Dr. Jumana Nagarwala is accused of performing FGM on minor girls out of a medical office in Livonia, Michigan. According to the complaint, some of the minor victims allegedly traveled interstate to have Nagarwala perform the procedure. The complaint alleges that Nagarwala performed FGM on girls who were approximately 6 to 8 years old.

In what appears to be the first case of its kind, a Detroit emergency room physician was recently charged with the federal crime of female genital mutilation (FGM).

Dr. Jumana Nagarwala is charged with committing FGM and transportation with intent to engage in criminal sexual activity. If convicted, Nagarwala could face 10 years to life in prison.

Nagarwala is accused of performing FGM on minor girls out of a medical office in Livonia, Michigan. According to the complaint, some of the minor victims allegedly traveled interstate to have Nagarwala perform the procedure. The complaint alleges that Nagarwala performed FGM on girls who were approximately 6 to 8 years old. This is believed to be the first case brought under 18 U.S.C. 116, which criminalizes FGM.

According to Nagarwala’s lawyer, the doctor never performed female genital mutilation, but merely wiped off a portion of the mucous membrane from the girls’ genitals. A small amount was allegedly placed on a gauze pad and given to the family for burial, purportedly as part of a religious custom.

FGM is sometimes called Female Genital Cutting (FGC), Female Circumcision (FC), or excision. Many communities in which FGM occurs also use local names to refer to this practice including ‘khatna,’ ‘tahor’, ‘sunna’ (all Arabic Terms). These terms are sometimes used to avoid offending cultural sensibilities and avoid the perception that the practice is always forced on women. In some communities in which the FGM occurs, elderly women often do the most to perpetuate the custom.

Nagarwala is a member of the Dawoodi Bohras, a sect of Shiite Muslims, which practices FGM. A survey taken in 2015 found that 80 percent of the survey respondents had undergone FGM, and that various rationales were given for the continuation of FGM, including for religious purposes (56 percent); to decrease sexual arousal (45 percent); to maintain traditions and customs (42 percent), and physical hygiene and cleanliness (27 percent). (Note: Unlike male circumcision, FGM provides no medical or hygienic benefits.)

Female genital mutilation is classified into four main types:

Type 1 – Clitoridectomy: partial or total removal of the clitoris and, in very rare cases, only the prepuce.

Type 2 – Excision: partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora.

Type 3 – Infibulation: narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the inner, or outer, labia, with or without removal of the clitoris. The remaining skin is sewn or sealed together leaving a tiny hole for menstrual blood and urine.

Type 4 – Other: all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping, and cauterizing the genital area.

FGM is often performed with razor blades or knives and without sterilized equipment or anesthetic. In some urban areas, however, medically trained personnel may perform the FGM.

In communities where FGM occurs, most girls are cut before they turn 14 years of age. Some girls, however, are cut in infancy, notes the Orchid Project. “In some areas of Ethiopia, for example, girls are often cut at just nine days old, and in half the countries in which FGC is practiced most girls undergo the procedure before the age of five,” add the Orchid Project. “In the Central African Republic, Egypt, Chad, and Somalia about 80% of girls are cut between five and 14, often in relation to coming-of-age rituals and the marking of their passage into adulthood.”

Between 100 and 140 million girls and women across the globe have either been subjected to FGM or at risk of being cut. The practice is most prevalent in Africa (where it occurs in at least 28 countries), parts of the Middle East, and Southeast Asia. FGC also happens in diaspora communities, including those in the United States.

“Female genital mutilation constitutes a particularly brutal form of violence against women and girls. It is also a serious federal felony in the United States,” said Acting U.S. Attorney Daniel Lemisch. “The practice has no place in modern society and those who perform FGM on minors will be held accountable under federal law.”

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