genital modification and mutilation

{{main|Body modification}}

Many types of genital modification are performed at the behest of the individual, for personal, sexual, aesthetic or cultural reasons.

Social acceptance for male intimate cosmetic surgery seem to have happened around the 2010s, decades after other types of cosmetic surgeries.

Penile subincision, or splitting of the underside of the penis, is widespread in the traditional cultures of Indigenous Australians. This procedure has taken root in Western body modification culture, the modern primitives. 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.

File:Clit piercing and mons pubis tattoo.jpg  – Taiwan, 2009]]

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.{{cite journal|vauthors = Neluis T, Armstrong ML, Young C, Roberts AE, Hogan L, Rinard K |year = 2014|title = Prevalence and implications of genital tattoos: A site not forgotten|journal = British Journal of Medical Practitioners|volume = 7|issue = 4 }}{{cite web|url=http://www.expressmilwaukee.com/article-7386-penises-piercings-and-pleasure.html|title=Penises, Piercings and Pleasure|date=2009-07-23|access-date=2010-01-17|archive-date=2015-07-09|archive-url=https://web.archive.org/web/20150709222053/http://expressmilwaukee.com/article-7386-penises-piercings-and-pleasure.html|url-status=dead}}

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. Similar to tattooing, genital scarification is primarily done for aesthetic reasons by adding decorative scars to the skin. The genital decoration by scars is an ancient tradition in many cultures, both for men and women.{{cite journal|vauthors=Angulo JC, García-Díez M, Martínez M |year = 2011|title = Phallic decoration in paleolithic art: genital scarification, piercing and tattoos|journal = The Journal of Urology|volume = 186|issue = 6|pages = 2498–2503|doi=10.1016/j.juro.2011.07.077|pmid = 22019163 }}

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. 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.

{{main|Gender-affirming surgery}}

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.

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. 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. Hijra, a third gender found in the Indian subcontinent, may opt to undergo castration.{{cite book|first=Serena|last=Nanda|author-link=Serena Nanda|title=Neither Man nor Woman: the Hijras of India|year=1999|publisher=Wadsworth Publishing|place=Belmont, CA|edition=2nd|isbn=9780534509033 }} 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.{{cite journal |vauthors=Gearhart JP, Rock JA |year=1989 |title=Total ablation of the penis after circumcision with electrocautery: a method of management and long-term followup |journal=J Urol |volume=142 |issue=3 |pages=799–801 |doi=10.1016/s0022-5347(17)38893-6 |pmid=2769863}}

