Is Female Genital Cosmetic Surgery for an adolescent with Body Dysmorphic Disorder ever ethically justified? Cosmetic genital surgery for adolescent girls is one of the most ethically controversial forms of cosmetic surgery and Body Dysmorphic Disorder is typically seen as a contraindication for cosmetic surgery. Two key ethical concerns are that Body Dysmorphic Disorder undermines whatever capacity for autonomy the adolescent has; and even if there is valid parental consent, (...) the presence of Body Dysmorphic Disorder means that cosmetic surgery will fail in its aims. In this article, we challenge, in an evidence-based way, the standard view that Body Dysmorphic Disorder is a contraindication for genital cosmetic surgery in adolescents. Our argument gathers together and unifies a substantial amount of disparate research in the context of an ethical argument. We focus on empirical questions about benefit and harm, because these are ethically significant. Answers to these questions affect the answer to the ethical question. We question the claim that there would be no benefit from surgery in this situation, and we consider possible harms that might be done if treatment is refused. For an adolescent with Body Dysmorphic Disorder, the most important thing may be to avoid harm. We find ourselves arguing for the ethical justifiability of cosmetic labioplasty for an adolescent with Body Dysmorphic Disorder, even though we recognize that it is a counter intuitive position. We explain how we reached our conclusion. (shrink)

In the UK, female genital mutilation is unlawful, not only when performed on minors, but also when performed on adult women. The aim of our paper is to examine several arguments which have been advanced in support of this ban and to assess whether they are sufficient to justify banning female genital mutilation for competent, consenting women. We proceed by comparing female genital mutilation, which is banned, with cosmetic surgery, towards which the (...) law has taken a very permissive stance. We then examine the main arguments for the prohibition of the former, assessing in each case both (a) whether the argument succeeds in justifying the ban and, if so, (b) whether a parallel argument would not also support a ban on the latter. We focus on the following arguments. Female genital mutilation should be unlawful because: (1) no woman could validly consent to it; (2) it is an oppressive and sexist practice; (3) it involves the intentional infliction of injury; (4) it causes offence. Our view is that arguments (3) and (4) are unsound and that, although arguments (1) and (2) may be sound, they support not only a ban on female genital mutilation, but also one on (some types of) costmetic surgery. Hence, we conclude that the present legal situation in the UK is ethically unsustainable in one of the following ways. Either the ban on female genital mutilation is unjustified because arguments (1) and (2) are not in fact successful; or the law's permissive attitude towards cosmetic surgery is unjustified because arguments (1) and (2) are in fact successful and apply equally to female genital mutilation and (certain forms of) cosmetic surgery. The people of the countries where female genital mutilation is practised resent references to ‘barbaric practices imposed on women by male‐dominated primitive societies’, especially when they look at the Western world and see women undergoing their own feminization rites intended to increase sexual desirability: medically dangerous forms of cosmetic plastic surgery, for instance …. (shrink)

The Abagusii are one of the many communities in Kenya that engage in female genital cutting. Locally, the practice is simply known as “circumcision.” Introduced as “female circumcision” to the West, the practice was thought to parallel male circumcision. Both are referred to as tahiri, and both are coming of age rites. However, female circumcision was thought inaccurately to reflect the difference in health outcomes. As presented to the West, FGC results in worse health outcomes for (...) females than circumcision does for males. While male circumcision is credited with lowering HIV transmission, the opposite is true for FGC (UNICEF... (shrink)

Debates about female genital mutilation/cutting have polarized opinion between those who see it as an abuse of women’s health and human rights, to be ‘eradicated’, and those who may or may not oppose the practice, but see a double standard on the part of western campaigners who fail to challenge other unnecessary surgical interventions — such as male circumcision or cosmetic surgery — in their own communities and cultures. This article interrogates these debates about FGM/c in (...) the context of measures to reduce it in the UK over recent decades. It does not suggest that FGM/c is a legitimate practice, seeing it, rather, as an abuse of women’s and children’s rights that should be combated using a combination of measures. However, it argues that reduction strategies are undermined by inconsistencies in the law and the failure to back up the law with research and education. (shrink)

Making links between different embodied cultural practices has become increasingly common within the feminist literature on multiculturalism and cultural difference as a means to counter racism and cultural essentialism. The cross-cultural comparison most commonly made in this context is that between ‘African’ practices of female genital cutting (FGC) and ‘western’ body modifications. In this article, I analyse some of the ways in which FGC and other body-altering procedures (such as cosmetic surgery, intersex operations and 19th century (...) American clitoridectomies) are compared within this feminist literature. I identify two main strategies of linking such practices, which I have termed the ‘continuum’ and ‘analogue’ approaches. The continuum approach is employed to imagine FGC alongside other body-altering procedures within a single ‘continuum’, ‘spectrum’ or ‘range’ of cross-cultural body modifications. The analogue approach is used to set up FGC and other body-altering practices as analogous through highlighting cross-cultural similarities, but does not explicitly conceive of them as forming a single continuum. Two key critiques of the continuum and analogue approaches are presented. First, because these models privilege gender and sexuality, they tend to efface the operation of other axes of embodied differentiation, namely race, cultural difference and nation. As such, the continuum and analogue approaches often reproduce problematic relationships between race and gender while failing to address the implicit and problematic role which race, cultural difference and nation continue to play in such models. This erasure of these axes, I contend, is linked to the construction of a ‘western’ empathetic gaze, which is my second key critique. The desire on the part of theorists working in the West to establish cross-cultural ‘empathy’ through models that stress similarity and solidarity conceals the continuing operation of geo-political relations of power and privilege. (shrink)

A UK doctor was recently acquitted of charges of reinstating a variety of female genital mutilation after delivering a child. In this paper, I contend that this incident reflects a broader confusion concerning the ethico-legal status of non-therapeutic genital surgeries for children and adults, which are not derivable from tenets of medical ethics, but rather violate them. I argue that medical professionals have an obligation to announce and address this confusion in order to motivate legislative reform, since (...) the inconsistency of the current law entrenches the underlying sexism and ethnocentrism upon which its sense depends. Without convincing arguments for condoning male circumcision and female cosmetic genital surgery and for treating adult women of colour as lacking the capacity to consent, the current legislation stands in need of urgent revision. (shrink)

Labiaplasty is a form of genital surgery to reduce large or protruding labia minora. Internationally, the rates of this surgery among women and girls is increasing and is viewed as a worrying trend. Currently, the main clinical strategy is to reassure adolescents that they are normal by talking about the variation of labia size and appearance and showing pictures demonstrating the wide range of normal female genital appearance. For the most part, policy documents recommend against (...) labiaplasty in adolescents, claiming that it is medically non-essential surgery. In this paper, we contrast findings from our interviews with clinicians with the existing literature and policy documents and we point out areas needing more thought. This is qualitative research using semi-structured interviews. We set out to find out on what basis clinicians decide how to treat or manage adolescent patients seeking labiaplasty. We interviewed clinicians who are likely to be approached by under-eighteens requesting labiaplasty. We use interpretive content analysis and thematic analysis to analyse the data. Our findings support the emphasis on education and reassurance as the first step for all patients, but other issues that have not figured previously in the literature that would alter clinical strategies for managing patients emerge as well. Key findings are that reassurance does not always work and that the distinction between functional and appearance concerns is not a solid foundation in itself for deciding whether surgery is ethically appropriate. We conclude that the distinction between functional and appearance concerns is not ethically relevant. It is open to different interpretations and is not regarded by all clinicians as the definitive factor in relation to surgery. The focus of clinicians should be on relieving distress whatever the cause. Appearance reasons may sometimes justify surgery but, also, functional reasons may sometimes not be sufficient justification for surgery. (shrink)

Book reviewed in this article: Reshaping the Female Body: The Dilemma of Cosmetic Surgery. By Kathy Davis.

Western media coverage of female genital modifications in Africa has been hyperbolic and one-sided, presenting them uniformly as mutilation and ignoring the cultural complexities that underlie these practices. Even if we ultimately decide that female genital modifications should be abandoned, the debate around them should be grounded in a better account of the facts.

