Skip to content

Female genital mutilation (FGM) and male circumcision: should there be a separate ethical discourse?

Female genital mutilation (FGM) and male circumcision: should there be a separate ethical discourse?

This month, the Guardian launched a campaign in conjunction with Change.org (the petition is here) to end “female genital mutilation” (FGM) in the UK—see Dominic Wilkinson’s recent analysis on this blog. I support this campaign and I believe that FGM is impermissible. Indeed, I think that all children, whether female, intersex, or male, should be protected from having parts of their genitals removed unless there is a pressing medical indication; I think this is so regardless of the cultural or religious affiliations of the child’s parents; and I have given some arguments for this view herehereherehere, and here. But note that some commentators are loath to accept so broadly applied an ethical principle: to discuss FGM in the same breath as male circumcision (and perhaps intersex surgeries), they think, is to “trivialize” the former and to cause all manner of moral confusion.

Consider these recent tweets by Michael Shermer, the prominent American “skeptic” and promoter of science and rationalism:

 

 

This sort of view appears to be common. One frequent claim is that FGM is analogous to “castration” or a “total penectomy,” such that any sort of comparison between it and male circumcision is entirely inappropriate (see this paper for further discussion). Some other common arguments are these:


Female genital mutilation and male circumcision are totally different. FGM is necessarily barbaric and crippling (“always torture,” according to Tanya Gold), whereas male circumcision is no big deal. Male circumcision is a “minor” intervention that might even confer health benefits, whereas FGM is a drastic intervention with no health benefits, and only causes harm. The “prime motive” for FGM is to control women’s sexuality (cf. Shermer in the tweets above); it is inherently sexist and discriminatory and is an expression of male power and domination. Male circumcision, by contrast, has nothing to do with controlling male sexuality – it’s “just a snip” and in any case “men don’t complain.” FGM eliminates the enjoyment of sex, whereas male circumcision has no meaningful effects on sexual sensation or satisfaction. It is perfectly reasonable to oppose all forms of female genital cutting while at the same time accepting or even endorsing infant male circumcision.


Yet almost every one of these claims is untrue, or is severely misleading at best. Such views derive from a superficial understanding of both FGM and male circumcision; and they are inconsistent with the latest critical scholarship concerning these and related practices. Their constant repetition in popular discourse, therefore—including by those like Shermer with a large and loyal audience base—is unhelpful to advancing moral debate.

What is going on here?

To see the source of the problem, we need to begin by defining our terms—“FGM” and “male circumcision.” For FGM, The World Health Organization (WHO) gives us four major types, with multiple subdivisions:

  • Type I — Partial or total removal of the clitoris and/or the prepuce (clitoridectomy). Type Ia, removal of the clitoral hood or prepuce only; Type Ib, removal of the clitoris with the prepuce.
  • Type II — Partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (excision). Type IIa, removal of the labia minora only; Type IIb, partial or total removal of the clitoris and the labia minora; Type IIc, partial or total removal of the clitoris, the labia minora and the labia majora.
  • Type III — Narrowing of the vaginal orifice with creation of a covering seal by cutting and appositioning the labia minora and/or the labia majora, with or without excision of the clitoris (infibulation). Type IIIa, removal and apposition of the labia minora; Type IIIb, removal and apposition of the labia majora.
  • Type IV — All other harmful procedures to the female genitalia for non-medical purposes, for example: pricking, piercing, incising, scraping and cauterization.

The first thing to notice about this list is that “FGM” is not just one thing. Disturbingly, there are many different ways to nick, scratch, or cut off parts of a girl’s vulva, ranging from, at the lowest end of the “harm” spectrum, pricking the clitoral hood (under anesthesia, and with sterile surgical equipment, as was proposed in the “Seattle Compromise” — note that this would qualify under FGM Type IV), up through various types of ‘piercing’ that do not necessarily remove tissue (of course, such piercing is common in ‘Western’ countries as a form of perceived “cosmetic enhancement”*), to interventions that alter the labia, but not the clitoris (the clinical term is labiaplasty – note that this is also popular in ‘Western’ countries), to, at the highest end, excising the (external) clitoris with a shard of glass and stitching together the labia with thorns. It is important to point out that the most severe types of FGM (such as the form just mentioned) are comparatively rare, whereas it is the more minor and intermediate forms that are more common.

Nota bene, such “cosmetic enhancement” surgeries in ‘Western’ countries are typically carried out under conditions of informed consent (a point to which I will return, as I think the moral analysis turns on this factor), although there is an alarming trend among some teenage girls in these countries — some as young as 13 or 14 — of having their labia reduced (or undergoing other forms of “designer vagina” surgery), apparently with the permission of their parents. Global health agencies such as the WHO, however, have been strangely silent on this issue, preferring instead to focus their FGM-eradication efforts almost entirely on the continent of Africa.

In this African context, genital cutting (of whatever degree of severity) is most commonly performed around puberty, and is done to boys and girls alike. In most cases, the major social function of the cutting is to mark the transition from childhood to adulthood, and it is typically performed in the context an elaborate ceremony. Increasingly, however, African, Middle Eastern, Indonesian, and Malaysian genital alterations (again, of both boys and girls) are being carried out in hospital settings by trained medical professionals—and on infants as opposed to teenagers–on the model of male circumcision in the United States.

Understanding the harm

It should be clear that the different forms of cutting listed above are likely to result in different degrees of harm, with different effects on sexual function and satisfaction, and different chances of developing an infection, and so on. But as Obermeyer notes in her systematic analysis of health consequences for FGM:

It is rarely pointed out that the frequency and severity of complications are a function of the extent and circumstances of the operation, and it is not usually recognized that much of [our] information comes from studies of the Sudan, where most women are infibulated. The ill-health and death that these practices are thought to cause are difficult to reconcile with the reality of their persistence in so many societies, and raises the question of a possible discrepancy between our “knowledge” of their harmful effects and the behavior of millions of women and their families.

Notwithstanding these gradient differences for types FGM, as well as the gradient consequences that vary along with them, all forms of FGM—no matter how sterilized or minor—are deemed to be mutilations. All are prohibited in Western democracies. Again: I am in support of the motives behind such legislation. I do not think that a sharp object should be taken to any girl’s vulva unless it is to save her life or health, or unless she has given her fully-informed consent to undergo the procedure. In the latter case, of course, she wouldn’t be a “girl” anymore, but rather an adult woman, who can make a decision about her own body.

What about male circumcision?

The story is very different when it comes to male circumcision. In no jurisdiction is the practice prohibited, and in many it is not even restricted: in some countries, including in the United States, anyone, with any instrument, and any degree of medical training (including none) can attempt to perform a circumcision on a non-consenting child—sometimes with disastrous consequences. As Davis notes, “States currently regulate the hygienic practices of those who cut our hair and our fingernails … so why not a baby’s genitals?”

But just like FGM, circumcision is not a monolith; it isn’t just one kind of thing. The original Jewish form of circumcision (until about 150 AD) was comparatively minor: it involved cutting off the overhanging tip of the foreskin—whatever stretched over the end of the glans—thus preserving (most of) the foreskin’s protective and mechanical functions, as well as reducing the amount of erogenous tissue removed. The “modern” form is substantially more invasive: it removes one-third to one-half of the motile skin system of the penis (about 50 square centimeters of sensitive tissue in the adult organ), eliminates the gliding function of the foreskin (see here for a video demonstration), and exposes the head of the penis to environmental irritation.

