Epidemiological surveillance study of female genital mutilation in the UK

Abstract

ObjectivesDescribe cases of female genital mutilation (FGM) presenting to consultant paediatricians and sexual assault referral centres (SARCs), including demographics, medical symptoms, examination findings and outcome.DesignThe well-established epidemiological surveillance study performed through the British Paediatric Surveillance Unit included FGM on the monthly returns.SettingAll consultant paediatricians and relevant SARC leads across the UK and Ireland.PatientsUnder 16 years old with FGM.InterventionsData on cases from November 2015 to November 2017 and 12 months later meeting the case definition of FGM.Main outcome measuresReturns included 146 cases, 103 (71%) had confirmed FGM and 43 (29%) did not meet the case definition. There were none from Northern Ireland.ResultsThe mean reported age was 3 years. Using the WHO classification of FGM, 58% (n=60) had either type 1 or type 2, 8% (n=8) had type 3 and 21% (n=22) had type 4. 13% (n=13) of the cases were not classified and none had piercings or labiaplasty. The majority, 70% had FGM performed in Africa with others from Europe, Middle East and South-East Asia. There were few physical and mental health symptoms. Only one case resulted in a successful prosecution.ConclusionsThere were low numbers of children presenting with FGM and in the 2 years there was only one prosecution. The findings may be consistent with attitude changes in FGM practising communities and those at risk should be protected and supported by culturally competent national policies

Diagnoses and Procedures of Inpatients with Female Genital Mutilation/Cutting in Swiss University Hospitals: A Cross-Sectional Study

“…The actual prevalence of FGM/C among communities of migrants remains unknown [12,13]. Recent studies conducted in the United Kingdom (UK) showed signi cantly less cases of FGM/C than expected among minors according to prevalence estimates [14,15]. Nevertheless, the total number of women and girls who have undergone FGM/C is expected to grow in high-income countries because of increasing migration from countries where FGM/C prevalence remains high [16].…”

Available evidence suggests that prevalence and risk of female genital cutting/mutilation in the UK is much lower than widely presumed - policies based on exaggerated estimates are harmful to girls and women from affected communities

“…As such, the number of women/girls recorded on the Dataset as experiencing FGC/M types 1, 2 or 3-often considered the more harmful forms-in the UK may be as few as one or two. Epidemiological surveillance studies of clinic populations which do not suffer from the same data limitations also indicate that the numbers of cases of FGC/M occurring in the UK among children are low, particularly type 3 which tends to dominate public and popular discussions of FGC/M [3,[23][24][25][26].…”

Widespread concerns still exist in relation to discrimination towards women and girls and FGM

“…It is heartening that the number of children presenting with female genital mutilation (FGM) in the UK is less than expected from the estimates. 1 This is against a decade of changes to legal frameworks, including introducing FGM Protection Orders (FGMPOs) to protect girls and women at risk, alongside educational efforts to increase public awareness by a range of stakeholders.…”

“…It is possible that FGM is abandoned after migration to the UK 1 and that anti-FGM measures need to be proportionate to the empirical evidence of the risk of FGM in the UK. However, there remain widespread concerns connected to discrimination towards women and girls of which FGM is one facet.…”

“…Using a disease progression model, we suggest that the study 1 is visualising the interconnection of legislation and health measures with education campaigns. 2 Interventions can include ‘upstream’ or ‘downstream’ approaches.…”