The Rise of Medicalization in Female Genital Mutilation/Cutting in South and South East Asia: A 2025 Overview

October 15, 2025

Rising Concerns as healthcare Professionals Perform Female Genital Mutilation in asia

A deeply concerning trend is unfolding across South and Southeast Asia: the escalating medicalization of Female genital Mutilation/Cutting (FGM/C). Experts are sounding alarms as obstetricians, gynecologists, and advocates report a growing number of procedures performed by trained healthcare workers, signaling a dangerous shift in this harmful practice.

The Rise of Medicalized FGM/C

New data reveals a disturbing pattern. Younger girls are now more likely to undergo FGM/C at the hands of medical professionals compared to older generations. This shift is particularly pronounced in urban areas, where access to healthcare is greater. A recent report, compiled by ARROW, Equality Now, and the Orchid Project, details evidence from Brunei Darussalam, India, Indonesia, Malaysia, Pakistan, Singapore, Sri Lanka, and Thailand.

indonesia currently stands alone in the region with laws explicitly prohibiting FGM/C,even when performed by doctors. This lack of consistent legal protection across the region leaves countless women and girls vulnerable. Advocates are urgently calling for complete legislation and stricter enforcement to criminalize all forms of FGM/C and prevent its medicalization.

Why Medicalization is Dangerous

While some believe medical settings make the practice safer, Dr. hannah Nazri from the Asia Network to End FGM/C emphasizes that “Medicalising FGM/C does not make the practice safe.” The involvement of healthcare professionals can falsely legitimize the procedure, masking its inherent harm. Furthermore, studies suggest doctors may even perform more severe forms of cutting than traditional practitioners, leveraging their anatomical knowledge and the use of anesthetics.

FGM/C, regardless of who performs it, is a grave violation of human rights with no medical justification, as affirmed by the World health Organization (WHO) and other international bodies.The practice carries immediate and long-term physical and psychological risks, rooted in gender discrimination.

Country-Specific Trends

The medicalization of FGM/C varies across the region. In Indonesia,nearly half of all procedures are now performed by trained midwives. Malaysia has witnessed a similar transition, with doctors increasingly involved.A 2020 study found that over 85% of Malaysian doctors believed female genital cutting should continue.

Singapore reveals high rates of medicalization, with nearly half of those who have undergone FGM/C having been cut by doctors. Sri Lanka is seeing a rise in physicians offering the procedure in private clinics, even advertising services on social media. Thailand is also experiencing an increase, with reports of doctors performing 10 to 20 procedures monthly.

Country	Medicalization Rate (approx.)	Key Findings
Indonesia	~50%	Midwives perform nearly half of all procedures.
Malaysia	Increasing	over 85% of doctors believe practice should continue.
Singapore	~47%	Nearly half of procedures are performed by doctors.
Sri Lanka	Rising	Physicians advertise services on social media.

Did You Know? The WHO estimates that 52 million women and girls alive today have been subjected to FGM/C performed by a health worker.

The Role of Silence and Cultural Justifications

Advocacy efforts are often met with resistance, dismissed as a “Western agenda,” or framed as an attack on religious or cultural traditions. This can strengthen community resolve to preserve the practice, particularly in Muslim-minority countries where Islamophobic narratives can further entrench it. A lack of clear guidance from national medical associations also contributes to the problem.

Safiya Riyaz of ARROW states, “Medicalisation of FGM/C does not make the practice safe. On the contrary, it risks embedding it within health systems, undermining medical ethics, and exposing women and girls to long-term physical and psychological harm.” Divya Srinivasan at Equality Now concludes that stronger laws, accountability for healthcare providers, and increased awareness are urgently needed to address this crisis.

Pro Tip: If you or someone you know is at risk of FGM/C, reach out to organizations like Equality Now or the Orchid project for support and resources.

Understanding FGM/C: A global Perspective

Female Genital Mutilation/Cutting (FGM/C) is not limited to Asia. It is indeed a global issue, practiced in over 90 countries, primarily in Africa, the Middle East, and Asia. The practice involves altering or injuring the female genital organs for non-medical reasons. It is indeed a deeply harmful tradition with devastating consequences for the health, well-being, and human rights of women and girls.

The fight against FGM/C requires a multifaceted approach, encompassing legal reforms, community engagement, education, and the empowerment of women and girls. International collaboration and sustained advocacy are essential to eradicate this practice worldwide.

Frequently Asked Questions About FGM/C

• What is FGM/C? Female Genital Mutilation/Cutting is the partial or total removal of external female genitalia for non-medical reasons.
• Is FGM/C a medical necessity? No, the World Health Organization and other international bodies affirm ther is *no* medical justification for FGM/C.
• Why is medicalization of FGM/C harmful? It lends false legitimacy to a harmful practice and doesn’t prevent physical or psychological damage.
• What can be done to stop FGM/C? Stronger laws,education,community engagement,and support for healthcare professionals are crucial.
• where can I find help if I am at risk of FGM/C? Organizations like Equality Now and the Orchid Project offer support and resources.
• Is FGM/C limited to specific religions or cultures? While practiced in communities with specific cultural or religious beliefs, FGM/C is not mandated by any major religion.
• What role do healthcare workers play in ending FGM/C? Healthcare workers have a responsibility to abstain from performing FGM/C and to advocate against the practice.