Circumcision—and other forms of male genital cutting—are performed at different ages, in different environments, with different tools, by different groups, for different reasons. Traditional Muslim circumcisions are done while the boy is fully conscious, between ages 5 and 8, or possibly later; American (non-religious) circumcisions are done in a hospital, in the first few days of life, with or without an anesthetic (usually without), and using a range of different clamps and cutting devices; metzitzah b’peh, done by some ultra-Orthodox Jews, involves the sucking of blood from the circumcision wound, and carries the risk of herpes infection and permanent brain damage; subincision, carried out in aboriginal Australia and elsewhere, involves slicing open the urethral passage on the underside of the penis from the scrotum to the glans, often affecting urination as well as sexual function; circumcision among the Xhosa in South Africa is done as a rite of passage, in the bush, with spearheads, dirty knives, and other non-sterile equipment, and frequently causes hemorrhage, infection, mangling, and loss of the penis—see here for some disturbing pictures—as well as a very high rate of death. But even “hospitalized” or “minor” circumcisions are not without their risks and complications: in 2011, nearly a dozen boys were treated for “life threatening haemorrhage, shock or sepsis” as a result of their non-therapeutic circumcisions at a single children’s hospital in Birmingham in England.

Here is the important point. When people speak of “FGM” they are (apparently) thinking of the most severe forms of female genital cutting, done in the least sterile environments, with the most drastic consequences likeliest to follow. This is so, notwithstanding the fact that such forms are the exception rather than the rule. When people speak of “male circumcision” (by contrast) they are (apparently) thinking of the least severe forms of male genital cutting, done in the most sterile environments, with the least drastic consequences likeliest to follow–because this is the form with which they are culturally familiar. This then leads to the impression that “FGM” and “male circumcision” are “totally different” with the first being barbaric and crippling, and the latter being benign or even health-conferring (on which more in just a moment). Yet as the anthropologist Zachary Androus has written:

The attitude that male circumcision is harmless [happens to be] consistent with Western cultural values and practices, while any such procedures performed on girls is totally alien to Western cultural values. [However] the fact of the matter is that what’s done to some girls [in some cultures] is worse than what’s done to some boys, and what’s done to some boys [in some cultures] is worse than what’s done to some girls. By collapsing all of the many different types of procedures performed into a single set for each sex, categories are created that do not accurately describe any situation that actually occurs anywhere in the world.

So it depends on what you’re talking about. Do those who oppose FGM (and that includes me) think (as I do) that even certain “minor” or “medicalized” forms of such cutting—done without consent, and without a medical indication—are inconsistent with medical ethics, deeply-rooted moral and legal ideals about bodily integrity, the principle of personal autonomy, and a child’s interest in an open future? Or is it only the wholesale removal of the clitoris – with a broken piece of glass – that inspires such condemnation? If the former is the case, then consistency would seem to require that one be opposed to the non-therapeutic, non-consensual circumcision of boys as well: not only is it much more invasive than several “minor” (yet prohibited) forms of FGM, but it is numerically a much greater problem, occurring several millions of times per year.

Cutting comes in degrees. Consequences vary. This is true for boys and for girls alike, and at some point the harms overlap. As a result of this realization, many scholars of ritual cutting are choosing to abandon the terms “FGM” and “male circumcision” (which presume a strict moral difference between them), and are using instead such terms as FGC, MGC, and IGC. These stand for female, male, and intersex genital cutting respectively; and they make no moral claims per se. Instead, the moral character of the genital cutting—regardless the person’s gender—can be assessed separately in terms of actual physical harms, as well with respect to such considerations as whether the cutting is therapeutic, consensual, or otherwise.

So let’s not be misled. There are many kinds of “FGM” as well as many kinds of “male circumcision” and the consequences vary for each one. But perhaps there are some other important differences between male and female forms of genital cutting – apart the sex or gender of the person being cut – that could serve to justify their strict separation in terms of ethical discussion. Let’s look at some further possibilities, from the set of common arguments I listed above.

Male circumcision … might … confer health benefits, whereas FGM [has] no health benefits, and only causes harm.

Both parts of this claim are misleading. First, how do we know that “FGM” (or FGC, as I’ll say from now on) does not confer health benefits? Certainly the most extreme types of FGC will not contribute to good health on balance, but neither will the spearheads-and-dirty-knives versions of genital cutting on boys. What about other forms of FGC? Defenders of FGC—including some medical professionals in countries where FGC is culturally normative—regularly cite such “health benefits” as improved genital hygiene as a reason to continue the practice, and at least one study has shown a link between FGC and reduced transmission of HIV! Indeed, the vulva has all sorts of warm, moist places where bacteria or viruses could get trapped, such as underneath the clitoral hood, or among the folds of the labia; so who is to say that removing some of that tissue (with a sterile surgical tool) might not reduce the risk of various diseases?

Fortunately, it’s impossible to perform this type of research in the West, because any scientist who tried to do so would be arrested under anti-FGM laws (and would never get approval from an ethics review board). So we simply do not know. As a consequence of this, every time you see the claim that “FGM has no health benefits”–a claim that has become something of a mantra for the WHO–you should read this as saying, “we actually don’t know if certain minor, sterilized forms of FGM have health benefits, because it is unethical, and would be illegal, to find out.”

Indeed, Western societies don’t seem to think that “health benefits” are particularly relevant to the question of whether we should be cutting off parts of the external genitalia of healthy girls. Without the girl’s consent, or a medical diagnosis, it’s seen as impermissible no matter what. By contrast, a small and insistent group of (mostly American) scientists have taken it upon themselves to promote infant male circumcision, by conducting study after well-funded study to determine just what kinds of “health benefits” might follow from cutting off parts of the penis. Why is there a double standard here? (Actually, there is an answer to this question; and it hinges on prejudicial cultural influences on what constitutes science and medicine—as well as on what sorts of research questions are deemed worthy of funding, among other problematic factors.)

Let’s look at one example of a “health benefit” that has been attributed to MGC: a lowered risk of acquiring a urinary tract infection. When it comes to girls, who get UTIs after the age of 1 fully 10 times more frequently than boys do, doctors prescribe antibiotics and try other conservative treatments; they also encourage girls to wash their genitals and practice decent hygiene. When it comes to boys, however, circumcision apologists tout the wisdom of performing non-therapeutic, non-consensual genital surgery, to the tune of 111 circumcisions to prevent a single case of UTI. Yet as Benatar and Benatar explain, “UTI does not occur in 99.85% of circumcised infant males and in 98.5% of un-circumcised infant boys.” And when it does occur, against those odds, it is both “easily diagnosed and treatable with low morbidity and [low] mortality.” So let’s review: washing the genitals for girls, foreskin amputation for boys?

With respect to reducing rates of HIV transmission in Africa—another health benefit that is frequently cited for MGC—remember that those studies were carried out on adult volunteers under conditions of informed consent, not on infants. I have no problem with a mature adult requesting surgery to remove a part of his own penis as a form of partial prophylaxis against HIV (in environments with very high base rates of such infection); that is certainly his right. Of course he would need to wear a condom either way to achieve any kind of reliable protection, but it’s his body, and it’s his decision to make. It’s quite a different matter, however, to circumcise an infant—who is not at risk of HIV or other STIs unless he is molested, who cannot consent to the procedure in the first place, and who might prefer to practice safe sex strategies when he does become sexually active, rather than forfeit a part of his penis. See herehereherehere, and here for further discussion of the “health benefits” arguments for MGC. The upshot is that they are not compelling, particularly in developed nations with functioning healthcare systems and access to soap and clean water.

So what other differences between FGC and MCG might justify their strict compartmentalization? Back to the arguments from above:

The “prime motive” of FGM is to control women’s sexualities – it is sexist and an expression of male power and domination. Male circumcision has nothing to do with controlling male sexuality.

