1. Can the category 'culture' (or religion) be used?	​Yes, as the practice is a type of traditional medicine within certain traditional medicines. No religious profiles are discernible.
2. Description of the cultural (or religious) practice and group.	Gua Sha: Gua Sha (stasis pressure, press-stroking or ‘coining’ in English) is a traditional medicine technique widely used in Asia, in Asian immigrant communities, and by acupuncturists and practitioners of East Asian traditional medicine worldwide. Specifically, it involves repeated, unidirectional pressure applied with a smooth-surfaced instrument (such as a Chinese soup spoon, an ordinary metal stopper with a smooth round lip, or slices of buffalo horn) on a skin area lubricated with oil or talcum powder until petechiae appear. The appearance of petechiae is transient. They immediately begin to fade into ecchymoses, disappearing completely in 2-4 days. The practice of Gua Sha is generally considered effective within Chinese and/or East Asian cultures for treating acute or chronic pain and for conditions such as colds, flu, fever, heat stroke and respiratory problems such as asthma, bronchitis and emphysema. It is also used for functional problems of the internal organs and musculoskeletal problems (from fibromyalgia to severe strains, spasms or injuries), and is indicated in all cases of recurrent fixed pain. Gua Sha is a therapeutic intervention to treat pain and pathologies that manifest as stasis of Qi (i.e. the life force, an invisible force behind all events) and blood, occurring on the skin surface. The term Gua Sha is Chinese. The literal translation of gua is scraping or scratching. Sha is a polysemous term: it describes the stasis within the tissue and the petechiae that form as a result of Gua sha practice, indicating the release of this stasis; it can be translated as “sand shark skin” or a red, raised rash, and represents the sensation one feels on the skin after Gua Sha, as if there were sand on it. The practice can be performed on both minors and adults.  Cupping: Like Gua Sha, another traditional medicine technique used mainly in East Asia is ‘cupping,’ or baguan, which is also indicated for 'blood stasis', characterised by fixed or recurring pain in acute or chronic disorders (the Chinese term ba means to pull out or pull up, while the term guan refers to a jar or pot). Cupping involves the application of round cups suctioned onto the skin. Cupping is a traditional Chinese medicine (TCM) therapy that dates back at least 2,000 years. The actual cup can be made of materials such as bamboo, glass or terracotta. By creating a vacuum using a flame or mechanical suction, the tissue is stretched inside the cup. This causes petechiae and round ecchymoses to be created. Almost without exception, in all cases where cupping is performed there will be a slight reddening or a ring-like mark caused by the edge of the cup at the treatment site. The extent of the cupping mark depends very much on the duration of the treatment and the strength of the suction. This procedure is used to counter painful conditions such as shingles and lower back pain. Cupping moves the Qi (energy, strength, vital breath) and blood and opens the pores of the skin, thus eliminating pathogens through the skin.
​3. Embedding the individual practice in the broader cultural (or religious) system.	The use of Gua Sha and cupping should be framed in the ideas of health/disease and medicine in East Asia, where there are philosophical concepts that look at the human body in correlation with the external environment and the forces that animate it (e.g. Qi) and not only in its individuality and separateness (see Anthropological insights below). In East Asian medicine, all pain is defined as a form of stasis. Common myalgias, i.e. muscle pains that come and go, are thought to result from the stress of repeated daily activity, prolonged posture or exposure to changes in temperature. If the myalgic pain resolves on touch or movement, we speak of Qi (energy, strength, vital breath) stasis. If the pain persists or returns to a fixed point, we speak of Qi and blood stasis, which indicates the presence of sha (stasis within the tissues). The term 'blood stasis,' which is difficult to define, generally refers to a pathological alteration of blood flow, but differences in definition remain, apparently reflecting regionally developed differences. The presence of sha is confirmed when pressing palpation causes a superficial reddening that slowly subsides. Over time, unresolved sha can be associated with and/or make the body more vulnerable to severe chronic pain, tension or disease. The stasis of sha can be released with sweating from a real fever or through treatment with Gua Sha or cupping.
4. Is the practice essential (to the survival of the group), compulsory or optional?	The practice is optional. Just as Western patients today have their choice of medical treatment between either Western medicine or Chinese medicine or both, so too do patients who live within Chinese/East Asian cultures have their choice of medical treatments, between the various medical systems of diverse cultures. While there is a margin of personal choice in what remedy to choose, it must be noted that Chinese medicine is widespread in Asia, and it is a defining element of the group, and it coexists in equal dignity with Western medicine in China (see anthropological insights).
