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Female genital mutilation in children presenting to a London safeguarding clinic: a case series

Arch Dis Child. 2015 Jul 27. pii: archdischild-2015-308243. doi: 10.1136/archdischild-2015-308243. [Epub ahead of print]

Female genital mutilation in children presenting to a London safeguarding clinic: a case series.

Hodes D, Armitage A, Robinson K, Creighton SM

BACKGROUND

OBJECTIVE: To describe the presentation and management of children referred with suspected female genital mutilation (FGM) to a UK safeguarding clinic.

DESIGN AND SETTING: Case series of all children under 18 years of age referred with suspected FGM between June 2006 and May 2014.

MAIN OUTCOME MEASURES: These include indication for referral, demographic data, circumstances of FGM, medical symptoms, type of FGM, investigations and short-term outcome.

RESULTS: Of the 47 girls referred, 27 (57%) had confirmed FGM. According to the WHO classification of genital findings, FGM type 1 was found in 2 girls, type 2 in 8 girls and type 4 in 11 girls. No type 3 FGM was seen. The circumstances of FGM were known in 17 cases, of which 12 (71%) were performed by a health professional or in a medical setting (medicalisation). Ten cases were potentially illegal, yet despite police involvement there have been no prosecutions.

CONCLUSIONS: This study is an important snapshot of FGM within the UK paediatric population. The most frequent genital finding was type 4 FGM with no tissue damage or minimal scarring. FGM was performed at a young age, with 15% reported under the age of 1 year. The study also demonstrated significant medicalisation of FGM, which matches recent trends in international data. Type 4 FGM performed in infancy is easily missed on examination and so vigilance in assessing children with suspected FGM is essential.

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