In Phoenix, Arizona, a staggering 98 percent of Somali women being treated at the Refugee Women’s Health Clinic have been circumcised, founder Dr. Crista Johnson said. She estimates the Somali community is at least 12,000-strong.

Johnson has supported such victims all over the country – from Washington,D.C., to Michigan to California – and says the spike in immigration from such communities has been astonishing in recent years.

“The number has easily quadrupled because of migration patterns,” she added.

So with such numbers, why has there only been one successful prosecution in the U.S.?

“People won’t report against their families,” Marie said. Since the mutilation is usually organized by the child’s mother or grandmother and supported by the father, many cases go unreported, case workers say.