When the benefits of surgery do not outweigh the harms or where they do not clearly do so, surgical interventions become morally contested. Cutting to the Core examines a number of such surgeries, including infant male circumcision and cutting the genitals of female children, the separation of conjoined twins, surgical sex assignment of intersex children and the surgical re-assignment of transsexuals, limb and face transplantation, cosmetic surgery, and placebo surgery.

Western feminists, physicians, and ethicists condemn the traditional genital surgeries performed on women in some non‐Western cultures. But coming to moral judgment is not the end of the story; we must also decide what to do about our judgments. We must learn to work respectfully with, not independently of, local resources for cultural self‐examination and change.

When the benefits of surgery do not outweigh the harms or where they do not clearly do so, surgical interventions become morally contested. Cutting to the Core examines a number of such surgeries, including infant male circumcision and cutting the genitals of female children, the separation of conjoined twins, surgical sex assignment of intersex children and the surgical re-assignment of transsexuals, limb and face transplantation, cosmetic surgery, and placebo surgery.

This review aims to identify (1) sources of knowledge and (2) important themes of the ethical debate related to surgical alteration of facial features in East Asians. This article integrates narrative and systematic review methods. In March 2014, we searched databases including PubMed, Philosopher’s Index, Web of Science, Sociological Abstracts, and Communication Abstracts using key terms “cosmetic surgery,” “ethnic*,” “ethics,” “Asia*,” and “Western*.” The study included all types of papers written in English that discuss the debate on rhinoplasty (...) and blepharoplasty in East Asians. No limit was put on date of publication. Combining both narrative and systematic review methods, a total of 31 articles were critically appraised on their contribution to ethical reflection founded on the debates regarding the surgical alteration of Asian features. Sources of knowledge were drawn from four main disciplines, including the humanities, medicine or surgery, communications, and economics. Focusing on cosmetic surgery perceived as a westernising practice, the key debate themes included authenticity of identity, interpersonal relationships and socio-economic utility in the context of Asian culture. The study shows how cosmetic surgery of ethnic features plays an important role in understanding female identity in the Asian context. Based on the debate themes authenticity of identity, interpersonal relationships, and socio-economic utility, this article argues that identity should be understood as less individualistic and more as relational and transformational in the Asian context. In addition, this article also proposes to consider cosmetic surgery of Asian features as an interplay of cultural imperialism and cultural nationalism, which can both be a source of social pressure to modify one’s appearance. (shrink)

Feminist studies of female genital cutting (FGC) provide ample evidence that many women exercise effective agency with respect to this practice, both as accommodators and as resisters. The influence of culture on autonomy is ambiguous: women who resist cultural mandates for FGC do not necessarily enjoy greater autonomy than do those women who accommodate the practice, yet it is clear that some social contexts are more conducive to autonomy than others. In this paper, I explore the implications for (...) autonomy theory of these understandings of the relation between culture, FGC, and women’s agency. I review the range of worldwide FGC practices – including “corrective” surgery for “ambiguous genitalia” in Western cultures as well as the various initiation rites observed in some African and Asian cultures – and the diverse cultural rationales for different forms of FGC. I argue that neither latitudinarian, value‐neutral accounts of autonomy nor restrictive, value‐saturated accounts adequately explain women’s agentic position with respect to FGC. I then analyze a number of educational programs that have enhanced women's autonomy, especially by strengthening their introspection, empathy, and imagination. Such programs, which engage women's autonomy skills without exposing them to autonomy‐disabling cultural alienation, promote autonomy‐within‐culture. This understanding of autonomy as socially situated, however, entails neither endorsement of FGC nor resignation to its persistence. (shrink)

Feminist studies of female genital cutting (FGC) provide ample evidence that many women exercise effective agency with respect to this practice, both as accommodators and as resisters. The influence of culture on autonomy is ambiguous: women who resist cultural mandates for FGC do not necessarily enjoy greater autonomy than do those women who accommodate the practice, yet it is clear that some social contexts are more conducive to autonomy than others. In this paper, I explore the implications for (...) autonomy theory of these understandings of the relation between culture, FGC, and women’s agency. I review the range of worldwide FGC practices – including “corrective” surgery for “ambiguous genitalia” in Western cultures as well as the various initiation rites observed in some African and Asian cultures – and the diverse cultural rationales for different forms of FGC. I argue that neither latitudinarian, value‐neutral accounts of autonomy nor restrictive, value‐saturated accounts adequately explain women’s agentic position with respect to FGC. I then analyze a number of educational programs that have enhanced women's autonomy, especially by strengthening their introspection, empathy, and imagination. Such programs, which engage women's autonomy skills without exposing them to autonomy‐disabling cultural alienation, promote autonomy‐within‐culture. This understanding of autonomy as socially situated, however, entails neither endorsement of FGC nor resignation to its persistence. (shrink)

