Vol.:(0123456789) 1 3 Journal of Immigrant and Minority Health https://doi.org/10.1007/s10903-020-00994-8 ORIGINAL PAPER Female Genital Mutilation/Cutting as Grounds for Asylum Requests in the US: An Analysis of More than 100 Cases Katherine Wikholm 1  · Ranit Mishori 2  · Deborah Ottenheimer 3  · Valeriy Korostyshevskiy 4  · Rebecca Reingold 5  · Colin Wikholm 6  · Kathryn Hampton 7 © Springer Science+Business Media, LLC, part of Springer Nature 2020 Abstract Female Genital Mutilation or Cutting (FGM/C) is a human rights violation used to claim asylum in the US. We sought to understand the nature of these asylum requests. Analysis of 121 FGM/C-focused medical afdavits, and 132 legal case reports. Of 119 eligible afdavits analyzed, 84% were reportedly cut: 4.6% Type I, 84.6% Type II, 16.5% Type III. Average age: 9. Reported acute efects: bleeding (76.3%), infection (27.6%), shock (6.7%), broken bones (2.7%), and hospitalization (2.7%). Reported chronic issues: intercourse difculty (81.7%), pregnancy complications (54.2%), chronic pain (42.4%), scarring (37.3%), urinary difculty (31.8%). Psychological consequences included PTSD (72.4%), depression (65.9%), anxi- ety (51.1%), and lack of trust (10.1%). Co-occurring abuses included domestic violence (62.4%), forced marriage (46%), rape (33.3%), torture (33.3%), child marriage (31.3%), assault due to LGBTQ + status (2.9%). Women claiming asylum based on FGM/C report high rates of chronic health issues. Their histories suggest FGM/C co-occurs with other forms of gender-based violence. Keywords Female circumcision · Female genital cutting/mutilation · Asylum · Asylum seekers · Violence against women · Human rights · Medico-legal · Forensic evaluation · Gender based violence? Background Female Genital Mutilation/Cutting (FGM/C) comprises all procedures that involve “partial or total removal of the external female genitalia, or other injury to the female geni- tal organs for non-medical reasons” [1]. According to the World Health Organization, over 200 million. women have undergone some form of FGM/C in all regions of the world [1, 2]. This non-consensual genital alteration is usually carried out on children between the ages of 2–15 [2]. It is illegal in many countries, including the United States (US), and is considered a human rights violation, yet it remains prevalent in many cultures and ethnic groups around the world. There * Ranit Mishori mishorir@georgetown.edu Katherine Wikholm wikholm.katherine@mayo.edu Deborah Ottenheimer deb@ottenheimerhealth.com Valeriy Korostyshevskiy vrk@georgetown.edu Rebecca Reingold Rebecca.Reingold@law.georgetown.edu Colin Wikholm cgw23@georgetown.edu Kathryn Hampton khampton@phr.org 1 Mayo Clinic Family Medicine Residency Program, Rochester, MN, USA 2 Department of Family Medicine, Georgetown University School of Medicine, Washington, DC 20007, USA 3 Women’s Holistic Health Initiative, Harlem United/URAM, The Nest Community Health Center, New York, USA 4 Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC, USA 5 O’Neill Institute for National and Global Health Law, Georgetown Law, Washington, DC, USA 6 Georgetown University School of Medicine, Washington, DC, USA 7 Asylum Program, Physicians for Human Rights, New York, NY, USA