Reviewed and updated 7 October 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 the still-limited 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.
UK and international guidance differ
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 different, but still cautious, position. It gives a conditional recommendation that clitoral reconstruction may be considered for selected women living with FGM, while rating the certainty of evidence as very low.
Those positions are not as contradictory as they may first appear. Both acknowledge the weakness of the evidence. The difference is how far practice should move while that uncertainty remains.
The research gap is still unresolved
The Women and Equalities Committee highlighted gaps in survivor care and called for better evidence on reconstruction.
The National Institute for Health and Care Research then opened a funding call on the clinical and cost-effectiveness of reconstruction surgery for FGM/C survivors. The specification included outcomes such as quality of life, mental health, sexual function, pain, body image, acceptability, complications and cost-effectiveness.
But opening a funding call is not the same as having a funded study under way.
In material published by Parliament in July 2026, NIHR said it had received two applications. Its independent funding committee considered them in May and concluded that neither was ready for funding. NIHR also said it remained committed to funding research in this area.
So the honest position is that the research question has been formally recognised, but the evidence gap has not yet been filled.
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;
- fund high-quality research capable of answering the reconstruction question;
- 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 stronger evidence.
It would be wrong to turn that uncertainty into a permanent 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
- NHS: National FGM Support Clinics
- NHS: female genital mutilation
- RCOG: Female Genital Mutilation and its Management
- WHO: guideline on prevention of FGM and clinical management of complications
- Women and Equalities Committee: female genital mutilation
- Women and Equalities Committee: correspondence on reconstruction research