By Lauren Notini and Brian D. Earp
*Note: a condensed version of this article titled “Iceland’s Proposed Circumcision Ban” is being cross-published at Pursuit.
For a small country, Iceland has had a big impact on global media coverage recently, following its proposed ban on male circumcision before an age of consent.
Iceland’s proposed legislation seeks to criminalise circumcision on male minors that is unnecessary “for health reasons,” stating individuals who remove “part or all of the sexual organs shall be imprisoned for up to 6 years.”
The bill claims circumcision violates children’s rights to “express their views on the issues [concerning them]” and “protection against traditions that are harmful.”
According to bill spokesperson Silja Dögg Gunnarsdóttir, a key reason for the bill is that all forms of female genital cutting (FGC), no matter how minor, have been illegal in Iceland since 2005, but no similar legislation exists for males.
“If we have laws banning circumcision for girls,” she said in an interview, then for consistency “we should do so for boys.” Consequently, the bill is not specific to male circumcision, but adapts the existing law banning FGC, changing “girls” to “children.”
There is much to unpack here. We first discuss self-determination and informed consent, before addressing claims about potential health benefits and harms. We then explore the religious significance of circumcision for some groups, and ask what implications this should have.
Self-determination and informed consent
Circumcision supporters often argue that young children are incapable of giving or withholding informed consent to decisions affecting them.
This may be true, but a child’s temporary inability to make informed decisions about their body does not create a blank cheque for parents to authorise whatever permanent bodily modifications they choose.
Where should the limits of parental decision-making lie?
Non-therapeutic genital cutting deprives the child, and the adult they will become, of the opportunity to remain genitally unmodified (or intact). Plausibly, the person whose ‘private parts’ will be permanently affected by the cutting should get a chance to weigh in on whether that is what they desire, in light of their longer-term preferences and values.
This doesn’t mean that one must defer to the child for all actions that affect their body. Distinctions need to be drawn. For example, if a procedure is clearly in a child’s best interests and cannot be postponed until the child is competent to consent (e.g., urgent appendectomy), performing it is ethically permissible.
However, the less clear it is that a bodily encroachment is in fact in the child’s best interests—considering the child’s strong interest in being able to autonomously make important self-affecting decisions in the future—“the more likely it is that the child’s bodily integrity rights are being impermissibly violated.”
Giving a child a haircut, a vaccination, or even an ear-piercing (comparisons that are often raised) are morally different from removing part of a child’s genitals. The status of the latter as being compatible with a child’s best interests is far more controversial.
Unlike, say, participating in sports (another common comparison), circumcision does not merely introduce a risk of some bodily injury or another. Rather, it is by its nature a bodily injury. Moreover, it is one that is guaranteed to affect the most psychosexually significant and emotionally charged part of the child’s body: his genitals. The risk is not ‘spread out’ and the ‘injury’ does not heal: the loss of valuable and functional tissue is permanent.
Clearly, the circumcision debate needs to move beyond a simplistic ‘children’s rights’ versus ‘parents’ rights’ dichotomy. Parents are permitted to authorise certain actions affecting their children, but not others. In our view, removing a healthy, functional component of a child’s most intimate bodily organ should fall in the latter category. But because the youngest of children are pre-autonomous and cannot consent to any intervention that affects them, simple appeals to self-determination will not be sufficient for such arguments to succeed.
Potential health benefits versus harms
Silja Dögg Gunnarsdóttir has stated that Iceland’s bill “is fundamentally about not causing unnecessary harm,” acknowledging while some boys do not experience surgical complications from being circumcised, “some do and one is too many if the procedure is unnecessary.”
The issue of complications is worth exploring. First, it is not only the likelihood, but also the magnitude of a surgical risk that is morally important. When the target is a non-consenting person’s healthy genitals, even a small chance of something going wrong should loom large: the consequences of a mistake on this part of the body may be devastating.
In other words, a small likelihood of certain complications multiplied by a large magnitude for at least some of them amounts to an ethically significant risk.
Circumcision supporters cite various potential health benefits of circumcision which they believe outweigh this risk of surgical complications, thus making the surgery permissible (see Box 1). But even this assumes that the only harms involved are possible complications. Given that the foreskin is erogenous tissue, and the most sensitive part of the penis to light touch, it has value in and of itself. Thus, its sheer removal is a harm, even if there are no complications.
Whether this harm (among others) is ‘worth’ the purported benefits of the surgery is something the individual himself has an interest in deciding. A person can always choose to have their genitals cut later on in life, if that is what they want, but those who resent being cut cannot reverse the operation.
Box 1. How compelling are the health benefits associated with childhood male circumcision? Box adapted from Earp and Steinfeld (2017).
Health benefits that have been attributed to male circumcision include a reduction in the risk of acquiring a urinary tract infection (UTI) in early childhood, some sexually transmitted infections (STIs) after sexual debut, and penile cancer later in life. With respect to UTIs, boys with normally developing anatomy have a low risk of infection regardless of circumcision status—far lower than the risk for girls after the first few months of life—and these can typically be cured with antibiotics, just as they are for girls. Penile cancer is rare in developed countries, such that, according to the American Academy of Pediatrics (AAP), it would take between 909 and 322,000 circumcisions to prevent a single case. Most of the reliable evidence suggesting a reduced risk of STIs comes from studies of adult, voluntary circumcision in third world countries whose applicability to circumcision of infants in other contexts is unclear. Moreover, STIs are not a relevant health risk to children who are not sexually active. In light of alternative, less invasive means of achieving the above-mentioned health benefits, including basic hygiene and the adoption of safe sex practices, relevant health authorities worldwide generally agree that the potential medical advantages of non-voluntary childhood circumcision in developed countries are not sufficient to offset the costs, harms, and other disadvantages associated with the surgery in those contexts, some of which may be subjective in nature and therefore difficult to quantify. Thus, none of the paediatric or other medical bodies that have issued formal policies on routine neonatal circumcision consider the health benefits of the surgery to exceed the risks, regardless of the metric used. The sole exception to this is the AAP, whose 2012 policy is now expired. After considerable international criticism from experts in epidemiology and children’s health, including heads and representatives of national medical societies in England, mainland Europe, and Canada, a representative from the AAP Circumcision Task Force acknowledged significant problems with the AAP findings and methodology.
Religion and circumcision
Most practicing members of Jewish and Muslim communities regard male circumcision as central to their faiths. Circumcision is traditionally performed on the eighth day in the Jewish faith and at 10 years (with considerable variance) in the Muslim faith. Understandably, Iceland’s bill has been criticised by many spokespeople for Jewish and Muslim groups, with some labelling it “a dangerous attack on freedom of religion.”
Thus, two competing rights claims are at stake—children’s rights to bodily integrity and protection from unnecessary harm, and parents’ rights to practice their religion.
Parental religious rights are not unlimited. Consider a Jehovah’s Witness parent who, given their religious beliefs, refuses life-saving blood for their child. Most laws internationally permit healthcare professionals or courts to administer blood despite the parents’ refusal, even if parents believe they are acting in their child’s best spiritual interests.
The aim of this legislation is not to threaten the Jehovah’s Witness faith (indeed, adults in the community who refuse life-saving blood transfusions for themselves routinely have their wishes followed), but to protect children, who cannot defend themselves, from harm.
The relevant question, then, is not whether parents’ decisions are religiously motivated, but whether they fall within reasonable limits. So what counts as a reasonable decision and who should get to decide?
Ethics scholar Akim McMath has stated that, in the case of circumcision, “[p]eople disagree over what constitutes a harm and what constitutes a benefit.” Given this, some have concluded that the circumcision decision should rest with the parents.
However, an alternative conclusion could be drawn. As McMath notes, “the child will have an interest in living according to his own values, which may not reflect those of his parents.” Therefore, “if disagreement over values constitutes a reason to let the parents decide, it constitutes an even stronger reason to [not perform circumcision before] the child himself can decide.”
In the context of female genital cutting or FGC, parents’ decisions are almost universally not regarded to fall within reasonable limits, even if they are religiously motivated and the cutting is less severe than male circumcision.
This is demonstrated by the attempted “Seattle Compromise” of the 1990s, where a Seattle hospital received requests from Somalian mothers to circumcise their daughters and sons. The doctors agreed to circumcise the boys, but initially refused to cut the genitals of the girls. However, concerns were raised that the mothers might take their daughters elsewhere for a more severe procedure.
The hospital, worried about harms associated with these more severe forms of FGC, negotiated with the mothers to perform a symbolic ‘nick’ instead, which would draw blood but not involve scarring or removing tissue. Opponents of FGC, however, campaigned against the hospital and the compromise did not proceed, suggesting the bar for (relatively) acceptable harm is set extremely low in cases of FGC.
Non-religious circumcision
So far, in the media-driven debate regarding Iceland’s bill, most articles have focused on religiously-motivated circumcision. Indeed, some have interpreted the bill as applying only to religious circumcisions. For example, in an opinion piece, one writer claimed “[w]hen religion is out of the picture, the reasons for male circumcision tend to go out the window.”
This view is misinformed. If not in Iceland, at least in other countries—primarily, the USA—circumcision is regularly requested for non-religious reasons. In fact, most circumcisions in the USA are performed for social or cultural reasons having nothing to do with religion, and yet the surgery is widely treated as permissible even in those cases.
