Assessing the Infant/Child/Young Person with Suspected FGM/C

Femawle Genital Mutilation/Cutting (FGM/C) comprises all procedures that involve partial or total removal of the external female genitalia or injury to the female genital organs that are medically unnecessary (i.e. performed primarily for cultural or religious reasons), especially when done without the consent of the affected person. Such procedures are usually carried out in infancy or childhood and, most often before the age of 15. Although some pictorial and training tools are available, existing literature focuses primarily on adults. The signs of FGM/C particularly in prepubertal girls, can be subtle and depend on the type as well as on the experience of the examiner. The health care provider (HCP) should be trained to be familiar with, and able to identify a wide range of both modified and unmodified genitalia, as well as findings that may superficially look like FGM/C but actually reflect the normal range of genital anatomy. Knowledge of FGM/C types and subtypes, as well as complications and differential diagnoses of physical findings, are critical. We present a reference guide and atlas containing iconographic material of both the pre- and post-pubertal external female genital area with and without genital cutting/alteration. Our purpose is to facilitate training of health care professionals in making accurate diagnoses, providing appropriate clinical management, ensuring culturally informed/sensitive patient–provider communication, and accurate recording and reporting to child welfare/law enforcement agencies, where required.