Zehra Patwa learned only a few years ago that during a family trip to India at age 7, she was circumcised, which is common for girls in parts of Asia, Africa and the Middle East.
Patwa, 46, doesn't remember undergoing the procedure, which is also called female genital mutilation or cutting and which has been condemned by the United Nations and outlawed in the U.S. But she doesn't want to.
"I have no desire to get that memory back. ... Psychologically, it feels like a violation, even though I don't remember it," said Patwa, a technology project manager from New Haven, Connecticut, who now campaigns against the centuries-old practice.
The recent arrest of a Michigan doctor accused of performing the procedure on two 7-year-old girls from Patwa's own Shiite Muslim sect, the Dawoodi Bohra, highlights how female genital mutilation is alive and well in parts of the Western world where its adherents have migrated and formed communities.
Depending on the culture, female circumcisions are performed on girls of various ages and by various methods, and they are seen as a way of controlling a girl's sexuality, maintaining her purity or even making her more fertile as she grows into adulthood. Critics, though, say it can cause complications during childbirth, make intercourse painful and eliminate any pleasure a woman can derive from sex.
Dr. Jumana Nagarwala is accused of performing the procedure on two Minnesota girls that left them with scars and lacerations. Her attorney, Shannon Smith, insists that Nagarwala conducted a benign religious ritual that involved no mutilation.
Prosecutors on Friday charged two other Bohras, Dr. Fakhruddin Attar and his wife, Farida Attar, with conspiracy. Fakhruddin Attar owns the Detroit-area clinic where the alleged procedures were performed in February, and investigators say the couple knew Nagarwala was doing the procedures after business hours.
There are more than a million Bohras in the world, most of whom live in India. No one knows how many there are in the U.S., but it's estimated there are about 25,000 and that they have about 20 mosques and gathering places.
Patwa, who is part of the activist group Speak Out on FGM, said that given its clandestine nature, it's hard to estimate how many people perform female circumcisions in the U.S. But there are a small number in the Bohra community who are known by elders and tend to be clustered around large cities with Bohra mosques, she said.
When many Bohra girls are age 6 to 8, their parents approach — or are approached by — a "secret network" of female elders about getting the girls cut. There is then an informal vetting process to make sure a request is legitimate and not an attempt to expose any activities, Patwa said.
"Everybody knows somebody who has gotten their daughter cut ... but nobody wants to rat out their family members or friends," she said.
A spokesman for the Syedna, the Bohras' religious head in Mumbai, India, could not be reached for comment. The two men vying to succeed the Syedna, his half brother and the son of a former Syedna, have different views on female circumcision. The half brother says it is time to end the practice of female circumcision. The former Syedna's son, whom most Bohras accept as their new leader, says the tradition must continue and notes that Bohra men are also circumcised.
"Men have to do it, and even women have to do it," Syedna Muffadal Saifuddin said in a speech last year.
The World Health Organization said the practice of removing or injuring female genital organs has no known health benefits but has been performed on roughly 200 million women and girls in 30 countries.
Multiple Islamic scholars and experts say the practice is cultural, not based in religious principles. Those who don't have their daughters circumcised are subjected to pressure, and those who do believe they are protecting the girls.
Although Patwa and others describe it as a widespread practice, it's not universally performed among the Bohra. Sahiyo, a Mumbai-based organization that campaigns against the procedure, estimates that about 80 percent of girls within the community have had it done.
She said she attends a Bohra mosque near Boston, which she describes as a welcoming and largely educated and tolerant congregation, but not one in which the procedure they call "khatna" is openly discussed.
"Part of my campaigning is always, 'We have a problem within our community. We can only deal with it as a community," she said. "We can expose it, but other people aren't going to swoop in and help us.'"
Patwa said many Bohra mosques, including hers, have sent letters to members encouraging them not to engage in khatna because it could be considered illegal. But she said some critics don't see this as a serious attempt by mosques to end the practice, but rather as legal cover.
Dr. Mohammed Arsiwala, president and CEO of Michigan Urgent Care and a board member of the Michigan State Medical Society, said he was a Bohra until about five years ago. He has shared his concerns about the procedure through a resolution presented to the state medical group, which adopted a policy several years ago labeling it unethical for doctors to perform.
Jiwajee Bhai Bootwala belongs to the Minneapolis-area Bohra community, which he said consists of about 25 to 30 families. He said he doesn't know of anyone involved in the practice and didn't know about the families who went to Michigan, or if they even belong to his group. Still, he said, the news will spoil his community's image.
"The law for the country is part of your faith," he said. "So we would never do something against the laws of the country."