This is a preview of subscription content, access via your institution
Subscribe to this journal
Receive 8 print issues and online access
$259.00 per year
only $32.38 per issue
Rent or buy this article
Get just this article for as long as you need it
Prices may be subject to local taxes which are calculated during checkout
This claim is based on the fact that in western liberal societies there are currently morally unjustifiable differences in legal and medical assessments of women’s consent-making capacities depending on their cultural background, where women from marginalised groups are often assessed as less capable of giving informed consent than women from dominant groups [4,5,6,7,8,9,10].
There is not enough space to provide a lengthy explanation of what counts as medically necessary/unnecessary—and it is almost certain that there will be disagreement within the medical community. But I should state for clarity regarding my position in the relevant debate, that I would include terminating an unwanted underage pregnancy as “medically necessary care” .
Townsend KG. Defending an inclusive right to genital and bodily integrity for children. Int J Impot Res. 2021.
Buckler M. The ethics of child genital cutting_when does a violation occur? Int J Impot Res. 2022.
NSPCC Learning. Gillick competency and Fraser guidelines. London: NSPCC Learning; 2020.
Ehrenreich N, Barr M. Intersex surgery, female genital cutting, and the selective condemnation of “Cultural Practices.” 40 Harv Civ Rights Civil Lib Law Rev 71. 2005:114–20.
Chambers C. Choice and female genital cosmetic surgery. In: Female genital cosmetic surgery. In: Creighton SM, Liao L-M editors. Cambridge: Cambridge University Press; 2019. p. 72–9.
Shahvisi A. “FGM” vs. female “cosmetic” surgeries: why do they continue to be treated separately? Int J Impot Res. 2021.
Shahvisi A, Earp BD. The law and ethics of female genital cutting. In: Female genital cosmetic surgery. In: Creighton SM, Liao L-M editors. Cambridge: Cambridge University Press; 2019. p. 58–71.
Braun V. Selling a perfect vulva? Selling a ‘Normal’ vulva! In: Female genital cosmetic surgery. In: Creighton SM, Liao L-M editors. Cambridge: Cambridge University Press; 2019. p. 23–32.
Braun V. The women are doing it for themselves. Aust Fem Stud. 2009;24:233–49.
Jones M. Intersex genital mutilation—a western version of fgm. Int J Children’s Rights. 2017;25:396–411.
Fowler T. The status of child citizens. Polit Philos Econ. 2014;13:93–113.
Townsend KG. The child’s right to genital integrity: protecting the child, rejecting harmful practices, and enabling sexual autonomy [PhD]. Exeter: University of Exeter; 2021.
Williams MS. Tolerable liberalism. In: Minorities within minorities. Eisenberg A, Spinner-Halev J. editors Cambridge: Cambridge University Press; 2005. p. 19–40.
Galeotti AE. Relativism, universalism, and applied ethics: the case of female circumcision. Constellations. 2007;14:91–111.
Galeotti AE. Autonomy and cultural practices: the risk of double standards. Eur J Political Theory. 2015;14:277–96.
Hannan S. Childhood and autonomy. In: Gheaus A, Calder G, de Wispelaere J, editors. The Routledge handbook of the philosophy of childhood and children. London: Routledge; 2019. p. 112–22.
Gheaus A, Calder G, de Wispelaere J. The Routledge handbook of the philosophy of childhood and children. London: Routledge; 2019.
Earp BD. The child’s right to bodily integrity. In: Ethics and the contemporary world. Abingdon, Oxon, New York: Routledge; 2019. p. 217–35.
Townsend KG. The child’s right to genital integrity. Philos Soc Crit. 2020;46:878–98.
British Medical Association (BMA). Ethics toolkit for medical students: autonomy or self-determination as a medical student. 2021.
Arneil B. Becoming versus being: a critical analysis of the child in liberal theory. In: Archard D, Macleod CM, editors. The moral and political status of children. Oxford: Oxford University Press; 2002. p. 70–93.
Carmack A, Notini L, Earp BD. Should surgery for hypospadias be performed before an age of consent? J Sex Res. 2016;53:1047–58.
Kaposy C. The public funding of abortion in Canada: going beyond the concept of medical necessity. Med Health Care Philos. 2009;12:301–11.
Dalke KB, Baratz AB, Greenberg JA. Protecting children with intersex traits: legal, ethical and human rights considerations. In: Legato MJ, editor. The plasticity of sex: the molecular biology and clinical features of genomic sex, gender identity and sexual behavior. Academic Press: Elsevier Science; 2020. p. 207–24.
Feinberg J. The moral limits of the criminal law volume 1: harm to others. Oxford: Oxford University Press; 1987.
Chambers C. Sex, culture, and justice: the limits of choice. University Park, Pennsylania: Penn State University Press; 2008.
Klein D. Gender X; the battle over boy of girl. Stanford Medicine Special Report; Bioethics, no easy answers. 2011.
Yankovic F, Cherian A, Steven L, Mathur A, Cuckow P. Current practice in feminizing surgery for congenital adrenal hyperplasia; a specialist survey. J Pediatr Urol. 2013 ;9:1103–7.
Chambers C. Are breast implants better than female genital mutilation? Autonomy, gender equality and Nussbaum’s political liberalism. Crit Rev Int Soc Political Philos. 2004;7:1–33.
Female Genital Mutilation Act. United Kingdom Acts of Parliament, 2003.
KGT would like to thank Max Buckler for his engagement with the work, and the journal editors for the opportunity to reply.
The author declares no competing interests.
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Townsend, K.G. On becoming autonomous and “coercive cultural acts”: a reply to Max Buckler. Int J Impot Res 35, 35–37 (2023). https://doi.org/10.1038/s41443-022-00617-w
This article is cited by
Child genital cutting and surgery across cultures, sex, and gender. Part 1: female, male, intersex—and trans? The difficulty of drawing distinctions
International Journal of Impotence Research (2022)