This article is more about the difficulty Europe is having trying to adapt to immigrant cultures than the specific genital mutilation issue.
They were immigrants to Italy who had been subjected back in Africa to a brutal girlhood ritual, common throughout much of the continent, in which part or all of their external genitalia had been sliced off.
Dr. Abdulcadir treated their infections or inflammation and then, earlier this month, took an unusual step — intended, he said, to protect their daughters from the same fate. He publicly proposed that the hospital where he works let him perform a much less severe version of — or alternative to — female genital cutting.
His goal, he said, was to ease the physical toll of a tradition that was not going away.
"My proposal isn't ideal," he said. "But is there a better answer for how to save the children?"
Health officials in the region of Tuscany are seriously considering that question and have yet to reject his proposal, which he says may prevent immigrants from bringing girls under 10 years old to Africa or to illicit places here for more extreme operations. Opponents have denounced the doctor's proposal, calling it an implicit endorsement of an unacceptable practice.
But as an intense debate plays out in Italy, it encompasses more than a medical issue and touches on the same quandary that France confronts in regard to Muslim head scarves and that other European countries face in other ways.
How far can, and should, Europeans bend to accommodate so many new immigrants with such a wide variety of cultural traditions?
Italians' difficulties in coming up with an answer were reflected in the positions articulated by Cristiana Scoppa, a spokeswoman for the Italian Association for Women in Development, an education and advocacy group.
She adamantly opposes Dr. Abdulcadir's proposal. "It would undermine the fight of hundreds of thousands of women throughout Africa who have said that no form of genital manipulation can be permitted and that it symbolizes a culture that submits women to the control of men," she said.
But she also said she opposed a bill in the Italian Parliament that would explicitly criminalize genital cutting. She said that more general laws against violence covered the situation and that a law against genital cutting would represent "a specific attack against a culture."
Marzia Monciatti, a Florence city official, said certain cultural traditions were at such odds with Italian values that accepting them in any form was impossible.
Genital cutting was one example, she said. Marriages of Romanian Gypsy immigrants in their early teens, which also happen here, was another.
But she said she sympathized with efforts by some Muslim immigrants to have crucifixes removed from classroom walls. That, too, has been the recent subject of fervent debate in Italy, where an estimated 85 percent of the population is at least nominally Roman Catholic.
Public buildings, Ms. Monciatti asserted, "are places where people with diverse origins, cultures and traditions gather." That diversity warranted respect, she said.
Female genital cutting is practiced in more than two dozen African countries, as well as in countries with immigrants from those places.
It has become enough of a concern in Europe that Denmark, Britain and Sweden, for example, have enacted laws that expressly criminalize it. Broader laws in other countries also serve to ban the procedure.
Immigrants who want their daughters to submit to it either return briefly to Africa or have the operation done illegally, outside of a licensed medical setting, said Dr. Abdulcadir and other health officials who have studied the issue.
Dr. Abdulcadir said he did not know how frequently that was happening in Italy because most of the 500 new patients he saw yearly were grown women whose genitals were cut in Africa at least a decade ago. He treats them for menstrual problems, swelling and chronic infections, among other problems.
But he said he did indeed know, from his conversations with those patients, most of whom come from Somalia, that a change in country did not necessarily mean a change of thought.
"Whether they live in Italy or Britain of France or America, they don't want to let go of their traditions," he said as he sat in his office on Monday afternoon. "So I'm trying to give them a way to save that tradition."
He developed his proposed alternative in consultation with immigrants from Somalia, which is also where he was born and reared. Female genital cutting there is widespread, and he said his seven sisters, who now live outside Somalia, were all subjected to it.
That alternative, as he described it, would be a piercing of the tip of the clitoris that would draw just a drop or two of blood and would be largely symbolic. He said he would use a topical anesthetic.
But whether immigrant women would actually use the procedure, which would probably not violate any law, remains unclear.
Several opponents said immigrants who were deeply invested in tradition would probably deem the alternative insufficient, while immigrants who were liberated from that tradition would feel no need for a substitute.
Other opponents said his proposal tacitly approved genital cutting.
"We will teach our daughters that this doesn't have to be done and that's that," said Ghanu Adam, an immigrant from Somalia, at a recent news conference in Florence.
There has been an outpouring of reaction to the doctor's proposal, and the force and range of it partly reflect relatively sudden demographic changes in Italy, whose population of about 57 million includes an estimated 1.5 million legal immigrants and hundreds of thousands of illegal ones.
Italians are still absorbing that reality and sifting through the related challenges, both practical and philosophical.
A front-page article in the Turin daily La Stampa on Jan. 23 asked why a symbolic alternative to genital cutting would validate that practice any more than the symbolic consumption of the body of Jesus at a Catholic Mass would validate cannibalism.
A front-page article in the Rome daily Il Messaggero on Monday mulled the process of cultural integration, concluding that "to consider people as if they were irredeemable prisoners of their customs" was its own kind of offense.
"This is all difficult, very difficult," said Marisa Nicchi, a regional official in Tuscany, in an interview in Florence on Monday. "It condenses many problems, the biggest of which is how two cultures coexist together."