(251) Concordance Between Self-Assessment Through Watercolors and Clinical Examination: Implementing a Visual Tool to Improve Recognition of and Communication on Female Genital Mutilation/Cutting

Introduction Female genital mutilation/cutting (FGM/C) affects more than 230 million women worldwide. Accurate classification of FGM/C types is essential for clinical care, research, and prevalence estimates. However, most epidemiological data rely on self-report, which may be limited by inaccurate self-anatomical knowledge, recall bias, and sociocultural factors. Visual tools have been proposed to support self-recognition, but their validity compared to clinical examination remains underexplored. Objective To evaluate the agreement between women’s self-assessment of their type of FGM/C using a watercolor visual tool and the WHO type identified through clinical examination. Methods This is a prospective observational study including 80 women with a history of FGM/C who were asked to self-report their vulval appearance choosing one of eight watercolor illustrations based on a selection of the most representative images of the atlas “Female Genital Mutilation/Cutting in Children and Adolescents: Illustrated Guide to Diagnose, Assess, Inform and Report.” Their choices were compared to the diagnoses made with clinical vulval examinations by a trained specialist. Data on sexual health outcomes (desire, pleasure, arousal, orgasm, satisfaction, and pain) were collected through structured interviews. Results Eighty women were included. The most common types were Type IIb (n = 30, 37.5%) and Type III (n = 25, 31.2%). The highest significant self-report accuracy was observed in women with Type III (n = 13, 52%). Among the 16 participants who selected the illustration of a vulva without FGM/C, 37.5% (n = 6) had undergone defibulation. Self-report accuracy was statistically significantly influenced by the type of FGM/C, with Type III being the only independent predictor of correct recognition. Conclusions Self-assessment and reporting of FGM/C have limited accuracy, even when supported by visual tools. Type III FGM/C was more often correctly self-recognized and was the only independent predictor of accurate reporting. Neither the presence nor absence of sexual pleasure or pain was statistically significantly associated with self-recognition accuracy. The watercolor tool was well accepted and showed potential to raise awareness and facilitate dialogue on FGM/C. Nevertheless, clinical examination remains essential for accurate classification, and future studies should also rely on direct clinical assessment rather than self-reported data alone for prevalence and incidence estimates. Disclosure No