There is a lot to say here. First, female genital cutting is performed for different reasons at different times in different cultures; likewise for male genital cutting. Contrary to common wisdom, however, it is not the case that FGC is uniformly “about” the control of female sexuality. For example, in Sierra Leone:

Among the Kono there is no cultural obsession with feminine chastity, virginity, or women’s sexual fidelity, perhaps because the role of the biological father is considered marginal and peripheral to the central ‘matricentric unit.’ … Kono culture promulgates a dual-sex ideology … [The] power of Bundu, the women’s secret sodality [i.e., initiation society that manages FGC ceremonies], suggest positive links between excision, women’s religious ideology, their power in domestic relations, and their high profile in the ‘public arena.’

In nearly every place that FGC is performed, it is carried out by women (rather than by men) who do not typically view it as an expression of patriarchy, but who instead believe that it is hygienic (see above), as well as beautifying, even empowering, and as an important rite of passage with high cultural value. (The claim that such women are simply “brainwashed” is a gross oversimplification.) At the same time, the “rite of passage” ceremonies for boys in these societies are carried out by men; these are done in parallel, under similar conditions, and for similar reasons–and often with similar (or even worse) consequences for health and sexuality: see this discussion by Ayaan Hirsi Ali.

Nevertheless, anthropological research does suggest that FGC is, in some cultures–especially in Northeast Africa and parts of the Middle East–intimately tied up with sexist expressions of patriarchal values; in these settings, the emphasis on female sexual ‘purity’ can more readily be discerned. As I have argued elsewhere, such an asymmetrical focus on female virginity in Islam (as expressed through genital cutting as well as through other practices) is extremely problematic and morally unjustifiable. However, it is important to note that, speaking generally:

The empirical association between patriarchy and genital surgeries is not well established. The vast majority of the world’s societies can be described as patriarchal, and most either do not modify the genitals of either sex or modify the genitals of males only. There are almost no patriarchal societies with customary genital surgeries for females only. Across human societies there is a broad range of cultural attitudes concerning female sexuality—from societies that press for temperance, restraint, and the control of sexuality to those that are more permissive and encouraging of sexual adventures and experimentation—but these differences do not correlate strongly with the presence or absence of female genital surgeries.

Indeed, in cultures where forms of FGC (and MGC) are culturally normative, many women regard the cutting as part of their cultural heritage and vigorously defend against the efforts of Western agencies, and sometimes the men in their own societies (see also here), who seek to wipe it out. Such a realization has led to the emergence of a counter-discourse among some Western feminists, who regard anti-FGC campaigns as a form of cultural imperialism. On this sort of view, the fight against FGC is inextricably bound up with a broader colonial and neo-colonial project of “white people saving brown women from brown men” (as well as from themselves). Thus as Nancy Ehrenreich writes in the Harvard Civil Rights-Civil Liberties Law Review:

 … the mainstream anti-FGC position is premised upon an orientalizing construction of FGC societies as primitive, patriarchal, and barbaric, and of female circumcision as a harmful, unnecessary cultural practice based on patriarchal gender norms and ritualistic beliefs. … Lambasting African societies and practices (while failing to critique similar practices in the United States) … essentially implies that North American understandings of the body are “scientific” (i.e., rational, civilized, and based on universally acknowledged expertise), while African understandings are “cultural” (i.e., superstitious, un-civilized, and based on false, socially constructed beliefs). [Yet] neither of these depictions is accurate. North American medicine is not free of cultural influence, and FGC practices are not bound by culture—at least not in the uniform way imagined by opponents.

Dustin Wax makes a similar argument:

In the case of anti-FGC advocacy, the voice of  “brown women” is almost entirely absent, literally silenced by an insistence that the horrendousness of the practice precludes any possible positive evaluation, and therefore the only valid voices are those that condemn FGC. All contradictory testimony is dismissed as the result of  “brainwashing,” “false consciousness,” “fear of male reprisal,” “anti-Westernism”, “ignorance,” or other forms of willful or unwillful complicity.

What about the other side of things? The usual claim is that male circumcision has “nothing to do” with controlling male sexuality. While it is probably true that most contemporary, Western parents who choose circumcision for their children do not do so out of a desire to “control” their sexuality (just as is true of most African parents who choose “circumcision” for their daughters), male genital cutting has been historically steeped in just such a desire, and it is implicated in problematic expressions of power to this day. Contrary to common wisdom, male genital cutting has indeed been used as a form of sexual control, and even punishment, for a very long time; the Jewish philosopher Maimonides argued that diminished sexual sensitivity was part of the point of doing circumcisions (to reduce excessive “lust” as well as “concupiscence”); circumcision was adopted into Western medicine in the Victorian period largely as a means to combat masturbation (as well as other expressions of juvenile sexuality); and forced circumcision of enemies has been used as a means of humiliation since time immemorial: this practice continues among the Luo of Kenya among numerous other groups. To return to the specific question of patriarchy, in Judaism, only the boys are allowed to “seal the divine covenant,” so the ritual is sexist on its face.

But it’s different in different communities. Moreover, the “reasons” given by most parents are not necessarily the same as the “reasons” the practice originally came about, nor the “reasons” for which it was consciously performed (i.e., as a “cure” for masturbation) in previous eras. As the renowned anti-FGC activist Hanny Lightfoot-Klein has stated: “The [main] reasons given for female circumcision in Africa and for routine male circumcision in the United States are essentially the same. Both promise cleanliness and the absence of odors as well as greater attractiveness and acceptability.”

So what are the implications here? Given that both male and female forms of genital cutting express different cultural norms depending upon the context, and are performed for different reasons in different cultures, and even in different communities or individual families, how are we meant to assess the permissibility of either one? Do we need to interview each set of parents to make sure that their proposed act of cutting is intended as an expression of acceptable norms? If they promise that it isn’t about “sexual control” in their specific case, but rather about “hygiene” or “aesthetics” or something less symbolically problematic, should they be permitted to go ahead? But this is bound to fail. Every parent who requests a genital-altering surgery for their child – for whatever reason under the sun – thinks that they are acting in the child’s best interests; no one thinks that they are “mutilating” their own offspring. Thus it is not the reason for the intervention that determines its permissibility, but rather the consequences of the intervention for the person whose genitals are actually on the line. So what kinds of consequences follow from FGC and MGC? Let us clear up one familiar legend:

Male circumcision is “just a snip” and in any case “men don’t complain.”

Before addressing these oft-repeated claims about male genital cutting, let us reflect on the analogous female forms that tend to dominate popular discussions. The interventions associated with extreme forms of FGC are gut-wrenching to think about. Many people find FGC to be “barbaric” and “inhumane” in part because they can call to mind grotesque and vivid images of slicing and cutting—perhaps with a shard of glass—and they react with a mix of sadness, horror, and disgust. Much less disturbing, however, are the images apparently called to mind by male circumcision, as evidenced by the widely repeated (but false) declaration that circumcision is “just a snip.”

Male circumcision is never “just a snip.” It is a frequently traumatic intervention; it is usually extremely painful, even in hospital settings, since adequate analgesia is rarely given; the same is true in ritual settings; and indeed sometimes the excruciating pain of circumcision is used as a test of masculinity. As Nelson Mandela reported about his own (tribal) circumcision:

Flinching or crying out was a sign of weakness and stigmatized one’s manhood. I was determined not to disgrace myself, the group or my guardian. Circumcision is a trial of bravery and stoicism; no anaesthetic is used; a man must suffer in silence. [Before] I knew it, the old man was kneeling in front of me. … Without a word, he took my foreskin, pulled it forward, and then, in a single motion, brought down his assegai [knife]. I felt as if fire was shooting through my veins; the pain was so intense that I buried my chin in my chest. Many seconds seemed to pass before I remembered the cry, and then I recovered and called out, ‘Ndiyindoda!’ [‘I am a man!’]

