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Though tattoos in general have enjoyed an upsurge of popularity, particularly in the west and among younger people, genital tattoos are still relatively rare. There are several probable reasons for this: the genital area is sensitive, it is not often publicly visible, and sometimes covered with hair. Also, some tattooists refuse to place tattoos in these (and other) areas for a variety of reasons.
There are many reasons why a person might choose to have their genitals tattooed. Often the choice is decorative, and genital tattoo designs have been created to decoratively imitate pubic hair, to enhance the appearance of the genitals, or to create whimsical or other designs around the genital area. Some men have incorporated genital tattooing into the creation of a tattoo design in such a way that the penis becomes a part of the overall design motif (for example, as a "nose" in a tattooed face, or as the "trunk" of an elephant). Women have created similar designs, incorporating their genitals into tattooed designs like faces and animals. This practice has long been a part of tattooing, and examples can be seen incorporating the nipples and other parts of the body into designs.
Some heavily tattooed people choose to have their genital and anal regions tattooed to complete the work they have over much of their bodies. Others have used genital tattooing in a BDSM context, for example to indicate "ownership" of a submissive by a dominant.