Dena S. Davis, the lead author of the American Academy of Pediatrics’ (AAP) retracted 2010 ‘ritual nick’ policy on female genital cutting, told me in an email on June 19, 2026 that she does not believe the AAP should have retracted it.

“No, I did not think AAP should have retracted the policy statement,” Davis wrote. “Still don’t.”

The 2010 policy recommended that physicians be permitted to perform a “ritual nick” on girls’ genitals. The AAP retracted the recommendation within weeks after public outcry. What has not been reported until now is that the lead author who wrote the policy never changed her mind. Davis stands behind the recommendation sixteen years later.

In 2001, Davis published “Male and Female Genital Alteration: A Collision Course with the Law?” in Health Matrix at Case Western Reserve. She argued that the federal law criminalizing all genital alteration on female minors was constitutionally vulnerable because it banned procedures on girls “no matter how minimal the surgery or how safe and sanitary the procedure,” while leaving male circumcision untouched. Once female genital alteration was understood to include a hygienic “ritual nick,” Davis wrote, the two practices “lack a legally defensible distinction.”

The article called out the double standard directly: “What this boils down to is, if you are an American Jew, you can have your baby boy genitally altered with impunity, even if it is done outside a hospital by an unlicensed ritual practitioner, and without the analgesia deemed ‘essential’ by the AAP. But if you are recent immigrant from Somalia, even if you would take the enlightened route and subject your daughter to a ritual nick at the Seattle clinic, you (and the doctor) would be subject to criminal prosecution. This is unacceptable on First Amendment grounds.”

Her recommendation: “Federal and state laws should be rewritten to allow the sort of minor genital nick.”

Nine years later, the AAP’s Committee on Bioethics adopted that position. The committee, chaired by Douglas Diekema of Seattle Children’s Hospital, published a policy statement concluding that “the ritual nick suggested by some pediatricians is not physically harmful and is much less extensive than routine newborn male genital cutting.” The statement lists Davis as “Consultant” with an asterisk denoting her as lead author and cites her 2001 law review article.

The statement suggested that the AAP “opposes all forms of FGC that pose risks of physical or psychological harm” but that “pricking or incising the clitoral skin… is no more of an alteration than ear piercing.” The conditional phrasing — “that pose risks” — created space for forms of genital cutting the committee judged not to pose such risks.

Anti-FGM organizations condemned the recommendation. Equality Now Executive Director Taina Bien-Aimé told The Lancet the statement “defies decades of extremely hard work” to eradicate female genital mutilation. On May 22, 2010, twenty-six days after publication, the AAP’s Board of Directors voted to retire the policy. In a new statement published in July, the AAP wrote: “The AAP does not endorse the practice of offering a ‘clitoral nick.’ This minimal pinprick is forbidden under federal law and the AAP does not recommend it to its members.”

In April 2017, the FBI charged Dr. Jumana Nagarwala in the first federal prosecution under the United States’ female genital mutilation statute. Dr. Fakhruddin Attar, who owned the Livonia, Michigan clinic where the procedures were performed, was also charged.

At Nagarwala’s detention hearing, defense counsel Shannon Smith described the procedures in terms that tracked the AAP committee’s own language. Smith told the court the procedure involved removing a small amount of mucus from the clitoral area — “the amount of a sesame seed” — placed on gauze and given to the family. “It was completely a religious practice,” Smith said.

The defense described the procedures in terms that tracked the AAP committee’s own language. At a detention hearing, defense counsel told the court the procedure involved removing a small amount of mucus from the clitoral area — “the amount of a sesame seed” — placed on gauze and given to the family. “It was completely a religious practice,” the attorney said.

In the criminal complaint, a seven-year-old said Nagarwala took off her pants and underwear and put her on the table. She “got a shot” that “hurt really badly and she screamed.” She drew a picture of the room with an “X” to mark blood on the examining table. Her parents told her “the procedure is a secret and that she is not supposed to talk about it.” Afterward, she could barely walk and felt pain all the way down to her ankle. Nagarwala told her she was fine.

In November 2018, Judge Bernard Friedman of the Eastern District of Michigan dismissed the charges. He struck down the federal FGM statute as exceeding Congress’s authority under the Commerce Clause. The court did not reach the equal protection question of whether banning genital cutting on girls while permitting it on boys constituted sex-based discrimination. The court avoided resolving the constitutional collision Davis described in 2001.

As previously reported, both Nagarwala and Attar hold active, unrestricted Michigan medical licenses with no record of discipline. The state opened investigations into both physicians and closed them without action.

In an exchange over multiple emails between June 18 and June 19, Davis told me she believes “the ritual nick is a good way to equalize male and female, but it would be even better, in my opinion, not to do it at all.”

I asked her to clarify what she meant by “equalize.” She did not answer.

I contacted the AAP on June 21 with five questions: on what basis the statement was retracted, whether the committee was consulted, whether any committee member has said the recommendation was an error, the AAP’s position on the Nagarwala prosecution and its licensing outcome, and whether the AAP has a response to its own lead author’s statement that it would be better if genital cutting were not performed.

Alex Hulvalchick, a media relations specialist in the AAP’s Advocacy and External Affairs division, responded. She did not answer any of those questions. Instead, she sent the AAP’s 2020 clinical report on “Diagnosis, Management, and Treatment of Female Genital Mutilation or Cutting in Girls.”

The 2020 report takes a stronger stance against female genital cutting. It classifies “nicking” as type IV FGM/C and says health care providers “should not perform any type of FGM/C” on girls. This report rejects the harm-reduction argument behind the ritual nick proposal, stating that “By agreeing to perform the procedure, however, health care providers are granting it medical legitimacy, which not only undercuts the moral prohibition on the procedure but also contributes to its spread and ongoing societal acceptance.”

The report directly acknowledges the Nagarwala prosecution but treats it as a constitutional ruling. It does not mention Attar, does not mention their continued licensing, and does not mention the absence of any disciplinary action. It was reaffirmed in January 2026.

I replied to the AAP: “The report does not address my five questions about the 2010 policy statement, its retraction, or Dr. Davis’s position. It also does not address my May 27 inquiry about the licensing of the Michigan physicians. I still need responses to both.” I asked directly, based on the report the AAP itself sent me: “Does the AAP believe physicians who performed FGM/C on children should lose their medical license?”

They did not reply.

Diekema is listed as Committee on Bioethics liaison on the 2020 report. He chaired the committee that recommended the ritual nick in 2010. I contacted Diekema separately with five questions, including whether he agreed with Davis that the retraction was wrong.

He did not respond.

The federal FGM statute that was struck down in the Nagarwala case has been replaced by the STOP FGM Act of 2020. Hadachek v. Oregon, filed in state circuit court in March 2025, argues that Oregon's FGM statute violates equal protection by protecting only girls from non-therapeutic genital cutting.

Davis wrote the argument in 2001. The AAP adopted it in 2010 and retracted it twenty-six days later. The author who wrote it still says the AAP should never have retracted it. No medical organization, insurer, or licensing board has said that physicians prosecuted for FGM should lose their licenses.

“No, I did not think AAP should have retracted the policy statement--still don’t. Good luck with publishing.”

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A federal prosecutor told Michigan's licensing investigator that a medical witness in the state's investigation would not be providing a statement. The state never interviewed another witness in the case.

The witness was Dr. Dena Nazer, a board-certified child abuse pediatrician at Kids TALK Medical Center. Nazer is a professor of pediatrics at Wayne State University School of Medicine and currently serves as chair of the Michigan Human Trafficking Health Advisory Board, appointed by the governor. Her job is evaluating children suspected of being maltreated.

Michigan’s licensing agency wanted to talk to her. The federal government said no.

On September 27, 2017, Michigan Department of Licensing and Regulatory Affairs (LARA) investigator Jennifer Pappas left a message for Nazer at Kids TALK. The interview had been requested by the Michigan Attorney General’s office itself. Pappas’s investigation report states that “an Additional Investigation was requested from the Assistant Attorney General’s Office requesting this Investigator interview WITNESS NAZER.”