A common reason provided by American parents requesting circumcision is they want their son to “look like dad.” Other reasons include concerns their son will be teased if not circumcised, and mistakenly believing a circumcised penis is easier to clean. Similar findings have been reported in surveys of Canadian parents.
Finally, according to another survey, most Jews identify as non-religious. Clearly, if religious motivations are required to justify non-therapeutic alteration of children’s genitals, far fewer circumcisions should be permitted than currently occur.
Are parents’ reasons ethically significant?
This raises important questions about the ethical significance (if any) of parents’ reasons. Should these reasons be considered when deciding whether parents’ circumcision requests should be followed?
Silja Dögg Gunnarsdóttir suggests no, claiming that it is not about the “intention” of circumcision; “it’s about the children.” Conversely, South Africa’s Children’s Act 2005 bans non-medical circumcision of males under 16, but makes an exception for religious motivations, suggesting parents’ reasons do matter.
Some may argue Iceland should adopt a similar ‘middle-ground’ approach and permit only religiously-motivated circumcisions before an age of consent. But if circumcision is in fact harmful, such an exception may send a confusing signal.
Specifically, it could be taken to imply that children of religious parents are less worthy of being protected from harm than children of non-religious parents (or parents with non-religious reasons for genital cutting).
Consider again the Jehovah’s Witness example. All parental refusals of life-saving blood are treated the same, even if they are motivated by religious reasons. The focus is on potential harm to the child, not parents’ motivations.
In any case, reasons can be multifactorial, complex, and difficult to tease apart. In some cases, parents’ actual reasons for requesting circumcision may be different to reasons they disclose to providers. In other cases, parents may be unaware of their true motivations. Furthermore, assessing parents’ motives would be challenging in practice.
Moving forward
This question about the moral significance of parents’ reasons highlights an important limitation of Iceland’s bill. While the bill concerns circumcisions not performed for “health reasons,” it does not define the term ‘health.’ This is an oversight, as the term is not self-evident. Rather, this term is value-laden and invokes complex ideas about the proper goals of healthcare.
Some define ‘health’ broadly. For example, the World Health Organization defines health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” Some parents may therefore claim they are requesting circumcision for these broader ‘health reasons,’ seeing circumcision as promoting the social or spiritual aspects of their son’s well-being.
If pivotal terms such as ‘health’ are not clearly defined in legislation, too much remains open to interpretation. Parents and practitioners are left to apply their own discretion about whether a circumcision is requested for ‘health reasons,’ effectively rendering even the most well-intentioned legislation moot.
Lauren Notini, Research Fellow in Biomedical Ethics, Melbourne Law School, University of Melbourne and Honorary Fellow, Biomedical Ethics Research Group, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
Brian D. Earp, Research Fellow, The Oxford Uehiro Centre for Practical Ethics, University of Oxford; Associate Director, Yale-Hastings Program in Ethics and Health Policy, Yale University and The Hastings Center
Key readings from the authors
Carmack, A., Notini, L., & Earp, B. D. (2016). Should surgery for hypospadias be performed before an age of consent? The Journal of Sex Research, 53(8), 1047-1058.
Earp, B. D. (2015). Female genital mutilation and male circumcision: toward an autonomy-based ethical framework. Medicolegal and Bioethics, 5(1), 89-104.
Earp, B. D. (2017, August 15). Does female genital mutilation have health benefits? The problem with medicalizing morality. Quillette Magazine. Available at http://quillette.com/2017/08/15/female-genital-mutilation-health-benefits-problem-medicalizing-morality/.
Earp, B. D., & Darby, R. (2017). Circumcision, sexual experience, and harm. University of Pennsylvania Journal of International Law, 37(2–online), 1–57.
Earp, B. D., Hendry, J., & Thomson, M. (2017). Reason and paradox in medical and family law: shaping children’s bodies. Medical Law Review, 25(4), 604-627.
Earp, B. D., & Shaw, D. M. (2017). Cultural bias in American medicine: the case of infant male circumcision. Journal of Pediatric Ethics, 1(1), 8–26.
Earp, B. D., & Steinfeld, R. (2017). Gender and genital cutting: a new paradigm. In T. G. Barbat (Ed.), Gifted Women, Fragile Men. Brussels: ALDE Group-EU Parliament.
Earp, B. D., & Steinfeld, R. (2018). Genital autonomy and sexual well-being. Current Sexual Health Reports, 10(1), 7-17.
Frisch, M., & Earp, B. D. (in press). Circumcision of male infants and children as a public health measure in developed countries: a critical assessment of recent evidence. Global Public Health, 13(5), 626-641.
McDougall, R. J., & Notini, L. (2014). Overriding parents’ medical decisions for their children: A systematic review of normative literature. Journal of Medical Ethics, 40(7), 448-452.
Notini, L. (2016). The ethics of performing elective appearance-altering procedures to alleviate or prevent psychosocial harms to the child: the case of paediatric otoplasty. In McDougall, R., Delany, C., & Gillam, L. (Eds.), When Doctors and Parents Disagree: Ethics, Paediatrics and the Zone of Parental Discretion (pp. 190-206). Sydney, NSW: Federation Press.
Shahvisi, A., & Earp, B. D. (in press). The law and ethics of female genital cutting. In Creighton & L.-M. Liao (Eds.), Female Genital Cosmetic Surgery: Interdisciplinary Analysis & Solution. Cambridge: Cambridge University Press.
This is an important discussion that is likely to stimulate lengthy commentary, both supportive and critical. Right now I want only to emphasise the point that Brian and Lauren make in their last two paragraphs – that if the Iceland legislators allows circumcision “for health reasons” they are installing a loophole that can be exploited by any parent who wants to get a boy (or girl) circumcised for any reason; and indeed by any adult male who wants to get circumcised for cosmetic reasons and wants the public health system or private insurance to pay for it.
The trouble with “health reasons” is that the expression is far too vague, and certainly includes circumcision for prophylactic health reasons – i.e. as a precaution against possible future diseases and “problems”. This was in fact the entire rationale for circumcision of male infants and boys, from the late nineteenth century until the 1970s; and it remains the insistent mantra of circumcision advocates to this day. Not only this: defenders of culturally and religiously motivated circumcision these days nearly always stress the “health benefits” when defending their practices, and often give them priority over the various cultural justifications. You can be sure that sexually transmitted diseases and especially HIV will be brought up in this context. In South Africa the Children’s Act makes circumcision of boys under the age of 16 years illegal, except for religious or medical reasons – exceptions that have turned the provision into a dead letter
If the proposed wording of the bill allows circumcision “for health reasons” it will be possible for any parent to assert that circumcision is more healthy, and to demand circumcision for that reason. Doctors may disagree, but in a free enterprise medical market there will always be some practitioners who, sensing a business opportunity or out of ideological sympathy, will be willing to attest that the procedure is necessary “for health reasons” and who will perform it on request.
To ensure that abuses of this kind do not occur, the bill should specify that genital cutting of children is illegal unless necessary for therapeutic reasons – i.e. that it is necessary to treat a pathological condition that has not responded to medical (non-surgical) treatment after reasonable efforts.
And what if circumcision advocates turn out to be right, and that infant circ. actually does have genuine health benefits, that outweigh the risks? If that were so then your insistence on disallowing circ. for “health reasons” will only condemn males to needless suffering, even death. You will be no better than an anti-vaxer. This is what happens when you put ideology before science. Better to insist that the procedure be performed to a high medical standard, and let the science settle the “health reasons” debate. And right now the science is not going your way.
The supposed health benefits are not strongly supported by the data (which was often shoddily obtained). In order to justify an intervention of this nature the burden of proof is not on those who think nature knows better but on those who support cutting off functional tissue from a newborn’s genitals. Moreover, even if there were modest health benefits, a person should be able to make that decision for themselves when they can consent to it, rather than having the choice unilaterally made for them.
Iceland proposes only to make the existing genital cutting law gender-neutral. Are you suggesting that little girls may be genitally cut (minimally, surgically) for supposed “health reasons” too?
It is not just a matter of the benefits “outweighing the risks”. There is also the inevitable loss of a functional sensory organ, and the choice of the owner (a human right applicable to every other normal, healthy, functional, non-renewing body part).
How do you figure that “your insistence on disallowing circ. for “health reasons” will only condemn males to needless suffering, even death” when that is not the case in most of the developed world?
Did you read the article?
The health benefits are basically non-existent.
This IS the issue, isn’t it? And why should genital cutting be any different from anything else parents do to their babies and children in the name of their [the parent’s] religious beliefs.
Religion is a belief system, not necessarily a fact – ask Galileo. And Bruno. Both said the Earth goes around the Sun but at the time, G*d said otherwise.
Notini and Earp on the rights side of history.
Cutting male and female genitals are similar.
1) They are unnecessary, extremely painful, and traumatic.
2) They can have adverse sexual and psychological effects.
3) They are generally done by force on children.
4) They are generally supported by local medical doctors.
5) Pertinent biological facts are not generally known where procedures are practiced.
6) They are defended with reasons such as tradition, religion, aesthetics, cleanliness, and health. These reasons are used to mask underlying reasons.
7) The rationale has currently or historically been connected to controlling sexual pleasure.
8) They are often believed to have no effect on normal sexual functioning.
9) They are generally accepted and supported by those who have been subjected to them.
10) Those who are cut have a compulsion to repeat their trauma on their children, a symptom of post-traumatic stress disorder.
11) The choice may be motivated by underlying psychosexual reasons.
