mutilation reversal
Gynecological surgeon Dr. Marci Bowers begins clitoral restorative surgery on a woman in Nairobi on May 11, 2017 Getty Images

As many as 100 girls may have had their genitals mutilated during a 12-year operation involving three Metro Detroit doctors, said a federal prosecutor on Wednesday.

Assistant U.S. Attorney General Sara Woodward released this information while attempting to convince a judge to keep a couple involved in the conspiracy locked up. This accusation is the most recent development that is shedding light on a procedure practiced by some members of Dawoodi Bohra, a small sect of Shia Muslims.

Dr. Jumana Nagarwala is accused of mutilating the genitals of two Minnesota girls in February, at a Livonia clinic owned by Dr. Fakhruddin Attar. Attar has been indicted along with his wife, Dr. Farida Attar, who has been accused of helping organize the procedure and being in the room while it occurred. Dr. Farida Attar supposedly held the girls’ hands to keep them from squirming during the procedure.

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"Due to the secretive nature of this procedure, we are unlikely to ever know how many children were cut by Dr. (Jumana) Nagarwala," Woodward said on Wednesday. "The Minnesota victims were not the first victims."

One girl told the FBI that Nagarwala "pinched” her on the "place (where) she goes pee." A study of the girl's genitals revealed abnormalities and that a section had been altered or removed, according to a court filing. A doctor also noticed scar tissue and healing lacerations.

The second girl recognized Nagarwala as the doctor she visited in Detroit. A medical examination of her genitals revealed she had a small incision and a small tear, according to a court filing.

The government estimated that 100 girls were mutilated based on Fakhruddin Attar telling investigators that Nagarwala treated girls at the clinic for "problems with their genitals" five or six times a year. Prosecutors believe the operation began 12 years ago.

If convicted, Fakhruddin Attar, 53, and Nagarwala, 44, face up to life in prison for conspiracy to transport minors with intent to engage in the criminal sexual activity. Farida Attar, 50, may face up to 20 years in prison if she is convicted of conspiring to obstruct the investigation.

Fakhruddin Attar’s lawyer, Mary Chartier, has criticized the government for reporting that 100 girls have been victimized.

"I think the government has overstated so many aspects of this case," she said to reporters on Wednesday. "That could be me, Dr. Attar, or the pope himself," Chartier said of the surveillance footage that allegedly shows the Attars, Nagarwala and the victims at the clinic on Feb. 3.

The defense argues that the Attars did not commit criminal acts because the procedure is a protected religious rite-of-passage that does not involve cutting, but rather a scraping of the genital membrane. Nagarwala's lawyer has said that the doctor removed the mucous membrane from the girls' genitals, put it on gauze pads and presented it to their families for burial. The girls' mothers willingly brought their daughters to the clinic to undergo the rite of passage. Defense lawyers also presented the argument that the Attars are not endangering society and that they are not flight risks.

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The couple is forbidden from contacting alleged victims or witnesses, according to U.S. District Judge Bernard Friedman, who freed the Attars until their Oct. 9 trial. They are currently under house arrest with no computer or internet access. The judge has also ruled that the Attars cannot live with their 9-year-old daughter because state officials are attempting to revoke their parental rights.