Liberians started off 2018 with a major win for women’s rights — the outlawing of female genital mutilation (FGM). But on Jan. 22 the ban on the harmful practice expired, once again leaving girls and women in the country vulnerable.

Now, activists and advocates are concerned that the country may see a rise in FGM cases if the government does not pass new legislation soon.

It is hard to gauge the exact number of girls and women who have undergone FGM in Liberia. The procedure is typically performed by the traditional leaders of the Sande, a politically influential women’s secret society, and is seen as an initiation into adulthood.

However, UNICEF estimates that 44% of Liberian women between the ages of 15 and 49 have undergone FGM. The cultural practice — often mistaken for a religious practice — involves the full or partial alteration or removal of a female’s external genitalia for non-medical reasons.

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In many parts of the world, FGM is performed by traditional healers or elders, with no medical background, training, or licenses, which can make it difficult to catch and hold perpetrators to account in countries where FGM is illegal.

However, as Felister Gitonga, nonprofit Equality Now’s end harmful practises officer, points out, Liberia actually licenses the “Zoes” who carry out FGM on behalf of the Sande.

"The Liberian government has been licensing Zoes who are the custodians of the FGM through the Ministry of Internal Affairs and or the National Traditional Council of Liberia. This indicates that the Liberian Government’s public declarations to eradicate the practices are just a public show,” Gitonga told Global Citizen.

Read More: Sierra Leone Bans FGM in Clampdown on Secret Societies

Liberia — the first country on the African continent to elect a female president — is now one of just two countries in West Africa that has not passed a long-term, outright ban on FGM. Neighboring Sierra Leone outlawed FGM earlier this month, but the practice remains legal in nearby Mali.

Currently, FGM can technically be prosecuted in Liberia as a form of "...maliciously and unlawfully injur[ing] another by cutting off or otherwise depriving him of any of the members of his body.” However, no perpetrators have ever been convicted of FGM under this legislation, according to Equality Now.

The government has not indicated whether or not it will pass new law to replace the expired ban, but activists remain steadfast in calling for comprehensive legislation to protect girls and women against FGM.

Globally, more than 200 million girls and women alive today have undergone FGM, according to the World Health Organization. While the practice remains more prevalent in West Africa, East Africa, and the Middle East, it is a form of gender-based violence that affects girls everywhere, from the US and the UK to Indonesia and Australia.