Protecting Children or Policing Gender?

Laws on genital mutilation, gender affirmation and cosmetic genital surgery are at odds. The key criteria should be medical necessity and consent.

By Brian D. Earp (@briandavidearp)

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In Ohio, USA, lawmakers are currently considering the Save Adolescents from Experimentation (SAFE) Act that would ban hormones or surgeries for minors who identify as transgender or non-binary. In April this year, Alabama passed similar legislation.

Alleging anti-trans prejudice, opponents of such legislation say these bans will stop trans youth from accessing necessary healthcare, citing guidance from the American Psychiatric Association, the American Medical Association and the American Academy of Pediatrics.

Providers of gender-affirming services point out that puberty-suppressing medications and hormone therapies are considered standard-of-care for trans adolescents who qualify. Neither is administered before puberty, with younger children receiving psychosocial support only. Meanwhile genital surgeries for gender affirmation are rarely performed before age 18.

Nevertheless, proponents of the new laws say they are needed to protect vulnerable minors from understudied medical risks and potentially lifelong bodily harms. Proponents note that irreversible mastectomies are increasingly performed before the age of legal majority.

Republican legislators in several states argue that if a child’s breasts or genitalia are ‘healthy’, there is no medical or ethical justification to use hormones or surgeries to alter those parts of the body.

However, while trans adolescents struggle to access voluntary services and rarely undergo genital surgeries prior to adulthood, non-trans-identifying children in the United States and elsewhere are routinely subjected to medically unnecessary surgeries affecting their healthy sexual anatomy — without opposition from conservative lawmakers.

One group affected by these non-voluntary surgeries are infants born with intersex traits due to one or more ‘differences of sex development’. These traits are often harmless, naturally-occurring variations in human sexual and reproductive anatomy that occur in an estimated 0.018 percent to 0.08 percent of all live births.

Doctors will often recommend risky, even radical surgeries for intersex infants with genital features that differ from cultural ideals of ‘normal’ or ‘typical’. These surgeries attempt to make the child’s body fit within a stereotyped gender binary. They are not to promote the infant’s physical health — which may be impaired by the surgeries.

Studies published between 1955 and 2000 (mostly looking at populations in developed economies) estimate that these surgeries are performed on around one in every 1,000 children, although exact rates are unknown.

Since most intersex surgeries are medically avoidable, are performed without the consent of the affected child, and involve damaging or removing healthy genital tissues, human rights scholar Melinda Jones has called them a “Western form of female genital mutilation”.

The term ‘female genital mutilation’ (FGM) is primarily used to describe (and condemn) non-Western, mostly African, practices. Currently, the World Health Organization (WHO) defines such mutilation as any cutting or alteration of female-typical genitalia that is not done for “medical reasons”.

The WHO’s sex-specific definition includes highly invasive procedures, like excision of the external clitoris and infibulation. But it also counts as FGM relatively minor interventions, such as ‘ritual nicking’ of the clitoral foreskin or hood.

This form of cutting is practiced, alongside male circumcision, by some Islamic sects such as the Dawoodi Bohra.

In 2017, a member of the Bohra community — Dr Jumana Nagarwala — was arrested in Detroit, Michigan on charges of FGM. She was brought to trial for allegedly performing a ritual nick or similar procedure on several young girls.

The federal judge in charge of the case struck down the US anti-FGM law as unconstitutional. However a replacement law was signed by President Trump near the end of his term. The STOP FGM Act of 2020 clarifies that ritual nicking without tissue removal — even for explicitly religious purposes — is now banned as female genital ‘mutilation’.

But like the WHO definition, this law excludes children with intersex traits who undergo medically unnecessary genital cutting, even if categorised by doctors as female at birth.

The language of mutilation is not applied consistently.

Scholars of genital cutting also question why cosmetic labiaplasty surgeries are not condemned as mutilation despite fitting the WHO definition, and despite new findings showing that nearly 20 percent of these surgeries in the United States, between 2016 and 2019, were carried out on under-18-year-old girls.

Few labiaplasties prior to adulthood are done on grounds of physical health. Most are performed to relieve psychological distress in girls who regard their own healthy anatomy as falling outside restrictive gender norms for female genital appearance.

Genital surgeries are also regularly carried out on children who are categorised as male at birth, based on the visual appearance of a penis.

Some of these children have a condition known as hypospadias, where the urethra opening — the hole for urine and semen — is not at the tip of the penis, but is somewhere closer to the body on the underside of the shaft.

