A debate is raging among doctors over Muslim women who ask for operations to reconstitute their hymens before marriage, and medical certificates stating they are virgins. This has become a very hairy situation.
The controversy has flared in France, where gynaecologists say they are facing a growing number of requests from women desperate to avoid the repudiation that can follow the loss of chastity.
The phenomenon, which is also dividing doctors in other European countries, the US and Africa, is denounced by critics as a sign of social regression driven by Islamic fundamentalists.
Jacques Lansac, chairman of the French National College of Gynaecologists and Obstetricians, is leading the campaign against what he describes as "an attack on the dignity of women".
He has also issued advice against hymenoplasty – a surgical operation that involves reconstructing the membrane usually broken during the first act of sexual intercourse.
"We get more and more women coming in and saying that their brothers or fathers will kill them if they find out they’ve slept with a man. But it’s important to say no, because if we don’t we’re giving in to the fundamentalists," Professor Lansac said.
However, he said some doctors were ignoring his advice in the hope of protecting patients from being ostracised or beaten.
Isabelle Levy, an author who studied the issue for her book Religion in the Hospital, said the search for chastity certificates and hymenoplasties stemmed from conflicting pressures among France’s five million Muslims.
"On the one hand, young Muslim girls born in France go out a lot more than they used to," she said.
"They are modern and they have adventures like other Europeans – which never happened in the past.
"But on the other hand, fundamentalism is spreading and these girls are getting sent back to their countries of origin to marry. And they will be rejected if it is found out that they are not virgins."
The plight was evident from the account of one woman of North African origin on a French internet chat forum.
She slept with her boyfriend because "he said that he was mad about me and wanted to marry me and I believed him because I was madly in love with him". But he left her when she fell pregnant.
The woman had an abortion, which she kept secret from her family until her mother discovered a letter from the clinic.
"I fainted and afterwards it was total despair – tears, insults, blows, disappointment and finally a dressing-down. She has asked her gynaecologist to redo her hymen because she says that ‘if not, it will ruin my future’."
Several private French clinics carry out hymenoplasties. But some doctors agree to undertake the operation in public hospitals, where it is funded by the welfare state, a practice that is not in theory authorised by officials.
Stephane Saint-Leger, head of gynaecology at Aulnay-sous-Bois hospital refuses virginity certificates because "it’s not a medical problem, whether you’re a virgin or not".
While some doctors will not sign virginity certificates because it is not a medical problem, others will.
Jacques Milliez, head of the department of gynaecology and obstetrics at Saint-Antoine hospital in Paris, said: "I worked in Algeria as a junior doctor and when I was on call at night I saw these young women whose throats had been slit because they were suspected of having lost their virginity. So if someone asks me, I sign the certificate."