FGM/C remains a deeply rooted but often unseen practice in Asia. Dr Chandni Shiyal and Dr Hannah Nazri reflect on their advocacy journeys and the Asia Network to End FGM/C as a platform for evidence-based, Asian-led solidarity.

First encounters with FGM/C

Dr Chandni Shiyal (CS): I first encountered FGM/C in 2011 during my MPhil at the University of Mumbai. I knew I wanted to focus on women’s and children’s rights, and while exploring potential topics, I came across the practice. The more I read, the more overwhelmed I became: the stories were harrowing, and the silence surrounding them deeply unsettling.

As I sought insights from African organisations, I realised FGC wasn’t just an issue elsewhere–it was happening in India too. An article by Rehana Ghadially titled All for 'Izzat': The Practice of Female Circumcision among Bohra Muslims (1991), and the book Female Genital Mutilation: A Guide to Laws and Policies Worldwide by Anika Rahman and Nahid Toubia (2000), revealed that FGM/C existed in India specifically within the Dawoodi Bohra community. I searched for more sources, hoping for updated data or survivor accounts, but found almost nothing, so I assumed the practice had quietly faded away. I now know that silence does not mean cessation; it often means invisibility.

Dr Hannah Nazri (HN): I first gave serious thought about FGM/C when I was asked to give a keynote address for a 2019 Kuala Lumpur conference. Working on my keynote brought me face‑to‑face with uncomfortable realities about womanhood and FGM/C in Malaysia. It dawned on me that we did not need to go far to experience extremism. When a society believes that cutting a female infant’s genitalia is necessary to prevent “future promiscuity,” it denies her the most basic right to bodily autonomy. Confronting this reality was the moment I knew I had to commit myself to advocacy.

Beyond imported narratives

CS: In 2013, I came across an article about Priya Goswami’s documentary, A Pinch of Skin. The study confirmed what I had long suspected: FGM/C in India was still widespread. As women began speaking out in the media, I connected with Aarefa Johari, among the earliest to do so. By 2015, the movement was gathering strength. Two organisations, Sahiyo and WeSpeakOut, were formed, and I joined Sahiyo soon after, marking the beginning of my advocacy journey.

I began speaking with friends from FGM/C‑practising communities to understand why this practice continued. During this time, I chose to pursue a PhD on FGM/C in India. What began as academic inquiry became a personal mission: to end FGM/C through education, awareness, and safe spaces for women to share their stories. Sahiyo’s ethos of empathetic listening resonated deeply, and my research became a bridge between silence and solidarity.

HN: Ending FGM/C in Malaysia and Southeast Asia cannot rely on strategies imported from elsewhere. African‑centred models are often applied uncritically, flattening our distinct cultural, medical, and legal contexts. However well‑intentioned, they do not serve efforts to end FGM/C in Southeast Asia. When I first connected with Professor Rashid, author of the only peer-reviewed study on FGM/C medicalisation in Malaysia, we shared a belief that ending FGM/C advocacy must be evidence‑driven, respectful of our audience’s intellect, attuned to ethical and cultural plurality, and willing to challenge the distortions that often shape this discourse. The difficulty many have in reconciling Kuala Lumpur’s modernity with the persistence of FGM/C reflects a trite and superficial understanding of how harm coexists with modernity. It assumes that urban development naturally eliminates harmful practices, even though gender‑based violence persist in modern Western cities as well. With troubling regularity, Western narratives cast non-Western women as passive victims of oppression–stripped of agency, nuance, and voice. As a proud Malay woman, I refuse to kowtow to that. Therefore in 2021, I founded the Malaysian Doctors for Women & Children.

Asian leadership, Asian terms: The Asian Network to End FGM/C

HN: I joined the Network as one of its earliest members, committed not just to participating but to helping shape a credible Asian voice in the global movement. My focus has always been on ensuring that our communities lead their own narratives.

Leadership here demands editorial discipline, contextual intelligence, and a break from paternalistic global models. Advocacy must be rooted in lived experience and accountable to its communities.

Within the Network, we build regional ownership and intellectual plurality. Members contribute in different ways–some visible, others quieter–but all committed to culturally attuned, evidence‑based approaches. The 2025 Colombo meeting made it clear: Asia is ready to lead.

CS: Over time, I came to understand that FGC is practiced across many Asian countries, yet evidence remains limited and efforts often feel isolated. I have long believed that Asia needed a regional platform to connect researchers, activists, and organisations working on this issue.

I joined the Network in 2019 and soon became involved in its meetings, campaigns, and strategic work, including shaping its logo and mission. The Network has strengthened my understanding of regional nuances and reinforced the sense of shared purpose across Asia. In 2024, I joined the Board. Our meetings in Bangkok and Colombo were especially impactful–Bangkok, for bridging global frameworks with local realities, and Colombo, for field insights that echoed my own and highlighted the emotional complexity of this work.

Ending FGM/C is a slow, sensitive process. It calls for patience, empathy, and respect for people’s fears. After more than a decade in this movement, I see progress. And I remain hopeful, because together, we are building something enduring.

