In the 21st century— yes, in today’s world— there are tens of millions of teenage girls who are getting forced to have their genitalia mutilated under the most inhumane conditions.

Female genital mutilation (FGM), or “cutting,” is a practice that gives credit to the fact that if you take a knife and you cut off portions of a female’s vagina, the desired end results are that the woman would have less of a sexual appetite, would be a better mate for her husband, and that her husband would have stronger sexual pleasure. The practice is meant to mark a girl’s passage to womanhood or to prepare her for marriage.

These girls and women are often pinned down by multiple people, or they are demanded to lie down and just endure the pain. During this modern form of human torture, untrained practitioners will cut them up with scissors, knives, razor blades or crude pieces of glass.

If that is not the definition of sickness, I don’t know what is.

FGM still affects women in many parts of the world, primarily in Africa and the Middle East, but it also affects those living in westernized regions. Case in point, a report completed in 2014 by London’s City University and the NGO Equality Now, and that is gaining traction online now, shows that an estimated 137,000 women and girls— from infancy to at least age 50 who were permanent residents in England and Wales in 2011— have experienced this brutality.

According to the report, most cases reside in London boroughs, with 47.4 per 1,000 women in Southwark, in the south, as well as 38.9 per 1,000 in Brent, in the northwest. In England and Wales, an estimated 0.5 percent of women have been  victims of the practice.

The U.K. Department of Health found that nearly 4,000 new cases of FGM were reported between September 2014 and March 2015, and that 60 of them were girls under age 18. Since 2008, the country estimates that women who underwent FGM comprised about 1.5 percent of all women giving birth in England and Wales annually. While some women are apparently being flown abroad to get “cut,” it may be that the practice is occurring within the country too.

Shockingly, this practice also affects females living in the United States: According to research published this year by the Population Reference Bureau, the number of women and girls in the U.S. who have undergone FGM or are at risk of facing this brutality has more than doubled since 2000 to more than half a million. That’s despite the fact that the U.S. government banned FGM in 1996, and passed legislation in 2012 that outlaws shipping women overseas to undergo FGM. Since 2014, 24 out of 50 states have also passed laws prohibiting FGM. Now, activists are calling for the remaining states to also take action.

No matter the country, this primitive, torturous act must be stopped, criminalized and heavily prosecuted.

According to UNICEF, FGM has been practiced for nearly 1,000 years. Today it is concentrated in 29 countries, including in Somalia, Guinea, Djibouti and Egypt— where more than nine out of 10 females ages 15 to 49 are being cut.

The potential dangers involved in this inhumane act can either kill or permanently cripple a woman’s life, from creating excessive scar tissue, bladder problems and chronic nerve issues— not to mention infection, fistulas that can develop, and emotional pain. FGM also directly affects the children these women bear: A 2006 World Health Organization (WHO) study found that FGM leads to an extra one to two perinatal deaths per 100 deliveries. As FGM rages on in many parts of the world, that number may be even higher today.

It boggles my mind that the parents of these girls today— and especially so in a westernized places like the U.S. and the U.K.— would continue to even contemplate, much less perform, this practice. Unfortunately, for the young women, this traumatizing experience is so scary that many of them can’t even talk about it, but rather they internalize their pain, which ultimately affects their daily lives.

I know that many teachers and police officers are looking at ways to identify victims, but it’s not an easy task. For many women, this personal tragedy is a secret that they will keep for the rest of their lives. But it has to stop somewhere, for the sake of these young women’s emotional and physical health— as well as for the sake of their unborn children.

UNICEF predicts that FGM will affect 30 million girls worldwide within the next eight years. If the rates of decline seen over the past three decades don’t improve, an estimated 63 million more girls could be cut by 2050. Thus far, 41 countries, including the U.K., have outlawed the practice.