L11: Female Genital Mutilation

Question 1

What is the definition of Female genital mutilation (FGM)

Answer 1

A term used by WHP make it clear that FGM is avid action of human rights, emphasise harmfulness of act

Question 2

What is FGM distinct from

Answer 2

Male circumcision

Question 3

Why are the following terms of female genital cutting, excision, genital cutting used by some people

Answer 3

People feel that mutilation stigmatises FGM affected communities

Question 4

What term does WHO state that is should be avoided for use

Answer 4

Female circumcision

Question 5

Why should female circumcision be avoided

Answer 5

It is felt to be misleading as it suggests a similarity to male circumcision

Question 6

What is the definition of FGM

Answer 6

Partial or compete removal of or injury to female genitalia for NON-MEDICAL reasons

Question 7

How many types of FGM is there

Answer 7

4 types

Question 8

What differs from as you increase from type 1 to type 3

Answer 8

Amount of genital tissue cut increases

Question 9

What is the type 3 FGM also called

Answer 9

Infibulation

Question 10

What is type 1 also called

Answer 10

Clitoridectomy

Question 11

What is type 1 FGM

Answer 11

Partial or total removal of the clitoral hood or clitorial glans

Question 12

What is type 2 FGM also called

Answer 12

Excision

Question 13

What is type 2 FGM

Answer 13

Partial or total removal of clitoral glans and inner labia or/and outer labia

Question 14

What is type 3 also known as

Answer 14

Infilbulation

Question 15

What is type 3 FGM

Answer 15

Partial or total removal of the clitoris glans and inner Labia or/and outer labia with inner or/and outer labia sewn together leaving a small hole

Question 16

What is the small hole in type 3 for

Answer 16

Urination or sexual intercourse

Question 17

What is type 4 FGM

Answer 17

Any other harmful procedure that involves piercing, scraping, burning, pricking

Question 18

Which countries does FGM predominantly occur occur

Answer 18

Africa (most)
Eastern Europe
Latin America

Question 19

What is happening to the prevalence of FGM

Answer 19

Declining very slowly (but not fast enough)

Question 20

In the U.K. what are the 2 statistics sources we have for FGM

Answer 20

Census data from 2011

NHS digital from 2015+

Question 21

What does NHS digital data rely on to date FGM

Answer 21

Healthcare professionals knowledge of FGM

FGM survivors that access healthcare services

Question 22

What are the strength of census based estimates

Answer 22

• Good starting point
• record changes in population
• accessible for analysis

Question 23

What are the weaknesses of census based estimates

Answer 23

• estimated
• too generalised
• only collected every 10 years

Question 24

What are the strengths of NHS digital data

Answer 24

• accessible
• clean data
• enable service planning

Question 25

What are the weaknesses of NHS digital data

Answer 25

- poor data recording - statistics are experimental - low reliability in some areas

Question 26

Are there any health benefits of FGM

Answer 26

No

Question 27

What are the categories of impact of FGM

Answer 27

Health Psychological Sexual Economic

Question 28

What are the immediate impacts of FGM to the female

Answer 28

``` Cut without Anaesthetic- pain Haemorrhage Acute urinary retention Urinary, vaginal infection Septicaemia Trauma Transmission of Hep b, HIV Death Bone fracture - due to being held down ```

Question 29

What are the shorter term impacts of FGM on the female

Answer 29

``` Delayed wound healing Scarring Pelvic infection Epidermoid cysts Neuroma ```

Question 30

What are the longer term impacts of FGM on females

Answer 30

``` Reproductive tract infection Impaired flow of menstrual Painful menstruation Painful urination Painful sex Childbirth Pelvic inflammatory disease Social trauma Mental health Increased risk of HIV Death ```

Question 31

How can type 3 FGM be treated

Answer 31

Deinfibulation

Question 32

What is type 3 deinfibulation

Answer 32

You release the vagina opening and suture the raw edges to prevent it healing back together

Question 33

In what settings can de-infibulation be done

Answer 33

Outside pregnancy Antepartum Intra partum

Question 34

What are the benefits of de-infibulation

Answer 34

Improved health Wellbeing Allow sexual intercourse Allows childbirth

Question 35

Describe how the FGM procedure is performed on females

Answer 35

1) circumsers use razors, scissors, broken glans, sharpened glass to cut 2) no anaesthetic 3) unsanitary condition 4) girl is held down 4) legs are bond for weeks after the procedure

Question 36

What are the 6 categorical reasons for FGM

Answer 36

1) sociological and cultural reasons 2) psychosexual reasons 3) socio-economic factors 4) hygiene and feminity reasons 5) marriage ability 6) religious reasons

Question 37

What are the sociological and cultural reasons for FGM

Answer 37

- historical and cultural tradition - respect for elderly - acceptance in community - community identity - gender inequality i.e male control - myths about clitoris growing into a penis - passage from childhood to woman hood

Question 38

What are the psychosexual reasons

Answer 38

- control of woman’s sexuality - preservation of her virginity before marriage - increase male sexual pleasure as the hole is much tighter - protect family honour

Question 39

What are the socio-economic factors

Answer 39

Prerequisite for marriage and right to inherent | Income for cutters

Question 40

What are the hygiene and feminity reasons for FGM

Answer 40

Cut is perceives as clean Spiritual purity Hygiene Clitoris is seen as masculine so removal makes is feminity

Question 41

What are the marriage ability reasons

Answer 41

Eligible for marriage | Mean want to marry cut woman

Question 42

What are the religious reasons

Answer 42

Religious obligation but there is no evidence in books

Question 43

When might a child be at risk of FGM

Answer 43

``` Child mother has had FGM Father from a FGM background Parent say they are taking her abroad Girl is withdrawal from FGM lessons Family thinks FGM is important ```

Question 44

What should be done with a girl has had FGM

Answer 44

Documented in medical notes | Referral to social services

Question 45

Under what act is FGM illegal in the U.K.

Answer 45

Serious crime act 2015

Question 46

What are the offences of FGM

Answer 46

Committing FGM Assisting a girl Assisting a non U.K. person to mutilate overseas Faulting to protect a girl at risk

Question 47

What is mandatory recording

Answer 47

In regards to adult women, as HCP you record into the nhs data set and medical notes

Question 48

What is mandatory reporting

Answer 48

As a result of serious crime act 2015 you have to report under 18s as all healthcare professionals

Question 49

When do you have to directly report to the police

Answer 49

- girls under 18 - examination reveals she has had FGM - girl discloses FGM

Question 50

When you report to the police can you transfer the responsibility to another HCP

Answer 50

NO the duty is personal

Question 51

When does mandatory reporting not apply

Answer 51

- woman over 18 - if you think a girl has FGM but she does not disclose it and no signs and symptoms are seen - if it has been reported already

Question 52

How do you report as a HCP

Answer 52

- call police by 101 - make a detailed record on it system - alert senior manager and safeguarding lead

Question 53

When should you report

Answer 53

As soon as possible by end of next working day

Question 54

In FGM act 2003 what are the expectational cases for reporting

Answer 54

Up to 1 month with reasons of delay in reporting

Question 55

What happens if you as a HCP fail to report

Answer 55

- failure to fitness to practise | - regulators consider your ability to practise safely

Question 56

After post partum is it legal or illegal to suture to re-infinbulate after birth

Answer 56

Illegal