Genital modification and mutilation

Permanent or temporary changes to human sex organs

Genital modifications are forms of body modifications applied to the human sexual organs, including invasive modifications performed through genital cutting or surgery.[1] The term genital enhancement seem to be generally used for genital modifications that modify the external aspect, the way the patient wants it.[1] 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.[1] Mutilations are sometimes performed without consent or on people who cannot consent such as children and the mentally disabled.

## Reasons

[edit]

### Body modification

[edit]

Main article: Body modification

#### Voluntary

[edit]

Many types of genital modification are performed at the behest of the individual, for personal, sexual, aesthetic or cultural reasons.[1]

Social acceptance for male intimate cosmetic surgery seem to have happened around the 2010s, decades after other types of cosmetic surgeries.[1]

Penile subincision, or splitting of the underside of the penis, is widespread in the traditional cultures of Indigenous Australians.[2] This procedure has taken root in Western body modification culture, the modern primitives.[2] 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.[2]

Woman with clitoral hood piercing – 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.[3][2]

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.[2] Similar to tattooing, genital scarification is primarily done for aesthetic reasons by adding decorative scars to the skin.[4] The genital decoration by scars is an ancient tradition in many cultures, both for men and women.[4]

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.[4] 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.[4]

##### Gender-affirming surgery

[edit]

Main article: 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.[5]

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.[5] 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.[5] Hijra, a third gender found in the Indian subcontinent, may opt to undergo castration.[5] 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.[6] Similarly, intersex people often benefit from gender-affirming surgeries but are also sometimes subjected to them without consent in a violation of intersex human rights. The specialized term is intersex medical interventions.

##### Nontherapeutic

[edit]

The following types of unvoluntary genital cutting or surgery are sometimes performed on children for nontherapeutic (medically unncessary) reasons:[7] clitoral reduction surgeries on children with CAH,[7]: 24 hypospadias surgeries,[7]: 24 removal of internal gonads[7]: 24 and penile circumcision.[7]: 24 In some societies, other types of endosex girl genital cutting happen.[7]: 22 They can be done for psychosocial, cultural, subjective-aesthetic, or prophylactic perceived benefits, as judged by doctors or parents.[7]: 1 : 17 : 22

Penile subincision, or splitting of the underside of the penis, is widespread in the traditional cultures of Indigenous Australian children.[2] This procedure has been adapted for adults in Western body modification culture, the modern primitives.[2] 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.[2]

###### Opposition

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

This section needs expansion. You can help by adding to it. (February 2025)

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###### Intersex

[edit]

Main articles: Sex assignment, Intersex surgery, History of intersex surgery, and Intersex human rights

Intersex children and children with ambiguous genitalia may be subjected to surgeries to "normalize" the appearance of their genitalia.[8]

These surgeries are usually performed for cosmetic benefit rather than for therapeutic reasons.[8] Most surgeries involving children with ambiguous genitalia are sexually damaging and may render them infertile.[9] For example, in cases involving male children with micropenis, doctors may recommend the child be reassigned as female.[10] 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.[11]

#### 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.[12] 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.[12] Many wars, religious conquests, and genocides have involved forced circumcision. A related practice is killing people based on their circumcision status, notably in the Bangladesh genocide and recently in the 2025 India-Pakistan Crisis.[13]

### As treatment

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If the genitals become diseased, as in the case of cancer, sometimes the diseased areas are surgically removed.[14] 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).[14] Reconstructive surgery may be performed to restore what was lost, often with techniques similar to those used in gender-affirming surgery.[15]

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.[14]

Hymenotomy is the surgical perforation of an imperforate hymen.[14] It may be performed to allow menstruation to occur.[15] An adult individual may opt for increasing the size of their hymenal opening, or removal of the hymen altogether, to facilitate sexual penetration of their vagina.[14][15]

### Self-inflicted

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Main article: Self-mutilation

A person may engage in self-inflicted genital injury or mutilation such as castration, penectomy, or clitoridectomy.[1] The motivation behind such actions vary widely; it may be done due personal crisis related to mental illness, self-mutilation, body dysmorphia, or social reasons.[1] Not all regions have proper transgender health care or gender-affirming surgeries available, which can lead to people attempting self-surgery.