12) Critical public discussion is generally taboo where the procedures are practiced.
13) They can result in serious complication that can lead to death.
14) The adverse effects are hidden by repression and denial.
15) Dozens of potentially harmful physiological, emotional, behavior, sexual and social effects on individuals and societies have never been studied. 16) On a qualitative level, cutting the genitals of male and female children are the same. The harm starts with the first cut, any cut.
RONGOLDMANPHD
Actually they are very dissimilar, and none of your points stand up to scrutiny. Using your own numbering, and “FGC” to refer to female genital cutting:
1. No pain or trauma if proper pain relief is provided. Male circ. is necessary in high-HIV settings if the epidemic is to be turned around. It is arguably useful (but not necessary) in low-HIV ones. FGC is neither necessary nor useful in any setting.
2. No adverse sexual effects from male circ. as shown by the majority of studies, and all the best quality ones. Psychological effects may be the result of being duped by anti-circ propaganda.
3. No more force than taking a kid to the dentist.
4. Perhaps male circ is supported because it actually does have benefits. Vaccinations are supported by local doctors too.
5. Pertinent biological facts indicate that the foreskin has little practical function and is likely an evolutionary relic, like the eyes of blind cave animals.
6. Cleanliness and health are real benefits of male circ, backed up by science. Unlike FGC.
7. Genetic fallacy.
8. True in the case of male circ. Often not so for FGC. This argument also contradicts no. 7, making your list self-contradictory.
9. Justifiably so for male circ. I wonder how you would explain non-circ’d men who have their sons done? Or mothers who do so but who have not experienced FGC?
10. Evidence please. Perhaps those who have been vaccinated have a compulsion to stab their children with needles too? Or perhaps they recognise a good thing, and want the best for their kids.
11. Or motivated by the medical benefits. Multiple studies now show that when parents are properly educated about the procedure majorities would have a son done.
12. False regarding male circ. Its opponents dominate the Internet, and have no difficulty getting their misleading message across, whilst doing all they can to intimidate and silence the opposition with abuse and threats.
13. Vanishingly rare for male circ., and likely greatly outweighed by damage and deaths it prevents.
14. But there are no adverse effects of male circ.! Perplexed by the contentment of the great majority of circ’d males, circ. opponents assume they must be in denial, so wedded are they to their “foreskins are wonderful” ideology they cannot conceive the possibility that actually, being circ’d, is just fine. It is the anti-circs who are “in denial”.
15. Male circ. has been thoroughly researched, but only a handful of weak (mostly survey-based) studies find any negative effect. The great majority (including all the best designed) ones find no adverse effect. In desperation the anti-circs scrape up ever more fanciful notions from their barrel and whine that they have never been studied. One that seems to be spreading across comments threads now is the notion that circ. leads to serial killing! Scientists are busy people and do not have the time to chase every wild goose pseudoscientists point to.
16. They are not the same. Male circ. has a list of proven benefits, FGC does not. You are using a fallacy of false equivalence. I might also add that comparisons with FGC are irrelevant. Ultimately, male circ. stands or falls on its own merits or shortcomings, not the merits or shortcomings of other procedures.
Your post seemed reasonable until you compared circumcision to vaccines. If it’s wrong to compare male and female genital cutting, then it makes even less sense to compare either to vaccines.
You can’t have it both ways.
You are pushing a pro-circumcision agenda. I get it. It’s a multi-billion dollar industry. It’s just sad how people are so eager to compromise their integrity to make a quick buck at the expense of others.
It seems as though those who are defending this horrible practice are themselves victims or performing circumcisions as part of their livelihood. It’s a shame that people have to defend business practices which deliberately harm children just so they can profit from gullible parents.
Circumcision is nothing more than a particularly brutal example of infant sexual abuse…
Reply Stephen Moreton
You are spreading a lot of false or dodgy information here, I take them on in the order you posted them
1) Pain relief on a new-born is in itself vary dangerous to do. We have had one death in Sweden so far from a circumcision where pain relief was given. But that is not the actual point. Any unnecessary surgical operation should simply not be done – unless the person who it is done to can give an informed affirmative. That is, they have to be of legal age to do so.
Secondly the data shows that genital cutting of males show no help with HIV infection, because the highest number of infected people in the worst place for HIV transmission are circumcised. And none of the highly flawed data from the three African trials have ever been repeated in the West. (where we can actually check the result). And most importantly, babies do not have sex! That means that the whole idea of cutting the genitals of a baby to stop an STD in their adult life is ludicrous at best. It’s like doing a double mastectomy of all girls before puberty in order to stop them getting breast cancer.
2) There have been several Danish and Korean studies that have shown an adverse effect on sex after being circumcised, but the obvious thing is this:
You are removing the majority of the soft-touch receptors from the penis when you cut away the foreskin – most of them located in the ridged band. To think that removing the cells that detect pleasure will not have an adverse effect on feeling pleasure is simply wrong. It’s like saying that women’s sexual pleasure will not be effected if we removed the clitoral hood (the female homologous organ). Both men and women with intact genitals will be able to tell you how wrong you are here.
3) Utterly false. You do not strap in a child when you take it to the dentist and the dentist doesn’t start pulling out the teeth of the child without anaesthetics jut to please the personal pleasure of the parents, now do they?
4) There are no medically beneficial things that outweighs the risk to the child and the violation of that persons bodily integrity. This is why this procedure is not forced on the adult population.
5) The foreskin and the clitoral hood are not evolutionary relics but play an active part in the sex-life of men and women. You are simply wrong here
6) A 2005 study from genitally cut African women showed a reduced risk of them getting HIV. [“Female Circumcision and HIV Infection in Tanzania: for Better or for Worse?”, Stallings R.Y. and Karugendo E.] But that is not reason enough to demand that women should be subjected to FGM now is it? Because the risk of damage and death from genital cutting of both males and females are too high, and it is a gross invasion of privacy.
7) The use of genital cutting of boys have been a part of the Jewish Tradition of reducing male sexual drive and pleasure. This is spelled out in the work of Maimonides [“The Guide to the perplexed”, Part III, 49]
8) Already dealt with. Genital cutting of both males and females does effect the sexual pleasure of the person as it removes the nerve receptors for pleasure.
9) There is NO justification to remove a functional and sexually important body part from an individual without that persons informed consent. PERIOD! If you did this to an adult man against his will or a boy randomly chosen against his will you will go to jail for:
Aggravated sexual assault; and Genital mutilation or Aggravated sexual assault of a minor , and Genital mutilation. You are not even allowed to do this to a corpse or to a prisoner of war (that is officially classified as a war-crime). So cutting the genitals of a person (male of female) against their will is a felony crime – and should be prosecuted as such.
Note here that you can never use “freedom of religion” to justify the action taken against another human being (or even animals). Religious freedom gives you an INDIVIDUAL right. So you can use this as an argument why you, yourself should be allowed to be circumcised but you can never use it to force this on another, this includes your children or pets. (Cutting the foreskin off a dog without anaesthetics will get you a jail sentence for cruelty to animals)
10-12) Not going there, that is not really of importance anyway.
13) The fatality rate of male circumcision is given in two independent studies of late:
The first state 117 deaths per year in the USA [Bollinger,Dan, “Lost boys, An estimate of US circumcision-related infant deaths”, Thymos (2010)].
The second is a Brazilian study which gives the fatality rate of 0.013% [Korkes, Fernando et al. “Circumcisions for medical reasons in the Brazilian public health system: epidemiology and trends”, (2012) ]
Now looking at both of these studies and knowing that the rate of genital cutting of boys in the USA is about 1 million per year, we get a fatality rate of 12-13 deaths per 100,000 boys cut so they agree with each other. Circumcision does not prevent death but it provably causes it. The complication rate (which is anything from sepsis to amputation of the penis to death) is normally given to be between 2% and 5%. That is one in 50 to one in 20.
14-16). The adverse effects of male genital cutting is well documented and there are no medical benefits unless there is an already diagnosed problem and those are very rare.
But all in all none of the above matters. They are excuses you use but they carry no weight. The question that must be asked is this. Do you have the right to subject another person to a felony crime just because your religion tells you to?
The answer to that is simple; NO!
I have not the time to answer all your bogus claims in your lengthy Gish gallop. In any case answers for some are already readily available, e.g. on circfacts.org, if you could just overcome your confirmation bias for once and take a look at what the other side in the debate has to say. I note you even peddle the long ago discredited 117 deaths myth, and are misleading with the Brazilian study which found that deaths tended to be in old men, and in poor regions with poorer standards of health care. For infant circ the mortality rate was virtually zero.
Steve, why are you arguing in defense of what is essentially a gross violation of the basic human rights of a child?
If female circumcision was legal, would you be extolling the virtues of removal of the labia and/or clitoral hood? I bet dollars to donuts you wouldn’t. Why? Because you are biased. You accuse others of having a cognitive bias that you yourself are guilty of.
Oh, and you failed to respond to my other earlier comment. That tells me and everyone else here, one simple thing – that you have just lost the argument.
Do you perform circumcisions on infants by any chance? Your defending it with such vigor suggests that you sound like the doctors who perform them. Of course, making all this extra money, why wouldn’t they defend this horrible practice?
I do clearly remember one doctor who performed thousands of circumcisions and who claimed to have paid for his first home through circumcisions alone.
Tell me, Steve, is this greed or is it something else entirely?
What about the right to preventative medicine? To having one’s health protected?
