Female Genital Mutilation/Cutting:

Existing Federal Efforts to Increase Awareness Should Be Improved

GAO-16-645: Published: Jun 30, 2016. Publicly Released: Aug 1, 2016.

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What GAO Found

The Centers for Disease Control and Prevention (CDC) estimated that 513,000 women and girls in the United States were at risk of or had been subjected to female genital mutilation/cutting (FGM/C) in 2012, a threefold increase from its 1990 estimate. CDC attributes this change primarily to increased immigration from countries where FGM/C is practiced, rather than an increase in the occurrence of FGM/C. Agency estimates were not able to distinguish between those who have already been subjected to FGM/C and those who are at risk.

CDC Estimates of the Number of Women and Girls in the United States at Risk of or Who Have Been Subjected to Female Genital Mutilation/Cutting, 1990 and 2012

HL_5 - 100129

Women and girls at risk of or who have been subjected to FGM/C in their home country may seek federal protection in the United States through different avenues of the immigration process, and GAO found that there have been few U.S. investigations and prosecutions. According to Department of Homeland Security officials, protection is most commonly provided through the asylum process, where individuals must demonstrate that they have been persecuted or fear persecution in their home country on account of protected grounds such as religion or nationality. While FGM/C is a crime under federal and many state laws, law enforcement officials identified few investigations and prosecutions related to FGM/C. Officials said that this may be due, in part, to underreporting.

Federal agencies and others provide education and assistance regarding FGM/C, but gaps exist and agencies lack documented plans for future efforts. The Department of State (State) directly provides information on FGM/C in a fact sheet only to certain types of visa recipients who apply in countries where FGM/C is practiced. State does not provide the fact sheet to nonimmigrant visa recipients as these visas are for temporary stays; however, some of these visas permit stays in the United States for multiple years. In addition, State does not directly provide the fact sheet to visa recipients who are nationals of countries where FGM/C is common, but apply at posts in other countries. Visa recipients who do not directly receive the fact sheet may be unaware of the health and U.S. legal consequences of FGM/C. Federal agencies have made efforts to increase awareness of FGM/C among stakeholder groups, including hosting roundtables and developing educational materials. However, the agencies lack documented plans for future efforts. Internal controls state that agencies should establish plans and document activities. Absent this, the federal government may be unable to ensure that its activities meet the needs of and that it communicates effectively with external parties, such as key stakeholder groups.

Why GAO Did This Study

FGM/C comprises all procedures that involve partial or total removal of the external female genitalia, or other harm to the female genitals for non-medical reasons. The rationale for FGM/C often includes cultural, religious, and social factors in families and communities. In the United States, women and girls believed to be most at risk of FGM/C are those from immigrant families from countries where FGM/C is practiced.

GAO was asked to review the federal response to address FGM/C in the United States. In this report, GAO examines (1) what is known about the number of women and girls at risk of or subjected to FGM/C, (2) the protections available and actions taken to protect women and girls, and (3) the extent to which actions are taken to educate and assist immigrant communities and key stakeholders. GAO analyzed documents and spoke to officials from five relevant federal agencies; spoke with officials from local law enforcement, health care, education, and social services sectors; and assessed agency actions against federal internal control standards.

What GAO Recommends

GAO recommends that State provide information to additional visa recipients and that each federal agency document its domestic FGM/C awareness efforts. The agencies generally agreed with the recommendations; however, State disagreed with documenting its awareness efforts, noting that it is not responsible for domestic outreach and education. GAO maintains that the recommendation is valid as discussed in the report.

For more information, contact Marcia Crosse at (202) 512-7114 or crossem@gao.gov.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: The Department of State (State) took action to address our recommendation by expanding the pool of visa applicants who will receive information on FGM/C. Specifically, State finalized its transition to providing paperwork electronically during the visa application process in May 2019, which resulted in its ability to directly distribute the fact sheet on FGM/C to both immigrant and nonimmigrant visa recipients. According to State, both immigrant and nonimmigrant visa recipients will have to certify that they have read and understood the fact sheet on FGM/C before signing and submitting their respective visa applications.

    Recommendation: To increase awareness of the health and legal consequences of FGM/C among visa recipients, the Secretary of State should update the Foreign Affairs Manual to require posts located in countries where FGM/C is commonly practiced to directly provide information about FGM/C to nonimmigrant visa recipients in the same manner as is done for immigrant visa recipients.

