Male Circumcision and HIV

BMJ: Circumcision in boys and girls, Why the double standard?

Mihail Evans, former postdoctoral researcher in ethics and philosophy, University of the West of England, discusses the odd double standard that tolerates male genital cutting, but condemns female genital cutting.

Circumcision in Boys and Girls, Why the double standard?

New legislation in France has led to more debate on whether wearing the veil amounts to the sexual repression of Muslim women. Islam’s treatment of women is a regular topic in the Western press, yet few jump to the defence of Muslim and other little boys subjected to childhood circumcision. Indeed, the circumcision of the grandson of President Sarkozy, ironically a proponent of the veil ban, made only the gossip pages in France. As a permanent surgical genital alteration, circumcision is arguably a much more serious matter. After all, a Muslim woman has, at least in theory, the option to throw away her veil. The circumcised man’s foreskin has been thrown away already.

Download PDF of BMJ: Circumcision in Boys and Girls: Why the double standard?

ETHNICITIES Vol. 10: Male genital mutilation: Beyond the tolerable?

The journal, Ethnicities, has recently published an article refreshingly entitled Male genital mutilation: Beyond the tolerable? that takes on the double standard often applied to genital cutting. Matthew Johnson writes that the liberal establishment (a descriptor used broadly, and not necessarily meaning left-leaning) ignores the harms of male circumcision by essentially refusing to examine it objectively, using the same criteria employed to condemn female circumcision. Abstract below.

ABSTRACT For liberals like Martha Nussbaum, Female Genital Mutilation (FGM) has come to mark the boundary of toleration. By impairing physical, sexual and psychological functioning, the likes of Nussbaum believe the non-western practice to fulfil, most clearly, the conditions for proscription according to the harm principle. However, those same liberals assume the western practice of male circumcision, generally, to be benign or, even, necessary. As there is seen to be no harm, there is no reason to intervene. I argue that this assumption is erroneous, highlighting evidence that suggests that, according to the criteria of sexual diminution, pain and coercion employed by liberals to criticize FGM, circumcision can be viewed as a harmful act of Male Genital Mutilation (MGM). I highlight the qualitative similarities in the harmfulness of FGM and MGM in order to establish in Nussbaum an empirical and, I argue, ethnocentric oversight in which the criteria of harm are inadequately applied to the latter. I then attempt to identify the obstacles to Nussbaum’s recognition of this harm, arguing that she is party to culturally constituted beliefs in the medical and sexual necessity of the practice and, importantly, the methodological tenet of gender oppression. Having attempted to explain obstacles to the recognition of harm, I then consider the possibility that Nussbaum’s inconsistency is grounded in toleration of religious obligation, arguing that MGM should stimulate certain liberals to reconsider their engagement with theology. My aim is to enable liberals to overcome, often justifiable, claims of ethnocentricity, in order to develop a consistent approach to harmful cultural practices.

Johnson's method of examination of male genital mutilation/circumcision is one that gets almost no attention in the media. It seems the discussion is almost always centered on the old debates of cost/benefit and never on the more important debate of the ethics of decision-shifting, coercion, and the unacknowledged harms of withholding choice in medical practice. This article is well worth the read to inform one's outreach and activism.

Reference

Johnson, M. Male genital mutilation: Beyond the tolerable? Ethnicities, Vol 10(2):181–207;361654;DOI:10.1177/1468796810361654

Download JohnsonMaleGenitalMutilation2010

Dr. Dix Poppas's Incredible Clitoris Reduction and Stimulation Program at Cornell University

I can't do any better than Dan Savage on this one. He has written a blog post on the Frankensteinian program of female genital cutting, and what sounds to me like sexual molestation, at Weill Cornell Medical College (Cornell University), run by one improbably named Dix Poppas.

Dr. Dix PoppasThe professor cuts the girls and then brings them back for sessions with a vibrator to prove they still have sensation. This outrageous program was first exposed by Alice Dreger and Ellen Feder, which Dan quotes at length from their article published in the Bioethics Forum.

