FGC has been documented in individuals from many religions, including Christians, Muslims, and Jews.5 The relationship of FGC and Islam is complex and controversial. Some of the most conservative Islamic societies, such as Saudi Arabia, do not practice FGC, whereas in some African settings, the primary motivation seems tribal and nationalistic rather than religious.16 For many Muslim religious scholars, male circumcision is considered obligatory, whereas some form of female "circumcision" is considered optional but virtuous.17 Across nations and cultures that practice FGC, the perception that it is religiously obligated or at least encouraged is ubiquitous.5
Kopelman18 summarized 4 additional reasons proposed to explain the custom of FGC: (1) to preserve group identity; (2) to help maintain cleanliness and health; (3) to preserve virginity and family honor and prevent immorality; and (4) to further marriage goals, including enhancement of sexual pleasure for men. Preservation of cultural identity was noted by Toubia19 to be of particular importance for groups that have previously faced colonialism and for immigrants threatened by a dominant culture. FGC is endemic in many poor societies in which marriage is essential to women's social and economic security. FGC becomes a physical sign of a woman's marriageability, with social control over her sexual pleasure by clitorectomy and over reproduction by infibulation (sewing together the labia so that the vaginal opening is about the width of a pencil).
When parents request a ritual genital procedure for their daughter, they believe that it will promote their daughter's integration into their culture, protect her virginity, and, thereby, guarantee her desirability as a marriage partner. In some societies, failure to ensure a daughter's marriageable status can realistically be seen as failure to ensure her survival.20 It is tragic that the same procedure that made the daughter marriageable may ultimately contribute to her infertility.21 Parents are often unaware of the harmful physical consequences of the custom, because the complications of FGC are attributed to other causes and are rarely discussed outside of the family.22 Women from developing countries who are advocates for children's health have differing perspectives on how to respond to FGC. Some activists put the campaign against FGC at the center of their work, but others complain that the West's obsession with FGC masks an indifference to children's suffering caused by famine, war, and infectious disease.23