In 2015, UN member states committed to eliminate female genital mutilation (FGM) by 2030 as part of the Sustainable Development Agenda. To reach this goal, interventions need to be targeted and guided by the best available evidence. To date, however, estimates of the number of girls and women affected by FGM and their trends over time and geographic space have been limited by the availability, specificity and quality of population-level data. We present new estimates based on all publicly available nationally representative surveys collected since the 1990s that contain both information on FGM status and on the age at which FGM occurred. Using survival analysis, we generate estimates of FGM risk by single year of age for all countries with available data, and for rural and urban areas separately. The likelihood of experiencing FGM has decreased at the global level, but progress has been starkly uneven between countries. The available data indicate no progress in reducing FGM risk in Gambia, Guinea-Bissau, Mali and Guinea. In addition, rural and urban areas have diverged over the last two decades, with FGM declining more rapidly in urban areas. We describe limitations in the availability and quality of data on FGM occurrence and ageat-FGM. Based on current trends, the SDG goal of eliminating FGM by 2030 is out of reach, and the pace at which the practice is being abandoned would need to accelerate to eliminate FGM by 2030. The heterogeneity in trends between countries and rural vs urban areas offers an opportunity to contrast countries where FGM is in rapid decline and explore potential policy lessons and programmatic implications for countries where the practice of FGM appears to remain entrenched.

Female genital mutilation (FGM) is a harmful practice rooted in gender inequality. Its elimination is part of national and international agendas including the Sustainable Development Goals of the United Nations. Understanding its geographical evolution is crucial for targeted programming. However, due to sparse data, it is challenging to establish international comparability and statistical reliability. Data on FGM is observed at different points in time and periodicity across countries and in contexts with varying age‐risk patterns, all of which can be a source of inaccurate and biased estimates. We perform an exemplary analysis, drawing on survival and complex survey analysis in Ethiopia, Kenya, and Somalia. This novel approach addresses measurement challenges specific to FGM data and produces an internationally comparable indicator—the probability of not experiencing FGM by age 20. We pinpoint the onset of statistically significant FGM decline at the subnational level from cohorts born in the 1970s until the 1990s. In the same period, we observe no decline in FGM risk across regions clustered around international borders and increasing subnational inequalities within countries. Our methods thus provide crucial insights into the geographical pattern of temporal trends in FGM risk.