the purposes of fgm; the maximum prison sentence for each is 14 years. the first conviction was in november 2019, for a september 2016 offence by the father and mother of a girl aged 21 months, who were sentenced to 5 years 6 months and 4 years 9 months in prison. the health service executive has responsibility for raising awareness of the health and legal risks, and liaises with akidwa. the irish family planning association runs a clinic for fgm survivors. on a prime time report on fgm broadcast on 8 february 2018, ali selim of the islamic cultural centre of ireland said "female circumcision" should be allowed with medical approval. protesting students in selim's arabic-language class at trinity college dublin (tcd) were offered an alternative lecturer, while tcd students' union called for his part-time post to be terminated. on 12 february umar al-qadri of the separate al-mustafa islamic cultural centre ireland issued a fatwa against fgm. on 18 february selim apologised for not clearly distinguishing medically necessary interventions from fgm, and condemned the latter. tcd later made selim redundant on the grounds of course reorganisation and low student demand; in september 2019 the labour court awarded him compensation for unfair dismissal. italy after a few cases of infibulation practiced by complaisant medical practitioners within the african immigrant community came to public knowledge through media coverage, the law n°7/2006 was passed on 1/9/2006, becoming effective on 1/28/2006, concerning "measures of prevention and prohibition of any female genital mutilation practice"; the act is also known as the legge consolo ("consolo act") named after its primary promoter, senator giuseppe consolo. article 6 of the law integrates the italian penal code with articles 583-bis and 583-ter, punishing any practice of female genital mutilation "not justifiable under therapeutical or medical needs" with imprisonment ranging from 4 to 12 years (3 to 7 years for any mutilation other than, or less severe than, clitoridectomy, excision or infibulation). the penalty can be reduced up to 2⁄3 if the harm caused is of modest entity (i.e. if partially or completely unsuccessful), but may also be elevated up to 1⁄3 if the victim is a minor or if the offense has been committed for profit. an italian citizen or a foreign citizen legally resident in italy can be punished under this law even if the offense is committed abroad; the law will as well afflict any individual of any citizenship in italy, even illegally or provisionally. the law also mandates any medical practitioner found guilty under those provisions to have his/her medical license revoked for a minimum of six up to a maximum of ten years. netherlands fgm is considered mutilation and is punishable as a criminal offense under dutch law. there is no specific law against fgm: the act is subsumed under the general offense of inflicting harm ("mishandeling" in dutch, art. 300–304 dutch criminal code). the maximum penalty is a prison sentence of 12 years. the sentence can be higher if the offender is a family member of the victim. it is also illegal to assist or encourage another person to perform fgm. a dutch citizen or a foreign citizen legally resident in the netherlands can be punished even if the offense is committed abroad. doctors have the obligation to report suspected cases of fgm and may break patient confidentiality rules if necessary. norway fgm is punishable as a criminal offense under norwegian law even if the offense is committed abroad. russia fgm is not a crime in russia. a study on female genital mutilation practiced in dagestan, made public in 2016 by legal initiative for russia (also known as russia justice initiative), revealed that fgm is widespread in dagestan. the girls undergo mutilation in early age, up to three years old. the practice has been publicly approved in the predominantly muslim region of dagestan by religious leaders such as mufti ismail berdiyev. later an orthodox christian priest also backed the cleric. the russia justice initiative estimated that tens of thousands of muslim women had undergone fgm, especially in the remote mountain villages of dagestan, but investigators from the prosecutor general's office reported they had not found any evidence of the practice. that year, dissident united russia mp maria maksakova-igenbergs introduced a bill criminalising fgm, but its status was unclear as of 2018. in late november 2018, meduza exposed the moscow-based best clinic as running advertisements offering 'female circumcision' to girls between the ages of 5 and 12. the clinic since removed the advertisements and stated that 'clitoridectomy, a surgical procedure, is being performed only on medical grounds', denying that it was performed on female patients under the age of 18. by contrast, the ministry of health declined to comment on the matter, saying that female circumcision is, in fact, 'not a medical procedure', and therefore 'not in their competence'. spain the criminal code states that sexual mutilation, such as fgm, is a criminal offense punishable by up to 12 years in jail, even if the offence is committed abroad. sweden in 1982, sweden was the first western country in the world to explicitly prohibit genital mutilation. it is punishable by up to six years in prison, and in 1999 the government extended the law to include procedures performed abroad. general child protection laws could also be used. the prevalence of fgm among immigrant groups in sweden is unknown, but there have been 46 cases of suspected genital mutilation since the law was introduced in 1982, and two convictions, according to a report published in 2011 by the national centre for knowledge on men's violence against women. the national board of health and welfare has estimated that up to 38,000 women living in sweden may have been the victims of fgm. this calculation is based on unicef estimates on prevalence rates in africa, and refer to fgm carried out before arriving in sweden. in 2014, a somali-born national coordinator at the county administrative board of östergötland said the problem is