In infant circumcision, the “snip”—if there is one—only comes at the end: the foreskin must first be separated from the head of the penis, to which it is adhered throughout much of childhood, then it is either stretched out and sliced, or crushed, or torn, or even strangled to the point of necrosis. When any of these things is done with unsterilized equipment, by a medically untrained practitioner, in environments with limited access to healthcare, the risk of serious infection, loss of the penis, and death is dramatically increased. I suggest that readers of this blog watch this video (of a hospitalized, American circumcision) or this one (of a traditional Muslim circumcision) or this one (of a Jewish circumcision), or this one (of a circumcision in Uganda) so that they can permanently lay to rest the idea that circumcision is “just a snip.” It is time to retire this phrase; it should not be used any more.

As to the notion that “men don’t complain” – that is simply false. Just as some women who have undergone forms of FGC complain passionately about what was done to them without their consent, so too do some men who have undergone forms of MGC. Here are some examples of thoughtful and articulate complaints about MGC by resentful, circumcised men: here, herehere, and hereThis man lost his penis. Several thousands of men are attempting “foreskin restoration,” which is an arduous process of stretching skin from the shaft of the penis using weights, tapes, and other materials, in an attempt to “restore” some semblance of their pre-circumcised state. This is not an insignificant number. Of course, when men do complain, their feelings are often trivialized; but they continue to complain nevertheless – in increasing numbers, and ever more vocally as they find the courage to speak out.

Many men do not complain, of course; but then many women who have undergone various forms of FGC do not complain either: in a survey of 3,805 Sudanese women, of whom 89% had experienced FGC, 96% said they would do it to their daughters and 90% favored the continuation of the practice generally. Yet it is enough that some men do complain, and that some women do as well: in both cases a healthy part of their body was removed, and without their informed permission. In Western societies, we teach our citizens that they have a right to bodily integrity: we forbid the tattooing of children, for example, and we tell them that adults should not so much as touch them inappropriately. In this sort of social and legal environment, complaints about having a part of one’s genitals removed without one’s own consent should be treated with serious concern. Finally:

FGM eliminates the enjoyment of sex, whereas male circumcision has no meaningful effects on sexual sensation or satisfaction.

Again, this depends. Obviously more minor forms of FGC – such as ritual ‘pricking,’ some kinds of piercing, or even removal of the vaginal lips – will not eliminate erogenous sensation; however, does this make any of these interventions permissible, if they are done without consent? The answer, in my opinion, is “no.” Even the risk of damaging sensitive nerve tissue with a ‘prick’ should be avoided unless the person taking on the risk is acting freely as an informed adult. Or what about removing “just” the clitoral hood? The clitoris might lose some sensitivity over time, as it rubs against environmental factors (just as the penile glans seems to do after male circumcision; in fact the clitoral hood and the foreskin are anatomically analogous structures), but perhaps some sensation would be preserved, and in any case sexual enjoyment cannot be reduced to stimulation of the clitoris or even ability-to-orgasm. Does that make ”clitoral unhooding” OK?

Not if it’s done without consent.

Finally, what about one of the most invasive forms of FGC – the excision of the external clitoris? According to a recent review published by the reputable Hastings Center, “Research by gynecologists and others has demonstrated that a high percentage of women who have had genital surgery [including excision] have rich sexual lives, including desire, arousal, orgasm, and satisfaction, and their frequency of sexual activity is not reduced.” Indeed, in one study, up to 86% of women who had undergone even “extreme” forms of FGC reported the ability to orgasm, and “the majority of the interviewed women (90.51%) reported that sex gives them pleasure.” These counterintuitive findings might be explained by the fact that much of the clitoris (including most of its erectile tissue) is actually underneath the skin and is therefore not removed by even the most invasive types of FGC: only the glans of the clitoris (the “part that sticks out”) can be excised. But this does not make the surgery somehow “OK.” Every girl’s body is different, and the value she will end up placing on having an intact clitoral glans cannot be known in advance–even in cultures in which the glans is socially stigmatized. At the end of the day, if a fully-informed adult woman chooses genital surgery for herself, it may be permissible on some analyses. However, it is not permissible on children.

What about male circumcision? The same sort of reasoning applies. While the majority of circumcised men (whose circumcisions were not seriously “botched”) report that they experience sexual pleasure during intercourse, and even enjoy sex quite a lot: (a) they do not have a point of comparison, unless they were circumcised in adulthood, so they cannot know what sex would feel like had they not been circumcised (the same point applies to FGC done early enough in childhood) (b) the risk that a “botch” might in fact occur means that the surgery should be undertaken voluntarily, insofar as it is non-therapeutic in nature, (c) some men whose circumcisions did not result in “botches” may nevertheless experience adverse sexual outcomes, simply through the loss of erogenous tissue, and (d) some men’s sexual experiences are hampered via psychological mechanisms, including through the resentment they may feel at having been circumcised before they could object.

Scientists are divided over the “average” effect of (expertly performed, perfectly executed) circumcision on key sexual outcome variables. What is not controversial, however, is that any sensation in the foreskin itself is guaranteed to be eliminated by circumcision (just as any sensation in the labia or the clitoral glans will be eliminated by labiaplasty or excision, respectively), as are “any sexually-relevant functions associated with [the foreskin’s] manipulation. In other words, a man without a foreskin cannot ‘play’ with his foreskin, nor can he glide it back and forth during sex. That these can be pleasurable activities, with great subjective value to genitally intact men and their partners, is uncontroversial.” Finally, the most extreme forms of male genital cutting (e.g., when it leads to penile amputation) eliminate sexual capacity altogether.

As Sara Johnsdotter has pointed out, there is no 1:1 relationship between the amount of genital tissue removed (in either males or females), and subjective satisfaction while having sex, so “FGM” (and male “circumcision”)—of whatever degree of severity—will affect different people differently. Each individual’s relationship to their own body is unique, including what they find aesthetically appealing, what degree of risk they feel comfortable taking on when it comes to elective surgeries on their “private parts,” and even what degree of sexual sensitivity they prefer (for personal or cultural reasons). Thus each individual should be left to decide what to do with his or her own genitals when it comes to irreversible surgery.

To summarize, if “FGM” is wrong because it “destroys sexual pleasure” – then forms of “FGM” that do not destroy sexual pleasure must (on this logic) be considered permissible, or else they should be given a different name. But if “FGM” is wrong because it involves cutting into the genitals of a vulnerable child, without a medical indication and without consent, thereby exposing the child to surgical risk (without the presence of any disease), and (in some cases) removing a healthy part of her body that she might later wish she could have experienced intact, then male circumcision is equally wrong on those grounds. This is true whether sexual pleasure is “destroyed” or whether it isn’t, and whether a complaint is made later or not.

Explaining the double standard

Given everything that has been said so far about the relevant objective “overlaps” between male and female genital cutting, why exactly have they become so compartmentalized? Rebecca Steinfeld, a political scientist at Stanford who studies ritual cutting, has speculated as follows:

Alongside the differences in harm and misperceptions about the contrasting settings and ages at which the procedures take place, the double standard stems from two further factors: sexism and ethnocentrism. Male bodies are constructed as resistant to harm or even in need of being tested by painful ordeals, whereas female bodies are seen as highly vulnerable and in need of protection. In other words, vulnerability is gendered. And little girls are more readily seen as victims than little boys. The consequence of this … is that patriarchy often allows men’s experiences to remain unquestioned.

Familiarity also creates comfort, and since MGC has been practised in the West for millennia and been routine in English-speaking countries for a century, we’re desensitised. By contrast, since FGC is geographically or culturally remote, it’s more liable to be seen as barbaric.

On this last point, Andrew DeLaney (unpublished manuscript) gives a similar analysis:

It is safe to say that [male genital cutting] is a norm in the United States, despite any activists’ efforts to raise awareness about it. In the words of one law professor describing her generation, “Everyone was circumcised.” … FGM, on the other hand, is likely a completely foreign idea to the vast majority of people living in the United States or the rest of the western world, with the only exposure to it being horrific reports that are presented based on cases or reports out of Africa. With this being the case, moral objection to the practice of FGM is taken as self-evident, with research and activism being conflated and data on FGM that is sometimes not actually investigated taken as true. All the while, [male genital cutting] occurs as a completely normalized practice.

