Genital modification and mutilation
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Genital modifications are forms of body modifications applied to the human sexual organs, including invasive modifications performed through genital cutting or surgery.<ref name=Cosmeticmalegenitalsurgery2023/> The term genital enhancement seem to be generally used for genital modifications that modify the external aspect, the way the patient wants it.<ref name=Cosmeticmalegenitalsurgery2023>Template:Cite journal</ref> The term genital mutilation is used for genital modifications that drastically diminish the recipient's quality of life and result in adverse health outcomes, whether physical or mental.<ref name=Cosmeticmalegenitalsurgery2023/>
ReasonsEdit
Body modificationEdit
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VoluntaryEdit
Many types of genital modification are performed at the behest of the individual, for personal, sexual, aesthetic or cultural reasons.<ref name=Cosmeticmalegenitalsurgery2023/>
Social acceptance for male intimate cosmetic surgery seem to have happened around the 2010s, decades after other types of cosmetic surgeries.<ref name=Cosmeticmalegenitalsurgery2023/>
Penile subincision, or splitting of the underside of the penis, is widespread in the traditional cultures of Indigenous Australians.<ref name="expressmilwaukee"/> This procedure has taken root in Western body modification culture, the modern primitives.<ref name="expressmilwaukee"/> Meatotomy is a form that involves splitting of the glans penis alone, while bisection is a more extreme form that splits the penis entirely in half.<ref name="expressmilwaukee"/>
Genital piercings and genital tattooing may be performed for aesthetic reasons, but piercings can have the benefit of increasing sexual pleasure for the pierced individual or their sex partners.<ref>Template:Cite journal</ref><ref name="expressmilwaukee">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>
Similarly, pearling involves surgical insertion of small, inert spheres under the skin along the shaft of the penis for the purpose of providing sexual stimulation to the walls of the vagina.<ref name="expressmilwaukee"/> Similar to tattooing, genital scarification is primarily done for aesthetic reasons by adding decorative scars to the skin.<ref name = "piercing and tattoos"/> The genital decoration by scars is an ancient tradition in many cultures, both for men and women.<ref name = "piercing and tattoos">Template:Cite journal</ref>
Clitoris enlargement may be achieved temporarily through the use of a clitoral pump, or it may be achieved permanently through the application or injection of testosterone.<ref name = "piercing and tattoos"/> Penis enlargement is a term for various techniques used to attempt to increase the size of the penis, though the safety and efficacy of these techniques are debated.<ref name = "piercing and tattoos"/>
Gender-affirming surgeryEdit
{{#invoke:Labelled list hatnote|labelledList|Main article|Main articles|Main page|Main pages}} People who are transgender may undergo gender-affirming surgery to alter their genitals to match their gender identity. Not all transgender people elect to have these surgeries.<ref name = "Neither Man nor Woman"/>
Some of the surgical procedures are vaginoplasty (creation of a vagina) and vulvoplasty (creation of a vulva) for trans women and metoidioplasty (elongation of the clitoris), phalloplasty (creation of a penis), and scrotoplasty (creation of a scrotum) for trans men.<ref name = "Neither Man nor Woman"/> Trans women may also benefit from hair removal and facial feminization surgery, while some trans men may have liposuction to remove fat deposits around their hips and thighs.<ref name = "Neither Man nor Woman"/> Hijra, a third gender found in the Indian subcontinent, may opt to undergo castration.<ref name = "Neither Man nor Woman">Template:Cite book</ref> In some cases, a child's gender may be reassigned without their consent due to genital injury, including David Reimer, who was the subject of John Money's John/Joan case.<ref>Template:Cite journal</ref>
NontherapeuticEdit
The following types of unvoluntary genital cutting or surgery can be done on children, for nontherapeutic (medically unncessary) reasons:<ref name=BCBI2024>Template:Cite journal</ref> clitoral reduction surgeries on children with CAH,<ref name=BCBI2024/>Template:Rp hypospadias surgeries,<ref name=BCBI2024/>Template:Rp removal of internal gonads<ref name=BCBI2024/>Template:Rp and penile circumcision.<ref name=BCBI2024/>Template:Rp In some societies, other types of endosex girl genital cutting happen.<ref name=BCBI2024/>Template:Rp They can be done for psychosocial, cultural, subjective-aesthetic, or prophylactic perceived benefits, as judged by doctors or parents.<ref name=BCBI2024/>Template:RpTemplate:RpTemplate:Rp
OppositionEdit
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IntersexEdit
{{#invoke:Labelled list hatnote|labelledList|Main article|Main articles|Main page|Main pages}} Intersex children and children with ambiguous genitalia may be subjected to surgeries to "normalize" the appearance of their genitalia.<ref name=":0"/>
These surgeries are usually performed for cosmetic benefit rather than for therapeutic reasons.<ref name=":0">"David Reimer, 38, Subject of the John/Joan Case" The New York Times, New York, US, Published May 12, 2004</ref> Most surgeries involving children with ambiguous genitalia are sexually damaging and may render them infertile.<ref name = "Brief on Intersex Genital Surgery">ISNA's Amicus Brief on Intersex Genital Surgery The Intersex Society of North America, Dated February 7, 1998</ref> For example, in cases involving male children with micropenis, doctors may recommend the child be reassigned as female.<ref>Karen S Vogt, MD, Michael J Bourgeois, MD, Arlan L Rosenbloom, MD, Mary L Windle, PharmD, George. P Chrousos, MD, FAAP, MACP, MACE, FRCP, Merrily P M Poth, MD, Stephen Kemp, MD, PhD Microphallus: Epidemiology Medscape, Updated August 3, 2011</ref> The Intersex Society of North America objects to elective surgeries performed on people without their informed consent on grounds that such surgeries subject patients to unnecessary harm and risk.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>
As sexual violenceEdit
Genital mutilation is common in some situations of war or armed conflict, with perpetrators using violence against the genitals of men, women, and non-binary people.<ref name = "Homosexualization">Template:Cite journal</ref> These different forms of sexual violence can terrorize targeted individuals and communities, prevent individuals from reproducing, and cause tremendous pain and psychological anguish for victims.<ref name = "Homosexualization"/>
As treatmentEdit
If the genitals become diseased, as in the case of cancer, sometimes the diseased areas are surgically removed.<ref name = "Pediatric surgery: diagnosis and management"/> Females may undergo vaginectomy or vulvectomy (to the vagina and vulva, respectively), while males may undergo penectomy or orchiectomy (removal of the penis and testicles, respectively).<ref name = "Pediatric surgery: diagnosis and management"/> Reconstructive surgery may be performed to restore what was lost, often with techniques similar to those used in gender-affirming surgery.<ref name = "A Practical Guide to Office Gynecologic Procedures"/>
During childbirth, an episiotomy (cutting part of the tissue between the vagina and the anus) is sometimes performed to increase the amount of space through which the baby may emerge.<ref name = "Pediatric surgery: diagnosis and management"/>
Hymenotomy is the surgical perforation of an imperforate hymen.<ref name = "Pediatric surgery: diagnosis and management"/> It may be performed to allow menstruation to occur.<ref name = "A Practical Guide to Office Gynecologic Procedures"/> An adult individual may opt for increasing the size of her hymenal opening, or removal of the hymen altogether, to facilitate sexual penetration of her vagina.<ref name = "Pediatric surgery: diagnosis and management">Template:Cite book</ref><ref name = "A Practical Guide to Office Gynecologic Procedures">Template:Cite book</ref>
Self-inflictedEdit
{{#invoke:Labelled list hatnote|labelledList|Main article|Main articles|Main page|Main pages}} A person may engage in self-inflicted genital injury or mutilation such as castration, penectomy, or clitoridectomy.<ref name=Cosmeticmalegenitalsurgery2023/> The motivation behind such actions vary widely; it may be done due personal crisis related to gender identity, mental illness, self-mutilation, body dysmorphia, or social reasons.<ref name=Cosmeticmalegenitalsurgery2023/>
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FemaleEdit
Female genital mutilationEdit
{{#invoke:Labelled list hatnote|labelledList|Main article|Main articles|Main page|Main pages}} Female genital mutilation (FGM), also known as female genital cutting (FGC), female circumcision, or female genital mutilation/cutting (FGM/C), refers to "all procedures involving partial or total removal of the external female genitalia or other surgery of the female genital organs whether for cultural, religious or other non-therapeutic reasons."<ref name = "Definition ">Definition of the World Health Organization</ref> It is not the same as the procedures used in gender-affirming surgery or the genital modification of intersex persons.<ref name = "Definition "/>
It is practised in several parts of the world, but the practice is concentrated more heavily in Africa, parts of the Middle East, and some other parts of Asia.<ref name="125million"/> Over 125 million women and girls have experienced FGM in the 29 countries in which it is concentrated.<ref name="125million">UNICEF 2013 Template:Webarchive, p. 22: "More than 125 million girls and women alive today have been cut in the 29 countries in Africa and the Middle East where FGM/C is concentrated.
