A federal prosecutor told a judge this week that as many as 100 girls could have had their genitals cut by a Muslim doctor in Michigan, according to the Detroit Free Press.
The historic case centers on allegations that two 7-year-old Minnesota girls, as part of a religious rite of passage, had their genitals cut at a Livonia clinic in February and were told to keep it a secret. Livonia is northwest of Detroit.
"Due to the secretive nature of this procedure, we are unlikely to ever know how many children were cut by Dr. (Jumana) Nagarwala," Assistant U.S. Attorney Sara Woodward said, referring to the lead defendant.
"The Minnesota victims were not the first victims," she added later.
Woodward's comments came while she tried to persuade the federal judge to keep two other defendants in the case behind bars.
U.S. District Judge Bernard Friedman ruled against Woodward and awarded bond to Dr. Fakhruddin Attar, 53. He is accused of letting Nagarwala, 44, use his clinic for genital cutting procedures on minor girls.
His wife, Farida Attar, 50, is accused of holding the girls' hands during the procedure to soothe them and keep them from moving.
The Detroit Free Press reports that all three defendants belong to a local Indian-Muslim sect known as the Dawoodi Bohra.
The government says for 12 years, the defendants forced numerous girls to undergo genital cutting procedures. Woodward said up to 100 victims is a conservative estimate that stems from Dr. Attar's alleged disclosure to authorities that he allowed Nagarwala to treat children for genital rashes in his clinic as many as six times a year.
Attar's attorney refuted the estimate.
"I think the government has overstated so many aspects of this case, and this is one more example of overreaching," Mary Chartier said after the hearing.
The defense has said that the Attars did not do anything criminal, and the procedure did not involve cutting, but instead scraping genital membrane. The defense has also argued that it's a protected religious rite of passage.
The prosecution says the procedure was a lot more severe. Court documents show the two Minnesota girls had scarring and abnormalities on their genitalia. Court records also show that the girls told authorities that the procedures were painful, according to the Detroit Free Press.
One girl said she "could barely walk after the procedure, and that she felt pain all the way down to her ankle."
The other described the procedure as being "pinched" in the genital area and it "hurted a lot." She also said there was "pain and burning," according to court documents.
Nagarwala remains in jail pending the result of her trial. Her attorney, Shannon Smith, decided not to comment on the allegations that Nagarwala cut the genitals of as many as 100 girls. She did say she would seek to have her client granted bond.
Smith has said in court several times that what Nagarwala did is "completely a religious practice," the Detroit Free Press reported.
If the two doctors are convicted, they could spend life in prison. Attar's wife faces up to 20 years behind bars.
A trial is scheduled for October 10.
The law bans cutting the genitals of a young girl. It has not been challenged for 21 years until now, the Detroit Free Press reported.