Female genital mutilation (FGM) is a widespread practice affecting up to 140 million girls and women worldwide (World Health Organization, 2008a). A substantial advocacy literature reports long-term psychological consequences of FGM, but there is little in the psychiatric literature to document this (Behrendt & Moritz, 2005). Within the broader psychiatric literature on refugee mental health, there are debates about the general validity of psychiatric diagnoses in refugee communities, including somatic disorders and posttraumatic stress disorder (Summerfield, 2008). We present the case of a young woman with a history of FGM, who was repeatedly hospitalized for gastrointestinal complaints of unclear etiology and discuss how her case illustrates the diagnostic and cultural complexity of the psychosocial consequences of FGM and political asylum-seeking.