The following types of unvoluntary genital cutting or surgery can be done on children, for nontherapeutic (medically unncessary) reasons:{{cite journal|last1=Abdulcadir|first1=Jasmine|last2=Adler|first2=Peter W.|last3=Almonte|first3=Melanie T.|last4=Anderson|first4=Frank W. J.|last5=Arguedas-Ramírez|first5=Gabriela|last6=Aulisio|first6=Mark P.|last7=Bader|first7=Dina|last8=Balashinsky|first8=David|last9=Baratz|first9=Arlene B.|last10=Bariş|first10=Maide|last11=Bauer|first11=Greta|last12=Behrensen|first12=Maren|last13=Ben-Yami|first13=Hanoch|last14=Boddy|first14=Janice|last15=Bootwala|first15=Yasmin|last16=Bowman-Smart|first16=Hilary|last17=Bruce|first17=Lori|last18=Buckler|first18=Max|last19=Cabral Grinspan|first19=Mauro|last20=Cannoot|first20=Pieter|last21=Carpenter|first21=Morgan|last22=Catto|first22=Marie-Xavière|last23=Catalán|first23=Moisés|last24=Chambers|first24=Clare|last25=Chapin|first25=Georganne|last26=Chegwidden|first26=James|last27=Christian Ghattas|first27=Dan|last28=Clough|first28=Sharyn|last29=Conroy|first29=Ronán M.|last30=Dabbagh|first30=Hossein|last31=Dalke|first31=Katharine B.|last32=Dallière|first32=Sophie|last33=Danon|first33=Limor Meoded|last34=Davis|first34=Dena S.|last35=Davis|first35=Georgiann|last36=Dawson|first36=Angela J.|last37=DeLaet|first37=Debra L.|last38=Dranseika|first38=Vilius|last39=DuBoff|first39=Max|last40=Dwyer|first40=James G.|last41=Earp|first41=Brian D.|last42=Esho|first42=Tammary|last43=Essén|first43=Birgitta|last44=Fahmy|first44=Mohamed A. Baky|last45=Feder|first45=Ellen K.|last46=Ferreira|first46=Nuno|last47=Fillod|first47=Odile|last48=Florquin|first48=Stéphanie|last49=Foldès|first49=Pierre|last50=Fox|first50=Marie|last51=Frisch|first51=Morten|last52=Fusaschi|first52=Michela|last53=Garland|first53=Fae|last54=Geisheker|first54=John|last55=Gheaus|first55=Anca|last56=Giménez Barbat|first56=Teresa|last57=Levin Freifrau von Gleichen|first57=Tobe|last58=Godwin|first58=Samantha|last59=Goldman|first59=Ronald|last60=Gonzalez-Polledo|first60=E. J.|last61=Goodman|first61=Jenny|last62=Gradilla|first62=Alexandro José|last63=Gruenbaum|first63=Ellen|last64=Gwaambuka|first64=Tatenda|last65=Hatem-Gantzer|first65=Ghada|last66=Hakim|first66=M.|last67=Hammond|first67=Tim|last68=Hannikainen|first68=Ivar R.|last69=van der Have|first69=Miriam|last70=Herbenick|first70=Debby|last71=Higashi|first71=Yuko|last72=Hill|first72=B. Jessie|last73=Johansen|first73=R. Elise B.|last74=Johari|first74=Aarefa|last75=Johnson-Agbakwu|first75=Crista|last76=Johnson|first76=Matthew T.|last77=Kimani|first77=Samue|last78=Komba|first78=Eva|last79=Kolak|first79=Julia|last80=Koukoui|first80=Sophia|last81=Kraus|first81=Cynthia|last82=Latham|first82=Stephen R.|last83=Laurent|first83=Bo|last84=Learner|first84=Hazel|last85=Lempert|first85=Antony|last86=Lenta|first86=Patrick|last87=Lesslar|first87=Olivia|last88=Lewis|first88=Jonathan|last89=Liao|first89=Lih-Mei|last90=Lorshbough|first90=Erika|last91=Lurenbaum|first91=Jean-Christophe|last92=MacDonald|first92=Noni E.|last93=McAllister|first93=Ryan|last94=Meddings|first94=Jonathan|last95=Merli|first95=Claudia|last96=Mertens|first96=Mayli|last97=Milos|first97=Marilyn|last98=Mishori|first98=Ranit|last99=Monro|first99=Surya|last100=Moss|first100=Lisa Braver|last101=Munzer|first101=Stephen R.|last102=Nazri|first102=Hannah M.|last103=Ncayiyana|first103=Daniel|last104=Neiders|first104=Ivars|last105=Ngosso|first105=Londé|last106=Nguena|first106=Marianne|last107=van Niekerk|first107=Anton A.|last108=Nobis|first108=Nathan|last109=Oduor|first109=Alphonce Odhiambo|last110=O’Neill|first110=Sarah|last111=Ottenheimer|first111=Deborah|last112=Paalanen|first112=Panda|last113=Palacios-González|first113=César|last114=Qing|first114=Xin|last115=Radcliffe Richards|first115=Janet|last116=Ramus|first116=Franck|last117=Rashid Khan|first117=Abdul|last118=Ray|first118=Saarrah|last119=Reis|first119=Elizabeth|last120=Reis-Dennis|first120=Samuel|last121=Remennick|first121=Larissa|last122=Richard|first122=Fabienne|last123=Roen|first123=Katrina|last124=Rubashkyn|first124=Eliana|last125=Sarajlic|first125=Eldar|last126=Sardi|first126=Lauren|last127=Schuklenk|first127=Udo|last128=Shahvisi|first128=Arianne|last129=Shaw|first129=David|last130=Sinden|first130=Guy|last131=Sidler|first131=Daniel|last132=Skitka|first132=Linda|last133=Somerville|first133=Margaret A.|last134=Sterckx|first134=Sigrid|last135=Svoboda|first135=J. Steven|last136=Taher|first136=Mariya|last137=Tangwa|first137=Godfrey B.|last138=Thomson|first138=Michael|last139=Townsend|first139=Kate Goldie|last140=Travis|first140=Mitchell|last141=Van Howe|first141=Robert S.|last142=Vash-Margita|first142=Alla|last143=Verhagen|first143=Emmanuelle|last144=Vilponen|first144=Tiina|last145=Villani|first145=Michela|last146=Viloria|first146=Hida|last147=Vintiadis|first147=Elly|last148=Virgili|first148=Tommaso|last149=Vissandjée|first149=Bilkis|last150=Ungar-Sargon|first150=Eliyahu|last151=Wahlberg|first151=Anna|last152=Wald|first152=Rebecca|last153=Walsh|first153=Reubs J.|last154=Weisenberg|first154=Desmond|last155=Wenger|first155=Hannah|last156=Wisdom|first156=Travis|last157=Zelayandia|first157=Ernesto|last158=Ziemińska|first158=Renata|last159=Zieselman|first159=Kimberly|last160=Ziyada|first160=Mai Mahgoub|date=17 July 2024|title=Genital Modifications in Prepubescent Minors: When May Clinicians Ethically Proceed?|url=https://www.tandfonline.com/doi/epdf/10.1080/15265161.2024.2353823|journal=The American Journal of Bioethics|volume=|issue=|pages=50|doi=10.1080/15265161.2024.2353823|pmid=39018160 |access-date=22 October 2024|hdl=11590/474747|hdl-access=free}} clitoral reduction surgeries on children with CAH,{{rp|p=24}} hypospadias surgeries,{{rp|p=24}} removal of internal gonads{{rp|p=24}} and penile circumcision.{{rp|p=24}} In some societies, other types of endosex girl genital cutting happen.{{rp|p=22}}