Lessons learnt

• Modernity does not erase harm; it often conceals it.
• Regional nuance is non-negotiable; advocacy must be contextually grounded.
• Leadership demands humility especially when navigating privilege, representation, and voice.
• Narratives must be authored by those who live them, or risks distortion.
• Solidarity is forged through shared conviction and mutual respect, not sameness.
• Effective advocacy must reject saviourism and centre agency.
• Asia is not waiting to be included. It is ready to lead on its own terms.

About the authors

Dr Chandni Shiyal, PhD is a researcher and advocate whose work on FGC in India bridges academic inquiry and grassroots activism. Her journey began during her MPhil at the Centre for African Studies, University of Mumbai, and evolved into a decade-long commitment to survivor-led advocacy, evidence-based education, and community engagement through organisations like Sahiyo and the Asia Network to End FGM/C.

Dr Hannah Nazri, MBChB BSc (Hons) MSc DPhil (Oxon) is a Malaysian obstetrics and gynaecology doctor, academic, and global health advocate. Her work spans clinical medicine, policy roundtables, and international conferences, with a focus on reproductive rights and women’s health. She is the founder of Malaysian Doctors for Women and Children and serves on the board of the Asia Network to End FGM/C. Her advocacy is rooted in editorial precision, cultural nuance, and a refusal to let Southeast Asian voices be spoken for.

A landmark legal moment is unfolding in India, and the Asia Network to End FGM/C is watching closely, because what happens in that courtroom will matter far beyond it. After more than seven years of procedural delays, India's nine-judge Constitution Bench of the Supreme Court has begun its final hearings on a petition that could redefine the legal status of Female Genital Mutilation/Cutting (FGM/C)¹ in the country. Filed in 2017 by lawyer Sunita Tiwari, the Public Interest Litigation seeks to declare FGM/C as unconstitutional, direct the government to enact specific anti-FGM/C legislation, and ensure prosecution under existing criminal provisions. The case has been clustered with a broader set of constitutional questions on religious freedom, including women's entry into the Sabarimala Temple and mosques, meaning that FGM/C in India is now being examined primarily through the lens of Articles 25 and 26 of the Constitution: the right to religious freedom.

This framing matters. And it should concern everyone working on FGM/C across Asia.

One of the crucial voices before that bench is Asia Network to End FGM/C member Masooma Ranalvi - survivor, activist, and founder of WeSpeakOut. Masooma filed an intervention petition to ensure that survivor voices were not absent from what is, at its core, a case about their bodies. As she has said: "As survivors and as an organisation working on this issue every day, it was important that our voices were heard. In a sense, we didn't really have a choice; we had to be present and represent those most affected by the practice."² 

Masooma's journey to this moment spans decades. She was cut at seven years old, taken under the pretence of an ice cream trip. For years, she had no language for what had happened. It was only after reading a media report about FGM/C in Africa that she began connecting the dots and that recognition was met first with denial, then with a reckoning. In 2015, she wrote publicly about her experience and WeSpeakOut was born from that breach of silence and has since become a significant survivor-led organisation in the country and region. 2015 marked a broader shift in the community’s public engagement on FGM/C in India. Seventeen women from the community took a major initiative to publicly sign a petition to abandon the practice of FGM/C and sending it to the government, which in the span of two days had more than 2,600 signatures when it was placed online. Founded by five women coming together to build a collective platform to challenge the practice, Sahiyo, an Asia Network To End FGM/C member, was also established as the first NGO solely focused on ending FGM/C among Dawoodi Bohra and other Asian communities in India.

The evidence that WeSpeakOut, Sahiyo and anti-FGM/C advocacy organisations in India have built is clear. A 2017 study³ published by Sahiyo, surveying 385 women documents that 98% of respondents reported immediate pain after cutting and 87% reported negative impacts on their sexual lives. A 2018 study commissioned by WeSpeakOut⁴ further corroborated these findings revealing that 81 out of the 83 women that they surveyed had undergone khatna, with 97% recalling it as painful and nearly 35% reporting effects on their sexual lives⁵. Yet the Indian government responded in 2017⁶ by claiming there was no official data confirming the existence of FGM/C, a position that is, as Masooma rightly notes, circular: there is no specific offence of FGM/C in Indian criminal law, making it structurally impossible for data systems to record it. Policy silence produces evidentiary silence, and then evidentiary silence is used to justify policy inaction.

That cycle has costs. In Masooma's words: "What has happened in the interim? Hundreds of girls have been cut because the practice continues, unabated."⁷

Before the court, the primary defence is that khatna is a religious right, a protected practice, not a harm. This is precisely the framing that requires pushback. As Masooma and others have consistently argued, FGM/C predates Islam and has been documented across cultures, communities, and faiths globally; its roots are sociocultural, not strictly religious². Several Muslim-majority countries, including Egypt⁸ and Indonesia⁹, have introduced legal measures restricting incidents of FGM/C, directly challenging claims that it is integral to Islam⁵. The religious freedom defence does not hold on its own terms. And accepting it as the governing frame risks something more corrosive: it shifts the burden of proof away from the violation and onto the survivor. Once harm is made contingent on whether a practice is 'essential' to religion, the question is no longer whether a rights violation has occurred; it is whether well-meaning but misinterpreted beliefs can justify it.

