Bottom line: Regardless of assigned sex at birth, genital cutting sufferers experience real trauma. We don't need scientific breakthroughs—we need healthcare professionals willing to disrupt unethical practices. Any transgender bill of rights that bans some, but not all forms of forced genital cutting, is failing to live up to the principles of justice, inclusivity, and equality and fails to account for the actual lived experiences of trans and intersex people.

When we looked across our eight testimonials, we found that the principle of subsidiarity was the best way to address these problems. SUBSIDIARITY: The person best positioned to judge the desirability of ANY genital modification is the person whose genitals would be affected. Children should decide about their own bodies—both regarding circumcision AND gender-affirming care.

Importantly: Foreskin restoration is gender-affirming care. Whether we are choosing to keep our penises or pursuing vaginoplasty (more genital tissue = fewer grafts needed), restoration helps us feel comfortable in our bodies. Trans men may also benefit from foreskin restoration techniques if they experience genital chafing on HRT.

Finding #5: Penile circumcision is enmeshed with dysphoria. We identified distinct, though deeply intertwined, experiences of dysphoria: iatrogenic genital dysphoria (from unwanted modifications forced upon one's body) and gender dysphoria (about the gender of one's body). These dysphorias, plural, interact in complex ways, making it harder to determine our gender projects and transition goals.

Finding #4: Circumcision normalizes violations of patient dignity. We shared experiences of sexual battery, breached confidentiality, and retraumatization by healthcare providers—all rooted in the logic that bodies can be acted upon without consent. The normalization of forced circumcision teaches clinicians and parents that they enjoy a license to do violence to children in order to make their bodies conform to gendered expectations.

Finding #3: The trauma of forced genital cutting, including circumcision, extends beyond the individual. It damages parent-child bonds, shatters trust in healthcare providers—which is especially problematic when seeking gender-affirming care and other genital modifications. Our grief as intersex, trans, and gender-expansive people is frequently disenfranchised and dismissed.

Finding #2: Unwanted genital cutting is deeply gendered. Penile circumcision marks the body as male, masculinizes it. For some of us, circumcision trauma complicated our gender identity. One author said it delayed accepting themselves as intersex partly because there is a vulvar bias in how people talk about intersex experiences of forced genital cutting.

Finding #1: So-called "intactivist" spaces are often unwelcoming to anyone who isn't a cis male. We experienced misogyny, antisemitism, and transphobia in online Intactivist spaces (Reddit, Discord, etc.).

Still, some established organizations (like GALDEF and Intact Global) are trying to be more inclusive, though they still center cis males in their activism and philosophical approach.

There's more background on the poster if you want it. Let's get into the methods now. Our methods: 8 members of the Genital Autonomy Collective wrote testimonials about how forced genital cutting, including circumcision, affected our identities, relationships, activism experiences, and gender transitions. We wrote our testimonials separately and then met together to identify key themes and patterns.

Despite the words and recommendations of bioethicists, non-voluntary genital cutting remains the most common class of surgical procedures in the US. This includes "normalizing" surgeries forced on intersex children and circumcision forced on children born with a penis. About 1 in 7 circumcised American men resent the forced genital cutting they experienced, and this resentment is highest among non-heterosexual people, including trans women and nonbinary people.

Frankly, whether or not parents should experience shame for forcibly amputating their child's healthy genital tissue without consent is not an appropriate way to discuss forced genital cutting. The fiduciary duties of medical professionals are to the child-patient first and foremost. It is inappropriate for the AAP to have made medical recommendations about forced genital amputations based primarily on whether or not parents might risk feelings of guilt or shame.

Since the presentation of this poster, even more news has been made regarding the ethics of forced penile circumcision. The lead bioethicist of the AAP's 2012 Taskforce on Circumcision recently recanted his previous advocacy for forced genital cutting, going so far as to say that circumcision is "not a medical procedure", and that the AAP should "get out of the business" of doing forced penile circumcisions.

https://jme.bmj.com/content/early/2025/11/13/jme-2025-111357.abstract?casa_token=X_IbjTAl4IgAAAAA:zUyTaZBAFIGrYKnhXqHdBMozecb56wqof0r9G097Sedl5pshzz82j-1KNv_PqdpCeE-46dpgnYUp

In 2024, a broad coalition of ethicists, researchers, and advocates published a united statement about genital cutting of children. According to the united experts of the Brussels Collaboration on Bodily Integrity, laws that ban forced genital cutting on children assigned female at birth, but permit genital cutting of other children, are violating the principles of justice, inclusivity, and equality.

If forced genital cutting is banned for AFAB children, it should be banned for all children.

This research belongs to a category of methods called ethnography. Because we wrote about our own experiences and analyzed them as a group, this is more accurately called collaborative autoethnography.

If you want to learn more about ethnography, I have some slide presentations you can review.

Beginning Autoethnography: https://mastodon.social/@ttpphd/115566929967316791

Collaborative Autoethnography:
https://mastodon.social/@ttpphd/115572957778243108

First, though, some context: Genital autonomy means freedom to pursue desired changes to your body AND freedom from forced changes. The Genital Autonomy Collective is a peer support group of intersex, trans, and gender-expansive people who have experienced violations of their genital autonomy or who want to exercise their autonomy.

https://autonomycollective.org/

Our poster was presented at GLMA's 43rd annual conference on LGBTQ+ health. You can view the research poster itself, or even watch a video of me presenting the poster if you'd prefer those formats over a social media thread. Here's what we found...

Poster PDF: https://drive.google.com/file/d/1k_a9zOOtsMu0Pio6PznMFL7Dusbhpa_6/view

Video Walkthrough: https://www.youtube.com/watch?v=uNADMye4hec

In light of the proposed "Transgender Bill of Rights", in this thread I want to walk you through research by and about trans, intersex, and gender-expansive people and our lived experiences of unwanted genital cutting vs. gender affirming care. By the end of the thread you will understand the principle of subsidiarity and why forced genital surgeries should be banned.🧵

#Trans #Intersex #Circumcision #LGBTQ #USPol