WUNRN
The Lancet
FGM - LEGAL & MEDICAL BASES FOR
GRANTING ASYLUM IN THE USA TO WOMEN WITH FEMALE GENITAL MUTILATION: A
SYSTEMATIC REVIEW
Abstract
Background
A
precedent exists for granting asylum based on fear of persecution in the form
of female genital mutilation (FGM), but it does not apply to women who have
already undergone FGM on the logic that they have no grounds to fear further
persecution. I assessed the published work about whether women who have already
undergone FGM should be granted asylum to the USA on the basis of the medical
consequences of the procedure.
Methods
I
searched legal and medical databases (HeinOnline and PubMed) for the terms:
“asylum and female genital mutilation”, “health consequences of female genital
mutilation”, “mental health consequences of female genital mutilation”, and
“PTSD and female genital mutilation”. All articles published since 1994 were
screened. In the legal database, only documents fitting the description
“articles”, rather than “notes” or “commentaries”, were screened. I excluded:
articles about asylum or FGM but not about both, articles that did not discuss
asylum for women who have already undergone FGM, articles that relayed
anecdotes about treatment or clinical advice for patients who have undergone
FGM, articles about countries other than the USA, and articles analysing
women's and health-care providers’ attitudes toward FGM. Articles had to be
about FGM in particular and not about other forms of violence against women.
Findings
The
database searches yielded 1007 articles. Most articles (n=881) were from the
legal database. The final analysis included 35 articles. The medical—especially
obstetric—complications associated with FGM can be severe but might be reduced
by deinfibulation, which is done in the USA. Women who are forced to return to
their native countries might be subject to a repeat FGM procedure. Furthermore,
return to the scene of FGM engenders substantial risk of worsening
trauma-related psychiatric illness.
Interpretation
Women
who have already undergone FGM should have the right to be granted asylum in
the USA on the basis of significant threats to their physical and mental health
if returned to their native countries.
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