{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T20:48:25Z","timestamp":1782420505766,"version":"3.54.5"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"vor","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Research and Development Projects"},{"DOI":"10.13039\/501100006388","name":"Geneva University Hospitals","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006388","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Accurate identification and reporting of female genital mutilation\/cutting (FGM\/C) are essential for clinical care, documentation, and epidemiological research, yet self-reporting of FGM\/C type remains unreliable and may benefit from visual support tools. This study aimed to evaluate the concordance between women\u2019s self-assessed FGM\/C type using a watercolor-based visual tool and the World Health Organization classification determined by clinical examination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective observational study including women with a history of FGM\/C. Participants self-assessed their vulval appearance by selecting one of eight watercolor illustrations inspired by representative images from a clinical atlas. Self-assessments were compared with diagnoses established during standardized vulval examinations by a trained specialist. The primary outcome was agreement between self-assessment and clinical classification, while secondary outcomes included recognition rates, predictors of accurate self-reporting, and acceptability of the tool. Insights gathered during clinical use informed the development of a digital version intended to facilitate implementation in clinical and community settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eighty women were included. The most common types were Type IIb (n\u00a0=\u200930, 37.5%) and Type III (n\u00a0=\u200925, 31.2%). Agreement between self-assessment and clinical examination was low for both subtypes (\u03ba\u00a0=\u20090.205, 95% CI: 0.101-0.308) and types (\u03ba\u00a0=\u20090.204, 95% CI: 0.063-0.344). Recognition was achieved in 27\/80 (34%) for a subtype and 35\/80 (44%) for a type of FGM\/C. Self-report accuracy was highest among women with Type III (n\u00a0=\u200913, 52%). Among the 16 participants (20%) who selected the watercolor of a vulva without FGM\/C, 37.5% (n\u00a0=\u20096) had previously undergone defibulation. Type III was the only independent predictor of correct self-reporting (aRR\u2009=\u20092.16, P\u00a0=\u2009.009).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Visual self-assessment tools may enhance communication and patient engagement but cannot replace clinical examination for accurate FGM\/C classification and documentation. Strengths include the prospective design, standardized clinical examination, and a novel patient-centered visual tool, while limitations include single-center recruitment and tool development without direct input from affected women. Agreement between self-assessment and clinical examination was limited, indicating that visual tools may support awareness and communication but cannot replace clinical evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jsxmed\/qdag190","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T11:50:57Z","timestamp":1780055457000},"source":"Crossref","is-referenced-by-count":0,"title":["Concordance between self-assessment using watercolor illustrations and clinical examination: implementing a visual tool to improve recognition and communication on female genital mutilation\/cutting"],"prefix":"10.1093","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-6883-0936","authenticated-orcid":false,"given":"Laleh","family":"Hunziker","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Geneva , 1205 Geneva,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Locher","sequence":"additional","affiliation":[{"name":"Division of Gynecology, Department of Pediatrics, Obstetrics and Gynecology, Geneva University Hospitals (HUG) , 1205 Geneva ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmine","family":"Abdulcadir","sequence":"additional","affiliation":[{"name":"Division of Gynecology, Department of Pediatrics, Obstetrics and Gynecology, Geneva University Hospitals (HUG) , 1205 Geneva ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"issue":"1","key":"2026062516174980700_ref1","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1038\/s41443-022-00542-y","article-title":"Gendered genital modifications in critical anthropology: from discourses on FGM\/C to new technologies in 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