Too Young To Remember

In an article about an Australian couple arrested for “allegedly organising the illegal circumcision of their one-year-old baby girl in Bali,” this anecdote from Edith Cowan University’s head of medical sciences Moira Sim about patients she has treated is insightful:

She said the women she treated did not see the mutilation of their genitals as an issue because they did not remember having the procedure.

That’s a defense for male circumcision so commonly offered in the United States. Yet, in this anecdote, it’s clear how irrelevant their opinion is as a defense. The violation occurred, and we can easily assume that these women would not feel that way if they hadn’t had their genitals mutilated as children. Ex post facto defenses of non-therapeutic genital cutting offered by the victim, or an assumption that the recipient will develop a specific opinion, can never justify imposing the procedure on a minor.

Joya Banerjee Misunderstands Opposition to Circumcision reviews of Tinderbox: How the West Sparked the AIDS Epidemic and How the World Can Finally Overcome It, by Craig Timberg and Daniel Halperin, PhD, are the subject of a flawed essay by Joya Banerjee, titled “How an anti-circumcision fringe group waged an ideological attack against AIDS scholarship”. I doubt Ms. Banerjee wrote the headline, although it doesn’t much matter because she ues the same silly accusation in her article. After an introduction describing Tinderbox, she writes:

One of the preventive measures discussed in the book, male circumcision, has become an unexpected source of controversy. Anti-circumcision activists have hijacked’s “peer review” comments section, which allows readers to vote on which book reviews are helpful. This system has morphed into a vicious game of character assassination by conspiracy theorists who reject decades’ worth of scientific evidence, showing how easy it is for a concerted crusade to squelch good science.

My first response is to ask if Ms. Banerjee has ever been on the Internet before researching this piece. I mean that only partially in jest. This is how every comments section works, with few exceptions. The primary focus for blame here is probably in the design of Amazon’s peer review system, or at least in anyone placing any significant value on its worth in 2012 as the criterion for buying a book with a controversial topic.

She seems to understand this later in her article, which makes her unfocused back-and-forth attack on opposition to circumcision feel more like an agenda than a critique.

Where does all of this leave us? Two diligent and dedicated authors spent years researching the origin, spread, and potential prevention of AIDS in Africa. Two minutes and a few clicks were all that was required for a passionate extremist group to obfuscate and delegitimize their findings in front of one of their most important and public audiences. Having failed to prove their beliefs through scientific evidence, the intactivists decided to have circumcision, and this entire book, judged in the court of public opinion. Unfortunately for the public, this jury was rigged.

If all it takes is “two minutes and a few clicks”, that’s a flawed system, however inappropriate the action motivation’s may be.

She’s ignorantly inflammatory in her article because she does not appear to understand opposition to circumcision. It is not “extremist” to argue that potential benefits learned through adult volunteers do not negate concern for the ethics of applying that science to healthy, non-consenting individuals (i.e. minors). For some reason she never addresses this aspect of the debate. If she were interested enough to become informed, she could’ve challenged this behavior without misstating the facts about opposition to circumcision.

That said, there is a legitimate problem with this strategy. It’s inappropriate. We can do better. The full set of facts are on our side, and we should always act like it.

But, as problematic as this is, it isn’t as widespread as she declares with her bizarre, broad attack. Most who are against non-therapeutic child circumcision do not engage in this behavior or condone it from those who do. The title states that an “anti-circumcision fringe group” participated in this without naming any group. The group is somehow all “intactivists”. That’s irresponsible, bordering on the same type of unfair maligning she criticizes. She writes later in her article:

Although male circumcision occupies less than 10 percent of the book’s pages, it was enough to spark outrage among a tiny but passionately vocal fringe group, many of whom call themselves “intactivists.” They argue that the procedure is a grave human rights violation and are lobbying to ban the procedure in many countries.

Let me be clear: I do not support what happened on the Amazon page for Tinderbox. I didn’t participate. I don’t recall seeing anything resembling an attempt at an organized tactic. I recognize a couple names among those attached to 1-star reviews, and at least one name attached to a 5-star review, but that’s it. The correct way to state the facts here is that a small group of individuals have done this. It is incorrect, and defies common sense, to suggest that those who engaged in this constitute the entire group of people who oppose circumcision (of healthy children), as Ms. Banerjee’s sloppy accusation does.

Look at the numbers, which are no doubt now influenced further (in both directions) by Ms. Banerjee’s article. Consider this sample of the helpful ratings for one star reviews:

  • 91 of 232
  • 83 of 215
  • 81 of 212
  • 124 of 342
  • 76 of 277
  • 52 of 221
  • 33 of 197

Now consider this sample of the helpful ratings for five star reviews:

  • 114 of 129
  • 104 of 133
  • 111 of 151
  • 131 of 186
  • 73 of 135
  • 76 of 165
  • 101 of 153

They look similar¹, right? That’s not to minimize or dismiss (or legitimize) the gaming of the system. And voting down many of the 1-star reviews is probably appropriate. But it can work both ways. Amazon’s review system allows those who support the book to vote down a 1-star review on the basis of it being a 1-star review, without regard for its content. One seems more likely than the other, of course. Reasonable analysis and criticism must still start with the system, not its users. Where the users are wrong, the problem should be identified without hyperbole.

That last rating is also interesting because it’s the rating on the review left by Ms. Banerjee in June.

It’s really too bad that the reviews here have been taken over by an ideological group that shuns science and hard fact. This group has mobilized hundreds of people to write bad reviews and then rate their friend’s bad reviews as helpful.

The reviews (by people who obviously haven’t read the book) are really about their opposition to male circumcision, not about the content of the book at all. Which is pretty nonsensical, seeing as how the majority of legitimate public health institutions (including the World Health Organization and UNAIDS) have accepted that voluntary medical male circumcision prevents HIV by over 60%, and long term data shows it protects by 76%! That’s better than even the flu vaccine- so it’s surprising that these ideological quacks would rather let Africans die from a preventable disease than admit they don’t understand science.

Anyway, READ THE BOOK! There were (sic) always be quacks and naysayers out there (akin to those who still oppose the measles vaccine because they think it causes autism). The racist attacks on the author in these reviews do nothing to bolster their credibility!

I haven’t rated Tinderbox because I haven’t read it. I’ve skimmed it to get a feel for its treatment of circumcision. I have an unfavorable opinion about it based on that, but skimming isn’t enough to rate it.

She has read it. That doesn’t excuse that she engaged in nonsense in her review, as she also does now in her current article. It’s odd to suggest that “hundreds” of people are rating the book down when the number that could be attributed to opponents is obviously under 100. Exactly one 5-star review has more than 100 “unhelpful” ratings, and that one belongs to Professor Brian Morris, who engaged in the same sort of unhelpful ad hominem evidenced in Ms. Banerjee’s article. The math doesn’t add up to this being widespread among all intactivists, unless she honestly believes opposition to circumcision consists of fewer than one hundred people. The population who would do this probably is that small, but she painted opposition with the broadest brush possible, as she inexcusably does in her current Slate article.

