It is a mistake to think this only happens "somewhere else." Many Americans still operate under the assumption that ritual cutting is a distant, overseas issue relegated to rural villages in sub-Saharan Africa or parts of Southeast Asia. That’s just not the case. The reality of female genital mutilation in the US is much closer to home, affecting hundreds of thousands of women and girls living in major metropolitan hubs from Minneapolis to Atlanta.
Estimates are heavy. According to the Centers for Disease Control and Prevention (CDC), over 513,000 women and girls in the United States have either undergone the procedure or are at risk of it. That’s a massive number. It’s roughly equivalent to the entire population of a city like Sacramento.
Why don't we hear about it? Because it’s hidden in the margins. It happens in quiet apartments behind closed doors, or during "vacation cutting" trips where girls are sent abroad under the guise of visiting family. It's a complex, deeply sensitive intersection of culture, trauma, and a massive failure in the American healthcare and legal systems to protect the most vulnerable.
What is Female Genital Mutilation in the US Actually?
Basically, FGM (also known as female genital cutting or FGC) involves the partial or total removal of external female genitalia for non-medical reasons. It’s got zero health benefits. None. In fact, it's the opposite of healthy.
There are four types defined by the World Health Organization. Type I is the partial or total removal of the clitoral glans. Type II involves the removal of the labia minora. Type III, often called infibulation, is the most extreme, where the vaginal opening is narrowed by creating a seal. Type IV covers everything else—pricking, piercing, incising, or scraping.
In the States, Type I and II are more common, but survivors of all types live here. Dr. Jasmine Abdulcadir, a renowned specialist in this field, has often pointed out that the medical community in the West is frequently "clueless" when a survivor walks into an ER or a delivery room. Imagine being a survivor, already dealing with trauma, and your doctor looks at you with confusion or horror because they’ve never seen an infibulated body before. It happens all the time.
The Legal Rollercoaster: Why Federal Laws Floundered
For a while, the legal landscape of female genital mutilation in the US was a mess.
In 1996, Congress passed a federal law criminalizing the practice. Everyone thought the matter was settled. Then came the 2018 Michigan case involving Dr. Jumana Nagarwala. She was accused of performing FGM on several young girls. It was the first major federal test of the law.
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But then a federal judge in Detroit dropped the most serious charges. Why? Because the judge ruled that Congress didn't have the authority under the Constitution to pass a federal law against FGM—that it was a "local crime" issue for individual states to handle. It was a massive blow to activists.
Thankfully, things changed. In 2021, the STOP FGM Act was signed into law. This effectively bypassed the previous legal hurdles by grounding the ban in the Commerce Clause. It also clarified that the practice is a form of child abuse and a human rights violation.
Still, the state-level response is a patchwork. Some states have ironclad laws. Others? Not so much. If you live in a state without a specific FGM statute, prosecutors have to rely on general battery or child abuse laws, which don't always capture the specific nature or the long-term psychological damage of this practice.
The "Vacation Cutting" Phenomenon
You might have heard this term. It’s sort of a euphemism for something pretty dark.
"Vacation cutting" refers to parents taking their daughters out of the US during summer breaks or holidays to their home countries to have the procedure done. They do this to avoid the legal scrutiny here. The girls come back to school in September, and often, nobody knows. Their teachers don't know. Their pediatricians don't know.
The 2013 Transport for Female Genital Mutilation Act was designed to stop this. It made it illegal to knowingly transport a girl out of the US for the purpose of FGM. But enforcing this is a nightmare. How do you prove intent when a family says they’re just going to visit grandma?
Customs and Border Protection (CBP) officers at major airports like JFK and Dulles now receive training to look for signs. They sometimes hand out "Blue Cards" or flyers to families traveling to high-risk regions, explaining that FGM is a crime in the US. It’s a delicate balance between education and policing.
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Cultural Nuance vs. Criminal Acts
We have to be careful here. This isn't about "attacking a culture."
Most parents who put their daughters through this aren't doing it out of malice. Honestly. They often believe they are doing what is best for their daughter’s future—ensuring she is "pure" or marriageable within their specific community context. It's a social pressure that is incredibly hard to resist.
But—and this is a big "but"—cultural tradition is never an excuse for a human rights violation. The girl has no choice. The physical consequences are lifelong. We’re talking chronic pain, recurring infections, cysts, increased risk of childbirth complications, and the psychological weight of PTSD.
Health Disparities and the Medical Gap
If you're a survivor of female genital mutilation in the US, finding a doctor who actually knows what they're doing is like finding a needle in a haystack.
Medical schools in the US rarely spend more than a few minutes on FGM in their curriculum. Consequently, we have a generation of OB-GYNs who might see a patient with Type III FGM and not know how to perform a "deinfibulation"—a surgical procedure to open the scarred tissue to allow for normal urination, menstruation, or safe childbirth.
There are specialized clinics, like the African Women’s Health Center at Brigham and Women’s Hospital in Boston. They do amazing work. But if you’re a survivor in a rural area or a city without a dedicated center, you’re basically on your own, navigating a system that doesn't understand your body.
Survival and Reclaiming the Body
It isn't all tragedy. There is a massive movement of survivors in the US who are reclaiming their narratives.
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Groups like Sahiyo and the US Network to End FGM are led by women who have lived through this. They focus on community outreach because they know that laws alone won't stop the practice. You have to change hearts and minds within the communities where it's happening.
One of the most interesting developments in recent years is clitoral reconstruction surgery. Surgeons like Dr. Marci Bowers (who is also a pioneer in gender-affirming surgery) have adapted techniques to help survivors restore some physical sensation and, more importantly, a sense of wholeness. It’s controversial in some circles, and it’s not always covered by insurance, which is a whole other battle.
Actionable Steps for Professionals and Allies
If we want to actually move the needle on this, it's not about being a "savior." It's about being informed.
For Healthcare Providers:
Don't wait until you have a patient in labor to learn about FGM. Resources like the Refugee Health Technical Assistance Center offer clinical guidelines. Use a professional interpreter, not a family member, when discussing this. Family members might be the ones who supported the procedure in the first place.
For Educators:
Keep an eye out for girls who show signs of distress before or after long school breaks. If a girl mentions a "special ceremony" or "becoming a woman" before a trip to a high-risk country, that’s a red flag. In many states, teachers are mandatory reporters for suspected FGM just as they are for any other form of child abuse.
For Policy Advocates:
Check if your state has a specific FGM law. If not, look at the "AHA Foundation" legislative maps to see where the gaps are. Pushing for state-level bans is crucial for providing local prosecutors with the tools they need.
For the General Public:
Support survivor-led organizations. Don't frame the conversation as "us vs. them." Frame it as a universal right to bodily autonomy.
The issue of female genital mutilation in the US is deeply rooted in the gaps of our social safety nets. It thrives on silence and the discomfort of outsiders who are afraid to speak up for fear of sounding culturally insensitive. But the health and safety of girls have to come first.
Next Steps to Take Now
- Educate Yourself on Local Laws: Visit the AHA Foundation or the Equality Now websites to see the current status of FGM legislation in your specific state.
- Identify Specialized Care: If you are a survivor or know one, look for the "National Network to End FGM" directory to find culturally competent healthcare providers who understand the specific needs of FGM survivors.
- Support Community Outreach: Donate to or volunteer with organizations like Sahiyo, which works directly within diaspora communities to foster dialogue and end the cycle of cutting through education rather than just criminalization.