UNICEF 2013, p. 121, n. 62: "This estimate [125 million] is derived from weighted averages of FGM/C prevalence among girls aged 0 to 14 and girls and women aged 15 to 49, using the most recently available DHS, MICS and SHHS data (1997–2012) for the 29 countries where FGM/C is concentrated. The number of girls and women who have been cut was calculated using 2011 demographic figures produced by the UN Population Division ... The number of cut women aged 50 and older is based on FGM/C prevalence in women aged 45 to 49."
</ref> Over eight million have been infibulated, a practice found largely in Djibouti, Eritrea, Somalia and Sudan.<ref name=Yoder2008p13>P. Stanley Yoder, Shane Khan, "Numbers of women circumcised in Africa: The Production of a Total", USAID, DHS Working Papers, No. 39, March 2008, pp. 13–14: "Infibulation is practiced largely in countries located in northeastern Africa: Djibouti, Eritrea, Ethiopia, Somalia, and Sudan. Survey data are available for Sudan, Eritrea, Ethiopia and Djibouti. Sudan alone accounts for about 3.5 million of the women. ... [T]he estimate of the total number of women infibulated in [Djibouti, Somalia, Eritrea, northern Sudan, Ethiopia, Guinea, Mali, Burkina Faso, Senegal, Chad, Nigeria, Cameroon and Tanzania, for women 15–49 years old] comes to 8,245,449, or just over eight million women." Also see Appendix B, Table 2 ("Types of FGC"), p. 19.
UNICEF 2013 Template:Webarchive, p. 182, identifies "sewn closed" as most common in Djibouti, Eritrea, Somalia for 15–49 age group (survey in 2000 for Sudan was not included), and for daughters, Djibouti, Eritrea, Niger and Somalia.
UNICEF statistical profiles on FGM, showing type of FGM: Djibouti Template:Webarchive (December 2013), Eritrea Template:Webarchive (July 2014), Somalia Template:Webarchive (December 2013).
Gerry Mackie, "Ending Footbinding and Infibulation: A Convention Account" Template:Webarchive, American Sociological Review, 61(6), December 1996 (pp. 999–1017), p. 1002: "Infibulation, the harshest practice, occurs contiguously in Egyptian Nubia, the Sudan, Eritrea, Djibouti and Somalia, also known as Islamic Northeast Africa."
