I asked eight organizations that work to end female genital mutilation whether two physicians charged in America’s first federal FGM prosecution should continue to hold active medical licenses. Six did not respond. One responded, but did not answer the questions. One initially took a position that meant that FGM doctors should keep their licenses, and had to be told to read the reporting they were responding to before they gave a new comment.
As previously reported, Dr. Jumana Nagarwala (License No. 4301071795) and Dr. Fakhruddin Attar (License No. 4301067384) hold active, unrestricted Michigan medical licenses. The state investigations into their licenses were closed before the federal court ruling. Neither physician was convicted.
On July 25, I emailed Equality Now, the U.S. End FGM/C Network, Sahiyo, the AHA Foundation, the Tahirih Justice Center, Safe Hands for Girls, the Orchid Project, and the End FGM European Network, asking each organization three questions:
Is your organization aware of this case and its current status?
Does your organization intend to take any action or make any public statement?
Does your organization believe physicians who perform female genital mutilation on children should hold active medical licenses?
I requested response by Friday, July 31.
Equality Now did not respond. Safe Hands for Girls did not respond. The Orchid Project did not respond. The End FGM European Network did not respond.
Sahiyo was founded by members of the Dawoodi Bohra community, the specific community at the center of the Nagarwala case. Its website describes FGM within the Bohra community as its primary focus area. Sahiyo did not respond.
The AAP’s clinical report on FGM in children directs clinicians to the U.S. End FGM/C Network’s website to find a regional FGM expert. The U.S. End FGM/C Network did not respond.
I followed up by emailing its executive director, Caitlin LeMay, directly on August 4. I noted the original request had received no response and that a colleague at another organization had referred me to LeMay by name. The deadline was Friday, August 7. She did not respond.
Two organizations did respond: the AHA Foundation and the Tahirih Justice Center.
The AHA Foundation was founded by Ayaan Hirsi Ali, herself a survivor of FGM. On July 31, the deadline for my questions, Michele Hanash, the Director of Policy and Women’s Programs at the AHA Foundation, responded with the following:
1- The Nagarwala case? Yes.
2 - We filed an Amicus Brief in the Nagarwala case and have spoken about it. Is there an update in particular that you are referring to?
3- We support and promote that any physician found guilty of FGM should be subject to automatic revocation of their medical license.
AHA’s position, as stated in this email, “that any physician found guilty of FGM should be subject to automatic revocation of their medical license” [emphasis added] implies that the organization would support the continued licensing of the FGM doctors, since neither Nagarwala nor Attar were found guilty.
However, their reply indicates that they did not read my email or reporting before making a public statement. I did not ask them about the legal case, but the medical licensing. Before the questions, my email read:
I am writing to request comment on two FGM doctors who still have a medical license.
Both physicians charged in United States v. Nagarwala, America’s first federal FGM prosecution, hold active, unrestricted medical licenses in Michigan today. Investigations into their license were closed before the federal court ruling.
My reporting on this story is here: https://www.hegemonmedia.com/p/fgm-doctors-still-licensed
Both my email and reporting told them what I was asking about. Though AHA replies to their email (unlike most anti-FGM organizations contacted), their reply indicated they did not read it. Had I not followed up, it would have been reasonable to run the headline “Anti-FGM Organization Supports Licensing FGM Doctors” with their comment.
Instead, I replied, laying out the facts and suggested they read the reporting before responding further. I noted that Nagarwala’s licensing investigation was formally closed September 25, 2018, one day after AHA filed its Amicus Brief.
Michele Hanash of AHA replied that:
We were unaware that Nagarwala’s medical license had recently been renewed. Thank you for bringing this to our attention.We have been exploring potential avenues for action, including possible civil remedies for survivors, although those options did not appear to be feasible. However, we are now looking into what additional actions may be available in connection with this case.
We believe the facts of the case were sufficient to warrant revocation of the physicians’ medical licenses, and we do not understand why the licensing board would have simply closed the matter without taking further action.
I sent a third email offering to meet with them and share what I’ve learned about the medical licensing case after six months of investigation and filing over 100 public records requests. They did not reply.
The Tahirih Justice Center responded on July 27. Casey Carter Swegman, Director of Public Policy, did not answer any of the three questions. She referred me to Nicole Warren at Johns Hopkins University, an external expert not affiliated with Tahirih.
I replied the same day, thanked Swegman for the referral, noted I was documenting each organization’s own position, and restated the three questions. Tahirih did not answer.
An hour later, Rachel Pulda, Tahirih’s Director of Communications, sent a second referral, directing me to Caitlin LeMay at the U.S. End FGM/C Network, an organization I had already contacted on July 25. Tahirih sent two emails and answered zero questions. The organization knew who to refer me to. It would not say what it thought.
Warren, the referred expert, responded substantively within thirty minutes. Nicole Warren is an Associate Professor at Johns Hopkins University School of Nursing and Women’s Health Director at the HEAL Refugee Health and Asylum Cooperative. She answered all three questions directly.
On the licensing status, Warren wrote:
“Allowing these individuals to be licensed suggests that FGM/C is not ‘worth’ being held accountable. This is contradictory to every legal and health profession guidance at local, state, national, and international levels. I have heard dozens of first-hand accounts of FGM/C - there is no benefit to the individual, only long-term, mostly irreversible, psychological and physical harm. I do not believe any clinician, even those from a community that practices FGM/C, who understand these impacts would continue the practice.”
On the role of licensing boards, she wrote:
“I am not a physician but I feel strongly that any entity that licenses health care providers has an obligation to hold applicants accountable for unethical behavior including FGM/C.”
Warren’s initial response contained two factual errors: she identified the physician as a family physician and cited the AAFP’s policy, which does not apply to Nagarwala’s specialty. I sent corrections the same day with the accurate details. Warren acknowledged them and said she would reply in the next couple of days with a revised response. Her answer on what continued licensing signals does not depend on either error and stands as written. She did not send the revised response.
Warren referred me to Janine Young, lead author of the AAP’s clinical standard on FGM in children. Young answered all three questions in writing and stated that anyone who performs “any medically unnecessary treatments on a child” should be thoroughly investigated by the medical board and that the state should follow a structured disciplinary process. You can read her full statement in previous reporting here.
Of the eight organizations contacted, only one stated that the facts warrant revocation of the physicians’ medical licenses. That organization did not know the licenses were still active until I told them twice, and initially gave a response that implied they were fine with the FGM doctors’ continued licensing. They did not respond when I offered to share what I have learned through six months of investigation.
One final note:
Equality Now: $12,083,779 in revenue for fiscal year 2024, $28.4 million in total assets.
Safe Hands for Girls: $877,303 in revenue.
Orchid Project: £957,920 in income.
End FGM European Network: €684,048 in revenue, with 66% from a European Commission operating grant and 30% from EU-cofunded projects.
Sahiyo: $576,444 operating budget.
U.S. End FGM/C Network: does not publish standalone financial statements; operates under a fiscal sponsor and does not publicly disclose its annual budget.
AHA Foundation: $1,187,403 in revenue.
Tahirih Justice Center: $11.9 million in Form 990 revenue; including donated professional services, its stated total budget reaches $36.7 million.