Lawmakers in Minnesota and Texas are pushing to crack down on parents involved with genital cutting after an indictment against a Detroit-area doctor accused of performing the procedure on two young Minnesota girls highlighted the little-known practice.

Dr. Jumana Nagarwala is charged with female genital mutilation, conspiracy and other crimes. Prosecutors say Nagarwala performed the illegal procedure on two 7-year-old girls at a clinic in February and that the girls were brought to Michigan by their mothers. A clinic manager and his wife who are members of the same Islamic sect have also been charged. Nagarwala’s attorney has said she was merely performing a harmless religious ritual.

In Minnesota, a Republican lawmaker has offered a bill that could strip custody from parents who knowingly allow their children to be subjected to genital cutting. A Texas Senate committee recently passed similar legislation that clarifies religious or cultural rituals are not an acceptable defense.

The procedure, also known as female circumcision, has roots in various cultures in Asia, Africa and the Middle East. It’s generally performed as a way of controlling a girl’s sexuality, maintaining her purity or even making her more fertile as she grows into adulthood. But health and welfare organizations in the United States say it’s a barbaric practice that offers no health benefits but instead can cause great pain and complications for women and render them unable to enjoy sex.

It’s difficult to gauge how often genital cutting occurs in the United States. A 2012 study from the Centers of Disease Control and Prevention estimated that more than 513,000 girls in the United States had been subjected to or were at risk of undergoing genital cutting. Nagarwala is believed to be the first person to be charged with violating the U.S. government’s ban.

Many states also have bans in place, but only for those who actually do the cutting. Minnesota Republican Rep. Mary Franson acknowledged that her bill wades into a culturally sensitive issue, but said she wanted to ensure parents involved also face punishment. Court records show one of the Minnesota girls was returned to her parents in suburban Hennepin County; Anoka County court records for the other girl are sealed.

“It’s an issue that we’re not used to in the United States. But that doesn’t mean that we’re going to allow it,” Franson said Friday. “We need to send a strong message that this is not tolerated. We are going to protect these children.”

Her bill would make it a felony for parents to knowingly allow their children to be subjected to genital cutting and could strip their custody rights. Similar legislation is in the works in Texas, which already has a ban for physicians on the books.

In Michigan, prosecutors are relying on federal law to charge Nagarwala, clinic manager Dr. Fakhruddin Attar and Attar’s wife, Farida. State Sen. Patrick Colbeck introduced legislation this week that would make the practice a state felony. His bill doesn’t address parents.

“When you see people coming in from other states to have their young girls subjected to this barbaric procedure, it begs the question as to why Michigan would be an attractive place to have these unconscionable practices done,” Colbeck said.