not actively being pursued by authorities and the issue is avoided for fear of being perceived as racist or as stigmatising minority ethnic groups. the ministry of health and social affairs launched an action plan against fgm in 2003, which included giving courses to african women and men, who are now working as health advisors and influencing the public opinion among their fellow countrymen. united kingdom main article: female genital mutilation in the united kingdom fgm was made a criminal offence by the prohibition of female circumcision act 1985. this was superseded by the female genital mutilation act 2003, and (in scotland) by the prohibition of female genital mutilation (scotland) act 2005. taking a uk citizen or permanent resident abroad for the purpose of fgm is a criminal offence whether or not it is lawful in the country the girl is taken to. since april 2014, all nhs hospitals will be able to record if a patient has undergone fgm or if there is a family history of this, and by september 2014, all acute hospitals will have to report this data to the department of health, on a monthly basis. despite fgm being illegal since 1985 the authorities are yet to prosecute even one case successfully. the number of women aged 15–49 resident in england and wales born in fgm practicing regions having migrated to the uk was 182000 in 2001 and increased to 283000 in 2011. the number of women born in the horn of africa, where fgm is nearly universal and the most severe types of fgm, infubulation, is commonly practiced, increased from 22000 in 2001 to 56000 in 2011, an increase of 34000. the number of women of all ages having undergone fgm rituals was estimated to be 137000 in 2011. the number of women of ages 15–49 having undergone fgm rituals was estimated to 66000 in 2001 and there was an increase to 103000 in 2011. additionally, approximately 10,000 girls aged under 15 and 24,000 women over 50, who have migrated to england and wales, are likely to have undergone fgm. the city with the highest prevalence of fgm in 2015 was london, at a rate of 28.2 per 1000 women aged 15–49, by far the highest. the borough with the highest rate was southwark, at 57.5 per 1000 women, while mainly rural areas of the uk had prevalence rate below 1 per 1000. north america canada there is some evidence to indicate that fgm is practiced in ontario and across canada among immigrant and refugee communities. fgm is considered child assault and prohibited under sections 267 (assault causing bodily harm) or 268 (aggravated assault, including wounding, maiming, disfiguring) of the criminal code. united states the centers for disease control estimated in 1997 that 168,000 girls living in the united states had undergone fgm, or were at risk. khalid adem, a muslim who had moved from ethiopia to atlanta, georgia, became the first person to be convicted in the us in an fgm case; he was sentenced to ten years in 2006 for having severed his two-year-old daughter's clitoris with a pair of scissors. performing the procedure on anyone under the age of 18 became illegal in the u.s. in 1997 with the federal prohibition of female genital mutilation act. however, in 2018, the act was stuck down as unconstitutional by us federal district judge bernard a. friedman in michigan, who argued that the federal government did not have authority to enact legislation outside the "interstate commerce" clause. as part of the ruling, friedman also ordered that charges be dropped against 8 people who had mutilated the genitals of 9 girls. the department of justice decided not to appeal the ruling; however, the us house of representatives has appealed it. as of august 2019, 35 u.s. states have made specific laws that prohibit fgm, while the remaining 15 states had no specific laws against fgm. states that do not have such laws may use other general statutes, such as assault, battery or child abuse. the transport for female genital mutilation act was passed in january 2013, and prohibits knowingly transporting a girl out of the u.s. for the purpose of undergoing fgm. fauziya kasinga, a 19-year-old member of the tchamba-kunsuntu tribe of togo, was granted asylum in 1996 after leaving an arranged marriage to escape fgm; this set a precedent in us immigration law because it was the first time fgm was accepted as a form of persecution. in 2016, the centers for disease control and prevention (cdc) released a report compiled with data from 2010 to 2013. the 2013 study estimated 513,000 girls and women in the united states were either victims of fgm or at risk of fgm, with 1⁄3 under age 18. the marked increase in the number of girls and women at risk of fgm in the united states was attributed to an increase in the total number of immigrants from countries where fgm is most common, not an increase in the frequency of the practice. latin america colombia, ecuador and panama the first indigenous tribe in latin america known to practice fgm was the emberá people, living in the chocó department of colombia and across the border in the panamanian part of the darién gap. superstition held that a girl's clitoris had to be cut to prevent it from growing to become a penis. it is thought that the tradition is only a couple of centuries old, having been introduced by african slaves brought to colombia during spanish colonial rule. the tradition was extremely secretive and taboo until a 2007 incident, in which a girl died as a result of fgm. the incident caused much controversy, raised awareness and stimulated debate about ending the practice altogether. in 2015, it was reported that of the approximately 250,000 members of the tribe, 25,000 (10%) had decided to discontinue female genital mutilation, with a community leader saying they hoped to eradicate it by 2030. in 2017, retired prosecutor victor martinez claimed that fgm was also practiced amongst tribes in the sierra nevada de santa marta, such as the arhuaco and kogi people, and amongst tribes in la guajira department. as of march 2020, there is no law in colombia that specifically prohibits fgm.: 32 it has been claimed that members of the emberá people living on the