Shadi Heidarifar

Female Genital Cosmetic Surgery (FGCS) is an umbrella term referring to different procedures including labiaplasty (reducing the length of the labia minora), clitoral hood reduction (reducing excess folds of the clitoral hood), hymenoplasty (building the hymen), labia majora augmentation (reducing the labia majora), vaginoplasty (tightening the vagina), and G-spot amplification (increasing the size and sensitivity of the G-spot). This paper is concerned with “all-or-nothing” approaches to FGCS procedures in women’s healthcare, i.e., those that overemphasize either women’s autonomy so as to defend total accessibility to the procedures, or the oppressive social context affecting women as to defend the total banning of the procedures. What is missing in the literature, however, is an articulation of how both approaches ignore that the practice of autonomy can coexist and coincide with facing up to oppression. This paper first provides an articulation of how these attitudes – seemingly in disagreement – have underlying normative assumptions in common. This articulation further helps frame the so-called tension between oppression and autonomy in a way that highlights unique aspects of FGCS procedures. By contrast, I argue in favor of an “in-between” approach, which takes both phenomena into consideration. I argue that merely emphasizing psychophysical harm is not sufficient to justify the total banning of an FGCS procedure. Instead, identifying patterns of false consciousness, as a form of epistemic injustice and weighing those against other forms of potential harm done to a patient provides a moral basis for a doctor to possibly deny a patient’s consent at face value. This also requires a substantial shift in the doctor patient relationship such that it centers around moral deliberations between the two parties. This deliberative model of the doctor patient relationship is intended as a first step toward a feminist model for women’s healthcare; by grounding an “in-between” approach to FGCS where the denial or acceptance of the patient’s consent to an FGCS procedure relies on their epistemic situatedness, and whether the doctor considers that situatedness to justify their motivation to undergo the surgery.

In this paper, I show that there is a bidirectional relationship between gender-based social norms and gender-segregated education policies that excludes girls from knowledge production within the Iranian school system. I argue that gender segregation in education reproduces hermeneutic inequality through the reinforcement of epistemic segregation as a form of epistemic injustice. In particular, I focus on gender-based instructional epistemic injustice, which refers to a set of epistemic practices that actively exclude a student or an education professional in their capacity as a knower from the process of knowledge production within an education system based on gender dynamics, roles, norms, or expectations. This, in addition, has an impact on schoolboys through the reproduction of active ignorance. I conclude that in societies such as Iran, where highly gendered norms play out in the school system and are further reinforced by that system, the result is not limited to gender segregation itself, but extends beyond it to a form of epistemic injustice that wrongs students by reproducing and reinforcing those highly gendered norms.