There are no significant benefits from FGM, and in its more extreme forms only harm. Your argument is a fallacy of false equivalence.
I have no vested interest in this topic. I am a skeptic and debunker of pseudoscience who is tired of seeing endless nonsense being spread on this topic.
An apparent “failure to respond” may actually be due to the fact that the great majority of my posts fail to appear. Most come up with “Awaiting moderation” and never appear on this thread. I was surprised when the one above did. The problem is so bad I am temped to give up, rather than waste time writing posts that fail to appear. Besides, this thread is old, and few will be reading it now. Now to find out if this post meets the same fate.
Wow! My last post didn’t get censored. A welcome change.
“False equivalence” or not, the issue is essentially about cutting off parts of someone else’s genitals by force. To make matters worse, this is a baby we’re talking about.
Yes, penile cancer does exist and yes it is a terrible disease…but so is breast cancer and so are all other cancers.
Do you know how many women in 1000 get breast cancer? The number is far, far higher than the number of men who get penile cancer.
What is the problem with letting your son make it to adulthood with all of his sexual anatomy intact and then letting him make the decision as to whether he wants parts removed later on. Of course he would probably think the rare chance of penile cancer wouldn’t justify it, because most women do not get double mastectomies either.
Therefore your argument is essentially throwing dust and sand in the air trying to convince others that cutting off healthy INFANT genital tissue is ethical when it is obviously not.
1) As usual you are making claims without any references to back it up. Note here that I gave two (2) independent studies, one from Brazil and one from the US that came up with roughly he same number for the fatality rate of male circumcision i.e. about 10-13 people per 100,000 mutilations. In reply you claim one is discredited – without any references, mind you. So what ? The other one is not, so the statement still stands. What is especially important is that the fatality rate were much higher in remote areas, because your argument that genital cutting should be used in high HIV rich areas , i.e. Africa. This means you are advocating for a procedure to be used in a situation where it is known to increase the fatality rate.
2) Yes I had to give a lot of information because I was writing a *reply* to your own post. If you have a problem with that, the source of it is in your own writing. You can’t claim you didn’t know this because the very first line states; “You are spreading a lot of false or dodgy information here, I take them on in the order you posted them”. So this is not a “Gish gallop”, it is a reply to one – yours.
3) You write: >”In any case answers for some are already readily available, e.g. on circfacts.org “
Ha ha ha. The website “Circfacs.org” (with no listed editors or people to contact) is linked to the organisation “circlist” – they even recommend that site on their own web-page, look it up. “Circlist” is a *circumfetish* organisation (someone who has a sexual fixation for the circumcised penis, and/or derives sexual gratification from the act of circumcision itself) belonging to, among others, the convicted paedophile Vernon G. Quaintance. Sorry if I don’t take your reference seriously.
Briefly, and in your order:
1. I have references to back up my claims, but I find that any attempt to post links here results in my post not appearing. It is also time-consuming to look out and copy the bibliographic references, and time is something I have very little of just now. One example is referenced on the circfacts.org website, in the “Medical matters” section, “Risks and complications”, “117 babies die…”. See Wiswell. There are others, and hopefully I will update that section to include them, but it is unlikely to happen until winter-time which is when I do most of my writing. You also continue to be misleading with the Brazilian study. I also pointed out that most of the fatalities were elderly. The African circ program is on fit young males, and it seems the very few deaths there have been are mostly from tetanus infection, so now tetanus jabs are being offered alongside circ. A few deaths from tetanus, bad though it is, is better than millions from AIDS.
2. A Gish gallop consists of a long list of bogus claims. Note “bogus”. A long list of factual ones is not a Gish gallop, no matter how long it is. Your post was a Gish gallop, mine was not, but it would be immensely time-consuming to go through each claim in the detail needed for a proper rebuttal, and would result in unmanageably long posts, which may not even appear (a recurring problem with this site). I’d rather not waste my limited time writing a lengthy rebuttal which may not appear, or if it does may only be read by a handful in people on what is an old thread.
3. Your attacks on circfacts are pure ad hominem. I have raised the issue of Circlist with the circfacts owner, and my co-editors, but it is not up to me to dictate which sites are listed there. Circlist is a mix of material but does include relevant and interesting factual content, and for that reason alone it would be remiss not to include it. Note that there is a “Contact” option on circfacts, so you are just wrong to say there is not. If those involved (other than me) choose to remain anonymous it is unsurprising given the abuse and death threats some of us have received from you people. See the “Cyber-bullying” section on circfacts for examples.
As for Quaintance, he seems to have disappeared since his disgrace. As far as I am aware he no longer has anything to do with any website anywhere. And if you are going to drag up the paedophilia accusation, be aware there have been scandals in your own ranks too. Ever heard of Paul Zimmer, founder of the (now defunct) “Newborn Rights Society”? Caught fondling an 11-year-old boy. And he is not alone.
I have every respect for the arguments above. However, opinions are hopelessly divided between those who believe that circumcision is a holy requirement of religion and/or medically advisable and those who feel that boys, like girls, have a right to their own bodies.
To do something about circumcision I think we need to step away from this binary choice and consider what can be done to minimise the harm of juvenile circumcision. Here are six steps that most people might have a a chance of accepting, even though it may be through gritted teeth for some.
Circumcision is surgery and there are always risks. Infant circumcision is always questionable, because the owner of the foreskin cannot give his own consent to the surgery.
While the moral question remains, some common sense rules could reduce the risks of this surgery.
1 Unqualified people should be banned from circumcising anyone!
2 Incompetent circumcisers should be banned from circumcising anyone else!
3 Dangerous traditional practices such as metzitzah b’peh (oral suction of the circumcision wound) should be discouraged by public education and other suitable measures.
4 Before anyone is circumcised, an independent doctor must certify in writing that the person is free of any bleeding disorders and any other contra-indications and is strong enough to withstand the surgery. It is scandalous when bleeding disorders are discovered after a child’s life is endangered by uncontrolled bleeding
5 No child should be circumcised against the objection of a parent. The informed and written consent of both parents should be mandatory.
6 If a man or an older child is forcibly circumcised against his will, this should be treated as a sexual assault, and the perpetrator prosecuted accordingly.
These rules won’t interfere with most circumcisions and they don’t answer the ethical problem of circumcising young boys, but they would reduce the medical risks of this operation and deal with other abuses.
Same argument can be used for female circumcision. So should we, instead of banning it, require it to follow the same ruling you proposed here to reduce the medical risk?
I don’t think so.
Michael Glass’ suggestions are perfectly reasonable. The comparison with female circ (FGM) fails as FGM confers no significant health benefits, only risks. At least male circ has benefits, although the debate rages on whether they are enough to justify the procedure outside of high-HIV settings. In those settings it is certainly justified.
As I understood Michael’s argument, he said that it would be done nevertheless so it shouldn’t be forbidden but ruled to minimise harm. With “it” he meant MGC but I say that this applies for FGC as well.
It doesn’t matter for this argument if the procedure has health benefits.
Female genital cutting reduces promiscuity, which in turn helps reduce transmission of sexually transmitted diseases. That’s a potential health benefit. However, female genital cutting is considered immoral and is illegal.
Your arguments supporting male genital cutting are disingenuous and hypocritical.
I don’t think that the ban on female genital cutting is going to be overturned. In fact, the campaign against female genital cutting is making headway even in countries that traditionally practised it. See https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5422681/
That leaves male circumcision to be dealt with. I think there are two choices: regulating circumcision or banning it for juveniles.
Regulating circumcision as I have proposed will help to minimise the harm of this procedure and could be supported by many supporters and opponents of the practice. Condemning this reform because it doesn’t go far enough will allow certain harms to continue.
* The forced circumcision of grown men will continue to be downplayed instead of being treated as a sexual assault.
* Haemophiliac boys’ lives will continue to be put at risk.
* Unqualified people and incompetent doctors will continue to butcher boys’ genitals.
* Boys will continue to be circumcised on the authority of one parent (or perhaps a grandparent) against the will of another parent who objects.
Of course, some argue that these reforms don’t go far enough, and they oppose them. I say that 100% of something is more than 0% of everything. Remember that William Wilberforce took decades to ban the slave trade, and even longer to ban slavery in the British Empire. The Reform Bill of 1832 extended the franchise to the better off. It was 1867 before the franchise was widened again and only in 1884 that the majority of males got the vote. Manhood suffrage (and votes for women over 30 was achieved in 1919, and universal suffrage only in 1929.
I hope you will continue to push for infant circumcision to be banned. Pressure like this is the only way to achieve more moderate reforms. All I ask is that you consider whether opposing partial reforms could be counterproductive.
While the suggestions offered by Glass involve harm reduction, they are already in place with regard to U.S. hospital circumcisions. However, even those ‘standard of care’ surgeries involve intrinsic harm through the functional losses imposed by circumcision. Some of this physical, sexual and emotional harm is documented in a survey of over 1,000 neonatally circumcised men [Hammond T and Carmack A. Long-term adverse outcomes from neonatal circumcision reported in a survey of 1,008 men: an overview of health and human rights implications. Int J Hum Rights. 2017 21(2):189-218; and also online at the Global Survey of Circumcision Harm.
As a recent California case reveals “it should be self-evident that unnecessary surgery is injurious and causes harm to a patient. Even if a surgery is executed flawlessly, if the surgery were unnecessary, the surgery in and of itself constitutes harm.” [California Court of Appeal, Second District, Division 3. Tortorella v. Castro. No. B184043. 2006].
