Monday, December 15, 2014

On Anti-GM (Anti-Circumcision) as a Cultural Prejudice

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NOTE: This is a follow-up post to my first piece on MGM. I would recommend reading it before this (Click Here).
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The Journal of Medical Ethics held a virtual “Symposium on Circumcision” in its June 2004 issue [1], and as an introduction, “S. Holm,” who had apparently already read all of the articles prior to publication, made some remarks that seem to me to have been missing the point in many respects.

The title of his short introduction to the issue was “Is the Opposition to Circumcision Partly Driven by Cultural Prejudices?” [2] In what follows, I will debunk a few of his quotes to the point where I could only conclude that the author’s hyperbole was simply intended to make sure that people read the rest of the issue.

For starters, and to introduce and summarize his remarks:

“When reading the papers I found it strange, but of course not really surprising given its symbolic importance, that we are so worried about interventions on the male penis. Why are we not equally worried about other irreversible bodily and mental interventions to which parents subject their children?” [2]

The answer is that we are (or at least should be) worried about other such interventions, and in fact, in this very same issue of The Journal of Medical Ethics [3], S. K. Hellsten makes the case that both male genital mutilation (MGM) and female genital mutilation (FGM) are questionable practices born out of cultural dogma, which is in turn derived from religious texts in each of such cultures:

“Throughout history human beings have mutilated and harmed their bodies (and minds) in the name of culture, tradition, religion, and concepts of beauty, health, normality, or social status. One of the most persistent forms of these physical violations is mutilation of human genitalia. This practice has been related to: taboos about human sexuality; children’s initiation to adulthood, maturity, and reproductive age; aesthetic values; the demands set by various religions, and to hygienic, individual, and public health medical beliefs.” [3]

And:

“From a human rights perspective both male and female genital mutilation, particularly when performed on infants or defenceless small children, and for non-therapeutic reasons can be clearly condemned as a violation of children’s rights whether or not they cause direct pain. Parents’ rights cannot override children’s rights. If we allow parents to decide what is best for their children on the basis of the children’s religious or cultural identity, we would have no justification for stopping them cutting off their children’s ears, fingers, or noses if their religious and cultural beliefs demanded this.” [3]

So, again, perhaps Holm was merely hyping up the magazine with his statements, while Hellsten made his sarcasm, or reductio ad absurdum, perfectly clear and obvious (Hellsten also mentioned governments allowing cannibalism in deference to religious beliefs, just in case his point wasn’t perspicuous enough).

For fear of quoting only half of the article, I will summarize the rest:

Holm next makes a lengthy comparison between genital mutilations (GM) and ear piercings, and questions whether it is right and proper to perform these types of procedures on very young children without their consent, to which I would say that such a line of thinking is at least a start to a sane policy. But, as referenced in my own earlier post [4], there are cultures where young women and men have been so thoroughly brainwashed into a particular set of beliefs that they will, in fact, agree to being tortured in all manner of ways in order to satisfy their parents, tribal elders or religious leaders.

These “rites of passage” have been the basis for psychological studies concerning harsh initiation rituals of various kinds, and it has been demonstrated that they have the effect of bonding subjects to the larger group (fraternity, sorority, military organization or religion) which sanctions the rituals. [5] This phenomenon is so often observed that it is no surprise that the study was partially sponsored by the U.S. Army, which makes no pretense that it is not “breaking” young recruits so as to “remake” them in the proper “militarized” image.

Anyway, to continue the example, does a young girl who asks her parents to allow her to have her ears pierced compare with Army boot camp? (Sarcasm can work both ways.) Obviously, fully cognizant children do want to become socially accepted as they grow older (ear piercing is generally considered a normal sign of womanly “maturity” or “maturation”), and some are willing to do things more extreme than others to achieve this.