The next day, Nazer called back and left a message. That afternoon, Pappas reached Nazer by phone and requested an interview. She also emailed a formal witness letter. Nazer responded that she would forward the request to her attorneys.

On September 29, 2017, at 1:35 PM, U.S. Assistant Attorney Sara Woodward, the lead federal prosecutor on the FGM case, called Pappas. Woodward told Pappas that Nazer “will not be providing a statement to our Bureau due to the pending Federal Court Case and due to WITNESS NAZER’s limited knowledge about the licensee’s activities.”

The federal prosecutor called the state investigator and told her the witness was off limits.

When contacted for this article, Nazer said she was “always willing to cooperate with the state licensing investigation.” She did not address whether the federal prosecutor directed her not to provide a statement. She said “the investigation was still ongoing, and I did not have direct knowledge about Nagarwala’s actions” — language matching Woodward’s stated rationale but attributed to herself.

Nazer also said she “had contact with the office” in 2019 “for updates,” after the investigation had closed. She did not specify which office. She said she remains willing to share her perspective with the state licensing investigation.

Pappas submitted her investigation report to her supervisor on September 29, 2017. The report lists two attachments: the witness letter she sent to Nazer and the email Nazer sent back. It does not document any further investigative activity.

The Michigan Board of Medicine had authorized the investigation on April 18, 2017, after Nagarwala’s arrest. The state closed the investigation on September 25, 2018, with no action taken, nearly two months before the federal court ruling. The memo explaining why is fully redacted.

Nagarwala’s medical license (No. 4301071795) remains active and unrestricted. Michigan renewed it through 2029 while this reporting was underway. She and Dr. Fakhruddin Attar have since opened a new clinic together in Detroit, where they advertise school physicals for children.

This sequence is documented in LARA’s own Investigation Report for complaint file 43-XX-146153, authored by Pappas. The report was obtained through a Freedom of Information Act request to the Michigan Attorney General’s office.

LARA did not release this report. In January 2026, I filed a FOIA request to LARA for “all records relating to Dr. Jumana Nagarwala, including investigative files.” LARA produced the complaint file with redactions but did not include the Pappas investigation report. The report was authored by LARA’s own investigator, about LARA’s own complaint file, and submitted to LARA’s own supervisor. It was obtained only because the Attorney General’s office had a copy in its files and released it. LARA has previously lied to the press about its investigations.

Sara Woodward, who is no longer at the U.S. Attorney’s Office and now works as a Trial Attorney in the Health Care Fraud Unit at the Department of Justice in Washington, responded but did not answer questions about her actions. She redirected the inquiry to the current U.S. Attorney’s Office. When informed the questions concerned her personal actions, she did not respond further.

LARA, the Michigan Attorney General’s office, and the U.S. Attorney’s Office for the Eastern District of Michigan did not respond to requests for comment.

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Taxpayer-funded insurance programs pay two physicians federally prosecuted for performing genital cutting on children. No insurer or government agency will say whether it has ever reviewed them.

Dr. Jumana Nagarwala and Dr. Fakhruddin Attar were charged in the first federal prosecution of female genital mutilation in United States history. Both hold active, unrestricted Michigan medical licenses after the state closed its investigations without discipline. As previously reported, they now practice together at Livernois Primary and Urgent Care in Detroit, a clinic Nagarwala founded. The clinic’s website lists 13 accepted insurers. Seven are taxpayer-funded programs.

On June 15, I sent comment requests to Blue Cross Blue Shield of Michigan, Aetna Better Health of Michigan, Priority Health, UnitedHealthcare, Molina Healthcare of Michigan, HAP, Meridian Health Plan and Ambetter (both operated by Centene), McLaren Health Plan, Humana, the Michigan Department of Health and Human Services, and the Centers for Medicare and Medicaid Services. Each received a set of questions about physicians federally prosecuted for genital cutting on children with a request to respond by June 18.

Three responded. None named either physician. None answered the questions.

Blue Cross Blue Shield of Michigan (BCBSM) issued a statement attributable to the company:

“Blue Cross Blue Shield of Michigan is committed to providing our members with access to high quality healthcare providers. Part of our role is to protect our members from the human and financial costs of waste, fraud, and abuse. Should we determine that a crime has been potentially committed by a provider in our network, we have a dedicated investigations team that works with law enforcement to bring that provider to justice.”

BCBSM did not confirm or deny whether Nagarwala or Attar are in its network. It did not say whether it had reviewed either physician.

Aetna Better Health of Michigan, a Medicaid managed care plan, responded through Phillip Blando:

“Aetna Better Health of Michigan complies with all federal and state rules and regulations. Health care providers serving Medicaid beneficiaries in Michigan are screened through the State’s provider enrollment system. In addition, providers that are suspended or removed from the system, or subject to state or federal payment suspensions are not reimbursed by the state’s Medicaid program.”

Aetna did not name either physician. It deferred responsibility to the state’s provider enrollment system.

The Michigan Department of Health and Human Services, which administers Medicaid in Michigan, responded through spokesperson Lynn Sutfin:

“MDHHS is committed to ensuring that Michigan families have access to affordable health care and that every Medicaid provider is properly licensed and meets all state and federal requirements.”

MDHHS did not name either physician. It did not answer any of the five specific questions it received, including whether it was aware that Nagarwala and Attar are Medicaid-eligible providers, whether it had reviewed the federal prosecution, or whether it had any concerns about these physicians treating Medicaid beneficiaries, including children.

The following did not respond:

• Priority Health.

• United Healthcare.

• Molina Healthcare of Michigan.

• HAP (Health Alliance Plan).

• Meridian Health Plan and Ambetter, both operated by Centene

• McLaren Health Plan.

• Humana.

• The Centers for Medicare and Medicaid Services.

All of the above insurers are listed on the website for Livernois clinic owned by Nagarwala here.

Aetna says Medicaid providers are screened through the state’s enrollment system. MDHHS says it ensures providers are properly licensed. The licensing agency, Michigan’s Department of Licensing and Regulatory Affairs, closed its investigations into both physicians without discipline. LARA’s Board of Medicine unanimously recommended summary suspension in April 2017. Neither license was ever suspended. Both investigations were closed before the federal case ended.

The insurer relies on the state enrollment system. The state enrollment system relies on the licensing system. The licensing system closed the case.

No institution in this chain said it had reviewed whether these physicians should be in its network.

Female genital cutting on children is a federal crime under the STOP FGM Act of 2020 and is illegal in most states, including Michigan.

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Two state agencies denied appeals to release the memo that closed Michigan’s only licensing investigation of a doctor federally indicted for performing female genital mutilation on children. They issued their denials on the same day. They used the same language.

The document at issue is a July 27, 2018 memorandum authored by Assistant Attorney General Bridget K. Smith, titled “Request to Close File.” It recommended that the Bureau of Professional Licensing end its investigation of Dr. Jumana Nagarwala without disciplinary action. A redacted version exists in the state’s files. Every word of substance has been blacked out.

As previously reported, the investigation closed on September 25, 2018, two months before the federal prosecution was dismissed. No licensing discipline resulted. Dr. Nagarwala holds an active, unrestricted Michigan medical license. LARA renewed it through June 2029 this past April, in seven minutes, with no screening of her complaint history. Dr. Fakhruddin Attar, the clinic owner charged alongside her, also holds an active, unrestricted license through March 2027. His clinic has reopened at a new location in Farmington Hills. Both physicians now also practice together at Livernois Primary and Urgent Care in Detroit.

The closure memo is the only document that explains why.

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On May 1, 2026, I appealed to LARA, the licensing agency that received the memo and closed the investigation. The appeal argued that Michigan’s FOIA statute requires agencies to separate privileged legal analysis from factual content and release the non-privileged portions. It cited the AG’s own privilege log, which revealed two versions of the memo sent to two different bureau directors, neither previously disclosed by LARA.

