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Shift in FGM including medicalization among the Maasai communities call for deeper understanding. We sought to determine the nuances around medicalization of FGM in the Maasai communities. A mixed design study was conducted in 6 villages in Suswa ward, Narok county, Kenya. KIIs were held with policy makers, leaders, and service providers. IDIs captured information women and married girls FGM survivors and FGM practitioners. FGDs were conducted with women, girls, men and young men. A confidante method obtained FGM status of the respondents (women), their three confidantes and daughters (0–14 years). Study involved 1235 women disaggregated into respondents (356) and confidants (879). Most (88%) women had undergone traditional (60.8%) or medicalization (38.9%) FGM performed by HCWs (21.5%), traditional cutters (73.4%) or traditional birth attendants (5.1%). Only 4.4% of the girls (0–14 years) had undergone medicalization (75%) or traditional (15.6%) FGM. Evidence of kisasa or medicalization as a safer form of FGM corroborated by responses from stakeholders, survivors and beneficiaries. Maasai community code named/framed FGM as kisasa or Kiswahili for secrecy and circumventing the law. A convergence of HCWs and traditional cutters in performing kisasa or medicalized FGM is a key highlight. Beyond economic reasons, medicalization is preferred for faster healing, culture, evading the law, shared cultural beliefs, intimidation, and teenage pregnancy. A shifting landscape of medicalization characterized by intersection of HCWs and traditional cutters in using health supplies to perform FGM. The hallmark of this shift is new framing and coding FGM as kisasa or kiswahili to circumvent the law. A change of strategy involving policy and administrative interventions should focus on HCWs and pharmacists/chemists who sell and dispense health supplies to cutters to strictly adhere to over the counter (OTC) and prescription only principles and regulations.