It’s also silly to assume one has to shun science and hard fact to oppose non-therapeutic child circumcision. I don’t shun either science or hard fact. My position is that there are probably flaws in the methodology, but I don’t worry about them in my position because the correct position starts with present health and the ethics involved in consent. I assume every potential benefit is real, including reduced female-to-male HIV transmission in high-risk populations with low circumcision rates. But I am not a utilitarian who ignores individual rights, including the rights to bodily integrity/autonomy and self-determination. The right to be free from unwanted – and critically in this case, unnecessary – harm supersedes every potential benefit until the individual can weigh in with his personal preference on which he values more, the benefits or his foreskin. Where public policy or Tinderbox limits itself to voluntary, adult circumcision, I have no issues. The former rarely does, to its great discredit. The latter appears to follow the same pattern. For example, in Note 18 on page 352, Timberg and Halperin write:

… There has also been some confusion caused by mistaken comparisons with “female genital mutilation,” which is a very different type of procedure and can have serious negative medical consequences. …

This ignores the science and hard facts of male circumcision. Non-therapeutic genital cutting on a non-consenting individual is unethical whether it’s forced on a girl or a boy. Gender doesn’t matter here because all people, including male minors, possess the same basic human rights equally. That’s the ethical principle being ignored. That must stop.

Timberg and Halperin mistakenly imply that male circumcision is innocuous. All non-therapeutic genital surgeries have negative medical consequences for the individual that he or she may not want. (e.g. loss of foreskin, severed nerve endings, damage to/loss of frenulum) And some number of males have serious negative medical consequences, including partial or full amputation, as well as death. Perhaps they discuss this in the book. From my review of the indexed circumcision segments, I’m not convinced they take this into account. (During my prior reviews of Halperin’s work, most notably in this two part series on an awful paper to which he attached his name, I’ve seen no evidence that he assigns any weight to these facts.)

Continuing with Note 18 on page 352:

… Further confusing the issue of male circumcision are the protests of a small but vocal community of activists who often call themselves “intactivists” because of their belief that the male genitalia should remain entirely intact. This constituency has launched aggressive campaigns, including one that resulted in getting an initiative on the ballot in San Francisco to ban the performance of any circumcisions on minors in the city. California officials later ruled that cities had no authority over medical proceduress (sic). …

Neither I nor anyone I know believes that the male genitalia should remain entirely intact. That’s too simplistic and unconcerned with hard fact. I believe my gentials should have remained intact because I was healthy and my foreskin belonged to me. I believe every other male child’s healthy penis and foreskin should also remain intact until he may choose for himself, even if he ultimately chooses circumcision. The issue is bodily integrity and autonomy, not opposition to circumcision full stop. The San Francisco ballot initiative would’ve prohibited the performance of any circumcision on healthy, non-consenting minors in the city, not “any circumcisions on minors”. Omitting key words incorrectly frames the discussion and dismisses valid ethical (and scientific) concerns.

It’s also indefensible to engage in ad hominem (i.e. “ideological quacks” who “would rather let Africans die from a preventable disease than admit they don’t understand science”), as Ms. Banerjee does, without understanding the necessary qualifiers. Personally, I think everyone should use condoms because they prevent the transmission of HIV. If the adult male is so inclined, he may also volunteer to undergo circumcision. I don’t want anyone to die from HIV, but I don’t want anyone’s rights violated in a condescending good faith effort to force on him what someone else thinks he should want. If Ms. Banerjee wants to limit the discussion to voluntary adult male circumcision, that’s fine. She fails to explicitly limit the application of the science to the bodies of adult volunteers. From what I’ve read of Tinderbox, Timberg and Halperin fail to do so, as well. They should all recognize that they’re ignoring the ethical distinction between voluntary adult circumcision and non-therapeutic child circumcision.

Since this is indirectly a critique of Tinderbox, consider another footnote, note 18 on page 385.

… Meanwhile, some critics have suggested that male circumcision is similar to “female genital mutilation’ because it allegedly also reduces sexual functioning and pleasure. Unlike male circumcision, however, these practices-particularly the most extreme forms such as infibulation-can pose significant health risks for women. …

They’re repeating their error, treating male circumcision as if it carries an irrelevant risk of serious complications. But circumcision also changes the form of the penis, which changes the function. The mechanics are different. Maybe that’s better, maybe it isn’t. It’s unique to the individual, contrary to the majoritarian argument they’re about to make.

… In the rigorous studies that have investigated male circumcision’s effect on sexual pleasure, (115-28) nearly all men and their female partners report that after men become circumcised sexual pleasure is the same or enhanced, for both partners. During the 2005-2006 Swaziland pilot circumcision program mentioned in chapter 26, many women began saying that after getting circumcised their partners could have sex longer before reaching orgasm. Some of the clinic nurses reported that women would use metaphors such as, “He used to go from here [Mbabane] to Manzini [a city half an hour’s drive away], now he can go all the way to the border.”

Source 123, “Sensation and sexual arousal in circumcised and uncircumcised men”, states:

It is possible that the uncircumcised penis is more sensitive due to the presence of additional sensory receptors on the prepuce and frenulum, but this cannot be compared with the absence of such structures in the circumcised penis.

They (unintentionally?) demonstrate as much in their footnote, if only they were interested in the issue. The conclusion is that (voluntary, adult) circumcision doesn’t damage sexual pleasure because it is the same or enhanced for nearly all men and their female partners. So? This dismisses the diminished sexual pleasure for those outside the “nearly all” group. Those individuals matter, and no one should expect them to be mollified because another male is happy with his circumcision.

This approach is also based on “heads I win, tails you lose”. Circumcision is the same or better, and men can have sex longer. What logical reason can we think of that might explain lasting longer? Maybe this is good, but sexual pleasure involves a degree of individual preference. Not all males (or females) will want or need sex to last longer to enjoy it to the maximum extent for themselves.

Ms. Banerjee endorses this flawed argument in her article:

Although tens of thousands of men who were circumcised as adults and were studied in several large-scale clinical trials (and in a Slate series) reported no loss—and in many cases an increase—in sexual pleasure and function, the intactivists claim that male circumcision is equivalent to female genital mutilation, a practice whose purpose is to constrain a woman’s sexuality and impair sexual function. In one of its worst forms, a pre-teen girl’s clitoris and entire external genitalia are cut, scraped, or burned out, which can cause severe pain, infection, life-long incontinence, obstructed labor and delivery, and even death. To be truly equivalent, one would have to cut off a man’s entire penis in order to produce the same effect, rather than a small flap of skin.

First, that Slate series was ridiculous. I refuted it here and here.

Second, the possibility that one person might not like being circumcised as a healthy child exposes the ethical problem that she fails to address. Male circumcision involves control, and can be intended to directly impair sexual function. (It definitively alters sexual function.) Most forms of FGM result in far more harm than a typical circumcision, but civil law recognizes no level of acceptable harm from non-therapeutic female genital cutting, including forms less harmful than male circumcision. One does not have to remove the entire penis to produce the same effect that is legally prohibited for female minors. Male circumcision is not acceptable because FGM is usually worse. Even if the foreskin should be viewed as a “small flap of skin”, it is the male’s small flap of skin. Self-ownership rights do not disappear because possible benefits exist from a non-therapeutic surgical intervention.

