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Drawing and critiquing ethical distinctions among diverse forms of genital modification: Commentary on Fusaschi (2022)

International Journal of Impotence Research volume 35, pages 16–17 (2023)Cite this article

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Although Fusaschi proposes the Gendered Genital Modifications (GGMo) approach in her study, this is inadequate for a number of reasons. She begins her study by stating that she aims for “future interdisciplinary studies on how consent, bodily integrity and personal autonomy influence concepts of agency and subjectivity in the sex/gender system”.

While one can agree that all genital surgeries, whether on infants, adolescents or adults, are influenced by the sex/gender system, it is necessary to keep in mind that we live in a society that is governed by the sex/gender system, which affects all aspects of our lives. So one cannot expect genital surgeries to fall outside its scope. That is, genital surgeries are of course linked to the sex/gender system, this is inevitable, but still we must each make our own informed decisions about how best to respond to that reality, in terms of potential surgeries affecting our bodies, so that consent and personal autonomy remain the most important ethical considerations in evaluating these surgeries. We cannot somehow banish or do away with the omnipresent sex/gender system only in regard to genital surgeries while all the other aspects of society remain governed by said system.

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References

  1. American Psychological Association. Resolution on supporting sexual/gender diverse children and adolescents in schools. 2020. https://www.apa.org/pi/lgbt/resources/policy/gender-diverse-children.

  2. Brussels Collaboration on Bodily Integrity. Medically unnecessary genital cutting and the rights of the child: moving toward consensus. Am J Bioeth. 2019;19:17–28.

    Article  Google Scholar 

  3. European Union Agency for Fundamental Rights. The fundamental rights situation of intersex people. 2015. https://fra.europa.eu/en/publication/2015/fundamental-rights-situation-intersex-people.

  4. Kehrer I. Cuts into children’s future: a comparative analysis between FGM, male circumcision and intersex genital surgeries. Peace Hum Rights Gov. 2019;3:333–63.

    Google Scholar 

  5. Svoboda JS. Promoting genital autonomy by exploring commonalities between male, female, intersex, and cosmetic female genital cutting. Glob Discourse. 2013;3:237–55.

    Article  Google Scholar 

  6. Parliamentary Assembly of the Council of Europe. Promoting the human rights of and eliminating discrimination against intersex people. Assembly debate on 12 October 2017. 35th Sitting. Text adopted by the Assembly on 12 October 2017. https://assembly.coe.int/nw/xml/XRef/Xref-XML2HTML-en.asp?fileid=24232.

  7. United Nations Human Rights. Office of the high commissioner. Intersex awareness day. End violence and harmful medical practices on intersex children and adults. 2016. https://www.ohchr.org/en/NewsEvents/Pages/DisplayNews.aspx?LangID=E&NewsID=20739.

  8. Chodzen G, Hidalgo MA, Chen D, Garofalo R. Minority stress factors associated with depression and anxiety among transgender and gender-nonconforming youth. J Adolesc Health. 2019;64:467–71.

    Article  PubMed  Google Scholar 

  9. Heylens G, Verroken C, De Cock S, T’Sjoen G, De Cuypere G. Effects of different steps in gender reassignment therapy on psychopathology: a prospective study of persons with a gender identity disorder. J Sex Med. 2014;11:119–26.

    Article  PubMed  Google Scholar 

  10. Kraemer B, Delsignore A, Schnyder U, Hepp U. Body image and transsexualism. Psychopathology. 2008;41:96–100.

    Article  PubMed  Google Scholar 

  11. Weyers S, Elaut E, De Sutter P, Gerris J, T’Sjoen G, Heylens G, et al. Long-term assessment of the physical, mental, and sexual health among transsexual women. J Sex Med. 2009;6:752–60.

    Article  PubMed  Google Scholar 

  12. Wierckx K, Van Caenegem E, Elaut E, Dedecker D, Van de Peer F, Toye K, et al. Quality of life and sexual health after sex reassignment surgery in transsexual men. J Sex Med. 2011;8:3379–88.

    Article  PubMed  Google Scholar 

  13. Cornell University. Center for the study of inequality. What does the scholarly research say about the effect of gender transition on transgender well-being? Center for the study of inequality. 2017. https://whatweknow.inequality.cornell.edu/topics/lgbt-equality/what-does-the-scholarly-research-say-about-the-well-being-of-transgender-people/.

  14. Bustos VP, Bustos SS, Mascaro A, Del Corral G, Forte AJ, Ciudad P, et al. Regret after Gender-affirmation Surgery: a systematic review and meta-analysis of prevalence. Plast Reconstr Surg Glob Open. 2021;9:e3477.

  15. Hess J, Neto RR, Panic L, Rübben H, Senf W. Satisfaction with male-to-female gender reassignment surgery: results of a retrospective analysis. Dtsch Ärzteblatt Int. 2014;111:795–801.

    Google Scholar 

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  1. Independent Scholars https://www.nature.com/ijir/

    Moises Catalan & Mariyka Emilova

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  1. Moises Catalan
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MC wrote the first draft based on his specialized knowledge on the subject. His knowledge was also key in the subsequent editing and translation process that MR conducted. MR was also the one in charge of revising the manuscript according to the editor’s indications.

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Correspondence to Moises Catalan or Mariyka Emilova.

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Catalan, M., Emilova, M. Drawing and critiquing ethical distinctions among diverse forms of genital modification: Commentary on Fusaschi (2022). Int J Impot Res 35, 16–17 (2023). https://doi.org/10.1038/s41443-022-00637-6

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