By Harshita Dasot
Female genital mutilation/cutting (FGM/C) is often discussed as a global issue, occurring elsewhere, but in recent years, within the United States, policymakers, healthcare professionals, and advocacy organizations have increasingly recognized that it is also a domestic concern. Despite growing public awareness and stronger legislation, one major challenge shapes nearly every conversation around FGM/C prevention in America: there is a lack of reliable national data on who is affected and who remains at risk.
Public policy depends on data. Legislatures use prevalence estimates to determine funding priorities, public health agencies rely on statistics to guide intervention strategies, and healthcare systems depend on accurate information to identify underserved populations. But when it comes to FGM/C in the United States, much of the available data remains indirect, outdated, or incomplete.
One of the most widely cited estimates comes from the Population Reference Bureau (PRB), which estimated that approximately 500,000 women and girls in the United States were at risk of or affected by FGM/C in 2012. While this figure appears frequently in advocacy and policy discussions, the problem is that even the most commonly cited numbers are still estimates, not exact measurements.
In reality, the United States still does not conduct a national survey specifically measuring FGM/C prevalence or risk. Instead, researchers generally combine census and immigration data with prevalence rates from 31 countries where FGM/C is traditionally practiced.
Researchers have attempted to improve these estimates through increasingly sophisticated methodologies. One notable example is a study conducted by Sean Callaghan, which used the 2015-2019 American Community Survey data alongside UNICEF age-specific prevalence rates, migration patterns, and acculturation factors to generate more detailed estimates of FGM/C prevalence and risk in the United States. The study estimated that approximately 421,000 women and girls were living with or affected by FGM/C in 2019, and roughly 31,000 of those girls were considered at risk. Importantly, the research also mapped impacted populations at the state and local level, helping identify where healthcare providers, educators, and policymakers may need additional resources and support.
Although studies such as Callaghan’s account for migration patterns and acculturation, researchers still face significant challenges in understanding how risk changes across generations and how FGM/C evolves within diaspora communities over time.
This gap creates a strange contradiction within American FGM/C policy. Policymakers, at the federal level and within 42 states, have recognized the issue of FGM/C as serious enough to justify criminal legislation and public health interventions, yet they are often moving forward with policy without comprehensive epidemiological data.
The lack of reliable data also contributes to inconsistent policy responses across states. Some states have enacted broader legislation that includes prevention initiatives and “vacation cutting” provisions, while others have adopted much narrower laws focused almost entirely on criminal penalties. Without standardized national data, there is a disconnect about where and how resources should be concentrated or which prevention frameworks are actually the most effective.
Healthcare systems face similar challenges. Many U.S. healthcare providers still receive limited formal training on FGM/C despite documented long-term physical and psychological health consequences. Research from the World Health Organization and peer-reviewed medical studies has linked FGM/C to chronic pain, infections, obstetric complications, PTSD, anxiety, and long-term reproductive health issues. Yet screening practices for FGM/C remain inconsistent, and many cases likely go undocumented entirely.
Part of the difficulty lies in the sensitive nature of data collection itself. Advocates and researchers have repeatedly emphasized that efforts to gather information about FGM/C can raise concerns about privacy, stigma, and unintended consequences for FGM/C impacted communities. That creates an ongoing tension: policymakers need better information to design effective, ethical interventions, but aggressive monitoring can also undermine trust within affected communities.
That challenge becomes even more complicated because research suggests that FGM/C is more geographically widespread than previously understood. A 2025 international report documented evidence of FGM/C in 94 countries worldwide, demonstrating that the issue extends far beyond the 31 countries UNICEF traditionally collects data from.
The issue is not that potential data is limited; it is that data is barely being recorded, and that affects nearly every stage of prevention and response.
Without accurate prevalence estimates, funding allocations become harder to justify. Without healthcare screening data, survivor support systems remain inconsistent. Without community-level research, policymakers struggle to design culturally competent interventions. And without long-term data, it becomes difficult to evaluate whether laws and prevention programs are actually reducing harm over time. At the same time, many survivor-led organizations caution against reducing FGM/C solely to numbers and statistics.
Ultimately, prevention efforts depend on education, healthcare access, and culturally competent outreach rather than surveillance alone, and good policy must reflect that. Addressing the data gap means ensuring that resources and interventions are grounded in the lived realities of those they aim to protect, preserving the agency, trust, and human dignity of affected communities. Only by bridging this divide between cold statistics and compassionate, community-led care can we truly advance the work of prevention and support in the United States.
