Female genital mutilation (FGM), also known as female genital cutting, refers to all procedures involving the partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons. This harmful practice affects over 200 million girls and women worldwide, primarily in parts of Africa, the Middle East, and Asia, and is recognized as a violation of human rights, including the rights to health, security, and physical integrity. Despite international efforts and legal bans in numerous countries, FGM persists, with millions more girls at risk each year. While criminalization has raised awareness and provided a framework for accountability, it has proven insufficient on its own to eradicate the practice. This article explores why legal prohibitions fall short without complementary strategies focused on community ownership, economic alternatives, and cultural reframing, drawing on evidence from affected regions and enriched with personal stories of survivors and advocates.

The Limitations of Criminalization: Driving the Practice Underground

Many countries have enacted laws criminalizing FGM, often with severe penalties such as fines or imprisonment. For instance, Gambia passed a ban in 2015, Egypt has enforced existing laws through mobilization of doctors and judges, and Ethiopia outlawed the practice years ago. However, these top-down approaches frequently fail to address the deep-rooted cultural and social norms that sustain FGM, leading to limited impact.

One major issue is that bans often drive the practice underground rather than eliminating it. In Kenya, the Prohibition of Female Genital Mutilation Act of 2011 has shifted FGM from public traditional ceremonies to secretive settings like private homes or clinics, where parents collude with healthcare providers to perform cuts on girls as young as five during school holidays. This “medicalization” of FGM where medical professionals conduct the procedure for a fee gives it a false sense of legitimacy and safety, perpetuating harm while evading detection. Enforcement challenges exacerbate this, as communities prioritize cultural values like marriageability and social status over legal compliance, creating a “cat-and-mouse” dynamic with authorities.

Sadia Hussein, a survivor from eastern Kenya, exemplifies the personal toll of these hidden practices. Cut at age 10 in the most extreme form (infibulation), she endured excruciating pain without anesthesia, performed by her grandmother in the bush. Years later, during childbirth, she labored for three days due to complications from the scarring, nearly dying as her mother resisted hospital intervention. This trauma fueled her resolve to protect her daughters, but it highlights how laws alone fail to prevent underground cuttings and their lifelong consequences.

In East Africa, particularly Ethiopia, criminalization has similarly resulted in clandestine operations, often at night, increasing health risks due to poor conditions or inexperienced practitioners. A study in rural Oromia revealed families continuing FGM despite awareness of the law, driven by fears of social stigma against uncircumcised girls, such as insults or barriers to marriage. Uzodimma Lucy Ogodo from Nigeria’s Ebonyi State was cut at age five, too young to remember the pain, but later learned of its psychological and health impacts, including diminished spirit and well-being. Her story underscores how early, hidden cuttings persist in communities where ignorance and tradition override bans. In Senegal, despite a 1999 ban, local customs and dispute resolution mechanisms override national laws, as noted in a 2014 study by Dr. Bettina Shell-Duncan, which concluded that prosecutions are ineffective without grassroots engagement. Dr. Gerry Mackie emphasizes that relying on criminalization creates an “illusion of progress,” diverting resources from non-legal methods that appeal to moral and social motivations. Overall, these examples illustrate how laws, without addressing underlying beliefs, merely suppress visibility rather than end the practice.

Empowering Communities: The Need for Ownership in Change

Sustainable eradication of FGM requires communities to take ownership, leading the shift away from the practice through collective decision-making and local initiatives. Legal bans alone cannot overcome the customary significance of FGM, which often marks rites of passage or social acceptance. Instead, community-led programs foster dialogue and build consensus, ensuring changes are voluntary and enduring.

In Kenya and Tanzania, Amref Health Africa’s Alternative Rites of Passage program exemplifies this approach. It preserves cultural celebrations of girlhood-to-womanhood transitions but eliminates FGM and early marriage, incorporating training on community values, sexual health, life skills, and FGM’s dangers. Over the past decade, more than 16,000 girls in Maasai and Samburu communities have participated, with elders and leaders endorsing the change to maintain ownership. A personal story from Nice Leng’ete, a Maasai woman who escaped FGM at age eight and convinced her grandfather to let her continue schooling, highlights the power of individual advocacy within community structures.

Purity Soinato Oiyie, another Maasai survivor from Kenya, fled at age 10 to avoid FGM and becoming the fifth wife of a 70-year-old man. Rescued by police with her teacher’s help, she lived in a center for eight years, facing family abuse and rejection. Now an advocate, she raises awareness through village talks and videos, pushing for free education for girls to break the cycle. Similarly, Catherine Meng’anyi, a Kenyan nurse cut at age 12 by a healthcare provider, has rescued over 200 girls and reached 25,000 people through advocacy, collaborating with authorities to enforce laws while building support networks for survivors.

