Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Correspondence
  • Published:

On becoming autonomous and “coercive cultural acts”: a reply to Max Buckler

International Journal of Impotence Research volume 35, pages 35–37 (2023)Cite this article

Subjects

In response to my suggestion that there should be a universal age at which people should be legally considered able to make decisions to alter their genitalia [1], Max Buckler argues that older children and teenagers should have their autonomous decision-making capacities assessed individually and be treated on a case-by-case basis when it comes to such procedures [2]. He claims that there is an important difference between “coercive cultural acts” and those sought out by older children for their “own desire” [2]. Buckler also asks for clarity on the following:

  1. (1)

    What practices count here as “genital cutting and/or modification?”

  2. (2)

    When does a child in the moral sense become a sufficiently autonomous “adult?” [2].

What practices count here as “genital cutting and/or modification?”

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Notes

  1. 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].

  2. 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” [23].

References

  1. Townsend KG. Defending an inclusive right to genital and bodily integrity for children. Int J Impot Res. 2021.

  2. Buckler M. The ethics of child genital cutting_when does a violation occur? Int J Impot Res. 2022.

  3. NSPCC Learning. Gillick competency and Fraser guidelines. London: NSPCC Learning; 2020.

  4. 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.

  5. 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.

  6. Shahvisi A. “FGM” vs. female “cosmetic” surgeries: why do they continue to be treated separately? Int J Impot Res. 2021.

  7. 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.

  8. 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.

  9. Braun V. The women are doing it for themselves. Aust Fem Stud. 2009;24:233–49.

    Article  Google Scholar 

  10. Jones M. Intersex genital mutilation—a western version of fgm. Int J Children’s Rights. 2017;25:396–411.

    Article  Google Scholar 

  11. Fowler T. The status of child citizens. Polit Philos Econ. 2014;13:93–113.

    Article  Google Scholar 

  12. 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.

  13. Williams MS. Tolerable liberalism. In: Minorities within minorities. Eisenberg A, Spinner-Halev J. editors Cambridge: Cambridge University Press; 2005. p. 19–40.

  14. Galeotti AE. Relativism, universalism, and applied ethics: the case of female circumcision. Constellations. 2007;14:91–111.

    Article  Google Scholar 

  15. Galeotti AE. Autonomy and cultural practices: the risk of double standards. Eur J Political Theory. 2015;14:277–96.

    Article  Google Scholar 

  16. 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.

  17. Gheaus A, Calder G, de Wispelaere J. The Routledge handbook of the philosophy of childhood and children. London: Routledge; 2019.

  18. Earp BD. The child’s right to bodily integrity. In: Ethics and the contemporary world. Abingdon, Oxon, New York: Routledge; 2019. p. 217–35.

  19. Townsend KG. The child’s right to genital integrity. Philos Soc Crit. 2020;46:878–98.

    Article  Google Scholar 

  20. British Medical Association (BMA). Ethics toolkit for medical students: autonomy or self-determination as a medical student. 2021.

  21. 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.

  22. Carmack A, Notini L, Earp BD. Should surgery for hypospadias be performed before an age of consent? J Sex Res. 2016;53:1047–58.

    Article  PubMed  Google Scholar 

  23. Kaposy C. The public funding of abortion in Canada: going beyond the concept of medical necessity. Med Health Care Philos. 2009;12:301–11.

    Article  PubMed  Google Scholar 

  24. 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.

  25. Feinberg J. The moral limits of the criminal law volume 1: harm to others. Oxford: Oxford University Press; 1987.

  26. Chambers C. Sex, culture, and justice: the limits of choice. University Park, Pennsylania: Penn State University Press; 2008.

  27. Klein D. Gender X; the battle over boy of girl. Stanford Medicine Special Report; Bioethics, no easy answers. 2011.

  28. 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.

    Article  PubMed  Google Scholar 

  29. 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.

    Article  Google Scholar 

  30. Female Genital Mutilation Act. United Kingdom Acts of Parliament, 2003.

Download references

Acknowledgements

KGT would like to thank Max Buckler for his engagement with the work, and the journal editors for the opportunity to reply.

Author information

Authors and Affiliations

  1. Politics Department, University of Exeter, Exeter, UK

    Kate Goldie Townsend

Authors
  1. Kate Goldie Townsend
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

KGT is the sole author.

Corresponding author

Correspondence to Kate Goldie Townsend.

Ethics declarations

Competing interests

The author declares no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

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

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41443-022-00617-w

This article is cited by

Search

Advanced search

Quick links