Where she challenges the appropriateness of the comments attached to Tinderbox’s Amazon page, Ms. Banerjee is correct. Where she expands that into an indictment of any position against circumcision, she stumbles. There is more to the application of science to healthy individuals, whether adults or minors, than just a limited subset of science and hard fact. No male’s healthy body is a platform for expressing another’s personal preferences and fears, whether those of parents or technocratic public health officials.

¹ Sampled on September 26, 2012, except for the rating on Ms. Banerjee’s review. I updated that today because I kept the link.

Evaluating the Genital Cutting Analogy

Catarina Dutilh Novaes has an excellent post on the comparison between male and female genital cutting.

 A heated discussion ensued from my post on circumcision last week, which in turn was essentially a plug to a thought-provoking post by Brian D. Earp at the Oxford Practical Ethics blog. The controversial point was whether circumcision is or is not to be compared to female genital cutting.

I’ve learned a lot from the different perspectives presented during the discussion; among other things, I’ve learned the terms ‘genital alteration’ and ‘genital cutting’, which now seem to me to be more adequate than either ‘circumcision’ or ‘genital mutilation’ to formulate the issue in a non-question-begging way (as argued here). And yet, I am now even more convinced that the analogy between male genital alteration and female genital alteration is a legitimate one – which (and let me say this again!) does not mean that there are no crucial differences to be kept in mind. That’s what an analogy is, after all.

I agree with this, and the bulk of the post. I recommend it with only a minor quibble and an additional piece of modern evidence.

My quibble:

It is well known that female genital cutting is practiced with different levels of severity, going from pricking and piercing to infibulation. …

I do not believe this is well known beyond academic knowledge. In my experience the average person hearing this comparison believes that female genital cutting is always a) the most severe form, b) performed to eliminate all sexual pleasure, and c) imposed at the insistence of males. Facts rarely correct that misunderstanding when presented. Most often the avoidance rests on imagined parental intent, as if that alone can dictate the outcome.

Modern evidence:

– Female genital cutting is embedded in a long history of oppression of female sexuality, and has as its main goal to diminish women’s sexual enjoyment. Male genital cutting in the form of circumcision has no such goal.

She is citing an objection from the comments of her original post rather than her opinion. She supports the challenge to the claim with the 19th century history of male circumcision in America. That is relevant, but there’s modern evidence that circumcision seeks to control male sexuality. Last year Rabbi Mark Glickman wrote (my post):

… Unlike female genital mutilation, Jewish circumcision is not a way to limit or control the child, and it does not destroy sexual desire.

Many find the practice troubling, I believe, because it so dramatically distinguishes religious values from commonly accepted modern American ones. America idealizes nature; Judaism and other religions try to control it and improve it. …

There are other examples. Religion still seeks to control the child and his sexuality through circumcision. A lack of ill intent does not negate the control from circumcision or its intentionality.

In a cultural rather than ritual context, circumcision is still about control. Parents circumcise so the boy will “look like his father”, regardless of what the child wants. Parents circumcise so that his sexual partners will not be repulsed. (This is an indirect form of control of his future sexual partners.) Parents circumcise to avoid STDs, even though condoms are still necessary. All of this controls the child and his sexuality. The control of males through non-therapeutic genital cutting is rarely as extreme as it is for females, but it is real and occurs now. There is no need to rely on history. The analogy holds up here.

Flawed Circumcision Defense: Rabbi Shmuley Boteach

Rabbi Shmuley Boteach has an opinion piece in The Wall Street Journal titled, “Germany’s Circumcision Police”. It starts off well.

There was a head-spinning moment in Germany last week: News emerged that a rabbi had been criminally charged for performing his religious duties. Rabbi David Goldberg of northern Bavaria, who shepherds a 400-member community, is the first person to run afoul of a ruling by a Cologne judge earlier this year that criminalized circumcision, a basic religious rite.

There is some precedent outside of Germany for such a ruling. …

Even though we disagree on policy, agreeing on basic facts is always good. But his essay slowly falls off the path.

… In the United States, a San Francisco ballot initiative tried last year to make circumcision an offense punishable by a $1,000 fine and up to a year in prison; it failed to get enough votes. …

That’s not an accurate summary of what happened last year. A court ruled that the local ballot initiative conflicted with an existing state law and struck it from the ballot. It had nothing to do with getting enough votes.

… But the circumcision ban deserves universal scorn.

Does the German government really want to get into a public battle over whether they are better guardians of the health and welfare of Jewish (and Muslim) children than their parents?

As long as parents continue to circumcise their healthy sons, I hope so. Obvious physical harm for subjective non-therapeutic benefits is unacceptable without the individual’s consent. Protecting the rights of all citizens is a legitimate role of the state.

The Los Angeles Times recently cited a study predicting that as the number of circumcisions goes down in the U.S., the cost of health care will steadily climb. Eryn Brown reported that “If circumcision rates were to fall to 10% . . . lifetime health costs for all the babies born in a year would go up by $505 million. That works out to $313 in added costs for every circumcision that doesn’t happen.”

I’m not impressed by Rabbit Boteach endorsing the idea that a child’s normal body – and by extension, his rights – has a price beyond which we’ll justify non-therapeutic intervention to remove parts of it. But, more importantly, the key in that is not $313. It’s predicting. Aaron Tobian and his co-authors used a data model to make a guess. There are many factors involved. They are not constant. Cost, availability, and need could be quite different in two decades. For the potential benefits against sexually transmitted infections, circumcision can be chosen later. That would match the ethics of the studies that used adult volunteers. This study seeks to “prove” that a specific, non-urgent solution should be applied now, regardless of ethics.

Why? Because circumcision has been proven to be the second most effective means—after a condom—for stopping the transmission of HIV-AIDS, with the British Medical Journal reporting that circumcised men are eight times less likely to contract the infection.

He gets credit for mentioning condoms, which puts him ahead of the AAP. Still, condoms provide greater protection than circumcision, and remain necessary after circumcision. So, cost-wise, it’s condoms or condoms and circumcision. The former is cheaper and ethical. Infant circumcision is not ethical, including when potential benefits against STDs are cited.

While the Germans decry the barbarity of circumcision for men, they also overlook the benefit to women who are the men’s partners. Male circumcision reduces the risk of cervical cancer—caused by the human papillomavirus, which thrives under and on the foreskin—by at least 20%, according to an April 2002 article in the British Medical Journal.

They overlook the potential benefit to women? Do they? They can agree that (voluntary, adult) circumcision may confer reduced risk to female partners while also finding it unacceptable to impose circumcision on infant males (i.e. not “men”). Rabbi Boteach ignores the ethical foundation for the court’s ruling.

