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Recognising female genital mutilation and referral

Essential points for quick revision.

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Treat acute harm and imminent risk

Active haemorrhage, sepsis, urinary retention, severe pain, obstetric obstruction, a recent procedure or credible plans to take a girl for FGM requires urgent medical and safeguarding action.

Action: Stabilise clinically, contact senior paediatric, gynaecology or obstetric and safeguarding teams, use police emergency response for immediate danger, and preserve the patient’s privacy and dignity while meeting legal duties.

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.

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.

Child direct disclosure

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

01
Sensitive clinical and safeguarding historyFirst step

Identify symptoms, procedure history, pregnancy implications and girls who may be at risk.

Management branches

Affected adultTreat symptoms, support autonomy and assess children at risk

An adult discloses FGM or anatomy is identified during consented clinical care.

  1. Ask what terminology and help the patient prefers, assess acute and chronic complications, pregnancy context, psychological wellbeing and immediate safety.
  2. Explain confidentiality, offer specialist FGM and relevant gynaecology, psychosexual or maternity services, and discuss deinfibulation without pressure when type III causes difficulty.
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Sources and review status6 sources · checked 27 Aug 2026 · clinical review pending
Sources

Sources and review status

National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 27 Aug 2026; clinical approval remains outstanding.

Authoring stateRapid draftClinical stateAwaiting reviewJurisdictionUnited Kingdom