Although regulation is a reasonable sounding interim step, the regulatory landscape is very uneven. In portions of Africa, where genital cutting of boys is done under the same rudimentary and unsterile conditions as female genital cutting, regulation to achieve harm reduction can be a useful first step. But as many female genital cutting opponents have taught us, when genital cutting is medicalized it makes it harder to eradicate. In many Nordic countries, like Sweden, genital cutting of boys is already highly regulated. Those countries are likely to be among the first to take the next step – total prohibition except when medically indicated – in order to address the intrinsic harm of even well-regulated circumcisions (i.e, the functional loss of the foreskin’s benefits, the loss of genital autonomy, and the violation of bodily integrity). Like most social change (women’s rights, marriage equality, etc), the world with regard to genital cutting of boys is likely to become a legal patchwork ranging from being totally unregulated to totally prohibited.
Tim, I think you have answered your own question when you wrote: ” In many Nordic countries, like Sweden, genital cutting of boys is already highly regulated. Those countries are likely to be among the first to take the next step – total prohibition except when medically indicated – in order to address the intrinsic harm of even well-regulated circumcisions” It worked with the banning of the slave trade and then the banning of slavery. It worked with votes for all. Yes, it will yield results that are uneven. Yes it will take a long, long time. But it will work..
Some issues with Notini & Earp’s (N&E) article:
Re complications. No one denies that these can happen, but the vast majority are minor and easily, and fully, resolved. Serious ones such as partial, or total, amputations are exceedingly rare. Tragic though these are they have to be balanced against devastating complications of foreskins themselves. Gangrene from paraphimosis, necrotising fasciitis from phimosis, and penile cancer, can all result physical loss of part or all of the penis, and the last is not rare (very roughly 1 in 1000 men in their lifetimes in developed countries, many more in developing countries). In short, a male is more likely to suffer a devastating consequence from not being circ’d than he is from being circ’d. Add in many more suffering renal damage from UTIs, or HIV infections, or any other infection circ prevents, and the toll of human suffering from failing to circumcise is surely “ethically significant”. Surely we should be asking which option reduces human suffering more, circ, or non-circ?
The foreskin is “erogenous tissue”. The paper N&E cite did not test erogenous properties, and referred to an old one which likewise merely asserted the erogenicity of the foreskin. The most extensive review of the histology indicates that the foreskin is not especially erogenous, but the glans is the most erogenous part (PMC4498824). Certainly, when men are asked to rank the different parts of their penis according to how erogenous they are, they put various parts of the glans and shaft first, the foreskin last (pubmed/19245445).
“most sensitive part of the penis to light touch”, he says, citing one of Earp’s own articles which is actually a commentary on a paper by Bossio et al. Why not cite the primary source? I shall return to this issue of self-citing later, but this obsession circ opponents have with “light touch” (more usually referred to as “fine touch”) is misplaced. This type of sensation comes mostly from Meissner’s corpuscles, but these are small and sparse in the foreskin. The greatest concentration is in the finger tips, and they are the largest too. But one does not get an orgasm by rubbing fingertips. Light touch is irrelevant, it is erogenous sensation that matters, and the nerve endings for that are abundant in the glans, but rare or absent in the foreskin (PMC4498824). In short, light touch is a red herring.
N&E overlook a great body of evidence, including high quality studies (cohort and RCTs) of men circ’d as adults, and finding no difference, or an improvement in, sexual function and pleasure following circumcision.
“A person can always choose to have their genitals cut later on in life, if that is what they want” But, unless incentivised (e.g. by seeing friends and relatives dying of AIDS in blighted countries) few will, even though they are favourably inclined towards the idea. There are barriers (painful erections, need for abstinence from sex during healing, cost …) that deter men from having the procedure. I explore this in detail on the circfacts.org website (“Medical topics/General information”). It is actually a very poor argument.
UTIs – are more common in boys in early infancy (which N&E indirectly acknowledge) but that is when the risk of renal damage is highest (which N&E ignore). They blithely dismiss UTIs as being curable with antibiotics, but ignore the fact that they are increasingly antibiotic resistant. What then?
Number of circs to prevent one penile cancer is about 900 according to the American Cancer Soc. That is actually rather good, and better than for many vaccines. Those afflicted by this dreadful disease might think it well worthwhile.
If adult circ protects against STIs why shouldn’t infant, once he has grown up?
Re the opinions of health authorities: most have not even attempted a thorough science-based analysis of the evidence. It is telling that of the three that did, two (AAP & CDC) concluded that the benefits exceeded the risks, even in developed countries. And the third (the Canadians) thought it “closely balanced”. Other policy statements seem to be ideology-based, rather than science-based.
The AAP’s “2012 policy is now expired”. According to their website this fate seems to be arbitrarily applied to all AAP policy statements after 5 years. Can we apply it to all those anti-circ European policy statements over 5 years old? And what about AAP statements on, say, vaccination, or antibiotic use, or anything else that they neglect to update after 5 years? Unless superseded, the 2012 statement remains their most recent, and the one US physicians will defer to.
“a representative from the AAP Circumcision Task Force acknowledged significant problems with the AAP findings and methodology” say N&E, referring to an article by Freedman who has complained that he was misrepresented, and to an article of Earp’s own (again) in which Earp complains about “cultural bias” in US medicine, even though the AAP threw this accusation straight back at its originators (mostly Europeans), for whom it is far more applicable.
Circ is now recognised as vital in the war against HIV and is being heavily promoted in epidemic settings in Africa. The epidemic is unlikely to be turned around without it. N&E seem oblivious to the message the Icelanders (and others in developed countries) are sending out. Just when Africans are being told to circumcise, they see Europeans saying this is wrong, or not good enough for them. This is being flagged on social media and has potential to do great harm if it undermines the African circ program, a program that is set to avert millions of new HIV infections. Are a handful of Icelandic foreskins really worth the lives of millions of Africans? Perhaps N&E can direct their ethical skills to that issue.
In an article in the UK “Skeptic” magazine (debunked in the “Debunking corner” of circfacts.org), Earp berated a critic for self-citing. Yet does this himself in the article above, and lists a load more of his “key readings” at the bottom of his article. I am not sure if the appropriate expression here is the pot calling the kettle black, or the one about people who live in glasshouses. But since he is fond of self-citing himself he can hardly complain if I do the same, so I invite readers to check out my latest article on the topic, just published in “The Pink Humanist” Go to thepinkhumanist.com and look for “Circumcision: regulation not prohibition” Enjoy.
Moreton claims that there is part of the penis that studies show is not erogenous. That is for its owner to decide. Plenty of men say the foreskin is the best part.
There will be no studies found supporting the reasons NOT to slice off children’s earlobes or pinkie toes. So should we allow these acts? The value of a whole intact body is self-evident. And not having a whole intact body is a harm. Further, infant circumcision outcomes are very haphazard. In addition to 100% loss of foreskin – including loss of its protective function and direct contribution to sensation – cases of skin bridging, skin tags, iatrogenic asymmetry, pits and gouges to the glans, painful tightness upon erection, bulgy painful truncated vein, meatal stenosis, and other unintended effects no cutter would brag about are easy to find.
Moreton claims that circumcision is vital in the fight against HIV in Africa. What has a disease transmitted by adult behavior to do with Icelandic children? Further, just because a practice like circumcision is credited by some as having such a benefit IS NOT to say there aren’t easier less-destructive ways to garner the same or superior benefit (e.g. condom use). The African controlled trials were not studies about the best way to fight HIV, they were studies of how to justify circumcision. And Gray, who did the Uganda trial, later found that males he cut to evaluate male-to-female transmission infected their female partners 50% more often than the men he left intact did, washing out the supposed female-to-male transmission reduction. And nobody has bothered to repeat that research to fine-tune our understanding of this. Until someone does, circumcising Africans or Icelanders to fight HIV is comically irresponsible.
One can find studies showing African FGM victims have reduced HIV incidence. Would that ever justify cutting Iceland’s children?
I will only address one claim you make here (I have dealt with other false claims in an earlier post) You write:
>”Gangrene from paraphimosis, necrotising fasciitis from phimosis, and penile cancer, can all result physical loss of part or all of the penis, and the last is not rare (very roughly 1 in 1000 men in their lifetimes in developed countries, many more in developing countries).”
This is a complete fabrication (and I do notice) that you give no references. We have 10 million people in Sweden and the rate of genital cutting is very low. So given your data we would expect to see 5,000 cases in this country. We don’t. In Japan there are 150 million people, given your claim we would expect to see 75,000 cases – we don’t. But please give the reference to where you got the information so I and other can check it.
Oh and in regards to penile cancer. If circumcision is so good at preventing it, why do Denmark, Finland and Japan (where most males are not circumcised) have lower rates of this cancer that the USA where about 70% of the male population is generally cut? That is a negative correlation.
Penile cancer rates in Sweden are here: https://onlinelibrary.wiley.com/doi/epdf/10.1111/bju.12993 2.1 cases per 100,000 men per annum. To arrive at a lifetime risk one must multiply by an average life expectancy (82.55 years for Swedish males). This is a slight oversimplification as the age distribution of penile cancer patients is skewed (more in older males) but it will suffice. Thus 2.1 X 82.55 = 173.4 men in every 100,000 will get penile cancer in the course of their lives. 100,000/173.4 = 577. I.e. 1 in 577 non-circumcised Swedish males will get this terrible disease. So when I said “very roughly 1 in 1000 men” I was clearly erring in your favour. The truth is actually a lot worse. Swedish males are even more prone to penile cancer. Thanks for pointing this out.