The implications of this case extend well beyond India. In Sri Lanka, Malaysia, Singapore, Pakistan, Bangladesh, and across the region, FGM/C is practised in contexts where it is similarly framed as a religious obligation, cultural tradition, or both. Legal and policy frameworks, and public education campaigns, remain absent or inadequate across these countries. As the Asia Network to End FGM/C and UNICEF has documented, FGM/C remains prevalent in the Asian region¹⁰, with 80 million women and girls affected¹¹, yet it remains largely unrecognised by governments and outside the scope of global FGM/C programmes, despite growing evidence of its consequences for women's health, agency, and wellbeing. What India's Supreme Court decides will set a precedent, not only in law, but in the legitimacy it accords to survivor testimony, to public health evidence, and to the principle that bodily integrity is not negotiable.

Survivors and activist groups from the community like Masooma, WeSpeakOut and Sahiyo have spent years doing the difficult work of building evidence, holding space for survivor communities, and forcing this issue into spaces that would rather look away. The Asia Network to End FGM/C recognises that work, stands in solidarity with it, and calls on governments, civil society, and health institutions across the region to pay attention to what is unfolding in New Delhi.

Every girl and woman who has been subjected to FGM/C, and then told it was for her own good, is owed more than a constitutional debate about religious freedom. She is owed an unambiguous verdict: that what was done to her was wrong, and that it will not be done to the girls who come after her.

In Solidarity,

Asia Network to End FGM/C.

Organisations:

• Asian-Pacific Resource & Research Centre for Women (ARROW)
• End Female Genital Cutting Singapore 
• Equality Now
• Sahiyo
• Sisterhood Initative
• Orchid Project
• Women's Action Network Sri Lanka
  
  

Individuals:

• Aarefa Johari, Journalist, Co-Founder (Sahiyo) and National Coordinator (India), Asia Network to End FGM/C
• Anjali Shenoi, Programme Manager, Asian-Pacific Resource & Research Centre for Women (ARROW)
• Aysha Hussain Shihab, Vice Chairperson (Hope for Women, Maldives), and Advisory Board Member, Asia Network to End FGM/C
• Cadar Basha Shaifun, Researcher, Women's Action Network (WAN), Activist and Community Advocate
• Dr. Chandni Shiyal, Researcher, Administrative Manager (Sahiyo) and Advisory Board Member (India), Asia Network to End FGM/C
• Dr. Hannah Nazri, ObGyn Doctor, Academic, and Advisory Board Member and National Coordinator (Malaysia), Asia Network to End FGM/C
• Dr. Nadirah Babji, Medical Doctor, Malaysia
• Fatima Pir Tillah Allian, National Coordinator (Philippines), Nisa Ul-Haqq Fi Bangsamoro
• Huda Syyed, PhD, National Coordinator (Pakistan), Asia Network to End FGM/C; Founder, Sahara Sisters Collective; Academician and GBV and Policy Researcher
• Ihsan Ali Khosa, PHRO (Sindh), Pakistan
• Nabeela Iqbal, Founder and Co-Director (Sisterhood Initiative) and National Coordinator (Sri Lanka), Asia Network to End FGM/C
• Phyu Nwe Win, Project Lead, Associate of Karenni Policy Support, Myanmar
• Qamar Naseem, Programme Manager, Blue Veins
• Sabir Ali, National Coordinator (Pakistan), Asia Network to End FGM/C
• Safiya Riyaz, Programme Officer, Asian-Pacific Resource & Research Centre for Women (ARROW)
• Saza Faradilla, Co-Founder, End Female Genital Cutting Singapore
• Sharmilah Rajendran, Programme Officer, Asian-Pacific Resource & Research Centre for Women (ARROW)
• Shreen Saroor, Founder, Mannar Women's Development Federation and Co-Founder, Women's Action Network

Endnotes:

1. This article uses the broad term “female genital mutilation/cutting” to refer to all procedures involving partial or total removal of the female external genitalia or other injuries to the female genital organs for non-medical reasons. There are many terms used to describe this practice in different countries in South and South East Asia, including ‘khatna,’ ‘female circumcision,’ ‘female genital cutting,’ ‘sunat,’ ‘sunat perempuan,’ ‘khitna,’ and many other terms or acronyms depending on the specific local context involved. The term FGM/C, as used in this article, is intended to be inclusive of all such terms.
2. The News Minute. (2026). FGM case reaches Supreme Court's nine-judge Constitution bench after 7 years of procedural delays. Available at: https://www.thenewsminute.com/news/supreme-court-to-hear-female-genital-mutilation-case-after-7-years-of-legal-limbo
3. Anantnarayan, L., Diler, S., & Menon, N. (2018). The clitoral hood: A contested site. Khafd or female genital mutilation/cutting (FGM/C) in India. WeSpeakOut & Nari Samata Manch. https://www.fgmcri.org/media/uploads/Academic%20Papers/anantnarayan_india_2018.pdf
4. Sahiyo (2017). Understanding Female Genital Cutting in the Dawoodi Bohra Community: An Exploratory Survey. Available at: https://sahiyo.org/wp-content/uploads/2025/08/sahiyo_report_final-5.21.19-1.pdf
5. The Print. (2026). Bohra Muslim women are fighting against FGM anonymously—they fear community boycott. Retrieved from: https://theprint.in/the-fineprint/bohra-muslim-women-female-genital-mutilation-supreme-court/2905410/
6. Reuters (2017). No evidence of FGM, India government tells court, appalling activists. Available at: https://www.reuters.com/article/world/no-evidence-of-fgm-india-government-tells-court-appalling-activists-idUSKBN1EN0QA/
7. The Quint. (2026). Is the Supreme Court Asking the Right Questions About FGM?. Available at: https://www.thequint.com/gender/fgm-matter-is-supreme-court-asking-right-questions
8. Human Rights Watch. (2016). Egypt: New Penalties for Female Genital Mutilation. Available at: https://www.hrw.org/news/2016/09/09/egypt-new-penalties-female-genital-mutilation
9.  UNFPA Indonesia (2026). One Decade of Indonesia Efforts to Eliminate FGM/C. Retrieved from: https://indonesia.unfpa.org/en/news/one-decade-indonesia-efforts-eliminate-fgmc
10. https://endfgmcasia.org/fgm-c-in-asia.html

