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Known female genital mutilation in a girl under 18 with risk to a younger sibling — DFSRH MCQ

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HardChild ProtectionKnown female genital mutilation in a girl under 18 with risk to a younger siblingDFSRH

A 17-year-and-10-month-old girl attends a sexual and reproductive health service in England alone, requesting contraception and assessment of superficial dyspareunia. She has decision-making capacity. During a clinically indicated genital examination, there is loss of the clitoral glans and labia minora with mature symmetrical scarring. She explains that she was “cut” abroad at the age of 8, before the family moved to the UK. There is no acute injury or immediate threat to her safety. She asks the doctor not to tell the police or her family. She also reports that her 10-year-old sister is due to travel abroad with relatives in 6 weeks and that the family has discussed arranging the same “ceremony” for her. The doctor considers that alerting the family before a safeguarding plan is agreed may increase the risk of travel being brought forward. Which is the most appropriate management plan?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Explain the limits of confidentiality to her, personally report the known FGM to police via 101 promptly, and make an urgent children’s social care referral concerning both sisters without first alerting the family.

The decisive facts are that the patient is under 18 at the time of identification, directly discloses that she underwent FGM, and has physical signs observed during an examination that was already clinically indicated. In England and Wales, this constitutes a known case triggering the statutory mandatory reporting duty. The historical timing and overseas location do not remove that duty. Her consent is not required, and complying with the duty does not breach confidentiality. The duty is personal: the doctor who identifies the case must report it and cannot transfer responsibility to the safeguarding lead, although the lead should be informed. Reporting should occur as soon as possible—best practice is by the close of the next working day—usually through police 101. It does not require prior specialist confirmation. Mandatory police reporting does not replace wider safeguarding action. The younger sister faces a credible prospective risk, requiring urgent referral through local children’s social care procedures and consideration of protective measures. The patient should normally be told what will be shared, but the family should not be alerted first where doing so may increase serious harm or precipitate travel. B incorrectly delegates the personal reporting duty. C wrongly makes disclosure contingent on consent. D imposes a confirmation threshold absent from the legislation. E wrongly treats the place and date of the original procedure as exemptions from reporting a known case identified while the girl remains under 18.

Reference: Mandatory reporting of female genital mutilation: procedural information (Updated 22 January 2020) — https://www.gov.uk/government/publications/mandatory-reporting-of-female-genital-mutilation-procedural-information/mandatory-reporting-of-female-genital-mutilation-procedural-information-accessible-version Mandatory reporting of female genital mutilation: procedural information (Updated 22 January 2020) — https://www.gov.uk/government/publications/mandatory-reporting-of-female-genital-mutilation-procedural-information/mandatory-reporting-of-female-genital-mutilation-procedural-information-accessible-version Multi-agency statutory guidance on female genital mutilation (Updated 30 July 2020) — https://www.gov.uk/government/publications/multi-agency-statutory-guidance-on-female-genital-mutilation/multi-agency-statutory-guidance-on-female-genital-mutilation-accessible-version