Recalcitrant disputes among health care providers and patients or their families may signal deep cultural differences about what interventions are needed or about clinicians’s professional duties. These issues arose in relation to a mother’s request for hymenoplasty or revirgination for her minor daughter to enable an overseas, forced marriage and protect her from an honor killing. The American College of Obstetrics and Gynecology committee recommends against members performing a hymenoplasty or other female genital cosmetic surgeries due to (...) a lack of data concerning their safety and efficacy. A key issue in such cases is how to determine what is in the minor’s best interest and the scope of health care moral or professional’s duties. The Best Interests Standard can serve as a powerful moral tool for resolving cross-cultural disputes and identifying needed policy. (shrink)

This paper addresses two related topics: 1. The disanalogies between elective cosmetic practices and sex reassignment surgery. Why does it seem necessary for me – an aging professional woman – to ignore the blandishments of hairdressers wielding dyes and dermatologists wielding acids and scalpels? Why does it not seem equally necessary for a transgendered person to repudiate sex reassignment procedures? 2. The role of the body in identity and agency. How do phenomenological insights regarding the constitution of selfhood (...) in relation to the interplay between the body image and corporeal know-how contribute to an account of the agency of transgendered individuals? Studying several paintings by contemporary feminist artist Jenny Saville has advanced my thinking on these topics. Saville’s imagery is an invaluable aid to reflection on these issues because she uses her painterly technique, which critics often dub “virtuoso,” to represent lived human bodies. In her work, viewers encounter representations of subjectivized, agentic corporeity, as distinct from inert, objectified flesh. Moreover, her sympathetic engagement with nonconformist, devalued bodies helps to reconfigure the standard gestalts of the human body that viewers typically carry with them and thus to convert fear and/or disgust into appreciation and understanding. In this paper, I consider three of Saville’s paintings. Plan, Saville’s self-portrait as a nude female whose body has been prepped for liposuction, conveys the pathos of this procedure. Matrix is a nude portrait of self-described “gender variant visual artist” Del LaGrace Volcano. In the words of one critic Saville’s depiction of Volcano’s nude intersexed body “restores beauty to the primitive [female] genital organ.” Passage, another nude portrait of an intersexed individual, is an image of vibrant sexuality despite the presumptively jarring juxtaposition of breasts and a penis. I argue that conceiving the agentic subject as a rational deliberative capability that uses a conjoined body as the instrument of its will makes it impossible to theorize the agency of transgendered people. In contrast, when agentic subjects are understood as embodied subjects and embodiment is understood as a dimension of practical intelligence, the agency of transgendered individuals is intelligible. (shrink)

It is suggested that the practice of attempting to normalise children with Down 's syndrome by subjecting them to major facial plastic surgery has no therapeutic benefit, and should be seen as mutilating surgery comparable to female circumcision.

Through illustrating the similarities between embodied practices rooted in different cultural contexts (such as `African' female genital cutting and `Western' cosmetic surgery), feminist theorists seek to reveal the instability of essentialist binaries which distinguish various groups as culturally, ethnically and morally `different'. They also aim to query how the term `culture' is employed differentially on the basis of embodied axes such as race and nation. However, in emphasizing overarching commonalities between practices, feminist cross-cultural comparisons risk collapsing (...) into economies of sameness that elide the complex relations of power through which such practices have been constituted. They can also fix the imagined subjects of these practices in troubling ways. Using the ubiquitous `African' female genital cutting and `Western' cosmetic surgery binary as an example, this article explores the difference it might make to address culturally essentialist constructions of embodied practice with a focus on relationality rather than commonality. As a means to reorient feminist cross-cultural approaches which depend on assertions of similarity or sameness, it argues for the theoretical and pedagogical utility of thinking through relational webs. (shrink)