 The Asia Network to End FGM/C is proud to share the launch of three newly published study reports, supported by the South and Southeast Asia Research Innovation Hub (SSEARIH), the Foreign, Commonwealth & Development Office (FCDO), and the UK Government.

These reports are part of a broader Southeast Asia–wide research series that examines Female Genital Mutilation/Cutting (FGM/C) practices across the region, with in-depth focus on Indonesia and Malaysia.

Female Genital Cutting (FGC) is internationally recognised as a grave violation of human rights, impacting the sexual and reproductive health and rights of women and girls. Globally, 230 million women and girls across 90 countries have been subjected to FGC, with Asia accounting for an estimated 35% of this burden, or about 80 million cases. Indonesia and Malaysia together account for more than one-third of Asia’s total, with approximately 70 million affected in Indonesia and 7.5 million in Malaysia. Despite the scale, FGM/C remains under-researched, under-addressed in national policies, and often normalised through cultural traditions, religion, and healthcare practices.

These reports examine the practice of Female Genital Mutilation/Cutting (FGM/C) in Indonesia and Malasia as part of a wider study across Southeast Asia. It explores the prevalence, trends, drivers, norms, and barriers to change associated with FGM/C. The research includes detailed case studies conducted within selected communities to provide localised insights and contextual understanding.

Download the reports here

Download the Policy Brief here.

Download the Malaysia Country Profile here.

Download the Indonesia Country Profile here.

About ARROW

ARROW is a regional non-profit women and young people’s organization based in Kuala Lumpur, Malaysia. It was established in 1993 upon a needs assessment arising out of a regional women’s health project, where the originating vision was to create a resource center that would ‘enable women to better define and control their lives.

About Orchid Project

Orchid Project is an international NGO, with offices in Nairobi and London, working at the forefront of the global movement to create a world free from FGM/C. At the heart of our mission are grassroots organisations that are pioneering change, and by working together, one step at a time, we believe we can help to end FGM/C globally.

About the Asia Network to End FGM/C

The Asia Network to End Female Genital Mutilation/Cutting (FGM/C) is a group of civil-society actors, led by ARROW and Orchid Project, working across Asia to end all forms of FGM/C. It does this by connecting, collaborating and supporting Asian actors and survivors to advocate for an end to this harmful practice. The Network comprises almost 100 members across 12 countries in the Asia region. Members are activists, civil society organisations, survivors, researchers, medical professionals, journalists and religious leaders, who are committed to working collaboratively together to promote the abandonment of all forms of FGM/C across the Asia region.

The medicalisation of Female Genital Mutilation/Cutting (FGM/C), where the procedure is performed by healthcare professionals, has complicated global efforts to eradicate this harmful practice. Rather than ending FGM/C, medicalisation risks legitimising it under the guise of clinical safety. These concerns were first raised during the April 2025 webinar hosted by the Asia Network to End FGM/C and Equality Now, which brought together experts from Asia and Africa to discuss the roles healthcare professionals play in perpetuating or preventing FGM/C.

This follow-up discussion explores how legal frameworks, medical ethics, and debates around female genital cosmetic surgery (FGCS) intersect with ongoing efforts to address FGM/C.

Medical Ethics and Legal Contradictions

In the UK, the Female Genital Mutilation Act 2003 criminalises excision, infibulation or other mutilation of a girl’s or woman’s genitals, including adult procedures. It permits exceptions only when medically necessary, such as during childbirth. Despite this, FGCS is legally offered to adult women and often promoted as enhancing sexual, gynaecological or mental health.

This duality exposes contradictions in how the law distinguishes between cultural harm and personal choice. Medical ethics face similar tensions. Healthcare professionals are tasked with protecting health, yet may accept patient consent at face value without examining the patriarchal narratives that shape such decisions.

Is Female Genital Cosmetic Surgery a Form of FGM/C?

