Bioethicists Okay Adolescent Genital Cosmetic Surgery

by Wesley J. Smith

Just to show you that the lines of bioethical discourse know no boundaries, writing in Bioethics, two bioethicists argue in favor of genital cosmetic surgery for minor girls suffering from Body Dysmorphic Disorder (BDD)–an obsessive mental illness in which the person can’t stop thinking about their own supposed bodily imperfections. From the article:

(i) Adolescents with BDD who want labioplasty may endure serious suffering. (Distress, suicidal tendencies)

(ii) Labioplasty will – or is likely to – secure relief from this suffering. (Empirical research.)70

(iii) This relief cannot be secured by other less drastic means.(Lack of evidence for alternative treatments.)

(iv) Securing relief from this suffering is worth the cost of labioplasty, i.e. the effect on the person of the surgery, and the physical consequences of that. (Labioplasty is a simple surgical procedure with low risk, and no on-going physically disabling effects).

Under that thinking, why not also do it for religious reasons, as in female genital mutilation–thwarted religious intensity can cause suffering–if it makes the girl feel more accepted in her community?

(Actually,the American Academy of Pediatrics once okayed a “symbolic” cutting in certain cases before backing off under intense public pressure.)

Some would say the former surgery does not impair sexual response. while the latter does. But in the latter case, that could be precisely what the girl wanted, and indeed, the existence of sexual response might be the very cause of her suffering.

Making the whole thing even more ridiculous, the bioethicists claim that their reasoning is akin to the scientific method:

So we find ourselves pushed to arguing in favour of cosmetic labioplasty for adolescents who have BDD. Initially, we did feel uncomfortable about this, as it is not what we expected and is certainly counter-intuitive, at least to us. However, we have reflected that this outcome shows the power of ethical reasoning.

If pursued thoroughly, using the available evidence and working from first principles, it is similar to the scientific method, in that it leads to a logical conclusion, regardless of what one might have expected at the outset.

No, it merely shows the power of relativism–here, in the priorities of autonomy and the elimination of suffering as dictated within a subjective narrative in determining “harm”–that leads logically to the conclusion reached.

Relativistic thinking can lead anywhere. Indeed, relevant to this post, some bioethicists advocate the propriety of amputating healthy limbs or severing healthy spinal cords of those who “identify” as amputees or disabled people, a terrible mental condition known as body identity integrity disorder (BIID), about which I have written before.

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