BPSU study - Surveillance of female genital mutilation (FGM) in children and young people under the age of 16 in the UK and ROI

Female genital mutilation (FGM) is a procedure which involves deliberately cutting or causing injury to the female genitals. This can include partial or total removal of the external female genitalia intentionally for non-medical reasons. There are no health benefits of FGM for girls and women and can seriously harm their health. FGM is child abuse and is illegal in the UK. Since 2003, it is also illegal to take a child out of the country for the purpose of FGM.
Last modified
25 July 2019

What is FGM?

FGM is mostly performed on young girls between infancy and the age of 15. There are four major types of FGM (WHO classification)1

  • Type 1: Clitoridectomy – partial or total removal of the clitoris (a small, sensitive and erectile part of the female genitals), and in very rare cases, only the prepuce (the fold of skin surrounding the clitoris).
  • Type 2: Excision – partial or total removal of the clitoris and the labia minora (the inner folds of the vulva), with or without excision of the labia majora (the outer folds of skin of the vulva).
  • Type 3: Infibulation – narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the labia minora, or labia majora, sometimes through stitching, with or without removal of the clitoris (clitoridectomy).
  • Type 4: Includes all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping and cauterizing the genital area.

Complications of FGM can include:

  • Severe pain
  • Excessive bleeding (haemorrhage)
  • Fever
  • Infections
  • Urinary problems
  • Shock
  • Complications in childbirth
  • Death 

About the study

This is a British Paediatric Surveillance Unit (BPSU) study in which surveillance of FGM in children in the UK and RoI was carried out from November 2015 to November 2017 (25 months surveillance) with a 12-month follow up period from November 2018 to November 2019. These cases of FGM were diagnosed by consultant paediatricians or sexual abuse referral clinics.

With the data, the study team hopes to identify the number of children who are diagnosed with FGM in the UK and RoI each year and collect information about FGM, how it presents in children and is treated.

A national mandatory reporting system is also in place which came into force on 31 October 2015. This mandatory reporting system requires that regulated health and social care professionals and teachers in England report ‘known’ (visually identified or verbally disclosed) cases of FGM in under 18s to the police. 

Case definition

Clinicians were asked to report any cases of FGM in children under 16 years of age seen in the past month, not already known to have FGM, with the following case definition:

  1. seen because of suspected or known FGM (for example referrals from social care), OR
  2. seen for another condition and FGM is suspected following assessment, OR
  3. has a genital piercing, OR
  4. has had female cosmetic genital surgery including labiaplasty.

Study team

Dr Deborah Hodes - Lead Investigator  Consultant Community Paediatrician, UCLH 
Dr Najette Ayadi O'Donnell - Co-Investigator Paediatric Registrar, UCLH 
Professor Sarah Creighton  Consultant Gynaecologist, UCLH 
Dr Geoff Debelle Consultant Paediatrician, Birmingham Children's Hospital
Dr Alison Armitage Imperial College NHS Healthcare Trust
Richard Lynn BPSU Scientific Coordinator
Wingsan Lok Researcher, RCPCH 

Data collection for the study has now closed and the study team are currently in the process of carrying out data analysis. A full report detailing study results will be available in summer 2019.

Approval

This study has been granted Section 251 HRA-CAG permission (CAG Reference: 15/CAG/0178).

Support group

Foundation for Women's Health Research and Development (FORWARD)

Further information

Female genital mutilation: what every paediatrician should know, Arch Dis Child 2016;101:267-271

Contact

If you have any queries related to the study, please email the study team at fgm@rcpch.ac.uk.