Saarrah Ray, a DPhil in Law candidate at the University of Oxford, challenges the separation between FGCS and FGM/C. In her thesis, she frames FGCS as a form of violence against women and argues for its recognition as a variant of FGM/C. In Sister, Is this Mutilation? she writes:

“It is worth appreciating that FGCS and FGM seem not so disanalogous if we take seriously the depth and harm of socio-cultural pressures, deriving from a shared system of women’s oppression, that inform women how to feel what their vulvas and vaginas should look like and whom they service.” (Ray, 2024)

Ray questions whether women’s consent to FGCS, often influenced by beauty myths, pornography and self-objectification, can be ethically relied upon by medical professionals. For instance, if a woman undergoes vaginal tightening to satisfy a partner, her satisfaction may not reflect autonomous decision-making but internalised gender norms.

This argument raises critical questions for both law and medicine. Should healthcare systems permit procedures rooted in oppressive social expectations? And should the law continue to draw rigid lines between culturally sanctioned FGM/C and socially accepted FGCS, when both may stem from the same systems of control?

The medicalisation of FGM/C, and the rise of FGCS, expose gaps in both legal and ethical frameworks. As highlighted in the April 2025 webinar, addressing these issues requires more than legal bans, it demands a deeper interrogation of consent, culture and power. When procedures rooted in patriarchal norms are reframed as healthcare, both medicine and law must respond with clarity, accountability and a commitment to women’s rights.

Speaker Profiles

Professor Samuel Kimani
Associate Professor, Faculty of Health Sciences, University of Nairobi. With over 20 years of experience in global health, medical training, and research, Professor Kimani is a leading expert on FGM/C in Africa.

Dr Hannah Nazri
NIHR Academic Clinical Fellow in Obstetrics & Gynaecology, University of Warwick. Director of Malaysian Doctors for Women & Children. Dr Nazri works internationally to end FGM/C through education, policy engagement, and healthcare leadership.

Saarrah Ray
DPhil in Law candidate, University of Oxford. Saarrah’s thesis explores radical feminist legal arguments reconceptualising Female Genital Cosmetic Surgery as a form of violence against women and a variant of FGM/C.

References:

Ray, S. (2021). The Husband-Stitch: Could it be Female Genital Mutilation?. Available on: https://www.durham.ac.uk/research/institutes-and-centres/ethics-law-life-sciences/about-us/blogs/obstetric-violence-blog/the-husband-stitch/

Ray, S. (2024). Sister, Is this Mutilation?. Fem Leg Stud 32, 357–359. https://doi.org/10.1007/s10691-024-09553-0

The medicalisation of Female Genital Mutilation/Cutting (FGM/C) is an alarming global trend. Performed by health professionals under the guise of safety, it reinforces a practice that is widely recognised as a violation of human rights. In reality, medicalisation neither eliminates harm nor erases the oppressive cultural roots of FGM/C.

These and related issues were explored in the 4 April 2025 webinar “Understanding the Medicalisation of Female Genital Mutilation/Cutting (FGM/C): Impacts, Challenges, and Solutions”, hosted by the Asia Network to End FGM/C and Equality Now. Experts from Asia and Africa addressed the scope of the practice, the shifting responsibility to healthcare professionals, and the barriers to transformative change.

A Global Practice, an Overlooked Asian Reality

FGM/C continues in over 90 countries, affecting 230 million women and girls worldwide (UNICEF, 2024)[i]. While often associated with Africa, 80 million of these cases are from Asia. The practice is prevalent in Indonesia, Malaysia, Singapore, Sri Lanka, Brunei, Thailand, the Philippines, the Maldives, India, and Pakistan. In many Asian countries, Types I and IV, considered less severe, are dominant. However, this perception has contributed to the practice being overlooked in global discourse (ARROW, 2020)[ii].

Despite progress at policy levels, including the SDG commitment to eliminate FGM/C by 2030, current efforts need to be 27 times faster to meet this goal (UNICEF, 2024)i. The practice persists largely due to misinformation, community resistance, and a lack of political will.

Quiet advocacy: The role of healthcare professionals

Healthcare professionals are increasingly implicated in the continuation of FGM/C. Dr. Hannah Nazri emphasises that advocacy isn’t limited to high-profile actions like lobbying or public campaigns—it can be quiet yet powerful. Routine patient interactions, education, workshops, and contributing to clinical guidelines are all meaningful forms of advocacy. Social media can amplify these efforts, but impactful advocacy doesn’t have to be loud to be effective.

That said, many doctors are overwhelmed by the demands of day-to-day clinical work, leaving little time or energy for broader advocacy efforts. Heavy workloads, long shifts, and administrative pressures can make it difficult to engage beyond immediate patient care, even when clinicians care deeply about issues like FGM/C. 

Advocacy within clinical settings also involves navigating complex social and ethical terrain. In societies where FGM/C is socially accepted or not criminalised, healthcare professionals may feel pressured to stay silent—or even comply. Dr. Nazri highlights that junior doctors in such contexts often struggle to challenge senior colleagues who support the practice, creating ethical dilemmas and limiting space for resistance. 

They must be meaningfully supported in their professional environments to realise their potential as effective advocates.

