As more details emerge about the first-ever charges of female genital mutilation in the United States, the case is opening a window onto a small immigrant community, while stirring impassioned discussion about genital cutting among women who have experienced it.
At a hearing in Michigan this past week, a federal prosecutor said the defendants — two doctors and a clinic manager from a small Shiite Muslim sect — were believed to have arranged cutting for up to 100 girls since 2005. The prosecutor, Sara Woodward, said investigators had identified eight girls.
The unprecedented charges provide an unusual case study of a practice outlawed in the United States two decades ago but still seen in parts of Africa, the Middle East and, less frequently, South Asia. The focus on the Dawoodi Bohra, a sect of about 1.2 million based in western India, with clusters in the United States, Pakistan and elsewhere, is spurring Bohra women to describe their experiences publicly. Some are doing so for the first time, defying the sect’s historical secrecy about cutting and taking a risk that they or relatives will be ostracized.
“This Michigan case made me think I want to speak out,” said Nazia Mirza, 34, who was cut at age 6 in her hometown, Houston. “To me it’s very much like a rape survivor. If you don’t say anything, then how are you going to expose it and bring awareness?”
The case prompted Tasneem Raja, 34, a journalist, to write about being cut in New Jersey. She said she had received “an outpouring of emails from people saying thank you.”
But Raja said the case was exposing a spectrum of feelings. Even among Bohra women who oppose cutting, she said, views range from “women who say this has greatly impacted their sex life and their ability to enjoy sex, to people like me who walked away with lifelong emotional trauma, to people who say, ‘I don’t see what the big deal is.’”
Some worry the case is stoking anti-Muslim sentiment, though cutting is not in the Quran or practiced in many Muslim societies. And some Bohras who oppose cutting nonetheless feel the defendants are being unfairly demonized for a practice endorsed by their religion’s leadership.
“I don’t want to be pro the practice, but I don’t want it to be exaggerated into something completely barbaric,” said Maryah Haidery, 37, who comes from a Bohra family in New Jersey and had never spoken publicly about her cutting before.
Haidery, who does medical writing for pharmaceutical companies, said she was “very concerned about this violation” in Michigan, but also “taken aback by how vilified that Michigan doctor had become.”
Prosecutors, citing phone records, texts, interviews and surveillance video, accuse Dr. Jumana Nagarwala, an emergency medicine physician, of cutting the genitals of two 7-year-old girls from Minnesota. Dr. Fakhruddin Attar, an internist, is accused of letting Nagarwala use his Burhani Medical Clinic in Livonia. His wife, Farida Attar, the clinic’s office manager, is accused of holding the girls’ hands during the Feb. 3 procedures and urging others to deceive investigators.
According to a criminal complaint, one of the Minnesota girls told investigators that it was a “special girls’ trip” for a procedure “to get the germs out.” A medical examination showed that the girl’s labia minora had been “altered or removed,” that the clitoral hood was “abnormal in appearance” and that she had scar tissue and small lacerations.
The other girl said that she “‘got a shot’ and it hurt really badly and she screamed,” and that “after the procedure, she could barely walk, and she felt pain all the way down to her ankle,” the complaint said. An examination found a small incision in her clitoral hood and a small tear to her labia minora.
Attar said Nagarwala occasionally used his clinic to see 6- to 9-year-old Bohra girls for “problems with their genitals, including treatment of genital rashes,” the complaint said.
The Minnesota girls’ parents have not been charged. At least one girl was briefly removed from her parents’ custody.
Michigan’s Child Protective Services has initiated petitions to terminate custodial rights of several Bohra parents whose daughters are believed to have undergone cutting, including Nagarwala’s 12-year-old daughter and the Attars’ 8-year-old daughter. The Attars were released on bond, confined to house arrest; Nagarwala remained in prison.
Michigan’s Dawoodi Bohra mosque, Anjuman-e-Najmi, where the defendants worship, said in a statement after the arrests that “any violation of U.S. law is counter to instructions to our community members” and “does not reflect the everyday lives of the Dawoodi Bohras in America.”
Recently, the Dawat-e-Hadiyah, an organization overseeing smaller Shiite Muslim sects, hired two well-known lawyers, Alan Dershowitz and Mayer Morganroth, to help the defense, The Associated Press reported.
Nagarwala, 44, who was born in the United States, received her medical degree from Johns Hopkins and worked at Henry Ford Health System, which fired her after the arrest and said no cutting had occurred at its facilities.
Her lawyer, Shannon Smith, said Nagarwala acknowledged “removing a sesame seed-sized amount of mucous membrane” from the clitoral hood.
“What she did does not meet the definition of female genital mutilation,” Smith said, calling it “a ritual nick” and “a protected religious procedure.”
Attar’s lawyer, Mary Chartier, said her client was at a bookstore when prosecutors claim he met Nagarwala at the clinic. But she said “he knew that this century-old religious rite of passage was being conducted at his clinic” and believed “it wasn’t female genital mutilation.”
Lawyers for the Michigan defendants argue that their clients’ practice is milder than male circumcision.
“With what my client was doing,” Smith said, “we’re talking removal of the mucous membrane, and the girls are walking out the door 10 minutes later just fine.”
But while male circumcision has opponents, it is legal, and some medical experts link it to health advantages. In contrast, the cutting of female genitalia can cause serious difficulty or pain during sex, pregnancy or childbirth.
“Health providers know the harms and the short-term and long-term complications,” said Dr. Nawal Nour, director of the African Women’s Health Center at Brigham and Women’s Hospital in Boston, who is experienced in treating such patients.
For the Dawoodi Bohra sect, which encourages education, particularly on a path toward medical and engineering professions, cutting increasingly generates debate.
In 2015, three Bohras in Australia were convicted of performing cutting. Afterward, leaders in India circulated letters to mosques worldwide, saying Bohras should follow laws of the countries where they live. Later, however, several Bohra women recalled, the highest Bohra leader gave a speech saying Bohra traditions should continue despite Western opposition.
Khatna, like many cutting traditions, is performed by women; men often say they are unaware of its occurrence. Justifications for it vary, including to curb sexual promiscuity, preserve tradition or, said Raja, “take a bad bug or a germ out of you.”
Mirza mostly remembers “a woman holding me — I was screaming.” Married with two children, Mirza, who left the sect, said cutting had “totally affected me in terms of my intimacy and struggling to feel pleasure.”
Haidery’s experience is complex. Cut by a relative with medical training using an anesthetic, she remembers little pain, saying she was told that “I had to do this in order to be fit to be married.” When an obstetrician examining her during pregnancy noticed nothing unusual, “I thought maybe it’s not a huge deal,” she said.
Still, she said that “I was shocked” when Bohra friends in New Jersey mentioned getting their daughters cut and was “very happy that I didn’t have a girl.”
Mariya Taher, a co-founder of a Bohra anti-cutting group, Sahiyo, which conducted a 2015 survey of Bohra women, said some Bohras considered cutting a “social norm” and “if you don’t get it done you’re doing something wrong and you’re not helping your daughter out.”
But more women now consider it “gender violence,” especially serious because “it’s happening to little girls,” she said.
“You’re tampering with female genitalia,” Mirza said. “It violates you as a human being and it shouldn’t be done, end of story.”