While some attempt to equate male circumcision with female clitoridectomy, the comparison is absurd. Female circumcision involves removing a woman’s ability to have pleasure during sexual relations. …

Not necessarily. Yet, in spite of that, it remains unethical. At some point, the human rights principle(s) involved must factor. Equal protection is a human rights principle.

… It is a barbarous act of mutilation that has no corollary to its male counterpart. …

This is also not true. Within what he wrote, it is, because he limited himself to clitoridectomy. The scope of illegal female genital cutting/mutilation is much broader than that, including any cutting that is anatomically analogous to (or less harmful than) male circumcision. That’s relevant.

… Judaism has always celebrated the sexual bond between husband and wife. Attempts to malign circumcision as a method of denying a man’s sexual pleasure are ignorant. …

Male circumcision controls male sexuality, with a long history as an attempt to limit sexual pleasure. It is still used to reduce pleasure for males.

… Judaism insists that sex be accompanied by exhilaration and enjoyment as a bonding experience that leads to sustained emotional connection.

If we ignore explicit statements in favor of circumcision as a way to diminish male sexual pleasure, Rabbi Boteach’s claim here is not mutually exclusive from reduced sexual pleasure. Intent does not guarantee outcome.

We Jews must be doing something right in the bedroom given the fact that, alone among the ancient peoples of the world, we are still here, despite countless attempts to make us a historical footnote.

This is evidence that male circumcision does not eliminate male reproductive ability. No one has claimed it does. His statement is a non-sequitor. The ability to reproduce is not proof that circumcision is acceptable or that it does not affect sexual pleasure or inflict harm.

Related: From the Cut Podcast, a debate between Rabbi Shmuley Boteach and Cut director Eliyahu Ungar-Sargon.

Procedures that Intentionally Alter or Cause Injury

In Reverse the Approach, I had in mind the numerous blog posts like this I’ve encountered:

In this installment of things that should not be compared as equal, we’ll discuss how female circumcision is not the same as male circumcision. …

There’s the subtle difference I discussed. When I make the comparison, it’s to compare male circumcision to female genital cutting. That method allows for the relevant comparison, as well as the opportunity to discuss how the comparison is limited. Trying to compare FGC/M to male circumcision hinders the goal, which should be an accurate analysis of male circumcision. Society has already assessed the ethics against FGC/M. No one wants to re-open or challenge that when using the valid, limited comparison of the two interventions.

The blogger, Lindsay Marie, finishes her introduction with more fence-sitting than her post demonstrates before moving into the comparison:

How they’re similar:
For one, they’re both called circumcision (this isn’t entirely accurate… I’ll get to that in a bit). For another, both involve cutting off a part of the person’s genitals.

Basically, yes. I wouldn’t start with the name, though. It’s semantically inaccurate for females, but it’s hardly a point to compare the two acts. They can both be mutilation while calling one mutilation and the other anything else. A consensus on nomenclature tells us something without proving anything on its own.

I would start with the principle, which she gets almost complete. Non-therapeutic genital cutting on a non-consenting individual is more accurate for what we’re describing. That applies to both females and males. There is no reasonable way to make a gendered distinction on that principle. The distinctions, which exist in practice, are relevant to punishment rather than prohibition.

She incorrectly moves on to differences at this point. As I argued, I think this results from comparing female genital cutting to male circumcision. It’s too easy to start with the most common forms, which are unfortunately also the more extreme forms. Again, that matters, but for the comparison, the validity of state intervention on male circumcision is the question for the comparison. Is there a comparison to be made between male circumcision and what the state prohibits with respect to female genital cutting? There is.

(a) Except as provided in subsection (b), whoever knowingly circumcises, excises, or infibulates the whole or any part of the labia majora or labia minora or clitoris of another person who has not attained the age of 18 years …

Any cutting, even that equal to (i.e. hoodectomy) or less destructive than male circumcision, is illegal. Those forms exist, although they are not the common forms. They are illegal. The comparison works on that limited scale, and points to other legal questions about the right to physical integrity and equal protection.

There’s also the comparison based on the WHO fact sheet for FGM (emphasis added):

Female genital mutilation (FGM) comprises all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons.

… It is nearly always carried out on minors and is a violation of the rights of children. The practice also violates a person’s rights to health, security and physical integrity, the right to be free from torture and cruel, inhuman or degrading treatment, and the right to life when the procedure results in death.

There is no reason to exclude males from that protection of rights, even though FGC/M is almost always more physically damaging, and to a significant degree. Males suffer injury in every case, and worse in some cases, including extremes such as amputation and death. The implicated rights are the same.

There are differences, of course. I’ve acknowledged them here, to some extent, but I’ll reiterate that most female genital cutting is more extensive, with more extreme and lasting consequences. It is evil and should be eradicated as much as possible.

With that stated, she continues (language warning):

How they’re different:
In every other fucking way. Male circumcision is practiced widely in developed countries as a way of preventing specific health issues in both men and women. Male circumcision is usually performed by a trained professional (almost always a doctor, but some religious parents ask a trained Rabbi to perform the procedure) in a sterile medical setting with the latest tools and effective healing techniques to eliminate infections and reduce pain. Male circumcision is performed on days-old infants who will not remember or even realize what happened and almost always with anesthetics to reduce pain. Pardon the comparison, but breeders clip dog tails at the same age and in a similar way, and zoo keepers clip bird wings at the same age and in a similar way. I don’t agree with clipping dog tails, but if it’s going to happen it might as well happen when they’re too young to realize.

First, I don’t want to put too much emphasis on widely, but it’s confusing. If it should be attached to “as a way of”, which is how I read it upon a second pass, I disagree because most circumcision is cultural. The science is a pretty way of making people feel better about doing something indefensible they wish to do for their own subjective reasons. If widely is meant to describe “in developed countries”, that’s inaccurate. It’s widely practiced in the United States and Israel. It’s been widely practiced at some point in the past in the UK, Australia, and Canada.

To the point, where it is intended as a prophylactic, it is practiced as an attempt to prevent specific, unlikely health issues. Statistics show that most circumcisions in the developed world prevent nothing for most males because most males will not develop a foreskin-related problem. When they do, it’s usually associated with some other corresponding behavior. (e.g. Does he get HIV because he has a foreskin or because he didn’t wear a condom?) People get incorrectly impressed by the relative risk differences between intact and circumcised when the absolute risk of foreskin-related issues is small. Even the most dedicated propagandist, Prof. Brian Morris, only claims that the risk of a foreskin-related issue requiring some form of medical attention (i.e. not just circumcision) within the male’s lifetime is 1 in 2 or 1 in 3, depending on where he’s writing. (I will not provide links to his propaganda. Use Google.) Imposing the most invasive solution on a healthy individual is unethical.

As for the sterile operating theater with modern techniques and equipment, I’m unconvinced. As her post makes clear later, she wouldn’t support female genital cutting conducted in a similar setting. That’s the correct stance, but if it’s not support for one, it isn’t support for the other. As the WHO’s fact sheet states, “more than 18% of all FGM is performed by health care providers, and this trend is increasing.” Defending it for male circumcision will likely lead to further justification from proponents of female genital cutting because they’ve modernized a cultural ritual.

