Female genital mutilation: everyone’s problem

In response to the publication released by Janice Rymer and Norma O'Flynn on female genital mutilation (FGM), we are writing to give supporting arguments towards what is currently a well-publicised dilemma.

Rymer and O'Flynn raise an important point, which stems around the belief that we must change the current perception of FGM being an issue that is foreign and irrelevant in our society, to the belief that it is an essential problem, which needs to be tackled from our own doorstep. Despite the various difficulties in attaining the true numbers of those affected by the practice, it is estimated that around 280,000 women across the UK are affected; including many young girls who are at risk.

The significance of primary care cannot be underestimated and as the authors state, there are many ways that GPs and primary care teams can help with this matter. Being the first port of call within the community allows them to hold a very privileged position to be able to engage actively with FGM-affected communities, addressing their unique needs, and safeguarding children by providing adequate support.

In order for GPs to be able to sufficiently tackle the problem, they need to have sufficient knowledge on both the practice and the main medical issues as well as be aware of UK law and national guidelines. We have investigated the knowledge, attitudes and practices of GP's (in Network 5, Hammersmith & Fulham) towards FGM by using online surveys to identify barriers to GP engagement within affected communities to determine training needs.

Our study shows that of the GPs surveyed, the majority have limited understanding of FGM including the definition and main demographics. However, they lack knowledge on the associated health issue, the UK regulations and availability of local specialist services. Many further lack confidence in discussing these health and legal implications with FGM -affected women.

It is of concern that GP practice in general was often not consistent with national guidelines and only a minority were aware of the existence of the respective guidelines. Only a small proportion of GPs actually received any training on FGM.

It is reassuring however, that the majority of GPs were aware of their need for further training and have requested this. Recommendations for the future must be focused on the need for more training for GPs. A recent increase in the awareness of FGM in the media has brought a distressing and violent truth of the abuse of women and with it, the much required awareness. However, there is still a long way to go and it is our duty as Rymer and O'Flynn so rightly stress, for GPs and those who are in the position to influence, to be informed and adequately trained in order for this sad reality to come to an end.

Conflict of Interest:

None declared