Debate is raging in Malaysia over Muslim female genital mutilation as the country's health ministry reportedly develops guidelines to reclassify it as a medical practice.
In 2009, the Fatwa Committee of Malaysia's National Council of Islamic Religious Affairs ruled that "female circumcision", as it has become known, was obligatory for Muslims but if harmful must be avoided.
Human rights activist Azrul Mohamad Khalib has written a scathing commentary calling for abolition of the practice.
He says it has no religious or medical benefits.
But according to the results of a university survey the practice is widespread, with more than 90 per cent of Malay Muslim female respondents reporting they have been circumcised.
Azrul Mohamad Khalib told Radio Australia's Connect Asia: "It certainly is a surprising figure, really. The study involves more than 1,000 female respondents and when we look at it, around 90 per cent or so are Malay Muslims."
Azrul Mohamad Khalib is also communications and resource mobilisation adviser of the SPRINT project with the International Planned Parenthood Federation.
He said that to have anecdotal evidence "captured" in the study is really "both surprising and a little bit disappointing".
What about the suggestion that the health ministry may be about to register the practice?
He said: "One of the things I find quite alarming with regards to this development is that the Ministry of Health is actually depending on a fatwa, a religious opinion that was actually issued by the national fatwa council, in which they made it obligatory, or 'wajib', for all Muslim women to be circumcised.
"It seems that the Ministry of Health is now (instituting) that fatwa.
"So, in contrary to quite a number of best practices as well as a WHO (World Health Organisation) advisory, the Ministry of Health is taking steps now to sort of make it standardised, or medicalised, in such a way that it might be applied to all public health-care facilities."
At the moment the practice is carried out generally by traditional practitioners, as well as private health practitioners, the activist said.
"One of the things that those working on gender issues in Malaysia have come to realise is that a barrier when we deal with these sort of issues is the lack of awareness - the 'why' of such practices and how harmful it can be.
"Certainly when it comes to female circumcision, the position that has been taken is that if it does do no harm why not do it? Well . . . if there are no benefits to doing it, why do it?
"One of the first steps that we are trying to push out forward is that we are very much trying to spread awareness that such practices are unnecessary.
"They're not required by religion, they're not having any medical benefits whatsoever and certainly when we look at it it's strictly cultural in its entirety.
"But as you mentioned, it is going to be extremely hard if more than 90 per cent of the Malay Muslim population already practising it."