For Dawoodi Bohras, a small, insular sect within Shia Islam, it’s still a deeply-engrained cultural tradition. The recent arrest of a Dawoodi Bohra physician in the U.S. for FGM is highlighting just how important the work of activists within the community is to putting a stop to this long-held cultural practice.

The Dawoodi Bohras are an about 1.2 million member sect based primarily in the western Indian city of Mumbai. For generations, Bohras have practiced a form of FGM called khatna, or khafz. The practice has continued in secret after members immigrated to countries around the world, like Pakistan, the United States, the United Arab Emirates, and the United Kingdom. An exploratory online survey suggested that khatna is very common for Bohra women ― 80 percent of respondents to the global survey said that they had undergone the procedure.

Khatna is understood as a religious requirement for Bohras, but is rarely spoken about in mosques. But over the past few years, a number of Bohra men and women have started campaigning against the practice.

In 2015, a group of five women who had already been speaking out against FGM individually came together to form a group called Sahiyo (a Bohra Guajrati word for “friends.”) Through social media campaigns, workshops, and videos, the group seeks to end female genital mutilation in the Bohra community in India and around the world.

In the days following Nagarwala’s arrest, activists at Sahiyo said they’ve been flooded with support from members of the community. Stories and blogs have been pouring in, as Bohras sought to share their reactions to the arrest.

The writers shared feelings of vindication, anxiety, and significantly, hope ― that the high profile case would finally compel more people in the community to stop this ancient form of gender violence.

Henry Ford Health System A photo of Jumana F Nagarwala, MD. The case against her is believed to be the first of its kind in the United States.

A Doctor’s Arrest Ripples Through The Community

Nagarwala was arrested in April after an FBI investigation revealed that she allegedly removed clitoral skin from two 7-year-old Minnesota girls earlier this year. The girls’ parents had reportedly brought them to a clinic in Livonia, Michigan, for the procedure. Two other members of the community were also charged in connection to the case.

A criminal complaint filed in U.S. District Court in Detroit attested that both of the young girls were examined by a doctor, who found their genitals to be abnormal in appearance. Federal prosecutors claim Nagarwala might have performed female genital mutilation on “countless” other girls since 2005.

In response to the case against Nagarwala, a Minnesota House panel unanimously passed a bill last week that would make it possible for parents who subject their children to FGM to lose custody rights and be charged with a felony.

Nagarwala has pled not guilty to the charge of female genital mutilation. Her lawyer Shannon Smith claims that the doctor merely removed a membrane from the girls’ genitals and gave it to their parents to bury. Smith said that the procedure was part of a religious practice.

There are only about 12,000 Dawoodi Bohras living in America. And in this small community, news spreads quickly.

“It has affected the Bohra community globally, but for those us living in the US, it hits closer to home,” Mariya Taher, a co-founder of Sahiyo, told HuffPost. “And since this is such a small community, someone knows someone who has been affected by the case on a personal level.”

The World Health Organization defines female genital mutilation (FGM) as procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons. There are different types of FGM, from Type 1, the partial or total removal of the clitoris and/or the prepuce, to the more extreme Type III, the narrowing of the vaginal orifice by cutting and repositioning the labia minor and/or the labia majora.

Activists say that the kind of cutting practiced by some Dawoodi Bohras usually falls under Type 1 category of cutting. Still, many Dawoodi Bohras tend not to think that khatna is similar to the more severe forms of FGM.

Regardless of the degree of the cut, Sahiyo’s activists still believe khatna is still an “unnecessary violation of a young child’s body.”

“Surely there can be less harmful, and painless ways of initiating a child within the Dawoodi Bohra fold?” Insia Dariwala, another Sahiyo co-founder, asked. “Why do something, which has the possibility of leaving behind traumatic memories on a little girl’s mind?”

Courtesy of Sahiyo Insia Dariwala speaking about FGC and social norms at a workshop for Bharatiya Muslim Mahila Andolan (Indian Muslim Women's Movement).

The Deep Cultural Roots Of Khatna

Within the Dawoodi Bohra community, khatna is seen as a coming-of-age ritual. It’s often done by traditional practitioners when a girl becomes seven years old, although qualified doctors within the community may also do the procedure. The young girls are often told not to speak about what happened to them.

Though the consequences of khatna vary significantly between different women, some experience short term and long term physical complications ― from painful urination to psychological trauma and pain during intercourse as an adult.

As part of its activism, Sahiyo conducted a global research study of khatna between July 2015 and January 2016. The online survey gathered the thoughts of 385 Bohra women, the majority of whom were between the ages of 18 and 25 years old, and lived in India or the United States. Others lived in the United Arab Emirates, the United Kingdom, Pakistan, Canada, and other countries. Eighty percent of the survey participants said that they had been subjected to khatna as children. Thirty-five percent of the women who were cut claimed that the procedure had affected their sexual lives.

The women gave multiple explanations as to why khatna was practiced in the community. The most common reason was for religious purposes (56 percent). Other common reasons were to decrease sexual arousal (45 percent) and maintain traditions and customs (42 percent).

Courtesy of Sahiyo Aarefa Johari, Insia Dariwala and Shaheeda Tavawalla-Kirtane representing Sahiyo at a Womens Day event in 2016 in Mumbai India.

Dariwala said she believes “there is no solid base of this practiced being rooted in Islam.”

“I strongly feel that this practice is just another form of child abuse, and hence any rite of passage, tradition or practice, religious or otherwise, if it causes physical or mental trauma to an innocent child, should definitely be abolished,” she wrote.

