Female Genital Cutting in Immigrant Children—Considerations in Treatment and Prevention in the United States

Abstract

Female genital cutting (FGC) is a pediatric practice; however, the vast majority of United States (US) and international review articles and research have focused on women. Given recent immigration to the US of immigrants from countries where FGC is practiced, there are children living in the US who have FGC or are at risk of having FGC performed. Children with FGC are underdiagnosed in the US. It is imperative for medical providers who care for children to learn of FGC including medical findings, treatment, cultural beliefs, as well as the legal and ethical issues that may arise. Required, standardized training needs to be developed for all pediatric providers so that they can appropriately take care of children with FGC. There are no standardized national training requirements for medical providers who may care for children affected by FGC. FGC is under-identified in children and in general, pediatric providers lack the skills needed to appropriately identify and treat children with FGC as well as training to appropriately discuss prevention of FGC with patients and families. Pediatric legal and ethical guidelines are also lacking. National training requirements need to be developed for medical providers who take care of children with FGC or who are at risk of being cut. This includes the development of standard of care practice guidelines recommending that all girls have external genital examinations at all well child checks. Without such guidelines and clinical expectations, children with FGC, including those with significant morbidity from the practice, will not be identified or treated. Cultural, legal, and ethical recommendations and guidelines must also be developed to guide medical providers.