Female genital mutilation in children presenting to a London safeguarding clinic: a case series.

<bold>Objective: </bold>To describe the presentation and management of children referred with suspected female genital mutilation (FGM) to a UK safeguarding clinic.<bold>Design and Setting: </bold>Case series of all children under 18 years of age referred with suspected FGM between June 2006 and May 2014.<bold>Main Outcome Measures: </bold>These include indication for referral, demographic data, circumstances of FGM, medical symptoms, type of FGM, investigations and short-term outcome.<bold>Results: </bold>Of the 47 girls referred, 27 (57%) had confirmed FGM. According to the WHO classification of genital findings, FGM type 1 was found in 2 girls, type 2 in 8 girls and type 4 in 11 girls. No type 3 FGM was seen. The circumstances of FGM were known in 17 cases, of which 12 (71%) were performed by a health professional or in a medical setting (medicalisation). Ten cases were potentially illegal, yet despite police involvement there have been no prosecutions.<bold>Conclusions: </bold>This study is an important snapshot of FGM within the UK paediatric population. The most frequent genital finding was type 4 FGM with no tissue damage or minimal scarring. FGM was performed at a young age, with 15% reported under the age of 1 year. The study also demonstrated significant medicalisation of FGM, which matches recent trends in international data. Type 4 FGM performed in infancy is easily missed on examination and so vigilance in assessing children with suspected FGM is essential. [ABSTRACT FROM AUTHOR]