Genital modifications are forms ofbody modifications applied to thehuman sexual organs, including invasive modifications performed throughgenital cutting orsurgery.^[1] The termgenital enhancement seem to be generally used for genital modifications that modify the external aspect, the way the patient wants it.^[1] The termgenital mutilation is used for genital modifications that drastically diminish the recipient'squality of life and result inadverse health outcomes, whetherphysical or mental.^[1] Mutilations are sometimes performed without consent or on people who cannot consent such as children and the mentally disabled.

Many types of genital modification are performed at the behest of the individual, for personal, sexual, aesthetic or cultural reasons.^[1]

Social acceptance for male intimate cosmetic surgery seem to have happened around the 2010s, decades after other types of cosmetic surgeries.^[1]

Penile subincision, or splitting of the underside of the penis, is widespread in the traditional cultures ofIndigenous Australians.^[2] This procedure has taken root in Westernbody modification culture, themodern primitives.^[2]Meatotomy is a form that involves splitting of theglans penis alone, while bisection is a more extreme form that splits the penis entirely in half.^[2]

Genital piercings andgenital tattooing may be performed for aesthetic reasons, but piercings can have the benefit of increasingsexual pleasure for the pierced individual or theirsex partners.^[3][2]

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.^[2] Similar to tattooing,genital scarification is primarily done for aesthetic reasons by adding decorative scars to the skin.^[4] The genital decoration by scars is an ancient tradition in many cultures, both for men and women.^[4]

Clitoris enlargement may be achieved temporarily through the use of aclitoral pump, or it may be achieved permanently through theapplication or injection of testosterone.^[4]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.^[4]

People who aretransgender may undergogender-affirming surgery to alter their genitals to match theirgender identity. Not all transgender people elect to have these surgeries.^[5]

Some of the surgical procedures arevaginoplasty (creation of a vagina) andvulvoplasty (creation of a vulva) fortrans women andmetoidioplasty (elongation of the clitoris),phalloplasty (creation of a penis), andscrotoplasty (creation of a scrotum) fortrans men.^[5] Trans women may also benefit fromhair removal andfacial feminization surgery, while some trans men may haveliposuction to remove fat deposits around their hips and thighs.^[5]Hijra, athird gender found in theIndian subcontinent, may opt to undergocastration.^[5] In some cases, a child's gender may be reassigned without their consent due togenital injury, includingDavid Reimer, who was the subject ofJohn Money's John/Joan case.^[6] Similarly,intersex people often benefit from gender-affirming surgeries but are also sometimes subjected to them without consent in a violation ofintersex human rights. The specialized term isintersex medical interventions.

The following types of unvoluntary genital cutting or surgery are sometimes performed on children for nontherapeutic (medically unnecessary) reasons:^[7] clitoral reduction surgeries on children with CAH,^[7]: 24 hypospadias surgeries,^[7]: 24 removal of internal gonads^[7]: 24 and penile circumcision.^[7]: 24 In some societies, other types ofendosex girl genital cutting happen.^[7]: 22They can be done forpsychosocial,cultural,subjective-aesthetic, orprophylactic perceived benefits, as judged by doctors or parents.^{[7]: 1 : 17 : 22}

Penile subincision, or splitting of the underside of the penis, is widespread in the traditional cultures ofIndigenous Australian children.^[2] This procedure has been adapted for adults in Westernbody modification culture, themodern primitives.^[2]Meatotomy is a form that involves splitting of theglans penis alone, while bisection is a more extreme form that splits the penis entirely in half.^[2]

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Intersex children and children with ambiguous genitalia may be subjected to surgeries to "normalize" the appearance of their genitalia.^[8]

These surgeries are usually performed for cosmetic benefit rather than for therapeutic reasons.^[8] Most surgeries involving children with ambiguous genitalia are sexually damaging and may render theminfertile.^[9] For example, in cases involving male children withmicropenis, doctors may recommend the child be reassigned as female.^[10] TheIntersex Society of North America objects toelective surgeries performed on people without theirinformed consent on grounds that such surgeries subject patients to unnecessary harm and risk.^[11]

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.^[12] These different forms ofsexual violence can terrorize targeted individuals and communities, prevent individuals from reproducing, and cause tremendous pain and psychological anguish for victims.^[12] Many wars, religious conquests, and genocides have involvedforced circumcision. A related practice is killing people based on their circumcision status, notably in theBangladesh genocide and recently in the2025 India-Pakistan Crisis.^[13]

If the genitals become diseased, as in the case of cancer, sometimes the diseased areas are surgically removed.^[14] Females may undergovaginectomy orvulvectomy (to the vagina and vulva, respectively), while males may undergopenectomy ororchiectomy (removal of the penis and testicles, respectively).^[14]Reconstructive surgery may be performed to restore what was lost, often with techniques similar to those used ingender-affirming surgery.^[15]

Duringchildbirth, anepisiotomy (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.^[14]

Hymenotomy is the surgical perforation of animperforate hymen.^[14] It may be performed to allowmenstruation to occur.^[15] An adult individual may opt for increasing the size of their hymenal opening, or removal of the hymen altogether, to facilitatesexual penetration of their vagina.^[14][15]

A person may engage in self-inflicted genital injury or mutilation such ascastration,penectomy, orclitoridectomy.^[1] The motivation behind such actions vary widely; it may be done due personal crisis related tomental illness,self-mutilation,body dysmorphia, or social reasons.^[1] Not all regions have propertransgender health care orgender-affirming surgeries available, which can lead to people attemptingself-surgery.

