Increasingly popular vaginal cosmetic surgery and genital piercing should in most cases not be prosecuted as female genital mutilation (FGM), according to fresh guidance issued by the Crown Prosecution Service.
In an attempt to improve the way police and prosecutors build cases in one of the most controversial areas of law enforcement, the CPS has revised its advice on what constitutes legitimate medical or therapeutic intervention and what amounts to criminal activity.
Since FGM was first outlawed in 1985, there has only been one conviction – earlier this year when a Ugandan woman, who lived in Walthamstow, east London, was sentenced to 11 years in prison for cutting her three-year-old daughter.
Female Intimate Piercings
There have been several failed prosecutions, including the first in 2015 when a doctor was acquitted after stitching up a mother after childbirth. The offence has been a notoriously difficult legal area for prosecutors, with accusations that cases were pursued to satisfy political pressure for action.
The fashion for “designer vagina” procedures and genital piercings has complicated consideration of what is illegal and made clearer guidance necessary. Among the most popular types of operation is labiaplasty, which involves cutting labial tissue either side of the vulva.
Jaswant Narwal, who is the chief CPS prosecutor in Thames and Chiltern as well as the organisation’s lead on FGM cases, said: “Female genital mutilation is a sickening offence that can have a serious, lifelong physical and emotional impact on victims.
Genital Piercing: Top Facts
“We want to send a strong message that this crime does not have to be carried out in the UK for people to be prosecuted by the CPS – we will seek justice for people affected by this horrific practice. There is no hiding place.
“We hope this new guidance will give victims, police and prosecutors the confidence and practical guidance they need to bring more perpetrators of this traumatic abuse to justice.”
The Female Genital Mutilation Act 2003 increased the maximum penalty for FGM to 14 years. Suspects can face prosecution in the UK regardless of where in the world any procedure took place.
Piercing Basics: History, Forms, Advice, And Care
The young age of victims and a reluctance to report the crime to the police because of cultural taboos have both been blamed for low levels of offences being reported.
The new guidelines published on Thursday provide clarity on drawing the line between “designer vagina” operations and FGM, according to the CPS. In theory, some cosmetic vaginal surgery such as labiaplasty could fall under the definition of FGM in the 2003 act.
But prosecutors are advised they should also consider public interest factors, including the age of the alleged victim, whether they provided fully informed and free consent, the level of physical or mental harm caused, and the impact on the individual’s quality of life now and in the future.
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Piercing female genitalia – “to adorn it with jewellery or other accessories purely for the purpose of personal decoration or in order to enhance the sensation of sexual contact” – will not usually amount to FGM, the advice says.
In relation to cosmetic surgery or labiaplasty, the guidance states: “Prosecutors should consider the evidence of necessity. This may include psychological reasons for the surgery which mean that the surgery will have a therapeutic element.”
Factors making it more likely that charges should be initiated are, among others, if the victim supports prosecution, if there is mental or physical harm caused, if the victim was under 18 and if there was no medical benefit.Purpose: More men with genital piercings (GP) are presenting to health care facilities, yet a paucity of medical literature exists about their body modifications, health issues, and medical needs. Historically, they have turned to a piercer or the internet for medical advice which may put their health at risk by receiving inappropriate guidance or delayed treatment by an experienced, well-informed clinician.
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Methods:A comparative, descriptive cross-sectional study was conducted using an 83 item web-based survey.Demographics, risk behaviours, procedural motives, and post-piercing experiences about men with GP were examined, as well as depression, abuse, self-esteem, and need for uniqueness.Similarly published studies were also compared.
Results:445 men from 42 states and 26 international sites reported 656 genital piercings.The average participant was 36 years of age, Caucasian, possessing some college education, married or in a monogamous, heterosexual relationships, and in excellent health. Deliberate decision-making was present: 36% chose a Frenum/Frenum Ladder GP and 56% chose a Prince Albert GP, with 25% experiencing urinary flow changes.Outcomes were related to their motives: sexual expression, uniqueness, and aesthetics, with improvement of personal and partner’s sexual pleasure.
