Last April, the local evening newscast in Detroit, introduced a foreign, perplexing problem to viewers in the Michigan area.
The nightly news anchor, Glenda Lewis of WXYZ-Detroit, appeared in a yellow dress, standing in front of a photo of a local medical doctor who had been arrested earlier that day.
“An emergency room doctor who was charged with what the feds call a ‘brutal form of violence against girls that has no place in modern society,’” she said.
Lewis was talking about Dr. Jumana Nagarwala, a 44-year-old doctor at the prestigious Henry Ford Hospital in Detroit who had more than a decade of medical experience and a medical degree from Johns Hopkins University. Earlier that week, Nagarwala had been arrested by federal authorities. A week later, two other doctors were also charged in conjunction with the case.
Lewis turned to an investigative reporter covering the case for the news channel, perplexed.
“Why in the world is this done, and who gets charged with it?” she asked.
For many viewers in the Detroit area — and, as the story spread over the national news, for many people across the United States — the case of Jumana Nagarwala was their first introduction to the illegal practice of female genital mutilation — or FGM, as it is known more familiarly in the countries where it is more regularly practiced.
And the questions — why it is done, and who is charged with it — turned out to be the central ones that prosecutors, law enforcement, educators, and activists across the country are grappling with amid an unnerving increase in the number of girls at risk for FGM in the United States over the past three decades.
That’s because Nagarwala’s case is the first federal criminal case of FGM in US history.
Read More: FGM Among Us
According to court documents, the case began when the FBI suspected that young girls were being taken to a medical clinic in Livonia, Michigan, outside of normal business hours for FGM, and began surveillance on the clinic, run by Dr. Fakhruddin Attar, 53.
The investigators say they witnessed two young girls and their mothers arrive at the office and go inside, while Attar and his wife, Farida Attar, 50, were inside, along with Nagarwala, who did not practice medicine at the clinic.
All three adults were members of the Dawoodi Bohra community, a group of Muslims originally from India that now number around 1.2 million around the world, and among whom FGM is still very prevalent.
The girls, age 7, were later interviewed by police. They said that they had been told they were going to Michigan from their home in Minnesota for a “girls trip” and then to the doctor’s office to “get the germs out.” They said that Nagarwala had “pinched” them. Doctors examined the girls, and found they had been cut on their labia and clitoris.
One girl told police that the adults said the practice was a secret and that it hurt so badly she could barely walk after, according to the criminal complaint.
The Attars and Nagarwala were charged with conspiracy, female genital mutilation, and aiding and abetting. All three pleaded not guilty. Their attorneys did not return request for comment.
As the case against Nagarwala and the Attars goes to court, the way the US views and prosecutes FGM will be up for debate. In fact, the case has already dealt with one major question.
Nagarwala and the Attars were initially charged with conspiracy to transport minors across state lines with the intent to engage in criminal sexual activity, but that charge was dismissed by the judge after the defense successfully argued that cutting did not qualify as criminal sexual activity.
Children’s rights attorneys working on the case are hoping for a verdict strong enough to protect children from any form of FGM.Others — including famed attorney Alan Dershowitz, who has weighed in publicly on the case — argue that groups like the Dawoodi Bohra should have the right of religious freedom to practice some form of FGM on girls the way that boys have undergone circumcision for centuries.
As of now, there is no precedent for how the government handles this crime. Indeed, before this case, the state of Michigan itself had no law against FGM, and the legislature quickly went to work passing legislation to prevent another case like the Nagarwala one from happening again in the future.
Few people in Michigan and around the country know what FGM is, that it’s a crime, and that it’s happening to girls every single year in the US. According to the Population Reference Bureau, there are currently 500,000 girls at risk for FGM in the US.
And their future is — in some ways — at stake in what happens this year in Michigan.
Though the FGM case in Michigan specifically has to do with the Dawoodi Bohra community in the Detroit area, FGM is practiced around the world and is not dictated by any one religion or religious texts. In fact, it is practiced by all religions, and is most accurately viewed, according to the World Health Organization, as a cultural practice — not a religious one.
FGM is a tradition that has its roots in the belief that cutting a young girls’ genitals is important for her transition to adulthood and marriage, according to the WHO. It can be practiced as a coming-of-age ritual; it can be imbued with the belief that it makes a girl or woman sexually pure or proves her virginity; or it can be perpetuated because of social pressure and stigmatization.
Because it is a tradition, it adds to a sense of cultural or community identity, according to the organization. And that is why, despite modern science and medicine proving the FGM provides no medical benefits at all — and in fact is extremely dangerous to a woman’s health — FGM has continued among certain communities, even when they immigrate to new nations.
FGM is regularly practiced in over 30 countries, including much of the Global South. In the countries that practice it the most, the prevalence rates are extraordinarily high: in Somalia, 98% of girls undergo FGM; in Guinea, 97%; in Djibouti, 93%, and in Sierra Leone, 90%.