The one word summary is creepy. Dan goes on a bit longer, describing his entirely reasonable objection, which I join, to the clitoris reduction and stimulation program this way.

There's so much to be angry about I hardly know where to start. Applying a vibrator to a girl's clitoris after it's been surgically shortened may demonstrate that she still has "sensation" in what's been left behind—that she still has a few nerve endings that function—but that's not proof that she hasn't been physically or emotionally harmed by the surgery and those traumatic follow-up "procedures." These post-op visits with the doctor and his vibrator do the girls no good—what can the doctor do if a girl reports no sensation? reassemble her clit?—and retaining sensation isn't proof that these girls will grow up to be healthy, sexually functional adults. All of the tissues that make up the clitoris—the glans, the stem, the erectile tissues [and I would add the clitoral hood]—are important to sexual response, orgasm, and fulfillment, not just the part of the clitoris that's "normally" exposed.

Are you as angry and outraged as I am? Then write to Cornell and tell the University that these children are not the scientific playthings of Dr. Dix.

Link: Female Genital Mutilation at Cornell University

Sexism and Circumcision: A YouTube response powerfully presents the case for considering female and male circumcision together

YouTuber freedomof5peech has created a fantastic video response to fellow YouTuber AngryAussie. Freedomof5peech succeeds in perfectly encapsulating the most compelling arguments for considering male and female circumcision together, and goes further to demonstrate that female circumcision cannot be viewed separately from the male counterpart. Powerfully presented.

UPDATE: YouTube channel freedomof5peech was suspended due to false terms of use complaints. The video in this post is now available from the new channel now known as freedom0speech, and has been embedded below.

American Academy of Pediatrics Withdraws Policy Statement on Female Genital Cutting

"The AAP's goal is to protect the health and well-being of all children."

- AAP President Judith S. Palfrey, MD, FAAP

We shall see if she means it.

The American Academy of Pediatrics has withdrawn its odious weakened statement on female genital mutilation also known as female circumcision. The importance of this in light of the new Dutch statement on infant and childhood male circumcision (see post below) cannot be fully appreciated yet.

I will speculate on what I think it means. The double standard between the protections afforded boys and girls in this regard will have to be addressed eventually. It is possible that we will witness a long trajectory of dissembling positions to the logical conclusion, which is no double standard in protecting both sexes from genital cutting.

It was feared that the weakened stance on protections for girls was cover for the forthcoming revised policy statement on male genital cutting. If Palfrey means what she says, the revised policy will be favorable to boys. If she doesn't, she will be squarely in the center of the next campaign. As this experience has taught, until all children are safe, none are.

Press Release: American Academy of Pediatrics Withdraws Policy Statement on Female Genital Cutting

AAP okays some forms of FGM, prepares to usher in gender neutral circumcision policy?

The American Academy of Pediatrics is moving backwards fast. It has now decided that female genital mutilation also known correctly and rightly as female circumcision (so as not to differentiate and distance it from male circumcision) is okay as long as it is medicalized and can be characterized as a "ritual nick." This is all said to be in deference to communities who practice this atrocity and in an effort to confer beneficent cultural sensitivity to their way of life no matter how it impinges on the rights of their often US citizen daughters, who enjoy or should enjoy the protections of US law and the Constitution said laws are founded upon.

Really, AAP? Dedicated to the unhealthy agenda of all its members, maybe?

The first big issue is the fact that one person's ritual nick is another person's mutilation. So what definitions are to be used? The U.N.'s? Those written into various state, federal or foreign jurisdiction laws? Perhaps those of the ethnic community from which the girl comes? Genital cutting always takes on a life of its own and often devolves into the most invasive where perceived to be minor or cosmetic. Any examination of cosmetic surgeries generally and male circumcision particularly will reveal this truism. Medical opinion as to what a "nick" is will be ever changing just as medical opinion changes as to what a complication in male circumcision is. The conflicts of interests between the doctor, the victim, the parents, and any prosecuting authority to characterize and define will create chaos and pain and suffering only the surgery itself can rival. 

