Synopsis
Recognise health consequences and safeguarding risk from female genital mutilation, provide sensitive symptom and maternity care, and apply reporting duties only within their precise age, disclosure and UK-jurisdiction boundaries.
- Use neutral language the patient understands, ask whether they use terms such as cutting or circumcision, and avoid repeated unnecessary examinations.
- FGM has no health benefit and can cause immediate bleeding, infection and urinary injury plus long-term scar, pain, sexual, menstrual, obstetric and psychological complications.
- In England and Wales, regulated health and social-care professionals and teachers must personally report known FGM in an under-18 directly disclosed by the girl or visually identified in professional work.
Key red flags
A girl disclosing that FGM has occurred or a regulated professional visually identifying it during ordinary care triggers the England and Wales police reporting duty.
Suspicion that a girl is at risk is a safeguarding concern but is not the same legal trigger as a known case under the England and Wales mandatory-reporting duty.
Parent or third-party disclosure about a girl does not itself trigger that personal mandatory-reporting route, although child safeguarding action remains required.
Acute bleeding, infection, urinary retention or severe genital injury after cutting needs emergency treatment and evidence-aware safeguarding.
Pregnancy with type III FGM may require planned deinfibulation and specialist maternity care before labour; do not leave discussion until delivery.
Adults may have pain, urinary, menstrual, sexual, psychological or obstetric complications, but identification alone does not create automatic police or adult-social-care referral.
Direct disclosure by a girl or visual identification during professional work activates the England and Wales regulated-professional police duty.
Travel plans, family pressure or a sibling history may indicate child risk requiring safeguarding even though the known-case reporting trigger is absent.
Bleeding, fever, severe pain, shock or urinary obstruction after recent cutting requires emergency clinical and safeguarding response.
Reasoning priorities
Establish symptoms, terminology, procedure history, maternity needs and risk to the patient or connected children.
Country or community background modifies inquiry but cannot diagnose FGM or establish imminent risk.
Worked reasoning
A mother tells an English GP that her 14-year-old daughter underwent FGM abroad, but the GP has not seen or spoken with the girl.
- Recognise that the parent’s third-party disclosure does not itself activate the regulated professional’s personal known-case police-report duty.
- Treat the information as a serious child-protection concern and contact the designated safeguarding lead immediately.
- Follow the England children’s social-care and police safeguarding pathway without arranging an unnecessary genital examination merely to create a reporting trigger.
- Record the source of information, advice, referrals and safety plan, then ensure the girl reaches appropriate specialist care.