</ref> Infibulation, the most extreme form of FGM (known as Type III), consists of the removal of the inner and outer labia and closure of the vulva, while a small hole is left for the passage of urine and menstrual blood; afterwards the vagina will be opened after the wedding for sexual intercourse and childbirth (see episiotomy).<ref name = "Full list"/> In the past several decades, efforts have been made by global health organizations, such as the WHO, to end the practice.<ref name = "Full list"/> FGM is condemned by international human rights organizations.<ref name = "Full list"/> The Istanbul Convention prohibits FGM (Article 38).<ref name = "Full list">{{#invoke:citation/CS1|citation
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FGM is considered a form of violence against women by the Declaration on the Elimination of Violence Against Women, which was adopted by the United Nations in 1993; it states: "Article Two: Violence against women shall be understood to encompass, but not be limited to, the following: (a) Physical, sexual and psychological violence occurring in the family, including ... female genital mutilation ...".<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> However, because of its importance in traditional life, it continues to be practised in many societies.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>
HymenorrhaphyEdit
{{#invoke:Labelled list hatnote|labelledList|Main article|Main articles|Main page|Main pages}} Hymenorrhaphy refers to the practice of thickening the hymen, or, in some cases, implanting a capsule of red liquid within the newly created vaginal tissue.<ref name = "Brief on Intersex Genital Surgery"/> This new hymen is created to cause physical resistance, blood, or the appearance of blood, at the time that the individual's new husband inserts his penis into her vagina.<ref name = "Brief on Intersex Genital Surgery"/> This is done in cultures where a high value is placed on female virginity at the time of marriage.<ref name = "Brief on Intersex Genital Surgery"/> In these cultures, a woman may be punished, perhaps violently, if the community leaders deem that she was not a virgin when her marriage was consummated.<ref name = "Brief on Intersex Genital Surgery"/> Individuals who are victims of rape, who were virginal at the time of their rape, may elect for hymenorrhaphy.<ref name = "Brief on Intersex Genital Surgery"/>
Labia stretchingEdit
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Labia stretching is the act of elongating the labia minora through manual manipulation (pulling) or physical equipment (such as weights).<ref name=Rwanda>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref name=enlargement>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> It is a familial cultural practice in Rwanda,<ref name=Rwanda/> common in Sub-Saharan Africa,<ref name=who>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> and a body modification practice elsewhere.<ref name=enlargement/> It is performed for sexual enhancement of both partners, aesthetics, symmetry and gratification.<ref name=Rwanda/><ref name=enlargement/>
Vulvoplasty and vaginoplastyEdit
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Cosmetic surgery of female genitalia, known as elective genitoplasty, has become pejoratively known as "designer vagina". In May 2007, an article published in the British Medical Journal strongly criticised this craze, citing its popularity being rooted in commercial and media influences.<ref name="bb">Template:Cite news</ref><ref name="bmj">Template:Cite journal</ref> Similar concerns have been expressed in Australia.<ref name="bb"/>
Some women undergo vaginoplasty or vulvoplasty procedures to alter the shape of their vulvas to meet personal or societal aesthetic standards.<ref name="The Perfect Vagina Documentary">{{#invoke:citation/CS1|citation |CitationClass=web }}Template:Cbignore</ref> The surgery itself is controversial, and critics refer to the procedures as "designer vagina".<ref>Template:Cite journal</ref><ref>Template:Cite journalTemplate:Cbignore</ref><ref>Template:Cite journal</ref>
In the article Designer Vaginas by Simone Weil Davis, she talks about the modification of woman's vagina and the outside influences women are pressured with, which can cause them to feel shame towards their labia minora. She states that the media, such as pornography, creates an unhealthy view of what a "good looking vagina" is and how women feel that their privates are inferior and are therefore pressured to act upon that mindset. These insecurities are forced upon women by their partners and other women as well.<ref>Davis, Simone Weil. "Designer Vaginas." Women's Voices, Feminist Visions. Ed. Susan Shaw and Janet Lee. New York: McGraw Hill (2012): 270–77.</ref> Also leading to a surge of these types of procedures is increased interest in non-surgical genital alterations, such as Brazilian waxing, that make the vulva more visible to judgment. The incentive to participate in vulvo- and vaginoplasty may also come about in an effort to manage women's physical attributes and their sexual behavior, treating their vagina as something needing to be managed or controlled and ultimately deemed "acceptable".<ref>Template:Cite journal</ref>
Clitoral enlargement methodsEdit
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Clitoral hood reductionEdit
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Clitoral hood reduction is a form of hoodplasty. When performed with the consent of the adult individual, it can be considered an elective plastic surgery procedure for reducing the size and the area of the clitoral hood (prepuce) in order to further expose the glans of the clitoris; the therapeutic goal is thought to improve the sexual functioning of the woman, and the aesthetic appeal of her vulva. The reduction of the clitoral prepuce tissues usually is a sub-ordinate surgery within a labiaplasty procedure for reducing the labia minora; and occasionally within a vaginoplasty procedure. When these procedures are performed on individuals without their consent, they are considered a form of female genital mutilation.