​5.     Is the practice shared by the group, or is it contested?	The practice is shared by the group to which it belongs. Overall, in East Asian countries the medical system is plural, which means that Traditional Chinese medicine and Western allopathy coexist and both are institutionalized, although in different ways according to the country under consideration. In China, for example, the modalities within traditional medicine are explicitly acknowledged through legal classifications, medical training, and service provisions. Furthermore, these modalities are interconnected and unified under the supervision and comprehensive practice rights of traditional medicine doctors (as well as allopathic doctors), who have the authority to practice either form of medicine based on their professional judgment
​6.     How would the average person belonging to that culture (or religion) behave?	In the presence of pain, the average person may turn to either official or traditional medicine or both. When it comes to paths to health, it is important to bear in mind that these are individual and personal choices. A person may choose to turn to traditional medicine and Western biomedicine in parallel, actively seeking the best of both worlds to meet their own or their children's health needs, aware of the fundamental differences and complementary nature of these two medical models.
​7.     Is the subject sincere?	To verify the subject's sincerity is important to ascertain the non-detrimental nature of the practice, which indeed has a curative function. To this end, it is appropriate to investigate, through experts and through the same hearing of those involved (parents and minors): the link between these methodologies and the culture of origin; Gua Sha/coining/press-stroking and cupping/cupping are two traditional remedies typical of Chinese medicine, as highlighted above, but are also widespread in other Asian cultures such as the Vietnamese and Laotian; the function (curative reason) for which the practice was performed, i.e. what kind of ailments the subject underwent; the reasons that led to the use of the practice: use of the traditional remedy due to the lack of seriousness of the ailment; poor access to other health facilities and services (communication difficulties etc.); distrust of conventional Western medicine and professional medical personnel; the ability of the subjects to explain the practice and its functions (which can then be confirmed by an expert in both anthropological and medical-scientific fields); the degree to which the family is aware of the use of the practice, not as a total replacement for conventional Western medicine, but perhaps as an aid in cases of minor ailments. In some cases, these particular signs on the body are noticed by health service workers, during specialist or routine visits, at conventional Western health facilities, where the child is accompanied by the parents themselves, perhaps because the problem persists or in order to ascertain the most effective treatment.
8.     The search for the cultural equivalent: the translation of the minority practice into a corresponding (Italian) majority practice. ​	Some techniques of traditional Oriental medicine are also particularly widespread in Italy. Cupping is often used in sports, to soothe pain and reduce muscle tension, as are acupuncture and other forms of massage to be performed according to special techniques. Moreover, it should be pointed out that 'traditional' forms of healing have also always been implemented in the majority culture, albeit in a less structured manner than in the East. Examples of this are the allopathic form of Western medicine practiced at clinics and private health facilities (e.g. homeopathy, reflexology) and what are often referred to in common parlance as 'folk remedies', as well as the dissemination among families of small pamphlets containing basic therapeutic indications, necessary for the initial treatment of minor ailments (now replaced by the practice of consulting the web when ailments or pains occur) containing indications of basic medical care. In Italy, those remedies are certainly not a substitute for specialised official medical treatment, but they are widely used in cases of transitory, frequent and non-serious illnesses (colds, transitory febrile conditions, migraines, neuralgia, etc.). These particular curative methods are framed in the majority culture under the category of 'home remedies' and are partly comparable to the curative practices mentioned above, even though they lack the same historical and philosophical structure that characterises Oriental remedies. It should also be pointed out that today, in contemporary Western society, most of these remedies have evolved into a 'pharmacological' perspective. ‘Home' remedies for mild and transient ailments often consist of over-the-counter medicines, sold without the need for a prescription, to be kept at home for emergencies or to be taken with one's person during travel and journeys. The administration of such drugs is left to the conscience and self-control of individuals. Unlike cupping and Gua-sha, however, these are pharmacological, and therefore chemical, substances that can cause harm to adults and minors in the event of incorrect use, even if not as immediately obvious as the marks left by the Oriental practices under consideration. Another example of a cultural equivalent in the broadest sense can be found in massages that are widely practised in the majority culture among sportsmen or as physiotherapy treatments. Vigorous massages can, in fact, leave marks and are also a cultural equivalent to the possible sensation of pain that these treatments may cause when performed.