They can be done for psychosocial, cultural, subjective-aesthetic, or prophylactic perceived benefits, as judged by doctors or parents.{{rp|p=1}}{{rp|p=17}}{{rp|p=22}}

{{See also|Children's rights|Bodily integrity|Intersex human rights|Female genital mutilation|Circumcision controversies|Ethics of circumcision|Circumcision and law|Compulsory sterilization}}

{{expand section|date=February 2025}}

{{Main|Sex assignment|Intersex surgery|History of intersex surgery|Intersex human rights}}

Intersex children and children with ambiguous genitalia may be subjected to surgeries to "normalize" the appearance of their genitalia.

These surgeries are usually performed for cosmetic benefit rather than for therapeutic reasons."David Reimer, 38, Subject of the John/Joan Case" The New York Times, New York, US, Published May 12, 2004 Most surgeries involving children with ambiguous genitalia are sexually damaging and may render them infertile.[http://www.isna.org/node/97 ISNA's Amicus Brief on Intersex Genital Surgery] The Intersex Society of North America, Dated February 7, 1998 For example, in cases involving male children with micropenis, doctors may recommend the child be reassigned as female.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 [http://emedicine.medscape.com/article/923178-overview#a0199 Microphallus: Epidemiology] Medscape, Updated August 3, 2011 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.{{cite web |title=What's ISNA's position on surgery? |url=http://www.isna.org/faq/surgery |work=Intersex Society of North America}}

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.{{cite journal |last1= Eichert |first1= David|date= 2019|title= 'Homosexualization' Revisited: An Audience-Focused Theorization of Wartime Male Sexual Violence|journal= International Feminist Journal of Politics|volume= 21|issue= 3|pages= 409–433|doi= 10.1080/14616742.2018.1522264|s2cid= 150313647}} 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.

If the genitals become diseased, as in the case of cancer, sometimes the diseased areas are surgically removed. 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). Reconstructive surgery may be performed to restore what was lost, often with techniques similar to those used in gender-affirming surgery.

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.