She also underscores the importance of cultural literacy. Marginalised communities experience structural exclusions that shape their access to care and health decisions. As Dr. Nazri notes, advocacy approaches must be context-specific—what works in one region may not apply elsewhere. For example, research in Malaysia shows many Muslim women who have undergone FGM/C report fulfilling sexual lives and reject dominant narratives linking the practice solely to sexual disempowerment (Isa et al., 1999)[iii].

Rising Medicalisation: Urban and Institutional Trends

The assumption that medicalisation is more common in rural areas is misleading. As societies begin to recognise the harms of traditional forms of FGM/C, medical professionals are increasingly taking over. In Malaysia, 20.5% of doctors admitted to performing Type IV FGM/C, typically involving pricking and needling, and some to performing Type I (Rashid et al., 2020[iv]). In Indonesia, healthcare workers conducted incision (26%) and excision (52%), often more invasive than traditional attendants who used scraping or symbolic cutting (Budiharsana, 2016[v]; Hidayana, 2024 [vi]).

Dr Nazri also warned of early signs that FGM/C is becoming medicalised. These include incorporating the practice into delivery packages, shifts in community narratives that frame it as “safer,” and informal medical training outside regulated curricula. She argued that regulatory gaps enable the quiet normalisation of medicalised FGM/C and highlighted the need for legal and ethical clarity.

Community-based strategies are essential to disrupting this trend. Dr Nazri advocated for engaging local influencers and religious leaders through culturally appropriate education, storytelling, and community health programmes. She noted that effective advocacy often happens when FGM/C is discussed as part of broader public health dialogues, not as a stand-alone issue.

Investing in Change: Education, Ethics and Legal Gaps

While some may argue that medicalisation reduces physical risks, Dr Nazri underscored that it gives the false impression of legitimacy. Ministries of Health and medical associations often remain silent, creating policy ambiguity and weakening enforcement.

The conversation also touched on how students and early-career professionals can contribute to change. Dr Nazri advised students to collaborate with advocacy organisations, organise educational events, and engage with academic supervisors on FGM/C research. For long-term impact, curriculum reform is crucial, especially for midwifery and healthcare education. She proposed that norms change be embedded into training, supported by mentorship and real-world engagement with communities.

Medicalised FGM/C is often passed down through informal channels, without any formal guidelines. Dr Nazri clarified that the lack of regulation has led to varied practices, and any effort to formalise procedures would risk legitimising them.

The medicalisation of FGM/C exposes a critical fault line in global health advocacy. While healthcare professionals can be powerful allies in ending the practice, they also risk perpetuating it in the absence of clear guidance and cultural accountability. The April 2025 webinar made it clear: dismantling FGM/C requires a united effort across legal, medical, and community platforms. Every patient interaction, every educational initiative, and every policy reform must push toward one goal, eradicating FGM/C in all its forms.

Speaker Profiles

Professor Samuel Kimani
Associate Professor, Faculty of Health Sciences, University of Nairobi. With over 20 years of experience in global health, medical training, and research, Professor Kimani is a leading expert on FGM/C in Africa.

Dr Hannah Nazri
NIHR Academic Clinical Fellow in Obstetrics & Gynaecology, University of Warwick. Director of Malaysian Doctors for Women & Children. Dr Nazri works internationally to end FGM/C through education, policy engagement, and healthcare leadership.

Saarrah Ray
DPhil in Law candidate, University of Oxford. Saarrah’s thesis explores radical feminist legal arguments reconceptualising Female Genital Cosmetic Surgery as a form of violence against women and a variant of FGM/C.

References:

1.  Unicef (2024). Female Genital Mutilation: A global concern. https://data.unicef.org/resources/female-genital-mutilation-a-global-concern-2024/
2.  Asian-Pacific Resource and Research Centre for Women (ARROW) and Orchid Project, 2020. “Asia Network to End Female Genital Mutilation/Cutting (FGM/C) Consultation Report,” 2020, https://bit.ly/3lz5O4w. 
3.  Isa, Ab. R., Shuib, R., & Othman, M. S. (1999). The practice of female circumcision among Muslims in Kelantan, Malaysia. Reproductive Health Matters, 7(13), 137–144. https://doi.org/10.1016/S0968-8080(99)90125-8
4.  Rashid, A., Iguchi, Y., & Afiqah, S. N. (2020). Medicalization of female genital cutting in Malaysia: A mixed methods study. PLOS Medicine, 17(10).
5.  Budiharsana, M. (2016). Female genital cutting common in Indonesia, offered as part of child delivery by birth clinics. The Conversation. https://theconversation.com/female-genital-cutting-common-in-indonesia-offered-as-part-of-child-delivery-by-birth-clinics-54379
6.  Hidayana, I. M. (2024). The Medicalization of Female Genital Cutting (FGC) in Indonesia: A Complex Intersection of Tradition, Religion, and Human Rights. Current Sexual Health Reports, 16(4), 217–220. https://doi.org/10.1007/S11930-024-00393-2/FIGURES/1

Join us as we learn about FGM/C in the Bangsamoro region in the Philippines through the lens of a homegrown activist, Fatima Allian @ Shalom.