To return to the Guardian and the Change.org petition, it is of course to be welcomed that a prominent global newspaper is campaigning to protect the rights of girls to be free from non-therapeutic, nonconsensual cutting into their genital organs. I cannot state enough that I am in support of such efforts (although I do not favor the use of the term “FGM” for the reasons I have already given). My argument has been that they should not be stopping there. Female, male, and intersex genital cutting should be done exclusively with a medical indication or with the informed consent of the individual. Children of whatever gender should not have healthy parts of their most intimate sexual organs removed, before such a time as they can understand what is at stake in such a surgery and agree to it themselves. It is time to stop the compartmentalization exhibited by Shermer and others and recognize that there is “1 cause” here: respecting children’s rights and protecting them from harm.

———————————————

See Brian’s most recent previous post by clicking here.

See all of Brian’s previous posts by clicking here.

Follow Brian on Twitter by clicking here.

————————————————————–

Share on

44 Comment on this post

  1. Excellent analysis, Brian, dealing very fairly with the twin misconception that exaggerates the harm of female genital cutting while downplaying the harm and exaggerating the benefits of male circumcision: the very terms embody the prejudice that the first is mutilation, the second a harmless “snip”. The one point that you do not perhaps bring out as clearly as you might is that male circumcision is also a highly variable operation, depending on how much of the foreskin tissue is excised, the age at which it is done and the methods used. In an article published by J. Steven Svoboda and me a couple of years ago** we sought to devise a 5-point scale for measuring circumcision damage to complement the classification of the various forms of female genital mutilation put forward by the World Health Organisation, available on-line here:

    http://www.circinfo.org/documents/RoseByAnyOtherName-Zabus.pdf

    Like FGM, circumcision of a male can mean many different things in practice.

    As you point out and as we emphasise, it is the fact that FGM is a variety of procedures, while circumcision is thought to be a unitary procedure that is chiefly responsible for promoting the illusion that the first is barbarism, the latter an instance of modern medicine. For an analysis of how this double standard originated in the debate over clitoridectomy as a remedy for female sexual dysfunction in 1860s Britain (the Baker Brown affair), see my book A Surgical Temptation.

    ** Robert Darby and J. Steven Svoboda, “A rose by any other name: Symmetry and asymmetry in male and female genital cutting”, in Chantal Zabus (ed.), Fearful Symmetries: Essays and Testimonies around Excision and Circumcision (Amsterdam and New York: Rodopi, 2009).

    1. Thank you, Rob – I think you’re right. Perhaps I’ll make an update to the blog after I’ve got some sleep. In any case, your paper with Steven is to be highly recommended, and has inspired much of my thinking on this topic.

      Warm regards,
      Brian

      1. I’m circumcised, and thought the same way you thought, but that’s changed.

        It’s true that circumcision can decrease sensitivity by 50% or more, but…

        The answer to stop the desensitization of a circumcised penis is using virgin coconut oil 24/7, and spreading the word for circumcised males to continuously use virgin coconut oil 24/7, as it prevents damage to the skin and repairs damaged skin.

        Without coconut oil, I’d rather be un-circumcised, but with a steady supply of coconut oil, I’d rather be circumcised.

        Women pay attention to fgm at least a good 18x more often than circumcision, because it looks better to them & it subliminally means ‘cleaner’ to them. It’s socially unacceptable for them to admit that, so they just keep saying they don’t care, but it’s quite obvious they prefer circumcised penises.

        It’s mostly women who are the ones who sign the consent forms for male circumcision.

        1. No amount of coconut oil can replace the tens of thousands of nerves of the foreskin itself (specialised like those of the fingertips or lips – and who can deny that the lips are important to the pleasure of kissing?), conferring not just “more sensitivity” but a “symphony of sensation”. Nor can it replace the unique rolling action of the foreskin.

          It is impossible to generalise to all women. Cultural conditioning plays an enormous part. European women seem perfectly happy with men as they are, and many an American woman has been cured of any aversion to foreskins in a single session.

          1. well, actually, it was a bit ignorant of me to say “it looks better to them”. I believe it comes more down to geographical location and the social norms in that area.

            I don’t advocate circumcision, I just advocate the use of coconut oil to lessen the damage of genital mutilation by a great amount.

  2. Actually FGM is often done WITH the girls “consent,” yet is still deemed illegal in most Western countries. Also of note, the male foreskin contains most of the fine-touch nerve endings which in girls are spread over the mucosal vulva not just the clitoral hood. The glans penis is mostly devoid of fine touch receptors, unlike the clitoris which has many on both the glans and prepuce as well as the minor labia. I point this out not to trivialize FGM, but rather to engender appropriate horror over what circumcision of males removes (basically everything removed with infibulation).

    1. Its very good that you pointed out the difference in innervation of the male/female genitalia. Many people do not know that the glans penis composes of non-tactile free-nerve endings. They mistakenly think of a penis as a giant clitoris as if it is just proportionally larger. They lack the mechanical and evolutionary understanding as well as significance of the penile configuration.

      Interestingly, the human foreskin is evolutionarily unique, it is quite specialized in contrast to our primate cousins. Its important for the public to be educated in genital anatomy as well as, and most importantly, demystifying the sexual somatosensory responses of both sexes.

    2. Christopher Larson

      No. Actually most of it isn’t done with their consent. Circumcision, whether done as FGM or to males, is done without the consent of the individual undergoing the procedure. The girls that actually agree to FGM are not aware of the lasting permanent damage and pain that results. They are essentially children, merely going along with what is seen as “normal” in their society, and they naïvely think that they are going to undergo a procedure that will make them “normal” like other women. They’re usually forced. Children are held down by their own family members to the extent that even the pinning down of the body can cause bones to be broken. While the male foreskin does contain nerves that when removed reduce male sexual pleasure, it in no way results in the lasting physical and painful damage that FGM causes. That’s not to say at all that there are never any negative repercussions to male circumcision. The difference is that FGM renders female genitalia reproductively nonfunctional. Male circumcision does not have the same medical effects. Of course, any human being should be allowed to decide what’s going to happen to their body, but male circumcision (when done for medical purposes) is done with anesthesia, clean instruments, and actually reduces the chances of contracting HIV. It is not performed using dirty random knives and objects that lead to infection. The rate at which male circumcision results in lasting physical and permanent damage is nil in comparison to FGM.

  3. I’ve actually been engaged in an ongoing e-mail discussion with Mr. Shermer where I’ve shared some of this information with him in the hopes that he might see this double-standard and the ethnocentrism involved. So far he has seemed receptive to the information I’ve passed onto him.

  4. Removing the clitoris, the main organ responsible for female sexual pleasure, and then stitching her vagina mostly shut is in no way like male circumcision. Taking away a person’s ability to feel sexual pleasure has nothing to do with purity or morality — in fact, it’s about the least moral thing I’ve ever heard of. And cutting off tissue and sewing what’s left back together so the woman has to be cut or torn open the first time she has intercourse is barbaric. It does not belong in the 21st century. We don’t even treat animals this cruelly.

    1. 825 boys died from ritual circumcision in Eastern Cape, South Africa alone since 1995. Just as many lost their entire penises.

      It doesn’t seem like you read the article.

    2. Wow. I can’t believe you actually put your name on a comment about an article you obviously didn’t read.

      On the other hand, you very handily (though inadvertently) demonstrated the knee-jerk reaction of a person brought up in a culture in which MGM (RIC/MGC) is common: automatically assuming the worst of FGM, and the (propagandised and overinflated) “best” of MGM.

