Signs FGM may have happened and urgent health concerns

A child who has had FGM may not say so. Staff might notice physical discomfort, distress, changes in behaviour or avoidance after contact with family, travel or a period away from the home. These signs do not prove FGM, but they can justify immediate safeguarding action.

If there is bleeding, severe pain, collapse, fever, difficulty passing urine, suspected infection or any immediate danger, staff should use urgent health or emergency routes. Do not delay safeguarding while seeking certainty.

Possible signs after FGM

• Movement and sitting: difficulty walking, standing, sitting or taking part in physical activity.
• Toileting changes: spending excessive time in the bathroom or reporting pain on passing urine.
• Health concerns: abdominal pain, urinary infections, bleeding, unusual discharge, fever or unexplained discomfort.
• Emotional signs: withdrawal, low mood, fear, anger, shame or sudden mistrust.
• Avoidance: reluctance about medical appointments, bathing, intimate care or discussing family contact.

Staff do not need proof before sharing concern. The safer threshold is: notice the pattern, protect the child and escalate.