I have no idea how you arrive at your figures. And I note you give no sources. Perhaps you are too quick to believe the pseudoscience you find on anti-circ websites.
Hellow my name is Martinmaype. Wery proper post! Thx 🙂
With all due respect Stephen, perhaps you should watch a live infant circumcision. It’s pretty traumatic.
I won’t deny that there are some (but very minor, if any) health benefits. But I will deny that it is ethical to subject any infant to what amounts to unnecessary genital surgery and the pain and suffering that it causes.
Women suffer more incidence of UTIs and genital conditions than men. What solution do we have for reducing the incidence of UTIs in the female population? Obviously surgery is rarely if ever considered.
Perhaps maintaining basic personal hygiene and cleanliness is more effective. Perhaps being more careful who you share your genitals with is more effective. And then we have condoms. All of these three measures are much more effective than painful and traumatic genital surgery on an infant.
There is a reason why most of the Western world have largely abandoned the practice. To that end, anyone who really believes that this procedure does anything other than cause unnecessary pain and suffering is bordering on delusional.
I am not claiming that it is always unnecessary. But it is almost always unnecessary. There are a handful of conditions – paraphimosis, repeated infections, scarred or damaged foreskin, various skin problems where it would be necessary. But the vast majority of boys do not need to be subjected to painful and traumatic surgery. This is where the ethical problem is.
If it is healthy tissue it should really be left alone.
And this procedure is in no way comparable to immunisation shots or other routine procedures. It is vastly different. One good example of why it is different: It was originally introduced in to medical practice in the USA as a way to deter masturbation since the pain caused by the procedure would have a deterrent effect on the mind of the boy who is subjected to such extreme genital pain. To me that is an egregious breach of the bodily integrity and human rights of the child. No child should be forced to suffer genital pain unless it is deemed absolutely necessary – certainly not routine!
I’m not saying the procedure should be banned outright, but it needs to be heavily regulated and only resorted to where other treatments have proven ineffective.
Hundreds of thousands of men – Jews and Muslims among them – are doing non-surgical foreskin restoration to undo some of the predictable sexual damage of childhood circumcision. Informed adults can decide for themselves.
You say that we should not circumcise Jewish children (this would apply also to Muslims, but I speak for myself as a Jew) because children may grow up to want to follow a different value system. However, in banning circumcision you are stealing Jewish children away from being a member of the covenant as they are growing up. This is cruel to many children who feel a need for belonging to a religious community and to have a religious identity. In banning circumcision you would exile children from the covenant and only allow them to return when the state deems it allowed. Thus the state would, in fact, be intervening and regulating religious beliefs, though in preventing choice rather than forcing one. It is de facto discrimination to prevent children from being members of only a couple select religions until they come of age. The only way to avoid this de facto discrimination is to prevent children from being a part of any religious community until they come of age.
The dream of a universal normative morality is more-or-less dead, or at least the desire to apply it by force to other people’s has been rightfully criticized. We decide that we only intervene to enforce negative norms when we are defending someone who agrees with such a norm. In the case of the child who cannot speak for themself, the move to apply your own norm on this blank slate reveals that you still believe that you possess the true universal normative morality.
Additionally, the fact that you point to Jews identifying as “non-religious” as support for not respecting Jews’ choice to circumcise shows a complete lack of understanding of Jewish identity in the 21st (going back to the 19th and 20th) centuries. A Jewish identity is complex, and does not solely follow the Protestant conception of religion that was standardized over the past few centuries. The conception of religion under the Protestant conception of religion was done by Moses Mendelssohn, whose conception of Judaism not all Jews identify with (hence they are not “religious” in the Protestant categorization as such.) Your analysis of the state’s respect for religious practices is based in the Protestant model and so has to be reevaluated when you are addressing other cultures.
Hi again Eliyahu,
My co-author and I fully respect all Jews’ choice to circumcise themselves; our concern is with adults who want to circumcise other people besides themselves, namely, children who are not yet capable of refusing. I understand that Jewish identity is complex; I said only that if a religious reason is required for the state to permit childhood genital cutting, then those Jews who do not identify as religious, and thefore do not seem themselves as acting on behalf of religious reasons, would arguably not meet that criterion. One could respond to this by saying, “Well, genital cutting should be allowed for religious reasons in the Protestant sense, but also in the service of a complex ethnoreligous group identity,” and then perhaps the answer would be different. But the distinction between “religious” and “non-religious” (in the Protestant sense) has been used in Western law to prohibit all forms of female genital cutting, including forms that are less invasive than male circumcision as practiced in Islam and Judaism, precisely due to the law’s failure to recognize parents’ complex enthoreligious identities as a sufficient basis for cutting their children. I have argued elsewhere that “religious” reasons should NOT be given any more (or less) respect than complex enthnoreligious identity-based reasons (see my co-authored essay “Reason and Paradox in Medical and Family Law”), so I think the law is out of touch and inconsistent. Thus, it is not my personal understanding of Jewish identity that was at issue in the paragraph you are referring to; rather, it was the prevailing Western legal conception of religion and religious reasons, which that same paragraph could be seen as calling into question.
Sincerely,
Brian
Out of curiosity about Judaism: Because an infant or child can’t decide about circumcision, would god really deny the covenant to an uncircumcised innocent little boy who can’t change anything about the circumcision decision of his parents?
Would god deny the covenant to the boy to punish the parents?
Hello Eliyahu – thanks for your feedback. We do not say anywhere in the article that Jews should not circumcise their children because the children may grow up to follow a different value system. We also do not call for “banning” circumcision. We provide reasons for and against different decisions parents may make, and for and against different positions the state might take given its role in restricting other religious practices.
A covenant is an agreement. An infant cannot agree to anything. It is the father or parents or community who are “agreeing” to do something based on their understanding of what God wants them to do. The state cannot possibly evaluate parents’ theology; it must remain neutral to such matters and consider only the ‘earthly’ interests of the child.
If a Jewish boy is not circumcised, and grows up to desire to be a part of a covenant that requires the sacrifice of a part of his penis, then, given that he will be mature enough to understand something as complex and abstract as ‘being in a covenant with a deity’ he will probably be in a position to make a relatively more considered choice about whether to undergo a surgery on his genitals. Thus, he will indeed have the choice to be a part of the covenant, right around the time he is competent to evaluate such metaphysical claims.
There is an important asymmetry here in terms of who is robbed of what if circumcision is not permitted until an age of consent. A child who is circumcised in infancy and grows up to reject his parents’ religion will have forever lost a part of his penis; there is no recourse for him. A child who was not circumcised, but, upon reaching an age where he can actually understand that he is ‘not a member of a coventant’ (I’m not sure what that means as on most interpretations a boy is Jewish if his mother is Jewish, and it is up to the community whether they welcome him or exclude him) then he can enter into the covenant by making a sacrifice commensurate with his desire to be included. The latter boy seems in a much better position than the former: essentially, as soon as he understands what you describe as the ‘cruelty’ of his not having been circumcised, he is able to rectify his situation by his own volition. If he is too young to understand that he is ‘not a member of a covenant’ then he won’t see it as cruel.
You write “many children … feel a need for belonging to a religious community and to have a religious identity.” That seems right. Are you suggesting that a Jewish boy who has not been circumcised, but who has had that decision left to himself, cannot belong to a religious community or have a religious identity? Jewish girls are not circumcised, and they they seem fully capable of belonging to a religious community and having a religious identity. As I said, if there is a Jewish boy who has not been circumcised and, perhaps due to ostracization from others in the community (which is their decision; it is not a foregone conclusion), does not feel a part of his religious community and wishes he had a stronger religious identity, he has an option available to him: he can undergo circumcision. The boy who does not want to have a religious identity surgically imposed on his genitals, by contrast, has no similar means of rectifying an undesired situation.
Warmly,
Brian
Hi Brian,
Thank you for your thoughtful response. I understand that the intention of this article is not to specifically make advocate one side or another, and would like to respectfully withdraw my heated claim that you were specifically calling for a ban. Still, I think my comments hold on the level of the evaluation of the sides. The primary mistake I think you are making in evaluating Jews’ religious claims is to take a modernist view of covenants and religion in general. The covenant is not made between an individual and God, but between the entire Jewish people and God. (This does not mean that Jews do not have a personal relationship with God, of course.) The language that you use of religion as an individual agreement speaks to a Protestant, post-Kant understanding of religion and how religion relates to the state that does not encompass many Jewish understandings of Judaism. This is, I think, the primary difference which is leading to the cross-cultural difficulty. You talk about an uncircumcised (let us say for simplification) cis-male Jew being able to enter the covenant after coming of age. This still necessarily means he was excluded before, and so the state would have already, as I said, legislated religious affiliation.
Jews have historically considered themselves to be a separate people, were often treated as a state within a state, and the religious practices developed in rabbinic Judaism reflect this self-understanding and self-governance. To now force a different way of relating to the state is to force a different self-understanding on the Jewish people. In this way, the state cannot possibly be remaining “neutral” to theology as you advocate. The ban impacts religion, so it evaluates theology even if its only insofar as refusing to include it in the conversation.