On May 2, I filed a parallel appeal to the Attorney General, the agency whose lawyer wrote it. That appeal made four arguments: that the statute requires segregation of exempt and non-exempt material, that the AG’s role in this case was investigative rather than purely advisory, that factual content is not automatically privileged because an attorney wrote it, and that privilege may have been waived through disclosures to federal prosecutors.

Both agencies denied the appeals on May 18, 2026.

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LARA’s denial, signed by Appeals Officer Adam Sandoval, did not address the segregation argument. It did not address the two-version discrepancy. It did not address LARA’s independent authority to waive privilege as the client. It offered one paragraph of analysis: the memo “fall[s] squarely within this privilege, and redactions made were appropriate.”

The AG’s denial, signed by Division Chief Eric Jamison of the State Operations Division, did not address the segregation argument. It did not address the waiver question. It did not address the AG’s mixed investigative role. It accused the requester of having “neglected to mention” that privilege covers an attorney’s factual materials.

My appeal had stated: “Even if portions of the memorandum contain privileged legal analysis, the AG has not justified withholding the document in its entirety.” This statement directly addresses the point their denial claims I “neglected to mention.”

Both denials share a distinctive feature. Sandoval’s response refers to the filing as one “which has been characterized as an ‘appeal.’” Jamison’s response refers to the filing as one “which you identify as an ‘appeal.’” Both place the word appeal in quotation marks. Both use distancing language to suggest the filings were not, in their view, actually appeals.

This is the same rhetorical construction, scare quotes around the same word, applied through the same syntactic structure, appearing in official legal determinations from two different agencies, signed by two different officials, on the same day.

The AG’s Licensing and Regulation Division is the common thread. AAG Smith authored the closure memo. Her division would have been consulted before LARA could rule on whether to release a communication from its own attorney. The parallel language in the denials is consistent with both responses having been shaped by the same legal position, if not the same drafter.

However, the scare quotes and editorializing in the response raised a question: Was what I sent them an appeal or merely “characterized” as an appeal? Because, if it was not an appeal, I still had a legal right to file one.

On May 24, I asked both agencies whether their May 18 responses constituted final determinations under MCL 15.240. I asked why the responses used language distinguishing the filings from appeals, and whether I was entitled to file one.

LARA’s FOIA Office responded on May 26 and confirmed the filing was an appeal and their response a final determination and I could not file another appeal. They did not explain why Sandoval’s written denial characterized that same filing as something other than an appeal when LARA says it treated it as one.

The Attorney General did not respond. I sent a follow-up on June 6. The AG did not respond to that either. Since the AG would not confirm whether they considered my first appeal an actual appeal or its May 18 response was a final determination, I filed a second appeal on June 8.

My second appeal restated the four original arguments, documented that the AG’s May 18 response had not addressed any of them, and proved that the “neglected to mention” claim was wrong by quoting the passage from the first appeal that directly argued the point. It asked the AG to address each argument individually, to identify any arguments it was declining to address, and to explicitly state whether its response constituted a final determination.

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On June 12, the AG responded. The response is seven pages. It is signed by FOIA Coordinator Christy Wendling-Richards, not by Division Chief Jamison, who signed the May 18 denial.

The first five pages reproduce the text of the June 8 appeal. Page six reproduces the May 18 Jamison denial, word for word. Page seven adds a referral to the Michigan State Bar’s lawyer referral service, where a $25 fee will connect the requester with an attorney for a 25-minute consultation.

The AG did not address the segregation argument. It did not address the mixed investigative role argument. It did not address the privilege waiver argument. It did not address the request for particularized justification. It did not identify which arguments it was declining to address. It did not state whether the response was a final determination.

The letter does contain one structural change. The May 18 denial referred to “your May 2, 2026 email, which you identify as an ‘appeal.’” The June 12 response refers to “your May 2, 2026 appeal.” The scare quotes are gone. The AG now calls it an appeal, while reproducing a denial that treated it as something less than one.

The June 12 letter also contains a particular arrangement. Pages two through five include the passage from the second appeal proving that the first appeal argued the very point the AG claimed it “neglected to mention.” Page six reproduces the “neglected to mention” claim. The AG placed the refutation and the claim it refutes in the same document, in sequence, and issued both as its official position.

The closure memo remains sealed. The public has no way to know why the state continues to license physicians federally prosecuted for FGM and their response to attempts to disclose their reasoning indicate they will not address arguments for disclosure unless a court compels them to.

A Court of Claims lawsuit could unseal the memo. If you’d like to support legal action, contribute here: Expose Medical Board for Licensing an FGM Doctor

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The two physicians at the center of America’s first federal FGM prosecution have opened an urgent care clinic together in Detroit where they are advertising school physicals for children.

Dr. Jumana Nagarwala and Dr. Fakhruddin Attar are listed as providers at Livernois Primary and Urgent Care, a clinic at 18254 Livernois in Detroit’s University District neighborhood. Nagarwala is listed as the clinic’s founder. Attar is listed as staff. Both hold active, unrestricted Michigan medical licenses with no public record of discipline.

The last time Nagarwala and Attar worked out of the same clinic was Burhani Medical Center in Farmington Hills — the location where, according to the federal indictment in United States v. Nagarwala (2:17-cr-20274, E.D. Mich.), Nagarwala performed FGM procedures on minor girls while Attar opened his clinic after hours to let her do it.

Now they’ve rebuilt together, 20 miles southeast, in a clinic Nagarwala founded herself.

The practice registered its National Provider Identifier (NPI 1659021509) on March 24, 2022. The current website launched in spring 2025, with staff photos uploaded in April and May of that year. As of June 15, 2026, the clinic’s Google listing shows 131 reviews and a 4.8-star rating. The business identifies itself on Google as “women-owned,” “Asian-owned,” and “LGBTQ+ friendly.”

The clinic’s services page lists general illness and injury care, occupational health screenings, labs, x-rays, flu shots, and physical exams. The physical exams page specifically advertises “school physicals,” “sports physicals,” “camp and program physicals,” and “childhood and adult immunizations,” services marketed to children and their parents.

The clinic accepts 13 insurance providers, at least seven of which are taxpayer-funded: Medicaid of Michigan, Medicare of Michigan, UnitedHealthcare Community Plan, Molina Healthcare, Meridian Health Plan, Aetna Better Health of Michigan, and McLaren Medicaid. (I have reached out to all for comment and will update once they respond.)

Nagarwala’s bio on the clinic’s website describes her as “a board-certified emergency medicine physician with over 20 years of clinical and academic experience” and a graduate of Johns Hopkins School of Medicine. It mentions senior roles at Henry Ford Hospital. It does not mention the federal prosecution.

Attar’s bio describes him as “a board-certified Internal Medicine physician who has been practicing for over 25 years,” with residency training at Albert Einstein College of Medicine. It does not mention the federal prosecution.

A third provider, listed only as “Mr. Ayyub,” is described as a certified physician assistant with a master’s from Western Michigan University and 13 years of experience on the Acute and Critical Care Team at Corewell Health in Royal Oak. A Tebra listing identifies him as Ayyub Ahmad (NPI 1861708711). Physician assistants in Michigan practice under physician supervision, in this case, under Nagarwala or Attar.

In 2017, federal prosecutors alleged that Nagarwala performed FGM on at least nine minor victims at Burhani Medical Center, Attar’s clinic, between 2015 and 2017. The indictment alleged that Attar opened his clinic after hours to allow the procedures, and that both physicians instructed others not to speak about what had taken place. Families traveled from as far as Minnesota to bring their daughters to the clinic.

The federal case was dismissed in 2018 after the trial judge ruled the federal FGM statute unconstitutional. Michigan’s Department of Licensing and Regulatory Affairs opened complaint investigations into both physicians and closed them without disciplinary action, before the federal case concluded. Both physicians retained their licenses throughout. Nagarwala renewed hers through June 19, 2029, despite complaints.

Now they are seeing patients together again, at a clinic that advertises school physicals for children, accepts Medicaid, and identifies itself as “women-owned” and “LGBTQ+ friendly” on Google.

