Female genital mutilation/cutting burden and perceptions among asylum-seeking women in Berlin, Germany: A cross-sectional study.

Introduction: Germany is a major destination country for asylum-seekers, including from many countries where female genital mutilation/cutting (FGM/C) is practiced. Our study aimed to provide empirical data on FGM/C prevalence, associated health complaints and FGM/C-related perceptions among asylum-seeking women in Berlin. Methods: A cross-sectional study was conducted among asylum-seeking women in Berlin, Germany between October 2018 and September 2022. Adult women self-reporting FGM/C were interviewed using a questionnaire querying FGM/C type, physical complaints, and pain domains, and open-ended questions on women's experiences regarding FGM/C. Results: In total, 15,167 women underwent the mandatory medical examination for asylum-seekers during the study period, 1.9% of which self-reported FGM/C. The prevalence reached 18.6% when restricting the population to FGM/C-practicing countries. Women living with FGM/C came predominantly from the African WHO region (61.9%). A total of 151 women consented to being interviewed. The majority (57.0%) self-allocated to FGM/C Type I/II. Menstrual pain was the most reported complaint (77.5%), followed by pain during defecation (29.1%). Most physical complaints were reported by slightly higher proportions among women with FGM/C type III. Women reported a median age of six years at FGM/C execution, which was performed largely by female, non-relatives (64.5%). The majority (90.1%) perceived FGM/C negatively while 7.9% had a neutral or positive attitude towards it due to its cultural significance. Conclusion: FGM/C is prevalent in host countries like Germany with a potentially associated physical and psychosocial health burden. Our findings emphasize the need for a holistic, culturally sensitive response to such health demands by healthcare systems.