    Agency Affected: Department of State

  2. Status: Closed - Implemented

    Comments: The Department of State (State) took action to address our recommendation by expanding the pool of visa applicants who will receive information on FGM/C. Specifically, State finalized its transition to providing paperwork electronically during the visa application process in May 2019, which resulted in its ability to directly distribute the fact sheet on FGM/C to both immigrant and nonimmigrant visa recipients who are from or were nationals of a country where FGM/C is commonly practiced. State noted that this change will ensure the widest distribution possible by providing all individuals from countries where FGM/C is commonly practiced with access to the fact sheet on FGM/C regardless of place of application or visa recipient type.

    Recommendation: To increase awareness of the health and legal consequences of FGM/C among visa recipients, the Secretary of State should update the Foreign Affairs Manual to require posts located outside of the countries where FGM/C is commonly practiced to directly provide information on FGM/C to immigrant and nonimmigrant visa recipients who are nationals of countries where FGM/C is commonly practiced.

    Agency Affected: Department of State

  3. Status: Closed - Implemented

    Comments: The Department of Homeland Security (DHS) took action to address our recommendation in January 2017 by creating an outreach strategy on female genital mutilation/cutting (FGM/C) awareness efforts. DHS's outreach strategy describes both the general approach and specific actions it plans to take to educate and reach key stakeholders in the United States with relevant information about FGM/C. To create the strategy, DHS noted that it convened regular meetings with stakeholders throughout the department through its Council on Combatting Violence Against Women. DHS also noted that its efforts will involve continued strategic planning and coordination across DHS components and offices, as well as consultation and coordination with other relevant federal agencies and stakeholders.

    Recommendation: To make the best use of federal resources directed toward combating FGM/C in the United States, the Attorney General and the Secretaries of Education, Health and Human Services, Homeland Security, and State should each develop a written plan that describes the agency's approach for conducting education and outreach to key stakeholders in the United States regarding FGM/C.

    Agency Affected: Department of Homeland Security

  4. Status: Open

    Comments: The Department of Education (Education) concurred with this recommendation. In February 2020, Education told us that it had awarded three grants that, while not focused on FGM/C, may be used for student safety and health at the U.S. state and local levels. After it evaluates grantees' need for information and resources related to FGM/C, Education will determine its next steps. In addition, Education reported that it continues to participate on the federal interagency workgroup devoted to FGM/C and has dedicated program staff to respond to issues related to FGM/C. Education expects to finalize its written plan by August 2020.

    Recommendation: To make the best use of federal resources directed toward combating FGM/C in the United States, the Attorney General and the Secretaries of Education, Health and Human Services, Homeland Security, and State should each develop a written plan that describes the agency's approach for conducting education and outreach to key stakeholders in the United States regarding FGM/C.

    Agency Affected: Department of Education

  5. Status: Closed - Implemented

    Comments: In December 2019, the Department of Health and Human Services (HHS) provided documentation of its Office on Women's Health FGM/C activities. In this written plan that was last updated in April 2018, the Office on Women's Health describes its key activities, including 3-year grant funding for eight organizations to address FGM/C in their communities, data collection through a multi-site study to better assess the characteristics and impact of FGM/C among potentially at-risk women, and participation in the federal interagency workgroup devoted to FGM/C.

    Recommendation: To make the best use of federal resources directed toward combating FGM/C in the United States, the Attorney General and the Secretaries of Education, Health and Human Services, Homeland Security, and State should each develop a written plan that describes the agency's approach for conducting education and outreach to key stakeholders in the United States regarding FGM/C.

    Agency Affected: Department of Health and Human Services

  6. Status: Closed - Implemented

    Comments: The Department of Justice (DOJ) took action to address our recommendation in January 2017 by creating an outreach strategy on its female genital mutilation/cutting (FGM/C) awareness efforts. DOJ's outreach strategy notes the importance of educating stakeholders about laws prohibiting FGM/C and described how it will continue its outreach and the activities in which that would occur. For example, DOJ described how it will continue to disseminate a multi-language brochure on laws prohibiting FGM/C that also lists options for reporting possible violations of the law.

    Recommendation: To make the best use of federal resources directed toward combating FGM/C in the United States, the Attorney General and the Secretaries of Education, Health and Human Services, Homeland Security, and State should each develop a written plan that describes the agency's approach for conducting education and outreach to key stakeholders in the United States regarding FGM/C.