      You might want to open your mind, and actually read the next article you want to comment on.

    3. I strongly agree that the stitching and cutting of a female is barbaric and nothing short of cruel. I wish more people were like you and could speak up. This is, sadly, reality. God Bless.

  5. Excellent work. Glad to see brains working. Lee Wigmore, I would like to see you confront what non-consenting male circumcision actually is–torture.

    A rabbi in Pittsburgh just cut off a baby’s penis. How does that make you feel? Are you capable of imagining not being able to have sex, or ejaculate, ever?

  6. Earp’s deconstruction of what I call the “severity argument” is a very important point. There is a wide range of what we call FGM and MGM, with a huge amount of overlap. The severity of the assault is unimportant when compared to classifying all these acts as criminal and protecting all of the victims.

  7. Thank you, Brian, for yet another brilliant article! Genital cutting should not be an issue of competitive suffering and, while males are blamed for the subjugation of women, in a patriarchal society, males are often the first victims, setting up the dynamics for patriarchal rule. In truth, regardless of gender, it is the first cut into the normal body of a non-consenting minor that is the human rights violation. Thank you for stating the argument so well!

  8. Thank you for a comprehensive arguement. I fully agree, no form of child genital mutilation should be acceptable, including infant/child male circumcision. The fundamental argument in principle against male infant/child circumcision is the loss of choice. How can it be right or lawful to cut off part of a boy’s body before he is an adult and old enough to make an informed choice of his own? As concluded in this article, this is a basic human rights issue.

  9. A male has very little sexually sensitive or ‘sensual’ tissue compared with females, this is fact and recent high technology research in Australia by a lady that could not accept the nonsense written in the age old text books BY MEN, has proven that the medical books are wrong. She proved that the female has a wealth of sexual tissue inside the vagina that contains semi erectile tissue that makes the cliterous and other parts simply the ‘tip of the iceberg’ in sexual stimulation.

    In comparison with the mutilated male the sensation lost due to FGM is in most forms minute compared with the loss of the MGM male, this is simple fact.

    But these comparisons are simply a non-issue because here in the UK and Europe we have laws on EQUALITY and the simple fact is that men are less EQUAL than women (that said there has never been a prosecution of FGM since the first law in 1985 and none since the 2003 FGM Act made FGM a criminal act with a tariff of up to 14 years in prison). What the hell is going on here?

    Penial operations are forbidden on animals by statutory instrument (source RCVS) and the shocking fact is that children are not only having to suffer this sexual abuse, but also the adult the child will become has to live with the sexual abuse and his/her violation of human right for the rest of their lives.

    One baby died only 15 minutes after his sexual abuse in London and another had a similar fate in Birmingham, many other die or are maimed and the crime is covered up by technical terms for the death, often reference to excessive bleeding septic shock etc., of which would never have occured had they not been sexually abused.

    There cannot be any debate on harm done or not done, the fact is that all those under legal maturity or the vulnerable must be protected with EQUALITY as though they are adults and that means every part of the physical and mental integrity MUST be preserved until they reach the age of legal competence.

    Its simple. http://www.intacthumanity.org
    Kevin Elks,
    Dover, Kent. CT16 3DJ (UK, England)

    1. Very well-said. I have noticed, from raising two sons and one daughter in the U.S., that males actually seem to be more discriminated against than females. This is especially true in the school system here. Plus, there is this idea in our culture that males are not as sensitive as females, and therefore, can be treated more aggressively. Their emotions and vulnerabilities are ignored. I believe the opposite is true: females seem stronger and more resilient, etc., at least early on. Boys have gotten the short shrift here in many ways.

  10. Germaine Greer has been accused of supporting FGC, but actually offered a much more nuanced view and made the point about our different view of male cutting back in 1999 in “The Whole Woman”.

    Female genital mutilation (FGM) has been condemned as a violation of human rights by the International Conference on Population and Development, the Fourth World Conference on Women in Beijing, the World Health Organisation, UNICEF, and the United Nations Family Planning Authority. Male genital mutilation is seldom condemned. Men mutilate the genitals of other men; usually women mutilate the genitals of other women, except where the procedure is carried out by a male professional. In England a doctor will be struck off the medical register if it is found that he has carried out a female circumcision of any kind. He will not be struck off for splitting a penis down the middle so that its owner can insert rings in it fore and aft for the gratification of himself and partners. He will not be struck off but rather encouraged to ‘tidy up’ the ambiguous genitalia of intersexual newborns, usually by removing the inadequate penis and creating an opening that will pass for vagina, so that the child becomes a girl, regardless of actual chromosomal make-up. And he may massively mutilate built men and women seeking gender reassignment. But he may not carry out any form of female circumcision at the request of a patient or her parents.

    Human beings have always modified the external appearance of their bodies in one way or another; one man’s beautification is another man’s mutilation. Looked at in its full context the criminalization of FGM can be seen to be what African nationalists since Jomo Kenyatta have been calling it, an attack on cultural identity. Any suggestion that male genital mutilation should be outlawed would be understood to be a frontal attack on the cultural identity of Jews and Muslims.

    Notwithstanding, the opinion that male circumcision might be bad for babies, bad for sex and bad for men is steadily gaining ground. In Denmark nearly 2 per cent of non-Jewish and non-Muslim men are circumcised on strictly medical grounds; in Britain the proportion rises to between 6 per cent and 7 per cent, but in the US between 60 per cent and 70 per cent of male babies will have their foreskins surgically removed. No UN agency has uttered a single protocol condemning the widespread practice of male genital mutilation, which will not be challenged until doctors start to be sued in large numbers by men they mutilated as infants. Silence on the question of male circumcision is evidence of the political power both of the communities where a circumcised penis is considered an essential identifying mark and of the practitioners who continue to do it for no good reason. Silence about male mutilation in our own countries combines nicely with noisiness on female mutilation in other countries to reinforce our notions of cultural superiority.

  11. Groan: Hint: The throne Pharaoh sat on was Isis. Oh great patriarchal Leonides King of Sparta why did you fight to the death? Because his matriarchal Queen said ‘Either return alive victorious or return with your dead body on your shield.” Why? Because if he returned alive in loss she could have him killed and pick a new king. Just like the main queen of Pharaoh was Isis incarnate and what the Mesopotamians did with their yearly Sacrifice of the King. For the BS of the “Willing Sacrifice” see Part 6 Joseph Campbell video, “The Power of Myth,” Part 6 = The Sacrifice. For Criminology do not even disallow thinking them different until you understand Passive Initiation and what a MO and Signature of a crime is. Then learn the internal anatomy of the clitoris which is larger than the penis. The simple fact is that the social genitals belong to the feminine whether in child abuse or prevention of child abuse. Just a simple look at the structure of Intactivism which illustrates it. So get with it. The “Collective Male” is not the answer because the male does not think in the Collective. The Collective is first and foremost a function of her Eros and when initiated is from her Animus – which is only a reach into masculine Logos. Now: What is the symbolic meaning of the Shield of Achilles? The Ethical Structure of the Feminine and Masculine is different; yet, either way it’s child abuse and molestation.

  12. No form of genital mutilation whatsoever is acceptable to any infant. If you want to see the results of the viafin-Atlas survey on infant circumcision then google viafin-atlas survey. The results are surprising so far. James

  13. No form of genital mutilation whatsoever is acceptable to any infant. If you want to see the results of the viafin-Atlas survey on infant circumcision then google viafin-atlas. The results are surprising so far. James

  14. Congratulations to Brian Earp for a fine article. However, where do we start to remedy the wrongs that he has so clearly pointed out? Here is one starting point:

    In no jurisdiction is the practice prohibited, and in many it is not even restricted: in some countries, anyone, with any instrument, and any degree of medical training (including none) can attempt to perform a circumcision on a non-consenting child—sometimes with disastrous consequences. As Davis notes, “States currently regulate the hygienic practices of those who cut our hair and our fingernails … so why not a baby’s genitals?”

