The world is silent on female genital mutilation (FGM). Race plays a role.

It happened to three sisters under 18 in Egypt. And 7-year-olds in Michigan. For "Real Housewives of Dubai" star Chanel Ayan, it happened in Kenya.

"I was tricked when I was 5 years old," Ayan tells USA TODAY. She and her older sister survived female genital mutilation and were circumcised as children, the model first revealed to a therapist during an emotional hypnotherapy session on a recent "Housewives" episode.

Over 200 million women and girls in more than 30 different countries have lived through female genital mutilation (FGM), according to the United Nations International Children's Emergency Fund. Cutting a girl or woman's genitalia for non-medical reasons, especially without their consent, is tantamount to sexual assault and abuse, and despite religious and cultural traditions, experts say the practice must end.

What is FGM? Where and why does it happen?

Female genital mutilation (FGM) is rooted in traditional beliefs and multiple religions, and involves cutting and/or sewing a girl or woman's genitals usually for the purpose of preserving her chastity.

Though most of the focus of FGM has been on African countries, experts say people should know it happens worldwide, including in the U.S. It's sometimes carried out in American medical clinics under the supervision of licensed doctors.

"It is in fact happening all over the world in every continent except Antarctica," says Divya Srinivasan, a legal advisor for Equality Now. "It happens across religions, cultures and communities, so one of the main drivers behind the practice is rooted in gender inequality and it's aimed at controlling women's sexuality."

'Real Housewives of Dubai' star ChanelAyan says she survived female genital mutilation at 5

Chanel Ayan talks her FGM experience

Ayan's experience with FGM began when her grandmother and aunt came to pick her and her sister up under the guise of an ordinary family visit. They even had pancakes and she was having a pleasant time, the model recalls, until the next morning she was woken up and taken to a stranger's house.

"I was tied down with no anesthesia and then I was sewn," Ayan recalls of her experience. "It's barbaric. It's torture. It's child abuse. Why are you taking a 5-year-old girl that has no power and do that to them?"

What about culture and religion?

Cutting is such an ingrained practice in communities that it becomes normalized as a part of life.

The "Real Housewives of Dubai" star says she never planned to share her experience with FGM.

"I still know that it's a normal thing in my culture," Ayan, who is a Kenyan-born Somali, says. "I still know that this happens today … but I was always thinking, 'You know what? This is who we're supposed to be, this is supposed to be done to us, maybe this is the way it's supposed to be.'" Ayan was a menstruating teenager when she realized this wasn't "normal."

Adeyinka Akinsulure-Smith, professor of psychology at the City College of New York, has cared for patients at the Bellevue Program for Survivors of Torture since 1999. She's learned through her research that though it may be difficult to fathom, in certain cultures this is a way the elder women, with the approval of men, believe they are protecting their girls.

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"It can be an act of love, it can be an act of culture passing the heritage on. And as a service provider it's one of the things we have to understand," she says. "I have clients that I've worked with who've said, 'I'm not mutilated, this is a source of pride for me'."

Ayan's story is fairly relatable to millions of women across the world. Leyla Hussein, a psychotherapist and founder of The Dahlia Project, can understand why people can be conditioned to believe FGM is "normal."

"As a survivor myself … I grew up in that environment where you're told this is your culture … it's your religion," Hussein says. "So you really don't have the space to say anything and now you feel terrible for even acknowledging this is violence."

Why is FGM still happening around the world?

Hussein attributes FGM's connection with culture and religion as one of the reasons people fail to condemn it. The fear of offending one's culture or religion becomes greater than protecting young girls, Hussein says.

"I actually refuse to have a conversation about religion and culture when we're talking about FGM. If this was happening to white girls, it'd be a really crazy outrage. It's important to question people why they even hold that bias," Hussein says. "The world is silent on this because it's happening to mainly Black, African girls. It's not a cultural practice, it's not a religious practice we just hold different views on how Black girls should be protected versus white girls."

Though some people may argue that FGM is connected to religious practices, mainly Islam, Ayan, who is Muslim herself, and experts challenge that notion. Though the practice is notoriously associated with Islam, FGM also happens in Christian and Jewish communities as well, according to Building Bridges to End FGM, but is not mentioned in their holy texts.

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"I'm a Muslim. I grew up in a Muslim household. I know what the Quran says so I can call you out on your (expletive)," Hussein says.

"This is not a Muslim thing," Ayan says. "Because there's nowhere in Islam that says this should be done to any woman."

The trauma surrounding FGM

FGM causes both psychological and physical trauma that varies from depression and shame to sexual dysfunction and post-traumatic stress disorder, experts say. Aside from the actual procedure sometimes resulting in death, Srinivasan adds it can also cause "excessive bleeding, hemorrhaging, pain and urinary tract infections."

Hussein notes that FGM survivors can experience severe PTSD during typical vaginal exams and will "find it extremely traumatic. It's the same thing for women who experience sexual assault."

The trauma happens regardless of the severity of the type of FGM the woman survives, Hussein says. The World Health Organization classifies FGM under four different types that vary from Type 1, which is "partial or total removal of the clitoral glans" to Type 4 which includes "all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping and cauterizing the genital area."

"I always say to people, don't focus on the type. It's the act of being pinned down, your legs being spread apart. And this is being done by people you trust the most, so you lose trust in people. So you constantly can never trust anyone 100%," Hussein says.

How do we stop FGM and what role do men have in it?

Ayan hopes educating people and speaking out can help change ideologies around a woman's sexuality, therefore stopping FGM.

"If the girls don't want to be virgins it's OK. I have friends who weren't virgins and they're married and they're happy with families and kids. I've been a virgin until I was married … and I'm still happy. So does it really matter?" Ayan asks.

Hussein says stopping FGM requires a systemic restructuring to one that isn't based in patriarchal ideals.

"We need to become a society that actually respects women and their bodies," Hussein says, using the U.S. decision to overturn Roe v. Wade as a prime example of America prioritizing religion over women's bodies. "If the system is never built to protect the women and children, there's no point of me running workshops every day saying FGM is wrong because the system allows for this to happen."

She adds public outrage also pushes governments to act. "First of all it's a violent act …it's not something that's happening to a small number of people and even if it's happening to one girl we should be outraged," Hussein says.

Akinsulure-Smith says men have power and can have a huge role in helping stop the practice. She implores men to also ask themselves what it would be like for them to have sex with a woman who's in constant pain and distress when being intimate.

"Do you want every time you go and try to engage sexually with your wife for her to burst into tears? It creates distress on the relationship, it creates distress on the individual as well," Akinsulure-Smith says.

The Ayaan Hirsi Ali Foundation offers a 24-hour, free anonymous crisis help text line to girls and women who've undergone FGM, who fear they are in danger of genital mutilation, or who face honor violence or forced marriage. Text FREE to 741-741.

This article originally appeared on USA TODAY: Female genital mutilation: Chanel Ayan shares story; why FGM persists