Mali, Egypt, Sudan, and many other African nations also have high prevalence rates, as well as Indonesia.
But the practice isn’t relegated to the developing world. FGM has been documented in the United States as far back as the 1980s, and has been closely linked to immigrant communities in the US and other western nations including the UK, Canada, and western Europe.
The US government passed a federal law banning the practice in 1996 called the Female Genital Mutilation Act — a major step for a country that had not previously recognized the problem within its own borders.
But since 1996, not one case was prosecuted under the law. During that same period, the number of at-risk girls more than doubled. It is now estimated that 500,000 girls are at risk.
Mariya Taher grew up in a Dawoodi Bohra community in California. She never spent much time thinking about FGM, even though it was done to her when she was 7.
“I don’t remember,” Taher told Global Citizen. “I don’t remember when it happened to me, I have vague memories but I don’t remember whether my parents talked to me about it or not.”
“It would have been my mother, not my father,” she added.
Taher said that FGM — which she refers to as FGC (female genital cutting) or simply “cutting” — was “very normal” for her growing up and she didn’t think to question it until she was in graduate school for her Master’s in social work, when she began studying violence against women and domestic violence. She learned that cutting was a form of gender violence and, like other domestic violence, it is passed down to children who witness it.
“I thought, there are so many similarities,” she said. “But it was such a unique form of gender violence because it was something that women were carrying on with women.”
Taher found that almost all of the existing research that had been done was focused on Africa or African communities. She decided to do research herself, focusing on Americans, to find out why the practice continued. The top two reasons she heard were religion and controlling sexuality — including increasing and decreasing sexuality — but she also heard reasons related to health and hygiene. Religious leaders, in particular, said it did not have to do with religion, she said.
“There were many reasons given for why it continued, but what it boiled down to it was this tradition, and traditions are hard to break. It had become known as a social norm and people felt like it was part of their identity and they had to continue it.”
Because she was a member of the Bohra community, Taher was able to ask questions of girls and women who might otherwise not have been open to talking about it, she said. She already had their trust, and they shared their stories with her about their experiences. Taher began presenting her research in 2012, and even more women reached out to her about their experiences in the Bohra community. Soon, she realized she wanted to do more than just research the issue.
“Eventually we started talking more and wondering what we can do, and that’s how Sahiyo started,” she said.
Sahiyo is now one of the organizations at the forefront of combating FGM around the world, and its goal is to get women talking about FGM. They have collected stories from dozens of women who talk about their own memories and thoughts anonymously, without fear of backlash from the community, in the hopes that the more women who talk about FGM and their pain and fear and regrets around it, the fewer girls who will be cut in the future.
They post the stories online and host storytelling events on the ground in India.
And they’ve had surprising success. The group did a survey of 400 Bohra women around the world and found that 80% had been cut. But they also found that 81% of respondents agreed they did not want to continue the practice.
“Now this is really widely talked about in the Bohra community worldwide,” she said. “And in the last few years religious leaders have given a statement, for first time. It was always: we don’t talk about it. But the religious leaders in India have now.
Mariya Taher, 34, poses for a photo, April 21, 2017, in Cambridge, Mass.
The Michigan FGM case has a lot riding on it.
Following the initial arrest of Nagarwala and the Attars, Michigan lawmakers were left to explain why this was happening in their state — and why there were no laws against it.
“I was shocked when I first read the story,” Michigan state Sen. Rick Jones told Global Citizen. “I could not believe this was going on in Michigan, and then I found out it was only a five-year federal offense and Michigan had no laws against it.”
Jones, a Republican, worked with his Democratic colleague Margaret O’Brien to draft bills that would make it a 15-year felony to commit FGM in Michigan and to take your child to have the procedure done. The senate voted unanimously to pass the bills, and Gov. Rick Snyder signed them into law just months after Nagarwala’s arrest.
“We felt this would send a very very strong message across the world that FGM is not acceptable in Michigan,” Jones said.
Jones said that many other states that had tried and failed to pass FGM laws had been unable to do so because of religious freedom arguments from legislators who believed the practice was tied to a religious belief. The argument did not hold water for Jones.
“I think it’s outrageous that any senator would think such a thing. I suppose in the past there were religions in the world that condoned human sacrifice. Would they think that was OK, too?” he said.
“It’s just shocking that you would allow mostly young girls and in some cases teenagers to be horribly mutilated, because really, what this is all about was men attempting to control women’s behavior in the future,” he said.
While the state of Michigan acted quickly to outlaw FGM, the argument for the religious right to practice FGM likely will still come up in the criminal case of Nagarwala and the Attars, according to lawyers.
Nagarwala’s defense attorney, Shannon Smith, told US Magistrate Judge Mona Mazjoub in an initial court hearing that her client did, in fact, “scrape” the membrane of the girls identified as victims in the case, but that it was not considered “cutting” and was part of a religious practice by the Dawoodi Bohra. She said the parents of the girls would then bury the membrane per the custom of the group.