I also think that your analysis still relies on assuming that circumcision is itself a harm, since, if it is not, your talk of having “recourse” for it would be unfounded. This would be an aspect of the presumed-as-default value system that I criticized above.
Regarding what you said that touches on halacha (Jewish law), a Jew can be a Jew by matrilineal descent but still experience exclusion from worldwide Judaism in not sharing the same tradition that Jews have practiced for over two millenia. There is a difference between being a Jew and being part of and keeping the covenant. I speak to this on the level of Jewish law more elsewhere (I think I accidentally put it as a separate comment rather than in this chain.) Regarding Jewish girls, they are not required to be circumcised, so of course Jewish girls won’t feel excluded for not being circumcised nor does halacha have rulings regarding their not being circumcised.
I also still wonder what your thoughts are regarding the state assuming the prerogative to force its value system on the blank slate of the unspeaking child over and above the protestations of the Jewish community. Does this not suggest that the state considers its own value system to be the default, and thus retains aspects of assuming a universal morality?
Best,
Eliyahu
Hi again Eliyahu,
Thank you for such a thoughtful reply. Yes, Western law is founded on post-Kantian, post-Enlightenment principles that recognize the individual as the fundamental unit of moral analysis. I think there are very good reasons to prioritize the individual over the group in multi-cultural societies, where people are constantly exposed to different norms and value systems, and where conformity of thought, identity, and so on, cannot so readily be maintained or enforced by sub-groups within the larger society. Nevertheless, it seems to me that if a group living within a society whose legal framework is (for whatever reason) oriented around individual rights, especially when it comes to matters of body self-ownership, asserts that it has a completely different metaphysical understanding of the world, whereby (male) children’s genitals actually ‘belong’ to the group with which their parents affiliate and not to the child himself, and therefore the laws that generally prevent parents from removing parts of their children’s bodies do not apply to them, a deep tension is introduced that needs to be resolved. In principle, any religious (or other) group could say, “Yes, we understand that it is illegal to do X in this country based on Y underlying principle, but in our religion, we don’t see the world that way,” which would make every religion a law unto itself. This is completley untenable. It is one thing if members of a religious or enthoreligious group really do form a separate (I guess, theocratic) state and lay down different laws based on an entirely different understanding of the metaphysics of morality, but that is not the situation we face in a place like Iceland. Moreover, it seems clear that most Jews living in Western states are perfectly happy to accept the post-Kantian, post-Enlightenment metaphysic that gives them individual rights, bodily self-ownership, and so on: thus, if someone tried to cut off part of *their* body without their consent, they would strongly object and would presumably appeal to the moral and legal prohibitions in Western states on violating another’s bodily autonomy, and regard these as perfectly reasonable and respectable. My only point here is that children, being the most vulnerable members of society, need *more* protection from such un-consented violations than adults. A Jewish child growing up — not in a separate Jewish ethnoreligious state with its own metaphysics, but rather in a larger, multi-cultural, post-Kantian (etc.) Western state like Iceland — is bound to get some mixed messages: when he goes to school, and participates in the wider life of his surrounding society, and studies law, and meets other people from other backgrounds, and generally is confronted with the individual-rights-based worldview around him, he will get the impression that his body is his own, that his genitals are an especially personal and private part of his body, and that no one should be allowed to touch, much less cut, his genitals without his informed consent. But then at home, in the synagogue, in the smaller community in which he is being raised, he gets a different message: you, whether you like or not, from the moment you were born, were already placed into a covenant with a deity you may or may not ‘believe in’ (I realize that is a Protestant formulation), by having part of your penis removed when you were only 8 days old. Your body, your genitals, were not your own; they were touched, and cut, without your consent, and that is because in our community, we have a different metaphysical view than the one in the society around us. How is such a boy to feel? Well, he might very strongly identify with his immediate community and be happy that he was non-voluntarily entered into a covenant at the price of a part of his penis. Or, he might have come to think that those individual-rights-based laws and norms in the wider society, of which he is *also* a member, have something going for them, and, indeed feel extremely resentful about having had part of his penis removed without his consent (this is not a hypothetical case; this is a common story I hear from Jewish men who write to me because of my research). Given this tension, given these competing metaphysics that are operating both at the same time on a person living in a multi-cultural society where he has many identities (his local, Jewish identity, his wider sociocultural or national identity, and so on), it seems to me that it would be best to defer such contestible surgeries until the person whose most intimate body part will permanently be affected them has the opportunity to decide how *he* weighs up those competing meta-ethical views in light of his own understanding.
Warmly,
Brian
Something seems contradictory to me:
You wrote:
“The covenant is not made between an individual and God, but between the entire Jewish people and God.”
and later:
“There is a difference between being a Jew and being part of and keeping the covenant.”
A Jew (even if not circumcised) is part of the Jewish people (or meant this term something else?) and if the covenant is made between Jewish people and God, this Jew is also part of the covenant?
But I agree with you that a state creates to some degree a morality expressed by its laws, e.g. stealing will be punished, so it can be seen as bad; helping people in imminent danger is good because you will be punished if don’t do it, (depends on state and situation, naturally).
Of course a state just has to do that or it couldn’t work. The question is how far the regulations (and implicit formulations of state moral) should go and that is discussed in Icelandic parliament and here.
I would make a distinction between being part of the covenant by obligation and being excluded from fulfilling that obligation.
So there are different levels of participation in the covenant? And the level is individual to a single Jew?
No. Covenant is not the whole of halachah is not the whole of Talmud etc. etc. Look, you aren’t going to be able to read one thing I say and give a witty remark that brings an entire minhag crashing down.
I find it simply fascinating that the same people who promote multiculturalism and demand respect for their own cultural practices, like infant genital cutting in Judaism, are themselves ethnocentric and intolerant of other cultural practices, like female genital cutting.
It has nothing to do with principle and everything to do with self-interest. It’s hypocritical.
Eliyahu,
Sorry to burst your bubble but the government absolutely applies a moral fabric on society through various machinations – including laws and public policies.
Want a perfect example? Look no further than the drug laws.
If the government has the right to tell an adult what they can and cannot put into their own body, then the government is well within their rights to ban infant genital mutilation (also known by its euphemism as circumcision) for non therapeutic reasons – and nearly all cases are non therapeutic.
You’re taking a limited scope as your frame of reference for addressing an issue whose historical context spans over a thousand years and many civilizations. In any case, your quick and dirty equivalence by analogy shows that you aren’t engaging in good faith anyway. If you eventually do want to touch on this issue and want to know where the other side is approaching from, the two big points underpinning the conversation here are Mendelssohn’s reformulation of Judaism in light of the newly invented nation-state and Foucault’s analysis of biopower (more treated in secondary literature than primary to be honest).
It’s not a quick and dirty equivalence but rather indubitable PROOF that if the government wants to ban something they will find a way.
Maybe mutilating infants is a power thing. So yeah maybe forcing genital torture on an infant is equivalent to telling an adult what they can put into their own body.
Let me ask you this: why is abortion legal in spite of the controversy and opposition because a large portion of the population believe it is murder?
Are you aware that abortion violates the commandments prescribed by the Christian and Catholic covenants? So why is abortion legal?
Why does the government ignore religion when it comes to abortion whilst at the same time honoring religion when it comes to cutting the genitals of infants?
Could it be because both of these practices are highly lucrative businesses?
I say it is. And in saying this, I am pro-choice on the abortion issue because I believe that a person has the right to decide what happens to their body, but that is a topic for another discussion even though the issue is relevant to the discussion of circumcision – the core issue being bodily autonomy.
As in all interesting quetsions regarding halachah (Jewish law,) it’s complicated. Rabbi Yosef Shaul Nathanson stated “whoever is uncircumcised is no longer part of Judaism.” Other authorities stated that circumcised is just required before the Bar Mitzvah, which welcomes a male child into the community as an adult. Many authorities were responding to already existing conditions such as those in the Soviet Union, which suppressed the practice, and so they made decisions that would include those who were forcibly prevented from being circumcised. This, however, does not mean that a country should think it is no bother to Jews to ban circumcision.
It is extremely complicated, contentious, and depends on which posek you follow. However, even if one determines that an uncircumcised child is still a Jew, there is still an element of exclusion existing, one that the legal conclusions were trying to ameliorate because there really was a problem in the first place.
Regarding the element of exclusion, this quote from Eliyahu Ungar-Sargon, a filmmaker raised in the Orthodox Jewish tradition, may be instructive.
“If the motivation is religious, postponing the decision until the child reaches majority would actually enhance the religious experience of the practice, because the individual would be cognizant of the fact that he is fulfilling a commandment. … Might an intact Orthodox Jew feel alienated from Judaism as a result of his foreskin? Possibly. But contrary to common belief, there is not a single ritual that an intact Jewish male is excluded from in contemporary religious life according to the strictest letter of Orthodox law. So his feelings of alienation would be unmerited, not to mention reversible.”
Eliyahu Ungar-Sargon. On the impermissibility of infant male circumcision. Journal of Medical Ethics 41, (2015), 186-190.
I think Eliyahu Ungar-Sargon makes a good point. His comments speak to how circumcision is being questioned by some Jews. What I object to is a government de facto making the decision for the religious community. I do not make the claim that an uncircumcised Jew is not a Jew. Rather, an uncircumcised Jew experiences exclusion from the community in many respects, some legal and some psychological, and is not included in the covenant (this is a theological point, not a claim that the individual is not a Jew.)
