Why Are Doctors Still Performing Genital Surgery on Infants? Exploring the Ethics, Risks, and Calls for Change

The outcomes of infant genital surgeries are indeed often problematic, both physically and psychologically. Many intersex adults who have undergone these procedures report a range of serious issues. Given the potential for harm and the complex, personal nature of these surgeries, many medical professionals, ethicists, and intersex advocates argue that non-essential genital reshaping should be deferred until the individual can participate in the decision. This shift recognizes the importance of bodily autonomy, respecting the affected person’s right to make informed choices about their own identity and well-being. The practice of performing genital surgery on infants is controversial and continues for several reasons, often tied to medical, social, and cultural factors.

Here are some of the main reasons why this practice persists:

1. Medical and Diagnostic Reasons

Disorders of Sex Development (DSD): In cases where infants are born with atypical genitalia (often grouped under DSD), some doctors recommend surgery to make the genitals appear more typically male or female. This has historically been done to prevent potential future psychological distress, though this reasoning is now widely debated.

Urinary Function: In rare cases, surgeries are conducted to improve urinary function, as some intersex conditions may cause difficulties in urination that could lead to infections or other complications.

2. Cultural and Societal Norms

Many cultures expect people to have a clearly defined male or female physical appearance from birth. Medical professionals may suggest surgeries to help the child fit societal gender expectations, especially in cases of intersex infants. Parents may feel pressured by these norms to consent to surgery, believing it will spare their child future social difficulties or stigma.

3. Historical Medical Practices and Biases

For decades, medical professionals assumed that surgically “normalizing” genitalia would prevent later psychological harm, although recent studies have shown that early surgeries can lead to negative physical and emotional consequences. Traditional views on gender have influenced these practices. Until recently, medical authorities largely encouraged early surgery, which parents often accepted, trusting that doctors were acting in their child's best interest.

4. Lack of Awareness and Informed Consent

Some parents may not fully understand the long-term implications of infant genital surgery. Because it is often framed as a necessary medical intervention, parents might feel they are making the best choice to ensure their child has a “normal” life, without knowing about potential future health, sexual, or emotional issues linked to these surgeries.

Related Blogs- Understanding Genital Anomalies in Newborns: A Guide for Parents

5. Changing Perspectives and Legal Debates

In recent years, advocacy groups and medical organizations have raised awareness about the risks and ethics involved in performing irreversible genital surgeries on infants, especially without the child’s consent. This movement has led to some countries reconsidering these practices, encouraging a “wait-and-see” approach that allows individuals to decide for themselves when they’re older.

Dr. Dhanesh Agrahari is a Senior Consultant - General Surgery, Laparoscopic Surgery with a super specialized degree (M.Ch) in - Pediatric Surgery and  Pediatric Urology & Co Founder of Phoenix Hospital, Allahabad. He has more than 25+ years experience in the field of Pediatric Surgery, Pediatric Urology and Pediatric Laparoscopic Surgery. He has a unique mix of experience of having worked in Academic Institutions and Corporate Hospitals in his field. The continued practice of infant genital surgeries highlights a complex intersection of medical tradition, cultural expectations, and evolving ethical standards. With growing awareness of the potential for harm, many advocates and some medical organizations are pushing to minimize these surgeries unless there is a compelling, immediate medical need, suggesting that the decision should be left to the individual when they are old enough to consent.