9.      Does the practice cause harm? ​	The practice does no harm if performed correctly, according to the modalities that are required for the curative result to be achieved. Usually these modalities are spelled out in actual Chinese medicine manuals or transmitted orally. They are practices that are always performed to cure an ailment, and without any other objective. The signs resulting from these treatments can be interpreted as symptoms of abuse, beatings, or mistreatment, but they are nothing more than the residue of the execution of the practice and indeed often highlight its correct practice. These signs are quite similar to those following vigorous forms of massage, which are also often widespread in the majority culture. However, in the event that the practice is not performed by a professional, it may prove to be quite painful and may leave marks on the body such as actual bruises or even cause a slight discharge of blood (see images in the anthropological insights). The threshold of pain experienced while performing the practice is influenced by the perception of the subject undergoing it, by the more or less pathological state he or she is in. For example, from the perspective of children, even health treatments that adults consider to be more banal and painless - such as taking a syrup, undergoing an injection, swallowing a pill, dressing a wound with disinfectant - cause suffering and have traumatising effects. Pain is thus not an element that alone can be indicative of actual physical harm, being an element that at least transiently characterises the multiplicity of healthcare treatments, not only from an objective point of view, but also from a psychological one.
​10.  What impact does the minority practice have on the culture, constitutional values, and rights of the (Italian) majority?	On the majority culture, the practices of Gua sha and cupping have an apparently strong impact, including a visual one: the marks left by these treatments could be interpreted as child abuse by health or school workers. Even when the 'healing' nature of the intention emerges, they appear as treatments that generate suffering that should not be performed on minors in particular.   The marks left by the aforementioned practices could be mistakenly placed in the category of beatings (Article 581 of the criminal code), in that of injuries (582 of the criminal code), or even in the more serious forms of ill-treatment in the family (572 of the criminal code). The lack of knowledge of the function and meaning of these practices makes them difficult to accept by the majority culture, despite their curative value. It is assumed that they cause unjustified pain and suffering and no benefit. Both in criminal and civil law, therefore, the practices could potentially be relevant in proceedings involving the delicate context of the family and the assessment of the adequacy of parents in exercising parental responsibility and caring for children. For this reason, an in-depth knowledge or willingness to investigate such practices would be essential to protect the interest of the child who risks being removed from perfectly functional and protective family realities. In fact, Article 8 of the ECHR requires the preservation of the family and private life of minors. The latter in the absence of abuse and harm has no reason to be disturbed. The child's right to physical integrity is only apparently involved, since it is only materially violated if the practice is not carried out properly. In addition to cultural rights, those inherent in the parents' right and duty to educate their children according to their own system of values (art. 30 of the Italian Constitution) come into play, including: the will to make their children know and understand the function of traditional remedies, typical of their own culture, to teach them when to use them or not to use them, to choose them in place of others (analgesics and over-the-counter drugs); to exercise consent on certain medical treatments rather than others. The only limitation is always represented by the child's right to health, which is usually not questioned since these forms of traditional medicine are not considered as substitutes for conventional Western medicine. In some jurisdictions, these practices are mentioned in child abuse prevention manuals for social service personnel and legal practitioners so that they are not misinterpreted as forms of parental abuse. This is the case in Colorado and Kansas. The reference is not only to coining and cupping, but also to the so-called 'blue spots' (due to melanin accumulation) that appear on the skin of some children of Oriental or African ethnicity from birth and disappear as they grow up, and which have no pathogenic significance.
​11.   Does the practice perpetuate patriarchy?	The practice does not perpetuate patriarchy. It is performed indifferently by and on individuals of both sexes. It could, if associated with pain and suffering, be linked by the majority culture to a form of patriarchy, understood as authoritarianism, subjection and control by adults over minors or as a form of imposition, but since it does not generate greater suffering or pain than other widely practised and accepted treatments, this interpretation must be considered without merit, especially when compared to the typical functions of the practices, which are precisely to heal and relieve pain.
12.  What good reasons does the minority present for continuing the practice? The criterion of an equally valid life choice.	In the Chinese philosophical system, diseases arise from a stasis of Qi, vital energy, which Gua sha and cupping serve to rebalance.