Fathima (name changed) was 20 years old when she spoke about the practice of Female Genital Mutilation (FGM) with the elder women in her family. Suddenly, one of them told her: “Oh we have done this to you as well.” 

“I felt a mix of emotions because this practice is done when you are very young or as a baby – when you are seven days old. I questioned whether I should feel upset about it because I didn’t remember it, but I also wanted to forgive the women in my family who had done it to me because they didn’t know any better. I felt like some part of myself had been violated without my consent,” said Fathima, speaking to The Sunday Morning. 

FGM is not spoken about in Muslim communities, said Ayesha (name changed), who found out that she was circumcised only when she was in university. 

“‘How else would you have become Muslim?’ asked my mother, when I questioned her about it,” Ayesha told The Sunday Morning. 

FGM involves the partial or total removal of external female genitalia or other injury to the female genital organs due to non-medical reasons, according to the World Health Organization (WHO). 

Women’s Action Network (WAN) Co-Founder Shreen Abdul Saroor, who recently conducted a study across nine districts in Sri Lanka on FGM, termed the practice as “barbaric and backwards”. 

“What is worrisome is that even though Islam doesn’t require it, it is a cultural practice that continues to be performed under the pretext of Islam,” said Saroor, calling upon the Muslim community to eradicate it together. 

Medicalised, commercialised

Beginning in July last year, the study conducted by Saroor and other ground-level activists, concluded in December 2024, surveyed 998 participants across nine districts (Batticaloa, Ampara, Trincomalee, Mannar, Polonnaruwa, Puttalam, Colombo, Kandy, and Galle). 

Out of the 998 participants, 465 Muslim women reported either personally experiencing FGM or Cutting (FGM/C) or knowing someone who had undergone the procedure, while 208 interviewees chose not to answer. 

“Nearly 70% of the respondents indicated that FGM/C is perceived as a religious requirement to mark newborn girls as Muslims, and this practice is often referred to as ‘khatna’ or female circumcision,” said Saroor.  

To add to existing concerns, the study has found an increasing trend of the medicalisation of FGM/C, with procedures being performed in private medical clinics by Muslim doctors. 

“It’s also commercialised, where you are charged higher if you request anaesthesia and a sterilised environment. You are charged more if you call from Colpetty, but less if you call from Dehiwala. ‘Ostha maamis’ charge about Rs. 3,000,” said Saroor. 

The service is now even being advertised on Facebook and other social media platforms by Muslim doctors and traditional practitioners known as ‘ostha maamis,’ the study has found.

However, Saroor said they were unable to conclude if the practice of FGM had increased in Sri Lanka, as there was no previous research to compare their current findings to. 

One other study conducted a few years ago focused on the Dawoodi Bohra community’s practice of FGM. This community comprises relatively recent immigrants from India. They are smaller in number compared to other groups of Sri Lankan Muslims such as Moors and Malays. 

“The United Nations conducted the study but didn’t release it due to the prevalent anti-Muslim rhetoric at the time,” said Saroor, pointing to the years from 2015 onwards when anti-Muslim riots and rhetoric caused serious harm to the Muslim community in the country. 

In 2018, the Director General of Health Services, at the request of the Parliament’s Sectoral Oversight Committee on Women and Gender, issued a circular prohibiting medical practitioners from carrying out female circumcision. 

“But the circular didn’t reach far. Some Muslim men tried to compare FGM to cosmetic surgery, but cosmetic surgery is done on adult women with consent,” said Saroor. 

Despite the circular, the study has found that private clinics and doctors are continuing the practice as a commercialised venture for Rs. 3,000-7,000. “It didn’t have much of an impact as Government clinics anyway did not conduct FGM, but it is still important that the Government recognised the harmful impacts of the practice.” 

At the 90th session of the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) held last week, Ministry of Women and Child Affairs Legal Officer Kumudu Perera referred only to the previously issued circular when commenting on Sri Lanka’s actions to prevent FGM.

She noted that the circular stated that conducting or encouraging FGM was considered highly unethical and all medical practitioners promoting or practising FGM could face disciplinary action. However, The Sunday Morning has observed Facebook posts advertising the service being offered by private clinics and medical practitioners in a number of areas, including Kandy, Colombo, and Moratuwa even as of last year. 

Meanwhile, Deputy Solicitor General Kanishka De Silva Balapatabendi, who also formed part of the Government’s CEDAW delegation, said that while FGM and obstetric violence weren’t specific offences, they were still offences under other provisions of the Penal Code, such as causing hurt and grievous hurt.

