RAMS chapter 9 is an interesting discussion of the interaction between policies and local realities, specifically regarding population control in the Islamic Republic of Iran.  It discusses the discord between forces of conservatism rooted in tradition, and policy makers who want to improve life conditions through modernisation. Caught up in the midst of these two sides was the young people themselves in Iran, who reproductive health was the issue at hand.  The question is raised as to why the same authorities who initially agreed to implement a family planning programme, then subtly changed their minds half-way through making restrictions for policy makers.  This case is an example of a clash between the agenda of the religious political elite and that of modernising bureaucrats.  It was seen that top-down policies can provoke reactions which may be passive and indirect, slowly hampering policies.  I think that this case is by no means isolated.  Many, many countries in the world today are facing conflicts between their traditional values and ways of life, and new ‘Western’ or modern ways of thinking and living.  This can extend to all areas of life, including reproductive health.  I think it is essential that policies are not made in a vacuum or simply by the leaders in charge of a nation.  It is important the voices of the people are heard, and on-the-ground research is carried out to see where people are at and what compromises might be found that would achieve a modern goal yet also allow traditions to remain.  But what does this look like in practice and in other related issues such as FGM?