Female genital mutilation (FGM)

Question 1

Define female genital mutilation (FGM).

Answer 1

Any procedure involving partial or total removal of the external genitalia and/or injury to the female genital organs whether for cultural, religious or other nontherapeutic reasons.

Question 2

What are the types of FGM?

Answer 2

• Type 1: clitoroidectomy – partial/total removal of the clitoris and/or the prepuce.
• Type 2: partial/total remove of clitoris + labia minora +/- excision of labia majora.
• Type 3: excision of part of all of the external genitalia (clitoris, labia minora and majora) and stitching/narrowing the vagina (infibulation)
• Type 4: piercing the clitoris, cauterisation, cutting the vagina, inserting corrosive substances. Also includes any plastic surgery procedures done as an adult.

Question 3

Summarise the epidemiology of female genital mutilation (FGM).

Answer 3

Around 200 million girls worldwide have undergone FGM.

Question 4

What is the management for FGM?

Answer 4

FGM is ILLEGAL – it is illegal to arrange/assist in arranging for a UK national or resident to be taken overseas for purposes of FGM.

If FGM is confirmed in a girl < 18 years, MUST report to the police within 1 month of confirmation.

Female genital cosmetic surgery may be prohibited unless it is necessary for the patient’s physical or mental health

De-infibulation (reversal of infibulation): Ideally should be identified pre-conceptually. Should be performed with adequate analgesia. Incision is made along the vulval incision scar. Women should receive prior urinary infection screening and given appropriate antibiotics.