A/HRC/44/33 incidence of the practice. For instance, reports from several countries indicated that securing prosecutions under such laws was difficult, especially taking into account the potential liability of parents and relatives of the victim for performing or organizing the procedure and consequently being reluctant to report it. That was further complicated by the difficulties in collecting evidence, as it was often not readily apparent if a girl had undergone female genital mutilation. Experts reported that some of the barriers faced by the authorities in the United Kingdom of Great Britain and Northern Ireland in collecting evidence on female genital mutilation were due to a number of issues, including the underground nature of the practice and the difficulty of obtaining medical evidence. Furthermore, children of parents facing the consequences of criminal sanctions might be left in a dire situation, especially where there were no social protection systems. The need to regularly assess the impact of legal frameworks to identify possible adverse consequences was therefore stressed. 15. In addition, some experts raised concerns about the disproportionate impact of punitive approaches on women and girls, as they might, for example, push the practice underground, making it even more dangerous for the girls concerned and resulting in the stigmatization of communities, in particular women and girls, in the context of migration and movement of populations (for example in Europe). In that respect, some experts emphasized the need to complement legislation with measures aimed at encouraging a change in social norms and understanding the other factors supporting the practice. 16. Another related challenge, identified during the meeting, related to gaps in the enforcement of legislation owing to its narrow conceptualization and interpretation by judges. An experience shared from Kenya was illustrative in that regard: three adult women who had agreed to undergo female genital mutilation were sentenced to three years in prison for not having reported their cases to the authorities, since the legislation stated that consent could not be used as a defence for performing female genital mutilation and stipulated mandatory reporting. 3 While discussing this issue, the experts noted that terms such as consent, bodily autonomy, choice and harm challenged the implementation of punitive approaches to female genital mutilation. Experts agreed on the need for more research on those issues and on the human rights implications of different policy and legal approaches to female genital mutilation, in particular concerning adult women. Furthermore, those issues should also inform the much-needed supplementary efforts to monitor the impact of legislation against female genital mutilation, for example who was being prosecuted and the impact of prosecutions on those prosecuted, always having at its core the human rights of the women and girls concerned. Analysis and monitoring of the human rights impact should inform the work of human rights mechanisms and their recommendations concerning the elimination of female genital mutilation. 17. Concerns were raised over the issue of mandatory reporting of female genital mutilation by health-care professionals and the ethical dilemmas that entailed in terms of confidentiality and the potential harm to the patient-doctor relationship and public trust, as without the assurance of confidentiality, survivors of female genital mutilation (and their families) might avoid seeking medical help in general practice, even for nongynaecological conditions.4 While data was limited as to whether mandatory reporting, in the manner that it was applied, was successful in safeguarding girls and women at risk of female genital mutilation,5 experts considered that the issue required further research and clarification. 18. Some experts also mentioned that where legislation was in place it was often inadequate in its scope or suffered from weak implementation owing to numerous factors. For instance, despite the fact that cross-border female genital mutilation was taking place in both East and West Africa, failure to address the cross-border dimensions of the practice was a critical gap in most African laws against female genital mutilation. 6 Girls and young 3 4 5 6 See the Prohibition of Female Genital Mutilation Act (2011), arts. 19 (6) and 24. See Joel Naftalin and Susan Bewley, “Mandatory reporting of FGM”, British Journal of General Practice, vol. 65, No. 638 (September 2015). Yusuf Malik and others, “Mandatory reporting of female genital mutilation in children in the UK”, British Journal of Midwifery, vol. 26, No. 6 (June 2018). See for example: UNFPA-UNICEF Joint Programme on the Elimination of Female Genital Mutilation, How to Transform a Social Norm: Reflections on Phase II of the UNFPA-UNICEF Joint 5