4. Prevention and protection: Counseling families with daughters at risk for female genital mutilation/cutting

Abstract

Though an estimated 16 417 women and girls in Philadelphia, PA are currently living with or at risk of FGM/C, the U.S. has no formal protocols for assessing risk of FGM/C or delivering prevention counseling. Physicians from the Drexel Women's Care Center specialty clinic for FGM/C have developed a model for counseling parents of girls who may be at risk. Designed for use in various pediatric and primary care settings, the model includes the following steps: Establish family's country of origin. 2) Promote discussion about exposure to FGM/C. 3) Offer services related to FGM/C for affected women. 4) Explore and assess risk to female children. 5) Discuss health consequences and U.S. legal repercussions. 6) Refer to child services as needed. To facilitate implementation in practice settings, we have developed a toolkit with the following segments: a list of high prevalence countries, considerations for identifying at-risk patients, information on the health consequences of FGM/C, legal resources, and practices for documentation in medical records. Training pediatricians to screen for FGM/C risk bridges a critical gap in U.S.-based prevention efforts. By implementing a protocol for counseling parents of at-risk girls, providers can play a key role in prevention of FGM/C among future generations.