TESTING

Health Impacts of FGM/C

It is well established that the experience of undergoing FGM/C can result in immediate and long-term consequences and complications related to health and health risks, including mental health. Please see the table below for a list of possible short- and long-term health risks that you may encounter when caring for a patient who has undergone FGM/C.

FGM/C Screening Tools

These screening tools have been developed to help guide patient screenings and evaluations for (1) women over the age of 18 who may have undergone FGM/C and (2) minors under the age of 18 who may have undergone FGM/C or at risk of FGM/C.

Women over age 18

Minors under age 18

Guidance for Conducting a Patient Evaluation: Likely a Survivor of FGM/C

Determine how the woman refers to the practice of female genital cutting and use this terminology throughout her care.
Provide a well-trained, trusted, and neutral interpreter who can ensure confidentiality and who will not exert undue influence on the patient-physician interaction when providing care to a woman who faces language challenges.
Protect the woman's or child’s privacy and confidentiality by limiting attendants in the examination room to those who are necessary and part of the health care team.
If your patient shares having sexual or reproductive health issues or answered yes to any of the screening questions above, offer a physical examination.
Perform physical examination in a sensitive manner, after consent is obtained, to identify the type of FGM/C and any complications (particularly infection, labial fusion/vaginal stenosis, and keloids or other evidence of scarring).
Properly document all information in her medical record to minimize repeated sharing/ examination. Our care checklist can help track FGM/C concerns in a patient's medical record.

Screening questions below:

Many women from your country have been circumcised or “closed” as children. If you do not mind telling me, were you circumcised or closed as a child?
Do you have any problems passing your urine? Does it take you a long time to urinate? (Note: women with obstruction may take several minutes to pass urine)
Do you have any pain with menstruation? Does your menstrual blood get stuck?
Do you have any itching or burning or discharge from your pelvic area?
(If sexually active) Do you have any pain or difficulty when having relations?

Reporting: Recent FGM/C Experience or Imminent Risk of FGM/C

Health Care providers who suspect that a minor has had FGM/C recently or is at risk of FGM/C may contact or refer to the following resources:

National Child Abuse Hotline: 1-800-4-A-CHILD (1-800-422-4453)
DC Hotline for Child Abuse and Neglect: 202-671-7233
DC Metropolitan Police Department: 202-727-9099
Office of Women’s Health (U.S. Department of Health and Human Services) Helpline: 1-800-994-9662
Other State-specific Child Abuse Reporting