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Michigan renewed the medical license of Dr. Jumana Nagarwala, the physician charged in America’s first federal FGM prosecution, through 2029 in seven minutes, with no human review, no screening of her complaint history, and no reference to the federal case or the cutting allegations anywhere in the renewal record.

Records obtained through the Freedom of Information Act show that Nagarwala submitted her renewal application on April 14, 2026 at 12:53 PM. By 1:00 PM, the system had emailed her a confirmation.

The production contained only what Nagarwala submitted and the automated system emails. Nothing in the record indicates anyone at the Michigan Department of Licensing and Regulatory Affairs (LARA) looked at Nagarwala’s file before extending her license by three years.

Her license number (4301071795) now shows an expiration date of June 19, 2029 in the state’s public licensing database. When this publication first reported on Nagarwala’s license status in January 2026, the same database showed an expiration of June 19, 2026. Her previous medical license is archived here and the new medical license is archived here.

LARA has at least four complaint files on this physician:

• The original civil investigation (43-XX-146153), which the agency closed in September 2018 with the disposition “No Action Taken” two months before the federal charges were even dismissed.

• The criminal monitoring file (146169), opened to track the federal prosecution.

• A 2019 complaint from a physician who called Nagarwala’s practice of genital cutting on children without anesthesia “torture,” which LARA dismissed by citing the monitoring file rather than the closed investigation.

• A 2025 patient complaint filed against Nagarwala by a patient she treated at GCH Westland Emergency Room.

LARA renewed Nagarwala’s license anyway.

The renewal application asks two good moral character questions. Both ask only about convictions not previously reported to the department. Since the federal case against Nagarwala was dismissed on constitutional grounds, Nagarwala was not required to disclose her history with FGM or the previous federal case against her.

The form does not ask about criminal charges, indictments, arrests, or investigations, open or closed, by this department. The sanctions question asks only whether another state or country has imposed sanctions. Michigan’s own history with the licensee is structurally invisible on its own renewal form.

A patient complaint filed in 2025 alleged Nagarwala improperly administered a drug injection at GCH Westland Emergency Room. Her controlled substance license was also renewed.

The renewal took place during a period when LARA’s own communications director had personally responded to this publication’s questions about whether the agency made false statements to Medscape about the status of the investigations, breaking a months-long pattern of silence across multiple published articles. The agency’s Director of Legal Affairs had been CC’d on correspondence from a Board of Medicine reviewer who treated the inquiry as a legal exposure question. FOIA requests targeting internal communications about the case were active and pending response.

None of that stopped the renewal.

Nagarwala was charged in April 2017 with performing genital cutting on young girls at a Livonia clinic, in what federal prosecutors called the first FGM case in U.S. history. The FBI identified nine victims between the ages of seven and thirteen from Michigan, Minnesota, and Illinois. Prosecutors estimated as many as 100 girls may have been cut over a twelve-year period. The federal case ended in November 2018 after U.S. District Judge Bernard Friedman ruled the federal FGM statute unconstitutional. No party in the case disputed that the procedures occurred.

Michigan’s Board of Medicine authorized an investigation days after the federal arrest. Internal emails show LARA staff requested a summary suspension and administrative complaint. Neither was executed. Michigan never held hearings on her license. The state closed its investigation with “No Action Taken,” and the closure memo, authored by Assistant Attorney General Bridget K. Smith and addressed to then-Bureau of Professional Licensing Director Cheryl Wykoff Pezon, remains withheld in full under attorney-client privilege.

Dr. Fakhruddin Attar, who owned the Livonia clinic where prosecutors alleged the procedures took place, also holds an active, unrestricted medical license (No. 4301067384). His clinic is still open and his license does not expire until March 2027. As previously reported, LARA never assigned an investigator to his case and certified that “a traditional investigation was not conducted.”

No medical organization contacted for this investigation was willing to say that a physician who performed genital cutting on children should lose their medical license.

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State licensing records obtained through a Freedom of Information Act request show the complaint was filed on May 17, 2025, through Michigan’s MiPLUS system. The patient reported that Nagarwala administered a 30-milligram ketorolac injection following a car accident involving a concussion. The incident occurred on April 28, 2025. The complaint lists Nagarwala’s business address as GCH Westland Emergency Room, 6245 Inkster Road, Garden City, MI 48135.

Garden City Hospital, asked to comment, provided a statement through a spokesperson describing Nagarwala as “an independent physician” who “is not employed by Garden City Hospital.” The hospital did not address whether she holds active privileges at the facility.

The statement characterized the federal prosecution as a case that was “dismissed by the courts.” The federal FGM charges were dismissed after the presiding judge ruled the statute unconstitutional, finding that Congress lacked authority under the Commerce Clause to criminalize the practice. The ruling addressed the law, not Nagarwala’s conduct.

The hospital said it maintains “rigorous screening and credentialing processes” including verification of “licensure, background, certifications, training, professional qualifications, and other relevant information,” but declined to say whether it was aware of Nagarwala’s federal prosecution when she was credentialed. Notably absent in their statement was a direct answer to my question “Does Garden City Hospital's credentialing process include an internet search of a physician's name?” or what its position is on credentialing physicians who have been prosecuted for performing genital cutting on children.

“As a matter of policy, Garden City Hospital does not comment on individual credentialing matters or personnel-related issues,” the statement said.

Nagarwala, contacted for comment, initially responded to ask about the identity of the patient who filed the complaint. “This is the first I have heard about this,” she wrote. She has not yet responded to follow-up questions or to an invitation to share her perspective in a recorded longform interview.

The complaint itself appears insignificant. Though Ketorolac risks worsening an undetected intracranial bleed, it is still a common pain medication administered in emergency rooms. What is significant is that a patient walked into a suburban Detroit emergency room, was treated by a doctor who had been charged with performing genital cutting on children, and had no way of knowing.

This is not the first complaint on Dr. Nagarwala’s license. In June 2019, a board-certified anesthesiologist filed a complaint calling Dr. Nagarwala’s cutting of young girls “torture.” LARA dismissed the complaint by claiming they had already conducted an investigation they had not. Now there is a second complaint, filed by a patient who apparently did not know her history at all.

Emergency rooms are not like other medical settings. You do not choose your doctor. You are brought in by ambulance or you walk in from the waiting room, and you see whoever is on shift. Patients rely on the system — the licensing board, the hospital credentialing process, the state — to protect them.

Nothing on Nagarwala’s public license record would make a patient aware of her history, despite there being two complaints on her file. No action has been taken on the complaints against her. No medical organization will say that doctors who perform FGM should not be licensed.

The patient who filed this complaint had no way of knowing who their doctor was. Neither would you.

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Michigan’s Department of Licensing and Regulatory Affairs (LARA) took “no position” on a bill to permanently revoke the medical licenses of doctors convicted of female genital mutilation, while its own medical board was investigating two physicians charged with that conduct.

LARA’s enrolled bill analysis of Senate Bill 410, obtained through a Freedom of Information Act request, records the agency’s official stance: “ADMINISTRATION POSITION: No position.” The bill amended the Public Health Code to require permanent revocation of a health professional’s license upon conviction for FGM. It passed the Michigan House 105-2 and the Senate 38-0. Governor Snyder signed it into law.

Two months before the analysis was completed, LARA’s Board of Medicine authorized investigations into both physicians. On April 18, 2017, board reviewers approved an investigation into Dr. Jumana Nagarwala, one of the physicians federally indicted for performing FGM on minor girls. On April 21, Kim Gaedeke, then the Director of LARA’s Bureau of Professional Licensing, directed staff to open a file on Dr. Fakhruddin Attar, who owned the clinic where prosecutors alleged the procedures took place, and associate it with the already-opened Nagarwala matter. In Attar’s file, board reviewer Dr. Peter Graham recommended summary suspension.

LARA’s own analysis identified the case by name. Its PROBLEM/BACKGROUND section states: “Two Detroit-area doctors, and a third person, have recently been charged under the Federal FGM statute, related to the performing of FGM on two girls from Minnesota at a medical clinic in Livonia.”