By modifying the body in meaningful ways, human beings establish their identity and social status. Lip plugs, ear plugs, penis sheaths, cosmetics, ornaments, scarification, body piercings, and genital modifications encode and transmit messages about age, sex, social status, health, and attractiveness from one individual to another. Through sociocultural sexual selection, male genital modification plays an important role as a sociosexual signal in both male competition and female mate choice. The reliability of the signal correlates with the cost (...) of acquiring the trait. Women use a variety of cues to assess male quality. Male genital modification is one way that some women assess their mates. Extreme male genital modifications not only honestly advertise status, sexual potency, and ability to provide sexual satisfaction, they may provide a reliable index of male-female cooperation through the male’s commitment to endure pain and risk. (shrink)

Why do physicians who've taken the Hippocratic Oath willingly cut into seemingly healthy patients? How do you measure the success of surgery aimed at making someone happier by altering his or her body? Sander L. Gilman explores such questions in Creating Beauty to Cure the Soul, a cultural history of the connections between beauty of body and happiness of mind. Following these themes through an impressive range of historical moments and players, Gilman traces how aesthetic alterations of the body (...) have been used to "cure" dissatisfied states of mind. In his exploration of the striking parallels between the development of cosmetic surgery and the field of psychiatry, Gilman entertains an array of philosophical and psychological questions that underlie the more practical decisions rountinely made by doctors and potential patients considering these types of surgery. While surveying and incorporating the relevant theories of Sigmund Freud, Alfred Adler, Karl Menninger, Paul Schilder, contemporary feminist critics, and others, Gilman considers the highly unstable nature of cultural notions of health, happiness, and beauty. He reveals how ideas of race and gender structured early understandings of aesthetic surgery in discussions of both the "abnormality" of the Jewish nose and the historical requirement that healthy and virtuous females look "normal," thereby enabling them to achieve invisibility. Reflecting upon historically widespread prejudices, Gilman describes the persecutions, harrassment, attacks, and even murders that continue to result from bodily difference and he encourages readers to question the cultural assumptions that underlie the increasing acceptability of this surgical form of psychotherapy. Synthesizing a vast body of related literature and containing a comprehensive bibliography, Creating Beauty to Cure the Soul will appeal to a broad audience, including those interested in the histories of medicine and psychiatry, and in philosophy, cultural studies, Jewish cultural studies, and race and ethnicity. (shrink)

This article explores the unusually high levels of cosmetic surgery in South Korea – for both women and men. We argue that existing explanations, which draw on feminist and postcolonial positions, presenting cosmetic surgery as pertinent only to female and non-western bodies found lacking by patriarchal and racist/imperialist economies, miss important cultural influences. In particular, focus on western cultural hegemony misses the influence in Korea of national identity discourses and traditional Korean beliefs and practices such (...) as physiognomy. We show how these beliefs provide a more ‘gendered’ as opposed to feminist analysis, which allows space for discussion of men’s surgeries. Finally, we critique the accepted notion of the ‘western body’, especially its position in some literature as a more unobtainable ideal for non-western than for western women. We argue that this body has little in common with actual western women’s bodies, and more in common with a globalized image, embodying idealized elements from many different cultures. (shrink)

Very little research has attempted to describe normal human variation in female genitalia, and no studies have compared the visual images that women might use in constructing their ideas of average and acceptable genital morphology to see if there are any systematic differences. The objective of the present work was to determine if visual depictions of the vulva differed according to their source so as to alert medical professionals and their patients to how these depictions might capture variation (...) and thus influence perceptions of ‘normality’. A comparative analysis was conducted by measuring (a) published visual materials from human anatomy textbooks in a university library, (b) feminist publications (print and online) depicting vulval morphology and (c) online pornography, focusing on the most visited and freely accessible sites in the UK. Post hoc tests showed that labial protuberance was significantly less (p<0.001, equivalent to approximately 7 mm) in images from online pornography compared to feminist publications. All five measures taken of vulval features were significantly correlated (p<0.001) in the online pornography sample, indicating a less varied range of differences in organ proportions than the other sources where not all measures were correlated. Women and health professionals should be aware that specific sources of imagery may depict different types of genital morphology and may not accurately reflect true variation in the population, and consultations for genital surgeries should include discussion about the actual and perceived range of variation in female genital morphology. (shrink)