1. Share with us about your organisation and its work surrounding FGM/C

 Nisa Ul Haqq Fi Bangsamoro Inc. or Women for Justice in the Bangsamoro is a group of Muslim women NGO leaders advocating for women’s rights in the context of Islam and culture. In 2019 Nisa was invited FGM/C as part of an exploratory research in the Bangsamoro region. This was initiated due to the dearth of data on both FGM/C practices and its impact on women and girls in Bangsamoro. This is the first FGM/C  in- depth research in the Bangsamoro region. 

2. What are some latest important finding on FGM/C in Bangsamoro?

Type of FGM

Bangsamoro girls as young as two months old and older women as old as late 20s are subjected to type IV. Blades, bamboo sticks, small knives,needle nail-cutting knives and cotton are interchangeably used depending on the traditional birth attendants’ (panday) preference.

Medical Practitioners and Government leaders

In the research, all the medical practitioner key interviewees strongly believe that this tradition is Islamic. Medical practitioners not only encourage this practice as it is deemed as a religious obligation, but they also enable the perception that FGM/C can control the haram of lustfulness. Ultimately, the medical profession also reflects the bigger social norm that puts FGM/C as a way to prove one’s strong dan devoted faith to Islam.

Economic implication for non-circumcised Moro and revert women

Social stigma against Moro and revert Muslim women who are not cut or circumcised will bear the cost financially as the community will stop buying from them as their businesses are deemed haram. 

Deprivation of quality of childhoods and life

This practice is silently signaling the immediate  transition from childhood to puberty indicating her readiness for womanhood despite her very young reproductive age. That at the onset of her menarche,  limits her opportunity to advance self development for her future and puts her at risk for reproductive health related problems due to betrothal arrangements of the elders.

3. As a field researcher, what was your key takeaway when engaging with the community throughout this study? 

This research reminded me of the differences that exist within the communities. Our Bangsamoro girls and women’s lived realities should be acknowledged and documented so researchers and lawmakers have a better idea to formulate impactful and survivor sensitive policies that will benefit and protect them optimally.

4. How has the COVID-19 pandemic impacted FGM/C in the Philippines? 

On policy formulation and advocacy work against the practice of  FGM/C, we were not able to sustain the momentum after the presentation of the research with selected Ministries and members of the parliament due to the first (2020) and second (2021) wave of the pandemic in all areas of the Bangsamoro Autonomous Region in Muslim Mindanao (BARMM).

5. Who are the key stakeholders to engage as allies in anti-FGM/C advocacy in the Philippines, and how should we engage with these groups? 

The potential allies are policy makers of the BARMM, senate and congress' women, children , education and health committees respectively,  religious leaders , academic institutions,  peace builders and peace makers, SRH and human rights  network organizations. Exploring engagement activities such as series of dialogues, presentations of research and formulation of  policy papers that can popularise strong  anti FGM/C advocacy and lobbying works in the country. 

6. In your experience, how can CSOs and grassroots organisations working on FGM/C engage donors or the international community to fund community-led research? 

Utilising the political track of the peace processes between the government of the Philippines and the Moro Islamic Liberation Front and the national elections in 2022 is an entry point as well. This shall leverage FGM/C a national issue of concern in combating SRH implications, protecting the bodily integrity of women and girls and ending child marriages. 

7. Why is it so important to have a network such as the Asia Network to support activists in the region? How can the Network help to increase awareness of FGM in Asia? 

There is power in numbers and that is definitely helpful in creating ripple effects in any advocacy and lobbying work. When policy makers and donor communities feel our presence in different parts of the world calling for an end to a harmful traditional practice, they cannot afford to recognise the call to end FGM/C as a form of human rights violation against women and girls.  There is a need to strengthen the call using IEC online and other platforms such as social media and academic institutions. The network can engage with the community partners of activists to develop sharper gender lens and understanding on Islamic rulings on FGM/C. The  production of IEC in local languages used in the madaris, community dialogues and local radio programs encourages activists to articulate effectively in engaging with local, national and regional policy makers and donor communities.

We spoke to the creative team behind the Asia Network’s branding to get a glimpse behind the scenes! Read on to learn about the design process of the Asia Network’s logo and website.

Nicolette Mallari is a freelance graphic designer and creative consultant from the Philippines. Getting to work on projects with a higher purpose and collective scope provides her the opportunity to contribute to social transformation – this has been her approach to publication and information design for clients like ARROW. Nicolette designed the logo of the Asia Network, working in consultation with ARROW and Orchid Project.

Why did you decide to take on this project?

I am more than happy to take on projects that have an impact on human rights, and women and girls’ SRHR.

Of all the graphic design disciplines, visual identity is the yardstick of a designer’s skill set. Much more than a merging of shapes, colors, and fonts to create an aesthetic, logos need to be able to express a visual narrative in the simplest and clearest of terms. The project for the Network started off with a design brief from the client, who outlined the purpose and objectives of the organisation. Design briefs are critical for designers, these provide focus and direction for the concept and outputs. Given the nature of the project, the Network also provided a shortlist of visuals to avoid.

What was the inspiration behind the logo design? What do the different elements symbolise and how did you choose the colour palette? Could you share a little more about the ideation/design process? 

THE CONCEPT

Before the mouse hits the pad, the pencil hits the paper. This meant research – symbols, shapes, typefaces, colour themes – anything that would consolidate the message, values, and visions of the organisation into a graphic element was noted and sketched out. One of those concepts was a flower, long used as a symbol of femininity, fertility, and health.

