The search strategy for MEDLINE (Ovid MEDLINE In-Process & Other Non-Indexed Citations 1946 to 20 January 2012) is shown: Circumcision, Female/ ((female$ or wom#n or girl$1) adj3 (mutilation$ or circumcis$ or cutting$)).tw. Crizotinib ROS1 “fgm/c”.tw. ((removal$ or alteration$ or

excision$) adj6 female genital$).tw. pharaonic circumcision$.tw. sunna.tw. (clitoridectom$ or clitorectom$).tw. (infibulat$ or reinfibulat$ or deinfibulat$).tw. or/1–8 One reviewer (RCB) manually screened the bibliographies of published reviews on FGM/C and all included studies for additional qualifying studies. RCB did additional searches for the relevant grey literature and unpublished studies in OpenGrey, OpenSigle, OAIster, browsed websites of six international organisations that are engaged in projects regarding FGM/C, and communicated with experts

in the field. Selection of studies and extraction of data Studies retrieved were eligible for inclusion if they satisfied all our criteria: Be an empirical quantitative study with or without a comparison group published in any language that presented original quantitative data for physical health outcomes in women who had undergone any type of FGM/C as defined by the WHO.1 All physical health outcomes were eligible, including but not limited to death, infections, infertility, fistula, pain, urinary complications, shock (primary outcomes), and bleeding/haemorrhage, menstrual complications, obstetric complications, vaginal calculus formation, cysts, tissue injury,

fractured/displaced bones, urethral meatal stenosis/ urethral stricture, abscesses, keloid and other scarring (secondary outcomes). We applied the following exclusion criteria: Qualitative studies, studies without a quantitative measure of a physical consequence of FGM/C, and all genital modifications not captured by the WHO stated FGM/C definition. Screening, quality appraisal and data extraction were independently undertaken by two investigators (RCB and VU), with discrepancies resolved by consensus. The two investigators confirmed the eligibility of first titles and Drug_discovery abstracts and then full texts. Quality assessment of the identified studies was undertaken as recommended in the Cochrane Handbook, using design specific checklists based on the User’s Guide framework.16 This was done at the study level. The investigators extracted study information and data onto a standardised data collection form, which had been piloted. Data extracted included publication details, study design, sample characteristics, FGM/C characteristics, methods of outcome measurement and health consequences. We contacted authors for additional data or clarification where needed. Statistical analysis We grouped the data according to outcomes across the studies, keeping the outcome categories or labels as reported in each individual study.