Few parents-to-be consider that their child may be born with ambiguous sex. Still, parents of a newborn child with ambiguous sex are expected to make a far-reaching decision for the child: should the child be operated upon so that it has either female or male genitals? The aim of this article is to examine, phenomenologically, why parents decide to have their children undergo genital surgery when it is not necessary for the child’s physiological functions. Drawing on phenomenological (...) work by Maurice Merleau-Ponty, Simone de Beauvoir and Sara Ahmed, we examine parents’ frustration when their child’s sex is ambiguous and their experiences of the practice of medical sex assignment. We also examine parental identity work when the child has been assigned a sex and the interaction between parents and medical professionals when parents make decisions regarding surgery on their child. Furthermore, we provide a critical perspective on the surgical practice. (shrink)

Cosmetic surgery is a fast-growing medical practice. In 1997 surgeons in the United States performed the four most common cosmetic procedures443,728 times, an increase of 150% over the comparable total for 1992. Estimated total expenditures for cosmetic surgery range from $1 to $2 billion. As managed care cuts into physicians' income and autonomy, cosmetic surgery, which is not covered by health insurance, offers a financially attractive medical specialty.

Male-to-female transsexualism manifests itself in the form of a discrepancy between the male sex assigned at birth and the subjective experience of belonging to the female gender, which in many cases also involves a somatic transition by cross-sex hormone treatment and genital surgery. Until now, no studies related to MtF transsexualism have been carried out within the framework of a phenomenological/existential approach. This paradigm would make it possible to better articulate the transsexual experience beyond the simplistic (...) diagnostic criteria by which it is currently defined. In this study, I will reread MtF transsexualism in the light of Ludwig Binswanger’s theories on Mannerism and Jean Paul Sartre’s remarks on the self and the body. I will do this largely by focusing on first-hand accounts of the MtF transsexual’s experience, in other words from a first-person viewpoint. Finally, I will present some considerations on the meaning of psychological intervention in this field. (shrink)

Leading feminist scholars have been brought together for the first time in this comprehensive volume to reveal the complexity of feminist engagements with the exponentially growing cosmetic surgery phenomenon. Offering a diversity of theoretical, methodological and political approaches Cosmetic Surgery: A Feminist Primer presents not only the latest, cutting-edge research in this field but a challenging and unique approach to the issue that will be of key interest to researchers across the social sciences and humanities.

Recently, there has been a shift in attitude among some feminists towards the practice of cosmetic surgery away from that of outright rejection. Kathy Davis, for instance, offers a guarded `defence' of the practice as a strategy that enables women to exercise a degree of control over their lives in circumstances where there are very few other opportunities for self-realization. Others, such as Kathryn Morgan, Anne Balsamo and Orlan, though highly critical of the current practice of cosmetic (...) surgery, go even further than Davis in advocating its redeployment as a tool to subvert the dominant patriarchal ideals of feminine beauty. In this article I critically appraise this `rehabilitation' of cosmetic surgery, arguing, in the case of Davis, that she leaves unchallenged the social structures of inequality responsible for women's dissatisfaction with their bodies. The proposal to use cosmetic surgery as a tool of political critique is equally problematic insofar as it shares with the cosmetic industry its instrumentalization of the body as mere matter, which is almost infinitely transformable, and also effaces the economic inequalities within which such body transformations occur. (shrink)

In this paper, I analyse the issue of conscientious objection in relation to cosmetic surgery. I consider cases of doctors who might refuse to perform a cosmetic treatment because: (1) the treatment aims at achieving a goal which is not in the traditional scope of cosmetic surgery; (2) the motivation of the patient to undergo the surgery is considered trivial; (3) the patient wants to use the surgery to promote moral or political values (...) that conflict with the doctor's ones; (4) the patient requires an intervention that would benefit himself/herself, but could damage society at large. (shrink)