Surgical attempts to relocate the urethra opening to the tip remain standard practice, despite a high rate of serious complications, including fistulas, long-term scarring and other damage.

These childhood genital surgeries are rarely needed for physical health reasons. More often, they are motivated by psychosocial concerns, with parents and doctors believing a boy should be able to ‘pee standing up’, or that a child will want his sexual organ to look ‘typical’ for his anticipated gender — even at the risk of losing sexual sensation.

But there is no evidence that non-voluntary surgeries for hypospadias tend to improve psychosocial well-being compared to voluntary surgeries or no surgery.

In addition to children with hypospadias, states now advocating bans on gender-affirming healthcare for trans adolescents allow medically unnecessary genital surgeries on another group of young males without their consent.

This group includes children who have no known differences of sex development nor any medical problems affecting their genitals. The surgery — which occurs over one million times a year in US hospitals — is almost always done for primarily cultural, not strictly medical reasons.

It is circumcision, or cutting and removing the penile foreskin.

The foreskin is often dismissed in US culture as insignificant. However it makes up about 30 percent of the skin system of the human penis. Similar to the female labia and clitoral hood, it is an elastic erogenous tissue that covers and protects the rest of the organ, unless it is removed. Studies suggest it is the most sensitive part of the penis to light touch.

While some American doctors claim that newborn circumcision carries health benefits such as reducing the risk of urinary tract infection (UTI), European doctors dispute these benefits, arguing there’s no medical justification for non-consensual genital surgery on healthy minors.

These doctors stress that circumcision in early childhood, when the organ is not fully developed, carries non-trivial risk. Recent data from California show that 1 in every 100 newborn circumcisions results in late-occurring complications, most of which require surgical repair.

Increasingly, scholars and advocates criticise what they see as biased or selective expressions of concern for children’s bodily integrity. Why is labiaplasty allowed on young teen girls, but not less-severe Islamic ritual nicking — with only the latter defined as ‘FGM’? Why is medically unncessary genital surgery on intersex infants — and non-intersex boys — permitted, while voluntary puberty suppression for trans adolescents with gender dysphoria banned?

Some critics suggest the real motive behind the recent bans is not principled ethics, but conservative policing of the sex/gender binary.

Gender-affirming procedures are considered suspect, because they alter a person’s body to align with a gender category other than the one assigned at birth. Males are expected to identify as boys/men, and females as girls/women. Any other relationship between sex and gender violates traditional norms.

By contrast, even genital operations that are not medically necessary are approved by conservatives if they preserve the status quo of what is considered ‘normal’ for boys and girls.

This includes removing signs of sexual ambiguity in children with intersex traits, reshaping girls’ vulvas through labiaplasty — to make them more ‘feminine’ and petite, banning ‘foreign’ practices like ritual nicking, and altering boys’ penises with hypospadias surgery or circumcision to match cultural norms.

Scholars who study the ethics of genital cutting are increasingly of the view that the same moral and legal principles should apply in this area, regardless of sex or gender.

They argue the key is consent.

For children who are too young to consent, if a genital surgery is not necessary to preserve the child’s physical health, they suggest it should not be performed. Doctors, they argue, should not agree to elective labiaplasties, ritual nicking, ‘normalising’ surgeries for hypospadias or intersex traits, or penile circumcisions in non-consenting minors.

For older teens and adolescents, who have relatively more autonomous decision-making capacity, it is possible that some can give their own valid consent to certain body alterations, such as circumcision — or to medically approved hormone therapies for gender dysphoria, preferably with parental support.

Gender-affirming surgeries for trans minors are not recommended, although in rare individual cases they could be deemed medically necessary prior to age 18. Either way, it is acknowledged that better research on long-term risks and benefits is sorely needed.

And for legal adults, these ethicists claim, there should be the widest leeway for undergoing genital modifications under conditions of informed consent, up to and including purely ‘cosmetic’ procedures with no medical indication.

Brian D. Earp is a senior research fellow in the Uehiro Centre for Practical Ethics at the University of Oxford and associate director of the Yale-Hastings Program for Ethics and Health Policy at Yale University and The Hastings Center. He is a signatory to the 2019 Brussels Collaboration on Bodily Integrity international scholarly consensus statement on the ethics of child genital modification.

Originally published under Creative Commons by 360info™.

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10 Responses to Protecting Children or Policing Gender?

