The first lady of Sierra Leone has denied that she supports female genital mutilation amid rising anger around her perceived approval of the practice.

But in an exclusive response to the Guardian, Fatima Maada Bio, the wife of President Julius Maada Bio, also said she would not openly condemn FGM until she saw “reliable data” that the practice was harmful.

Now, a group of health professionals, survivors, human rights activists and politicians has written to the Organisation of African First Ladies for Development (Oaflad) to raise concerns. Sent on 10 June, the letter demands clarification on public statements made by Maada Bio, currently president of Oaflad.

More than 20 signatories, including Amy Smythe, who served as Sierra Leone’s first minister of gender and children’s affairs, and Isha Dyfan, a human rights lawyer and UN expert, wrote that “perceptions of support for FGM, whether direct or indirect, risk undermining years of advocacy … and creating misalignment with national, regional and international commitments”.

Maada Bio, 45, a former film producer and actor who met her husband in the UK where she had fled as a teenager to escape a child marriage, has also attracted controversy for continuing her rental of a council flat in Southwark, London, for her children, who are British citizens. Southwark council this week confirmed it had repossessed the flat.

An advocate for women’s rights and against child marriage, Maada Bio leads a campaign called “Hands off our girls” in Sierra Leone. However, since her husband was elected in 2018, she has refused to condemn FGM.

FGM, or cutting, the partial or total removal of the external female genitalia, can have serious long-term health consequences, including infertility. The practice is considered to be a grave violation of human rights and in 2012 the UN general assembly passed a resolution for a global ban.

Sierra Leone has one of the highest rates of FGM in the world. A national survey found that the proportion of women who are cut decreased from 90% in 2013 to 83% in 2019; 71% of them were subjected to the practice before the age of 15.

There is no law in Sierra Leone that criminalises FGM. It is often performed as part of a ritual that marks a girl’s entry into womanhood and is carried out by women, known as sowei, of the influential and secretive Bondo and Sande societies. Every year, women and children are left with health complications, and some die, as a result of such rituals.

Ranya Kargbo, a senior UN professional and FGM survivor, who signed the letter, said she was concerned about the recent public appearance by Bio where she was filmed being supportive of FGM practitioners.

“When you are in a leadership position, your words matter,” said Kargbo. “When [Bio] said to the soweis [the cutters], not to be afraid of anything and that she stands with them, those were powerful words from the highest office in Sierra Leone.

“When somebody says that, it means ‘I have all the resources and support, do what you want’. It is an absolute slap in the face for all of us.”

Maada Bio said her comments had been taken out of context and were “intended to encourage dialogue and reassure women who felt marginalised”. In a statement to the Guardian she added: “I am not in favour of any form of circumcision that is forced upon an individual.”

She said she is “not using her voice to campaign either in favour of or against circumcision” and that as a circumcised woman, she expected to see reliable data demonstrating the extent of harm caused by FGM in Sierra Leone.

Last week, Maada Bio posted an article from September 2025 on her Facebook page, which has more than 600,000 followers, entitled “Harms of the current global anti-FGM campaign”. The piece, published in the BMJ Journal of Medical Ethics, argued that “a ubiquitous ‘standard tale’ obscures the diversity of practices, meanings and experiences among those affected” by cutting.

She named on Facebook several prominent anti-FGM campaigners, including Nimco Ali, an independent UK government adviser for tackling violence against women and girls, and Anita Koroma, founder of Girl Child Network Sierra Leone, and wrote “they do nothing for our country”. In another post, she called them “scammers”.

Maada Bio told the Guardian her comments were not “directed at survivors of circumcision or those genuinely working to improve the lives of women and girls”. She said: “My criticism has been directed at individuals whom I believe have misrepresented my position and sought to create a narrative that does not reflect my actual views.”

Last year, a ruling by the Economic Community of West African States (Ecowas) court of justice, described FGM as “one of the worst forms of violence against women” which “meets the threshold for torture”. The court ordered Sierra Leone “to enact and implement legislation criminalising female genital mutilation and to take appropriate measures to prohibit its occurrence and protect victims”.

The ruling came a few weeks after President Bio became chair of Ecowas. He has never acknowledged the ruling publicly, and in October last year signed the Child Rights Act 2025 into law, which did not contain any provision addressing FGM.