Conclusions:Several unsubstantiated assumptions about men with GP were challenged regarding the amount of STDs, GP complications, and overall demographics. Currently their GP care information is still obtained from a piercer or the internet. Clinician awareness of GP is important to educate and inform adequately, give professional advice, and provide a realistic picture of structural complications.
The Piercing Urge
Humans have always been interested in altering their body. Whether through piercings or tattoos, for aesthetics, religious reasons, or self-expression, the practice of body modification is a well known art.
One not as familiar or easily observed body modification type is genital piercings. Genital piercings (GP) are defined as developing a tract under the skin with a large bore needle to create an opening into the anatomical region for decorative ornaments such as jewelry.
Currently, this once taboo practice is on the rise and more men with GP are presenting with a variety of medical needs to clinics and hospitals.
Female Genital Piercings
From the rare Pubic Piercing (a piercing through the dorsal base of the penis) to the Guiche (a piercing through the perineum), the male genitalia provides ample area to pierce. Men commonly choose from nine different types of GP and often use three major types of piercing jewellery (Figure 1).
This rapid growth trend is creating its own set of complications and questions among clinicians.The medical literature suggests the most common risks are infection and bleeding, but there are other structural considerations as well.
An example of this is with the most widely known and commonly encountered male GP, the Prince Albert; the jewellery pierces the urethral meatus, exiting through the ventral surface of the penis.
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The piercing effectively creates a fistula for urine to drain, and many men report experiencing the need to sit down during urination due to the change in stream and difficulty in aiming.
Other reported single case histories of more severe complications are Fournier’s gangrene, urethral tears, priapism, post-coital bleeding or lost jewellery in female partners, paraphimosis, and recurrent sexually transmitted diseases.
Given the variety of negative issues that could arise from GP, any subject related to the health and well being of men having an intimate piercing should be directed to a well informed clinician.Currently, when questions or problems arise, men are more likely to seek assistance from the internet or a piercer rather than a health care provider.
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Considering the limited medical literature, as well as the minimal availability of clinicians knowledgeable about body piercings and modifications, men with GP are at high risk for delays in appropriate treatment of complications related to piercings as well as for overall preventive healthcare.Over concentration on the presence of GP by clinicians could delay important health care.
Our purpose for this study was to elucidate information about men with GP in order to aid the clinician in providing relevant information for patients considering GP, as well as to provide further scientific evidence by examining their demographics, risk behaviours, procedural motives and post-piercing experiences.Additionally, several motives or characteristics of those with body art such as depression, abuse, self-esteem, and need for uniqueness were examined.
Problems in attempting any study about those with GP is reaching a sizeable sample for a study and an acceptable data collection methodology as those with GP have a hidden variable of study, making it difficult to make contact.Networking or “snowball” sampling for data collection, as well as anonymous questionnaires, becomes one approach,
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But this also makes it difficult to validate if respondents actually have GP.In an effort to address this issue, survey questions were specifically written for individuals with GP, making it extremely difficult and time-consuming to answer if the respondents did not have applicable experiences.Previous research experience also indicates that after about 10-15 questions, interest can wane and the questionnaire will not be completed.
Data, collected in 2000 and actually published in 2005 hada national convenience sample of 63 women and 83 men with nipple and/or GP.Forty-eight men in the study had GP; the average man was 31 years of age, single, heterosexual, Caucasian, in good-excellent health, who sought out annual physicals, possessed some college education, and spoke of moderately strong religious faith.Almost all were employed, reporting an average annual salary of $36, 000, or higher.Over half admitted and continued their belief they were risk takers; many of them also had 3 or more general body piercings.Most did not smoke or use drugs routinely and in this study, no questions about alcohol use were asked.Their average age at first sexual intercourse was 15.7 (the national male average is 16.9).
Of those that participated (37%) in sport activities or exercise, they reported with no problems. They voiced minimal, if any, regrets to obtaining a
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