We have to draw rational lines, though, between trivial things that a child might want to do to become an adult, and potentially harmful things, whether harmful to themselves mentally or physically, or harmful to society. One simply cannot compare a youngster wanting pierced ears with another youngster stealing a car or killing someone to join a gang, or ear piercing with truly brutal rituals taking place in third world countries. And, there is likewise no comparison between any forms of genital mutilation, which often require the removal of significant portions of sex organs, and an almost invisible pinhole in the adipose tissue of the earlobe.

Are there any procedures that make sense to perform before a child can speak for themselves? Of course there are. Isn’t this, at least to a certain extent, common sense? For example, we give babies and very young children injections to prevent disease, we treat wounds, we perform emergency surgeries when an infant’s life is in danger, and even though there are some “new age” people who would disagree, we typically remove the placenta and umbilical cord from newborns rather than having it drop off naturally as it would among non-human animals. [6]

However, there is no medically necessary (and currently solidly evidenced) reason to go beyond these very basic common sense things. Until more definitive studies prove otherwise, the potential benefits to MGM are negligible at best, and the benefits to FGM are non-existent. There is no need to carry out such procedures unless absolutely medically necessary, and even that parameter primarily only applies to anomalous cases (medical emergencies).

Holm seems to momentarily come to his senses here:

“No, just as in the case of circumcision the question of whether ear piercing is allowable must very much depend on the risk and magnitude of permanent harm, both physical and in terms of later conscious rejection of the procedure.” [2]

But, do you see what he did there? Or rather, what he does all throughout his article. He uses the fact that many people have their children’s ears pierced, largely as a cosmetic procedure (and often at the child’s insistence!), as a crowbar (leverage) to set up a justification for GM being not such a bad thing.

Is it just me, or is this argumentum ad populum not nearly subtle enough? I can only surmise that most people who draw such equivalences are simply not very intelligent (and I forgive them that). However, S. Holm, according to the article header, is either a student at, or more likely, on the faculty of, Cardiff Law School & University of Oslo.

Go figure.

Finally:

“It is therefore very interesting that the piece of evidence we really need to have in order to be able to assess the status of circumcision is singularly lacking. We simply do not have valid comparative data concerning the effects of early circumcision on adult sexual function and satisfaction. Until such data become available, the circumcision debate cannot be brought to a satisfactory conclusion, and there will always be a lingering suspicion that the sometimes rather strident opposition to circumcision is partly driven by cultural prejudices, dressed up as ethical arguments.” [2] 

Once more, we see the trick; simply denying that there is any evidence of harm when, in fact, there is an abundance. And, his final sentence pushes the argument even further, implying that those who oppose GM have their own cultural axes to grind, when in the vast majority of cases, the situation is just the opposite.

All forms of GM that have been referenced here go back to one or two holy books, and then the cultures that sprang up around them. There is no cultural precursor to merely letting nature take its course. It hardly fits the definition of a “rite of passage” [7] to inform a subject that, in order to become an adult, they need do nothing, which is the actual state of affairs, and does not require slicing off bits of oneself.

A rite of passage is a ritual which involves doing something. Those of us who oppose GM of all kinds instead recommend doing nothing, especially when what is being proposed is a mostly superfluous procedure that violates bodily autonomy and even human rights (as I demonstrated in my previous post on MGM). His implication that the entire issue is just a cultural matter of opinion is nonsense.

NOTE II: I used a total of 33 references in my previous piece on male circumcision (mentioned above), and most of them refer to MGM as well as FGM, so I will just suggest that readers go there for many articles on the subject, both pro and con (link provided below on [4]).

And, to be sure, there are also many sources that try, by twisting logic to the breaking point, to make the case that somehow GM is not only harmless, but in a few ways, desirable. I have added a couple links to such articles at the end of my references list at the bottom of this post, and I think that as folks read them, they will recognize these same tricks and attempts at deception being used repeatedly.

The article that I am responding to here is ten years old, but the debate (especially over male circumcision) still rages even today, and that speaks to the fact that for many people, it simply is a religious or cultural “habit” that they are reluctant to give up, no matter what the science says.