    A good first step might be to ban unqualified people from circumcising anyone.

    American (non-religious) circumcisions are done in a hospital, in the first few days of life, with or without an anaesthetic, and using a range of different clamps and cutting devices;

    Even Jewish circumcision is delayed until a week after birth. Is it ethical to circumcise sooner? Doctors know full well that circumcision without anaesthetic is painful. Is it ethical to perform circumcision in this way? Are the clamps and cutting devices safe? are the anaesthetics safe? Apart from the question of whether infant circumcision itself is ethical, there are a lot of questions about present practices.

    …metzitzah b’peh, done by some ultra-Orthodox Jews, involves the sucking of blood from the circumcision wound, and carries the risk of herpes infection and permanent brain damage;

    Here is a dangerous cultural practice that needs to be discouraged or banned. Is it too much to ask medical associations and the writers of baby books to discuss this danger to ultra-Orthodox baby boys? Is it too much to expect public health officials to produce brochures warning of this danger, and for maternity hospitals to carry these brochures for all to read?

    …subincision, carried out in aboriginal Australia and elsewhere, involves slicing open the urethral passage on the underside of the penis from the scrotum to the glans, often affecting urination as well as sexual function; testicular crushing is an initiation rite in some parts of Africa and Micronesia; circumcision among the Xhosa in South Africa is done as a rite of passage, in the bush, with spearheads, dirty knives, and other non-sterile equipment, and frequently causes hemorrhage, infection, mangling, and loss of the penis—see here for some disturbing pictures—as well as a very high rate of death.

    Once again, surely the state and the medical profession has a duty to point out the danger of these traditional practices, and to discourage them at the very least.

    …even “hospitalized” or “minor” circumcisions are not without their risks and complications: in 2011, nearly a dozen boys were treated for “life threatening haemorrhage, shock or sepsis” as a result of their non-therapeutic circumcisions at a single children’s hospital in Birmingham in England.

    Another case where public health officials and the medical profession has a duty to put into effect controls to prevent these near misses, both by tighter controls over circumcision and by discouraging its practice.

    …forced circumcision of (male) enemies has been used as a means of humiliation since time immemorial

    I believe this “traditional practice” needs to be treated as a sexual assault. If you doubt why, please read this evidence: http://jme.bmj.com/content/suppl/2013/09/06/medethics-2013-101626.DC1/medethics-2013-101626supp.pdf

    Finally, is it too much to insist that if parents disagree on having a child circumcised, that decision to circumcise or not should be deferred until the owner of the foreskin is an adult, and can decide the issue for himself?

    My suggestions don’t fit neatly into either of the two competing narratives: that circumcision is good/holy/medically recommended etc. and that circumcision is bad/damaging/mutilating etc. However, I do believe that a harm minimisation approach is not a bad place to start.

  15. Thank you, Brian, for a clear and comprehensive review of the differences AND the common ground between male and female genital cutting. You rightly pointed out that what is most important is not the intention behind these acts but the consequences to the individuals who must live with these intrusions upon their bodily integrity.

    It must be noted here also that the medical community has never investigated the adverse long-term consequences to boys and the men they become even from hospital-based circumcisions that met the ‘standard of care.’ This is why it has become our task as men to document the harm ourselves. In 2011-2012, a grassroots effort to identify the harm and give a voice to these men was launched online at the Global Survey of Circumcision Harmhttp://www.CircumcisionHarm.org.

    More than 1,000 men circumcised as infants or children without medical necessity answered an extensive online questionnaire and uploaded photographic evidence and video testimonies of their harm. Approximately 4% of respondents were Jewish, along with a number of Muslim respondents. They reported a wide array of physical, sexual, psychological and self-esteem damage from this genital cutting practice for which they were too young to understand, consent, resist or escape.

  16. Intention does not matter – what matters to me in these cases is that the potential harm outweighs any good (ie. . health benefits) of either procedure in any of their varieties and is done without adult informed consent against the will of the children/infants. It should all be banned as a human rights violation. If at some age of consent (at least 16?), someone wants a useless procedure to cut up their own genitals, they should be able to get that done to themselves on their own if they really want that or have some religious belief that it is important to them.

    The number of people willingly wanting genital mutilation without anesthesia must be incredibly small – which tells us most of what we need to know here.

    I believe in self-determination and that free will should over-ride religion/cultural matters when it comes to the physical boundaries of the person and permanent damage or changes to the body unless there is some medical/life or death/health reason (benefit) to do so that outweighs the permanent damage/changes/risks.

  17. A good article Brian but you pull your punches on the most important point. The popular and false understanding that FGM is predominantly the harsher forms has not happened by accident – it’s being quite deliberately influenced by the WHO.

    If you read carefully the WHO documents around this, and particularly compare the documents aimed at journalists and the public (such as the factsheet you cite) and the more detailed ones for professional consumption such as the 2008 Interagency statement on FGM, you can see that facts which evidence similarities between male and female circumcison are being quietly erased or misrepresented, and that key claims may rely on an extraordinary cherry picking of data.

    For example the 2008 Interagency statement notes that type IA FGM (excising the prepuce – the direct equivalent of male circumcision) is ‘relatively rare’, whereas the factsheet says ‘very rare’ . Is this a typo, or a wilful attempt to mislead? Either way the statement looks questionable given that type IA FGM is reported to be the predominant form of FGM in Indonesia*, the world’s most populous Muslim country and one in which FGM has mass popularity. If we look at the citation for the ‘relatively rare’ point (p26), what do we find? It turns out this claim is referenced by a single study focusing on… Sudan.

    Take also the case of type IV FGM (usually involving an incision of the prepuce) . Anectotal evidence suggests this is hugely popular in Malaysia, and we also know it exists in other countries – for example Ayaan Hirsi Ali has noted it’s practiced in Somalia (specifically saying that it’s much less harsh than male circ), it’s also acknowledged as one of the Egyptian forms of FGM, and the Israelis have campaigned in their region for the Bedouin to stop doing it**. The 2008 Interagency statement notes (p5) that type IV is in fact among the most common forms of FGM and that infibulation (type III) is the least common – accounting for 10% of surgeries, internationally. You’d think this prevalence data might be useful to include in the factsheet but it’s not there.

    Likewise the info on reasons for cutting is subtly and not so subtly massaged. The 2008 statement notes that women are more likely to support FGM than men (p6) and may see an attack on it as an attack on their identity and culture; these points are not made in the factsheet, and among the list of benefits given by subjects of FGM the WHO has dropped some they previously acknowledged, including a “sense of pride” and of “coming of age”.

    All of these missing or misrepresented facts are issues which would have helped the public to a more accurate understanding of FGM as a complex thing, existing on a wide spectrum and with many and varied connections to male circumcision practice and rationales. I say again, this is active spin doctoring. It’s time someone senior asked the World Health Organisation to justify why they are doing it.

    I suggest the reason is that they promote the forced excision of male children’s prepuces***, while trying to argue that even nicking the female prepuce is be an abuse of her human rights (p28 Interagency statement). The former can only succeed if we don’t understand FGM as commonly targetting the prepuce. I’d argue therefore that their position is likely to entrench FGM in its milder forms: the very opposite of what they say they want to do.

    * http://www.nytimes.com/2008/01/20/magazine/20circumcision-t.html
    ** http://www.sciencedaily.com/releases/2009/02/090220090748.htm
    ***http://www.who.int/hiv/pub/malecircumcision/manual_infant/en/

    1. Your comment is an excellent one, and feeds my detestation of the WHO and its intellectual dishonesty.

      Hirsan Ali has expressed the opinion that male circumcision in Somalia is at least as sexually consequential as FGM. That got me thinking.

