The U.S. Legal System is Failing FGM Survivors

Half a million. That is how many women and girls across the U.S. are currently at risk of or have been subjected to female genital mutilation (FGM), according to the Centers for Disease Control and Prevention. It’s a number that surprises many—and so should the fact that just 28 states have enacted laws to provide protection against this form of violence and control over female bodies and sexuality.

FGM involves removing and damaging external female genitalia for non-medical reasons, thereby interfering with the natural functions of girls’ and women’s bodies. The World Health Organization cites four classifications of FGM: clitoridectomy, which is the partial or total removal of the clitoris; excision, involving the removal of the entire clitoris and the cutting of the labia minor; pricking, nicking or in other ways damaging the female genitalia; and infibulation, recognized as the most extreme form of FGM, in which all external genitalia are removed and the two sides of the vulva are stitched together, leaving only a small hole. All forms of FGM are internationally recognized as gender based violence, with no medical benefit, and FGM is also recognized as a human rights violation.

The procedure is typically carried out on girls between infancy and 15 years of age. Survivors of FGM are impacted everyday for the rest of their lives. After being cut,  menstruation, and sexual intercourse can be excruciatingly painful, and women and girls who have undergone FGM can face serious difficulties during childbirth, along with other persistent risks to their physical and psychological well being. Some girls even die from infection or bleeding. As of 2016, there are over 200 million women and girls worldwide who are living with  FGM.

In September 2015, 193 countries, including the U.S., adopted a target in the United Nations Sustainable Development goals to eliminate FGM by 2030. FGM was made illegal in the U.S. in 1996, more than two decades ago, but it was not until last year that the first federal charges were brought under the law.

In 2017, a Detroit-area emergency room physician, Jumana Nagarwala, was charged with using a clinic belonging to another doctor, Fakhruddin Attar, to perform FGM on what federal law enforcement estimates was up to 100 young girls over a twelve year period. In November 2018 all eyes were on Judge Bernard Friedman’s courtroom in the Eastern District of Michigan as he heard the case brought against Nagarwala by nine girls, ranging in age from seven to 13, from Michigan, Illinois and Minnesota.

Equality Now joined FGM survivor-led organizations Sahiyo, WeSpeakOut and Safe Hands for Girls in submitting an Amicus Brief in the case, in which we argued that the federal government has the authority to prohibit FGM based on the cross-border nature of what is an organized community activity, and that Congress also has the power to enact laws in accordance with treaties the U.S. has signed—including the International Covenant on Civil and Political Rights, signed by the U.S. in 1992, which requires signatories to report on what is being done to address FGM in accordance with global recognition of the practice as a violation of the human rights of women and girls.

We knew that this wasn’t just about nine young girls whose lives had been irrevocably changed in a clinic in a Detroit suburb. At the time of the trial, Illinois and Minnesota had laws against FGM. Michigan didn’t. Among the 28 states with laws prohibiting FGM, only eleven have provisions in their laws prohibiting transporting a child out of state to undergo FGM. What happened to these girls in Michigan is indicative of what we know is at risk of happening to hundreds of thousands of girls across the U.S., or what has already happened to those women and girls living with FGM. 

FGM doesn’t just transcend geographic boundaries; it happens across lines of religion, culture, education and socioeconomic status. It happens among groups like the Dawoodi Bohra, at the center of the Michigan case, but also in white Christian communities. “FGM happened to me in white, Midwest America,” Dr. A Renee Bergstrom, whose clitoris was removed at the age of three as a “cure” for masturbation, wrote in a December 2016 essay for The Guardian. She goes on to describe “Christian leaders and doctors recommending circumcision,” “physicians carrying out the practice” and “American culture first accepting this form of sexual abuse and then denying it ever occurred.”

Judge Friedman ultimately ruled that Congress had overstepped its authority in the 1996 legislation outlawing FGM, and ruled the federal ban on FGM “unconstitutional.” But his argument did not sanction FGM, nor does it carry any authority outside of Michigan’s Eastern District. He failed to see that FGM is a “commercial practice,” ignoring the reality that, in most communities, medical practitioners and traditional cutters are compensated for their services—and that performing FGM is lucrative work. The Department of Justice, which recognizes FGM as a form of child abuse, appealed the decision, and now it’s up to the Sixth Circuit Court to reinforce that FGM clearly falls under the lawmaking authority of Congress as stated by the Constitution.

How is it that other countries are making positive progress on banning FGM—while the U.S risks potentially moving backwards?

Standalone laws against FGM, at the state and federal levels, send a powerful and important message about our nation’s will to protect girls in the U.S. and around the world from harm and human rights violations. Protecting children from FGM, however, also requires going beyond law enforcement. We need to be engaging schools, teachers, school counselors, health workers, community leaders and social workers—the people girls at risk engage most with and those who can provide services to FGM survivors. 

Advocates marked International Day of Zero Tolerance Day for Female Genital Mutilation earlier this month, on February 6—a day for the global community to come together to raise awareness around FGM. Building on informal working groups that began several years ago, this past Zero Tolerance Day, Equality Now was thrilled to be part of the launch of the U.S End FGM/C Network, and we’re proud to serve on the inaugural Steering Committee. The Network brings together policymakers, healthcare professionals, civil society organizations, foundations, activists and survivors committed to eradicating FGM in the U.S. and around the world.

The key to ending FGM around the world is talking about it, and using the law as a tool for prevention and education. Together—with survivors who are sharing their stories, raising their voices and making a different choice for their daughters—we can ensure the conversation around FGM is had more widely and more openly and engenders more protections for those at risk.

And we can start right here at home—by demanding a law against FGM in every single state.


Shelby Quast is a human rights lawyer and girls’ rights advocate. She sits on the Steering Committee of the U.S. End FGM/C Network and is the Co-Founder of VoteEquality.US. She is the CEO of Robertson, Quast & Associates and former Americas Director at Equality Now.