Survivors of female genital mutilation are fighting back against a so-called compromise that could let a modified form of the procedure continue.

Key points: Two gynaecologists say "nicks" could be used as compromise to reduce effects of FGM

Two gynaecologists say "nicks" could be used as compromise to reduce effects of FGM Victims and campaigners say doctors should not condone harmful social norms

Victims and campaigners say doctors should not condone harmful social norms An estimated 80,000 girls in Australia are survivors of female genital cutting

In a paper published in the Journal of Medical Ethics, two gynaecologists argue that category 1 "nicks" should be used as a compromise to reduce the effects of the procedure.

The UN estimates that at least 200 million girls worldwide have been subjected to genital cutting in both developed and developing countries.

The practice, which is known variously as female genital mutilation, FGM, genital alteration and cutting, is considered a rite of passage in some cultures.

It is illegal in many countries, including Australia.

(A warning: this story contains confronting medical details which you may find distressing.)

Kavita Shah Arora, an assistant professor of reproductive biology and bio-ethics at MetroHealth Medical Center, is the co-author of the paper.

"Despite over 30 years of advocacy, the prevalence of female genital alteration remains high and largely unchanged in areas where it's practiced," she said.

She said practices that had no permanent physical effects could protect young women from severe forms of genital cutting.

"An example would be a nick on the vulva," she said.

"So just a small, little cut, it would heal over, just like a cut does on any other part of our body, but draw blood and perhaps fulfil the religious or cultural requirement."

Dr Arora has drawn comparisons with male circumcision, which is widely practiced in the Western world, particularly in America.

"I think we have to ask ourselves why we can have a procedure where there is morphological change done to male infants but not any sort of procedure on female infants, even if there is no risk.

"And so there's definitely a gender bias there and perhaps a religious or cultural bias in that a more prominent or powerful religious group does one versus the other.

"And so what I am seeking to do it make a more uniform treatment of these ritual non-therapeutic procedures on infants."

However, Dr Arora admits the practice may not be a sufficient compromise.

"I fully acknowledge that I'm unaware of any regions currently adopting this compromise strategy, or that would even be open to such a compromise.

"I think there's hope however. My position is one for a public health stand point. It really is a harm reduction strategy."

FGM survivors outraged

Khadija Gbla was 13 years old when she came to Australia as a refugee from war-torn Sierra Leone.

"Just before I came to Australia, my mum had female genital mutilation performed on me," she said.

"She came home one day and said we're going on a holiday and once we got to the village, this old lady came out and started having a conversation with my mum. I couldn't understand what she was saying.

"She went back and come out with a rusty old knife.

"She went into a little hut, my mum forced me to follow, and when we got there, she took my clothes off and then she held me down on the floor where she grabbed hold of my clitoris and then she started cutting and sawing away for what felt like hours, but then she also cut off my labia majora, my outer lips.

"And she cut all of that off and I was just lying there passing out, crying and screaming in pain and wanting it to stop, wanting my mother to get off me."

Ms Gbla was deeply traumatised by the event.

Almost 20 years on, she still has nightmares about that day.

"Once this old lady was done she threw away the flesh, my clitoris and my labia majora like it was the most disgusting thing, and they just left me there to bleed and wonder what the hell just happened to me."

Khadija Gbla wants to use her own experience to help bring the practice of female genital mutilation to an end. ( ABC News: Simon Lauder )

Usually women carry out the practice, but Ms Gbla said the women were simply the messengers for a culture of patriarchy.

"They believe that if they cut off the clitoris, essentially you will have no sexual desire, and apparently women don't need sexual desire, and you will stay faithful to your husband."

Ms Gbla said Dr Arora's message was a dangerous one.

"It's almost as if we're trying to water down FGM to a point where, in fact, it's not FGM anymore, it's just normalised that we think little girls and their private parts needs to be altered somehow.

"FGM has no health benefits whatsoever, whatsoever. Not a single one.

"I didn't consent to what happened to me, no child across the world is consenting to FGM happening to them.

"We don't want this to be done to us."

Global campaigners against FGM said doctors should not be condoning harmful social norms.

"What you're talking about with female genital mutilation is a form of control of female sexuality and often destroying female sexuality, and that is not what happens with male circumcision," Paula Ferrari, managing director of the non-profit group No FGM Australia, said.

The group estimates that some 80,000 girls in Australia are survivors of female genital cutting.

"The first thing we need to do is talk about FGM as being a problem for Australian girls," Ms Ferrari said.

"And the second thing we need to do is people need to speak out if they know about girls who are in danger of female genital mutilation."

If you or someone you know is affected, the helpline for No FGM Australia is 1800 522 707.