Female Genital Mutilation, Forced Marriage and Honour-Based Abuse

Female genital mutilation, forced marriage, and honour-based abuse are serious safeguarding concerns that can affect children, young people, and adults. Although they may seem outside everyday pharmacy work, you may notice warning signs during routine contact at the counter, reception desk, on the telephone, or through repeated family interactions. These concerns can involve fear, secrecy, coercion, control, and significant risk of harm.^[1][2][3][5]

Forced marriage is not the same as an arranged marriage. The key difference is consent. A person may be pressured through threats, emotional blackmail, violence, surveillance, or family pressure until they feel they have no real choice. Honour-based abuse can involve punishment or control linked to so-called family or community honour. Female genital mutilation, or FGM, is a form of abuse and a safeguarding issue that may affect girls or young women before travel, during school holidays, or after a procedure has taken place.^[2][1]

What Might Raise Concern

In pharmacy settings, warning signs may be subtle. You might notice:^{[2][1][5] [2][1]}

• a child or young person seeming fearful about an upcoming trip abroad^[1]
• someone being closely watched, not allowed to speak privately, or showing distress around family members^[2][3]
• requests for pain relief, dressings, or health advice linked to unexplained genital pain or recent travel^[1]
• a person suddenly withdrawn, missing regular contact, or talking about pressure to marry^[2]

If you think someone may be at immediate risk of FGM, forced marriage, or honour-based abuse, treat it as an urgent safeguarding concern and follow the correct escalation route without delay.

Your Response Matters

You are not expected to investigate or question someone in depth. Your role is to listen, notice, record, and escalate. Do not contact family members to check the story, and do not assume the person accompanying someone is safe to involve. If a child or adult shares a worry, respond calmly and avoid making promises you cannot keep, such as promising complete secrecy.^[2][1][6]

A brief disclosure or small pattern of concern in a pharmacy may be the first opportunity someone has had to be noticed. Clear recording and prompt escalation through the safeguarding lead or emergency route, depending on the level of risk, can make a vital difference.^[1][5]

References (numbered in text) Why we include references

1. HM Government. Multi-agency statutory guidance on female genital mutilation. GOV.UK. (Multi-agency statutory guidance describing indicators, health consequences, safeguarding responses and legal protections for FGM.) Find (opens in a new tab)
2. Home Office & Foreign, Commonwealth & Development Office. The Right to Choose: Multi‑agency statutory guidance for dealing with forced marriage and Multi‑agency practice guidelines: Handling cases of forced marriage. (Statutory guidance for professionals on definitions, warning signs, safeguarding actions and use of the Forced Marriage Unit.) Find (opens in a new tab)
3. Crown Prosecution Service. Guidance on so‑called ‘honour’-based abuse, forced marriage and harmful practices (prosecution and practitioner guidance on honour‑based abuse and related offences). Find (opens in a new tab)
4. Home Office. Mandatory reporting of female genital mutilation: procedural information for health professionals. (Procedural guidance on the legal duty to report known cases of FGM in under‑18s and associated professional responsibilities.) Find (opens in a new tab)
5. UK SAYS NO MORE. Safe Spaces Set‑Up Toolkit for pharmacies (Safe Spaces initiative and codeword schemes such as ‘Ask for ANI’ used in UK pharmacies to provide private help and referral routes for victims of domestic abuse, forced marriage and honour‑based abuse). Find (opens in a new tab)
6. Royal College of Obstetricians and Gynaecologists. Female Genital Mutilation and its Management (Green‑top Guideline No. 53). (Clinical guidance on care, consent and examination considerations for women and girls with FGM.) Find (opens in a new tab)