title: Multidisciplinary approach to the management of children with female genital mutilation (FGM) or suspected FGM: service description and case series.
abstract: OBJECTIVE
  To describe the first dedicated clinic in the UK for children with suspected or confirmed female genital mutilation (FGM) including referral patterns, clinical findings and subsequent management.
  
  
  METHODS
  A prospective study of all children seen in a dedicated multidisciplinary FGM clinic for children over a 1-year period.
  
  
  METHODS
  Patients aged under 18 years referred for clinical assessment or for a second opinion on Digital Versatile Disc (DVD) images.
  
  
  METHODS
  Data were collected on reasons for referral, demography, genital examination findings including FGM type, and clinical recommendations.
  
  
  RESULTS
  38 children were referred of whom 18 (47%) had confirmed FGM; most frequently type 4 (61%). Social care and police referred 78% of cases. According to UK law FGM had been performed illegally in three cases. Anonymous information given to the police led to the referral of six children, none of whom had had FGM.
  
  
  CONCLUSIONS
  Mandatory reporting and increased media attention may increase the numbers of referrals of children with suspected FGM. This patient group have complex needs and management in a dedicated multidisciplinary service is essential. Paediatricians and gynaecologists should have the skills to carry out the consultation and detect all types of FGM including type 4 which was the most common type seen in this series. This is the first dedicated FGM service for children in the UK and similar clinics in high-prevalence areas should be established.
authors.affiliation: Department of Women's Health, University College London Hospital, London, UK.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Creighton
authors.affiliation: Department of Women's Health, University College London Hospital, London, UK.
authors.forename: Joanna
authors.initials: J
authors.lastname: Dear
authors.affiliation: Department of Women's Health, University College London Hospital, London, UK.
authors.forename: Claudia
authors.initials: C
authors.lastname: de Campos
authors.affiliation: Department of Women's Health, University College London Hospital, London, UK.
authors.forename: Louise
authors.initials: L
authors.lastname: Williams
authors.affiliation: Department of Paediatrics, University College London Hospital, London, UK.
authors.forename: Deborah
authors.initials: D
authors.lastname: Hodes
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019093:Circumcision, Female / Q000523:psychology / Q000534:rehabilitation*; D003376:Counseling; D005260:Female; D006801:Humans; D007223:Infant; D011446:Prospective Studies; D012017:Referral and Consultation; D006113:United Kingdom
keywords: FGM; Female Genital Mutilation