MaleEdit
CastrationEdit
{{#invoke:Labelled list hatnote|labelledList|Main article|Main articles|Main page|Main pages}} Castration in the genital modification and mutilation context is the removal of the testicles. Occasionally the term is also used to refer to penis removal, but that is less common. Castration has been performed in many cultures throughout history, but is now rare. It should not be confused with chemical castration.
The removal of one testicle (sometimes referred to as unilateral castration) is usually done in the modern world only for medical reasons.
CircumcisionEdit
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Circumcision is the removal of the foreskin, the double-layered fold of skin, mucosal and muscular tissue at the distal end of the human penis.<ref name=":7">Template:Cite book</ref> Around half of all circumcisions worldwide are performed for reasons of preventive healthcare; half for religious or cultural reasons.<ref name="hay_2012">Template:Cite book</ref><ref name=":73">Template:Cite book</ref> Circumcision involves either a conventional "cut and stitch" surgical procedure or use of a circumcision instrument or device. Complications are rare.<ref>About 0.13% in American neonates; Krill AJ, Palmer LS, Palmer JS (2011). "Complications of circumcision". TheScientificWorldJournal. 11: 2458–2468. doi:10.1100/2011/373829. PMC 3253617. PMID 22235177.</ref><ref name="williams">Template:Cite journal</ref><ref name="krill">Template:Cite journal</ref> Modern proponents say that circumcision reduces the risks of a range of infections and diseases and confers sexual benefits.<ref>{{#invoke:citation/CS1|citation
|CitationClass=web }}</ref><ref name="AAP Statement 2012">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Opponents, particularly of routine neonatal circumcision, question its preventive efficacy and object to subjecting non-consenting newborn males to a procedure that is potentially harmful, in their view, with little to no benefit, as well as violating their human rights and possibly negatively impacting their sex life.<ref name="AAP Critique 2013">Template:Cite journal</ref><ref>Template:Cite book</ref><ref>Template:Cite journal</ref> There is a consensus among the world's major medical organizations and in the academic literature that circumcision is an efficacious intervention for HIV prevention in high-risk populations if carried out by medical professionals under safe conditions.<ref name="WHO-PrevHIV">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref name="Chikutsa-2015">For sources on this, see:
- Template:Cite journal
- Template:Cite book
- Template:Cite book</ref> They hold variant perspectives on the prophylactic efficacy of the elective circumcision of minors in developed nations.<ref>Template:Cite journal</ref>
Foreskin restorationEdit
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Foreskin restoration or reconstruction is the recreation of the foreskin after its removal by circumcision or injury.
Surgical restoration often involves grafting skin taken from the scrotum onto a portion of the penile shaft. Nonsurgical methods involve tissue expansion by stretching the penile skin forward over the glans penis with the aid of tension. Nonsurgical restoration is the preferred methodTemplate:According to whom as it is less costly and typically yields better results than surgical restoration. A foreskin restoration device may be of help to men pursuing nonsurgical foreskin restoration. While restoration cannot recreate the nerves or tissues lost to circumcision, it can recreate the appearance and some of the function of a natural foreskin.
InfibulationEdit
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Infibulation literally means "to close with a clasp or a pin.” The word is used to include suturing of the foreskin over the head of the penis.
Early Greek infibulation consisted of tying the most distal portion of the foreskin with Template:Transliteration to conceal the glans. The kynodesme was also used by the Etruscans and Romans (ligatura praeputii), but the Romans preferred to apply a gold, silver, or bronze ring (annulus), a metal clasp (fibula) or pin.<ref name="Schultheiss">Template:Cite journal</ref>
In modern times, male infibulation may be performed for personal preferences or as part of BDSM.