Second, the whole concept of equality under the law is that exceptions to prohibitions against violating the rights of others are prohibited even where a whole community's cultural identity is at issue. Supposedly, we're living in the 21st Century and not the 8th. Hence, we adhere to the decidedly modern notion of equal protection. A little girl's right to genital integrity is not abridged solely due to her age and ethnic derivation. If a grown Somali woman wants to submit to blood-letting, let her. However, she should be thrown in jail if she does it to her daughter and so should any doctor complicit in it.

Advocates such as the AAP should be civilly held accountable for encouraging such barbarism.

So why is the AAP making these terrible policy statements? It may not be about the girls. Rather it could be about the upcoming revision to the male circumcision policy statement. The equal protection argument works just as well against infant circumcision of boys. You can't say girls deserve protection, but boys don't and hide behind a thin argument of health benefit that will never reach consensus in the medical community. Eventually, something has to break. Either boys and girls can be cut or they can't. Collectively. Either the laws of the land protect children from genital cutting. Or they don't. Taken as a whole.

I wouldn't be surprised if the AAP is looking far and wide to adjust all its positions to be able to counter any argument that supports male children over doctors and parents who wish to cut them. If the AAP decides to cave in to pressure to recommend male circumcision against all reasonable assessments of the evidence, this will be exactly how it appears. 

Link: American Academy of Pediatrics (AAP) Is Advocating for U.S. Pediatricians to Perform Certain Types of Female Genital Mutilation (FGM)

Brian Morris, the Fred Phelps of the Pro-Circumcision Lobby

Brian Morris is a well known circumcision obsessed fanatic. He is known to employ name calling, personal attacks, mischaracterization, lies, and slander in his responses to individuals espousing thoughtful objections to the practice. And as if that isn't enough, he uses a heaping helping of hyperbole in praise of infant circumcision.

One wonders if the various media outlets and policy bodies that have suffered his intrusions (in the form of playing the imposter of an expert) are aware that Brian Morris has also advocated female genital mutilation. Morris's obsession with penises has obscured his truer obsession, which is cutting genitals of either sex. 

Anecdotally, true female circumcision (= removal of the clitoral hood) is said to increase sexual sensitivity and frequency of orgasm. This claim awaits research support, however. - Brian Morris

From Morris's Circumcision, whose responsibility? ... Legal (See sixth full paragraph from the bottom)

While the comparison hasn't been made anywhere else, I see him as the Fred Phelps of the pro-circumcision lobby.

Brian Morris asks, "Does God also hate clitoral hoods?"

Lest anyone doubt that Morris is advocating felony behavior, see the World Health Organization's own paper [pdf] on the issue wherein the definition of female genital mutilation is clearly laid out and various legal injunctions against it around the world are discussed. Morris would appear to advocate Type 1a.

From a genuine Fred Phelps "protest"

AFRICA: Uganda to outlaw female circumcision

The irony continues to pour forth from Africa ...

Uganda to outlaw female circumcision

AFP Fri Jul 3, 7:45 am ET KAMPALA (AFP) – Uganda will pass a law banning female genital mutilation, which is rampant among pastoralist tribes in the country's eastern region, the president said in a statement Friday.

"The way God made it, there is no part of a human body that is useless," President Yoweri Museveni told a gathering in the eastern Karamoja district.

"Now you people interfere with God's work. Some say it is culture. Yes, I support culture but you must support culture that is useful and based on scientific information," he added.

Last year, the United Nations passed a resolution that called female genital mutilation a violation of the rights of women and said it constituted "irreparable, irreversible abuse."

The resolution also said female circumcision increases the risk of HIV transmission, as well as maternal and infant mortality. The UN estimates that between 100 million to 140 million worldwide have undergone the practice.

Link: Uganda to outlaw female circumcision - Yahoo! News.