680 under-18s received any form of gender-affirming surgery.³ Over 3,200 of these surgeries were breast or chest surgeries, and the majority of recipients were likely cisgender males undergoing reduction procedures. A Harvard study of 70 million insurance claims from 2019 revealed that 97% of chest surgeries performed on minors were reductions for cisgender youth.³

Similarly, puberty blockers and hormones are rarely prescribed to US trans adolescents, according to research from Harvard T.H. Chan School of Public Health, Harvard Pilgrim Health Care Institute, and FOLX Health.³

Political Motivations and the Trump Administration

Transphobia has develop into a central tenet of the legislative agenda under the Trump presidency. An executive order issued shortly after his inauguration in January 2025 branded gender-affirming care as “mutilation” and directed the Department of Health to remove a 2022 definition recognizing such care as “crucial to overall health and well-being.”³ Although a court order temporarily reinstated the original definition and guidance, the shift signaled a broader political strategy.

Within three months, the attorney general instructed the Department of Justice to prosecute healthcare providers offering gender-affirming care under the federal Stop FGM Act. Representative Marjorie Taylor-Greene’s proposed legislation seeks to codify this instruction, mandating prosecution under the conflation of FGM and gender-affirming care.

The Impact on FGM/C Advocacy

Advocates for ending FGM/C express concern that this conflation undermines their efforts. “Survivors fought really hard in this country for many years to get that law,” said Kaitlin Mitchell, policy and advocacy coordinator of the US Finish FGM/C Network, opposing Taylor-Greene’s bill.³ “So when we use the word ‘mutilation’ to mean gender-affirming care and female genital mutilation, or to refer to both, we’re taking away from the specific practice of FGM.”