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 a few traditional cultures, including Indigenous Australians. This procedure 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."David Reimer, 38, Subject of the John/Joan Case" The New York Times, New York, US, Published May 12, 2004 Most surgeries involving children with ambiguous genitalia are sexually damaging and may render them infertile.ISNA's Amicus Brief on Intersex Genital Surgery The Intersex Society of North America, Dated February 7, 1998 For example, in cases involving male children with micropenis, doctors may recommend the child be reassigned as female.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 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 (to the vagina and vulva, respectively), while males may undergo penectomy or orchiectomy (removal of the penis and testicles, respectively). 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 (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.

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

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."Definition of the World Health Organization 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.UNICEF 2013 , 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." Over eight million have been infibulated, a practice found largely in Djibouti, Eritrea, Somalia and Sudan.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 , 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 (December 2013), Eritrea (July 2014), Somalia (December 2013).Gerry Mackie, "Ending Footbinding and Infibulation: A Convention Account" , 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." 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). 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 (Article 38).

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

Hymenorrhaphy