Hymenotomy is the surgical perforation of an imperforate hymen. It may be performed to allow menstruation to occur. 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.{{Cite book |last1=Puri |first1=Prem |title=Pediatric surgery: diagnosis and management |last2=Höllwarth |first2=Michael E. |date=2009 |publisher=Springer |isbn=978-3-540-69560-8 |location=Berlin New York |pages=963}}{{Cite book |last1=Blumenthal |first1=Paul D. |title=A Practical Guide to Office Gynecologic Procedures |last2=Berek |first2=Jonathan S. |publisher=Wolters Kluwer Health |year=2013 |isbn=9781451153897 |pages=49}}

{{main|Self-mutilation}}

A person may engage in self-inflicted genital injury or mutilation such as castration, penectomy, or clitoridectomy. 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.

{{Discrimination sidebar}}

{{category see also|Female genital modification}}

File:FGM prevalence UNICEF 2016.svg)UNICEF 2016.]]

{{Main|Female genital mutilation}}

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."Definition of the World Health Organization It is not the same as the procedures used in gender-affirming surgery or the genital modification of intersex persons.

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. Over 125 million women and girls have experienced FGM in the 29 countries in which it is concentrated.[http://www.unicef.org/media/files/FGCM_Lo_res.pdf UNICEF 2013] {{Webarchive|url=https://web.archive.org/web/20150405083031/http://www.unicef.org/media/files/FGCM_Lo_res.pdf |date=2015-04-05 }}, 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.

[http://www.unicef.org/media/files/FGCM_Lo_res.pdf 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."

{{Main|Hymenorrhaphy}}

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. 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. This is done in cultures where a high value is placed on female virginity at the time of marriage. 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. Individuals who are victims of rape, who were virginal at the time of their rape, may elect for hymenorrhaphy.

{{Main|Labia stretching}}

Labia stretching is the act of elongating the labia minora through manual manipulation (pulling) or physical equipment (such as weights).{{cite web |url=http://www.medicalnewstoday.com/articles/97388.php |title=Rwandan Women View The Elongation Of Their Labia As Positive |date=February 15, 2008 |access-date=April 25, 2021 |archive-url=https://web.archive.org/web/20080218124634/http://www.medicalnewstoday.com/articles/97388.php |archive-date=February 18, 2008}}{{cite web |url=http://www.sexylabia.com/labia-enlargement1.htm |title=Enlarging Your Labia |website=Sexy Labia |access-date=April 25, 2021}} It is a familial cultural practice in Rwanda, common in Sub-Saharan Africa,{{cite web |url=https://www.who.int/reproductive-health/hrp/progress/67.pdf |title=Sexual health—a new focus for WHO |page=6 |date=2004 |publisher=WHO |archive-url=https://web.archive.org/web/20080316071919/https://www.who.int/reproductive-health/hrp/progress/67.pdf |archive-date=March 16, 2008}} and a body modification practice elsewhere. It is performed for sexual enhancement of both partners, aesthetics, symmetry and gratification.

{{Main|vulvoplasty|vaginoplasty|}}

File:Nach der Entfernung der inneren Schamlippen 1.jpg

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.{{cite news|last=Bourke|first=Emily|title = Designer vagina craze worries doctors|publisher = Australian Broadcasting Corporation|date = 2009-11-12|url = http://www.abc.net.au/news/stories/2009/11/12/2741446.htm?site=local|archive-url = https://web.archive.org/web/20121112002110/http://www.abc.net.au/news/stories/2009/11/12/2741446.htm?site=local|url-status = dead|archive-date = November 12, 2012|access-date = 2007-05-29}}{{cite journal|last = Liao|first = Lih Mei|author2=Sarah M Creighton|title = Requests for cosmetic genitoplasty: how should healthcare providers respond?|journal = BMJ|volume = 334|issue = 7603|pages = 1090–1092|date = 2007-05-26|doi = 10.1136/bmj.39206.422269.BE|pmid = 17525451|pmc = 1877941}} Similar concerns have been expressed in Australia.

