When Protection Causes Harm : Structural Injustice and Children's Rights in Anti-FGM Interventions
Year: 2026
Type: conference-paper
Abstract: Background: Efforts to eradicate female genital mutilation (FGM) are firmly embedded within global health, human rights, and legal frameworks, and are widely framed as necessary to protect girls from harm. However, a growing body of research—including studies to which I have contributed—points to significant unintended consequences of current interventions. These developments raise critical questions for health law, particularly regarding the risks of structural injustice, limitations on children’s rights, and forms of iatrogenic harm produced within systems designed to protect. Research Question: How do anti-FGM policies and practices generate unintended harms— such as structural injustice, constraints on children’s participatory rights, and iatrogenic effects—within national and global health law contexts? Methodology: The paper draws on three recent empirical and analytical studies in which I have been involved. The first examines genital examinations conducted in Sweden between 1982 and 2022 in cases of suspected FGM, analysing legal justifications and clinical practices. The second investigates the role of special representatives for children in such cases, with a focus on how the child’s right to be heard is interpreted and implemented in practice. The third study offers a critical analysis of global anti-FGM campaigns, with particular attention to dominant “zero tolerance” approaches and their broader implications. Results: Taken together, the studies reveal several interrelated forms of unintended harm. In the Swedish context, legally sanctioned genital examinations—while intended as protective measures—often disproportionately target migrant communities and may involve invasive procedures carried out without clear medical necessity. This raises concerns regarding bodily integrity, proportionality, and non-discrimination, and illustrates how legal mandates can contribute to structural injustice in clinical settings. Further, the analysis of special representatives shows that children’s participatory rights are frequently constrained in practice. Although the legal framework emphasizes the child’s right to be heard, children’s voices are often mediated, filtered, or marginalized within formal procedures, resulting in a gap between legal ideals and lived realities. At the global level, dominant anti-FGM strategies are shown to risk producing iatrogenic effects, including the reinforcement of stigmatizing narratives about affected communities, and the erosion of trust between patients and healthcare providers. These dynamics may ultimately undermine both healthcare access and the legitimacy of legal interventions. Conclusions: The findings highlight a fundamental tension in health law between the obligation to protect individuals from harm and the risk of harm caused by protective interventions themselves. Drawing on my involvement in these studies, the paper argues for a more reflexive and context-sensitive approach to anti-FGM regulation. This includes stronger safeguards surrounding medical examinations, more robust implementation of children’s participatory rights, and greater attention to cultural competence and community engagement. A key takeaway is that legal and health interventions must be evaluated not only in terms of their intentions and formal legitimacy, but also in relation to their practical effects. Ensuring that anti-FGM efforts are equitable, proportionate, and respectful of the rights and dignity of those they aim to protect
Author: Wendel, Lotta
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7204310009
FWCI:
Cites:
Cited by:
Related to: