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Genital modification and mutilation

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Genital modificationsare forms ofbody modificationsapplied to thehuman sexual organs.The termgenital enhancementis generally used for genital modifications that improve the recipient's quality of life in result in positive health outcomes.[1]The termgenital mutilationis used for genital modifications that drastically diminish the recipient'squality of lifeand result inadverse health outcomes,whether physical or mental.

Reasons[edit]

Body modification[edit]

Main article:Body modification

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

Penile subincision,or splitting of the underside of the penis, is widespread in the traditional cultures ofIndigenous Australians.This procedure has taken root in Westernbody modificationculture, themodern primitives.Meatotomyis a form that involves splitting of theglans penisalone, while bisection is a more extreme form that splits the penis entirely in half.

Woman withclitoral hood piercing– Taiwan, 2009

Genital piercingsandgenital tattooingmay be performed for aesthetic reasons, but piercings can have the benefit of increasingsexual pleasurefor the pierced individual or theirsex partners.[2][3]

Similarly,pearlinginvolves 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 scarificationis 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.[4]

Clitoris enlargementmay be achieved temporarily through the use of aclitoral pump,or it may be achieved permanently through theapplication or injection of testosterone.Penis enlargementis 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.

Intersex[edit]

Main articles:Sex assignmentandIntersex surgery

Intersexchildren 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.[5]Most surgeries involving children with ambiguous genitalia are sexually damaging and may render theminfertile.[6]For example, in cases involving male children withmicropenis,doctors may recommend the child be reassigned as female.[7]TheIntersex Society of North Americaobjects toelective surgeriesperformed on people without theirinformed consenton grounds that such surgeries subject patients to unnecessary harm and risk.[8]

Sex-reassignment surgery[edit]

Main article:Sex reassignment surgery

People who aretransgendermay undergosex reassignment surgeryto alter their genitals to match theirgender identity.Not all transgender people elect to have these surgeries.

Some of the surgical procedures arevaginoplasty(creation of a vagina) andvulvoplasty(creation of a vulva) fortrans womenandmetoidioplasty(elongation of the clitoris),phalloplasty(creation of a penis), andscrotoplasty(creation of a scrotum) fortrans men.Trans women may also benefit fromhair removalandfacial feminization surgery,while some trans men may haveliposuctionto remove fat deposits around their hips and thighs.[citation needed]Hijra,athird genderfound in theIndian subcontinent,may opt to undergocastration.[9]

In some cases, a child's gender may be reassigned due togenital injury,includingDavid Reimer,who was the subject ofJohn Money's John/Joan case.[10]

As treatment[edit]

If the genitals become diseased, as in the case of cancer, sometimes the diseased areas are surgically removed. Females may undergovaginectomyorvulvectomy(to the vagina and vulva, respectively), while males may undergopenectomyororchiectomy(removal of the penis and testicles, respectively).Reconstructive surgerymay be performed to restore what was lost, often with techniques similar to those used insex reassignment surgery.

Duringchildbirth,anepisiotomy(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.

Hymenotomyis the surgical perforation of animperforate hymen.It may be performed to allowmenstruationto occur. An adult individual may opt for increasing the size of her hymenal opening, or removal of the hymen altogether, to facilitatesexual penetrationof her vagina.[11][12]

Self-inflicted[edit]

Main article:Self-mutilation

A person may engage in self-inflicted genital injury or mutilation such ascastration,penectomy,orclitoridectomy.The motivation behind such actions vary widely; it may be done due personal crisis related togender identity,mental illness,self-mutilation,body dysmorphia,or social reasons.[citation needed]

As sexual violence[edit]

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.[13]These different forms ofsexual violencecan terrorize targeted individuals and communities, prevent individuals from reproducing, and cause tremendous pain and psychological anguish for victims.

Female[edit]

See also:Category:Female genital modification

Female genital mutilation[edit]

map
FGM in Africa, Iraqi Kurdistan and Yemen, as of 2015 (map of Africa)[14]
Main article: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 theexternal female genitaliaor other surgery of the femalegenital organswhether for cultural, religious or other non-therapeutic reasons. "[15]It is not the same as the procedures used ingender reassignment surgeryor thegenital modificationofintersexpersons.

