Clinical Review

Female genital mutilation: the role of health professionals in prevention, assessment, and management

BMJ 2012; 344 doi: http://dx.doi.org/10.1136/bmj.e1361 (Published 14 March 2012) Cite this as: BMJ 2012;344:e1361
  1. Jane Simpson, specialist trainee year 4, paediatrics1,
  2. Kerry Robinson, specialist trainee year 7, paediatrics2,
  3. Sarah M Creighton, consultant gynaecologist3,
  4. Deborah Hodes, consultant community paediatrician4
  1. 1Whittington Hospital, London, UK
  2. 2Great Ormond Street Hospital, London, UK
  3. 3Department of Women’s Health, University College Hospital, London NW1 2PG, UK
  4. 4University College Hospital, London, UK
  1. Correspondence to: S M Creighton sarah.creighton{at}uclh.nhs.uk
  • Accepted 14 February 2012

Summary points

  • Female genital mutilation (FGM) is a form of child abuse and is illegal in the UK

  • It is also a criminal offence to arrange (or try to arrange) FGM overseas for a UK national or permanent UK resident

  • FGM is prevalent in certain UK minority and ethnic communities and health professionals should be aware of its likelihood within their patient populations

  • Health professionals must identify the local services available for women seeking help and children at risk

  • Training is essential so that health professionals can raise the matter with women sensitively and advise families on the UK legal position

  • All pregnant women from practising communities must be asked about FGM at routine antenatal booking; systems should be in place for this information to feed back to the community team

Female genital mutilation (FGM), also known as female circumcision or cutting, is thought to affect 100-140 million women worldwide.1 It describes a range of procedures, often involving partial or total excision of the external female genitalia, that are carried out for non-medical reasons (box 1; figs 1-4 ).2 FGM breaches international human rights law, in particular the United Nations Convention on the Rights of the Child,3 and has been criminalised in much of the world, including many African countries in which it is traditionally practised. The United Kingdom is one of several Western countries that have enacted specific legislation in response to international migration (box 2).4

Box 1 Classification of female genital mutilation5

  • Type 1: Partial or total removal of the clitoris or prepuce, or both

  • Type 2: Partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora

  • Type 3 (infibulation): Narrowing of the vaginal orifice with creation of a covering seal by cutting and opposing the labia minora or majora …

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