The market for cosmetic surgery tourism is growing with an increase in people travelling abroad for cosmetic surgery. While the reasons for seeking cosmetic surgery abroad may vary the most common reason is financial, but does cheaper surgery abroad carry greater risks? We explore the risks of poorly regulated cosmetic surgery to society generally before discussing how harm might be magnified in the context of cosmetic tourism, where the demand for (...) cheaper surgery drives the market and makes surgery accessible for increasing numbers of people. This contributes to the normalisation of surgical enhancement, creating unhealthy cultural pressure to undergo invasive and risky procedures in the name of beauty. In addressing the harms of poorly regulated surgery, a number of organisations purport to provide a register of safe and ethical plastic surgeons, yet this arguably achieves little and in the absence of improved regulation the risks are likely to grow as the global market expands to meet demand. While the evidence suggests that global regulation is needed, the paper concludes that since a global regulatory response is unlikely, more robust domestic regulation may be the best approach. While domestic regulation may increase the drive towards foreign providers it may also have a symbolic effect which will reduce this drive by making people more aware of the dangers of surgery, both to society and individual physical wellbeing. (shrink)

I argue that the televisual cosmetic surgical makeover is usefully understood as a contemporary manifestation of normalization, in Foucault’s sense—a process of defining a population in relation to its conformity or deviance from a norm, while simultaneously generating narratives of individual authenticity. Drawing on detailed analysis of “Extreme Makeover,” I suggest that the show erases its complicity with creating homogeneous bodies by representing cosmetic surgery as enabling of personal transformation through its narratives of intrinsic motivation and authentic (...) becoming, and its deployment of fairy tale tropes. (shrink)

As our knowledge of the functional and pharmacological architecture of the nervous system increases, we are getting better at treating cognitive and affective disorders. Along with the ability to modify cognitive and affective systems in disease, we are also learning how to modify these systems in health. “Cosmetic neurology,” the practice of intervening to improve cognition and affect in healthy individuals, raises several ethical concerns. However, its advent seems inevitable. In this paper I examine this claim of inevitability by (...) reviewing the evolution of another medical practice, cosmetic surgery. Cosmetic surgery also enhances healthy people and, despite many critics, it is practiced widely. Can we expect the same of cosmetic neurology? The claim of inevitability poses a challenge for both physicians and bioethicists. How will physicians reconsider their professional role? Will bioethicists influence the shape of cosmetic neurology? But first, how did cosmetic surgery become common? (shrink)

It is sometimes argued that the non-therapeutic, non-consensual alteration of children‘s genitals should be discussed in two separate ethical discourses: one for girls (in which such alterations should be termed 'female genital mutilation' or FGM), and one for boys (in which such alterations should be termed 'male circumcision‘). In this article, I call into question the moral and empirical basis for such a distinction, and argue that all children - whether female, male, or indeed intersex - should (...) be free from having parts of their genitals removed unless there is a pressing medical indication. (shrink)

The paper identifies the phenomenal rise of increasingly invasive forms of elective cosmetic surgery targeted primarily at women and explores its significance in the context of contemporary biotechnology. A Foucauldian analysis of the significance of the normalization of technologized women's bodies is argued for. Three "Paradoxes of Choice" affecting women who "elect" cosmetic surgery are examined. Finally, two utopian feminist political responses are discussed: a Response of Refusal and a Response of Appropriation.

According to the World Health Organization, female genital cutting affects millions of girls and women worldwide, particularly on the African continent and in the Middle East. This paper presents a plausible, albeit hypothetical, clinical vignette and then explores the legal landscape as well as the ethical landscape physicians should use to evaluate the adult patient who requests re-infibulation. The principles of non-maleficence, beneficence, justice, and autonomy are considered for guidance, and physician conscientious objection to this procedure is discussed (...) as well. Analyses of law and predominant principles of bioethics fail to yield a clear answer regarding performing female genital cutting or re-infibulation on an adult in the United States. Physicians should consider the patient’s physical, mental, and social health when thinking about female genital cutting and should understand the deep-rooted cultural significance of the practice. (shrink)

