Female Genital Mutilation/Cutting-Pediatric Physician Knowledge, Training, and General Practice Approach

J Immigr Minor Health. 2020 Aug;22(4):668-674. doi: 10.1007/s10903-019-00938-x.

Abstract

Female genital mutilation/cutting (FGM/C) is outlawed in much of the world but still mainly occurs from infancy-age 15. Many at-risk and FGM/C-affected girls live in the US. No standard pediatric training exists. A questionnaire assessing FGM/C education, knowledge, diagnostic confidence and external genital examination (EGE) approach was sent to pediatric listservs at 3 hospitals and a child abuse pediatrician (CAP) network. Analysis used χ2 and Fisher's exact tests. Compared to general pediatricians, CAP reported more FGM/C education (RR 2.0 [95% CI 1.3-3.2]), awareness of ICD-9/10 codes (RR 3.2 [95% CI 1.4-7.3]), confidence in identifying sub-types (RR 4.5 [95% CI 2.3-8.7]) and discussing FGM/C (RR 4.2 [95% CI 2.3-7.6]). For 6-12 month olds, 10% of general pediatricians reported never performing EGE at female well child visits (WCV), increasing to > 50% for 17-18 year olds. Pediatric physicians are not trained to diagnose or manage FGM/C. EGE are not done at WCVs and FGM/C diagnoses are missed.

Keywords: Children; Female genital mutilation/cutting; Pediatrics.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Circumcision, Female*
  • Female
  • Gynecological Examination / methods
  • Gynecological Examination / statistics & numerical data*
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Infant
  • Male
  • Pediatrics / education*
  • Pediatrics / statistics & numerical data*
  • Residence Characteristics
  • Socioeconomic Factors
  • United States