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## Female

[edit]

See also: Category:Female genital modification

### Female genital mutilation

[edit]

FGM in Africa, Iraqi Kurdistan and Yemen, as of 2015 (map of Africa)[16]

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 the external female genitalia or other surgery of the female genital organs whether for cultural, religious or other non-therapeutic reasons."[17] It is not the same as the procedures used in gender-affirming surgery or the genital modification of intersex persons.[17]

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.[18] Over 125 million women and girls have experienced FGM in the 29 countries in which it is concentrated.[18] Over eight million have been infibulated, a practice found largely in Djibouti, Eritrea, Somalia and Sudan.[19] 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).[20] In the past several decades, efforts have been made by global health organizations, such as the WHO, to end the practice.[20] FGM is condemned by international human rights organizations.[20] The Istanbul Convention prohibits FGM (Article 38).[20]

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 ...".[21] However, because of its importance in traditional life, it continues to be practised in many societies.[22]

### 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.[9] 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.[9] This is done in cultures where a high value is placed on female virginity at the time of marriage.[9] 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.[9] Individuals who are victims of rape, who were virginal at the time of their rape, may elect for hymenorrhaphy.[9]

### Labia stretching

[edit]

Main article: Labia stretching

Labia stretching is the act of elongating the labia minora through manual manipulation (pulling) or physical equipment (such as weights).[23][24] It is a familial cultural practice in Rwanda,[23] common in Sub-Saharan Africa,[25] and a body modification practice elsewhere.[24] It is performed for sexual enhancement of both partners, aesthetics, symmetry and gratification.[23][24]

### Vulvoplasty and vaginoplasty

[edit]

Main articles: vulvoplasty and vaginoplasty

Vulva with labia minora surgically removed

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.[26][27] Similar concerns have been expressed in Australia.[26]

Some women undergo vaginoplasty or vulvoplasty procedures to alter the shape of their vulvas to meet personal or societal aesthetic standards.[28] The surgery itself is controversial, and critics refer to the procedures as "designer vagina".[29][30][31]

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.[32] 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".[33]

### Clitoral enlargement methods

[edit]

Main article: Clitoral enlargement methods

### 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 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.

## 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 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.

### Circumcision

[edit]

Main articles: Circumcision, Circumcision surgical procedure, and Circumcision controversies

Penis before and after circumcision

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.[34] Around half of all circumcisions worldwide are performed for reasons of preventive healthcare; half for religious or cultural reasons.[35][36] Circumcision involves either a conventional "cut and stitch" surgical procedure or use of a circumcision instrument or device. Complications are rare.[37][38][39] Modern proponents say that circumcision reduces the risks of a range of infections and diseases and confers sexual benefits.[40][41] 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.[42][43][44] 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.[45][46] They hold variant perspectives on the prophylactic efficacy of the elective circumcision of minors in developed nations.[47]

### Foreskin restoration

[edit]

Main article: Foreskin restoration

Circumcised at birth, the foreskin has been restored over years of foreskin restoration.

Foreskin restoration and reconstruction are techniques for the recreation of the foreskin after its removal by circumcision or injury.[48][49][50]

Surgical reconstruction often involves grafting skin taken from the scrotum onto a portion of the penile shaft.[48] Nonsurgical restoration involves tissue expansion by stretching the penile skin forward over the glans penis with the aid of tension, either by hand or with a restoration device.[48][50]

### Infibulation

[edit]

Main article: Infibulation

The Greek poet Anacreon (582–485 BC), showing 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 kynodesme to conceal the glans. The kynodesmē 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.[51] Use of a kynodesmē may also permanently lengthen the foreskin over time which was seen as proper and desirable.[52]

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

### Emasculation

[edit]

Main article: 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.[53] The term nullo is short for genital nullification.[54] Though the procedure is mostly sought by men, female genital mutilation may be referred to as clitoral nullification.[55]

In modern-day South Asia, some members of hijra communities reportedly undergo emasculation. It is called nirwaan and seen as a rite of passage.[56]

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.[57]

### 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: Penectomy and 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.[58]

In the United States In 1907 Bertha Boronda sliced off her husband's penis with a straight razor.[59] 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.[60]

### Penis enlargement

[edit]

Main article: Penis enlargement

### Penis reduction

[edit]

Main article: Penis reduction

### Penile subincision/meatotomy

[edit]

Main article: Penile subincision

Meatotomy Subincision

Penile subincision is a form of genital modification involving a urethrotomy and vertically slitting the underside of the penis from the meatus towards to the base. It was performed on children by people of some cultures, such as the Indigenous Australians, the Arrente, the Luritja, the Samburu, the Samoans, and the Native Hawaiians. Indigenous Australians also perform circumcision as a prerequisite for subincision.[61] 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.[62] 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 the glans penis without removing skin or tissue.