Some women undergo vaginoplasty or vulvoplasty procedures to alter the shape of their vulvas to meet personal or societal aesthetic standards.{{cite web |title=The Perfect Vagina Documentary |url=https://documentaryheaven.com/the-perfect-vagina/ |website=Documentary Heaven |access-date=October 12, 2022}}{{cbignore}} The surgery itself is controversial, and critics refer to the procedures as "designer vagina".{{cite journal|author = Green Fiona|year = 2005|title = From clitoridectomies to 'designer vaginas': The medical construction of heteronormative female bodies and sexuality through female genital cutting|journal = Sexualities, Evolution & Gender|volume = 7|issue = 2|pages = 153–187|doi=10.1080/14616660500200223}}{{cite journal |author1-last=Essen |author1-first=Birgitta |author2-last=Johnsdotter |author2-first=Sara |year=2004 |title=Female Genital Mutilation in the West: Traditional Circumcision versus Genital Cosmetic Surgery |url=http://lup.lub.lu.se/record/127139 |journal=Acta Obstetricia et Gynecologica Scandinavica |volume = 83 |issue = 7 |pages = 611–613 |doi=10.1111/j.0001-6349.2004.00590.x |pmid = 15225183 |s2cid = 44583626 |archive-url=https://web.archive.org/web/20130414232252/http://www.hmb.utoronto.ca/HMB303H/Case_Studies/Kenya-FGM/FGM_%26_Cosmetic_Surgery.pdf |archive-date=14 April 2013 |access-date=11 October 2022|doi-access=free }}{{cbignore}}{{cite journal|author = Braun Virginia|year = 2005|title = In search of (better) sexual pleasure: female genital 'cosmetic' surgery|journal = Sexualities|volume = 8|issue = 4|pages = 407–424|doi=10.1177/1363460705056625|s2cid = 145795666}}

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.Davis, Simone Weil. "Designer Vaginas." Women's Voices, Feminist Visions. Ed. Susan Shaw and Janet Lee. New York: McGraw Hill (2012): 270–77. 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".{{cite journal|author = Rodrigues Sara|s2cid = 145095068|year = 2012|title = From Vaginal Exception to Exceptional Vagina: The Biopolitics of Female Genital Cosmetic Surgery|doi = 10.1177/1363460712454073|journal = Sexualities|volume = 15|issue = 7|pages = 778–94 }}

{{Main|Clitoral enlargement methods}}

{{Main|Clitoral hood reduction}}

File:Clitoral hood reduction in adult caucasian female.jpg]]

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.

{{category see also|Male genital modification}}

{{Main|Castration}}

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.