  • Paul D. Van Pelt says:

    The whole notion of policing anything about gender and reproductive rights is, by my lights, puritanical wrongheadedness. Anyone believing there is a place for this in the twenty-first century is either ‘semi-Fascist’; ‘authoritarian populist’; or ‘eugenicist’. If someone derives a better term than any of those, I will be most interested in hearing it. Orwell’s big brother theme has evolved beyond his wildest fears, if they were fears at all. Terms like justice, fairness, ethics and morality take on whatever guise(s) their proponents assign, and much of this assumes the aspect of modern day tribalism. We have been warned about that, and, it remains a perilous path. Any reasonable person ought to be concerned. But reasonable people are busy too.

  • Norm Cohen says:

    Genital surgeries for “gender affirmation” are not rare. Just last week, the World Professional Association of Transgender Health (WPATH) removed age limits from its transgender treatment guidelines (See Medscape 9/16/22 “WPATH Removes Age Limits”). There are several well-documented cases of double mastectomies on girls of 16 in the US and the UK.

    Regressive gender stereotypes that essentialize male and female behavior are being perpetuated, thereby encouraging those who don’t conform to “transition.” A metaphysical gender ideology having no coherent evidence in science or history has taken hold of the medical industrial establishment by disguising gender claims as “human rights.” A large experiment is well-underway on troubled teenagers who have been affirmed in their belief that the way to authenticity and happiness is through surgery, drugs, and the right clothes. Fortunately, Sweden, Finland, and the UK have recently walked back from their aggressive protocols in favor of more psychological counseling.

    There are many bad reasons to mutilate bodies, and the transgender social contagion is just the latest. Anorexia, too, is another form of mutilation and is well-documented as contagious. For the first time in history, teenagers are being mutilated, sterilized, and sexually stunted upon their own initiative instead of others. The double standards found in those who condemn one form of mass mutilation but not another is not evidence of their insincerity, but of their priorities.

    Providing informed consent is often rendered irrelevant when it comes to minors, especially when their bodies are involved. For developmental reasons, a fifteen-year-old’s consent to a tattoo, breast augmentation, or sexual activity is meaningless. In the absence of disease, providing surgeries and drugs that likely result in sterility and/or sexual dysfunction must be delayed until the age of majority and then only after psychological counseling.

    Causing sterility, genital atrophy, sexual dysfunction, and mutilation of healthy sex organs in children and teenagers is not something any children’s rights advocate should ever support.

    • Thank you for your feedback Norm. Here are some replies:

      You write: “Genital surgeries for ‘gender affirmation’ are not rare. Just last week, the World Professional Association of Transgender Health (WPATH) removed age limits from its transgender treatment guidelines (See Medscape 9/16/22 ‘WPATH Removes Age Limits’). There are several well-documented cases of double mastectomies on girls of 16 in the US and the UK.”

      My response: the article acknowledges that double mastectomies are increasingly performed in legal minors, and it does not endorse this trend. Even so, ‘several well-documented cases’ of X does not contradict an assertion of ‘rarity’ — especially when the reference to rarity had to do, not with mastectomies, but rather, with genital surgeries in particular. The overwhelming majority of genital surgeries intended to address or alleviate gender dysphoria occur after the age of 18, with some prominent gender medicine clinics categorically refusing to perform them before that age. In any case, I do not endorse genital surgeries in anyone incapable of validly consenting to them that are not urgently medically necessary. In the highly unusual circumstances in which doctors perform genital surgeries in persons under the age of 18 (the vast majority of these instances being on 17-year-olds, who, presumably, do not have substantially less decision-making capacities than do 18-year-olds, on average) for purposes of attempting to address longstanding gender-dysphoric distress, it is because, in their judgment, it is in fact necessary for the health and well-being of the particular individual in question. Since I don’t know about the specific circumstances of each such judgment, I am not sure whether they could have been reasonable; if the surgeries were not in fact medically necessary (on some reasonable conception) or if the person requesting them could not have given morally meaningful consent, then on principle I would not support the surgeries. That being said, if you think that legal adults (i.e., 18 year olds) should in principle be permitted to choose body modifications for personal reasons, out of respect for the autonomy of sufficiently mature persons to decide about their own bodies, then I think some further thought would be needed to determine how best to distinguish the level of autonomy of an average 17-year-old compared to that of an 18-year-old. In general, the position I defend is one of *genital autonomy* — that means, protecting people from non-voluntary genital modifications that they don’t want, didn’t request, or definitely cannot consent to, while preserving and allowing the *choice* of relatively more mature and autonomous persons to decide whether or how they may want their bodies to be modified under conditions of informed consent. Whether someone has the mental and emotional capacity to give meaningfully informed consent to a given body modification is a difficult question; your position seems to be that no one, categorically, under the age of 18 has the capacity, whereas once they turn 18, suddenly they have the capacity. But I don’t think the legal age of majority/minority (which is essentially arbitrary and varies depending on the domain in question) necessarily tracks with the moral capacity to autonomously make certain choices about one’s own body in particular individual cases.

