Female Genital Mutilation/Cutting (FGM/C) in the United States. A study of the prevalence, distribution, and impact of FGM/C in the U.S., 2015-2019

This report reveals that previous FGM/C studies in the United States overestimated the affected population due to not accounting for the impact of migration. The previous estimate suggested over half a million impacted women and girls, while our calculation indicates 421,000 affected individuals in 2019. Most of these were already living with FGM/C, with 31,000 children at risk. Our study employs the extrapolation method, using prevalence rates from 26 countries of origin, population data from the 2015-2019 American Community Survey, and the impact of migration and acculturation on prevalence. When migration is considered, the estimated number of potentially impacted individuals increases to 577,000, primarily due to migration into the U.S. Predominant communities identified were Egyptian, Somali, Ethiopian, Nigerian, Indonesian, Sudanese, and Malay. With the reduction in prevalence due to migration and acculturation, we estimated that 385,000 women and girls were living with FGM/C in 2019, with 31,000 girls at risk. Additionally, 5,500 women and girls from the Dawoodi Bohra community were likely impacted, bringing the total to 421,000. In 2019, half of the at-risk girls lived in six states: Minnesota, California, New York, Texas, Washington, and Virginia, with ancestral ties to the wider Horn of Africa. We also estimated 68,000 women living with Type 3 FGM/C, with half residing in Minnesota, Ohio, California, Texas, and Washington. The impacted community was found to be poorer and more urban than the American average. This report includes state-by-state analyses for use in advocacy and education efforts. Furthermore, the report offers recommendations based on the 7P framework, centering on prevalence and framing responses (provision, prevention, protection, and prosecution) within policy and partnership. 1. **Prevalence**: Update estimates when new population data becomes available, and analyze the full census dataset for more accurate results. 2. **Partnership**: Establish and strengthen partnerships between affected communities, civil society organizations, service providers, and governments at various levels. 3. **Policy**: Shape policy using the 7P framework, emphasizing partnerships to enhance services for survivors and community-led prevention efforts. 4. **Provision**: Equip healthcare professionals to treat FGM/C survivors, including training in communication and cultural sensitivity. 5. **Prevention**: Initiate prevention strategies working with families before children are born and continuing through elementary school. 6. **Protection**: Consider the age of risk when designing protection mechanisms to balance the safeguarding of at-risk girls without discriminating against those who are not at risk. 7. **Prosecution**: Hone laws to comprehensively combat FGM/C in the United States, supporting survivors and professionals who may encounter FGM/C cases. A comprehensive approach that integrates prevalence, partnership, policy, provision, prevention, protection, and prosecution is essential to support the communities affected by this practice in the United States.