One of the most challenging issues in cross-cultural bioethics concerns the long-standing socio-cultural practice of female genital circumcision, which is prevalent in many African countries and the Middle East as well as in some Asian and Western countries. It is commonly assumed that FGC, in all its versions, constitutes a gross violation of the universal human rights of health, physical integrity, and individual autonomy and hence should be abolished. This article, however, suggests a mediating approach according to which (...) one form of FGC, the removal of the clitoris foreskin, can be made compatible with the high demands of universal human rights. The argument presupposes the idea that human rights are not absolutist by nature but can be framed in a meaningful, culturally sensitive way. It proposes important limiting conditions that must be met for the practice of FGC to be considered in accordance with the human rights agenda. (shrink)

Female genital mutilation is the removal or restructuring of healthy genital tissue. Under natural law, mutilation is an intrinsic evil and a grave violation of human dignity. If mutilation alleviates a threat to a person’s well-being, it may sometimes be permissible, but healthy genitals pose no such threat. The purported social benefits of FGM, such as decreased promiscuity, do not justify the practice, because there is no causal relationship between mutilation and virtue. In terms of autonomy, victims (...) are usually children and unable to consent. Parental rights and the rights of religion do not override children’s inherent rights to physical integrity and safety. Current support for minimal forms of FGM in an attempt to reduce the incidence of severe forms will instead prolong the practice and increase the number of victims. Finally, FGM differs from male circumcision in that it destroys the function and integrity of the organs themselves and promotes profound gender inequality. (shrink)

Herbert, Dilinie This article reports on the experiences of Female Genital Mutilation/Cutting for women living in countries where it is widespread and for those who migrate to Western countries. It explores the attitudes that shape the ongoing practice of FGM/C and the role of female hierarchy in sustaining these customs in practising communities. In particular, it investigates the dialogue between health professionals in Western countries like Australia and women presenting for antenatal care. This includes conversations around de-infibulation.

Khalafzai, Rida Usman Female genital mutilation (FGM) is thought to be a custom practiced for the subjugation of women. The significance of FGM for practicing communities, however, is much more profound. The best hope of eradicating this practice lies in the recognition and comprehension of its cultural and social meanings.

Introducción: La ablación o mutilación genital femenina incluye una amplia variedad de prácticas que suponen la extirpación total o parcial de los genitales externos o su alteración por razones que no son de índole médica. Causa daños irreversibles y pone en peligro la salud, e incluso la vida de la mujer o niña afectada. Objetivo: Caracterizar la mutilación genital femenina y sus complicaciones a largo plazo en la comunidad de Fajikunda, Gambia, entre marzo y septiembre de 2012. Método: (...) Se realizó un estudio descriptivo prospectivo a 117 mujeres que asistieron al centro de salud por cualquier motivo que requiriera examen ginecológico y se estudiaron las variables grupo de edades, tipo de mutilación, grupo étnico y complicaciones. Resultados: Del total, 98 mujeres eran de 45 años de edad o menos; la clitoridectomía fue la práctica más frecuente; la inflamación pélvica crónica y el dolor en los genitales fueron las complicaciones a largo plazo que mayor asociación estadística demostraron con relación a la mutilación. La anorgasmia presentó una alta incidencia en la población estudiada. Conclusiones: La prevalencia de la mutilación genital femenina en Fajikunda es aproximadamente la misma que en Gambia, la tipo I es la más practicada y generalmente en jóvenes de la etnia Mandinga. Introduction: The ablation or female genital mutilation includes a wide variety of practices dealing with total or partial extirpation of the external genitalia or its alterations for reasons other than of medical nature. It causes irreversible damages and puts in danger the health or even the life of the woman or child involved. Objective: The aim of the present study is to characterize female genital mutilation and its long-term complications in Fajikunda community, Gambia, between March and September 2012. Method: A descriptive prospective study was performed to 117 women that attended the health unit for reasons requiring gynecological examination and the variables age group, mutilation type, ethnic group and complications were studied. Results: Of the total, 98 women were 45 years old or less; the clitoridectomy was the most frequent practice; cronical pelvic and genital pains were the long-term complications that showed a major statistical association with relation to mutilation. Conclusions: The prevalence of female genital mutilation in Fajikunda is approximately the same as in Gambia, the type I is the most performed and generally within young women belonging to Mandinga ethnic group. (shrink)