UNICEF’s strategy further supports community mobilization, involving child protection committees that identify at-risk girls and facilitate intergenerational discussions to shift norms. In West Africa, Tostan’s Community Empowerment Program has prompted over 7,600 communities across eight countries to publicly declare abandonment of FGM, affecting three million people through human rights education and stakeholder engagement, including religious leaders and former cutters. Jaha Dukureh from Gambia, who underwent Type 3 FGM and child marriage, founded an NGO after her traumatic experiences and helped secure Gambia’s ban, working with leaders to delink FGM from religion using dialogue and evidence. These efforts demonstrate that when communities drive the process, change is more likely to stick, as opposed to externally imposed penalties.

Addressing Economic Drivers: Alternatives for Practitioners and Families

Economic factors play a significant role in perpetuating FGM, particularly for traditional practitioners who rely on it for income and for families viewing it as a pathway to marriage and financial security. Without viable alternatives, bans simply displace the practice without resolving root causes. Research shows that economic shocks, like droughts in Sub-Saharan Africa, influence decisions, with families delaying or abstaining from FGM during hardships, underscoring the link between poverty and the practice.

In Liberia, programs under the EU-UN Spotlight Initiative have successfully transitioned former FGM practitioners to alternative livelihoods. Traditional cutters, often part of Sande societies, receive training in climate-smart agriculture, business management, literacy, and village savings and loan associations. For example, 54-year-old Kema Dahn from Nimba County, who once performed FGM for financial gain, now focuses on farming and small businesses, calculating profits from sales like bags of salt. Similar initiatives provide goats or other assets to cutters as incentives to abandon the role. Irene from Uganda, cut at 18 under pressure for marriage “purity,” endured severe pain during childbirths. Now leading The Tumboboi Grandmother’s Group, she shares stories to educate and nearly eliminate FGM locally, collaborating with faith leaders and building schools for awareness. UNICEF integrates economic support through gender-responsive social protection, such as cash transfers, to reduce reliance on FGM-linked marriages, linking it to broader efforts in education and livelihoods to break poverty cycles. These alternatives not only empower individuals economically but also reduce the incentive to continue harmful traditions.

Cultural Reframing: Shifting Norms Through Education and Dialogue

Cultural reframing is essential to dismantle the myths and social norms that justify FGM, such as beliefs in purity, marriageability, or religious requirements. Without reframing, legal measures face resistance from communities that see the practice as integral to identity. Effective strategies involve non-judgmental dialogues to uncover motivations and promote new norms.

Plan International’s social-norms-change approach outlines a phased process: scoping to understand local contexts, designing tailored programs, implementing with key influencers, and evaluating impact. This includes increasing knowledge about FGM’s harms, changing attitudes through community discussions, and shifting practices collectively. A 14-year-old girl in the UK, cut at age six in a tent with ropes and a razor, faced painful recovery and ongoing issues with periods. She rejects community pressures, asserting that true partners accept women naturally, highlighting the need to challenge marital myths.

UNICEF’s Saleema campaign in Sudan reframes intact girls as “whole and healthy,” using media, symbols, and ambassadors to challenge taboos and celebrate non-mutilation. Fatoumata Diallo from Senegal, cut at 10 and enduring a second cutting for marriage at 13, campaigns via alert committees and radio, intervening in cases and educating on laws and harms to shift cultural views. Nimco Ali, a British-Somali survivor cut at seven in Djibouti, co-founded Daughters of Eve after facing dismissal and threats, emphasizing FGM’s roots in control rather than culture, and advocating for survivor-led human-focused change. In Europe and beyond, efforts focus on transforming norms among diaspora communities through education and engagement of all genders to address unequal power dynamics and control over female sexuality. By reframing FGM as a health and rights issue rather than a cultural imperative, these initiatives foster lasting behavioral change.

Conclusion: Toward a Holistic Approach

Criminalizing FGM is a crucial step, but its limited success underscores the need for an integrated strategy that combines legal frameworks with community ownership, economic alternatives, and cultural reframing. Programs like those from Amref, UNICEF, and the Spotlight Initiative show that when communities lead, supported by education and livelihoods, real progress is possible. Stories like those of Sadia Hussein, who turned her childbirth ordeal into a campaign saving girls, and Irene, who mobilizes grandmothers against the practice, illustrate the transformative power of personal narratives in driving change. As the UN Sustainable Development Goals aim to eliminate FGM by 2030, investing in these multifaceted efforts is essential to protect girls and women, ensuring change comes from within rather than imposed from above.