Peer-reviewed article
Assessing the Infant/Child/Young Person with Suspected FGM/C
Abdulcadir J, Guedj NS, Yaron M, Abdulcadir O, Albert J et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This is a clinical reference guide and training atlas designed to help healthcare providers identify and assess female genital mutilation/cutting (FGM/C) in infants, children, and young people. The guide addresses the challenge that signs of FGM/C can be subtle in prepubertal girls and that providers need to distinguish between actual FGM/C and normal genital anatomy variations. It provides iconographic material and clinical guidance to support accurate diagnosis, appropriate management, culturally sensitive communication with patients, and proper reporting to child welfare and law enforcement agencies.
Key points
- FGM/C comprises procedures involving partial or total removal of external female genitalia or injury to female genital organs performed for cultural or religious reasons, usually in infancy or childhood before age 15
- Existing literature on FGM/C diagnosis focuses primarily on adults, leaving a gap in guidance for identifying the condition in prepubertal children
- Signs of FGM/C in prepubertal girls can be subtle and depend on the type of FGM/C and the examiner's experience
- Healthcare providers must be trained to distinguish between modified and unmodified genitalia and to recognize findings that may superficially resemble FGM/C but reflect normal genital anatomy
- The guide includes both pre- and post-pubertal genital imaging to support training in accurate diagnosis, clinical management, culturally informed communication, and proper reporting
Limitations
This is a reference guide and training tool rather than a study with empirical findings; it does not evaluate the effectiveness of training using these materials or measure changes in provider diagnostic accuracy or child identification rates. The document does not indicate which specific countries the guide is designed for or adapted to, despite regional variations in FGM/C practices and legal contexts.
Abstract
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.