Female genital mutilation in children presenting to Australian paediatricians

Arch Dis Child. 2017 Jun;102(6):509-515. doi: 10.1136/archdischild-2016-311540. Epub 2017 Jan 12.

Abstract

Objective: The WHO reports that female genital mutilation/cutting (FGM/C) is an ancient cultural practice prevalent in many countries. FGM/C has been reported among women resident in Australia. Our paper provides the first description of FGM/C in Australian children.

Design: Cross-sectional survey conducted in April-June 2014.

Setting: Paediatricians and other child health specialists recruited through the Australian Paediatric Surveillance Unit were asked to report children aged <18 years with FGM/C seen in the last 5 years, and to provide data for demographics, FGM/C type, complications and referral for each case.

Participants: Of 1311 eligible paediatricians/child health specialists, 1003 (76.5%) responded.

Results: Twenty-three (2.3%) respondents had seen 59 children with FGM/C and provided detailed data for 31. Most (89.7%) were identified during refugee screening and were born in Africa. Three (10.3%) were born in Australia: two had FGM/C in Australia and one in Indonesia. All parents were born overseas, mainly Africa (98.1%). Ten children had WHO FGM/C type I, five type II, five type III and six type IV. Complications in eight children included recurrent genitourinary infections, menstrual, sexual, fertility and psychological problems. Nineteen children (82.6%) were referred to obstetrics/gynaecology: 16 (69.9%) to social work and 13 (56.5%) to child protection.

Conclusions: This study confirms that FGM/C is seen in paediatric clinical practice within Australia. Paediatricians need cultural awareness, education and resources to help them identify children with FGM/C and/or at risk of FGM/C, to enable appropriate referral and counselling of children, families and communities to assist in the prevention of this practice.

Keywords: Female Genital Mutilation; General Paediatrics.

MeSH terms

  • Adolescent
  • Africa / ethnology
  • Australia / epidemiology
  • Black People / statistics & numerical data
  • Child
  • Child Health Services / standards
  • Child, Preschool
  • Circumcision, Female / adverse effects
  • Circumcision, Female / education
  • Circumcision, Female / ethnology*
  • Circumcision, Female / methods
  • Clinical Competence / statistics & numerical data
  • Cross-Sectional Studies
  • Culturally Competent Care / standards
  • Education, Medical, Continuing / methods
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Pediatrics / education
  • Referral and Consultation / statistics & numerical data
  • Teaching Materials