In Iraqi Kurdistan, 40 percent of women and girls between the ages of 14 and 22 have been subjected to female genital mutilation (FGM), surveys suggest, a practice that involves cutting out the clitoris. The practice is perpetuated by women -- often mothers, aunts and grandmothers - who say they want the best for the children, as they believe it makes their girls "clean" and marriageable.
Some link the practice to Sunni Islam's Shafi'i school of thought, to which most Kurds belong.
Human Rights Watch researchers Nadya Khalife and photographer Samer Muscati traveled to the rural villages and farmlands of Iraqi Kurdistan to interview and photograph women about their experiences with FGM.
The ensuing Human Rights Watch report had immediate impact. Shortly after its release the Kurdistan Islamic Scholars Union issued a fatwa declaring that FGM isn't an Islamic practice and that people should abandon it if it is proven harmful.
As each traveled to Iraqi Kurdistan at a different time, it was only later that Nadya and Samer discussed their experiences researching this issue.
Nadya: FGM is such a nuanced issue for women, it's so sensitive. And yet, Samer, you're a man, and you photographed these women. Did you get any kind of push-back from such a conservative society because you're male?
Samer: I was concerned. As you know, we were both concerned as to whether the women would open up to us. But in some sense, I think not being a Kurdish male was an advantage - I was an outsider.
Nadya: I'm assuming that you were the only man around? When I spoke with the women, we would gather in one room and shut the door behind us, telling the men we were discussing a women's topic and that they weren't allowed in. Then we'd all sit on mats on the floor and drink tea together.
Samer: Basically, I was treated as one of the women. But my job was mostly to take photographs. You did most of the interviewing. And even though you're a woman it still had to be a hard topic to broach.
Nadya: It was. I tread carefully - I didn't want anyone to perceive the report as being against Kurds or Kurdish culture.
One woman I interviewed said to me, "You must think we're monsters." That really stuck with me. She was really worried about me judging them. But I worked to make sure the women didn't feel that way - that would only inhibit the work we're doing. I tried to communicate that I wanted to understand what they thought about the issue, how they felt, what they were still going through. Part of my job was simply listening.
Samer: What did you learn about why these communities carry out this practice?
Nadya: If I could single out the most important thing I learned, it's that women were actually confused about why they did this. Some said it was a social phenomenon, some linked it to tradition, and many associated it with their religion.
Samer: Which is why the report's impact among the religious community was so important.
Nadya: Absolutely. The fatwa declaring that FGM isn't an Islamic practice is very significant. Hopefully, it will help sever the tie between Islam and FGM. It's an important step.
Samer: What are the health problems surrounding FGM?
Nadya: The immediate problem is the bleeding and the pain - oftentimes, every girl in the room is cut with the same razor. Then there's the mental trauma -- girls who went through this remember every detail, where they were, who was there, if other girls were cut, too, were they crying, how much they bled, if they couldn't walk.
In the long term, they could have problems with their reproductive health, in childbirth, and with their periods. It also affects the sexual relationship between a husband and wife. It wasn't until recently that women started to understand their bodies, what happened to them, and what is now happening in their marriages.
Samer: I think that part of the reason why women have such vivid memories of what happened to them is because they didn't really know what was happening. They were playing with their friends or went over to a friend's house, and the next thing you know the midwife's there, and the family is holding them down, and it's people that they trust that did this to them. So it's quite traumatic for a young girl. They carry this memory for the rest of their lives.
Nadya: I spoke with a woman who was in her twenties. She had her small daughter with her. The woman told me how she underwent this practice as a little girl, but how her sister avoided it because no one could hold her down. The woman felt betrayed. How could her mother do this to her? How could someone cut a piece of flesh from her body and tell her that it's good for her?
Samer: And is she planning on circumcising her daughter?
Nadya: Absolutely not. She spoke to her husband and they're both adamant about not having their daughter circumcised.
But the problem is sometimes with the in-laws. They put pressure on the parents, or could take the girl away and circumcise her when her parents aren't home. The older women in the communities are really driving the process.
I met another woman who was in her 60s and had circumcised all five of her daughters. She was adamant that her grandchildren would also be circumcised. Her daughter even said to her "I don't want this for my children or grandchildren," and her mother's response was basically, "you have no say in this. This is the just the way things go."
Samer: It is amazing how some women have the inner strength to break away from this tradition. I spoke with a girl, she was about 18, who was had the procedure done when she was quite young. So had two of her sisters. Their father was insisting that his youngest daughter also have the operation. But the older girls banded together, and are planning on tricking their dad and saying they've already done it.