What are your thoughts on the growing trend of medicalized FGM/C? How can communities and governments work together to protect vulnerable girls and women?

What are the key legal challenges hindering the complete eradication of FGM/C in Indonesia, Malaysia, and the Philippines despite existing legislation?

the Shifting Landscape of FGM/C

Female Genital Mutilation/Cutting (FGM/C) remains a deeply entrenched practice in several countries across South and South East Asia, despite international condemnation and legal prohibitions. However, a concerning trend has emerged in recent years: the increasing medicalization of FGM/C. This refers to the practice being performed by healthcare professionals – doctors, nurses, and midwives – rather than traditional practitioners. While seemingly paradoxical, this shift presents unique challenges to eradication efforts. The practice is also known as female circumcision, sunna, and khitan depending on the region and community.

Geographic Distribution & prevalence (2025 Data)

Current estimates (October 2025) indicate the highest prevalence of FGM/C within specific communities in:

* Indonesia: Especially in provinces like Aceh, West Sumatra, and South Sulawesi. Prevalence rates among girls aged 0-14 range from 60-80% in some areas.

* Malaysia: Primarily among Muslim communities. While national prevalence is lower (around 9.8% according to 2023 UNICEF data), it remains notable in states like Kelantan and Terengganu.

* Philippines: Concentrated in the Bangsamoro Autonomous Region in Muslim Mindanao. Estimates suggest prevalence rates exceeding 73% among women aged 15-49.

* Myanmar: Prevalence is documented among Rohingya and other Muslim communities, though accurate data collection is hampered by ongoing conflict.

* Thailand: Limited to specific Muslim communities in the southern provinces, with prevalence estimated around 10-20%.

These figures represent a complex picture,with variations even within countries based on ethnicity,religion,and socioeconomic status. The term female genital alteration is increasingly used to encompass the spectrum of practices.

Why Medicalization is Occurring

Several factors contribute to the rise of medicalized FGM/C:

1. Perceived Safety: Families often seek medical professionals believing they will perform the procedure more hygienically and safely than traditional practitioners, minimizing risks like infection or hemorrhage. This is a key driver.
2. Social Pressure & Normalization: medicalization lends a veneer of legitimacy to the practice, normalizing it within communities and reducing stigma. When performed by a doctor, it’s frequently enough seen as a “medical necessity” rather than a harmful tradition.
3. Demand & Supply: Strong community demand for FGM/C, coupled with healthcare providers willing to perform the procedure (often for financial gain or due to social pressure), creates a hazardous supply.
4. Lack of Enforcement: Weak enforcement of existing laws prohibiting FGM/C, and a lack of accountability for medical professionals who violate them, exacerbate the problem.
5. Cultural Beliefs: Deeply ingrained cultural and religious beliefs surrounding female sexuality, purity, and marriage continue to fuel the practice, even when performed in a medical setting. Sunnat is often cited as a religious obligation, despite differing interpretations.

The Risks of Medicalized FGM/C

While medicalization may reduce some immediate health risks, it does not eliminate them. Furthermore, it introduces new concerns:

* False Sense of security: The involvement of a healthcare professional can create a false sense of security, leading families to believe the procedure is harmless.

* Complicity of the Medical Profession: Medicalization compromises the ethical principles of the medical profession, undermining trust in healthcare systems.

* Increased Accessibility: Medical facilities are often more accessible than traditional practitioners, potentially increasing the number of girls subjected to FGM/C.

* Long-Term Health Consequences: Irrespective of who performs the procedure, FGM/C can lead to a range of long-term health complications, including:

* Chronic pain

* Infections

* Difficulties with childbirth

* Psychological trauma

* Urinary and fecal incontinence

* Sexual dysfunction

Legal Frameworks & Challenges

Many countries in South and South East Asia have laws prohibiting FGM/C, but enforcement remains a significant challenge.

* Indonesia: The Indonesian Medical Ethics Code prohibits doctors from performing non-therapeutic FGM/C, but enforcement is inconsistent.

* Malaysia: FGM/C is illegal under the Penal Code, but prosecutions are rare.

* Philippines: The Anti-FGM/C Act of 2021 criminalizes the practice,but implementation is ongoing.

* Thailand: FGM/C is prohibited under the Penal Code, but awareness and enforcement are limited.

A key challenge is the ambiguity surrounding “therapeutic” FGM/C. Some practitioners argue that certain minor forms of alteration are medically justified, creating loopholes in the law. Harm reduction strategies are often debated, but generally opposed by international human rights organizations.

Intervention Strategies & Best Practices

Addressing the rise of medicalized