Human Rights
5
 min read

FGM Reconstruction Surgery in the UK: The NHS Pathway and Evidence Gap

The NHS provides specialist FGM care and deinfibulation, but there is no routine NHS pathway for clitoral reconstruction. Research is now testing the evidence gap.

FGM survivor care and the absence of a routine NHS reconstruction pathway
Aneeta Prem
March 19, 2026

Reviewed and updated 22 August 2026. This article provides general information and is not individual medical advice.

By Aneeta Prem MBE

The NHS already provides specialist care for women affected by female genital mutilation. What it does not currently provide as a routine pathway is clitoral reconstruction surgery.

Those two facts are sometimes blurred together. They should not be.

The real UK policy question is how established FGM care, survivor choice and emerging evidence on reconstruction should fit together.

What the NHS provides now

National FGM Support Clinics in England offer specialist assessment, information, emotional support and counselling, access to FGM health advocates and referral to other services where needed.

Many clinics also provide or arrange deinfibulation.

Deinfibulation is an operation to open scar tissue that narrows the vaginal opening after type 3 FGM. It can help with problems involving urination, sexual intercourse, examinations or childbirth.

It does not restore tissue removed by FGM and it is not the same procedure as clitoral reconstruction.

What clitoral reconstruction is

Clitoral reconstruction aims to expose or reposition remaining clitoral tissue after FGM.

Some women seek it because of pain, sexual function, body image, trauma or a wish to regain a sense of bodily autonomy.

Those reasons deserve respect. So does the uncertainty in the evidence.

The UK and international guidance are not identical

The Royal College of Obstetricians and Gynaecologists currently advises that clitoral reconstruction should not be performed because evidence has not shown conclusive benefit and there are concerns about complication rates and possible further nerve or vascular injury. RCOG supports further research.

The World Health Organization’s 2025 guideline takes a somewhat different position. It makes a conditional recommendation that clitoral reconstruction may be considered for selected women, while rating the certainty of evidence as very low and stressing the importance of sexual-health counselling and realistic expectations.

That difference is exactly why careful UK research matters.

Why this is now a live research question

The Women and Equalities Committee has criticised gaps in survivor care and the lack of evidence around reconstruction.

The National Institute for Health and Care Research subsequently opened a funding call asking directly about the clinical and cost-effectiveness of reconstruction surgery for FGM/C survivors.

The research specification includes outcomes such as quality of life, mental health, sexual function, pain, body image, acceptability, complications and cost-effectiveness.

That is progress because the debate is moving from assertion to evidence.

Why women may still travel abroad

Some specialist centres outside the UK offer clitoral reconstruction, and some women choose to explore those services privately.

Anybody considering surgery needs clear information about the exact procedure, the surgeon’s experience, expected benefits, known risks, follow-up and what will happen if complications arise after returning to the UK.

No website can make that decision for an individual patient.

Specialist care must be broader than surgery

FGM can affect physical, psychological, sexual and reproductive health in different ways.

A serious care pathway may therefore involve gynaecology, midwifery, counselling, psychology, continence services, pain care, psychosexual support and advocacy.

Surgery cannot address every consequence of FGM, and not every survivor will want surgery.

What informed choice should look like

There are two unhelpful extremes.

One is to present reconstruction as if it simply restores what was removed. It does not.

The other is to shut down the subject as if women are wrong to ask about it.

Good care should explain what is established, what remains uncertain and what support is available now.

What should happen next

The UK should:

  • make specialist FGM care easy to find regardless of geography;
  • ensure women receive clear information about deinfibulation and other established care;
  • maintain counselling and psychosexual support as part of the pathway;
  • complete high-quality research into reconstruction outcomes;
  • publish the results transparently; and
  • review NHS policy as the evidence develops.

Final word

Britain is right to be cautious about introducing a surgical procedure without strong evidence.

It would be wrong to use uncertainty as a reason not to investigate the question properly or not to improve the care already available.

Survivors deserve established treatment now, honest information about reconstruction and research good enough to tell us whether the NHS position should change.

Sources and further reading

Related on Aneeta.com

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