      You write: “Regressive gender stereotypes that essentialize male and female behavior are being perpetuated, thereby encouraging those who don’t conform to ‘transition.’ A metaphysical gender ideology having no coherent evidence in science or history has taken hold of the medical industrial establishment by disguising gender claims as ‘human rights.’ A large experiment is well-underway on troubled teenagers who have been affirmed in their belief that the way to authenticity and happiness is through surgery, drugs, and the right clothes. Fortunately, Sweden, Finland, and the UK have recently walked back from their aggressive protocols in favor of more psychological counseling.”

      My response: I oppose regressive stereotypes that essentialize male or female behavior or appearance, as evidenced in my various writings on gender. The reasons why some persons experience body dysphoria about their sex-typed anatomy are diverse and do not simply reduce to adherence to a certain contentious metaphysical view about gender. Nevertheless, I do agree that many stakeholders in the medical establishment seem to have taken on a relatively simplistic view about gender that ought to be critiqued. I also agree that any facile messages to teenagers that a simple way to achieve happiness and authenticity is to radically modify one’s body is problematic to say the least. That does not preclude the possibility, however, that for some individuals with persistent, otherwise unresolvable dysphoria about their sex-typed anatomy, changes to the body in conjunction with psychosocial support may be the best all-things-considered option for alleviating significant distress and feeling more “at home” in their physical embodiment.

      You write: “There are many bad reasons to mutilate bodies, and the transgender social contagion is just the latest.”

      My response: If someone voluntarily asks for surgical changes to be made to their bodies, because they view these changes as all-things-considered improvements or enhancements to the body, then, I don’t think it makes sense simply to define what they seek as “mutilation.” For example, although we may certainly want to raise moral objections to the social pressures that may incline some people to seek out cosmetic surgery, we don’t tend to accuse such people of “self-mutilation” … for example, elective rhinoplasty is not called “nose mutilation.” If a change is made to one’s healthy body that one does not prefer, resents, and didn’t ask for, then I think it makes much more sense to call such a change a “mutilation.” Second, you refer to “the transgender social contagion” — the evidence regarding the possibility of social contagion is not conclusive; but in any case, to return to our topic of genital surgeries, in the rare cases where these are performed on persons under the age of 18, my understanding is that, to be eligible, the individual must have lived for several years with unresolvable gender dysphoria; therefore, anyone who did suddenly and mistakenly take themselves to be transgender due to invidious social influence would not be eligible, prior to adulthood, for surgery.

      You write: “Providing informed consent is often rendered irrelevant when it comes to minors, especially when their bodies are involved. For developmental reasons, a fifteen-year-old’s consent to a tattoo, breast augmentation, or sexual activity is meaningless. In the absence of disease, providing surgeries and drugs that likely result in sterility and/or sexual dysfunction must be delayed until the age of majority and then only after psychological counseling.”

      My response: You seem to hold a particularly skeptical view about the capacity of young people to make adequately informed decisions for themselves. For very young children, it’s clear that they cannot meaningfully consent to significant body modifications. However, by the time someone is 15 or 16, they should be practicing autonomous decision-making and they have relatively more decision-making capacity. The “mature minor” doctrine was established to account for this. There are significant ongoing debates about whether, for example, a 15-year-old can give valid consent to an abortion without parental involvement; it is also not clear that the ability of a 15-year-old to choose to engage in sexual activity with a 16-year-old, say, is “meaningless” — that is why so-called “Romeo and Juliet” laws have been passed, to avoid having to criminalize the voluntary participants in such activities as rapists/victims of rape, etc. I do agree with you that, the more significant the intervention with greater risks or long-term implications, the better it would be, in general, to defer the decision to a point where the individual is – unambiguously – sufficiently mature to make the decision in a responsible way.

      You write: “Causing sterility, genital atrophy, sexual dysfunction, and mutilation of healthy sex organs in children and teenagers is not something any children’s rights advocate should ever support.”

