Eliminating FGM: what can health professionals do?

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Female genital mutilation (FGM)—defined by WHO as “procedures that involve the partial or total removal of external genitalia or other injury to the female genital organs for non-medical reasons”—is internationally recognised as a violation of the human rights of girls and women. Worldwide, more than 200 million girls and women suffer the physical and psychological consequences of FGM. FGM is a harmful practice and can cause several immediate and long-term health consequences such as haemorrhage, post-traumatic stress disorder, painful urination, and complications in childbirth. However, many health professionals worldwide are unaware of the negative health consequences of FGM and remain inadequately trained to recognise and manage the complications properly. Disturbingly, in several high-FGM-prevalent countries, between 9% and 74% of FGM procedures were performed by health professionals—the so-called medicalisation of FGM. On May 16, WHO published guidelines to help health professionals to improve the care of girls and women living with FGM. The new guidelines provide five up-to-date evidence-informed recommendations and eight best practice statements, including using deinfibulation to prevent and treat obstetric and urological complications and to facilitate childbirth; providing psychological support and sexual health counselling; and conveying accurate and clear health education and information. However, the guidelines also acknowledge that the quality of evidence was low or absent in several areas. Importantly, the guidelines emphasise the roles of health professionals in tackling FGM as caregivers rather than as perpetrators, and that health professionals should take a firm stance against medicalisation of FGM and in favour of the abandonment of FGM. The Sustainable Development Goals contain a specific target of eliminating FGM by 2030, and health professionals have a crucial role to intensify the global efforts to achieve the target, particularly in providing appropriate health interventions for women suffering from FGM complications and to generate further robust evidence to inform FGM-related health policy, clinical interventions, and prevention strategies.