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

> 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.[63]

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.

## References

[edit]

1. ^ a b c d e f g Danino, Michel Alain; Trouilloud, Pierre; Benkhadra, Mehdi; Danino, Arthur; Laurent, Romain (26 October 2023). "Cosmetic male genital surgery: a narrative review". Annals of Translational Medicine. 12 (1): 11. doi:10.21037/atm-23-351. ISSN 2305-5839. PMC 10777246. PMID 38304911.
2. ^ a b c d e f g h "Penises, Piercings and Pleasure". 2009-07-23. Archived from the original on 2015-07-09. Retrieved 2010-01-17.
3. ^ Neluis T, Armstrong ML, Young C, Roberts AE, Hogan L, Rinard K (2014). "Prevalence and implications of genital tattoos: A site not forgotten". British Journal of Medical Practitioners. 7 (4).
4. ^ a b c d Angulo JC, García-Díez M, Martínez M (2011). "Phallic decoration in paleolithic art: genital scarification, piercing and tattoos". The Journal of Urology. 186 (6): 2498–2503\. doi:10.1016/j.juro.2011.07.077. PMID 22019163.
5. ^ a b c d Nanda, Serena (1999). Neither Man nor Woman: the Hijras of India (2nd ed.). Belmont, CA: Wadsworth Publishing. ISBN 9780534509033.
6. ^ Gearhart JP, Rock JA (1989). "Total ablation of the penis after circumcision with electrocautery: a method of management and long-term followup". J Urol. 142 (3): 799–801\. doi:10.1016/s0022-5347(17)38893-6. PMID 2769863.
7. ^ a b c d e f g Abdulcadir, Jasmine; Adler, Peter W.; Almonte, Melanie T.; Anderson, Frank W. J.; Arguedas-Ramírez, Gabriela; Aulisio, Mark P.; Bader, Dina; Balashinsky, David; Baratz, Arlene B.; Bariş, Maide; Bauer, Greta; Behrensen, Maren; Ben-Yami, Hanoch; Boddy, Janice; Bootwala, Yasmin; Bowman-Smart, Hilary; Bruce, Lori; Buckler, Max; Cabral Grinspan, Mauro; Cannoot, Pieter; Carpenter, Morgan; Catto, Marie-Xavière; Catalán, Moisés; Chambers, Clare; Chapin, Georganne; Chegwidden, James; Christian Ghattas, Dan; Clough, Sharyn; Conroy, Ronán M.; Dabbagh, Hossein; Dalke, Katharine B.; Dallière, Sophie; Danon, Limor Meoded; Davis, Dena S.; Davis, Georgiann; Dawson, Angela J.; DeLaet, Debra L.; Dranseika, Vilius; DuBoff, Max; Dwyer, James G.; Earp, Brian D.; Esho, Tammary; Essén, Birgitta; Fahmy, Mohamed A. Baky; Feder, Ellen K.; Ferreira, Nuno; Fillod, Odile; Florquin, Stéphanie; Foldès, Pierre; Fox, Marie; Frisch, Morten; Fusaschi, Michela; Garland, Fae; Geisheker, John; Gheaus, Anca; Giménez Barbat, Teresa; Levin Freifrau von Gleichen, Tobe; Godwin, Samantha; Goldman, Ronald; Gonzalez-Polledo, E. J.; Goodman, Jenny; Gradilla, Alexandro José; Gruenbaum, Ellen; Gwaambuka, Tatenda; Hatem-Gantzer, Ghada; Hakim, M.; Hammond, Tim; Hannikainen, Ivar R.; van der Have, Miriam; Herbenick, Debby; Higashi, Yuko; Hill, B. Jessie; Johansen, R. Elise B.; Johari, Aarefa; Johnson-Agbakwu, Crista; Johnson, Matthew T.; Kimani, Samue; Komba, Eva; Kolak, Julia; Koukoui, Sophia; Kraus, Cynthia; Latham, Stephen