Writer's Note: This article is the third in a multi-part exposé on FGM/C in Sri Lanka. I am currently in conversation with leading doctors, legal professionals, and survivors who will speak for themselves in future editions. These voices will lend further medical and legal clarity to what you're about to read.
Trigger warning: This article may contain details on FGM/C that some may find disturbing. If you’ve been reading my articles, you know I’ve spoken about why talking about FGM/C is so hard in Sri Lanka and how false religious arguments are used to normalize it. But in this article, I want to address something even more serious. The push to medicalize FGM/C. That if we can't stop it, maybe we can "clean it up." Sanitize the blood. Cut the girl but do it in a clinic. With gloves. With a doctor. With dignity.
A Mirror into Silence
I recently spoke to 40 Sri Lankan Muslim women. We spoke in whispers, in texts, in voice notes that expired after one play. This is how deep the fear runs. Out of the 40, 20 said they were clearly against the practice. Another 16 stayed silent or said they "didn't know enough." Four defended it.
And even those four didn't defend it on theological or health grounds. They defended it because it was what their mothers or grandmothers insisted on.
But here's what those 40 voices reveal beneath the surface, that silence is not consent. Most of these women, even those who didn't speak, carry the trauma inside them. And they are living proof of this truth, that this practice is not only painful, but permanent. There is no healing a body that has been cut for no medical reason. No stitch, no salve, no surgery can undo the loss. The body remembers. So does the mind.
The Medicalization Myth
Let's make something clear from the outset. The World Health Organization defines all forms of FGM/C, including pricking, scraping, nicking, or cutting, as harmful, non-medical procedures that violate human rights. No health benefit. No justification. No "lesser evil."
And yet, certain individuals have been and are pushing to have FGM/C done by medical professionals in Sri Lanka. Their argument? That ‘if’ the way it's being done now by traditional practitioners like ‘Ostha Maami’s, in unsanitary settings, is risky then why not control it? Why not make it "safe"?
But let's call this what it is? Medicalized mutilation.
There is no safe way to harm a child. There is no sterile way to violate a girl's body. There is no ethical way to take a blade to a child's genitals and call it culture or science.
Recent research by Women's Action Network across nine districts in Sri Lanka found that FGM/C is being advertised on Facebook by Muslim doctors and traditional practitioners. They're charging Rs. 3,000-7,000 for the procedure. They're literally commercializing child abuse. Higher fees if you want anesthesia. Higher fees if you call from Colpetty versus Dehiwala. This isn't medicine, it's a marketplace for mutilation.
But it's not just rogue practitioners. We have community leaders, religious organizations, and self-appointed guardians of culture who are now pushing this medical lie as their new defense strategy. When they can no longer justify FGM/C theologically, because they know the Islamic scholarship is weak and so, they pivot to this sanitized version. "It's okay if a doctor does it. It's okay if it's sterile. It's okay if we call it medical."
This is what people do when they can no longer defend a lie theologically, so they try to mask it with pseudo-science. "Don't worry, it's just a nick. Don't panic, a doctor will do it." The lie has evolved, but the blade is the same.
Medical Ethics 101
The principle of primum non nocere ("first, do no harm") is one of the foundations of medical ethics. And yet, somehow, some practitioners are being courted to betray that very principle by sanitizing a practice that has no clinical justification whatsoever.
Let's be blunt. Any doctor who performs FGM/C is violating the Hippocratic Oath. They're not a healer; they're a tool for patriarchy. A glove-wearing accomplice to a crime.
Here's what the medical evidence, globally and locally says: It is irreversible.
Immediate Risks:
- Bacterial infections from unsterile tools or environments
- Excessive bleeding from rich vascular tissue
- Urinary retention, trauma to the urethra, painful urination
- Sepsis, fever, seizures, and in rare but real cases, death]
Long-term Health Consequences:
- Chronic genital and pelvic pain, scar tissue, nerve damage
- Complicated childbirth: tearing, prolonged labor, surgical intervention
- Sexual dysfunction: dyspareunia, numbness, reduced arousal
- Obstetric fistula, cysts, and recurrent infections
- Infertility risks, depending on severity of the procedure
Psychological Consequences:
- Post-traumatic stress disorder (PTSD)
- Anxiety, depression, self-harm, sexual avoidance
- Disassociation and body dysmorphia
There is no pill, no treatment that restores what was taken. We must understand the medical horror of this. A child is being permanently altered in one of the most sensitive anatomical areas of the human body, for no medical reason.