      My response: I don’t support medically unnecessary, permanent modifications of a person’s genitalia who is not capable of meaningfully consenting to them, given their particular circumstances and level of maturity. I do support sufficiently mature people being able to make informed personal decisions about their own bodies. For any given person, especially if they are dealing with severe body dysphoria due to internal unresolvable factors (rather than, say, invidious social pressures), I think may be hard to draw the line about when exactly they should be considered eligible for certain interventions. If a person really cannot live in their body the way it is, and if they understand the risks and adverse effects of seeking to change their body, such as those you cite, but nevertheless judge that they would be all-things-considered better off with the changes, then, if they are sufficiently mature to make an adequately informed and considered decision, ultimately, it should be their choice.

  • Alex says:

    No doubt that “conservative policing of the sex/gender binary” plays into some of this (particularly into which surgeries are emotively referred to as “mutilation”). Having said that, treatments likely or certain to result in infertility do seem particularly important to limit, even where consensual, as minors may not be forward looking enough to imagine a future desire for children. Seems somewhat analogous to the problem of whether you ought to be able to enter into voluntary slavery – freely consenting to something that significantly limits the freedom of your future self. Of course it’s not obvious what age should be deemed mature enough to make this decision; maybe 16 is usually old enough.

  • Paul D. Van Pelt says:

    I base much of my thinking about this on what seems to be the mood of the people. Right now, political acrimony and dissent is stoking that. Relentlessly. Also, that disease, that “would just go away”, is not going away—illogically, there remain people who will not receive vaccinations. I have contended that we make up reality as we go, and this creativity extends into our notions about ethics and morality. Terminology changes, sometimes in a matter of days. Or hours. Authoritarian populism dropped from the lexicon moments after the chief executive’s comment on semi-Fascism. My inquiries on that were met with stony silence. I guess people were to embarrassed, or too frightened, to address the matter. I submit the following proposition: our system of government is shifting towards something like a political theocracy. That term is imprecise because I don’t know what else to call it. Some folks think I’m crazy. There are forms of that as well. Denial is one.

  • Leif Thompson says:

    I agree on many points of this writing:
    1) The taxonomy of genital cutting should have the first devision at the level of the degree of autonomy expressed in the decision. Primarily this would be a devision between self chosen (voluntary) vs non-voluntary. Unfortunately, our systems, at least the ones advocated by medical organizations such as the WHO focus basically on the cultural familiarity of the cutting (western vs non-western forms). There is always a gray area in any taxonomy. Is an intervention “medically necessary” or can it be delayed? Or, what is a qualifying medical goal to warrant intervention? Is there sufficient decision making agency? For instance in the case of minors requesting permanent cosmetic alterations such as labioplasty or circumcision. Even for adult’s, some men may request castration or penectomy to satisfy fetish desires, and may suggest a higher level of psychologic assessment, even when agency is implied by the person’s age. There needs to be some flexibility within any system that takes into account agency, informed consent, and perhaps psychological state as well. But it is clear to me that the first level of the assessment of permissibility must be the agency of the one who is to be cut.

    2) Mutilation is an emotionally charged term. It has no place in the discussion of a permissibility or impermissibility of any form of genital cutting. In attempting at least a cursory definition of “mutilation” I would say that it is any genital alteration that was non-voluntary and is ultimately unwanted by the individual that was cut. Infant penile circumcision and intersex genital conformity operations clearly have lead to a large number of individuals that both did not choose the genital alteration they were subjected to, and view the alteration negatively. Everyone else I would say, should tread lightly.

    3) The concept of “gender conformity” actually needs to be considered from a different angle; that of “genital conformity,” which I believe is just as strong as the societal need for gender to be expressed within a narrow band of acceptable behaviors. We have a narrow band of genital phenotypes, and in the case of genital alterations such as cultural MGC and FGC, one of the main reasons for perpetuating the involuntary cutting, is just for the child to grow up to be “normal” within the cultural standard via enforced involuntary genital morphology.

    It is past the time to form a structural discourse for all genital cutting (alterations); from childhood forms of FGC and MGC, to voluntary and involuntary intersex alterations, to cosmetic alterations (including traditional FGC and MGC, but at an age that allows decision making capacity), piercings and fetish cuttings up to and including castration/penectomy/mastectomy/vulvectomy, transgender alterations, and restorative alterations such as pseudo-foreskin restorations or surgical attempts at reversing some of the negative effects of FGC.

    I doubt the WHO will ever attempt this without strong outside pressure (they are too dominated by the US and a narrow cultural perspective), but perhaps another organization such as the ISSM can serve this purpose; to create a model structure with some rational bases on this human obsession with genital cutting and genital conformity. There is no way to understand this obsession without an anthropological perspective, which the medical systems, and to some extent our ethical systems, have not yet fully developed.