The agency was not weighing an abstract policy question. It was taking no position on a bill about conduct it was actively investigating in two named physicians whose case it cited by name in the same document.

The “no position” was not a default. Internal LARA emails show it was a deliberate decision communicated to other state agencies. On June 13, 2017, nine days before the analysis was finalized, Marnie Wills, LARA’s Deputy Director for Policy and Legislative Affairs, emailed colleagues: “I let her know we will have no position but appreciate the head’s up that they will support I have no concerns with them supporting.”

Wills had communicated this to Debi Cain of the Michigan Domestic and Sexual Violence Prevention and Treatment Board. That board supported SB 410. So did the Michigan Catholic Conference. The bill analysis lists no arguments against it. The “Con” section is blank.

A separate Bureau Bill Response in the same FOIA production, an earlier, undated document prepared while SB 410 was still being drafted, explains the posture. BPL wrote: “Historically, it is not within the Bureau’s place to agree or disagree with any suggested sanctions, just so long as they are written properly and clearly in the statute for BPL to enforce.”

Wills had also written to Senator Colbeck’s legislative director during the drafting process: “Generally, the concept isn’t anything we would have a problem with, but we don’t take positions until we see final versions of the bill.”

In that same Bureau Bill Response, BPL noted that existing law already provided a path to revocation. A felony conviction, BPL wrote, “would be a violation of MCL 333.16221(b)(v),” and “permanent revocation would already be an option for a Board’s Disciplinary Subcommittee under MCL 333.16226(1).” BPL was telling the legislature it already had the authority to permanently revoke a doctor’s license for an FGM felony while both FGM investigations were still open on its own docket.

As previously reported, both investigations were later closed with no disciplinary action, the Nagarwala investigation on September 25, 2018 and the Attar closure recommended four months before federal charges were even dismissed. BPL used neither the authority it told the legislature it already had, nor the new authority SB 410 provided.

Neither physician was convicted — the federal case was dismissed on constitutional grounds — so neither conviction-triggered revocation route was triggered. But LARA also did not discipline either physician through any other means. Dr. Nagarwala and Dr. Attar both hold active, unrestricted Michigan medical licenses.

LARA did not respond to a request for comment.

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I sent medical organizations across the country the same question: Should a physician who has performed genital cutting on children retain an active, unrestricted medical license?

Not one said no.

For context: Dr. Jumana Nagarwala and Dr. Fakhruddin Attar, federally indicted in 2017 for performing genital cutting on minor girls, hold active, unrestricted Michigan medical licenses. Michigan’s licensing agency closed its investigations into both physicians with no disciplinary action.

On May 27, I sent each organization a set of questions regarding the licensing of FGM doctors.

Three organizations responded:

• The Federation of State Medical Boards declined to condemn genital cutting on children and refused to comment on the case.

• The American Medical Association condemned FGM in the abstract but declined to say whether these physicians should lose their licenses. They also deferred to an organization that refused to condemn genital cutting on children or licensing FGM doctors.

• The Oakland County Medical Society acknowledged receipt but did not answer the questions.

None said that female genital cutting on children should cost a physician their medical license.

The following organizations did not respond:

• American College of Physicians

• American Academy of Pediatrics

• American College of Obstetricians and Gynecologists

• American College of Emergency Physicians

• Michigan State Medical Society

• Wayne County Medical Society

• Michigan College of Emergency Physicians

• Michigan Chapter, American Academy of Pediatrics

Female genital cutting on children is a federal crime under the STOP FGM Act of 2020 and is illegal in most states, including Michigan.

If any of the organizations contacted for this article respond or send comment, I will update it with their statements.

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When I asked the American Medical Association (AMA) whether physicians who performed genital cutting on children should retain active medical licenses, they referred me to the Federation of State Medical Boards.

As I reported on June 1, FSMB declined to condemn genital cutting on children.

On May 27, I sent the AMA seven questions about the licensing outcome for Dr. Jumana Nagarwala and Dr. Fakhruddin Attar, federally indicted in 2017 for performing genital cutting on minor girls. Both hold active, unrestricted Michigan medical licenses. Michigan’s licensing agency closed its investigations into both physicians with no disciplinary action.

R.J. Mills of AMA Media & Editorial responded the next day. He answered none of the seven questions. He said the AMA “does not have an authorized role in the regulatory process run by the State of Michigan” and referred me to FSMB as “the national voice of the state-run regulatory system for medicine.”

Mills opened his response with: “While I am not an AMA spokesperson, I can provide the following background information to help inform your reporting.” He was writing from the AMA’s own Media & Editorial department.

His response included one substantive statement: “The AMA condemns the practice of female genital mutilation and opposes this form of child abuse by any physician in the United States.”

The organization the AMA endorsed as the authority on physician licensing will not say whether genital cutting on children should cost a doctor their license.

On June 1, I followed up with the AMA. I removed all questions about Michigan’s regulatory process and asked only about AMA policy: Does the AMA agree with FSMB’s decision not to condemn genital cutting on children? Should a physician who has performed genital cutting on children retain a license? Does the AMA Code of Medical Ethics address this? Do physicians have an ethical obligation to report colleagues?

I asked whether the AMA has an on-the-record position on these questions.

As of June 6, the AMA has not responded.

Female genital cutting on children is a federal crime under the STOP FGM Act of 2020 and is illegal in most states, including Michigan.

Screenshots of our emails can be found below:

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When the Federation of State Medical Boards was asked whether a physician who performs female genital cutting on children should retain a medical license, they declined to answer.

FSMB is the national non-profit organization that represents every state medical board in the United States. It describes itself as working to ensure that state licensing boards “protect the public.”

In response to questions I sent asking whether physicians who perform female genital cutting on children should retain active medical licenses, Joe Knickrehm, FSMB’s Chief Public Affairs Officer, responded:

“The Federation of State Medical Boards does not license or discipline individual physicians and is not involved in any decisions about investigations or cases. We therefore cannot comment on the circumstances involving any particular physician or on actions taken by one of our member boards.”

Of the questions I had sent, several concerned FSMB policy, not specific physicians or cases. I sent a follow-up, asking only about FSMB’s own policy positions, and removing all questions pertaining to specific cases. FSMB did not respond.

For context: Dr. Jumana Nagarwala and Dr. Fakhruddin Attar, doctors that were federally indicted in 2017 for performing genital cutting on minor girls, hold active, unrestricted Michigan medical licenses today. Michigan's licensing agency, LARA, closed its investigations into both physicians with no disciplinary action.

Female genital cutting on children is a federal crime under the STOP FGM Act of 2020 and is illegal in most states, including Michigan.

Screenshots of our emails can be found below:

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Michigan’s medical board lied to the press about investigating FGM doctors.

On December 10, 2018, Medscape reported that “as of December 7,” the licenses of Dr. Jumana Nagarwala and Dr. Fakhruddin Attar, two physicians charged in 2017 with federal counts related to female genital cutting, were “active but under investigation,” and that the Department of Licensing and Regulatory Affairs (LARA) “could not comment further on active investigations.”

Based on the agency’s own records, which I obtained through Freedom of Information Act (FOIA) requests, that was a lie.

FOIA records I obtained show the Michigan Attorney General’s office recommended closing the Attar investigation (file 43-XX-146259) on July 27, 2018. LARA confirmed under FOIA that “a traditional investigation was not conducted” on Attar at all.

LARA closed the Nagarwala investigation (file 43-XX-146153) on September 25, 2018, with a disposition of “No Action Taken.” LARA never held a single hearing on either physician’s license.

When the spokesperson told Medscape that LARA “could not comment further on active investigations,” there were no active investigations to comment on.

When they claimed both physicians’ licenses were “under investigation,” Dr. Nagarwala's investigation had been closed months earlier with no action taken, and no investigation into Dr. Attar was ever conducted at all.

The Medscape article ran three weeks after U.S. District Judge Bernard Friedman ruled the 1996 federal FGM statute unconstitutional, dismissing key charges against both physicians. LARA had closed its investigations before that ruling.

