Almost 20 years have passed since the genital mutilation of girls has been outlawed in the United States, but the traditional practice has continued to grow ever faster in recent years with increased immigration from parts of Africa where it is most common. It is estimated that more than 500,000 girls and women in the US have been affected or remain at risk of being forced to undergo the excruciatingly painful, dangerous procedure in their American communities or while on “vacation” in a family’s country of origin.

The apparently worsening situation in some American cities and states and the surprising lack of prosecutions are galvanizing action in numerous nongovernment organizations and the administration of President Barack Obama, who said in recent speeches during a trip to Africa that “there’s no reason that young girls should suffer genital mutilation.” Like the forced marriage of children, he said, these traditions “have no place in the 21st century.”

Shelby Quast, the policy director of Equality Now, a relatively small nongovernment organization in New York with global reach and years of work in Africa, said that over the last two years, as the number of cases multiplied, an earlier argument in the US and Europe that the procedure was an important part of some cultures and that outsiders should not try to stop it has greatly diminished. A White House decision to define female genital mutilation (known as FGM) as a form of violence against women helped change the terms of discussion.

The 1996 federal law against the practice has been strengthened by laws in 24 states, some calling for relatively long prison terms and hefty fines. In 2013, a campaign in Congress led by Representative Joseph Crowley, a New York Democrat, and Harry Reid, a Nevada Democrat who is the Senate minority leader, succeeded in closing a loophole in the 1996 federal law, which covered people charged with committing the crime only in the US. A new measure signed into law in early 2013 extends the illegality to anyone taking a girl out of the country to have the procedure done abroad.

Quast said that as a result, the practice can be defined not only as traditional culture but also as a crime with legal reach across borders. “We’ve met with the Inter-Africa Committee on traditional practices, which has a chapter in the US and works with the diaspora in their own communities, so that they know there’s a law, that it is not only illegal to perform FGM here, but it is illegal to take any daughters outside,” Quast said.

In the last two years, genital mutilation — in which parts or all of a girl’s genitals are cut off, often crudely — has been added to the US criteria for assessing the human-rights practices of countries worldwide in the annual State Department’s global rights survey. The cutting is often linked to a belief that it will make the girls — most of them under 9 or 10 years old — fit for marriage to men who demand obedient wives stripped of their sexuality.

“What we’ve found is that forced marriage and FGM are often very much interrelated,” Quast said in an interview with PassBlue. “We see a great connectivity in our work in Africa and other parts of the world.” Equality Now has a regional office in Nairobi and partnerships with local organizations across Africa, where the practice of FGM is found to one degree or another in 29 countries.

Although female genital mutilation takes place elsewhere in the world, including in the Middle East, the top 10 countries whose migrants have brought the practice to the US are all African. Egypt, Ethiopia and Somalia have the highest figures, according to research by the Population Reference Bureau, a Washington-based organization that analyzes demographic data and disseminates information internationally.

The three urban areas where girls and young women are most at risk in the US live in and around New York City, Washington, D.C., and Minneapolis-St. Paul, a February 2015 Population Reference Bureau report found.

The case that received the most attention was the first to be prosecuted, when an Ethiopian was convicted in Atlanta of mutilating his daughter and sentenced in 2006 to a 10-year prison term. Since then, Quast said, “There haven’t really been prosecutions, and I think that’s one of the discussions we’re having.”

She said that there have been scattered reports of cases or potential cases, some involving physicians. But concerted action to find and prosecute those who perform the procedure has been missing, although a government task force has been created to work on the situation and the Centers for Disease Control and Prevention studied the rising incidence in 2014. The results of that survey have not yet been released publicly.

“There is now a [US] Department of Justice unit set up,” Quast said. “They would very much like to take this forward, but for a lot of reasons it’s not really discussed openly, so they have not had prosecutions.”

Quast and others from Equality Now and similar organizations have met with several departments of government and members of Congress and have written directly to President Obama asking for more action. Advocates say that pledges made during the first international Girls Summit, held in London in July 2014 and sponsored by the British government and Unicef, have not been followed up.

In the US, where immigrant communities may be reluctant to report cases of genital mutilation, Quast said, community health workers, obstetricians and gynecologists who see affected women, as well as teachers in schools with African immigrants can all play a part in raising awareness.

“When we first went into the Department of Education, they said, ‘We’re not sure why you’re here,’ ” Quast said. “And we said: ‘Because you have a huge role.’ Most girls are aware when there’s something going on, when there’s a ceremony, when there are discussions about a big trip. Or they’ve heard of classmates that have come back. Teachers need not only to be aware of the issue but what to do when they learn about it. Who do they call? What services do they provide? Is there a mechanism for protective orders for young girls?”

Quast said that because securing protective orders is a complex process and that genital mutilation has to be defined as violence in each state, advocates ask if there might be another way to make protection “more readily available to a girl of 10 or 12 who is pretty certain this is going to happen and wants to put her family on notice.”

In many cases, parents are unaware that genital mutilation is now criminal and would not want to risk having their status in the US affected by subjecting their daughters to the practice.

“Girls have rights,” Quast said.

It is encouraging to see young women among African immigrants and asylum seekers — many fleeing their home countries to avoid the practice — vow never to allow their families to participate in the harmful ritual, Quast said. “There’s a youth movement. Many young women and girls are saying, I won’t let them cut my daughter; I can live in this society and not have this done.”

Barbara Crossette

Barbara Crossette is the senior consulting editor and writer for PassBlue and the United Nations correspondent for The Nation. She is also a member of the Council on Foreign Relations. She has also contributed to the Oxford Handbook on the United Nations.

Previously, Crossette was the UN bureau chief for The New York Times from 1994 to 2001 and previously its chief correspondent in Southeast Asia and South Asia. She is the author of “So Close to Heaven: The Vanishing Buddhist Kingdoms of the Himalayas,” “The Great Hill Stations of Asia” and a Foreign Policy Association study, “India Changes Course,” in the Foreign Policy Association’s “Great Decisions 2015.”

Crossette won the George Polk award for her coverage in India of the assassination of Rajiv Gandhi in 1991 and the 2010 Shorenstein Prize for her writing on Asia.