And then expected to grow up and function like nothing happened.
That is the real crisis. That's the real silence.
Debunking the Medical Lies
Let me address the most common medical justifications I've heard, and why they're not just wrong, they're dangerous:
LIE NUMER ONE: "It's just removing the hood, like male circumcision"
THE TRUTH: As Professor A.H. Sheriffdeen and Dr. Ruvaiz Haniffa clearly stated in their 2018 medical analysis, male and female genital anatomy are completely different. The clitoris has no equivalent function to the male foreskin. This comparison is medically ignorant and deliberately misleading.
LIE NUMBER TWO: "It prevents infections and keeps the area clean"
THE TRUTH: The clitoris is positioned away from the site of sexual activity and plays no role in transmitting sexually transmitted diseases. As the medical experts note, "No amount of 'hoodectomy' or washing only the clitoris is going to reduce" smegma production, which occurs primarily under the labia. This justification is medically baseless.
LIE NUMBER THREE: "Medicalization makes it safer"
THE TRUTH: This is the most dangerous lie of all because it sounds reasonable. Some argue that medicalization will reduce harms. That's like saying rape is less of a crime if done in a neat hotel room rather than an alley. The harm is in the violation itself. As Dr. Shemoon Marleen confirms, even "milder forms" cause sexual dysfunction, pain, and complications during childbirth.
But here's what they don't tell you.
Medicalization doesn't just normalize local harm, it globalizes it. When families can't find compliant doctors locally, they take their daughters abroad. Medical tourism for mutilation. This lie doesn't reduce harm, it exports it and makes it permanent.
LIE NUMBER FOUR: "Religious leaders support it if done medically"
THE TRUTH: This is perhaps the most insidious manipulation. Community leaders and organizations use strategic silence to imply support. They won't condemn the practice outright because they know it would anger traditionalists. But they won't defend it theologically because they know the Islamic scholarship is weak. So, they hide behind medical language, suggesting that if doctors do it, it must be okay.
This is moral cowardice disguised as religious leadership.
LIE NUMBER FIVE: "It's just a small cut, it heals"
THE TRUTH: Recent studies show that women experience tearing during sexual intercourse, obstetric complications, and long-term genital pain. The scar tissue doesn't just heal, it becomes a permanent source of trauma. As one survivor told researchers, "I felt like some part of myself had been violated without my consent."
Medicalized FGM/C is Still Abuse
The 2018 circular banning doctors from performing FGM/C was supposed to end this madness. Yet in 2024, private clinics and so-called medical professionals in Kandy, Colombo, and Moratuwa are reported to have still continued these mutilations like it’s a legitimate medical procedure.
Let me be crystal clear: FGM/C is not medicine. It is never medicine. No doctor, no clinic, no medical association has the right to claim otherwise.
Medicalizing FGM/C is a lie. It’s a calculated attempt to keep this brutal, harmful practice alive under a white coat and behind hospital walls. It’s abuse with a clean label, and it’s disgusting.
To anyone who tries to argue that “cutting” girls can be done “safely” or “with dignity”, you are enabling violence. You are complicit in child abuse.
Survivors, must know, what happened to you was not healing. It was harm disguised as care. And it’s still happening because too many people are too afraid to call it out.
We must stop pretending that medicalization makes FGM/C acceptable. Every doctor performing it must lose their license. Every clinic offering it must be shut down. Every medical body that stays silent is an accomplice.
If Sri Lanka allows medicalization to continue, we are failing our girls. We are failing our future.
So, no more excuses. No more hiding behind religion or “culture” or “health.” Medicalized FGM/C is mutilation, plain and simple. This is not a debate. This is child abuse. And it must stop.