R.; Laurent, Bo; Learner, Hazel; Lempert, Antony; Lenta, Patrick; Lesslar, Olivia; Lewis, Jonathan; Liao, Lih-Mei; Lorshbough, Erika; Lurenbaum, Jean-Christophe; MacDonald, Noni E.; McAllister, Ryan; Meddings, Jonathan; Merli, Claudia; Mertens, Mayli; Milos, Marilyn; Mishori, Ranit; Monro, Surya; Moss, Lisa Braver; Munzer, Stephen R.; Nazri, Hannah M.; Ncayiyana, Daniel; Neiders, Ivars; Ngosso, Londé; Nguena, Marianne; van Niekerk, Anton A.; Nobis, Nathan; Oduor, Alphonce Odhiambo; O’Neill, Sarah; Ottenheimer, Deborah; Paalanen, Panda; Palacios-González, César; Qing, Xin; Radcliffe Richards, Janet; Ramus, Franck; Rashid Khan, Abdul; Ray, Saarrah; Reis, Elizabeth; Reis-Dennis, Samuel; Remennick, Larissa; Richard, Fabienne; Roen, Katrina; Rubashkyn, Eliana; Sarajlic, Eldar; Sardi, Lauren; Schuklenk, Udo; Shahvisi, Arianne; Shaw, David; Sinden, Guy; Sidler, Daniel; Skitka, Linda; Somerville, Margaret A.; Sterckx, Sigrid; Svoboda, J. Steven; Taher, Mariya; Tangwa, Godfrey B.; Thomson, Michael; Townsend, Kate Goldie; Travis, Mitchell; Van Howe, Robert S.; Vash-Margita, Alla; Verhagen, Emmanuelle; Vilponen, Tiina; Villani, Michela; Viloria, Hida; Vintiadis, Elly; Virgili, Tommaso; Vissandjée, Bilkis; Ungar-Sargon, Eliyahu; Wahlberg, Anna; Wald, Rebecca; Walsh, Reubs J.; Weisenberg, Desmond; Wenger, Hannah; Wisdom, Travis; Zelayandia, Ernesto; Ziemińska, Renata; Zieselman, Kimberly; Ziyada, Mai Mahgoub (17 July 2024). "Genital Modifications in Prepubescent Minors: When May Clinicians Ethically Proceed?". The American Journal of Bioethics: 50. doi:10.1080/15265161.2024.2353823. hdl:11590/474747. PMID 39018160. Retrieved 22 October 2024.
8. ^ a b "David Reimer, 38, Subject of the John/Joan Case" The New York Times, New York, US, Published May 12, 2004
9. ^ a b c d e f ISNA's Amicus Brief on Intersex Genital Surgery The Intersex Society of North America, Dated February 7, 1998
10. ^ 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
11. ^ "What's ISNA's position on surgery?". Intersex Society of North America.
12. ^ a b Eichert, David (2019). "'Homosexualization' Revisited: An Audience-Focused Theorization of Wartime Male Sexual Violence". International Feminist Journal of Politics. 21 (3): 409–433\. doi:10.1080/14616742.2018.1522264. S2CID 150313647.
13. ^ "Pahalgam terror attack: Trousers of 20 victims pulled down, unzipped". The Times of India. 2025-04-26. ISSN 0971-8257. Retrieved 2025-07-23.
14. ^ a b c d e Puri, Prem; Höllwarth, Michael E. (2009). Pediatric surgery: diagnosis and management. Berlin New York: Springer. p. 963\. ISBN 978-3-540-69560-8.
15. ^ a b c Blumenthal, Paul D.; Berek, Jonathan S. (2013). A Practical Guide to Office Gynecologic Procedures. Wolters Kluwer Health. p. 49\. ISBN 9781451153897.
16. ^ UNICEF 2016.
17. ^ a b Definition of the World Health Organization
18. ^ a b UNICEF 2013 Archived 2015-04-05 at the Wayback Machine, 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."