The closure memos for Nagarwala and Attar have been withheld in full by both LARA and the Attorney General's office under attorney-client privilege. Both agencies denied appeals to release them.

Both physicians retain active, unrestricted Michigan medical licenses. Attar’s clinic has reopened at a new location and is accepting new patients, including children.

The Medscape story containing LARA’s false claims, “Surgeon: Physicians in Genital Cutting Case Should Lose Licenses,” written by Marcia Frellick and published December 10, 2018, is archived here.

On May 19, Emily Fitzgerald of LARA's Office of Communications replied to my request for comment, acknowledging receipt and stating that she was "working to get you a response” but “it is unlikely we will be able to issue a response within 24 hours of receiving this request, but I will try to get one to you as soon as possible.”

In order to allow LARA time to respond, I delayed my original publication date of this story a full week. On May 25, I sent a follow-up email, asking when I might expect a comment, because I could not delay indefinitely. As of publication, I still have not received comment. I will update this article to include LARA's statement if and when one is received.

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The state of Michigan never assigned an investigator into the medical license of a doctor who ran an FGM clinic.

Asked through the Freedom of Information Act to identify the investigator assigned to Dr. Attar’s file, the Department of Licensing and Regulatory Affairs responded: “A traditional investigation was not conducted under 43-XX-146259.” In other words, the requested information does not exist because no investigator was ever assigned.

Michigan’s Board of Medicine authorized the investigation on April 21, 2017. Board reviewer Dr. Peter Graham wrote: “I approve investigation. Please also refer to Director Gaedeke for summary suspension, which I approve.” Board reviewer Dr. James Sondheimer, a professor of medicine at Wayne State University, wrote: “Agree with proceeding with investigation. Res ipsa loquitur.” The Latin means the facts speak for themselves.

Despite the Board of Medicine authorizing an investigation and calling for suspension, the Department of Licensing and Regulatory Affairs, the state agency responsible for carrying out the Board’s directives, never assigned an investigator to the case.

As I have previously reported, Dr. Attar still holds an active, unrestricted Michigan medical license (No. 4301067384) with no record of discipline. Federal prosecutors alleged that Attar allowed Dr. Jumana Nagarwala to perform FGM on young girls at his Livonia clinic after hours for over a decade, with his wife Farida assisting during the procedures. Prosecutors estimated that as many as 100 girls were cut at the clinic over twelve years. His clinic has since reopened at a new location in Farmington Hills and is accepting new patients.

LARA did assign an investigator to the companion file on Dr. Nagarwala (43-XX-146153). State records identify Jennifer Pappas as the regulation agent on that case. Pappas attempted to interview a key medical witness but was blocked by the federal prosecutor. That investigation was also closed with no action taken.

Dr. Attar’s file was opened, authorized for investigation and summary suspension by the Board of Medicine, and closed. Between opening and closing, nothing happened. The file is a record of inaction.

The only document that would explain why is the closure memo authored by Assistant Attorney General Bridget K. Smith, dated July 27, 2018. It is redacted in full.

The Michigan Department of Licensing and Regulatory Affairs and the Michigan Attorney General’s office did not respond to requests for comment.

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On July 27, 2018, Michigan’s Assistant Attorney General Bridget K. Smith recommended closing the state’s licensing investigation into Dr. Fakhruddin Attar, the owner of the clinic at the center of America’s first federal FGM prosecution. The federal FGM charges were not dismissed until November 20, 2018, four months later.

Smith sent her recommendation in a memo titled “Request to Close File” addressed to Cheryl Wykoff Pezon, then Director of the Bureau of Professional Licensing at LARA. LARA received the memo on August 7, 2018, as recorded by a received stamp on the document.

Like the closure memo for Dr. Nagarwala, the physician accused of performing the procedures at Attar's clinic, the substantive content of the Attar memo is redacted in full. The state has never explained why it closed either investigation.

As I have previously reported, Dr. Attar still holds an active, unrestricted Michigan medical license (No. 4301067384) with no record of discipline. Federal prosecutors alleged that Attar allowed Dr. Jumana Nagarwala to perform FGM on young girls at his Livonia clinic after hours for over a decade, with his wife Farida assisting during the procedures. Prosecutors estimated that as many as 100 girls may have been cut at the clinic over a twelve-year period. His clinic has since reopened at a new location in Farmington Hills and is accepting new patients, including children.

Michigan’s Board of Medicine unanimously authorized the investigation into Dr. Attar on April 21, 2017. Board reviewer Dr. Peter Graham wrote: “I approve investigation. Please also refer to Director Gaedeke for summary suspension, which I approve.” Board reviewer Dr. James Sondheimer, a professor of medicine at Wayne State University, wrote: “Agree with proceeding with investigation. Res ipsa loquitur,” a legal term meaning “the facts speak for themselves.”

Despite the Board's authorization, no disciplinary action was taken. The only document that would explain this decision, the closure memo from AAG Smith, is redacted in full.

Documents obtained from the Attorney General’s office show that Smith authored both the Attar and Nagarwala closure memos on the same date, July 27, 2018, and sent them to the same recipient. A response from LARA’s Cynthia Rowe to Smith, dated August 14, 2018, is also withheld under attorney-client privilege.

Both closure memos were sent while the federal case was still active. Trial had been scheduled for January 2019. The state did not wait for the federal case to conclude. As we reported previously, Michigan closed the Nagarwala investigation on September 25, 2018, two months before the federal dismissal. The AG recommended closing the Attar investigation even earlier, on July 27, four months before the federal case ended.

Due to Bridget K. Smith’s recommendation and the Michigan Department of Licensing and Regulatory Affairs’ acceptance of it, the doctor who owned a clinic prosecuted for FGM still holds his medical license and would have retained it even if convicted.

Those involved have hidden their reason for protecting FGM doctors’ medical licenses from the public.

The Michigan Department of Licensing and Regulatory Affairs and the Michigan Attorney General’s office did not respond to requests for comment.

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Michigan closed its licensing investigation into Dr. Jumana Nagarwala, the physician at the center of America’s first federal FGM prosecution, on September 25, 2018, two months before the federal court dismissed charges against her on November 20, 2018.

This means that an FGM doctor retaining her medical license had nothing to do with losing the federal case. The investigation into the medical license ended while the federal case was still set to go to trial.

State licensing records obtained through the Freedom of Information Act show that the only licensing investigation Michigan ever opened into Dr. Nagarwala was closed with the disposition “No Action Taken.” The closure date of September 25, 2018 is recorded in a LICENSE 2000 COMPLAINT HISTORY printout from Michigan’s Department of Licensing and Regulatory Affairs (complaint file 43-XX-146153).

The closure was initiated by Assistant Attorney General Bridget K. Smith of the AG’s Licensing and Regulation Division. On July 27, 2018, Smith sent a memo titled “Request to Close File” to Cheryl Wykoff Pezon, then Director of the Bureau of Professional Licensing at LARA. The memo’s content is redacted in full.

Neither Michigan’s Department of Licensing and Regulatory Affairs nor the Michigan Attorney General’s office has disclosed why they recommended closing the investigation. Both agencies have withheld the memo under attorney-client privilege.

As I previously reported, Michigan never held administrative hearings on Dr. Nagarwala’s license. Dr. Nagarwala still holds an active, unrestricted Michigan medical license (No. 4301071795) with no record of discipline. She was federally charged in April 2017 with performing female genital mutilation on young girls in what prosecutors called the first federal FGM case in U.S. history. The federal charges were dismissed in November 2018 after a judge ruled the 1996 federal FGM ban was unconstitutional. No party in the case disputed that procedures were performed on the girls.

Michigan’s Board of Medicine unanimously authorized the investigation on April 18, 2017, days after the federal indictment. Multiple reviewers signed Board Review Sheets directing the Bureau of Professional Licensing to investigate under MCL 333.16231(2). One reviewer wrote that the charges “warrant suspension and investigation.”

Despite the Board’s authorization, the investigation produced no disciplinary action. The only document that would explain why, the closure memo authored by AAG Bridget K. Smith, is redacted in full.

