A doctor in the US city of Detroit has been charged with carrying out female genital mutilation (FGM) on young girls in what is believed to be the first case of its kind in the country.
Prosecutors said Jumana Nagarwala had been performing the practice on girls aged between six and eight for 12 years.
She was investigated after the authorities received a tip-off.
If found guilty, she faces a maximum sentence of life in prison.
FGM was made illegal in the US in 1996.
In a voluntary interview with investigators earlier this week Dr Nagarwala denied being involved in any such procedure, local media reported.
But prosecutors said she had performed "horrifying acts of brutality on the most vulnerable victims".
Some travelled to her practise from outside the state of Michigan and were told not to talk about the procedure, they added.
Dr Nagarwala appeared in a federal court in Detroit and was remanded in custody.
"Female genital mutilation constitutes a particularly brutal form of violence against women and girls. It is also a serious federal felony in the United States," acting US attorney Daniel Lemisch said.
"The practice has no place in modern society and those who perform FGM on minors will be held accountable under federal law."
The first recorded case of FGM in the US was in 2006, when an Ethiopian immigrant was jailed for 10 years for aggravated battery and cruelty to children for mutilating his two-year-old daughter five years earlier with a pair of scissors.
In 2012 the US authorities said more than 500,000 women and girls in the country had either been subjected to FGM or were at risk of it.
About 200 million girls and women around the world have suffered some form of FGM, the UN says, with half living in Egypt, Ethiopia and Indonesia, the UN says.