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 theexternal female genitalia or other surgery of the femalegenital organs whether for cultural, religious or other non-therapeutic reasons."^[17] It is not the same as the procedures used ingender-affirming surgery or thegenital modification ofintersex persons.^[17]

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.^[18] Over 125 million women and girls have experienced FGM in the 29 countries in which it is concentrated.^[18] Over eight million have beeninfibulated, a practice found largely in Djibouti, Eritrea, Somalia and Sudan.^[19] 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 (seeepisiotomy).^[20] In the past several decades, efforts have been made by global health organizations, such as the WHO, to end the practice.^[20] FGM is condemned by international human rights organizations.^[20] TheIstanbul Convention prohibits FGM (Article 38).^[20]

FGM is considered a form ofviolence against women by theDeclaration on the Elimination of Violence Against Women, which was adopted by theUnited 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 ...".^[21] However, because of its importance in traditional life, it continues to be practised in many societies.^[22]

Hymenorrhaphy refers to the practice of thickening the hymen, or, in some cases, implanting a capsule of red liquid within the newly created vaginal tissue.^[9] This new hymen is created to cause physical resistance, blood, or the appearance of blood, at the time that the individual's new husband inserts his penis into her vagina.^[9] This is done in cultures where a high value is placed on femalevirginity at the time of marriage.^[9] In these cultures, a woman may be punished, perhaps violently, if the community leaders deem that she was not a virgin when her marriage wasconsummated.^[9] Individuals who are victims ofrape, who were virginal at the time of their rape, may elect for hymenorrhaphy.^[9]

Labia stretching is the act of elongating thelabia minora through manual manipulation (pulling) or physical equipment (such as weights).^[23][24] It is a familialcultural practice in Rwanda,^[23] common inSub-Saharan Africa,^[25] and abody modification practice elsewhere.^[24] It is performed for sexual enhancement of both partners, aesthetics, symmetry and gratification.^[23][24]

Cosmetic surgery of female genitalia, known aselective genitoplasty, has become pejoratively known as"designer vagina". In May 2007, an article published in theBritish Medical Journal strongly criticised this craze, citing its popularity being rooted in commercial and media influences.^[26][27] Similar concerns have been expressed in Australia.^[26]

Some women undergo vaginoplasty or vulvoplasty procedures to alter the shape of theirvulvas to meet personal or societalaesthetic standards.^[28] The surgery itself is controversial, and critics refer to the procedures as "designer vagina".^[29][30][31]

In the article Designer Vaginas by Simone Weil Davis, she talks about the modification of woman's vagina and the outside influences women are pressured with, which can cause them to feel shame towards theirlabia minora. She states that the media, such as pornography, creates an unhealthy view of what a "good looking vagina" is and how women feel that their privates are inferior and are therefore pressured to act upon that mindset. These insecurities are forced upon women by their partners and other women as well.^[32] Also leading to a surge of these types of procedures is increased interest in non-surgical genital alterations, such as Brazilian waxing, that make the vulva more visible to judgment. The incentive to participate in vulvo- and vaginoplasty may also come about in an effort to manage women's physical attributes and their sexual behavior, treating their vagina as something needing to be managed or controlled and ultimately deemed "acceptable".^[33]

Clitoral hood reduction is a form of hoodplasty. When performed with the consent of the adult individual, it can be considered anelectiveplastic surgery procedure for reducing the size and the area of theclitoral hood (prepuce) in order to further expose theglans of theclitoris; the therapeutic goal is thought to improve the sexual functioning of the woman, and the aesthetic appeal of hervulva. The reduction of the clitoral prepuce tissues usually is a sub-ordinate surgery within alabiaplasty procedure for reducing thelabia minora; and occasionally within avaginoplasty procedure. When these procedures are performed on individuals without their consent, they are considered a form offemale genital mutilation.

Castration in the genital modification and mutilation context is the removal of thetesticles. Occasionally the term is also used to refer topenis removal, but that is less common. Castration has been performed in many cultures throughout history, but is now rare. It should not be confused withchemical castration.

The removal of one testicle (sometimes referred to asunilateral castration) is usually done in the modern world only for medical reasons.

