	Background

		Definition and Types of FGM/C

FGM/C comprises all procedures that involve partial or total removal of  the external female genitalia, or other injury to the female genital organs  for non-medical reasons. Prevalence of FGM/C

Available data from nationally representative surveys show that FGM/C is  concentrated in 30 countries and at least 200 million girls and women  alive today have undergone some form of FGM/C, according to UNICEF  (see fig. UNICEF also estimates  that more than 3 million girls annually are at risk for FGM/C in Africa. In September 2015, the UN General Assembly formally adopted the 2030  Agenda for Sustainable Development, along with a set of 17 Sustainable  Development Goals and 169 associated targets. In addition, State and USAID jointly  developed the U.S. Strategy to Prevent and Respond to Gender-Based  Violence Globally, released in August 2012. U.S. and UN Studies Have Identified Factors Contributing to the Persistence of FGM/C and Approaches to Address It

		Factors Contributing to the Persistence of FGM/C

FGM/C has persisted into the 21st century despite UN resolutions  condemning this practice and the passage of laws banning it in many  countries where it is prevalent, as UNICEF has reported. Recent U.S. and  UN studies of efforts to address FGM/C have identified several factors  contributing to its prevalence, including its power as a social norm, the  belief that FGM/C is a religious obligation, the medicalization of the  practice, and challenges enforcing existing laws. In addition, the practice is  exacerbated by poverty and poor education. Medicalization refers to the performance of  FGM/C by health care providers rather than traditional practitioners. Including FGM/C in Broader Gender Equality and Human Rights Efforts

FGM/C should be addressed as part of broader efforts to promote gender  equality and female empowerment, according to PRB. State’s and USAID’s Efforts to Address FGM/C Abroad Are Limited

State and USAID currently have limited international assistance efforts to  address FGM/C. In 2014, State and USAID each had one active  standalone project to address FGM/C. U.S. Contributions to UNFPA and UNICEF Have Not Supported Their Joint Program on FGM/C

State provides annual funding to UNFPA and UNICEF but, to date, none  of this funding supports the Joint Program on FGM/C, the largest  international effort to address FGM/C. However, if the general restrictions for  UNFPA funding are met, there are currently no specific legal restrictions  that would prohibit U.S. funding provided to UNFPA from being available  for the Joint Program on FGM/C. USAID’s Assistance Efforts to Combat FGM/C Are Limited

			Competing Priorities Limit USAID Funding for FGM/C

USAID has competing development priorities, which leave little funding  available for FGM/C-related efforts, according to USAID officials. This  report (1) summarizes findings from recent U.S. and United Nations (UN)  studies about the factors contributing to FGM/C and approaches to  addressing this practice internationally and (2) examines the Department  of State’s (State) and the United States Agency for International  Development’s (USAID) current efforts to address FGM/C abroad. We also collected  information on projects with FGM/C components from USAID’s overseas  missions in countries where FGM/C is prevalent. Appendix III: List of Countries Where Female Genital Mutilation/Cutting Is Concentrated with Decrees or Legislation Related to the Practice, According to the United Nations Children’s Fund

The United Nations Children’s Fund (UNICEF) reported in 2013 that 24  countries where Female Genital Mutilation/Cutting (FGM/C) is prevalent  have enacted legislation related to FGM/C.
Why GAO Did This Study

More than 200 million girls and women alive today have undergone FGM/C in the 30 countries where available data show this harmful practice is concentrated. More than 3 million girls are estimated to be at risk for FGM/C annually in Africa. FGM/C comprises all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs. It is rooted in the cultural traditions of many communities but has several adverse health consequences and the UN identifies it as a violation of human rights. In 2015, the UN General Assembly adopted a set of 17 Sustainable Development Goals for 2030 that included the elimination of FGM/C among its targets. UNFPA and UNICEF implement the Joint Program on FGM/C in 17 countries—the largest current international assistance effort to address FGM/C. State and USAID include FGM/C as part of their global strategy to respond to gender-based violence.
GAO was asked to review State's and USAID's efforts to address FGM/C abroad. This report (1) summarizes findings from recent U.S. and UN studies about factors contributing to FGM/C and approaches to addressing this practice and (2) examines State's and USAID's current efforts to address FGM/C abroad. GAO reviewed recent UN and USAID studies on assistance efforts to address FGM/C, analyzed related strategies and policies, and interviewed State and USAID officials. GAO also analyzed information on FGM/C-related projects and activities from USAID's overseas missions, and State and USAID bureaus.
GAO is making no recommendations in this report.

What GAO Found

U.S. and United Nations (UN) studies since 2010 have identified a variety of factors contributing to the persistence of female genital mutilation/cutting (FGM/C). In many communities where FGM/C is prevalent, FGM/C is an influential social norm that ensures social acceptance and is commonly perceived as a religious obligation. In addition, medicalization of the practice— when it is performed by health care providers rather than traditional practitioners—increases the perception of legitimacy in some countries. Although the United Nations Children's Fund (UNICEF) reports that many countries where FGM/C is prevalent have passed laws banning the practice, enforcement is a challenge. The studies also have identified key approaches to addressing FGM/C, including efforts to implement community education programs, outreach and training for medical professionals, and the inclusion of FGM/C in broader gender equality and human rights programs.
U.S. assistance efforts to address FGM/C are limited. The Department of State (State) and the U.S. Agency for International Development (USAID) each had one active standalone project in 2014, and the agencies also undertook some FGM/C-related efforts as components of projects with broader assistance goals. In addition, the U.S. government provides funding to the United Nations Population Fund (UNFPA) and UNICEF but, to date, has not contributed funds to the UN agencies' Joint Program on FGM/C. If congressional restrictions for UNFPA funding (such as the requirement for UNFPA to maintain U.S. funds in a separate account) are met, there are currently no specific legal restrictions that would prohibit U.S. funding provided to UNFPA from being available for the Joint Program on FGM/C. Competing development priorities, such as HIV/AIDS, leave little funding specifically for FGM/C, according to USAID officials.