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Back in 2017, Moodley and Rennie published a paper in the Journal of Medical Ethics entitled ‘Penile transplantation as an appropriate response to botched traditional circumcisions in South Africa: an argument against.’1 As the title suggests, we took a critical view towards penile transplantation as a way of responding to the problem of young men in South Africa experiencing genital mutilation and amputation as a result of traditional circumcision practices. Our main conclusion was that prevention is key: social, cultural and political strategies to prevent mutilations and amputations should be prioritised, rather than surgical solutions, particularly in low-resource communities. Van der Merwe, who led the surgical team for the first successful penile transplantation in Stellenbosch, South Africa, has responded to our views, and in what follows, we will distill and evaluate his main arguments.