{{Main|Circumcision|Circumcision surgical procedure|Circumcision controversies}}

File:Adult circumcision before and after.jpgCircumcision is the removal of the foreskin, the double-layered fold of skin, mucosal and muscular tissue at the distal end of the human penis.{{Cite book |last1=Yosha |first1=Assaf |title=Surgical Guide to Circumcision |last2=Bolnick |first2=David |last3=Koyle |first3=Martin |publisher=Springer Publishing |year=2012 |isbn=9781447128588 |pages=256–257 |quote=It seems likely that in the near future revised recommendations, taking a more positive attitude to circumcision, are likely in many English-speaking countries. What of the future? Current medical advice and public health projects now underway seem to point to a worldwide increase in circumcision rates in the first half of the twenty-first century.}} Around half of all circumcisions worldwide are performed for reasons of preventive healthcare; half for religious or cultural reasons.{{cite book |url=https://books.google.com/books?id=V8lMJniWK_QC |title=Current Diagnosis and Treatment Pediatrics 21/E |vauthors=Hay W, Levin M |date=25 June 2012 |publisher=McGraw Hill Professional |isbn=978-0-07-177971-5 |pages=18–19 |archive-url=https://web.archive.org/web/20160118224324/https://books.google.com/books?id=V8lMJniWK_QC |archive-date=18 January 2016 |url-status=live}}{{Cite book |last1=Alan Glasper |first1=Edward |title=A Textbook of Children's and Young People's Nursing |last2=Richardson |first2=James |last3=Randall |first3=Duncan |publisher=Elsevier Health Sciences |year=2021 |isbn=9780702065033 |pages=382 |chapter=Promote, Restore, and Stabilise Health Status in Children}} Circumcision involves either a conventional "cut and stitch" surgical procedure or use of a circumcision instrument or device. Complications are rare.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.{{cite journal | vauthors = Williams N, Kapila L | title = Complications of circumcision | journal = The British Journal of Surgery | volume = 80 | issue = 10 | pages = 1231–6 | date = October 1993 | pmid = 8242285 | pmc = | doi = 10.1002/bjs.1800801005 | s2cid = 27220497 }}{{cite journal |vauthors=Krill AJ, Palmer LS, Palmer JS |date=2011 |title=Complications of circumcision |journal=TheScientificWorldJournal |volume=11 |issue= |pages=2458–68 |doi=10.1100/2011/373829 |pmc=3253617 |pmid=22235177 |doi-access=free}} Modern proponents say that circumcision reduces the risks of a range of infections and diseases and confers sexual benefits.{{Cite web |last=Society |first=Canadian Paediatric |title=Newborn male circumcision {{!}} Canadian Paediatric Society |url=https://cps.ca/en/documents/position/circumcision |access-date=2023-06-05 |website=cps.ca |language=en}}{{cite web |url=https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/Newborn-Male-Circumcision.aspx |title=Newborn Male Circumcision |author= |date=27 August 2012 |publisher=American Academy of Pediatrics |access-date=11 August 2019 |archive-url=https://web.archive.org/web/20171107023110/https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/newborn-male-circumcision.aspx |archive-date=7 November 2017 }} 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.{{cite journal |last1=Aigrain |first1=Yves |last2=Barauskas |first2=Vidmantas |last3=Bjarnason |first3=Ragnar |last4=Boddy |first4=Su-Anna |last5=Czauderna |first5=Piotr |last6=de Gier |first6=Robert P.E. |last7=de Jong |first7=Tom P.V.M. |last8=Fasching |first8=Günter |last9=Fetter |first9=Willem |last10=Gahr |first10=Manfred |last11=Graugaard |first11=Christian |last12=Greisen |first12=Gorm |last13=Gunnarsdottir |first13=Anna |last14=Hartmann |first14=Wolfram |last15=Havranek |first15=Petr |date=April 2013 |editor1-last=Frisch |editor1-first=Morten |title=Cultural Bias in the AAP's 2012 Technical Report and Policy Statement on Male Circumcision |journal=Pediatrics |publisher=American Academy of Pediatrics |volume=131 |issue=4 |pages=796–800 |doi=10.1542/peds.2012-2896 |pmid=23509170 |s2cid=40444911 |editor1-link=Morten Frisch |first16=Rowena |last16=Hitchcock |first17=Simon |last17=Huddart |first18=Staffan |last18=Janson |first19=Poul |last19=Jaszczak |first20=Christoph |last20=Kupferschmid |first21=Tuija |last21=Lahdes-Vasama |first22=Harry |last22=Lindahl |first23=Noni |last23=MacDonald |first24=Trond |last24=Markestad |first25=Matis |last25=Märtson |first26=Solveig Marianne |last26=Nordhov |first27=Heikki |last27=Pälve |first28=Aigars |last28=Petersons |first29=Feargal |last29=Quinn |first30=Niels |last30=Qvist |first31=Thrainn |last31=Rosmundsson |first32=Harri |last32=Saxen |first33=Olle |last33=Söder |first34=Maximilian |last34=Stehr |first35=Volker C.H. |last35=von Loewenich |first36=Johan |last36=Wallander |first37=Rene |last37=Wijnen|doi-access=free }}{{cite book |author-last=Warren |author-first=John |editor1-last=Denniston |editor1-first=George C. |editor2-last=Hodges |editor2-first=Frederick M. |editor3-last=Milos |editor3-first=Marilyn Fayre |title=Genital Autonomy: Protecting Personal Choice |pages=75–79 |date=2010 |chapter=Physical Effects of Circumcision |chapter-url=https://books.google.com/books?id=2wYabLqzbFEC&pg=PA75 |location=New York |publisher=Springer-Verlag |doi=10.1007/978-90-481-9446-9_7 |isbn=978-90-481-9446-9 |editor3-link=Marilyn Milos |access-date=19 November 2019 |archive-date=6 August 2020 |archive-url=https://web.archive.org/web/20200806031140/https://books.google.com/books?id=2wYabLqzbFEC&pg=PA75 |url-status=live }}{{Cite journal|last=Svoboda|first=J. Steven|author1-link=J. Steven Svoboda|date=July 2013|title=Circumcision of male infants as a human rights violation|journal=Journal of Medical Ethics|volume=39|issue=7|pages=469–474|doi=10.1136/medethics-2012-101229|issn=1473-4257|pmid=23698885|s2cid=7461936}} 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.{{cite web |year=2020 |title=Preventing HIV Through Safe Voluntary Medical Male Circumcision For Adolescent Boys And Men In Generalized HIV Epidemics |url=https://www.who.int/publications/i/item/978-92-4-000854-0 |url-status=live |archive-url=https://web.archive.org/web/20211122140037/https://www.who.int/publications/i/item/978-92-4-000854-0 |archive-date=22 November 2021 |access-date=24 May 2021 |publisher=World Health Organization}}For sources on this, see:

• {{cite journal |vauthors=Chikutsa A, Maharaj P |date=July 2015 |title=Social representations of male circumcision as prophylaxis against HIV/AIDS in Zimbabwe |journal=BMC Public Health |volume=15 |issue=1 |pages=603 |doi=10.1186/s12889-015-1967-z |issn=1471-2458 |pmc=4489047 |pmid=26133368 |quote=It is now generally accepted in public health spheres that medical male circumcision is efficacious in the prevention of HIV infection. |doi-access=free}}
• {{Cite book |title=Health and Other Unassailable Values: Reconfigurations of Health, Evidence and Ethics |vauthors=Bell K |publisher=Taylor & Francis |year=2016 |isbn=978-1-317-48203-1 |pages=106 |quote=...defending the casual relation between male circumcision and reduced HIV transmission has become essentially hegemonic in the academic literature.}}
• {{Cite book |title=The AIDS Pandemic: Searching for a Global Response |vauthors=Merson M, Inrig S |publisher=Springer International Publishing |year=2017 |isbn=978-3-319-47133-4 |pages=379}} They hold variant perspectives on the prophylactic efficacy of the elective circumcision of minors in developed nations.{{Cite journal |last=Schoen |first=Edgar J. |date=1997-09-01 |title=Benefits of newborn circumcision: is Europe ignoring medical evidence? |url=https://adc.bmj.com/content/77/3/258 |journal=Archives of Disease in Childhood |language=en |volume=77 |issue=3 |pages=258–260 |doi=10.1136/adc.77.3.258 |issn=0003-9888 |pmc=1717326 |pmid=9370910}}

{{More citations needed section|date=April 2025}}

{{Main|Foreskin restoration}}

File:Forward and Right View of Foreskin Restoration.png

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 method{{According to whom|date=April 2025}} 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.

{{Main|Infibulation}}

File:Anacreon infibulated.jpg (582–485 BC), showing {{transliteration|grc|kynodesmē}}]]

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 {{transliteration|grc|kynodesme}} 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.{{Cite journal|author1=D. Schultheiss|author2=J.J. Mattelaer|author3=F.M. Hodges|date=2003|title=Preputial infibulation: from ancient medicine to modern genital piercing|journal=BJU International|volume=92|issue=7|pages=758–763|doi=10.1046/j.1464-410X.2003.04490.x|pmid=14616462|s2cid=8855134|doi-access=free}}

In modern times, male infibulation may be performed for personal preferences or as part of BDSM.