If Michigan had closed its investigation after the federal case collapsed, the state could argue it was deferring to federal proceedings and lost its basis for action when the charges were dismissed. But Michigan closed first. The state abandoned its own investigation while the federal case was still active.

At the time the medical licensing case was closed, the government had just obtained a Third Superseding Indictment thirteen days earlier, defendants had not yet been arraigned on it, and trial remained on the court's calendar.

Documents obtained from the Michigan Attorney General’s office confirm that both the AG and LARA hold copies of the closure memo, and both refuse to release it. The AG’s privilege log identifies it as Document 72: “Request to Close File,” July 27, 2018, from AAG Bridget Smith to Cheryl Pezon. A draft version is listed as Document 78, also withheld. LARA has separately confirmed that “no other closure letter exists” beyond this memo.

Michigan closed an investigation into female genital cutting on children while those responsible were still being prosecuted and will not explain why.

The Michigan Department of Licensing and Regulatory Affairs and the Michigan Attorney General’s office did not respond to requests for comment.

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The clinic where federal prosecutors say up to 100 girls had female genital cutting performed on them is still open at a new location under a nearly identical name. It is run by the same doctor, has the same phone number, and is currently accepting new patients.

In April 2017, Burhani Medical Clinic in Livonia, Michigan was raided by the FBI as a part of the first federal prosecution of female genital mutilation in United States history.1 Federal prosecutors alleged that Dr. Jumana Nagarwala had performed FGM on young girls at the clinic after hours, with the clinic’s owner, Dr. Fakhruddin Attar, allowing her to use the facility and his wife, Farida Attar, assisting during procedures.2 Prosecutors estimated that as many as 100 girls may have been cut at the clinic over a 12-year period.3

As we previously reported, both Dr. Nagarwala and Dr. Attar still hold active, unrestricted Michigan medical licenses with no public record of discipline.45 In addition to allowing both doctors to continue practicing medicine, the state of Michigan has allowed the clinic itself to reopen at a new location under a nearly identical name, where it is currently accepting new patients.6

Dr. Attar now operates a medical practice called Burhani Medical Center at 32910 W 13 Mile Road in Farmington Hills, Michigan.7 The practice uses the same phone number as the former Livonia clinic, (734) 427-9200, and is listed across major healthcare directories including Healthgrades,8 WebMD,9 and the U.S. News doctor database.10 Dr. Attar’s website, doctorattar.com, promotes the Burhani Medical Center as a family medicine practice and states that it is accepting new patients.11

The Burhani Medical Center website lists Sports Physicals among its services and promotes care for patients of “every age group.”12 The practice displays logos indicating it accepts Medicare, Medicaid, and major commercial insurers including Blue Cross Blue Shield, Aetna, and United Healthcare.13 This means a physician federally charged with facilitating genital cutting on minor girls is actively marketing pediatric services and receiving reimbursement from taxpayer-funded insurance programs.

Public records show a link between the two practices. Michigan LARA corporate filings show that Attar, M.D., P.C., the professional corporation that operated under the assumed name “Burhani Medical Clinic” at the Livonia address, was dissolved in May 2021.14 This dissolution came shortly before the final remaining charges against the Attars were dismissed in September 2021.15

The original Burhani Medical Clinic in Livonia was not a licensed health facility under Michigan law. In Michigan, private physician offices are exempt from the state facility licensing that applies to hospitals, surgical centers, and nursing homes.16 This means there was no facility license to revoke, no facility-level inspection triggered by the federal charges, and no regulatory mechanism to prevent the same practice from reopening at a new address under a nearly identical name. The only regulatory oversight over the practice ran through the individual physicians’ medical licenses. As we have previously reported, both physicians’ medical licenses are active, unrestricted Michigan medical licenses with no public record of discipline.

When I called the clinic on February 5, 2026, a staff member answered the phone and confirmed the practice is open. Dr. Attar did not respond to multiple requests for comment.

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The second doctor from America’s first FGM case, Dr. Fakhruddin Attar, still has an active unrestricted Michigan medical license (No. 4301067384).1

Dr. Fakhruddin Attar ran his clinic in Livonia, Michigan raided by FBI in April 2017 in what would become the first federal prosecution of female genital mutilation in United States history.2 According to federal prosecutors, Attar had been allowing Dr. Jumana Nagarwala to perform FGM on young girls for over a decade, with his wife Farida assisting in the examination room.3

As I reported in January, the doctor who performed FGM, Dr. Nagarwala, still holds an active Michigan medical license (No. 4301071795) with no record of discipline.45 The second doctor charged in America’s first FGM case, Dr. Fakhruddin Attar, also has an active unrestricted Michigan medical license (No. 4301067384) with no record of discipline.6

Although the federal case against both Dr. Attar and Dr. Nagarwala collapsed on legal technicalities, state medical boards could still remove both doctors’ medical licenses. Doctors can lose their licenses for inadequate recordkeeping, failing to complete continuing education hours, billing errors, breaches of patient confidentiality, and non-criminal behavior far less severe than performing FGM on minors. Instead, the Michigan medical board allowed both doctors to keep their medical licenses with no restrictions or discipline.

To understand what that means, consider what federal court documents say happened at Dr. Attar’s clinic:

Federal prosecutors allege that Dr. Fakhruddin Attar’s conspiracy ran from 2005 to 2017 and may have involved as many as 100 victims.78

The FBI’s investigation identified nine victims between the ages of 7 and 13 from Michigan, Minnesota, and Illinois.9 When the FBI interviewed those girls, one said she’d been told they were going to the doctor because “our tummies hurt.” She described being placed on an examining table with her knees near her chest and her legs spread apart. She said the doctor “pinched” her on the place where she “goes pee,” and she was given a pad to wear in her underwear. She was told not to talk about it.10

The second girl said she “got a shot” and that it hurt so badly she screamed. She drew an “X” on her picture of the examining room to show where there was blood on the table. She identified Farida Attar as one of the women who held her hands during the procedure. Her parents told her it was a secret. After it was over, she could barely walk. She said she felt pain all the way down to her ankle.1112

Court-ordered medical examinations confirmed the injuries. One girl’s labia minora had been “altered or removed” and her clitoral hood was “abnormal in appearance,” with scar tissue and healing lacerations.13 The other had an incision to her clitoral hood and a small tear to her labia minora.14 One Michigan girl in the broader case was given ground-up Valium mixed into liquid Tylenol during the procedure.15

When agents interviewed Attar on April 10, 2017, he acknowledged that Nagarwala treated girls ages 6 to 9 at his clinic, that she only came after hours on Fridays and Saturdays, that she performed the procedures for free with no paperwork, and that she did so five or six times per year. He described the visits as treatment for “problems with their genitals, including treatment of genital rashes.” He said his wife was present during the procedures “to comfort them and hold their hands.”1617

No party in the case disputed that procedures were performed on girls at Attar's clinic. Instead, the defense was able to prevail on legal technicalities by arguing that the 1996 federal FGM ban was unconstitutional.1819 Michigan passed its own state law banning FGM in 201720 and Congress passed the STOP FGM Act, a new federal ban, in 2020,21 but because the alleged procedures predated the new law, no state charges could be filed retroactively.

However, even though legal prosecution failed, the doctors could still lose their medical licenses. The state medical board could conduct its own separate hearings. Michigan's own Public Health Code empowers the Board of Medicine to discipline physicians for "negligence or failure to exercise due care."22 Undocumented procedures performed on minors’ genitals after hours, with no medical records, no informed consent, and no billing would appear to satisfy every threshold for professional discipline that exists. Yet today, Dr. Fakhruddin Attar’s Michigan medical license remains active, unrestricted, and carries no record of any disciplinary action.

Dr. Attar did not respond to multiple requests for comment. Despite acknowledging receipt of multiple requests for comment for previous stories, the Michigan Department of Licensing and Regulatory Affairs and the Michigan Bureau of Professional Licensing did not respond. Instead, the Michigan Department of Licensing and Regulatory Affairs is asking for $12,792.93 for public records that would explain their actions.23 To support this investigation, we have started a GoFundMe here.

