When "Sarah" first told her story, she did not want to show her face or give her real name. The American-born woman underwent female genital mutilation (FGM), also known as female genital cutting (FGC), when she was 7 years old.
In 2015, ABC News interviewed Sarah, obscuring her face for privacy, and giving her a pseudonym.
“I remember feeling pain,” Sarah had told ABC News. “I was crying, so I was scared during it because it hurt.”
In 2016, the 33-year-old decided to reveal herself publicly on camera.
“It’s definitely scary to come out with my face on camera,” Mariya Taher told ABC News. “I don’t want to be judged for having undergone female genital cutting, or viewed as a victim.”
There are four types of FGC/M, according to the World Health Organization. They range in severity, from removing parts of a woman’s genitals to sealing closed the vaginal opening (also known as infibulation). According to the organization, side effects range from bleeding and infections to complications with childbirth and increased risk of death for newborns.
The origins of FGC/M are unclear. But experts say the ancient practice is not officially linked to religion in any way. It’s done for a variety of reasons, with supporters saying it carries on tradition, protects a woman’s honor and ensures she will stay a virgin until marriage. In some places a woman can’t get married unless she has undergone the procedure.
“This is something that is viewed as child abuse, and it’s something that is happening to a girl that doesn’t have the capacity yet to consent to it," Taher said.
PHOTO: Mariya Taher, 33, underwent female genital cutting/mutilation when she was 7 years old. Olivia Smith/ABC News
Mariya Taher, 33, underwent female genital cutting/mutilation when she was 7 years old.
Taher lives in Cambridge, Massachusetts, and is “trying to work to stop the practice of female genital cutting from continuing.”
As a child, Taher underwent what is called “vacation cutting,” which is the act of sending a child abroad to have FGC/M performed. Taher was visiting her relatives in Mumbai, India, with her family when her mother took her to have the procedure done.
“I remember being taken to an old-looking building and going up a flight of stairs and going into the apartment building,” Taher said. “I remember being put on the ground and my dress was pulled up, and I remember something sharp cut me."
FGC/M is not just occurring abroad. This year the Centers for Disease Control and Preventionestimated that the number of women and girls who may have undergone the procedure in the past, or may be at risk for undergoing the procedure in the future, more than tripled in the U.S. from 2000 to 2013. The agency found more than 500,000 women and girls in America may be at risk in their lifetime.
“[That is] three-fold higher than the last time we did a similar estimate in the ‘90s, and in fact, four-fold higher in girls under the age of 18,” said Dr. Thomas Clark, a medical epidemiologistwithin the CDC’s Division of Reproductive Health.
Officials from various organizations attribute the increase in the U.S. to a combination of factors: an influx of female immigrants who were cut in their homelands, American born females sent abroad for “vacation cutting” and others who undergo the procedure on American soil.
PHOTO: Mariya Taher, 33, underwent female genital cutting/mutilation when she was 7 years old.Olivia Smith/ABC News
Mariya Taher, 33, underwent female genital cutting/mutilation when she was 7 years old.
Performing FGC/M on U.S. soil has been illegal since 1996. A 2013 federal law banned sending children overseas for the procedure.
Taher said her sister underwent FGC/M on U.S. soil.
“I remember her crying. I didn’t see her until after she got it done. At that point I was still in the innocent area like, 'This is something that happens to all of us, and now it’s happened to my sister,'” she told ABC News in 2015.
Shelby Quast, policy director of Equality Now, a legal advocacy organization that fights to protect and promote the human rights of women and girls around the world, said, "In terms of domestic policy [and awareness], there has been some work [done], but there's still a long way to go."
Quast said child protection services and U.S. educators need to learn how to recognize when girls are at risk of FGC/M.
PHOTO: The Massachusetts Female Genital Cutting Task Force is working on legislation at the state level to ban the practice.Olivia Smith/ABC News
The Massachusetts Female Genital Cutting Task Force is working on legislation at the state level to ban the practice.
As a social activist, Taher started an organization called Sahiyo, which works to empower communities to fight female genital cutting through education, collaboration and community engagement. She is also on the Massachusetts Female Genital Cutting Task Force, which is working on legislation at the state level to ban the practice.
“The importance of having a state law is that when something happens in the state, and there’s a crime that happens here, the state has a better ability to deal with it, to prosecute its residents to deal with the health, safety and welfare of its residents,” said Katie Cintolo, an attorney who is also on the task force.
“I wish I hadn’t undergone it, but I think because I did undergo it, I have this passion for gender violence issues that I’m able to be in a place where I can talk about it, I can do research on it...I have an insider’s perspective," Taher said.
ABC News' Luis Yordan contributed to this report.