The practice of female genital mutilation, or "circumcision", is widespread in Iraq's Kurdish region and authorities must develop a long-term plan to eradicate it, Human Rights Watch said on Wednesday.
In a 73-page report entitled: "‘They Took Me and Told Me Nothing': Female Genital Mutilation in Iraqi Kurdistan," the New York-based watchdog recorded the experiences of 31 girls and women in four villages in northern Iraq's semi-autonomous Kurdish region.
"I remember my mother and her sister-in-law took us two girls, and there were four other girls," a 17-year-old student called Gola from the village of Plangan told the watchdog.
"We went to Sarkapkan for the procedure. They put us in the bathroom, held our legs open, and cut something," she said.
"They did it one by one with no anesthetics... I have lots of pain in this specific area they cut when I menstruate."
It is estimated that more than 130 million women worldwide have undergone female genital mutilation (FGM), a centuries-old practice still common in some countries, mainly in sub-Saharan Africa, western and southern Asia and parts of the Middle East.
The most common form practiced, it said, is the partial or total removal of the clitoris and/or prepuce (clitoral hood).
It cited a German-Iraqi study conducted in 2007/08 in which more than 77 percent of female interviewees aged 14 and over in the Kurdish province of Sulaimaniya had undergone the procedure.
"It's time for the regional government to step up to the plate and take concrete actions to eliminate this harmful practice because it simply won't go away on its own," said Nadya Khalife, HRW Middle East women's rights researcher.
Often the practice is carried out for cultural or religious reasons, but opponents say it is a brutal form of oppression and potentially life-threatening.
Human Rights Watch said the Kurdish regional government elected in July 2009 had done nothing to eradicate the practice.
The health minister in Kurdistan's regional government, Taher Hawrami, said authorities were distributing posters to promote awareness, but he said religious leaders should do more to end the practice.
"The clerics should take on the main role," Hawrami told Reuters. "People need to have better understanding of religion in order to give up this phenomenon."
Mainly Sunni Muslim Kurdistan has enjoyed heavy Western protection since the end of the first Gulf War, and promoted itself to investors as a stable gateway to Iraq as the rest of the country descended into sectarian war after the U.S. invasion of 2003.
Human Rights Watch said the origins of genital mutilation in Kurdistan were unclear.
According to the report, some girls and women said they were told it is rooted in a belief that anything they touch is haram, or unclean, until they go through the procedure. "Most women referred to FGM as an Islamic sunnah, an action taken to strengthen one's religion that is not obligatory," it said.
But for many girls and women in Iraqi Kurdistan, the report said, genital mutilation is an unavoidable procedure they undergo sometimes between the ages of three and 12.
The report cited cases of girls being taken unaware by their mothers to unlicensed practitioners. "When they arrived, the midwife, sometimes with the help of the mother, spread the girl's legs and cut her clitoris with a razor blade," it said.
"Often, the midwife used the same razor to cut several girls in succession."
The report said there was no data to establish how common the practice might be in the rest of Iraq. Iraqi Kurdistan has enjoyed semi-autonomy since the end of the first Gulf War.
"Circumcision is part of the violence women face within the family, and no one can prevent it but the government by tracking it and stopping it from happening," said Kurdish women's rights activist Shanga Raheem.