This article, titled “Female Genital Mutilation and Cutting: Essentials for Pediatric Nurse Practitioners,” authored by Gail Hornor, DNP, CPNP, SANE-P, serves as a vital continuing education resource for healthcare professionals, particularly Pediatric Nurse Practitioners (PNPs). Published in the Journal of Pediatric Health Care, this paper addresses the critical and complex issue of Female Genital Mutilation and Cutting (FGM/C).
The article establishes FGM/C as a serious global public health problem and a profound violation of the basic human rights of girls and women, explicitly classifying it as a form of child maltreatment. It highlights the staggering statistic that over 200 million girls and women in thirty countries across Africa, the Middle East, and Asia have undergone FGM/C. Furthermore, the article notes that FGM/C is a significant concern within the United States, with approximately 513,000 girls and women living in the U.S. at risk for FGM/C or its consequences—a four-fold increase within a decade. The economic burden to healthcare systems treating the health consequences of FGM/C is substantial, estimated at 1.4 billion dollars per year.
Recognizing that many healthcare professionals, including nurses and advanced practice registered nurses, report a lack of knowledge and comfort regarding the identification and clinical management of FGM/C, the article aims to equip PNPs with the necessary understanding to intervene appropriately.
Key objectives and areas covered in this comprehensive article include:
- Defining FGM/C in terms of anatomical changes by type, classifying it into four distinct types with subtypes as per the World Health Organization (WHO). It specifically notes that Type III, or infibulation, leads to the most significant long-term consequences.
- Describing the possible short- and long-term complications of FGM/C, which range from severe pain, hemorrhage, and infections to chronic issues like keloid scarring, neuromas, infertility, and significant obstetric complications. Psychological trauma, including post-traumatic stress disorder, anxiety, and depression, is also addressed.
- Emphasizing the importance of cultural humility when addressing FGM/C, urging PNPs to be respectful of the deep-rooted familial and community traditions that perpetuate the practice, without condoning it. It explains the sociological roots and cultural myths surrounding FGM/C, such as maintaining chastity and enhancing male sexual pleasure.
- Exploring the PNP role in the prevention, identification, and clinical management of FGM/C, including how to conduct anogenital exams, assess for complications, and provide referrals for reconstructive surgery or defibulation. The article provides crucial information on the legal status of FGM/C in the U.S., including the illegality of “vacation cutting,” and the requirement to report FGM/C performed domestically or through “vacation cutting” to Child Protective Services and law enforcement. It also includes screening interview questions for assessing risk.
- Discussing the distinctions between male and female circumcision, clarifying why male circumcision is not a viable argument to support FGM/C.
Ultimately, this article aims to empower PNPs to provide culturally sensitive and comprehensive care to girls, adolescents, and their parents who have experienced or are at risk of FGM/C, advocating for this vulnerable population.
Reference: Hornor, G. (2025). Female Genital Mutilation and Cutting: Essentials for Pediatric Nurse Practitioners. Journal of Pediatric Health Care, 39, 112-121. https://doi.org/10.1016/j.pedhc.2024.07.010