The “he won’t remember it” defense is also not compelling. We wouldn’t be any more convinced that a little female genital cutting would be okay if inflicted on girls too young to remember it. We must judge the act on its own. Would we excuse a punch to the face of a child who won’t remember it? It is unlikely to leave a permanent alteration. Corporal punishment for children even has a biblical basis. At some point, the rights of the individual must matter more than peripheral arguments.

With male circumcision, it’s not “going to happen”, as her defense of “too young to remember” implies, unless we take the validity of parental choice as a given. I don’t. There is a risk, as with all normal body parts, male or female. But the chance of needing circumcision are very low. Most males left with their choice never need or choose circumcision. The “he won’t remember it” defense requires an assumption that he will either need or choose circumcision eventually. If it merely assumes he wants circumcision but will be too afraid of the pain, then he values not experiencing pain more than he values being circumcised. There is no reason to assume an infant thinks differently. This is related to female genital cutting more than it may seem. Like father, like son, so like mother, like daughter?

Next, she links to a comment on Reddit that discusses the issue of intent.

… One of the best explanations for the difference between male circumcision and female genital mutilation comes from a user called superdillin:

I think the intent and damage differences between male and female genital mutilation does need to be pointed out. What we do to our baby boys, often with no medical reason, is bad. Very bad and we should stop. BUT, what was done to OP’s girlfriend was done to take away her sexuality, and to control her. It has put her life at risk at worst, and at best has taken away her most sexual pleasure organ, and it was done with the intention of her becoming a breeding cow to be used for a man’s needs for the rest of her life.

What we do to our boys is due to misinformation about health and hygiene, combined with unhealthy aesthetic expectations and tradition. What some cultures do to their girls is deliberate, controlling, life-threatening and inherently sexist. [Her emphases.]

I agree with that, which differs somewhat from the blogger’s post. And I’ve already acknowledged the damage differences in the most common forms. Beyond that experience of the mutilated women described in the Reddit thread, there is evidence that some mutilated females retain some ability to orgasm, which just suggests that the issues and how they relate are more complicated than the idea that male circumcision somehow isn’t bad because female genital cutting is usually worse. (That evidence changes nothing on the ethical question. FGC/M remains evil.)

It is not clear that the intent for each exist as polar opposites. The motivations can have certain similarities. For FGC/M a (possibly overwhelming) majority of the cutting seems to be motivated in the way the West perceives. Sometimes it’s more complicated. But even with the best intentions, which apply to almost every male circumcision, they still aren’t enough. The act matters first. Non-therapeutic genital cutting on a non-consenting individual is wrong. We can’t get past that, ethically, so everything else is important but irrelevant to the validity of prohibiting unnecessary surgery on a child, regardless of gender.

The first key fact in the WHO’s fact sheet states that FGM “includes procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons.” (See footnote¹.) The intent that matters is the intent to act, not the intent to act for good or bad reasons. “Good” and “bad” are subjective, to some extent, anyway. Do the parents intend to alter the child’s normal, healthy genitals? Yes. It’s about the act and the objective harm that results.

Back to the word circumcision: I’ve noticed an increase in groups publicly opposed to male circumcision (part of this was seen during our recent Gay Pride parade), and some argue that male circumcision should be called male genital mutilation, to more closely align itself with female genital mutilation. Although circumcision in both sexes involves the cutting of the genitals, and both procedures can be unnecessary at best, only female circumcision can actually be called butchering because of how it’s performed and what its purpose is. It’s called “circumcision” to make it seem more acceptable and to hide what it really is. (Hell, even the Wikipedia page for female circumcision is titled “female genital mutilation.”)

I don’t believe use of the term male genital mutilation is primarily meant to more closely align the two. It does that, but the intent is to stop pretending that circumcision is so innocuous that it should remain a parental choice for the parents’ subjective, preferred reasons. Some forms of female genital cutting don’t reasonably constitute “butchering”, yet we still outlaw those forms. When does the individual who will live with the modified genitals get to offer input on whether it constitutes mutilation?

From this brief interview with Sister Fa (Fatou Diatta), a musician from Senegal who is a victim of genital mutilation.

Rebellion is in the words. You are dealing with issues such as forced marriage, female genital mutilation. How important is this for you?
“It’s more than important. But my struggle is not against Female Genital Mutilation (FGM, ed.). Me, I do not even use the word “mutilation,” because mutilate means cutting with the intention to hurt. I say ‘cutting’. I’m campaigning so that people would know that it is important that we can educate a child without going through certain practices that may harm his/her health. I’ve been a victim of this practice and I know its effect. It hurts.”

Again, this is so much more complicated than the world so many imagine we live in. The word mutilation is definitionally accurate for both genders, tied to outcome, regardless of parental intent. Whether to use the term or not is a marketing question, not an applicability question.

I wouldn’t publicly advocate one way or the other for male circumcision because there are benefits and consequences of the procedure that must be taken into consideration. I can, however, speak from the only experience I have, which is as a woman who has had sex with both circumcised and uncircumcised men. My experience taught me that male sexual pleasure has absolutely nothing to do with having been circumcised as an infant and that my own sexual pleasure had nothing to do with whether or not my partner was circumcised. However, if asked my opinion I might point out that even the cleanest of males can be less hygienic and more likely to spread a disease or infection with their foreskin intact, which from a female standpoint is a huge concern since an infection inside the vagina can be much worse than a topical penile infection. It seems to me like male circumcision has more benefits for a male’s sexual partner than for the male himself.

Perhaps, but that isn’t a defense for circumcising children. It’s a defense for encouraging and empowering women to stand up for themselves in sexual relationships and to choose their sexual partners and practices consciously. Ask the male to shower. Refuse to have sex if he won’t wear a condom. It’s also a defense for voluntary adult male circumcision.

I truly believe, when performed by a surgeon or urologist in a hospital with the proper tools, that male circumcision should be an option and that parents of sons should educate themselves on whether or not to do the procedure. But I also believe that even if female circumcision were to be performed in the exact same situations as male circumcision (on infants, by medical professionals in a sterile setting) that it would be genital mutilation. The intent automatically makes it wrong and the way a female’s body is designed opens the poor girl up to dozens of complications, many of which are life threatening. Male circumcision and female genital mutilation are not the same thing.

She’s wrong. Intent matters, but outcome matters first and most. An individual’s healthy body is permanently altered without the individual’s consent. The invasive act violates the individual’s right to physical integrity (and right to self-determination). In that core analysis, female genital cutting/mutilation and male circumcision are the same. They are both indefensible.

¹ Non-therapeutic “medical” male circumcision is a misnomer. It’s medicalized circumcision, which merely indicates that it’s performed in a modern, sterile operating theater. That is condemnable in its limited focus, but it is not enough to render the non-therapeutic surgery ethical. The patient’s consent is also necessary. The pursuit of possible benefits (i.e. reduce risk of UTIs or female-to-male HIV transmission in high risk populations) is speculative and may not be necessary for – or desired by – the individual himself. There are all sorts of interventions we could perform that might reduce the risk of some future malady. Society does not open those up to parental choice because they’re also harmful. They’re ethically wrong. Circumcision is the same.