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.[16]Over eight million have beeninfibulated,a practice found largely in Djibouti, Eritrea, Somalia and Sudan.[17]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 (seeepisiotomy). In the past several decades, efforts have been made by global health organizations, such as the WHO, to end the practice. FGM is condemned by international human rights organizations. TheIstanbul Conventionprohibits FGM (Article 38).[18]

FGM is considered a form ofviolence against womenby theDeclaration on the Elimination of Violence Against Women,which was adopted by theUnited Nationsin 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...".[19]However, because of its importance in traditional life, it continues to be practised in many societies.[20]

Hymenorrhaphy[edit]

Main article: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 femalevirginityat the time of marriage. In these cultures, a woman may be punished, perhaps violently, if the community leaders deem that she was not virginal at the time ofconsummationof her marriage.[citation needed]Individuals who are victims ofrape,who were virginal at the time of their rape, may elect for hymenorrhaphy.

Labia stretching[edit]

Main article:Labia stretching

Labia stretching is the act of elongating thelabia minorathrough manual manipulation (pulling) or physical equipment (such as weights).[21][22]It is a familialcultural practicein Rwanda,[21]common inSub-Saharan Africa,[23]and abody modificationpractice elsewhere.[22]It is performed for sexual enhancement of both partners, aesthetics, symmetry and gratification.[21][22]

Vulvoplasty and vaginoplasty[edit]

Main articles:vulvoplastyandvaginoplasty
Vulva withlabia minorasurgically removed

Cosmetic surgeryof female genitalia, known aselective genitoplasty,has become pejoratively known as"designer vagina".In May 2007, an article published in theBritish Medical Journalstrongly criticised this craze, citing its popularity being rooted in commercial and media influences.[24][25]Similar concerns have been expressed in Australia.[24]

Some women undergo vaginoplasty or vulvoplasty procedures to alter the shape of theirvulvasto meet personal or societalaestheticstandards.[26]The surgery itself is controversial, and critics refer to the procedures as "designer vagina".[27][28][29]

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 theirlabia 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.[30]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".[31]

Clitoral hood reduction[edit]

Main article:Clitoral hood reduction
Clitoral hood reduction

Clitoral hood reduction is a form of hoodplasty. When performed with the consent of the adult individual, it can be considered anelectiveplastic surgeryprocedure for reducing the size and the area of theclitoral hood(prepuce) in order to further expose theglansof theclitoris;the therapeutic goal is thought to improve the sexual functioning of the woman, and the aesthetic appeal of hervulva.The reduction of the clitoral prepuce tissues usually is a sub-ordinate surgery within alabiaplastyprocedure for reducing thelabia minora;and occasionally within avaginoplastyprocedure. When these procedures are performed on individuals without their consent, they are considered a form offemale genital mutilation.

Male[edit]

See also:Category:Male genital modification

Castration[edit]

Main article:Castration

Castration in the genital modification and mutilation context is the removal of thetesticles.Occasionally the term is also used to refer topenis removal,but that is less common. Castration has been performed in many cultures throughout history, but is now rare. It should not be confused withchemical castration.

The removal of one testicle (sometimes referred to asunilateral castration) is usually done in the modern world only for medical reasons.

Circumcision[edit]

Main articles:CircumcisionandCircumcision surgical procedure
Penis before and after circumcision

Circumcision is the removal of theforeskin,the double-layered fold of skin, mucosal and muscular tissue at the distal end of the human penis that covers the glans and the urinary meatus.[32]Around half of all circumcisions worldwide are performed for reasons ofpreventive healthcare;half for religious or cultural reasons.[33][34]

Circumcision involves either a conventional "cut and stitch"surgical procedureor use of a circumcisioninstrumentordevice. Complications are rare[35],but may includebleeding,infection,reduction in sensation of theglans penis,[36]and too little or too much tissue removal.[37]Deaths are extremely rare.[38][37]

Support for circumcision is often centered on its medical benefits, while opposition is often centered onhuman rights(particularly thebodily integrityof the infant when circumcision is performed in the neonatal period) and the potentially harmful side effects of the procedure.[39] Major medical organizations hold variant perspectives on the prophylactic efficacy of the elective circumcision of minors indeveloped nations.TheWorld Health Organization,[40]UNAIDS,[40]and American medical organizations[41]hold that its prophylactic health benefits outweigh the risks in these situations, while European medical organizations generally hold the belief that in these situations, its medical benefits do not outweigh the risks.[42]

Foreskin restoration[edit]

Main article:Foreskin restoration
Circumcised at birth, the foreskin has been restored over years of foreskin restoration.

Foreskin restoration is the partial recreation of theforeskinafter its removal bycircumcision.

Surgical restoration involves grafting skin taken from thescrotumonto a portion of the penile shaft. Nonsurgical methods involvetissue expansionby stretching the penile skin forward over theglans peniswith the aid oftension.Nonsurgical restoration is the preferred method 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. The existence of men performing foreskin restoration strongly supports the argument thatcircumcisionis genital mutilation and intrinsically violates autonomy when performed without consent.

