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

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.

Evaluating asylum claims based on female genital mutilation/cutting for immigration court—Opportunities and challenges for licensed mental health professionals.

“…Unlike medical professionals, who perform physical examinations to assess FGM/C claims (Mishori et al, 2021), psychological evaluations conducted by LMHPs rely on detailed clinical interviews. By adopting a trauma-informed approach, the LMHP creates a therapeutic alliance, establishes a sense of security, and builds trust, to avoid retraumatization and the potential ensuing sense of shame.…”

“…The practice of female genital mutilation/cutting (FGM/C) is a human rights violation and illegal in several countries, including the United States (U.S.). Since the precedent-setting Kassindja case in 1996 (Center for Gender and Refugee Studies [CGRS], 1996), FGM/C has been used as grounds for asylum in the United States (CGRS, 1996; Mishori et al, 2021). This type of asylum case requires a woman or girl to prove that she has undergone FGM/C or is at risk if she returns to her homeland.…”

FGM and Restorative Justice—A Challenge for Developing Countries and for Refugee Women

“…Not only are there global intervention and advocacy programs to prevent FGM, but there is a further argument that the existence of FGM is justification for asylum, as it is an important reason for women to seek protection or a safer life in another country to escape severe physical and psychological harm [4] (19,565), despite the total number of female applicants having increased from 65,125 in 2008 to 93,350 in 2011 due mostly to the general reduction in asylum claims from Somalia; Somali women and girls represented about 20% of all female applicants in 2011".…”

“…Apparently, EU states deal in different ways with this situation. Several recent reviews have addressed the role of medical evaluation of FGM in asylum cases [4,5]. A more recent study by van Baelen et al used data from the EU census not limited to refugees to demonstrate that more than half a million first-generation women and girls in the EU, Norway and Switzerland had suffered FGM before immigration [6].…”