“You noticed during my smear — are you going to report me to the police?”

FGM identified in an ADULT during a smear is, first and foremost, a moment for trauma-informed, non-judgemental survivor care: she underwent childhood abuse, is anxious and possibly ashamed, and must be reassured immediately that she is not in trouble and not being reported to the police — mishandling this, or threatening police, would retraumatise her and destroy trust. The reporting position must be understood correctly: there is NO duty to report an adult with historical FGM to the police (she has committed no offence), because the statutory MANDATORY police-reporting duty applies specifically to KNOWN/identified FGM in a girl UNDER 18, not to a woman aged 18 or over whose FGM was done to her as a child. There ARE duties, however: you must RECORD the finding in her medical record and the FGM Enhanced Dataset (mandatory for GP practices; her consent is not required, but she is told; a clinical/data duty distinct from a criminal report — recording is not reporting to police), and — the critical safeguarding action — carry out a RISK ASSESSMENT for any girls connected to her (daughters, younger sisters, nieces) who could be at risk of FGM, making a safeguarding referral if a child is at risk and flagging any daughter under 18 on the FGM Information Sharing system (FGM-IS). Assess and address her clinical needs (the type of FGM and its complications — urinary, menstrual, sexual, obstetric — and the option of deinfibulation, especially for type 3 and ideally before pregnancy/delivery) and her psychological needs (flashbacks, anxiety, sexual difficulties), referring to specialist FGM services (RCOG GTG 53) and offering psychological support (NICE NG116), because the point of identifying it is to help her. The hidden agenda is fear of being reported, judged, or having "a big thing" made of it, with shame and trauma beneath; discharge the duties correctly and compassionately, reassure about the police fear, explain clearly what actually happens, protect any at-risk girls, and treat her with dignity.