Peer-reviewed article
Conducting an asylum evaluation focused on female genital mutilation/cutting status or risk
Ranit Mishori, Deborah Ottenheimer, Elise Morris ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This clinical review provides guidance for healthcare professionals in the USA who conduct asylum evaluations for women and girls seeking protection based on female genital mutilation or cutting (FGM/C) status or risk. The document outlines best practices for history-taking, physical examination, and trauma-informed care specific to FGM/C cases. It recognizes FGM/C as a human rights violation and notes its use as grounds for asylum claims in the USA since 1996. The authors emphasize that clinicians need specialized knowledge and competencies beyond general clinical skills to properly evaluate these cases.
Key points
- FGM/C has been used as a basis for asylum claims in the USA since the 1996 precedent case Kissindja
- FGM/C is recognized as a human rights violation practiced worldwide
- Asylum evaluations for FGM/C require specialized clinical knowledge beyond general gynecological evaluation skills
- Best practices include evidence-based history taking, specialized physical examination, and trauma-informed care approaches
- Clinicians performing these evaluations need additional background knowledge and clinical competencies specific to FGM/C
Limitations
This is a clinical review paper providing guidance rather than empirical research. It does not present data on outcomes of asylum cases, the prevalence of FGM/C among asylum seekers, or the effectiveness of specific evaluation protocols.
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.