{{Main|Emasculation}}

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.{{cite book|author=Margo DeMello|title=Encyclopedia of Body Adornment|url=https://books.google.com/books?id=s0122BsqrZwC&pg=PA57|year=2007|publisher=ABC-CLIO|isbn=978-0-313-33695-9|pages=57–}} The term nullo is short for genital nullification.{{Cite web| title = The Most Extreme Body Hacks That Actually Change Your Physical Abilities| last = Knibbs | first = Kate| work = Gizmodo| date = 2015-05-14| access-date = 2017-08-23| url = https://gizmodo.com/the-most-extreme-body-hacks-that-actually-change-your-p-1704056851}} Though the procedure is mostly sought by men, female genital mutilation may be referred to as clitoral nullification.{{cite book|author=Lee Harrington|title=Traversing Gender: Understanding Transgender Realities|url=https://books.google.com/books?id=PBMHDAAAQBAJ&pg=PT23|date=1 May 2016|publisher=Mystic Productions Press|isbn=978-1-942733-83-6|pages=23–}}

In modern-day South Asia, some members of hijra communities reportedly undergo emasculation. It is called nirwaan and seen as a rite of passage.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.)

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.{{Cite book|author=Murray Gordon|title=Slavery in the Arab World|url=https://books.google.com/books?id=5l81hwFPvzYC|date=1989|publisher=Rowman & Littlefield|isbn=978-0-941533-30-0}}

{{Main|Pearling (body modification)}}

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.

{{Main|Penectomy|Penis removal}}

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.Rijken, D.J. (2014). [http://www.ulwaluko.co.za/Problems.html Description of the problems accompanying the ritual of Ulwaluko] {{Webarchive|url=https://web.archive.org/web/20211003000555/http://www.ulwaluko.co.za/Problems.html |date=2021-10-03 }}. Ulwaluko.co.za. Retrieved 2014-03-28.

In the United States In 1907 Bertha Boronda sliced off her husband's penis with a straight razor.{{cite news|title=Bobbitt's Amputation Case Similar to a 1907 Account|url=https://www.orlandosentinel.com/news/os-xpm-1993-11-30-9311300561-story.html|access-date=27 November 2019|agency=San Jose Mercury News|newspaper=Orlando Sentinel|date=30 November 1993}} 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.{{Cite web |title=John Bobbitt's surgeons describe the day they reattached his penis: 'It came to us… in a hot dog bag' |url=https://abcnews.go.com/US/john-bobbitts-surgeons-describe-day-reattached-penis-us/story?id=60023142 |access-date=2024-04-25 |website=ABC News |language=en|first1=Lauren|last1= Effron |first2=Sean |last2 =Dooley}}

{{Main|Penis enlargement}}

{{Main|Penis reduction}}

{{Main|Penile subincision}}

File:Meatotomy3.jpg]]

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.{{Cite web|url=http://wiki.bme.com/index.php?title=Meatotomy|title=Meatotomy – BME Encyclopedia|website=wiki.bme.com|language=en|access-date=2017-12-13}} 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.

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:

{{Blockquote|A few examples of Old Kingdom... statuary present some adult males—usually priests, functionaries, or low-status workers—as having undergone a vertical slit on the dorsal aspect of the prepuce, although no flesh has been removed.{{cite journal|last = Hodges|first = Frederick M.|year = 2001|title = The Ideal Prepuce in Ancient Greece and Rome: Male Genital Aesthetics and Their Relation to Lipodermos, Circumcision, Foreskin Restoration, and the Kynodesme|journal = The Bulletin of the History of Medicine|volume = 75|issue = Fall 2001|pages = 375–405|url = http://www.cirp.org/library/history/hodges2/|format = PDF|access-date = 2018-02-06|doi = 10.1353/bhm.2001.0119|pmid=11568485|s2cid = 29580193|url-access = subscription}} Hodges draws a strong distinction between the kynodesme and infibulation

"

Tethering the akroposthion with the kynodesme is frequently confused with preputial infibulation, which had different objectives and was achieved by surgically piercing the prepuce and using the holes so created for the insertion of a metal clasp (fibula) in order to fasten the prepuce shut."}}

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.

{{Reflist}}

{{Commons category|Genital modification}}

• [http://www.noharmm.org/geography.htm The Geography of Genital Mutilations]
• [http://healthsaveblog.com/female-genital-mutilation/ A world without female Genital Mutilation]

{{Sexual abuse}}

{{Genital procedures}}

{{Reproductive health}}

{{DEFAULTSORT:Genital Modification And Mutilation}}

Category:Mutilation

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