19. ^ 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 Archived 2015-04-05 at the Wayback 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: Djibouti Archived 2014-10-30 at the Wayback Machine (December 2013), Eritrea Archived 2014-10-30 at the Wayback Machine (July 2014), Somalia Archived October 30, 2014, at the Wayback Machine (December 2013).

Gerry Mackie, "Ending Footbinding and Infibulation: A Convention Account" Archived 2019-07-20 at the Wayback 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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30. ^ Essen, Birgitta; Johnsdotter, Sara (2004). "Female Genital Mutilation in the West: Traditional Circumcision versus Genital Cosmetic Surgery" (PDF). Acta Obstetricia et Gynecologica Scandinavica. 83 (7): 611–613\. doi:10.1111/j.0001-6349.2004.00590.x. PMID 15225183. S2CID 44583626. Archived from the original on 14 April 2013. Retrieved 11 October 2022.
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34. ^ Yosha, Assaf; Bolnick, David; Koyle, Martin (2012). Surgical Guide to Circumcision. Springer Publishing. pp. 256–257\. ISBN 9781447128588. "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."
35. ^ Hay W, Levin M (25 June 2012). Current Diagnosis and Treatment Pediatrics 21/E. McGraw Hill Professional. pp. 18–19\. ISBN 978-0-07-177971-5. Archived from the original on 18 January 2016.
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37. ^ 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.
38. ^ Williams N, Kapila L (October 1993). "Complications of circumcision". The British Journal of Surgery. 80 (10): 1231–6\. doi:10.1002/bjs.1800801005. PMID 8242285. S2CID 27220497.
39. ^ Krill AJ, Palmer LS, Palmer JS (2011). "Complications of circumcision". TheScientificWorldJournal. 11: 2458–68\. doi:10.1100/2011/373829. PMC 3253617. PMID 22235177.
40. ^ Society, Canadian Paediatric. "Newborn male circumcision | Canadian Paediatric Society". cps.ca. Retrieved 2023-06-05.
41. ^ "Newborn Male Circumcision". American Academy of Pediatrics. 27 August 2012. Archived from the original on 7 November 2017. Retrieved 11 August 2019.
42. ^ Aigrain, Yves; Barauskas, Vidmantas; Bjarnason, Ragnar; Boddy, Su-Anna; Czauderna, Piotr; de Gier, Robert P.E.; de Jong, Tom P.V.M.; Fasching, Günter; Fetter, Willem; Gahr, Manfred; Graugaard, Christian; Greisen, Gorm; Gunnarsdottir, Anna; Hartmann, Wolfram; Havranek, Petr; Hitchcock, Rowena; Huddart, Simon; Janson, Staffan; Jaszczak, Poul; Kupferschmid, Christoph; Lahdes-Vasama, Tuija; Lindahl, Harry; MacDonald, Noni; Markestad, Trond; Märtson, Matis; Nordhov, Solveig Marianne; Pälve, Heikki; Petersons, Aigars; Quinn, Feargal; Qvist, Niels; Rosmundsson, Thrainn; Saxen, Harri; Söder, Olle; Stehr, Maximilian; von Loewenich, Volker C.H.; Wallander, Johan; Wijnen, Rene (April 2013). Frisch, Morten (ed.). "Cultural Bias in the AAP's 2012 Technical Report and Policy Statement on Male Circumcision". Pediatrics. 131 (4). American Academy of Pediatrics: 796–800\. doi:10.1542/peds.2012-2896. PMID 23509170. S2CID 40444911.
43. ^ Warren, John (2010). "Physical Effects of Circumcision". In Denniston, George C.; Hodges, Frederick M.; Milos, Marilyn Fayre (eds.). Genital Autonomy: Protecting Personal Choice. New York: Springer-Verlag. pp. 75–79\. doi:10.1007/978-90-481-9446-9_7. ISBN 978-90-481-9446-9. Archived from the original on 6 August 2020. Retrieved 19 November 2019.
44. ^ Svoboda, J. Steven (July 2013). "Circumcision of male infants as a human rights violation". Journal of Medical Ethics. 39 (7): 469–474\. doi:10.1136/medethics-2012-101229. ISSN 1473-4257. PMID 23698885. S2CID 7461936.