The statements laid the groundwork for a defense based on religious freedom, according to Alan Dershowitz, the attorney and Harvard Law School professor who worked on the O.J. Simpson case. Dershowitz is consulting with a Dawoodi Bohra organization on a religious freedom argument and is advocating for the Bohra’s right to practice a “symbolic pin prick to the area,” he told Global Citizen. He declined to name the group, and national and Michigan-based Dawoodi churches declined to speak to Global Citizen about FGM.
The suggestion, he said, is analogous to how Jewish religious leaders will perform a symbolic circumcision on someone who was born Christian and circumcised medically at birth but wants to convert and has to have a bris.
“They do not touch the penis itself, just the area around what’s left of the foreskin. They draw one drop of blood under medically supervised conditions. That satisfies the religious aspect. That’s what I have been advocating for with female circumcision: no touching of the clitoris, draw one pinprick from the labia, the medical equivalent of foreskin. That satisfies the religious obligation and does no harm to the young woman,” he said.
“Many young women welcome this,” he added.
Dershowitz suggested that the Nagarwala case could help set a precedent for how FGM is handled in the future.
“The US government has to sit down with people like me and people who are in the groups and figure out a way of resolving this conflict short of criminal prosecution,” he said. “These are good people who want to do the right thing, the government are good people. I see my role to bring good people together to achieve a medical and religious agreement."
If Dershowitz and his clients are not successful in persuading a judge or US authorities of a right to practice cutting, the Nagarwala case could lead to stricter enforcement of FGM laws around the country. But that still may not lead to an end to FGM.
“I think in some way this case happening in Detroit is a wake up call,” Taher, the California native and co-founder of Sahiyo, said. “That, ‘oh, this does happen here.’ It’s not that it wasn’t happening before, people just didn’t recognize that it was happening.”
Michigan Sen. Jones went a step farther, arguing that the case in Detroit could pave the way for more criminal charges now that it’s better understood.
“I don’t believe people knew this was happening in the country. Obviously now that everyone knows this is happening in the USA, there will be a lot of prosecutions when people are caught,” he said.
Taher said that she hopes that the Michigan case will propel greater action on the issue.
“There are two things that need to happen: not just prevention but also how do we support women that have undergone it and live in this country as well?” she said.
Angela Peabody, who runs a group fighting FGM called the Global Woman Peace Foundation in Washington, D.C., is focused on both of those approaches, and said that there needs to be a holistic approach to fighting FGM that includes not just law enforcement but doctors, educators, and support staff like social workers.
Peabody, who grew up in Liberia and did not undergo FGM, remembers a friend who disappeared at age 8 from her neighborhood and came back very different two years later, after a trip to the “bush”. When Peabody found out, as an adult, that her friend died in childbirth, she realized the cause was likely FGM — and she was outraged.
Now, her nonprofit works on multiple fronts to help end FGM in the US. They send women for restorative surgeries, they counsel women who have undergone FGM, they do workshops and trainings with police departments on how to look for FGM and how to make arrests, and they have a medical network of nurses, OB-GYNs, physical therapists, psychologists, and social workers they can connect victims with.
Sameena, 22, a member of the Indian Dawoodi Bohra community, is pictured in New York. While living her dream of being a graduate student at an Ivy League school in the US, Sameena is also coming to terms with the fact that she was circumcised at seven.
“A lot of people are doing advocacy work and activism, and we are doing that, but we wanted to do more, to reach out to the community to do community work, where we get law enforcement involved, the medical personnel involved. That’s important when it comes to intervention,” Peabody said.
Taher echoed Peabody’s call for a holistic approach to ending FGM in the US and increasing training for doctors and law enforcement.
“Everybody is affected differently by this,” Taher said. “There are women who have felt traumatized after they learn what happened, feel it might be affecting long-term sexual health or relationships. Having a health professional who’s trained in knowing complexities and how to respond and how to communicate is so essential, or the social worker.”
“A law is very important but a law alone isn’t going to end the practice,” she said. “There was a federal law in 1996, that obviously did not stop it.”
For Taher, the outcome of the case isn’t the be-all-end-all for solving the problem of FGM. Criminalization isn’t a clear-cut answer; jailing parents who inflict it on their children would also hurt the children. FGM, she said, is a complicated problem.
“I don’t have an easy answer for that. I underwent it myself, I can’t imagine my parents going to jail for it. I feel like I had a very fortunate life as well. It’s clearly sexual assault but it’s also a part of culture. It’s a harmful practice, but a lot of cultures have harmful practices within them,” she said.
“It crosses religious lines, different backgrounds, economic status, ethnicities, and education levels, too. It’s not just one particular community that’s been practicing it,” she said. “So the question is how do you change the view?”