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 sometimes voluntarily sought out by adults and has taken root in Western body modification culture, the modern primitives. People seeking the procedure may or may not have ties to a culture that practices it. 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 (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. 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 (medically unnecessary) reasons: clitoral reduction surgeries on children with congenital adrenal hyperplasia (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

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.

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