Circumcision is the removal of theforeskin, the double-layered fold of skin, mucosal and muscular tissue at the distal end of the human penis.^[34] Around half of all circumcisions worldwide are performed for reasons ofpreventive healthcare; half for religious or cultural reasons.^[35][36] Circumcision involves either a conventional "cut and stitch"surgical procedure or use of a circumcisioninstrument ordevice. Complications are rare.^[37][38][39] Modern proponents say that circumcision reduces the risks of a range of infections and diseases and confers sexual benefits.^[40][41] Opponents, particularly of routine neonatal circumcision, question its preventive efficacy and object to subjecting non-consenting newborn males to a procedure that is potentially harmful, in their view, with little to no benefit, as well as violating their human rights and possibly negatively impacting their sex life.^[42][43][44] There is a consensus among the world's major medical organizations and in the academic literature that circumcision is an efficacious intervention for HIV prevention in high-risk populations if carried out by medical professionals under safe conditions.^[45][46] They hold variant perspectives on the prophylactic efficacy of the elective circumcision of minors indeveloped nations.^[47]

Foreskin restoration and reconstruction are techniques for the recreation of theforeskin after its removal bycircumcision or injury.^[48][49][50]

Surgical reconstruction often involves grafting skin taken from thescrotum onto a portion of the penile shaft.^[48] Nonsurgical restoration involvestissue expansion by stretching the penile skin forward over theglans penis with the aid oftension, either by hand or with arestoration device.^[48][50]

Infibulation literally means "to close with a clasp or a pin.” The word is used to includesuturing of the foreskin over thehead of the penis.

Early Greek infibulation consisted of tying the most distal portion of the foreskin withkynodesme to conceal the glans. The kynodesmē was also used by the Etruscans and Romans (ligatura praeputii), but the Romans preferred to apply a gold, silver, or bronze ring (annulus), a metal clasp (fibula) or pin.^[51] Use of a kynodesmē may also permanently lengthen the foreskin over time which was seen as proper and desirable.^[52]

In modern times, male infibulation may be performed for personal preferences or as part ofBDSM.

Emasculation is the removal of both thepenis and thetesticles, the externalmale sex organs. It differs fromcastration, which is the removal of the testicles only, although the terms are sometimes used interchangeably.

Genital nullification is a procedure practiced in abody modification subculture made up mostly of men who have had their genitals surgically removed. Those undergoing the procedure often go by the name of nullos, and are not necessarilytransgender ornonbinary; some identify aseunuchs.^[53] The termnullo is short forgenital nullification.^[54] Though the procedure is mostly sought by men, female genital mutilation may be referred to as clitoral nullification.^[55]

In modern-daySouth Asia, some members ofhijra communities reportedly undergo emasculation. It is callednirwaan and seen as arite of passage.^[56]

It was part of the eunuch-making of theChinese court, and it was widespread in theArab slave trade. A castrated slave was worth more, and this offset the losses from death.^[57]

Pearling or genital beading is a form of body modification, the practice of permanently inserting small beads made of various materials beneath the skin of the genitals—of the labia, or of the shaft or foreskin of the penis. As well as being an aesthetic practice, this is usually intended to enhance the sexual pleasure of the receptive partner(s) during vaginal or anal intercourse.

Penectomy involves the partial or total amputation of the penis. Sometimes, the removal of the entire penis was done in conjunction with castration, or incorrectly referred to as castration. Removing the penis was often performed oneunuchs and high ranking men who would frequently be in contact with women, such as those belonging to aharem. The hijra of India may remove their penis as an expression of theirgender identity. In the medical field, removal of the penis may be performed for reasons ofgangrene orcancer.

In theulwaluko circumcision ceremony, which is performed by spear, accidental penectomy is a serious risk.^[58]

In the United States In 1907Bertha Boronda sliced off her husband's penis with a straight razor.^[59]Lorena Bobbit infamously removed her husband's penis in 1993. In the latter case, the use ofmicrosurgery was able to reattach Bobbitt's penis.^[60]

Penile subincision is a form of genital modification involving aurethrotomy and vertically slitting the underside of the penis from themeatus towards to the base. It was performed on children by people of some cultures, such as theIndigenous Australians, theArrente, theLuritja, theSamburu, theSamoans, and theNative Hawaiians. Indigenous Australians also perform circumcision as a prerequisite for subincision.^[61] It may also be performed for personal preference. Penile subincision may leave a man with an increased risk ofsexually transmitted diseases,issues with fertility (due to lack of control over what direction the sperm goes afterejaculation), and may require a man to sit down whileurinating.^[62] When the surgery is not performed in a hospital or by a licensed medical professional, complications such as infection,exsanguination, or permanent damage are major concerns.

A rectal slit (also known as superincision) is an incision made along the upper length of the foreskin with the intention to expose theglans penis without removing skin or tissue.

The practice appears to have occurred in Ancient Egypt, though not commonly:

A few examples ofOld Kingdom... statuary present some adult males—usually priests, functionaries, or low-status workers—as having undergone a vertical slit on the dorsal aspect of the prepuce, although no flesh has been removed.^[63]

It may be performed as a part of traditional customs, such as those in thePacific Islands and thePhilippines. In the medical field, it may be performed for as an alternative to circumcision when circumcision is undesired or impractical. It remains a rare surgery and practice overall.

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