Examples of the Need to Reverse the Approach

Following on yesterday’s post, The Guardian posted four letters from readers about Catherine Bennett’s excellent essay against non-therapeutic male circumcision. Three of the letter-writers believe they’ve found a weakness in her argument. They’re mistaken, and in odd ways. (I’m omitting points that are mistaken but beyond the comparison.)


Female genital circumcision implies the removal of the clitoris, sometimes with the inner labia, sometimes infibulation. It is often practised with blunt razors or knives and without anaesthetics. The risks: fatal haemorrhaging, cysts, urinary and vaginal infections, chronic pain, obstetrical complications.

This supports my last post. This writer didn’t figure out how the comparison might work. She assumed it doesn’t. She started with FGM and worked back to discredit it.

The larger question is the relevance of the remaining facts in that paragraph. If those didn’t happen, and FGM occurred in a clean hospital room, I don’t believe her objection to it would change. She’s arguing for a distinction that doesn’t matter to the initial ethical question or the fundamental comparison. (It only matters to individual practices, which is still important to understand and change.)

She continues:

… There is no evidence whatsoever to support the notion that it affects function, sensation or satisfaction.

It’s incorrect to claim that there is no evidence that circumcision affects function, when the form changes. There is more to function than the ability to orgasm and impregnate. On that crude basis, an argument could be made that FGM doesn’t change function. Just limit “function” to whatever begs the question. (The latter two are subjective to the individual, which is also on the ethical point.)

Next writer:

Catherine Bennett is incorrect in describing female genital mutilation (FGM) as the “equivalent” of circumcision. Granted, both procedures involve a surgical modification of the external genitals of a non-consenting child. Both are, in my view, unacceptable.

That’s the key comparison. I don’t understand why this bizarre tangent follows:

There are, however, great differences: female genital mutilation is illegal in the UK and in many other countries worldwide, including in Africa. Circumcision is lawful. So campaigners against circumcision need to get into dialogue with the Jewish and Muslim communities and press for a change in the law.

Of course. But how is that relevant? The legality of an action doesn’t speak to its validity. Here, numerous historical examples could disprove that “correlation equals causation” mistake. Ms. Bennett made no error in comparing the acts.

This writer provides another paragraph, but it’s more helpful to move on to the next writer:

With reference to Catherine Bennett’s polemic on male circumcision, she should give more attention to the WHO’s statement that male circumcision can be a positive boon in relation to sexual cleanliness. …

This comment demonstrates the idea that one’s own subjective view should somehow be everyone’s objective view. It’s the idea that anyone against circumcision simply hasn’t considered some aspect allegedly in favor of circumcision. If the opponent would just think of benefit X valued by someone else, it would all be clear.

It doesn’t work that way. Much of the debate is subjective to the individual affected. That’s a reason the choice belongs only to the male himself. Me, I prefer to bathe properly and engage in safe sex practices. The so-called “positive boon” to “sexual cleanliness” is irrelevant to me. Ethically, we’re left with the objective facts from a non-therapeutic surgery.

… That hidden space underneath the flap of foreskin is indeed a fertile breeding ground for bacteria and disease. …

That just as accurately describes female genitalia. I don’t imagine the letter-writer thinks that’s a ringing endorsement for female genital cutting.

… The German court’s ban on male circumcision has rightly been overturned by its parliament. …

They did not overturn the court’s decision. They passed a resolution showing support for circumcision as a parental choice. The resolution is essentially a promise to address the issue in the legislature in the fall. The letter-writer erred on a simple, verifiable fact.

… Babies and young children are not able to make rational decisions as to their welfare: their parents have to decide how they are fed; what names they shall be known by; what schools they will go to; to which religion they will be directed; all of which decisions have a significant effect on their later life. …

Parents make decisions for their children. Circumcision is a decision. Therefore, parents may circumcise their children. That’s flawed logic. It assumes that a decision is just merely based on parental choice. Surely the letter-writer sees the negative implications of that. One such implication would be that parents may also cut the genitals of their healthy daughters. The silliness of the argument is that parents may make many decisions, and they all apply to their children, except this one so-called parental right that only applies to their sons. If they make this decision for their daughters, we incarcerate them. It’s incomprehensible in a rational analysis.

… The only effect of male circumcision on their later life is enhanced cleanliness and hygiene.

Taking the statement at face value, because the male still has to bathe, the claim is rather silly. The only basis on which it works as support for non-therapeutic child circumcision is with the assumption that the male will not undertake the minimal additional effort to bathe himself properly if left with his normal foreskin. Without that (offensive) assumption, the choice must be left to the male to decide whether he values his foreskin or saving a tiny bit of effort in the shower.

The larger problem is that this posited benefit isn’t the only effect. The male loses a normal, functioning part of his anatomy. He loses his foreskin, and suffers the damage to the nerve endings that remain. He is left with a scar that he may not find aesthetically appealing. He is left without the mechanical gliding action of his foreskin, so sex becomes a matter of friction rather than pressure. That’s not a valid parental choice.

Reverse the Approach

We’ve all encountered the steadfast refusal to consider that male and female genital cutting are comparable and can both be mutilation. The standard closed reaction consists of something along the lines of “the entire penis would be removed” if male and female genital cutting were really the same thing. For example, in response to a brilliant piece by Catherine Bennett in The Guardian, this:

FGM is NOT the equivalent of male circumcision, as an examination of the etymology of the latter word would make clea: O tempora, O mores! An appropriate synonym for FGM might be ‘excision’ or indeed ‘amputation’, were it not for the fact that infibulation is often carried out as well.

The male equivalent of FGM would be a penectomy, followed by a deliberate attempt to make the wound heal with an unnatural form and function.

Bennett might well have a strong personal belief that male circumcision should be left to the particular male to decide, once he is old enough to make an informed choice, and I might well agree; but she has erred grievously in introducing any mention of FGM in her article, thus making it possible for others to draw a preposterous parallel.

Apart from the ludicrous belief that circumcision doesn’t automatically make the penis heal with “an unnatural form and function”, which is not improved by the commenter’s flawed attempt to distinguish deliberate on parental intent, this commenter assumes his answer that there is no valid comparison. He’s wrong, of course. But the explanation for why never occurred to me before. I now think it’s clear.

Opponents of both forms compare male genital cutting to female genital cutting (i.e. mutilation). Opponents of that comparison perceive that we’re comparing female genital cutting to male genital cutting. We start with a different source and target for the comparison. We don’t start with the same gender, so opponents of the comparison think our claim is larger than it is.

We start with male circumcision. Even setting aside the obvious principle (non-therapeutic genital cutting on a non-consenting individual is wrong), removing the male prepuce (i.e. foreskin) is anatomically the same as removing the female prepuce (i.e. clitoral hood). There is a comparison to be made. Society rejects all non-therapeutic genital cutting on female minors, including cutting analogous to male circumcision (and that which is unarguably less damaging). That’s the physical comparison to pair with the principled rights discussion. It is correct.

