In 2009, Malaysia's National Fatwa Committee, the nation's top Islamic council, required all Muslim women in the country to undergo female genital mutilation, otherwise known as female circumcision.
A recent study indicated that nearly all Muslim women in the country have had the procedure. But now the United Nations is working with the Committee to repeal ruling that made it mandatory.
Government health officials who are in negotiations with Malaysia's National Fatwa Committee say the ruling by the country’s top religious authority requiring female genital cutting for all Muslim women may be overturned.
The World Health Organization defines any type of invasive procedure in the female genital area as mutilation, and subdivides practices into four types of increasing severity. It has banned them all.
According to health officials, the minimally invasive genital cutting typically practiced in Malaysia, falls under type IV of the WHO’s classification system. It sometimes involves just a pin prick to the clitoris, is typically performed during infancy, and has few or no health complications for the women later in life.
The fatwa issued in 2009 states female circumcision is required in all cases “except when harmful.” But international health experts say it is always harmful, even in its mild form in Malaysia.
Saira Shaheem, who works for the United Nations Population Fund in the Malaysian capital, Kuala Lumpur, said health officials are trying to work with the fatwa committee to bring the influential religious body’s ruling in line with WHO guidelines.
“We will continue to work with them on it. But what the Fatwa does not do, is it does not specify what the procedure should be. And that allows us an avenue to define the procedure in a noninvasive, nonharmful manner, and shift the practice accordingly,” said Shaheem.
Traditional midwives have typically performed the procedure on infants at home, but as doctors are increasingly asked to perform the surgery in a sterile setting, they face a dilemma in not wanting to violate Malaysian Medical Association recommendations.
Shaheem said ministry health officials are trying to replace the practice of cutting with a routine alcohol swab of the genital area performed by an obstetrician at birth, while the religious authorities try to repeal the fatwa.
There have been no fatwas issued regarding male circumcision, a procedure seen as required by religious authorities at a later age in Malaysia, and typically performed with public ceremony.
A study conducted by Malaysian health officials in 2012 showed 93 percent of Muslim women have undergone the practice. This puts Malaysia in the top percentile of practicing countries across the world, alongside East African countries such as Somalia and Sudan.
Although the study offered no systematic data on the extent of the cutting involved, researchers say midwives in Malaysia typically remove a piece of flesh no bigger than “half a rice grain” from the clitoral hood.
Julia Lalla-Maharajh is the director of Orchid Project, a London-based advocacy group that works to stop female genital mutilation. She is concerned the fatwa could contribute to a sense that a more invasive cut must be performed to complete the ritual.
“Every single form of intervention is harmful. There are no health benefits whatsoever to this practice. We would also point out that there have actually been fatwas around the world that say FGM is harmful and is forbidden in Islam,” Lalla-Maharajh said.
She said that the taboo nature of the subject contributes to the limited amount of data available.
Lalla-Maharajh added the continuing belief it is an important ritual whose cultural benefits outweigh the health risks has led Muslim religious leaders to say the classification of mutilation is a misnomer.
Even within communities in Malaysia, there is debate as to whether the practice is required by Islam. Anthropologists said the practice predates Islam in parts of Southeast Asia.
In the 2012 study, respondents listing reasons for undergoing the procedure cited religious obligation, cleanliness of private parts, a means to control women’s sexual urges, and a belief it would enhance their partner’s sexual pleasure.
The WHO claims these types of motivations show the practice arises from a deep-seated gender bias.
The U.N. Population Fund’s Shaheem said Malaysia’s widespread health care system means women who undergo the procedure do not appear to be at risk from life-threatening complications that faces many women in Africa.
But she said there is still little known about how the procedure is being performed and how much flesh a midwife or physician typically removes.
“Because it’s not defined by anybody, although it’s not harmful now, there is nothing to prevent anybody from interpreting what needs to be removed and how much needs to be removed. Parents wouldn’t know! It’s in the hands of doctors and you would only find out after the fact,” Shaheem said.
Despite ongoing talks to repeal the fatwa that makes the procedure mandatory, negotiators say there is no time-bound plan for making a decision.
The WHO estimates between 100 and 140 million women and girls have been cut worldwide, and 3 million girls are in danger of being cut every year in Africa alone.