Department of Paediatrics, University College London Hospitals NHS Foundation Trust, London, UK.
Royal Sussex County Hospital, Brighton, Brighton and Hove, UK.
Arch Dis Child. 2020 Nov;105(11):1075-1078. doi: 10.1136/archdischild-2019-318336. Epub 2020 Jun 4.
To describe the presentation and management of children with suspected or confirmed female genital mutilation (FGM) referred to a specialist paediatric clinic.
Data collected included referral source, age, ethnicity, circumstances of FGM and clinical findings in accordance with the WHO FGM classification.
Between September 2014 and January 2019, 148 children attended the clinic of whom 55 (37.2%) had confirmed FGM. Police or social care referred 112 (76%) children. The proportion of looked-after children (LAC) was significantly higher in the group with confirmed FGM (17/55, 31%) compared with children where FGM was not confirmed (5/93, 5%). In almost all children where FGM was confirmed, FGM was initially disclosed by the child or family (53/55, 96%) and of these 48/55 (87%) underwent FGM prior to UK entry. The remaining seven cases were British children, potentially meeting legal criteria under the FGM Act, and one resulted in a successful prosecution.
The number of children with FGM was significantly lower than expected based on UK prevalence estimates. Most children had undergone FGM prior to UK entry, and the majority of cases were initially disclosed by the child or family themselves. These results reflect the lack of large-scale proof of the practice of FGM in the UK and are consistent with growing evidence of the abandonment of FGM among communities after migration.
描述转诊至儿科专家诊所的疑似或确诊女性外阴残割(FGM)儿童的临床表现和处理方法。
收集的数据包括转诊来源、年龄、族裔、FGM 情况和根据世卫组织 FGM 分类的临床发现。
2014 年 9 月至 2019 年 1 月期间,共有 148 名儿童就诊,其中 55 名(37.2%)被确诊为 FGM。112 名儿童(76%)由警察或社会福利机构转介。在确诊 FGM 的儿童中,被照料儿童(LAC)的比例明显高于未确诊 FGM 的儿童(17/55,31%比 5/93,5%)。在所有被确诊为 FGM 的儿童中,FGM 最初是由儿童或家庭披露的(53/55,96%),其中 48/55(87%)在英国入境前就已经接受了 FGM。其余 7 例是英国儿童,可能符合《FGM 法案》的法律标准,其中一例成功起诉。
FGM 儿童的数量明显低于基于英国流行率估计的预期。大多数儿童在英国入境前就已经接受了 FGM,而且大多数病例最初是由儿童或家庭自己披露的。这些结果反映了英国缺乏大规模证明 FGM 实践的证据,与移民后社区放弃 FGM 的证据越来越多是一致的。