Instead, notice the approach within the commenter’s words. He starts with female genital cutting/mutilation to then make the comparison to male genital cutting. When doing that, it’s very easy – and understandable – to focus on the more extreme versions of female genital mutilation. When doing that, the commenter’s dismay is easier to understand, and perhaps, to counter. If you start with the worst, yes, the physical comparison does not work, even though the principled comparison always will. But this perpetuates an ignorance to what male circumcision is and how it compares physically to an outlawed form of female genital cutting.

As Ms. Bennett shows in her essay, based on the WHO’s FGM fact sheet (c.f. my genital mutilation fact sheet):

The extent of this cutting, which “has no health benefits”, involves removal of “healthy and normal female genital tissue” and is associated with ideas about “unclean” sexual parts, is immaterial. “It is nearly always carried out on minors and is a violation of the rights of children. The practice also violates a person’s rights to health, security and physical integrity, the right to be free from torture and cruel, inhuman or degrading treatment, and the right to life when the procedure results in death.”

That applies equally to male genital cutting. The rights involved are human rights, not female rights. Violates the rights to health, security, and physical integrity? That’s the Cologne ruling. The right to life when the procedure results in death? Unless someone wants to argue that male genital cutting never results in death, it’s inexcusable to pretend this doesn’t apply to males in the way that it obviously applies to females.

The commenter includes one more paragraph that further demonstrates my point here, and also cements my belief that opponents of the comparison believe the comparison legitimizes female genital cutting in the way they seem to believe everyone accepts – or should accept – male circumcision as innocuous, at worst. People who get frothy at the comparison think we’re trying to state that FGM is acceptable. That makes no sense, but there’s no other way to interpret this:

Shame on Bennett, for the barbarous torture and irredeemable loss of function she has helped to continue to be inflicted on young girls.

If you argue against female genital cutting, but also argue against male genital cutting for the same reasons, you encourage (and possibly support) the mutilation of females? That makes no sense. Everyone making the comparison, at least in the West, states that all non-therapeutic female genital cutting on non-consenting individuals is an unethical mutilation, including those forms that are physically analogous to – or less damaging than – male circumcision. To be clearer: FGM is evil. That point shouldn’t be in doubt. Anyone who reads the comparison otherwise should take a moment to question their conclusion and what they’re implying. The temptation is to see it as a cynical, dishonest ploy to discredit opposition to male circumcision, but it more logically flows from the misguided approach to the comparison I explained above.

The key is to figure out how to improve communication. Those with differing viewpoints on the comparison are talking past each other rather than to each other. As much as the burden of proof should be on those defending non-therapeutic interventions, reality doesn’t work that way. The onus is on us to demonstrate that our view is correct. If we figure out how to make the comparison clear, we have a chance to be more effective.

Achieving the Goal Requires Honesty

The principle against female genital mutilation is obvious and easy to understand. The facts are more complicated, contrary to the simplistic case so often put forth. For example (emphasis added):

Nine women have been sentenced to jail terms for the female circumcision of around 30 young girls, in what the UN said was the first criminal prosecution of its kind in Ivory Coast.

The women, aged between 46 and 91, were found guilty of “female genital mutilation”, or complicity.

From the Orchid Project (italics added):

The person performing female genital cutting differs according to the context. In rural areas, FGC may be performed by traditional birth attendants or cutters. Often FGC will be carried out in unsterile conditions using a basic instrument such as a blunt knife or a piece of glass. In other places, there may be a known cutter, who has high regard within her community. Generally, the person undertaking the cutting is a woman.

This does nothing to excuse this evil, of course. But it shows that it’s more complex than the often-cited narrative that it’s imposed by men on women as a form of control. It is control, and the ignorant preferences of males in those cultures plays a large part. The complicity and responsibility for the violence is far broader, though. Effective measures for stopping it are more likely to develop when we’re honest about how and why it happens.

Strong and Non-Conflicting Evidence

A few days ago in the Huffington Post Canada, Sheryl Saperia defended non-therapeutic male child circumcision against the German court ruling. The title of her essay is “Male Circumcision is Not Mutilation, Period.” She is wrong.

After a bit of setup, she states:

For instance, neither the right to security of the person nor to gender equality should operate in such a way as to proscribe male circumcision on the grounds that it is comparable to the justifiably prohibited custom of female genital mutilation (FGM).

The two are ethically comparable. They are both non-therapeutic genital cutting on a non-consenting individual. That’s the comparison. It applies to every scenario.

But ignore the comparison. She’s jumping to the “FGM is worse, so male circumcision is okay” defense. Truncate her statement to the minimum necessary facts to understand male circumcision and the content of the ruling. Do male infants have the right to security of person? Assuming she answers correctly, that males possess this right, then non-therapeutic circumcision violates that. It is surgery, and without the recipient’s consent. It inflicts harm. Sometimes that harm is greater than what is expected, and in thankfully-rare instances, it can be fatally so. But it always involves harm. The right to be secure in one’s person should include protection from unnecessary, unwanted harm for all children.

She continues:

FGM is sometimes termed female circumcision, but this is a misnomer as it implies a minor operation equivalent to male circumcision. According to Doriane Coleman, a Duke University law professor whose expertise is children and the law, “This analogy can and has been rejected as specious and disingenuous, as the traditional forms of FGM are as different from male circumcision in terms of procedure, physical ramifications, and motivation as ear piercing is to a penilectomy.”

The term female circumcision is a misnomer for semantic reasons, but also because, as she indicates, it fails to fully explain what FGM does. However, semantic accuracy of male circumcision does not prove that male circumcision cannot also be mutilation. Saying it’s not FGM isn’t enough.

Contrary to Professor Coleman, the analogy is neither specious nor disingenuous. It is not based on merely the traditional forms. The traditional form of FGM differs across cultures. The question of which version we should use exposes the flaw in the tradition approach. The varying extent of damage can be reflected in the codified punishment for violations.

It makes more sense to start with the principle involved. Again, non-therapeutic genital cutting on a non-consenting individual is wrong. The principle does not require equivalent damage for both to violate the principle. Anyway, the anatomical analogy to mnale circumcision is a hoodectomy. The latter is illegal, which brings in the topic of equal rights. The law does not protect the rights of male minors that it protects for female minors.

The motivations aren’t as different as suggested, either.


The World Health Organization is also clear that:

“FGM has no health benefits, and it harms girls and women in many ways. It involves removing and damaging healthy and normal female genital tissue, and interferes with the natural functions of girls’ and women’s bodies.”

I prefer my fact sheet because it deals with principles and equality rather than outcomes. Still, even on the appeal to authority she begins here, she’s wrong. Within its fact sheet, WHO states:

FGM has no health benefits, and it harms girls and women in many ways. It involves removing and damaging healthy and normal female genital tissue, and interferes with the natural functions of girls’ and women’s bodies.

