She became famous for her funny, irreverent videos on TikTok about a topic that most people avoid thinking about. Taking a razor blade to a rose and slicing into its soft petals, she recounted to millions of viewers her experience with genital cutting at age 6. She was held down by her aunt in Somalia, where almost all women and girls are cut.

Now 32, Shamsa Sharawe is a sweary and self-possessed British anti-cutting campaigner — perfect for the TikTok generation.

“Trigger warning, guys,” is how she begins her filmed account of how she was cut, fingering the needle and thread that she will use to stitch up the disfigured rose petals. Then she says louder: “Trig-ger warn-ing! If you don’t like horrific stories, go — now!”

In 2023, Ms. Sharawe regrew the rose. She traveled from her home in Britain to a clinic in Germany and put herself under a surgeon’s knife to create something she had never had: an adult vulva — external female genitalia.

The night before her operation, alone in a country she had never been to before, she was frightened.

Might she die on the operating table? If she did, what would happen to her 9-year-old daughter?

Lying on the bed in her hotel room, she recorded a video for her daughter, Sarah. She told Sarah how much she loved her and explained why she was having the surgery.

“I will finally have a clitoris. I will finally know what my vulva was meant to look like. And I can finally live in a body that I don’t view as being my enemy,” she said.

It might seem a bit much for a 9-year-old to take in. But being open about these issues is what Ms. Sharawe is all about.

“I don’t want girls thinking it’s shameful to talk about their genitalia, their chronic pain, their mental distress,” she said in an interview before the surgery. “They have a right to talk about it.”

For years, Ms. Sharawe had to keep silent about what happened to her.

Young girls subjected to cutting — usually the removal of parts of the external genitalia — are told never to speak about it. Uncut girls are often seen as unclean and unreligious among the citizens and diasporas of the African and Asian countries that practice cutting. And ​despite it being illegal in many countries, every year, millions of girls are cut anyway, tens of thousands of them dying as a result. Many more experience pain, emotional trauma, lack of sexual pleasure and danger giving birth.

Those who do tell their stories find few willing listeners.

But Ms. Sharawe — with her vivacious delivery — has managed to keep people’s attention.

It may be graphic, she said in an interview last summer in her little terraced house in northern England, but, she added: “This happened to me. You can take a little graphic.”

Sarah follows her mother on TikTok, so she knows all about female genitalia and cutting. But even for Sarah, sometimes it gets a bit much.

“Sarah, can you throw me the silicone vagina?” Ms. Sharawe yelled up the stairs at her daughter during our interview. Ms. Sharawe has taken an item usually marketed to men and repurposed it as an educational tool, a prop to show how girls are cut.

“I’m not touching that!” Sarah shouted back.

“No one’s used it.”

“I don’t care!”

Eventually, Sarah yielded, throwing the silicone vagina down the stairs. Ms. Sharawe picked it up.

“Imagine, that is the clitoris,” she said, marveling at how tiny it was.

When she was younger, Ms. Sharawe was told that the cutter in Somalia had removed her whole clitoris. But only part of it was lost, her doctors in Germany told her, leaving most of it intact under scar tissue.

That was what they would work with in surgery.

Genital reconstruction surgery can ease survivors’ pain, but can also make clitoral function worse, the World Health Organization says. It is unavailable under Britain’s National Health Service. At the time, Ms. Sharawe had crowdfunded more than 20,000 euros (about $22,700) to travel to Germany to be operated on by Dr. Dan O’Dey, who has pioneered techniques to reconstruct female genitalia.

On the morning of her operation, Ms. Sharawe smoked a cigarette on her hospital room’s balcony, looking over the gray rooftops of Aachen, a city on Germany’s western border.

She was about to go under the knife all over again, but this time it was by choice. She was scared but excited about what she stood to gain.

In over four hours of surgery, Dr. O’Dey formed part of the remaining clitoris into a new clitoral tip. He repositioned it, releasing it from the scarring that pulled at it and caused her extreme pain. He carefully crafted new labia majora, using tissue taken from areas around her vulva.

And, in a technique he pioneered, he placed nerve endings so that her new vulva would be fully functional.

When she woke up from the anesthesia, Ms. Sharawe had a whole new organ.

“I can’t feel my foot. It’s OK! Because I have a vulva,” she told her followers right after she had looked at it for the first time while her bandages were being changed.

She lay back on her hospital pillow, her fluffy zebra-print eye mask pushed up on her forehead, and took a deep breath.

“I have a vulva. I have a functioning vulva.”

Healing took time. Eventually, Ms. Sharawe found the surgery had gotten rid of her constant pain.

But it had also saddled her with medical debts, since she hadn’t raised enough to cover the full cost of her care.

The N.H.S. provides almost every kind of medical treatment to everyone — with no deductibles and no co-payments. It offers gender-affirming surgery for transgender people, Ms. Sharawe pointed out, and, in some circumstances, surgery to reduce the size of the labia minora. Survivors of cutting number at least in the tens of thousands in Britain, according to the N.H.S. And yet, it offers only deinfibulation — surgery to open the vagina when it has been sealed — the most extreme type of cutting, common in Somalia, Sudan and Djibouti.

N.H.S. officials did not respond to interview requests. Ten years ago, an N.H.S. statement said there was insufficient evidence to show reconstruction surgery was effective.

Ms. Sharawe has become increasingly angry at this state of affairs. The surgery, which many survivors of cutting say is life changing, is available in several European countries, a few African ones and parts of the United States. The N.H.S. should fund it, she said — and last year she started a petition to this effect.

“We’re telling you what we need,” Ms. Sharawe said, addressing the N.H.S. and adding an expletive. “And you’re not listening.”

Survivors of cutting are used to not being listened to, she said. The vast majority of them are Black women.

But things are changing, Ms. Sharawe said — and she is at the vanguard.

Previous generations of survivors of cutting in the West, she said, were often immigrant women steeped in the culture of their birth countries, trying to navigate new lands in foreign languages while raising families. “Those people had very few expectations,” she said.

Ms. Sharawe represents a new kind of survivor: thoroughly British; candid about how she was cut and the resulting, permanent, pain; aware of her rights and what ought to be her rights; and unafraid to criticize revered national institutions.

“We are not mere foreigners who, you know, our needs can’t be understood,” she said.

Some of those watching Ms. Sharawe on social media were fellow survivors of cutting. They asked questions.

“Which hospital please I need the contact,” commented one. “How much was that?” asked another.

She was very glad she’d had the surgery. But her new vulva was taking some getting used to.

“It’s a whole new system, and I don’t have a manual,” she said in a post a month after the operation.

A month after that, she filmed herself sitting on the edge of her bathtub — after weeks of being unable to sit without pain. “I can’t stay like this for long, but — I can sit down!” she said, doing a small seated dance of joy.

Two months later, she informed her followers that she had healed enough to start exploring.

“I tried it out myself, and it worked,” she said, her eyes widening a little.

One of the most unexpected things is how alien her new organ feels.

So, she said, sex will have to wait until it feels less like a prosthetic leg.

In a TikTok post in March, biting into an apple on the train home from a speaking engagement, she thought out loud about her message. It’s important, she said, that it’s “not just traumatizing and sad. No! You’re going to laugh.”

It’s not laughing at the trauma itself, she said.

“It’s making sure that you have this —”

She exhaled deeply.

“Like, sense of release.”