Chastity can exact a painful price from young Muslim women, who are forced into lies or surgery to go to the marriage bed as virgins.
Hymen repair, fake virginity certificates and other deceptions, said to be commonplace in some Muslim countries, are practiced in France and elsewhere in Europe, where Muslim girls are more emancipated but still live under rigid codes of family honor.
Such ploys have saved many young women from scorn and worse. But they also clash with the more liberal social mores of Europe, where some perceive an attack on human rights.
The procedures are legal but shrouded in silence -- "something that passes through nonofficial channels," via friends or the Internet, said Dr. Nathan Wrobel. "There are circuits that lead women to me."
Wrobel is one of an unknown number of gynecologists in France who will repair hymens, the membrane usually broken by the first act of sexual intercourse.
Wrobel says women convince themselves that the procedure will somehow reverse the irreversible. "They tell me, 'I'll be a virgin again. You will make me a virgin,' which in reality is totally false.... It's a secret we share."
Other doctors issue false virginity certificates or offer such tricks as spilling a vial of blood on the sheets to fool families into believing the bride has passed their purity bar.
Through the ages, virginity has been prized across religions and cultures, and doctors note that only a few generations back European brides also had to furnish "proof" of chastity.
In today's France, with an estimated 5 million Muslims, it's part of the larger question of how to deal with cultural clashes over such issues as head scarves in schools and sexual segregation in swimming pools.
A 2005 government report addressing culture clashes in hospitals, issued a year after Muslim head scarves were banned from classrooms, mentions the virginity issue, asking doctors to refuse to issue false certificates.
Isabelle Levy, author of "Religion in the Hospital," decries certificates and hymen repair, saying deception "increases the moral suffering."
In Islam, virginity is linked to bridal purity and family honor, said Dalil Boubakeur, head of the Paris Mosque. He notes that tradition holds that "adre," virgins, are among the delights of paradise. However, as a doctor and a moderate Muslim, he says the Koran does not address premarital virginity. He opposes deception, counseling bride and bridegroom to confide in each other.
It is not known how many doctors in Europe help Muslim women to fake virginity. But in Germany, Turkish Muslim immigrants are increasingly seeking virginity certificates, said Serap Cileli, who survived a forced marriage and now helps victims.
German doctors who do hymen repair are easy to find, according to Sibylle Schreiber, who works with a women's rights group in Tuebingen, but it's "a taboo topic really only discussed best friend to best friend."
Not on the Internet, however, where the desperation in Web forums is palpable. "If you have contacts to help me, I'll never be able to thank you enough," writes a woman calling herself Lubna who wants help finding someone to restore her virginity.
Wrobel, who teaches at the University of Paris, says he and another doctor at his clinic in a Paris suburb stitch up seven to eight hymens a month in 20- to 30-minute operations under general anesthesia that he likens to plastic surgery. He asked that the clinic not be identified.
The price, $500, is steep for a young woman from a poor family. A German doctor advertising on the Internet charges $1,250.
Dr. Emmanuelle Piet, who heads family-planning clinics in an area north of Paris where many Muslims live, says she has issued half a dozen virginity certificates a year for three decades.
But instead of hymen repair, she suggests less drastic measures, such as spilling blood on the sheet on the wedding night. It's deceptive but "it's one way to help the girls," said Piet, a women's rights advocate. "They are stuck in things so terrible."
In an interview, a French Muslim woman from Saint Denis recounted how she had to procure a virginity certificate at age 12 after her mother caught her with a friend. Although nothing had happened with the boy, her suspicious brothers beat her up, she said, requesting anonymity.
By age 19, she had lost her virginity, and underwent hymen repair before marrying a man who demanded a virgin. "I wanted to leave home. I took the first one who came along," she said. The marriage ended after five years.
AP correspondents Claire Levenson in Paris and David McHugh in Berlin contributed to this report.