Commentary to 'Neophalloplasty in boys with aphallia: A systematic review'.
From some of the oldest surviving cave art from more than 30,000 years ago to the frequency of the penis as a topic of modern cocktail (an apt attribution) parties, the phallus stands out as an organ of singular importance to humans [1]. Intervening millennia have witnessed phallic amulets for protection; phallic architecture and art in Egypt, Greece, and Rome; and symbols of phallic worship, power and creation in Hinduism, ancient Southeast Asia, and Central American civilizations. Indeed, adding all of this to phallic representations in Medieval to modern arts, along with the present preoccupation with internet pornography, intuition might award the phallus a priapic crown of centrality to the male soul itself. In fact, mid-20th century psychology literature intuited this, such that a genetic/hormonal male born without a penis was felt to be far better off raised as a female e the penis seemingly impossible to surgically construct. Then, the environment could be so-designed as to create a self-satisfied, developing girl from a sex-reassigned male infant. However, in 1979, Imperato-McGinley published what should have been a seminal study of 17 males, with 5-alpha reductase type-2 deficiencies, raised as females who converted to males after virilizing during puberty [2]. Later, a trickle of reports began appearing that questioned the clinical success of sexreassigning aphallic males. Counter intuitively, however, some clinicians questioned these newer studies, and ignored the earlier Imperato-McGinley studies e but they didn’t question the original psychology literature. Nonetheless, our 21st century clinical wisdom has (mostly) realized that the silk purse and the sow’s ear are, indeed, nonreciprocating: a male is a male is . Therefore, if the brain reigns supreme, surgeons must simply construct a functional