I will just point out that reference [10] from the Mayo Clinic is a rather lengthy and data rich article that refers back to the American Academy of Pediatricians 2012 statement on circumcision, which I believe has been incorrectly characterized as pro-circumcision by many, whereas my reading of the AAP work was that it was diplomatically neutral, and even serves to support the argument that the supposed benefits of male circumcision are not well-evidenced enough to warrant the procedure (they stated directly that they cannot recommend it themselves as a surgery which should be routinely performed).

As always, I am prepared to go wherever the research leads, and that path is subject to change without notice. My main objection to GM is that it is most often not done for necessary reasons of health, but for misguided cultural and religious reasons (or based on erroneous beliefs about medical benefits), and what lies at the root of these reasons is frequently a fairly demented view of human nature.

Ending GM (or Male Circumcision):

Of course, the primary solution for ending GM (or, more specifically, in this case, male circumcision) is for everyone to agree to go where the science leads. At one time, a large number of children were having their tonsils removed to prevent various types of infections. Later, it was shown that this procedure had the opposite effect. We know that there is nothing in the Bible about tonsils, so we can examine the meandering course of medical science in isolation in that instance. [8]

What is required now is for the public to be given the clinical facts related to circumcision so that they can make informed decisions on the issue themselves, and where there are matters of public policy, that policy should be informed by the science of the topic as well. Not by archaic cultural traditions, norms and/or customs.

Some aspects of the science may yet be in doubt, but for the most part, it is settled that GM, at least in general, is too risky and unnecessary to be performed without sound medical reasons, of which there are few (or none).

Author: Krista [@Femitheist]
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NOTE III: Part of the motivation for this follow-up piece was seeing similar arguments to some/much of the above appearing in numerous places (including comment threads on various videos and articles).

NOTE IV: I did not go into great detail in this post on specifics already addressed in my first MGM piece to avoid unnecessary repetition. Nearly all of the information that was not included in this can be found there.

NOTE V: For reasons that have not changed since my earlier post, I still support IntactAmerica and Foregen and the terrific work that they do, and I hope that rational people reading this will do so as well, however possible.

NOTE VI: Leave your thoughts in the comments below, and share this article if you like it.
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References (Last Accessed on December 15, 2014):

[1] Journal of Medical Ethics June 2004 Volume 30 Number 3.

[2] S Holm, Irreversible bodily interventions in children, J Med Ethics 2004;30:237 doi:10.1136/jme.2004.009001.

[3] S. K. Hellsten, Rationalising circumcision: from tradition to fashion, from public health to individual freedom—critical notes on cultural persistence of the practice of genital mutilation, J Med Ethics 2004;30:248-253 doi:10.1136/jme.2004.008888.

[4] Krista [Femitheist Divine], Male Circumcision (MGM) is a Matter of Bodily Autonomy, Fethez Hub, July 17, 2014.

[5] “Aronson, Elliot; Mills, Judson. The effect of severity of initiation on liking for a group.Journal of Abnormal and Social Psychology. 1959 Sep; 59(2):177–181.”

[6] Gillian Mahney, ABC News Health Blog, New Birthing Trend, Don’t Cut the Cord.

[7] “Right of Passage” defined (Websters):

[8] Stuck, B. A., Windfuhr, J. P., Genzwürker, H., Schroten, H., Tenenbaum, T., & Götte, K. (2008). Tonsillectomy in Children. Deutsches Ärzteblatt International,105(49), 852–861. doi:10.3238/arztebl.2008.0852

Other Articles Partially or Fully Justifying GM:

[9] A M Viens, Value judgment, harm, and religious liberty, J Med Ethics 2004;30:241-247 doi:10.1136/jme.2003.003921.

[10] Brian J. Morris, DSc, PhD; Stefan A. Bailis, PsyD; and Thomas E. Wiswell, MD.
“Circumcision Rates in the United States: Rising or Falling? What Effect Might the New Affirmative Pediatric Policy Statement Have?”
2014 Mayo Foundation for Medical Education and Research. Article referenced at: