The report, titled 'Female genital alteration: a compromise solution', has horrified anti-mutilation advocates and they're renewing calls for a zero-tolerance approach to the practice.
Finding a compromise on female genital mutilation, or FGM, is a controversial idea two gynaecologists are promoting in a new paper published in the Journal of Medical Ethics.
The article highlights that there's been only a slight decline in non-therapeutic procedures on female external genitalia.
It comes despite years of advocacy and legislation aimed at eliminating the practice.
The authors propose what they describe as a compromise solution that would still honour the religious and cultural requirements of the procedure.
Dr Allan Jacobs, Director of Gynaecologic Oncology at Coney Island Hospital in New York, is a co-author of the paper.
"Some of these groups who do this may be willing to modify the procedure to one which is not going to create either sexual or reproductive problems for the girls as they mature into women."
The article suggests accommodating cultural beliefs while protecting the physical health of girls, using a modified form of FGM.
Dr Jacobs explains.
"This is done is some places. I know that it's done in Indonesia, and it was proposed in certain places in the United States, also in Europe in Italy and in the Netherlands at one point. The idea would be to jab the female genitalia with a lancet or a needle, just enough to draw blood, and that would be the vulva nick."
Doctor Jacobs says he and co-author Kavita Shah Arora are also advocating for an improvement in the conditions under which the so-called 'vulva nick' is conducted.
"If you put topical anaesthesia on it and did it under sterile conditions there'd be little or no pain and there'd be no danger."
But it's raised the ire of anti-FGM campaigners, including from the not-for-profit group No FGM Australia.
The group's managing director, Paula Ferrari, says there needs to be a zero-tolerance approach to any form of genital cutting.
She says it's horrific that anyone could suggest any sort of alteration or cutting could be acceptable.
"You are talking about an abuse, you are talking about an assault on a child. It's not a consenting act, it's being performed on an individual who has no way of giving consent. It's sexual abuse, it's physical abuse. No matter what level of cutting is done, it's always harmful."
She said the paper is having a negative impact on FGM survivors.
"They are incredibly stressed that people are trying to water down the idea that there are some forms of genital mutilation or cutting which are acceptable. Some people are so distressed they've gone into post traumatic stress, they are remembering flashbacks of their own experience."
The group No FGM Australia estimates there are around 83,000 women affected by genital mutilation in the country.
While globally, the United Nations estimates at least 200 million girls and women have undergone some form of genital cutting.
