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Circumcision in boys and girls: why the double standard?

BMJ 2011; 342 doi: (Published 16 February 2011) Cite this as: BMJ 2011;342:d978

Re:Unhelpful to compare male circumcision with female genital mutilation

The only difference in male and female circumcision is cultural bias.

Before asserting that "male and female circumcision are not the same," I'd like to ask the religious and/or ethnic background of the person making the claim.

Are you Jewish? Muslim? Or do you otherwise belong to a cultural or ethnic group where circumcision is socially acceptable, or a requirement?

If so, then you could be pre-disposed to accept "evidence" that male circumcision has "medical benefits," and to reject evidence to the contrary.

This exists for whatever cultural procedure that you name. Go to societies where female circumcision is acceptable, even required, and you will hear the same long list of alibis of why female circumicison "should" happen, or that it should be a "parent's choice."

There is a long litany that people give of why male and female circumcision simply "cannot be compared," all of which are myths that can be applied to either procedure.

People will make claims that "female circumcision is meant to subjugate female sexuality." - Check your history; male circumcision began in the commonwealth as a way to curb masturcbation. Rabbi Maimonides has said that "putting the male organ in as quiet a state as possible" was the purpose of male circumcision.

"Female circumcision eliminates a woman's chances for orgasm." Actually, studies have shown that this isn't true. There are actually varieties of female genital cutting, ranging from a prick to draw blood, the excision of the clitoral hood, the excision of the clitoris itself, and then there is the famous "imfibulation," which involves sewing the vagina shut to leave a small hole. (Actually, according to the New York Times, imfibulation is actually the rarest kind of female genital cutting, comprising of 15% of all FGM annually.) Studies have shown that orgasm is not elliminated, not even the worst kind of FGM. WHERE are people making this claim?

"Female circumcision is traumatic because it is performed when a woman can remember." In some cases, yes. Actually, in Islam, boys are circumcised at ages 7 and 13. Any word on these? Are people aware of "sunnat," a procedure performed in baby girls in Indonesia, Malaysia and Singapore? Would people that say argue that "a boy is circumcised in infancy, thus he doesn't remember" advocate "sunnat?"

The list goes on. Female circumcision is supposed to be "far worse" because "it is performed on older girls, in the bush, with dirty utensils, by an amateur, with no pain killers." Male circumcision is "so much better," we are told, because "it is performed in a hospital, in babies, with sterile equipment, by trained professionals, with pain killers, and the baby doesn't even remember."

Would the same people advocate for "sunnat" performed by a doctor, in a hospital, in babies, with sterile equipment and all the proper pain killers? Watch the same alibis that work for male circumcision fall flat when it comes to female circumcision...

And then there's the all-time favorite alibi of the "potential medical benefit." "A large amount of studies show that circumcision in males could have potential medical benefit."

This is strange; how many "studies" have been performed in female circumcision to see if it has any "benefits?" Would such "studies" ever be deemed acceptable? What if "studies" showed the exact same "benefits?" Would we then argue that it is "acceptable practice" for parents to opt for?

But I think the bigger question is, what is the reason that there are even "studies" on male circumcision? Isn't it a little backwards to be placing primacy on trying to legitimize a surgical procedure as opposed to finding other better, safer, more effective, less invasive means of providing "medical benefit?" Does anybody else not see it strange that "researchers" are seeking ways to legitimize surgical procedure in the healthy?

I propose the following litmus test for those who argue in favor of male circumcision because there are "potential benefits": How far do you actually care for "potential medical benefits?"

If a doctor offered you circumcision, and a newer, better option, say an actual vaccine against HIV, which would you choose? Would you take the vaccine which actually immunizes your child, or would you still want to opt for circumcision? The answer to this will speak volumes.

Here is the bottom line: People can find reasons why male and female genitals are "different," but the principles violated when cutting off parts of genitals of a healthy, non-consenting individual of any sex is exactly the same.

The foreskin is not a birth defect. Nor is it a congenital deformity or a genetic anomaly akin to a 6th finger or a cleft. The foreskin is normal, healthy tissue found in all males at birth.

Circumcision is the cutting off of a part of a person's genitals. It is the destruction of tissue. Unless there is medical or clinical indication for the surgical amputation of flesh, it is by definition, genital mutilation.

Unless there is a clinical or medical indication, what business does a doctor have performing surgery in healthy, non-consenting individuals, much less pandering to a parent's sense of entitlement?

Unless there is clinical or medical necessity, what "choice" do parents actually have? And why are physicians pretending like they could give it?

Instead of "studying" ways to legitimize the deliberate destruction of healthy human flesh, why aren't "researchers" studying ways to cure or prevent disease WITHOUT having to forcefully cut off part of another human's body?

The "study" of circumcision is a modern-day atrocity.

It is a modern-day disgrace that the deliberate genital mutilation of infants and violation of their most basic of human rights is even a question, even something to be "studied."

Let's "study" the "potential medical benefits" of cutting off the labia. Labia-plasties are on the rise even in the west nowadays, and "studies show" that women enjoy sex better without these useless bits of flesh. Who knows! Perhaps it could prevent AIDS. It's all for "science," is it not?

Why is it perfectly acceptable to "study" male genital mutilation, but not female?

These "studies" on genital mutilation must end. They are a blight on modern medicine.

Competing interests: None declared

Competing interests: No competing interests

14 March 2011
Joseph Lewis
University of the Pacific