Many of the countries where cutting occurs are predominantly Muslim, but it would be wrong to say the religion is somehow at fault. There are Muslims around the world who abhor the practice, and it is often linked to other ethnic and social traditions unique to different regions. According to the UN, organizations that have encouraged people to abandon the practice "not as a criticism of local culture but as a better way to attain the core positive values that underlie tradition and religion, including 'doing no harm to others'" have had some luck in limiting the procedure.
"We have found that, addressed in this way, efforts to end [female genital mutilation] contribute to the larger issues of ending violence against children and women and confronting gender inequalities," reads the report.
Gerntholtz says that ending social ostracism is where civic organizations can come in.
Organizations need to let women know about specific imams, for example, who have disavowed the practice, so they don't see it as something absolutely required by their religion.
They also need to talk about the health consequences, Gerntholtz said, including to mental health.
But "women feel very strongly that they have to cut, that it is a religious obligation," she said, adding that convincing women to abandon a practice they see as so intrinsic to womanhood in cultures that value girls as wives and mothers above all else is complicated.
Women in these countries are not given the same political or educational opportunities as men. They hold very little power, and even when they want to end the cycle of mutilation, they face the prospect of being cast out if they resist. Some women fear that if they do not have their girls cut, they will be "unsuitable" for marriage, which would doom them to a life of ostracism and poverty in many places. Without education or means to support themselves, women are stuck in a vicious cycle of poverty and oppression.
To end female genital mutilation, Gerntholtz said, governments and nonprofits and other entities have to work together to broadly increase the status of women in these countries, and that's a complex, deep problem.
Education could draw women into the labor market, which could weaken traditional family structures. The report notes that women might be seen as desirable partners for their ability to contribute to household income, which might reduce what some see as the need for cutting. School can also expose girls to people from different cultures and to mentors who might oppose the practice. While many girls have been cut by the time they reach school, they may be more likely to not continue the cycle with their own daughters.
Educating men and boys about the dangers of cutting is important, too. And the report found that many men, like women, want the practice to end but feel they have to subject their daughters to it for social reasons.
Ultimately, as many as 30 million girls face genital mutilation in the next decade, but there is some hope.
"If, in the next decade, we work together to apply the wealth of evidence at our disposal, we will see major progress," Geeta Rao Gupta, deputy executive director of UNICEF, wrote in the report's foreword. "That means a better life and more hopeful prospects for millions of girls and women, their families and entire communities."