Medical concerns 

Consultant Obstetrician and Gynaecologist Dr. Shemoon Marleen told The Sunday Morning that FGM could lead to various problems related to menstruation and reproduction. 

“The removal of sensitive tissues, such as the clitoris and labia minora, may lead to reduced sexual sensation, while scarring over the clitoris can cause pain. More severe forms of FGM can result in painful menstruation and the buildup of blood in the vagina. 

“The reproductive potential of a female may be diminished due to pain during intercourse, inability to engage in sexual activity, and impaired sexual function resulting from vaginal narrowing and painful scar tissue,” said Dr. Marleen. 

She added that as a result of FGM, women could also experience tearing during sexual intercourse and obstetric complications such as difficult vaginal deliveries, excessive bleeding at the time of delivery, or in some cases, the need for a caesarean section.

She also highlighted the long-term physical pain that FGM could cause to a woman, such as pain in the genital area, pain during sexual intercourse, or pain during urination, especially if there was scarring or distortion of the genital area.

“The severity of these symptoms often depends on the type or extent of FGM performed,” she noted.  

According to Dr. Marleen, the most common type of Female Genital Cutting (FGC) practiced in Sri Lanka is termed Type I, which involves the removal of the clitoral hood or the clitoris itself, and the way this procedure is carried out varies among communities. 

“Members of the Dawoodi Bohra community may have it performed by a medical professional or a traditional cutter. On the other hand, in Moor and Malay communities, it is often done by someone called an ‘ostha maami,’ who is a medically unqualified traditional cutter. 

“In the Dawoodi Bohra community, girls typically experience FGC when they are about six to seven years old. In contrast, in the Moor and Malay communities, the procedure usually takes place 40 days after a baby is born.” 

As soon as they are subjected to the practice, girls may experience intense pain, heavy bleeding, swelling around the genital area, fever, and infections, according to Dr. Marleen. There is also a risk of more severe conditions like tetanus and sepsis, which can be life-threatening, as well as injuries to surrounding genital areas. 

Throughout her years of practice in Sri Lanka, Dr. Marleen has primarily encountered milder forms of FGM. 

“In these instances, the health issues have generally been less severe, although I cannot imply that they were not significant to the women involved. Most of the concerns were related to sexual pleasure or discomfort. In contrast, during my practice in the UK, I observed more severe cases of FGM, which often resulted in a broader range of health problems.” 

Interventions 

Saroor said that for many years, the practice of FGM/C had gone largely undetected in Sri Lanka, a claim further validated by the WHO reporting a ‘zero score’ for FGM in Sri Lanka in a 2008 report on gender-based violence. A joint Ministry of Health and WHO report in 2008 too stated that FGM/C was non-existent in Sri Lanka. 

Therefore, despite WAN’s and other groups’ best efforts to approach policymakers on this issue, “none have treated this harmful practice, particularly as it affects infants, as a serious issue,” said Saroor. 

Following the recently-concluded study on FGM, WAN has made the following recommendations:

• Systematically document and report instances of FGM/C in Sri Lanka, recognising it as a hidden threat to women’s health and well-being
• Develop localised guidelines for healthcare professionals to identify and address FGM/C in a sensitive and victim-oriented manner
• Increase awareness about the prevalence and risks of FGM/C at the community level and educate policymakers and medical practitioners on the issue
• Strengthen the capacity of community-level healthcare providers – especially nurses and midwives – to raise awareness about FGM/C and help bridge gaps between victims and healthcare services
• Repeal Article 16 of the Constitution, which currently protects harmful practices, and criminalise FGM/C

Dr. Marleen said that in the short term, the healthcare sector could at least establish a hotline or centres where patients could report their concerns regarding FGM and be referred to secondary or tertiary healthcare facilities with gynaecologists available to assist them.

“Effective laws are essential because cultural traditions and beliefs often contribute to the continuation of FGM. Legislation should clearly define what FGM is and make it illegal for anyone to perform these procedures, whether they are medical professionals or untrained individuals. 

“It should also specify exceptions for medically necessary procedures performed by qualified medical practitioners. Additionally, protection orders should be established for victims and individuals at risk of FGM,” said Dr. Marleen. 

A young researcher connected to the recently-concluded study, who wished to remain anonymous, reflected that she had understood that it was not just poor or uneducated women engaging in the practice. 

“Class or education isn’t a determining factor; it’s a lack of awareness and understanding,” she said.