45. ^ "Preventing HIV Through Safe Voluntary Medical Male Circumcision For Adolescent Boys And Men In Generalized HIV Epidemics". World Health Organization. 2020. Archived from the original on 22 November 2021. Retrieved 24 May 2021.
46. ^ For sources on this, see:
* Chikutsa A, Maharaj P (July 2015). "Social representations of male circumcision as prophylaxis against HIV/AIDS in Zimbabwe". BMC Public Health. 15 (1): 603. doi:10.1186/s12889-015-1967-z. ISSN 1471-2458. PMC 4489047. PMID 26133368. "It is now generally accepted in public health spheres that medical male circumcision is efficacious in the prevention of HIV infection."
* Bell K (2016). Health and Other Unassailable Values: Reconfigurations of Health, Evidence and Ethics. Taylor & Francis. p. 106\. ISBN 978-1-317-48203-1. "...defending the casual relation between male circumcision and reduced HIV transmission has become essentially hegemonic in the academic literature."
* Merson M, Inrig S (2017). The AIDS Pandemic: Searching for a Global Response. Springer International Publishing. p. 379\. ISBN 978-3-319-47133-4.
47. ^ Schoen, Edgar J. (1997-09-01). "Benefits of newborn circumcision: is Europe ignoring medical evidence?". Archives of Disease in Childhood. 77 (3): 258–260\. doi:10.1136/adc.77.3.258. ISSN 0003-9888. PMC 1717326. PMID 9370910.
48. ^ a b c Timmermans, Floyd Wilhelmus; Mokken, Sterre Elisabeth; Poor Toulabi, Sahaand Cris Zoë; Bouman, Mark-Bram; Özer, Müjde (August 2022). "A review on the history of and treatment options for foreskin reconstruction after circumcision". International Journal of Impotence Research. 34 (5): 424–433\. doi:10.1038/s41443-021-00438-3. ISSN 1476-5489.
49. ^ Hammond, Tim; Sardi, Lauren M.; Jellison, William A.; McAllister, Ryan; Snyder, Ben; Fahmy, Mohamed A. B. (May 2023). "Foreskin restorers: insights into motivations, successes, challenges, and experiences with medical and mental health professionals – An abridged summary of key findings". International Journal of Impotence Research. 35 (3): 309–322\. doi:10.1038/s41443-023-00686-5. ISSN 1476-5489.
50. ^ a b Collier, R. (2011-12-13). "Whole again: the practice of foreskin restoration". Canadian Medical Association Journal. 183 (18): 2092–2093\. doi:10.1503/cmaj.109-4009. ISSN 0820-3946. PMC 3255154.
51. ^ D. Schultheiss; J.J. Mattelaer; F.M. Hodges (2003). "Preputial infibulation: from ancient medicine to modern genital piercing". BJU International. 92 (7): 758–763\. doi:10.1046/j.1464-410X.2003.04490.x. PMID 14616462. S2CID 8855134.
52. ^ Keuls, Eva C. (1993). The reign of the phallus: sexualpolitics in ancient Athens. Berkeley, London: University of California Press.
53. ^ Margo DeMello (2007). Encyclopedia of Body Adornment. ABC-CLIO. pp. 57–. ISBN 978-0-313-33695-9.
54. ^ Knibbs, Kate (2015-05-14). "The Most Extreme Body Hacks That Actually Change Your Physical Abilities". Gizmodo. Retrieved 2017-08-23.
55. ^ Lee Harrington (1 May 2016). Traversing Gender: Understanding Transgender Realities. Mystic Productions Press. pp. 23–. ISBN 978-1-942733-83-6.
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59. ^ "Bobbitt's Amputation Case Similar to a 1907 Account". Orlando Sentinel. San Jose Mercury News. 30 November 1993. Retrieved 27 November 2019.
60. ^ 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. Retrieved 2024-04-25.
61. ^ Wilson, Christopher G. (2008-05-01). "Male genital mutilation: an adaptation to sexual conflict". Evolution and Human Behavior. 29 (3): 149–164\. doi:10.1016/j.evolhumbehav.2007.11.008. ISSN 1090-5138.
62. ^ "Meatotomy – BME Encyclopedia". wiki.bme.com. Retrieved 2017-12-13.
63. ^ 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. PMID 11568485. S2CID 29580193. Retrieved 2018-02-06. 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."

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