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Today is the annual International Day of Zero Tolerance to Female Genital Cutting. In recent years, laws have gone on the books in a variety of countries forbidding the practice, in many countries rates have decreased and the United Nations passed a resolution condemning it. Still, there remains a lot of work to be done, especially in reforming societal attitudes that contribute to female genital mutilation.

The World Health Organization estimates that 140 million girls and women as young as four years old have been affected by the practice. Though many people associate female genital mutilation with the Middle East and Africa, it occurs even in western countries like Germany, the Jewish Press reports. That can have difficult consequences in countries like Ireland, where 65 percent of physicians could not identify symptoms from women who had undergone the procedure, according to Irish Health.

The term "female genital mutilation", or any of its iterations like "female genital cutting" and "female circumcision", applies to procedures that alter the female genital organs for non-medical reasons. There are various kinds, which range from pricking to removing the woman's clitoris and/or labia. The practice, which has no health benefits, and cause hemorrhaging, urine retention and open sores in the short term, and cysts, infertility and increased risk of childbirth problems. The practice may even cause death. Worse, because the procedure is often performed without the use of sterile instruments or anesthetic, many risk infection or bleeding to death.

Because of inroads made by activists against the procedure, the rate of female circumcision has decreased. According to the Christian Science Monitor, 36 percent of girls between the ages of 15 to 19 have been cut. Comparatively, 53 percent of women between the ages of 45 to 49 have had the procedure done. There are outliers though; in Guinea Bissau, 90 percent of women have undergone female genital cutting.

The practice is knotted with a variety of social and economic norms. In portions of Uganda, for example, circumcised women enjoy economic liberties - like milking cows - that uncircumcised women do not. Women who perform the procedure earn $30 per girl, a hefty sum in countries like Uganda, where the average income is $300 a year. Some men will not marry uncircumcised women, which can make life difficult in communities that scorn unmarried women, according to All Africa. Even if uncircumcised women are married, cultural folklore states that an uncircumcised woman will suffer from a variety of illnesses.

Various efforts are underway to change public attitudes to the practice. They include raising awareness and educating governments and communities.