A/HRC/44/33 women living in Europe usually underwent the practice in their country of origin, which gave rise to the question of how laws against female genital mutilation could apply extraterritorially. A large majority of European countries had included the principle of extraterritoriality in their general criminal law, which allowed its application to female genital mutilation. 19. Efforts to address cross-border female genital mutilation that were shared during the expert meeting included the use of protection orders in the United Kingdom to minimize the risk of exposure of women and girls as an alternative option by preventing women and girls at risk from travelling outside the country. Experts however warned about the potentially disproportionate targeting of specific communities in implementing the protection orders. Another initiative that was shared during the meeting referred to an East African cross-border meeting to end female genital mutilation, at which representatives from Ethiopia, Kenya, Somalia, Uganda and the United Republic of Tanzania discussed the enactment of the East African community bill on female genital mutilation (2016) and adopted a plan of action on cross-border female genital mutilation,7 which included four results areas, namely the improvement of legislative and policy frameworks and the environment; effective and efficient coordination and collaboration between national Governments; communication and advocacy on prevention and response; and increasing capacities to generate and use evidential data to address the practice. It was stressed, however, that more research on the impact of cross-border female genital mutilation on the human rights of women and girls affected was needed to better inform interventions. 20. The role of the Optional Protocol to the Convention on the Rights of the Child on a communications procedure was highlighted as a tool to enhance the protection of girls at risk of female genital mutilation. In that regard, it was mentioned that in March 2018 the Committee on the Rights of the Child had adopted its first decision on the matter, in which it stated that the risk of being subjected to female genital mutilation was a ground for nonrefoulement and that when assessing this risk an individualized assessment that took the best interest of the child as a primary consideration should be conducted (see CRC/C/77/D/3/2016). IV. Countering the medicalization of female genital mutilation 21. WHO defines the medicalization of female genital mutilation as situations in which the practice is performed by any category of health-care provider, whether in a public or private clinic, at home or elsewhere.8 That also includes the procedure of reinfibulation at any time in a women’s life. 22. Under international human rights law, female genital mutilation is considered a form of gender-based violence and a harmful practice, regardless of whether it is performed in a medical setting. Article 5 (b) of the Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa specifically requires States to prohibit all forms of female genital mutilation, including its “medicalisation and para-medicalisation”. In addition, in a number of resolutions the General Assembly has called upon States to condemn all forms of female genital mutilation “whether committed within or outside a medical institution” (see, for example, resolutions 67/146 and 71/168). Furthermore, several treaty bodies, inter alia the Committee on the Elimination of Discrimination against Women, have called upon countries to eliminate the medicalization of female genital mutilation. Similarly, the Human Rights Council discussed medicalized female genital mutilation at its thirty-eighth session and stressed that the trend towards medicalization did not make the practice any more acceptable. In resolution 38/6, the Council called upon 7 8 6 Programme on Female Genital Mutilation (2018), p. 25; and Samuel Kimani and Caroline W. Karibu, “Shifts in female genital mutilation/cutting in Kenya: perspectives of families and health care providers”, Population Council (December 2018), p. ix. UNFPA-UNICEF, “Ending cross-border FGM” (April 2019),available at https://drive.google.com/file/d/1X48bGPutBbiYuFGtJQOg3stvmTLsJ6o_/view. WHO, Care of Girls and Women Living with Female Genital Mutilation: a Clinical Handbook (Geneva, 2018), p. 392, and WHO and others, “Global strategy to stop health-care providers from performing female genital mutilation” (2010), p. 1.