There are procedures (usually referred to as clitoral or labial reconstruction or reconstruction surgery) which attempt to ‘reverse’ or ‘restore’ a woman’s genitalia to how it was before she suffered FGM. There are many clinics globally who offer these treatments, largely across Europe and Africa, and there is emerging evidence of some of the benefits to women who receive this treatment.
In the UK, the NHS currently do NOT offer reconstruction surgery. The NHS does offer a procedure called ‘de-infibulation’ for women who have had FGM Type 3 (or pharaonic circumcision). This surgery opens the scar tissue that covers the urine hole and vaginal opening. It can help with some of the physical symptoms of FGM, such as allowing a woman to pass urine normally, have sex more comfortably, have a vaginal delivery at birth and to have a cervical smear examination. This is sometimes called a “reversal” but actually, this does not put back what has been removed during FGM.
The UK FGM RESTORE project
A new project is underway, the end goal of which is to establish a National Centre of Excellence providing FGM reconstruction surgery as a treatment option for FGM survivors. The plan is for reconstruction surgery to be integrated within a holistic care package offering psychosexual and trauma therapy alongside other treatment options and support. The co-designed service will be delivered by a multidisciplinary team with Patient and Public Involvement and Engagement (PPIE) at its core. Surgery may then be the final option after careful psychosexual assessment, education and offer of treatment alternatives. This will be carried out as part of a clinical trial to ensure that robust safeguards are in place and that we contribute to the development of new evidence in this important area of healthcare research.
We believe that although not all women will want or benefit from reconstruction surgery, women should be able to make an informed decision to access this if they wish and we believe that the NHS should be offering this type of surgery to FGM survivors.
Who is involved?
The project team includes specialist FGM midwives, urologists, urogynaecologists, gynaecologist, plastic surgeon, GP, FGM academics and specialist FGM counsellors, FGM survivors/women with lived experience, health advocates, and representatives from charities who support women with FGM. All members have significant experiences caring for women with FGM and have worked in this area for many years.
All project members are giving their time freely to support this work.
We are grateful to The Urology Foundation for providing funding to support Phase 1 of this project.
Everyone involved is a keen and committed #EndFGM advocate and we believe that the ultimate goal remains the complete eradication of FGM globally. The provision of the best treatment possible for FGM survivors is part of the #EndFGM campaign.
Progress
As of 2023, the project is in relatively early stages.
When there are project updates, we will update this page.
For more information, please email juliet.albert@nhs.net
Project Steering Group Members
- Juliet Albert – Specialist FGM/C midwife, The Sunflower Clinics, Imperial College Healthcare NHS Trust (Co-Lead)
- Professor Sohier Elneil – Consultant Uro-Gynaecology and FGM/C expert, University College London Hospitals NHS Foundation Trust (Co-Lead)
- Aurora Almadori – Plastic Surgeon, Royal Free Hospital
- Catriona Stalder – Gynaecologist, Imperial College Healthcare NHS Trust
- Tina Rashid – Urologist and Gender reassignment/feminizing surgeon, St George’s Hospital Foundation NHS Trust
- Roland Morley Urologist and Gender reassignment/feminizing surgeon – Imperial Healthcare NHS Trust and St George’s Hospital Foundation NHS Trust
- ‘KM’, Anonymous FGM/C survivor
- Suhad Adam FGM/C Health Advocate – The Sunflower Clinic, ICHNT
- Christie Coho Specialist FGM/C psychotherapist
- Huda Mohamed FGM/C Midwife – Whittington Hospital
- Alison Byrne FGM/C Midwife – University Hospitals Birmingham and Sandwell & West Birmingham Hospital Trust
- Vicky Bowler, GP – Bristol Rose clinic
- Professor Catrin Evans, academic FGM/C expert, University of Nottingham
- Stefania Palmieri – Uro-gynaecologist, UCLH
- Naana Otoo oyortey – FORWARD
- Toks Okeniyi – FORWARD
- N’Dey Gassama – founder of Holistic Support Ltd
- Astrid Fairclough – Churchill Fellow/Policy Advisor
- Dalia Saidan, Consultant Uro-gynaecologist, Croydon University Hospital
- Rachel Phillips – Imperial Clinical Trials Unit
- Hekate Papadaki – Manor Gardens
- Honorary member – Dr Jasmine Abdulcadir (HUG clinic, Switzerland)
- Njomeza Kartallozi – Manor Gardens
- Natasha Anderson-Foster – Psychosexual therapist
