Wednesday, August 09, 2017


The AMA came out with a paper on surgery for intersex babies, and it is about time that they did.
Are Physicians Blameworthy for Iatrogenic Harm Resulting from Unnecessary Genital Surgeries?
AMA Journal of Ethics
By Samuel Reis-Dennis, PhD, and Elizabeth Reis, PhD
August 2017

We argue that physicians should, in certain cases, be held accountable by patients and their families for harm caused by “successful” genital surgeries performed for social and aesthetic reasons. We explore the question of physicians’ blameworthiness for three types of genital surgeries common in the United States. First, we consider surgeries performed on newborns and toddlers with atypical sex development, or intersex. Second, we discuss routine neonatal male circumcision. Finally, we consider cosmetic vaginal surgery. It is important for physicians not just to know when and why to perform genital surgery, but also to understand how their patients might react to wrongful performance of these procedures. Equally, physicians should know how to respond to their own blameworthiness in socially productive and morally restorative ways.
And their conclusion was,
We have argued that physicians should not modify children’s genitals for nontherapeutic reasons. In addition, we believe that they should play a bigger role in educating their young patients about genital and body variability and consider their motivations when advocating surgical normalization. When physicians do perform genital surgeries for nonmedical reasons, a wronged patient’s feeling and expression of blaming attitudes can be both fitting and justified. In fact, the expression of anger can be part of a productive social interaction that can, under certain circumstances, prompt apology and facilitate psychological healing.

Hopefully, the AMA will develop this as a policy… no genital surgery without the patient’s permission.

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