Medicolegal evaluation of asylum seekers alleging torture and ill-treatment: A 4-year retrospective study in Montpellier, France

The history of torture and other forms of ill-treatment or abuse is relied largely upon asylum seekers' self-reporting given that several forms of torture don’t leave permanent marks. To the extent, however, that physical findings exist they are valuable confirmatory evidence in support of an asylum application. The aim of this study was to retrospectively document the self-reported history of torture and other forms of abuse, alongside the physical evidence and the degree of consistency observed during examinations of asylum seekers conducted at the Department of Legal Medicine, University Hospital of Montpellier, France, during a 4-year period. The information was retrieved through retrospective analysis of all consecutive cases of the asylum seekers examined from January 1, 2019, to December 30, 2022. Exclusion criterion was age under 18 years old. A total number of 495 asylum seekers were included in the study for the aforementioned period (males 68.1 % and females 31.9 %). Mean of age was 29.90 years. The majority of the sample was originated from Sub-Saharan Africa (76.6 %). The most common method of torture/abuse was blunt force impact (88.5 %). A history of incised wounds (stabs and cuts), burns, gunshot use, and food deprivation were mentioned in 31.2 %, 21.4 %, 7.9 % and 5.6 % of the cases, respectively. Psychological abuse and sexual abuse were reported by 58.0 % and 22.9 % of the asylum seekers, respectively. Female genital mutilation was reported by 34.0 % of the female asylum seekers, coming almost exclusively from Sub-Saharan Africa. The perpetrator was a member of the family in 30.6 % of the cases, followed by police/army (27.7 %). Old injuries were observed on head in 56.4 %, on neck in 3.6 %, on trunk in 58.8 %, on upper extremities in 77.2 %, on lower extremities in 74.3 % and on genital/anal area in 13.3 % of the cases. Regarding the type of injuries observed during forensic clinical examination, history of blunt forces was positively associated with scars (p = 0.004), teeth injuries (p = 0.014) and fractures (p = 0.009). A positive statistical association was shown between compatibility grading 2–4 and burns (p = 0.015), as well as female genital mutilation (p < 0.001). A positive statistical association was shown between compatibility grading 1 and the method of torture/abuse when this was reported to be sexual abuse ((p = 0.008) and blunt force impact (p < 0.001). The results of the study will contribute to the gained knowledge about torture invoked injuries, improving thus the capability of forensic examiners to conduct comprehensive medical evaluations regarding alleged torture survivors.