It seems to me that if a Jewish boy who has a foreskin is being excluded from the community, that should reflect on the community and its practices of ostracization, not on the boy himself, whose only ‘crime’ was not having had a part of his genitals involuntarily removed. And as Ungar-Sargon points out, if he does feel excluded (whether that exclusion is just or unjust) he can remedy the situation by his own volition.
I do not mean exclusion as in ostracization, that would be what is called a cherem. What I mean is more of a psychological (as well as legal in areas such as partaking of the Pesach meal) sense of exclusion.
Brian, I don’t think you are sufficiently grappling with the fact that you’re discussing banning one of the most central tenants of Judaism. No even somewhat religious Jew could live in a country that prohibits circumcision and it amounts in practice to banning the religion. You are free to disprove of it personally but making a central religious tenant like that illegal is not an action to take lightly and your casualness about it shows a lack of epistemological modesty.
Dear Josh,
Iceland, not I, am considering banning circumcision. In the piece, my co-author and I discuss the reasons behind the ban, reasons against it, and so on. If there is a particular argument you take issue with, I would be happy to read your critique and think about it and respond as best as I can. If your only critique is that you regard the post as expressing a “casual” perspective, I don’t know how to respond to that, other than to say that I do not at all regard this as a casual issue, and I am well aware of the importance of circumcision in traditional Jewish practice.
Sincerely,
Brian
premalignant disease that can transform into penile cancer years later. This has been reported from has England and other European countries.
The incidence of PCIS in England rose from 19 new cases reported in 1979 to 193 new cases in 2011, the year for which the most recent data are available.The data come from the cancer registration and mortality records maintained by the Office for National Statistics in England.
“This trend in the annual number of cases reported represents a 915% increase,” say the researchers.
The main driver of this disease is human papillomavirus (HPV). Rates of other HPV-associated conditions have increased in recent years, including genital warts and anal cancer and head and neck cancer. In particular, there has been a large increase in HPV-associated throat cancer in men, which has been linked to oral sex and more generally to an increase in sexual partners, a result of the “sexual revolution” of the 1960s.”Human papillomavirus…infection can be considered a major pandemic, causing both benign and malignant disease around the world. It is the most frequently acquired sexually transmitted disease, with more than 6 million new cases transmitted annually in the US. HPV is implicated in the oncogenesis of at least 5% of all cancers, including cervical, head and neck, anal, and penile cancers.”
But there is another factor that is specific to PCIS — circumcision, which protects against HPV infection and penile cancer.Neonatal circumcision rates in the United Kingdom have decreased substantially over recent decades, from an estimated rate of 49%, reported in a paper published in 1949, to more recent estimates of 3.8% (before age 15 years), from a paper published in 2000. Of interest, this more recent estimate is much lower than reported in the United States, where the Centers for Disease Control and Prevention in 2011 estimated a 55.8% to 59.1% national rate of infant circumcision.
The decreasing rates of circumcision and increasing rates of HPV infection could together explain the increase in PCIS, the doctors suggested.
An increase in penile cancer has also been reported in an 2013 paper reviewing the incidence of penile cancer in England which found 9690 men diagnosed between 1979 and 2009. The age-standardized incidence rates increased by 21%, from 1.10 to 1.33 per 100,000.
“The 21% increase in penile cancer incidence in England since the 1970s may be explained by changes in sexual practice, greater exposure to sexually transmitted oncogenic human papilloma viruses, and decreasing rates of childhood circumcision,” those authors wrote, adding: “There is a need for public health education and potential preventative strategies to address the increasing incidence.”
Europe with its mostly intact male genitals has about double the rates for most STI compared to the mostly-cut US. Hookman says circumcision “protects against HPV infection.” That is first quite debatable as the study I saw had the flaw that they ignored the fact that many men die with undiagnosed HPV infection and they didn’t count those. But also, IT DOESN’T protect. Lots of cut guys acquire HPV.
STI are based on adult behavior. Informed adults can decide for themselves what to make of the research and whether a condom does the job, or if losing the most pleasure receptive part of the penis forever is a better course.
Quote: “Europe with its mostly intact male genitals has about double the rates for most STI compared to the mostly-cut US.”
You mean half the rate as the US?
STIs are more common in the USA than they are in Europe. This is undisputed fact. STIs are more common in spite of the fact that most men in the US are cut.
That’s pretty damning evidence that circumcision has a very dubious claim to these health benefits.
The only benefit I can think of is a financial benefit – to the doctors who don’t care about children’s genitals and to those who use the foreskins to generate skin cell cultures. It is a very lucrative business. And who suffers? Millions of baby boys. It is disgraceful.
Thanks, I did mean HALF the STIs among intact Europeans. Sorry for the confusion.
Ok Perry, why don’t we just immunize everyone against HPV then…women get the immunizations so why shouldn’t men? Or should we resort to the cruel, traumatic, sexually damaging and unnecessary cutting the genitals of infants instead?
So instead of immunisation we’ll just slice up a boy’s genitals. Makes sense to me /S
In Australia both boys and girls are offered the HPV immunisation. If this is successful in eradicating cervical cancer and penile cancer this would be a significant medical advance. In any case it would appear that mortality from cervical cancer is greater in the USA than most of Western Europe. See http://globocan.iarc.fr/old/FactSheets/cancers/cervix-new.asp
Wow!!! This got the hares running!! Community Covenant vs Individual Rights of Baby.
Medical a complete side-issue compared to Allah/Jahweh the Creator/s of the Universe.
Well done, Lauren and Brian. Ob the right side of history. X
Cut the crap. Iceland committee has withdrawn proposal from a democratic vote in Parliament.
Get real. Parental Religious Faith belief versus Cutting Babies. If I tried to start a religion to do this now I’d be locked up as anlunatic or a pedophile.
Rabbi Goldschmidt resorts to Nazi argument and breaches Godwin’s Law (q.v.). He loses we win.
Not over yet….
The failure of the reform in Iceland contrasts with the success of a regulation of the practice in Sweden. See this report in The Lancet: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(02)07737-1/fulltext
Why did Sweden succeed in a modest reform whereas Iceland failed?
1 Iceland pushed for a complete ban; Sweden legislated for tighter regulations.
2. There was widespread consultation in Sweden; there was no consultation in Iceland with Jewish groups. See http://blogs.lse.ac.uk/europpblog/2018/04/27/the-problem-with-icelands-proposed-ban-on-circumcision/
3. There was a backlash from some interests. There was a review of the law after several years, but the law was reaffirmed. See http://din-online.info/pdf/fam5-3.pdf
Harm minimisation has a greater chance of success. Going for a total ban on childhood circumcision is just tilting at windmills.
Harm minimization assumes some children are less deserving of protection than others. I can’t believe such a law has stood up to scrutiny. In the US, it would certainly be struck down as unconstitutional as soon as a harmed child (whom the law failed to protect) came of age and sued for lack of due process and lack of equal protection under the law.
Harm minimization also assumes there is some magical dotted line on the genitals and that all procedures cut perfectly on that line and heal up beautifully. But among the reasons to oppose forced genital cutting of children is the haphazard nature of the procedure and the healing.
Harm minimization fails to reflect that 100% of circumcisions result in loss of the pleasure-receptive foreskin, altering sex forever.
No national medical association in the entire world recommends routine infant circumcision. To suggest they do is dishonest. In most industrialized countries circumcision has fallen out of favor and remains a minority practice in less than 10% of infant boys. Except for Muslim countries and Israel who circumcise for religious reasons, the USA stands alone in the world in continuing to circumcise between 25-65% of infant boys (depending on the state), but the practice continues to decline and over time will become a minority practice in the USA, as well. It would decline sooner if the doctors who practice it in the USA would be more honest with parents about the loss of function and long-term harm of amputating this normal healthy human tissue from a baby. The medical establishment readily admits that they don’t know the long-term complications of circumcision because they have never been adequately studied and records are not kept to document it. The fact is that such surgery on a baby is very imprecise so some men have been harmed by the procedure more than others. One man who feels he is okay with his circumcision cannot speak for another man whose circumcision was not performed as skillfully. If an adult man wants to have the surgery then that is his choice. But an infant should not have such body modification forced upon him without medical necessity.
I think a male is very different from a woman. This is for me the main reason because female circumcision is a horrible crime while male circumcision should be mandatory at least at legal adulthood. Women’s bodies deserve much more respect than male body. Our flesh is rough so mandatory circumcision is ok for us, at the contrary female body is gentle and cannot be forced to anything. Any comparison between female circumcision and male one should be not allowed. Anyway I think only women should decide about male circumcision, for it regards their health and pleasure.
Only women should be able to decide about male genital parts? Our flesh is rough? Women deserve much more respect than men? Wow, who is behind this message? This is like the most ridiculous I’ve ever read. This time I wasn’t angry, these comments were so comical I nearly gave myself a hernia.
On a serious note, men own their own genitals…nobody else. Not women, not parents, not religious leaders and not the government.
Ok, Benjamin Dowse, when you’ll stop of laughing start your protest against every nation in the world to conscript only women, because until now only men was considered cannon fodder, so now is the turn of women, because men deserve the same respect then women. After let me know the success of your protest. Thanks. Please write to Selective Service System first of all.
Obviously my last comment was sarcastic. I’m glad, like all men in the world, that conscription is for men only. Women will never be cannon fodder.
Looks like resident troll Stefano has entered the building…
Comments are closed.