Watch a Love Matters India video about khatna in the Dawoodi Bohra community below.

Statements From Leaders Have Little Effect

After Nagarwala’s arrest, Anjuman-e-Najmi Detroit, a Dawoodi Bohra mosque, issued a statement to the press reiterating that “The Dawoodi Bohras do not support the violation of any U.S. law, local, state or federal.”

“Any violation of U.S. law is counter to instructions to our community members. It does not reflect the everyday lives of the Dawoodi Bohras in America,” the statement obtained by the Detroit Free Press read.

But this isn’t the first time FGM within the Dawoodi Bohra community has come under scrutiny. In 2015, a similar case emerged in Australia and resulted in the imprisonment of a Dawoodi Bohra cleric. After that landmark case, Dawoodi Bohra congregations in cities across the world, including in Detroit, issued resolutions advising their members not to participate in khatna because it was against the law in their countries.

For Shaheeda Tavawalla-Kirtane, one of Sahiyo’s co-founders, Nagarwala’s arrest in Detroit is a sign that the leaders’ efforts haven’t worked.

“I believe the statements have not worked as effectively as intended due to considerable pressure from the religious order and large parts of the community to carry out the practice,” Tavawalla-Kirtane told HuffPost. “In my view, the resolution letters don’t seem sincere and their timing begs the question of whether they were meant more to save face in light of the Australian incident rather than serve as a strong message to the community to discontinue the practice.”

Dariwala said that while Sahiyo’s co-founders haven’t been directly attacked for speaking up about khatna, some of their supporters who attend mosques regularly have faced threats of being ostracized from the community if they do not give an unconditional apology for speaking up against the practice.

“What needs to be understood is this is a very small, and insular community, which derives its strength from being united. Any voice of dissent can break that unity, and cause a divide, which is obviously not something that the community leaders want,” Dariwala wrote. “No one wants to feel isolated, or uprooted from their people, and identity. Hence, the only way of maintaining control over the entire community is by creating the fear of ostracism.”

An Outpouring From The Community

One of the ways that Sahiyo engages the community is by seeking out stories and reflections. After Nagarwala’s arrests, a number of Dawoodi Bohras reached out to Sahiyo to offer their comments. The writers, many of whom chose to remain anonymous, expressed concerns that Nagarwala’s arrest will subject their community to increased surveillance during a time when Islamophobia is already causing anxiety for Muslims. One writer cautioned Bohras to “never speak to law enforcement without a lawyer present.” Others worried that Dawoodi Bohras will be ostracized by fellow American Muslims.

Still, others expressed feelings of relief that someone was finally being held accountable for the crime.

Dariwala said the group has heard from women who want to continue practicing khatna. She believes this outpouring of stories and diverse voices is a positive sign, because it means Sahiyo is making inroads into the community at large.

“The Detroit case has surely brought more attention to the cause, and more and more people have been reaching out to us, to offer us their support,” Dariwala told HuffPost in an email. “The Nagarwala case has provided an opportunity to understand the ‘why’ behind the continuation of this practice. This in turn will give us an insight into the consecutive steps we will now need to take, to educate the community, on why it should not be done.”

This attention to community engagement is exactly what makes the work of Sahiyo and other Dawoodi Bohra activists so important.

Courtesy of Sahiyo Sahiyo cofounders in Mumbai India displaying an award the organization received for their work on female genital cutting.

Activism That Engages The Community

Since its founding, Sahiyo has sought ways to empower Dawoodi Bohras and other Asian communities to end FGC.

Significantly, Sahiyo’s survey of Dawoodi Bohras found that many within the community are hungry for change. Eighty-one percent of the women Sahiyo surveyed said that they are not okay with khatna continuing in the community and 82 percent said they are unlikely or extremely unlikely to subject their daughter to the practice.

But because of how entrenched the practice is within the community, that change will take time.

The secretive nature of the practice means that women in the community sometimes don’t talk to each other about the practice. There is silence even among women who have chosen not to continue the practice ― meaning that these tradition-breakers are unaware about others who have also stopped practicing khatna.

Taher believes that the silence around khatna needs to be broken, so that these individuals know that they are not alone.

A key step, according to Sahiyo, is not to attack the community or alienate Bohra women. Sahiyo has realized that language matters when they’re trying to engage in dialogue. As a result, they’ve found that the term “female genital cutting” is less judgmental and more effective in starting a conversation than “female genital mutilation.”

Taher said that changing attitudes towards khatna within the Bohra community requires a “holistic” approach.

“Law alone won’t solve the problem. If that were the case, FGC would have ended in other countries along time ago, and if we think of FGC as a form of gender violence, we can see that law hasn’t helped to end domestic violence or other forms of sexual assault,” she told HuffPost.

“Everyone has to be on board, but we really must understand that without reaching out to the communities involved, we won’t be able to work to end it.”

Courtesy of Sahiyo A screenshot of Mariya Taher from the short video "A Small Nick or Cut."

Tavawalla-Kirtane said that her activism hasn’t stopped her from continuing to identify as Bohra. She’s happy to attend Dawoodi Bohra mosques and remain an active part of her community.

“Rejection of a harmful practice that has no place in modern society should not be the yardstick by which one’s entire belief system should be judged,” she wrote. “Dawoodi Bohras have eagerly embraced and accepted every aspect of modern or Western culture not expressly forbidden, such as being internet pioneers and using modern technology to connect followers in the remotest areas of the world. Why should we continue to uphold an archaic rite such as female khatna that has no value or place in the 21st century, but only causes pain, harm and suffering? Why not abandon it?”