The federal prosecutor on the case of Dr. Jumana Nagarwala of Detroit dropped what the Detroit Free Press describes as a “bombshell” in court hearings on Wednesday by estimating that “as many as 100 girls may have had their genitals cut” by the doctor.

The original allegations against Nargawala, who entered a not-guilty plea, involved two girls and six criminal counts, including a conspiracy to transport the victims across state lines from Minnesota. The owners of the clinic where the genital mutilations were performed, Dr. Fakhruddin Attar and his wife Farida, have also been charged in the case. The victims were seven years old.

Federal authorities have so far identified six other victims of the operation. Most of the families involved are facing custody termination proceedings for subjecting their children to female genital mutilation, as are Dr. Nagarwala and her husband.

Assistant U.S. Attorney Sara Woodward reportedly stunned the court by relating an estimate from the federal government that Nagarwala and her accomplices may have performed female genital mutilation on up to a hundred girls over the course of 12 years. She revealed the information in an unsuccessful attempt to convince U.S. District Judge Bernard Friedman to deny bond to the defendants.

Judge Friedman did grant them bond on the condition that they surrender their passports, remain under house arrest with GPS monitors, and communicate with no one except their families and legal teams.

“Due to the secretive nature of this procedure, we are unlikely to ever know how many children were cut by Dr. Nagarwala. The Minnesota victims were not the first victims,” said Woodward. She went on to say that one hundred victims might be a conservative estimate.

The defense rejected Woodward’s assertion. “I think the government has overstated so many aspects of this case and this is one more example of overreaching,” scoffed defense lawyer Mary Chartier, who represents Dr. Attar.

Defense lawyers argue that the procedures performed at Attar’s clinic by Nagarwala were part of a “protected religious rite of passage that involved no cutting,” and they insist the defendants are suffering persecution for their religious beliefs. They obtained bonds for their clients by arguing that they are not a danger to society and pose no flight risks.

The Attars belong to an Indian Shiite Muslim sect called the Dawoodi Bohra, which has been denounced for its practice of female genital mutilation in India. About 125 families are said to belong to the Bohra mosque attended by the Nagarwalas and Attars.

FGM practitioners believe the clitoral head is “unwanted skin” that serves as a “source of sin” and can lead women to stray from their marriages, as the Hindustan Times puts it.

The parents bury the tissue in a religious ceremony after the FGM procedure, which can inflict lifelong pain on its victims. One of the victims in the Nagarwala case said she could “barely walk, and felt pain all the way down to her ankle” after the procedure. The victims said their mothers lied to them about going on a “special girls’ trip” when transporting them from Minnesota to Attar’s clinic in Detroit and that they were told to keep quiet about their experience afterward.

The case against Nagarwala and the Attars is the first prosecution of female genital mutilation in the United States. Nagarwala, a Johns Hopkins graduate who worked as an emergency room physician for the Henry Ford Health System, was fired from her job after she was arraigned on the FGM charges, which could put her in prison for the rest of her life.

FGM is not limited to the relatively small Dawoodi Bohra sect, which has about a million members worldwide. It has become a highly controversial topic among Muslims, as seen in the unrelated case this week of a Virginia imam condemned by his mosque for endorsing the practice in a videotaped lecture. The imam, Shaker Elsayed, advised Muslim parents to discuss “minimal” FGM for their daughters with Muslim gynecologists, warning that in “societies where circumcision of girls is completely prohibited, hypersexuality takes over the entire society and a woman is not satisfied with one person or two or three.”

There is much debate over the incidence of FGM in the United States. Claims that the practice is almost unheard-of have fallen by the wayside as health authorities continually revise their estimate of victims upward. The most recent studies warned that over half a million women and girls in the United States are at risk of being subjected to the procedure.