It's a catch-22. One must be mentally well to consent to cosmetic removal of genitalia, however, the very nature of the request indicates the prospective patient is profoundly mentally unwell. No sane person wants their genitalia destroyed. These procedures, all of them, should be made illegal because no one who wants one can be said to be capable of consent.

It comes down to the fact that people can ask for procedures, at all. You don't stroll into a doctor's office and say you want a pacemaker or a knee replacement. A doctor has to recommend them, based on your symptoms.

But if we addressed that we'd have to address plastic surgery, and nobody's prepared to second guess anything that brings in the truckloads of money.