Men should have the right to choose circumcision, not have the choice forced upon them. Infant circumcision without consent or immediate medical justification is an unjustified violation of basic human rights, that shares more in common with ancient coming-of-age rituals than responsible medical practice
There are still many people who like to pretend that infant circumcision and genital mutilation are not the same thing. Some of them apparently work at Indonesia's health ministry, the Departemen Kesehatan, who recently issued guidelines for 'safe' female circumcision and wheeled out a spokeswoman to dispense the following words of wisdom: "I would like to stress that female circumcision is not genital mutilation, which is indeed dangerous. They are two things that are very different."
This nonsense comes from the same ministry that recently pushed the idea that swine flu was an American conspiracy - a sinister plot to achieve something or other through some improbable chain of unlikely events – and it isn't surprising that logic isn't their strong point. And yet the same attitude is widespread in Britain. Thousands of people believe, against all logic and reason, that male infant circumcision is somehow not genital mutilation.
Mutilation is a loaded term, so let me be clear what I mean. I don't mean that circumcision is mutilation. If consenting adults want to modify their bodies by snipping a bit off here or adding a bit there, then that's their right, and beauty is very much in the eye of the beholder.
Infant circumcision is a completely different matter. Infant circumcision involves performing surgery without consent to permanently alter an individual's genitals. In many cases this is done without good medical justification, for example to force the infant to conform to the expectations of a particular religion. Just as we call sex without consent 'rape', circumcision without consent or reasonable justification should be called 'mutilation'.
The practice became popular in the United States as a 19th century tool to stop boys masturbating. Female circumcision is ultimately a brutal means of oppressing women's sexuality, and male circumcision was intended to achieve the same.
Writing about the practice in 1978, Karen Paige suggested that, "When a custom persists after its original functions have died, it may be accorded the status of a ritual." Circumcision failed to stop masturbation, but became engrained in the American consciousness as a bizarre rite-of-passage, a throw-back to the burnings, whippings and cuttings still practised in other tribes around the world.
Divorced from its original purpose, circumcision has become a treatment in search of a disease, and post hoc justifications abound. Surveys suggest that the two most common rationalizations invoked by parents are hygiene and appearance. The hygiene argument is self-evidently daft – for no other part of the body do we advocate "chop it off" over "wash it more thoroughly" as the preferred option for improving hygiene. As for aesthetics, for a parent to be that concerned about the cosmetic appearance of their baby son's sexual organs is frankly a bit disturbing, but surely it should be for the individual to decide?
Health benefits of circumcision are commonly cited, but tend to evaporate when challenged, with medical professional bodies tending to dismiss it as a question of personal choice. The British Medical Association for example states that, "the medical harms or benefits have not been unequivocally proven but there are clear risks of harm if the procedure is done inexpertly." PZ Myers assessed the claims in blunter fashion recently, calling them "total bullshit":
"There have been progressive excuses: from it prevents masturbation to it prevents cancer to it prevents AIDS. The benefits all vanish with further studies and are all promoted by pro-circumcision organizations."
The most recent of these excuses invokes the spectre of AIDS, used as a justification for heavily promoting circumcision in Africa. A range of studies claiming to show that male circumcision reduces HIV transmission have been seriously flawed, most recently a trio of trials conducted in Kenya, Uganda and South Africa.
Robert Van How and Michelle Storms produced a well-referenced response earlier this year that documents the issues far better than I can here, but some of the problems should be fairly easy for the curious reader to spot. The studies are host to a catalogue of clear biases - for example the short length of the trial means that men circumcised were unable to have sex (for obvious reasons) for a significant chunk of it. The authors make the flawed assumption that all transmission was due to heterosexual sex, which is a) wrong and b) makes it a poor test of the hypothesis that circumcision reduces sexually transmitted HIV.
Most damning though is the fact that if the trials are correct, and circumcision provides major protection from sexually transmitted HIV infection, then the impact should be obvious in the wider population. It isn't, and the authors cite several countries where circumcised men are more likely to be HIV infected than intact men. In fact survey data across 19 countries showed no association between circumcision and HIV risk. Even if there were, the same benefits could be achieved through voluntary circumcision of adults.
Physical merits and demerits aside, infant circumcision has had a profound psychological impact on many men. "I can't get it out of my mind how I have been mutilated against my will," reads one testimony on the website of the charity Norm UK
I spoke to several circumcised men in the course of writing this article, who were kind enough to allow me to share their experiences with you. I'll be posting more of their testimony (and that of others) in a follow up to this post, but for now a couple of quotes are worth highlighting.
Philip, from London, told me how he felt when he first became aware of his status as a small child:
"I wanted it covered up. I felt mutilated. I also felt that my parents had abandoned me; why had they let someone do that to me? I had such a feeling of helplessness and abuse due to my circumcision."
His advice to parents considering it now?
"DON'T. Even if you think it may be necessary later, wait until later to see if it really does become necessary."
His thoughts were echoed by James, also from London:
"As an adult my status has always made me feel as if I have a 'condition'. Like being short sighted for example, it can be 'lived with' but is certainly something that I would much rather not have to live with. To think that well-meaning, responsible adults chose to affect in this way is a very sad thought."
If you're still not convinced, try this thought experiment. Imagine waking up tomorrow morning to find yourself tied to your bed and rendered mute, your naked genitals exposed to the harsh glare of hospital lights. Your parents have decided that some skin should be hacked from your penis; perhaps so you can be forced into their religion, perhaps because they don't trust you to clean yourself in the shower, or perhaps simply because they think your penis should look more like your father's.
If you don't like the thought of this happening to you, if this offends your belief in self-determination or the rights you have over what happens to your body, then how can you justify this practice being inflicted on infants? Infant circumcision without medical justification should be called what it is – genital mutilation.
Deliberately inflicting injury on a baby in order to enforce their conformity with a religion, or to satisfy their parents' views on what a penis should look like, is a sick act. It has no place in a modern society. Infant circumcision - regardless of gender - should be stopped.