Infibulation[edit]

Main article:Infibulation
The Greek poetAnacreon(582–485 BC), showingkynodesmē

Infibulationliterally means "to close with a clasp or a pin.” The word is used to includesuturingof the foreskin over thehead of the penis.

Early Greek infibulation consisted of tying the most distal portion of the foreskin withkynodesmeto 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.[43]

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

Emasculation[edit]

Main article:Emasculation

Emasculation is the removal of both thepenisand thetesticles,the externalmale sex organs.It differs fromcastration,which is the removal of the testicles only, although the terms are sometimes used interchangeably.

Genital nullification is a procedure practiced in abody modificationsubculture 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 necessarilytransgenderornonbinary;some identify aseunuchs.[44]The termnullois short forgenital nullification.[45]Though the procedure is mostly sought by men, female genital mutilation may be referred to as clitoral nullification.[46]

In modern-daySouth Asia,some members ofhijracommunities reportedly undergo emasculation. It is callednirwaanand seen as arite of passage.[47]

It was part of the eunuch-making of theChinese court,and it was widespread in theArab slave trade.A castrated slave was worth more, and this offset the losses from death.[48]

Pearling[edit]

Main article: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.

Penectomy[edit]

Main articles:PenectomyandPenis removal

Penectomy involves the partial or total amputation of 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 oneunuchsand high ranking men who would frequently be in contact with women, such as those belonging to aharem.The hijra of India may remove their penis as an expression of theirgender identity.In the medical field, removal of the penis may be performed for reasons ofgangreneorcancer.Penis removal may occur through unintentional genital injury, such as during routine neonatal circumcision mishaps.[49][50][51][52][53][54]

In theulwalukocircumcision ceremony, which is performed by spear, accidental penectomy is a serious risk.[55]

Penis removalfor purposes of assault or revenge is overwhelmingly a female-on-male crime,[citation needed]particularly inThailand.[citation needed]In the United States In 1907Bertha Borondasliced off her husband's penis with a straight razor.[56]Lorena Bobbitinfamously removed her husband's penis in 1993. In the latter case, the use ofmicrosurgerywas able to reattach Bobbitt's penis.[57]

Penile subincision[edit]

Main article:Penile subincision

Penile subincision is a form of genital modification involves aurethrotomyand vertically slitting the underside of the penis from themeatustowards to the base. It was performed by people of some cultures, such as theIndigenous Australians,theArrente,theLuritja,theSamburu,theSamoans,and theNative Hawaiians.It may also be performed for personal preference. Penile subincision may leave a man with an increased risk ofsexually transmitted diseases,issues with fertility (due to lack of control over what direction the sperm goes afterejaculation), and may require a man to sit down whileurinating.[58]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 superincision[edit]

A rectal slit (also known as superincision) is an incision made along the upper length of the foreskin with the intention to expose theglans peniswithout removing skin or tissue.

The practice appears to have occurred in Ancient Egypt, though not commonly:

A few examples ofOld 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.[59]

It may be performed as a part of traditional customs, such as those in thePacific Islandsand thePhilippines.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.

References[edit]

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  15. ^Definition of theWorld Health Organization
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    UNICEF 2013Archived2015-04-05 at theWayback Machine,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."
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    UNICEF 2013Archived2015-04-05 at theWayback Machine,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:DjiboutiArchived2014-10-30 at theWayback Machine(December 2013),EritreaArchived2014-10-30 at theWayback Machine(July 2014),SomaliaArchivedOctober 30, 2014, at theWayback Machine(December 2013).

    Gerry Mackie,"Ending Footbinding and Infibulation: A Convention Account"Archived2019-07-20 at theWayback Machine,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."
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  57. ^Effron, Lauren; Dooley, Sean."John Bobbitt's surgeons describe the day they reattached his penis: 'It came to us… in a hot dog bag'".ABC News.Retrieved2024-04-25.
  58. ^"Meatotomy – BME Encyclopedia".wiki.bme.com.Retrieved2017-12-13.
  59. ^Hodges, Frederick M. (2001)."The Ideal Prepuce in Ancient Greece and Rome: Male Genital Aesthetics and Their Relation to Lipodermos, Circumcision, Foreskin Restoration, and the Kynodesme"(PDF).The Bulletin of the History of Medicine.75(Fall 2001): 375–405.doi:10.1353/bhm.2001.0119.PMID11568485.S2CID29580193.Retrieved2018-02-06.Hodges draws a strong distinction between the kynodesme and infibulation " Tethering theakroposthionwith thekynodesmeis 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. "

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