Conducting an asylum evaluation focused on female genital mutilation/cutting status or risk

Int J Gynaecol Obstet. 2021 Apr;153(1):3-10. doi: 10.1002/ijgo.13428. Epub 2020 Dec 22.

Abstract

Background: Female genital mutilation or cutting (FGM/C) is considered a human rights violation and is practiced all over the world. It has been used as a basis for seeking asylum in various countries, including in the USA since 1996, and the precedent-setting matter of Kissindja. Clinicians in the USA and elsewhere who perform asylum evaluations may be called upon to evaluate women who seek asylum based on their FGM/C status or risk. In this manuscript, we provide expert-informed best practices to conduct asylum evaluations based specifically on FGM/C. We review evidence-based history taking, physical examination unique to the population of women and girls affected by FGM/C, and consider the evaluation in the context of trauma-informed care.

Conclusion: Although general clinical skills often suffice to perform asylum evaluations, FGM/C represents a unique niche within the field of gynecological asylum evaluations and requires additional background knowledge and clinical competencies.

Ethical approval: As this is a clinical review and does not involve patients or research subjects no ethical approval was sought or was necessary.

Keywords: Asylum evaluations; Asylum seekers; Female genital mutilation/cutting; Human rights; Immigrants; Medico-legal medicine; Violence against women.

Publication types

  • Review

MeSH terms

  • Circumcision, Female*
  • Female
  • Gynecology
  • Human Rights
  • Humans
  • Refugees*