EmasculationEdit
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Emasculation is the removal of both the penis and the testicles, the external male sex organs. It differs from castration, which is the removal of the testicles only, although the terms are sometimes used interchangeably.
Genital nullification is a procedure practiced in a body modification subculture made up mostly of men who have had their genitals surgically removed. Those undergoing the procedure often go by the name of nullos, and are not necessarily transgender or nonbinary; some identify as eunuchs.<ref name="DeMello2007">Template:Cite book</ref> The term nullo is short for genital nullification.<ref name="gizm_TheM">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Though the procedure is mostly sought by men, female genital mutilation may be referred to as clitoral nullification.<ref name="Harrington2016">Template:Cite book</ref>
In modern-day South Asia, some members of hijra communities reportedly undergo emasculation. It is called nirwaan and seen as a rite of passage.<ref>Nanda, S. "Hijras: An Alternative Sex and Gender Role in India (in Herdt, G. (1996) Third Sex, Third Gender: Beyond Sexual Dimorphism in Culture and History. Zone Books.)</ref>
It was part of the eunuch-making of the Chinese court, and it was widespread in the Arab slave trade. A castrated slave was worth more, and this offset the losses from death.<ref name="Gordon 1989">Template:Cite book</ref>
PearlingEdit
{{#invoke:Labelled list hatnote|labelledList|Main article|Main articles|Main page|Main pages}} Pearling or genital beading is a form of body modification, the practice of permanently inserting small beads made of various materials beneath the skin of the genitals—of the labia, or of the shaft or foreskin of the penis. As well as being an aesthetic practice, this is usually intended to enhance the sexual pleasure of the receptive partner(s) during vaginal or anal intercourse.
PenectomyEdit
{{#invoke:Labelled list hatnote|labelledList|Main article|Main articles|Main page|Main pages}} Penectomy involves the partial or total amputation of the penis. Sometimes, the removal of the entire penis was done in conjunction with castration, or incorrectly referred to as castration. Removing the penis was often performed on eunuchs and high ranking men who would frequently be in contact with women, such as those belonging to a harem. The hijra of India may remove their penis as an expression of their gender identity. In the medical field, removal of the penis may be performed for reasons of gangrene or cancer.
In the ulwaluko circumcision ceremony, which is performed by spear, accidental penectomy is a serious risk.<ref>Rijken, D.J. (2014). Description of the problems accompanying the ritual of Ulwaluko Template:Webarchive. Ulwaluko.co.za. Retrieved 2014-03-28.</ref>
In the United States In 1907 Bertha Boronda sliced off her husband's penis with a straight razor.<ref name="Bobbit">Template:Cite news</ref> Lorena Bobbit infamously removed her husband's penis in 1993. In the latter case, the use of microsurgery was able to reattach Bobbitt's penis.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>
Penis enlargementEdit
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Penis reductionEdit
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Penile subincision/meatotomyEdit
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Penile subincision is a form of genital modification involves a urethrotomy and vertically slitting the underside of the penis from the meatus towards to the base. It was performed by people of some cultures, such as the Indigenous Australians, the Arrente, the Luritja, the Samburu, the Samoans, and the Native Hawaiians. It may also be performed for personal preference. Penile subincision may leave a man with an increased risk of sexually transmitted diseases, issues with fertility (due to lack of control over what direction the sperm goes after ejaculation), and may require a man to sit down while urinating.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> When the surgery is not performed in a hospital or by a licensed medical professional, complications such as infection, exsanguination, or permanent damage are major concerns.
Penile superincisionEdit
A rectal slit (also known as superincision) is an incision made along the upper length of the foreskin with the intention to expose the glans penis without removing skin or tissue.
The practice appears to have occurred in Ancient Egypt, though not commonly:
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It may be performed as a part of traditional customs, such as those in the Pacific Islands and the Philippines. In the medical field, it may be performed for as an alternative to circumcision when circumcision is undesired or impractical. It remains a rare surgery and practice overall.
ReferencesEdit
External linksEdit
Template:Sexual abuse Template:Genital procedures Template:Reproductive health