  18. An excellent post, Brian. Your assessment of the language we use and the arguments used to ‘segregate’ perceptions of harm are accurate and necessary. You raised crucial points in any discussion of the genital cutting of children. Thank you.
    Where I might argue, too, is at the very end when you wrote, ‘Children of whatever gender should not have healthy parts of their most intimate sexual organs removed, before such a time as they can understand what is at stake in such a surgery and agree to it themselves.’ What I read here is that children, as long as they can understand what the consequences will be, should(or we consider it acceptable) be allowed to make a ‘choice’ whether to cut off their genital tissues? If this is either an argument of pragmatism(damage limitation) or an effort to give children a sense of respect in making autonomous decisions about their lives- they’re both poor. Children should never, especially since they are sexually immature, be faced with a permissible ‘choice’ to have destroyed some of their sexual anatomy. This is strictly an adult’s choice because of the irreversibility of amputation. The reasons we give regarding age-restriction from tattooing or potentially sacrificing your life in the armed services stem from good principles: immaturity in experience and permanency of consequences. Genital cutting and amputations are NOT appropriate decisions a child should be faced with.
    I also might have stressed that while anatomically the male and female both have a foreskin, neurologically their ablation has very different results depending on gender: the primary sensory organ for the male is his prepuce, overwhelmingly so. Not true for the female clitoral hood. Different consequences when severed. Both a loss made worse when the individual did not consent, as we both would agree.

  19. There’s a very simple reason for the double standard here.

    The anti-“FGM” campaign is driven by two forces primarily:

    1) Extreme feminists who aren’t sympathetic to any male suffering
    2) Anti-muslim xenophobes in Europe/America who don’t really care about “FGM” but use it as a stick to beat muslims with, even though most muslims in the West don’t practice it other than Somalis. They attack it because it is perceived as a “muslim thing” though, not because of any human rights concern.

    1. I disagree with this analysis. I’d say the campaign against female genital cutting is driven by genuine humanitarian concern.
      1) There is a feminist side to it, since female genital cutting is done only to females, but the fact that it is women who perpetrate it and often enough defend it is glossed over. The lack of sympathy to male suffering only comes into play when anyone dares to raise the parallel issue for males, and women fear “their” issue will be diluted.
      2) I doubt that many people know that FGC is a Muslim issue. In Africa it seems to be tribal more than anything, with Christian girls equally at risk in regions where it is prevalent. Numerically the greatest proportion of FGC is carried out in Indonesia, Malaysia and Singapore, but because it is surgical and relatively minor, sometimes just a token, it is ignored, even though it is done in the name of Islam.

      The curious aspect is that male genital cutting has been so acculturated in the western world that people have trouble seeing it as a human rights issue, or a matter of any concern at all.

      1. I disagree with this analysis. I’d say the campaign against female genital cutting is driven by genuine humanitarian concern.

        That’s not necessarily mutually exclusive of the explanations I gave. Vladimir Putin may well be concerned for Russian speakers in the Ukraine, but that doesn’t mean it’s the primary factor driving his actions.

        The lack of sympathy to male suffering only comes into play when anyone dares to raise the parallel issue for males, and women fear “their” issue will be diluted.

        That doesn’t make sense to me though because surely being against circumcision on children of both genders is a more coherent position than lieing that FGM is somehow innately worse than MGM.

        I doubt that many people know that FGC is a Muslim issue.

        In the real world, people (in the UK at least) don’t know about FGM full stop. It’s primarily an internet issue. If I go into work tomorrow and started using “FGM” in sentences, I’d honestly be stunned if anyone knew what I was talking about. For internet residents, it is certainly talked about primarily as a “Muslim issue” either directly or by associating it with other “Muslim issues”. The proof is in the pudding. It’s been illegal for over 20 years and only since the London bombings has it become a media scandal.

        1. “I disagree with this analysis. I’d say the campaign against female genital cutting is driven by genuine humanitarian concern.”

          That’s not necessarily mutually exclusive of the explanations I gave. Vladimir Putin may well be concerned for Russian speakers in the Ukraine, but that doesn’t mean it’s the primary factor driving his actions.

          “The lack of sympathy to male suffering only comes into play when anyone dares to raise the parallel issue for males, and women fear “their” issue will be diluted.”

          That doesn’t make sense to me though because surely being against circumcision on children of both genders is a more coherent position than lieing that FGM is somehow innately worse than MGM.

          “I doubt that many people know that FGC is a Muslim issue. ”

          In the real world, people (in the UK at least) don’t know about FGM full stop. It’s primarily an internet issue. If I go into work tomorrow and started using “FGM” in sentences, I’d honestly be stunned if anyone knew what I was talking about. For internet residents, it is certainly talked about primarily as a “Muslim issue” either directly or by associating it with other “Muslim issues”. The proof is in the pudding. It’s been illegal for over 20 years and only since the London bombings has it become a media scandal.

  20. I am surprised to hear that Female Genital Mutilation is still allowed in England. Please forgive my ignorance but why would it be considered even a possibility of being appropriate? Is it because of religious freedom? Thank You

    1. I am surprised to hear that Female Genital Mutilation is still allowed in England.

      It’s not legal. It’s been illegal since the 80s. It’s just not prosecuted because girls don’t report it because they don’t want their parents to go to prison.

      1. Thanks Ortega: Since reading this I went and read the petition and that explained the issue at hand. I was taught about it in school here in the states but, maybe that is because I was fortunate enough to be able to attend a private school.

  21. Hear hear! It’s time the for the smug established dogma to realise that, in the absence of acute necessity, all genital cutting of children is directly comparable.

    On the subject of antisemitism and islamophobia, I propose the following compromise: give these cultures time to adjust their own attitudes to both male and female genital mutilation in the light of contemporary objections. Meanwhile, western critics might focus their attention on the ongoing tolerance for genital cutting of boys in the west under the shelter of spurious ‘medical’ rationalization and on the ongoing tolerance for illegal genital cutting of girls both within western jurisdictions or on ‘holidays’ abroad.

  22. Brian, Thanks for writing this! The facts are so well organized, easy to follow and patiently explained – and the citations are invaluable. I do feel compelled to point out one fact that most people seem to be unaware of: MGM is absolutely “child abuse” in the United States as defined under US Federal Public Law 93-247 Child Abuse Prevention and Treatment Act (CATPA)
    • “Child Abuse is a Criminal Offense that involves the physical, emotional, or sexual mistreatment of or Infliction of Non-Accidental injury to a child committed by a parent or another party if responsible for the child’s welfare or not, either purposefully, or due to neglect.“
    • “Any recent act or failure to act on the part of a parent or caretaker or any other person, which results in death, serious physical or emotional harm, sexual abuse, or exploitation, or an act or failure to act which presents an imminent risk of serious harm.”

    Every act of forced circumcision on a healthy child makes that child a victim of outlawed child abuse. We already have the law in place that we need – now we need to focus on demand for law enforcement. If people would grasp this fact and act upon it, MGM would end sooner than later.

  23. Here’s another double standard: in the U.S. you’d get slapped with criminal charges if you circumcised a dog. Do it to a infant child and it’s “for his health”.

  24. A recent program exploring the increasing demand for labiaplasty in the United States questioned the need for the procedure, other than cosmetics, and found that a great many of the women interviewed do have seriously damaged, deformed labia. Some of these women were barely out of their teens, and had not borne children, so what happened?

    Further discussion pointed to the sexual behaviour of their partners, whose “lovemaking” might be better described as prolonged pounding.

    There are countless home-made videos posted on the internet which show the differences between circumcised males and intact males when engaged in sex — the former so violent and the latter so gentle.

    So I guess one could say that women can be harmed by MGM as well as FGM. Yet another reason to end all forms of genital mutilation.

Comments are closed.