  • Paul D. Van Pelt says:

    Outstanding, everyone. I am pleased that thinkers, more experienced and educated than I, are responding here. I do not get all of what is exchanged, but, I think, enough. My role is devil’s advocate, which I have pursued, elsewhere. Every advocate deserves his due. Even, the devil….when the devil makes you think. Been doing this since 2010. Ask the folks at Philosophy Talk. My thanks to this blog, as well…
    ….do the best you can, with what you have and know.

  • Georganne Chapin says:

    Thank you, Brian Earp, for this painstaking and painful-to-read explication.

    I find it enormously time-consuming to inventory and analyze and distinguish among (and to read about) all the permutations of genital alteration, medical terminology, “kinds” of children’s bodies, rationalizations and their refutations… all to end up with what we know from the beginning: unless there is a health-threatening pathology (and I’m talking about physical/medical, not psychological pathology), people’s bodies should be left alone until they are at an age when they (arguably) can understand the risks and freely give consent.

    Then the arguments start about what the age of consent might plausibly be. 13? 15? 18? 21? I don’t know. But we don’t allow people to do all kinds of permanently disfiguring procedures to themselves, social pressure be damned, until they are at whatever age of consent our culture deems logical for a given intervention or behavior. So, we don’t allow 20 year-olds to purchase and consume alcohol, or 16 year-olds to purchase and smoke cigarettes. But we allow “experts” like the late John Money to give advice, and surgeons to carve up their bodies or chemically alter the sexual identity and sexual function of a 10- or 12- year old?

    If you are not permitted to farm out your young child to the guy next door as his domestic slave or for his sexual gratification, then you shouldn’t be permitted to hire another person to permanently alter (mutilate) your child’s sex organs or alter your child’s future reproductive freedom through the administration of hormones that will render the child sterile for life. Those who lobby to allow all of this are in myriad ways benefitting from these procedures—as physicians who make money from them or as “expert” advisors. And there is absolutely no long-term research or evidence that this stuff works out well.

    As for psychological or psychiatric pathologies (e.g., “gender dysphoria”), these should be addressed by allowing the child to live as much as possible as the gender/sex they aspire to, in terms of their name, their clothing, with whom they associate, etc. I think it’s just as important to protect the body of an intersex child or a boy child who wants to be a girl, or a girl child who wants to be a boy (this is far more common than the opposite, which should tell you something about our culture), as it is to protect the genitals of a “normal” child, and leave them with “an open sexual future.” I know that it’s easier said than done to keep a child from being bullied, to reduce the stigma associated with not being “like everyone else” (whatever the F that means), but it’s not harder than dealing with the life-long consequences of irreversible surgeries or treatments that likely will not “work out” the way the child and the parents fantasized it would.

  • Chris Coughran says:

    In my dealings with a few of them, conservative pundits get hot under the collar whenever transgender interests are discussed, yet raise nary an eyebrow at the routine genital mutilation of infant males. So I agree with the OP, that gender/genital inscription and norm-policing (perhaps best exemplified by routine male circumcision) probably do trump ostensible concerns with the safety, protection or rights of children. On the more progressive side of politics too — among activists working in the “child safety” and “gender-based violence” domains — the moral claims of circumcised males are given the lowest possible priority (for different, though similarly vested reasons). As a male advocate of universal genital autonomy, I had been hoping that (female,) intersex and transgender activists would lead the charge into a more open future for all. But I have to admit, the whole edifice of human (not to mention children’s) rights is looking decidedly precarious these days.

  • Chris Coughran says:

    With male and female circumcision the procedure is said to be “botched” if the capacity for sexual reproduction is destroyed. This at least seems to be the inherited wisdom of patriarchal tradition. With transgender reassignment (I presume, given the current state of biotechnology) reproductive capability is effectively obliterated, on purpose. This is (I believe) quite modern.

    With MGM, FGM and non-consensual intersex “rectifications,” the surgical procedure is conducted in accordance with inherited gender/genital norms—inclusive of reproductive roles. Not so, transgender reassignment, the underlying rationale for which remains entirely subjective (and by that token also, it seems to me, radically modern).

    Random thoughts, not necessarily valid or meaningful or relevant. I stand to be easily corrected on any of the above. But it’s easy to see why transgenderism is a massive threat to patriarchal order, in starkest possible contrast to other forms of (non-consensual, non-therapeutic) genital surgery.

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