Synopsis
Recognise FGM without stigmatising or unnecessary examination, treat physical and psychological consequences, protect girls at risk, and apply the precise mandatory-reporting boundary alongside ordinary safeguarding duties.
- FGM means partial or total removal of external female genitalia or other injury to female genital organs for non-medical reasons; it has no health benefit and is illegal in the UK.
- WHO type I affects the clitoral glans or prepuce, type II also removes labial tissue, type III narrows the vaginal opening by infibulation, and type IV covers other non-medical injury such as pricking or cutting.
- Use the person’s preferred language, explain why you are asking and avoid assuming nationality, ethnicity, religion or symptoms establish FGM.
- Do not perform a genital examination solely to check whether a child has FGM; examine only for a genuine clinical or safeguarding purpose with specialist planning, valid consent or lawful best-interests authority.
- In England and Wales, a regulated professional must personally report to police when a girl under 18 directly discloses FGM or FGM is visually identified during professional work.
- The mandatory duty does not cover an adult disclosure, suspicion of future risk, or a third-party report; those situations still use local child or adult safeguarding processes and proportionate information sharing.
- Make a mandatory report to police using 101 as soon as possible, ordinarily by the end of the next working day; exceptional delay should never exceed the statutory procedural limit.
- After a mandatory police report, continue clinical care, local children’s social-care referral, assessment of siblings or other girls, and immediate 999 action when danger is current.
- Refer affected adults to an NHS specialist FGM service for symptom assessment, deinfibulation options, psychosexual care, maternity planning and safeguarding support with informed involvement.
- Discuss deinfibulation before pregnancy, antenatally or intrapartum according to need and preference; explain clearly that reinfibulation after birth is illegal and clinically harmful.
Key red flags
A girl says that FGM has happened, or a regulated professional visually identifies FGM during normal work in England or Wales, activates the personal police mandatory-reporting duty.
Planned overseas travel, a family history of FGM, community pressure, discussion of a ceremony or a sibling already affected can indicate imminent risk even without a completed act.
Acute bleeding, fever, wound infection, inability to pass urine or severe genital pain after a suspected procedure needs emergency medical treatment and evidence-sensitive safeguarding.
Pregnancy with type III FGM requires early specialist assessment and a documented deinfibulation and birth plan; reinfibulation must not be performed.
Flashbacks, panic, dissociation, self-harm or severe sexual pain needs trauma-informed mental and psychosexual support, not repeated genital examination.
Concern about a girl at risk, an adult disclosure or information from another person may fall outside the specific mandatory duty but still requires ordinary safeguarding assessment and possible police or social-care referral.
A girl under 18 personally states that FGM occurred; in England and Wales this triggers the regulated professional’s personal police report as well as safeguarding action.
Investigation priorities
Identify symptoms, procedure history, pregnancy implications and girls who may be at risk.
Management branches
An adult discloses FGM or anatomy is identified during consented clinical care.
- Ask what terminology and help the patient prefers, assess acute and chronic complications, pregnancy context, psychological wellbeing and immediate safety.
- Explain confidentiality, offer specialist FGM and relevant gynaecology, psychosexual or maternity services, and discuss deinfibulation without pressure when type III causes difficulty.
- Assess daughters, siblings and other girls proportionately and use local safeguarding referral where risk exists; do not make a mandatory police report solely because the affected person is an adult.