REFINING THE CONCEPT

The next challenge was to render the flower with clean, flowing lines and give it a recognisable figure. The final logo render is charismatic yet visually effective: a flower in full bloom – with petals resembling wings, and its stigma and ovule shaped to gently resemble female genitalia.

DEFINING THE COLOR PALETTE

The colours in the palette were carefully chosen to reflect the identity of the organisation. Specific color tones were requested in the creative brief. Teal green for its positive connotations in Islam; purple, as a nod to ARROW and the Orchid Project, and to the wider feminist movement, many of which have  purple in their logos; and yellow, for its sheer vibrance, is a symbol of hope and enlightenment.

Your hopes for the Asia Network to End FGM/C.

Like a flower in full bloom, may the Asia Network be the hope and renewal for women and girls.

The Silver Kick Company (TSKC) is a Bahrain-based creative agency with a big heart. The bright, young team have a burning passion to make the world a better place through the work they do, helping compassionate brands make an impact. We spoke to Maria Shaheen, the Digital Marketing Manager at TSKC. She handles everything digital: social media marketing, emails and newsletters, and website design and development.

Why did TSKC decide to take on this project?

The founder & CEO of the company, Shabana Feroze, is a survivor of FGM/C. So for her, anti-FGM/C projects are very close to her heart. As a company that believes strongly in being compassionate, we want to do whatever we can to help bring positive change to the world. Which is why we support non-profits in creating marketing material for their campaigns, workshops, events, and digital media. Whether it's pro-bono work or working on grants, we want to do whatever we can to help strengthen their voice!

What was the inspiration behind the layout and design of the website? What do the different elements/illustrations symbolise?

We mostly took inspiration from the amazing logo. (We shared the logo with our entire team because it’s so beautifully done. Kudos to the logo designer!).

Our design brief was super clear from ARROW and Orchid Project, which always helps! So we wanted to make an attractive, user-friendly website with vibrant colours to stand out from others in this field. Especially since this issue is a serious one, we don’t want to put people off from going through the website because it might be depressing or alarming to read information about FGM/C. With the Asia Network’s guidance, we chose illustrations that portray women from different ethnicities to make sure we include all communities that practice FGM/C. We used illustrations that create an impact and depict strong and empowered women.

All in all, the website depicts hope. That even though FGM/C is so prevalent, coalitions like the Asia Network won’t stop working to end it.

Your hopes for the Asia Network to End FGM/C.

We hope that by becoming more structured and raising more voices with other non-profits, the Asia Network can help stamp out FGM/C in our lifetime. No more women and girls should be subjected to this gender-based violence.

We hope to see harmful social norms and traditions changing because of the work the incredible members of the Asia Network do. And we hope we can help them in their journey.

by ARROW

Activists from around the world are calling on governments and members of the public to take action to support an end to female genital cutting. 

Cutting impacts at least 200 million women and girls, in over 45 countries across Africa, Asia, the Middle East, and within diaspora communities worldwide. It is a truly global issue, which presents multiple, complex challenges within each different context where girls are affected.

The good news is that committed activists, grassroots organisations, communities, NGOs and, increasingly, governments are turning towards this issue. Together we are presenting solutions as to how we can protect girls and allow them to thrive, free from the practice.

We are seeing significant progress. UNICEF reports that a girl is around one third less likely to be cut today than she was three decades ago. More and more, communities are deciding to leave cutting behind, but there is still so much more to be done.

On the International Day to End FGC 2019, Orchid Project brought three esteemed guests together to speak live on Facebook about the global movement to end cutting, and the challenges that we still face.

We were joined by Sivananthi Thanenthiran, Executive Director of The Asian-Pacific Resource and Research Centre for Women (ARROW), based in Malaysia, Wairimu Munyinyi-Wahome, Executive Director of the Coalition on Violence Against Women (COVAW) in Kenya, and Mariya Taher, Co-Founder of transnational Indian & US organisation, Sahiyo.

They called for governments and members of the public to take action and support an end to this harmful traditional practice.

Together with Siva, Wairimu and Mariya, we call on governments to:

• Engage meaningfully with custodians of the practice, such as cultural and religious leaders.
• Report on UN Sustainable Development Goal Indicator relating to cutting (5.3.2).
• Provide dedicated budgets and resources towards ending the practice.
• Support greater data collection on the practice at national, regional and local levels.
• Engage, support and partner with grassroots, community-led initiatives.
• Recognise cutting as a global issue, particularly in contexts such as Malaysia where it is not yet acknowledged.
• Approach cutting as a human rights issue, acknowledging that all forms of the practice are a rights violation, and harmful to women and girls.

…and for members of the public to:

• Elevate the voices of women, girls and communities affected by cutting on platforms like social media.
• Share and talk about the practice with friends, family and colleagues to raise awareness.
• Write to local and national representatives, asking them to support change.
• Support, volunteer and donate to organisations working to end FGC.
• Stay up-to-date with organisations working to end the practice, such as Sahiyo, COVAW, ARROW and Orchid Project.
  
  

By: Orchid Project