The chapter discusses the origins, dissemination, and contemporary global distribution of cultural, heritage-based genital modification practices of females and males. These are performed as rites of passage; religious obligations; safeguards to virginity, chastity, and marriageability of girls; or group and gender identity. Male genital modification practices are unevenly distributed globally and originated multiple times in parts of Africa, Asia, Australia, and the Pacific. Detailed accounts of the history of male circumcision in ancient Egypt and the Levant are provided as examples of the variations in practices and multiple origins, and male circumcision among Muslims in Africa, Asia, and elsewhere is covered. Female genital modifications were also known in antiquity and similarly originated multiple times in Africa, Asia, and possibly elsewhere, probably along with or following the establishment of male modifications. Female genital cutting is practiced by followers of several religions, and some Muslims believe it to be required or at least desirable in their faith. In the nineteenth and twentieth centuries, the spread of male circumcision was further accelerated by medical promotion, in the belief that it contributed to disease prevention and morality. The World Health Organization’s current support for male infant circumcisions while at the same time promoting abolition of female genital cutting (with some exceptions) is discussed. The contentious ethical issue of whether it violates human rights to surgically alter the genitalia of infants or children, who are unable to provide informed consent, is also discussed
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