Given the prevalence of forced mutilation of intersex babies as well as medically unnecessary circumcisions, I humbly disagree that these procedures are "weighted on total outcomes".

As I said, it's not a perfect system. However, a lot of the times the flawed treatments of their times were influenced by how physicians perceived cultural norms.

As cultural mores are adjusted and education within the medical community improves, treatment options are usually re-aligned to fit the science. For example circumcisions are becoming a thing of the past and intersex operations nare usually conducted after secondary sex organs develop.

Every doctor who has performed that procedure was fully aware that it was medically unnecessary and did not have reason to believe the baby would not come to regret not being given a choice years down the road. I'd argue these procedures are institutionalized medical malpractice.

Eh.... Doctors are a slave to social mores as much as anyone is. They are unfortunately just as susceptible to belief as lawyers or politicians. There were beliefs that spouted about hygiene etc, but in reality those were just to validate belief systems held by the vast majority of the population. In the end they believed that the harm was not very significant to the pts overall health.

but I think it's critical to acknowledge that the field of medicine still has very strong biases in these matters and is not nearly as Cartesian as it is sometimes made out to be.

I think it's fairly obvious that the medical system has failed several minority groups, most recently trans people. I am proclaiming how medical providers should behave and how we were trained to treat all patients. Unfortunately, as you have stated, beliefs systems unjustly often interjects itself in medical care. Whether that be in prescribing birth control or administrating gender affirming care.