A Detroit emergency room physician was charged in federal court Thursday with performing female genital mutilations on two girls in what is thought to be the first case of its kind in the U.S., and authorities suspect she may have been engaging in the practice for years.

Dr. Jumana Nagarwala is accused of performing mutilation procedures this year on at least two girls in a medical clinic in Livonia, Michigan. According to court documents, investigators believe she may have been involved in carrying out other procedures as far back as 2005.

The case is believed to be the first in which prosecutors have charged someone with performing female genital mutilation, which involves the removal of all or part of the genitals, under a 1996 federal statute banning the practice in the U.S.

“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 Daniel Lemisch, acting U.S. Attorney for the Eastern District of Michigan, where the charges were filed.

“The practice has no place in modern society, and those who perform FGM on minors will be held accountable under federal law,” he said.

Female genital mutilation is practiced most commonly in the Middle East and Africa, especially in majority Muslim countries. Its practitioners generally believe it to be religiously mandated, but scholars and theologians hotly dispute that argument. The practice is rare in many other majority Muslim societies.

The criminal complaint filed in court makes no mention of Dr. Nagarwala’s religion or ethnic background, stating only that she as well as the families of the two girls were members of a community that is known to conduct female genital mutilations as part of its religious and cultural practice.

Dr. Nagarwala was listed as an emergency room physician who speaks both English and Gujarati — a language used in western India — on the website of the Henry Ford Health System, where she worked.

The Detroit Free Press reported that Dr. Nagarwala appeared in federal court Thursday afternoon wearing a white headscarf, glasses and a long white dress with multicolored embroidery. She was ordered held in detention pending the results of a bond hearing Monday.

The paper reported that two male family members were in the courtroom but declined to comment to reporters, as did Dr. Nagarwala’s defense attorney.

According to a criminal complaint filed in court, FBI agents were tipped off from unidentified sources that Dr. Nagarwala was performing female genital mutilation procedures.

Agents said they interviewed two 7-year-old girls who told them that they traveled together from Minnesota with their families to see the doctor at a medical clinic.

One of the girls told investigators that the visit had been billed as a special girls’ trip, and the other said her parents instructed her not to tell anyone about the procedure. The girls described the procedures to investigators, and subsequent examinations showed evidence that their genitalia had been cut.

A parent of one of the victims told investigators that they had taken the girl to the doctor for a “cleansing” of extra skin, the court documents state.

A Michigan branch of child protective services subsequently conducted interviews of other girls in the area, and the children indicated that they had undergone similar procedures by Dr. Nagarwala, the affidavit states.

A Henry Ford spokesman told The Detroit News that the doctor was put on administrative leave.

“The alleged criminal activity did not occur at any Henry Ford facility,” health system spokesman David Olejarz told the paper. “We would never support or condone anything related to this practice.”

The court documents do not identify the medical clinic where the procedures took place and state only that the doctor was not employed at that clinic.

A study last year by the Centers for Disease Control and Prevention estimated that 513,000 women and girls in the U.S. had undergone or were at risk of being subjected to female genital mutilation.

Some cultures believe the painful procedures will initiate girls into adulthood or ensure their virginity or fidelity, according to Equality Now, a human rights organization. The World Health Organization recognizes female genital mutilation as a human rights violation.

The U.S. outlawed the practice in 1996, but prosecutors said this case is believed to be the first in which federal charges have been brought under that law.

In 2006, Georgia prosecutors obtained a conviction for aggravated battery and cruelty to children against a father who used a pair of scissors to remove his daughter’s clitoris. The father, Khalid Adem, was an Ethiopian immigrant who spent 10 years in prison and was deported from the U.S. this year.

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