Genital modification and mutilation


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

Reasons

Body modification

Voluntary

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.
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.
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.
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.
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 and vulvoplasty for trans women and metoidioplasty, phalloplasty, and scrotoplasty 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. In rare cases, a child's gender has been reassigned without their consent due to genital injury, such as David Reimer, who was the subject of John Money's John/Joan case. 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
The following types of unvoluntary genital cutting or surgery are sometimes performed on children for nontherapeutic reasons: clitoral reduction surgeries on children with CAH, hypospadias surgeries, removal of internal gonads and penile circumcision. In some societies, other types of endosex girl genital cutting happen.
They can be done for psychosocial, cultural, subjective-aesthetic, or prophylactic perceived benefits, as judged by doctors or parents.
Penile subincision, or splitting of the underside of the penis, is widespread in the traditional cultures of Indigenous Australian children. This procedure has been adapted for adults 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.
Opposition
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. Most surgeries involving children with ambiguous genitalia are sexually damaging and may render them infertile. For example, in cases involving male children with micropenis, doctors may recommend the child be reassigned as female. 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.

As sexual violence

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. 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. 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.

As treatment

If the genitals become diseased, as in the case of cancer, sometimes the diseased areas are surgically removed. Females may undergo vaginectomy or vulvectomy, while males may undergo penectomy or orchiectomy. 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 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 their hymenal opening, or removal of the hymen altogether, to facilitate sexual penetration of their vagina.

Self-inflicted

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 mental illness, self-mutilation, body dysmorphia, or social reasons. Not all regions have proper transgender health care or gender-affirming surgeries available, which can lead to people attempting self-surgery.

Female

Female genital mutilation

, also known as female genital cutting, female circumcision, or female genital mutilation/cutting, 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." It is not the same as the procedures used in gender-affirming surgery or the genital modification of intersex persons.
It is practiced in several parts of the world, but the practice is concentrated more heavily in Africa, most 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. Over eight million have been infibulated, a practice found largely in Djibouti, Eritrea, Somalia and Sudan. Infibulation, the most extreme form of FGM, 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. 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. The Istanbul Convention prohibits FGM.
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: Physical, sexual and psychological violence occurring in the family, including... female genital mutilation...". However, because of its importance in traditional life, it continues to be practised in many societies.

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.

Labia stretching

Labia stretching is the act of elongating the labia minora through manual manipulation or physical equipment. It is a familial cultural practice in Rwanda, common in Sub-Saharan Africa, and a body modification practice elsewhere. It is performed for sexual enhancement of both partners, aesthetics, symmetry and gratification.

Vulvoplasty and vaginoplasty

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. 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. The surgery itself is controversial, and critics refer to the procedures as "designer vagina".
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. 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".