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The Michigan medical licensing board that licensed Dr. Jumana Nagarwala, a Detroit physician federally charged in 2017 with performing female genital mutilation on young girls, wants $12,792.93 for emails that would explain why they are continuing to license FGM-practicing doctors.

As I’ve previously reported, Dr. Nagarwala still holds an active Michigan medical license despite federal prosecution, and state records show Michigan never held administrative hearings on her license. The medical board closed its investigation without public explanation.

To find out why, I filed multiple Freedom of Information Act (FOIA) requests asking for internal emails about how Michigan handled the FGM investigation. These FOIA requests seek the internal communications that would reveal how that decision was made. The requests were made only for electronic records, after LARA claimed that searching records prior to 2020 would require “manual review of thousands of paper files.”

The Michigan Department of Licensing and Regulatory Affairs (LARA) responded by sending an invoice for $12,792.93 to retrieve the emails. LARA’s fee estimates break down to $2,508 for one request, $2,093 for another, and $8,190 for a third. The largest invoice claims it would take 405 combined hours of labor to search their emails for basic keywords like “FGM” and “female genital cutting.”

According to LARA’s written response to my questions, although they confirmed they could search every email box at once with enterprise-wide keyword searches, their preferred method is “contacting every staff member with the terms to search,” each employee “performing the searches and providing results,” and the liaison “following up with any staff who do not respond timely.” One invoice explicitly calculates: “153 employees × 12 keywords × 5 minutes.”

When I asked why they don’t just search all inboxes at once, the same LARA representative gave multiple contradictory answers. One email claimed enterprise-wide search would involve “a similarly priced fee estimate” but could “take much longer.” Another cited the “heightened cost” of enterprise-wide search as the reason for using manual methods instead. In other words, according to LARA, keyword search would cost the same but take longer, unless it takes the same amount of time but costs more.

When I asked whether their email records are maintained in an electronic system that supports keyword searching, LARA’s FOIA liaison responded: “Not sure what they mean by this. Is Outlook an ‘electronic system?’” The liaison also admitted they would have “no idea of the volume” of responsive records until each employee performed their individual searches—meaning the fee estimate isn’t based on any actual assessment of how many records exist.

Michigan’s Freedom of Information Act requires agencies to use “the most economical means available” when fulfilling requests. Having 153 employees individually search their own inboxes, compile results, and forward them to a coordinator, rather than running a single enterprise search, is the least economical way to approach the problem.

Entering “FGM” into a search bar is not a $12,792.93 task that requires 153 people and over 400 hours of labor. Instead, this appears to be willful incompetence to avoid accountability. These are public documents that the state must provide me by law. They can’t legally say no directly, so instead it appears they are making the process of providing the documents as convoluted and expensive as possible, which is also against the law, but harder to prove.

The difference between their handling of reasonable questions from the public and female genital cutting could not be more stark. The Michigan medical licensing board closed an investigation into FGM for free, without a single hearing. Now, they want $12,793 to explain their actions to the public. The board has also not responded to multiple requests for comment, which is free.

I’ve filed a formal appeal challenging these fees. LARA has 10 business days to respond. However, if this appeal does not prevail, the only way to discover the full story behind why Michigan is licensing FGM-practicing doctors would be either to pay the fee or file a lawsuit. Since both would require funding, I have started a GoFundMe to support this investigation. Please contribute here:

GoFundMe: Expose Medical Board for Licensing an FGM Doctor

This is an ongoing investigation. I’m seeking to raise funds to cover FOIA costs and continue this work. If you’d like to support this investigation, you can contribute here:
https://www.gofundme.com/f/expose-medical-board-for-licensing-an-fgm-doctor

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Freedom of Information Act (FIOA) records show Michigan never held administrative hearings regarding Dr. Jumana Nagarwala, the Detroit physician federally charged in 2017 with performing female genital mutilation on young girls in what prosecutors called the first FGM case in U.S. history.

Records from the Michigan Office of Administrative Hearings and Rules (MOAHR) show zero proceedings related to Dr. Nagarwala despite her role in the landmark FGM case. Dr. Nagarwala still holds an active, unrestricted Michigan medical license (License No. 4301071795), valid through 2026.

MOAHR handles cases where physicians challenge disciplinary action. No records means that either Michigan never initiated proceedings against her or she did not contest action taken against her. Given that her license shows no restrictions, suspensions, or disciplinary notations, it is likely that the Michigan licensing board never took formal action against a doctor who performed female genital cutting on minors.

The FOIA records requested cover 2010 to present, including the 2017-2018 period when Dr. Nagarwala was under federal indictment and the federal FGM ban was still law. The federal law wasn't ruled unconstitutional until 2018. This means there is no evidence Michigan's licensing board took any disciplinary action against a physician facing federal charges for performing female genital cutting on minors, even while federal law prohibited the practice.

While federal law fell on constitutional grounds, state medical boards retain full authority to discipline physicians whose conduct violates medical standards. Medical boards routinely suspend or revoke licenses for issues far less severe than performing female genital cutting on minors. Their inaction raises questions as to whether or not the state medical board condones physicians practicing female genital cutting.

This sustained non-enforcement aligns with a 2010 American Academy of Pediatrics proposal to allow physicians to perform a “ritual nick” on girls’ genitals, similar to what Dr. Nagarwala practiced. They withdrew the policy only after public outcry. However, selective non-enforcement allows medical authorities to support female genital cutting, without explicit policy changes that would risk public backlash. Michigan’s inaction, even during a federal case, shows which strategy is more effective. Until now, no one noticed.

The Michigan Department of Licensing and Regulatory Affairs has not responded to multiple requests for comment.

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This is an ongoing investigation. I’ve filed additional FOIA requests to determine how widespread this issue may be. Subscribe to receive updates as records are released.

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In 2017, federal prosecutors charged Detroit emergency physician Dr. Jumana Nagarwala with performing female genital mutilation on young girls, some of whom had been driven across state lines from Minnesota to a Michigan clinic,1 in the first federal FGM prosecution in United States history.2 A year later, a federal judge threw out the core FGM charges, ruling that Congress had exceeded its power under the Commerce Clause when it first criminalized FGM in 1996.3

The case was such a failure that it ended the 1996 federal FGM ban.4 Not only did the doctor evade legal consequences, she still practices medicine today. Public records indicate Dr. Jumana Nagarwala still holds an active Michigan medical license (License No. 4301071795), valid through 2026, with no public record of discipline or suspension.5

Why does the doctor are the center of the landmark case that legalized female genital cutting in the United States still have her medical license?

There is no question that Dr. Jumana Nagarwala practiced female genital cutting. Rather than dispute the allegations, Dr. Nagarwala defense argued federal law was unconstitutional.6 Alan Dershowitz, the Harvard law professor who represented Jeffrey Epstein,7 consulted for the defense team and was prepared to argue that the Dawoodi Bohra community should be allowed to practice female genital cutting because the type they practice, what the World Health Organization classifies as Type I FGM,8 is merely a “symbolic pin prick” that is less harmful than male circumcision and part of their “religious freedom.”91011

Medical organization have already issued statements supporting legalizing female genital cutting. In 2010, the American Academy of Pediatrics (AAP) issued a policy statement proposing that U.S. physicians be allowed to perform a “ritual nick” on girls’ genitals.12 The statement was withdrawn only after public backlash.13 The “ritual nick” described in that policy statement is similar to the kind practiced by the Dawoodi Bohra and Dr. Jumana Nagarwala.

For years, Intactivists and other against circumcision have warned that American medicine would attempt to normalize female genital cutting with the same methods they use to defend male genital cutting. The fact that Dr. Jumana Nagarwala still has her medical license suggests that medical organizations are integrating female genital cutting into the medical community and engaged in a soft-legalization of FGM through non-enforcement.

Despite acknowledging receipt of multiple requests for comment, The Michigan Department of Licensing and Regulatory Affairs and the Michigan Bureau of Professional Licensing did not respond.

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