To repeat myself, would WHO rebrand female genital mutilation to “female genital cutting” and declare it an acceptable parental choice if some health benefits were found? I find the possibility doubtful, at best. So why shouldn’t we also apply the basic logic of harm as “removing and damaging healthy and normal genital tissue, and interferes with the natural functions of bodies” to males? It’s okay to do this without their consent because we’ve pursued a “health benefits” justification for enough years, even though almost every claimed benefit can be achieved with less invasive preventions and/or treatments?

Ms. Saperia quotes a 1997 joint statement from several groups declaring “FGM to be universally unacceptable, as it is an infringement on the physical and psychosexual integrity of women and girls and is a form of violence against them.” Even if we pretend that there is no psychosexual violation to males, there is the clear infringement on their physical integrity. (She returns to this point later, although she furthers her error.) Circumcision is a form of violence against males. It inflicts some level of harm in every instance.

Instead of acknowledging this connection, she quotes the WHO to push the irrelevant facts about circumcision being a long-standing practice and that many reasons exist for its imposition on healthy children. And then the predictable argument about HIV, which is easily refuted, and also countered with the truth that condoms are still necessary after circumcision.

She proceeds into the illogical “no real harm”:

In the absence of strong and non-conflicting medical evidence that male circumcision regularly causes substantial harm to young boys, the arguments against the procedure are severely weakened. …

Substantial is a subjective word. What one person finds substantial, I might not. And vice versa. The core question is whether or not there is non-conflicting medical evidence that non-therapeutic male circumcision causes harm. There is. It causes harm, in every case. Normal, healthy tissue is removed. Nerve endings are severed. The resulting scar provides further proof, and the mechanical functioning is altered. I accept that many people think this trade-off is acceptable for the possible benefits. But only the individual male is qualified to make that evaluation for himself.

… Since male circumcision and FGM are simply incomparable, gender equality should not demand the banning of the former just because the latter is illegal. [ed. note: Again, they’re comparable in principle (and to an extent within FGM Type IV). The law should reflect that.] And while the right to security of the person is certainly implicated by circumcision, the low risk of harm (and the fact that most complications are extremely minor) means that this right should be balanced against other compelling rights, such as religious freedom.

There is not a “low risk of harm”. There is a 100% risk of harm. There is a low risk of complications, of unexpected outcomes. Those harms are not the same. There is no implication. The guaranteed harm of non-therapeutic circumcision violates the child’s right to security. That should be balanced against competing rights, but as the court found, a child’s right to physical security outweighs his parents’ supposed right to practice their religion. From an individual rights perspective, the parents’ religious freedom ends where the child’s body begins. The child also possess a right to religious freedom.

After a paragraph praising the unity the three major religions are showing in their criticism, she writes:

According to the German court, the right to religious freedom “would not be unduly impaired” because the child could later decide for himself whether to have the circumcision. Aside from the court’s interference with a religious precept that the ritual must take place long before adulthood, the judgment could ironically cause greater harm to one’s bodily integrity because circumcision for adolescents and adults, as compared to infants, is more complicated and has a higher rate of adverse effects.

First, civil law already interferes with many religious precepts because they involve harm to others. Interference is not necessarily improper.

To her point, the issue is consent to the harm inflicted. The right to bodily integrity involves the ability to consent to harm. Or not. If a male wishes to get himself circumcised, he can decide for himself that whatever benefits he values from non-therapeutic circumcision outweigh the harm and risks of further harm. Or not. The perceived increase in difficulty in adults is not an ethical argument in favor of infant circumcision.

Within the religious context, we need to evaluate the number of teens and adults who would volunteer for ritual circumcision if left intact from birth. I assume that number would be very high. I do not believe it would be 100%, at which point the implications to individual rights should become obvious. More on this in a moment.

Outside the religious context, the number of teens and adults who would volunteer for cultural circumcision if left intact at birth would be very low, as it is now. I also assume the number of medically necessary circumcisions would increase, but only on a volume basis. The percentage would likely stay low, apart from the consequences of unnecessary fiddling with the non-retractable foreskins of children by doctors and parents.

While there appears to be the difference between infant and adult circumcision Ms. Saperia cites, there are other differences. Consent is the largest, but there is also the ability to say how much skin the individual wants removed, if he consents. Does he want to keep his frenulum? As an adult, he can have greater amounts of pain management medicine, as needed. The case isn’t as convenient to their argument as proponents seem to believe.

Ms. Saperia’s conclusion calls for a recognition of community rights, within limits, to support multicultural acceptance and integration. This is lacking on medical grounds because it is objective harm for non-therapeutic reasons. It is lacking on legal grounds because analogous surgical interventions are treated unequally in law. It is lacking on moral grounds because it lacks the consent of the recipient. Every proof she attempted failed to demonstrate that non-therapeutic circumcision on non-consenting children should be permitted.

Outrageous Outrage

In an article discussing outrage at the German court’s ruling, there is this infuriating comment:

Women’s rights groups and social policy makers also condemned the decision, but for the reason that it would have the effect of putting male and female circumcision on the same footing, when they were “in no way comparable”, said Katrin Altpeter, social minister in the state of Baden-Württemberg. Female circumcision she said, was a far more drastic act. It is already outlawed in Germany.

The basic comparison: non-therapeutic genital cutting on a non-consenting individual is a human rights violation. It is unethical, regardless of the recipient’s gender or the extent of the cutting. Katrin Altpeter is wrong.

Ms. Altpeter’s brief statement is the worst form of human rights advocacy. I’m hoping there’s more context to soften it, but if there is, I haven’t found any yet. As her words stand, she divides individuals. She puts forth the offensive notion that because female genital cutting is usually worse, male genital cutting isn’t something that should possess the same legal status. Or, as I’ve said before, it’s the theory that a punch to the face is not battery because a knife to the gut is worse. It’s absurd. Both non-therapeutic female and male child genital cutting can be – are – indefensible to the point of criminality.

Where Ms. Altpeter makes her idea worse is in the last bit of information in that paragraph. FGM is already illegal. The question is decided in Germany, and in the correct way. The court’s decision here doesn’t re-open that. It doesn’t change the reality that FGM is evil and illegal. The ruling moves non-therapeutic circumcision on a child into the same prohibited realm. More than one act is allowed to be bad at one time. Any relevant distinctions can be made in the punishment on a case-by-case basis. It should not be made bluntly with different legal statuses. No child should pay the price so that society can express a little more symbolic disgust.


This doesn’t flow well anywhere in the above, but it’s critical to state. I understand and sympathize with people who object to shifting a discussion from female to male genital cutting when the original topic is female genital cutting. There are conversations where the comparison is relevant and those where it isn’t. The latter probably outnumber the former, and significantly. A legitimate, important clarity is also necessary when comparing the two. The amount of cutting is usually quite different, with possibly extreme disparities in outcome to females versus males. It can work the other way, too, but that’s far less common. The key demonstrable point is that non-therapeutic genital cutting to any extent on a non-consenting individual is unacceptable. That is enough. It should be interjected only when appropriate, an unfortunately subjective standard.