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The number of young girls in the country being circumcised could increase following a Health Ministry decree on the procedure, health experts warn.

The decree appears to contradict a 2006 memo from the ministry prohibiting health workers from circumcising girls.

“It’s a huge setback that Health Minister Endang Rahayu Sedyaningsih, who is also a doctor, has allowed this nonmedical practice to persist,” Kartono Muhammad, a former head of the Indonesian Doctors Association (IDI), said on Tuesday.

“With female circumcision now formalized in regulation, this will encourage practitioners to perform the procedure.”

He said that female circumcision did not have any health benefits and instead harmed girls and young women.

Among the immediate complications are severe pain, shock, bleeding and tetanus as a result of infections arising from shoddy surgery, he said.

“Female circumcision, which is usually performed on newborn babies, is very dangerous because they are more susceptible to infections,” Kartono warned.

He also said the long-term consequences could include bladder and urinary tract infections, as well as cysts and infertility.

Ramona Sari, from the Indonesian Family Planning Association (PKBI), said the type of female circumcision most commonly done in Indonesia was risky, since it often involved lacerations to the clitoris.

“It’s widely performed across the country and is particularly dangerous because in small villages it’s often done by traditional healers without the right tools or proper sterilization,” she said.

Kartono said other forms of circumcision, including the removal of the clitoris, had also been reported in the country.

“Cases of removing the entire clitoris have been found in a few areas in West Java and West Sumatra, where they’re performed by ultraconservative Islamic communities,” he said.

He said the rationale for female circumcision was a mix of cultural, religious and social factors, motivated by the belief that it would ensure abstinence and future marital fidelity.

“Many communities believe circumcision helps reduce a woman’s libido and thereby helps prevent her from engaging in illicit sexual acts,” Kartono said. “No religious scripts prescribe the practice, but practitioners often believe otherwise.”

The World Health Organization says that up to 140 million girls and women worldwide are living with the consequences of female genital mutilation.

Speaking after protests on the issue last month, Ina Hernawati, a Health Ministry official, said the decree did not represent support for female circumcision, but instead offered guidelines to reduce the risks in cases where it occurred.