    Agency Affected: Department of Justice

  7. Status: Closed - Implemented

    Comments: The Department of State (State) took action that met the intent of our recommendation in February 2018 by releasing a statement for the International Day of Zero Tolerance to Female Genital Mutilation that described how it partners with a broad range of stakeholders and other governments to raise awareness of female genital mutilation/cutting's (FGM/C) harm to society. Its statement also described State's future plans, such as its support for survivor-centered programs in countries where FGM/C is most prevalent.

    Recommendation: To make the best use of federal resources directed toward combating FGM/C in the United States, the Attorney General and the Secretaries of Education, Health and Human Services, Homeland Security, and State should each develop a written plan that describes the agency's approach for conducting education and outreach to key stakeholders in the United States regarding FGM/C.

    Agency Affected: Department of State

  8. Status: Closed - Implemented

    Comments: The Department of Homeland Security (DHS) took action to address our recommendation in January 2017 by creating an outreach strategy on female genital mutilation/cutting (FGM/C) awareness efforts and sharing the strategy online. DHS's outreach strategy describes both the general approach and specific actions it plans to take to educate and reach key stakeholders in the United States with relevant information about FGM/C. DHS subsequently posted the plan on its U.S. Citizenship and Immigration Services (USCIS) website pertaining to FGM/C. USCIS also communicated the plan through an email blast to its subscribers.

    Recommendation: To make the best use of federal resources directed toward combating FGM/C in the United States, the Attorney General and the Secretaries of Education, Health and Human Services, Homeland Security, and State should each communicate the plan with other relevant federal agencies and stakeholder groups, as appropriate.

    Agency Affected: Department of Homeland Security

  9. Status: Open

    Comments: The Department of Education (Education) concurred with this recommendation, and noted in a February 2020 update that it is in the process of determining next steps for certain FGM/C awareness activities that may be included in the written plan it will develop. Education expects that it will finalize its written plan by August 2020, at which point it should also communicate that plan with other federal agencies and stakeholder groups to address our recommendation.

    Recommendation: To make the best use of federal resources directed toward combating FGM/C in the United States, the Attorney General and the Secretaries of Education, Health and Human Services, Homeland Security, and State should each communicate the plan with other relevant federal agencies and stakeholder groups, as appropriate.

    Agency Affected: Department of Education

  10. Status: Closed - Implemented

    Comments: The Department of Health and Human Services's (HHS) Office on Women's Health developed a written plan that describes its key activities, including 3-year grant funding for eight organizations to address FGM/C in their communities. In January 2020, HHS provided documentation of a March 2018 meeting where officials spoke about this grant funding and its early takeaways with various officials from other federal agencies and relevant stakeholders such as medical providers and educators. In addition, HHS told us that it has also shared the key activities in its written plan in a August 2019 public meeting where the eight organizations that received grant funding presented summaries of their work to officials from relevant federal agencies.

    Recommendation: To make the best use of federal resources directed toward combating FGM/C in the United States, the Attorney General and the Secretaries of Education, Health and Human Services, Homeland Security, and State should each communicate the plan with other relevant federal agencies and stakeholder groups, as appropriate.

    Agency Affected: Department of Health and Human Services

  11. Status: Closed - Implemented

    Comments: The Department of Justice (DOJ) took action to address our recommendation in October 2017 by sharing its outreach strategy on female genital mutilation/cutting (FGM/C) awareness efforts. Specifically, DOJ officials reported that they communicated their plan with an interagency working group comprised of agencies throughout the federal government, including the Departments of Education, Health and Human Services, Homeland Security, and State.

    Recommendation: To make the best use of federal resources directed toward combating FGM/C in the United States, the Attorney General and the Secretaries of Education, Health and Human Services, Homeland Security, and State should each communicate the plan with other relevant federal agencies and stakeholder groups, as appropriate.

    Agency Affected: Department of Justice

  12. Status: Closed - Implemented

    Comments: The Department of State (State) took action that met the intent of our recommendation in February 2018 by publishing a statement on its female genital mutilation/cutting (FGM/C) awareness efforts online. State's statement for the International Day of Zero Tolerance to Female Genital Mutilation described how it partners with a broad range of stakeholders and other governments to raise awareness of FGM/C's harm to society. Its statement also described State's future plans, such as its support for survivor-centered programs in countries where FGM/C is most prevalent. State posted this statement on the press releases section of its www.state.gov website.

    Recommendation: To make the best use of federal resources directed toward combating FGM/C in the United States, the Attorney General and the Secretaries of Education, Health and Human Services, Homeland Security, and State should each communicate the plan with other relevant federal agencies and stakeholder groups, as appropriate.

    Agency Affected: Department of State

 

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