Think Globally, Act Locally, the Circumcision Edition
Posted on | December 8, 2009 | 26 Comments
A recent reader of one of my blogs about male circumcision, after stating clearly and sincerely that she herself was anti-male circumcision, expressed reservations about my “lumping male circumcision with FGM.” She requested that I describe female circumcision so my readers would be aware of how it’s practiced. (Being above all a consilient Southern man, I have done just that at the end of this blog entry.)
But before I get to the description, I’ll give the simple reason that I don’t give female circumcision anywhere near equal time to male circumcision in my writing: Female circumcision is not a problem where I live. It does not happen in my city, in my state, in my county, within my religion. I do not have a friend or an acquaintance who I might advise to leave their daughter intact after her birth. All the girls will be intact. I cannot write to my congresswoman or man expressing my opposition to the practice. (Well, I guess I could but it might confuse them since it’s already against the law.) I will never have the opportunity to vote for an anti-female-circumcision politician; they are none of them for it.
In contrast, I live within a miles of several hospitals where hundreds of infant boys are being circumcised every day. I can write a useful letter to my congresswoman or man to express my opinion about the practice. I can and have talked to expecting friends about the decision to circumcise their sons. I can sign petitions to my own government, and so can you, here. Even for someone who wholeheartedly believes that female circumcision is 100 times, 1000 times, 10,000 times worse than male circumcision, there is not a mathematics perverse enough to make the problem of female circumcision in America worse than the problem of male circumcision in America. We only have the one problem here.
Do I find female circumcision to be barbaric? Yes. Of course I do. It would be bizarre in the extreme if anyone in America didn’t, if only for the trivial reason that it’s a modification of the body that is not part of our own tradition. All extra-traditional body modifications seem strange or cruel, so don’t even begin to imagine that you get ethics points for having the sensitivity to find female circumcision to be horrible. You don’t get any points at all for that. Since it’s something we can all agree on, it would certainly be strategic for me to get loud about how horrible female circumcision is.
(Similarly, it would be strategic for a writer in China to sidestep the locally touchy subject of human rights violations and compose an exposé about how Americans inhumanely ship their old people to convalescent homes to die alone. But the Chinese writers who are my heroes don’t take that path. They write about the locally important things, even when they are in jail for it with their teeth falling out.)
I’m sure I’ve lost some readership by pursuing the line of male circumcision as I have. In contrast, a well composed criticism of female circumcision would only make me friends by reassuring all my readers that they and I coexist in a cozy circle of civilized, right-thinking human beings. It locates the unimaginably horrible act in an primitive village, 10,000 miles away that almost none will visit and few could find on a map. If that’s not a warm glass of milk with a touch of honey stirred in, I just don’t know what is.
But I am not going to do that because my aspirations do not allow me to: As I understand it, the primary job of a writer of literature is not to compose pretty sentences or to use big words or to sell a ton of books but to engage deeply in the moral issues of his or her time and place. When I no longer have the stomach to do that, I promise that I will stop writing.
In the meantime, I will keep the first promise I made in this blog and describe female and male circumcision. If that’s going to gross you out, just stop reading.
There are four types of female circumcision (ref, J Sex Med 2007;4:1667, table). Type one is close in form to male circumcision. It cuts off the prepuce or clitoral foreskin. Sometimes this involves cutting off some or all of the exposed part of the clitoris, sometimes not. Practices vary. Type two involves cutting off the prepuce, the exposed part of the clitoris, and part or all of the labia minora. Type three involves doing type 1 or type 2 and also sewing up the vaginal opening (infibulation) and then sewing it up again at least after each birth. This is the kind that can cause a lifetime of bleeding and pain. Type 4 is a grab-bag involving burning or piercing or pricking and although these might sound even creepier than one through three, they usually leave most of the tissue in place so are actually not as bad.
That last sentence brings us to the ethics of ranking one kind of circumcision as better or worse than another. Didn’t it seem kind of gross when I said that type four wasn’t as bad? Even though it’s true, it felt kind of gross to me.
I’ll divide male circumcision into three types. I don’t have a reference. This is just from memory from my reading. Type one, let’s call it, trims off a token amount of foreskin. Type two is Western medical circumcision, which separates the whole foreskin from the glans then cuts it off. Type three is analogous to type four on women and involves a grab bag of piercing and pricking and burning that nevertheless leaves the foreskin in place so is ultimately kinder.
If you wanted to rank these methods by severity, maybe it would be:
Type 4 FGM = Type 3 MGM
Type 1 MGM
Type 1 FGM
Type 2 MGM
Type 2 FGM
Type 3 FGM
It could be argued that Type 2 (Western) MGM is more severe than everything but FGM 3, seeing as the foreskin is the most sensitive part of the penis, so should be counted as the equivalent of the clitoris. I can’t imagine that anyone would argue that any of it is worse than infibulation, if only because it’s not a one-off but a persistent return to the scene of the crime to do more damage. Pro-male circumcisionists would be obliged to put all kinds of male circumcision at the very top of the list as not-at-all injurious (infection aside). This can’t be right as many type 4 female circumcisions don’t take any tissue away at all. For the record, I don’t think of this ranking as important in any way as I consider all of it to be horrible.
One last note: I have not considered infection risk in my ranking scheme mainly because the insistent emphasis on the sanitary / unsanitary conditions of the circumcision are a rhetorical effort by pro-male circumcision forces to laminate the positives / negatives of the circumcision victim’s general living conditions onto the circumcision itself. Would anyone be happy if the Medicins Sans Frontier doctors went off to give lady parts a trim with their sterile scalpels? or if US hospitals would allow doctors to clitorectimize girls in acceptable conditions? I don’t think so. I certainly wouldn’t be. Yet, that is exactly what an army of Western evangelical male circumcisionists is doing to men in Africa. That’s what got me creeped out in the first place and started me writing and thinking about male circumcision.
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26 Responses to “Think Globally, Act Locally, the Circumcision Edition”
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December 8th, 2009 @ 7:37 pm
Good post! I often wonder what gender has to do with GENITAL cutting. Both genders have
genitals. Too many people focus on the male vs. female aspect and not the genital mutilation part.
Culturally, female genital cutting is not acceptable in the US. Unfortunately, male genital cutting is culturally acceptable. With posts like yours, we will change the culture here in the US. It has happened in many other countries. It is time for the US to embrace genital integrity for all, regardless of gender.
December 9th, 2009 @ 9:29 am
I agree with most of your article. That being said, I did want to make note that the foreskin cannot be compared to the clitoris. Though I believe that men should remain intact, men without one can still enjoy sex. Most women cannot enjoy sex without their clitoris, since it is the only way they can reach climax. Just wanted to point that out…not all women have g-spot orgasms.
Though both forms are genital mutilation and should not be practiced.
December 9th, 2009 @ 10:55 am
Judith,
Thanks for reading my blog. I completely understand your annoyance about the comparison between the foreskin and the clitoris. I included that aside in respect for comments and emails from intact men who talk about their foreskins in the same way an intact woman would talk about her clitoris, that it’s something they can even imagine losing; that it’s the best, most sensitive part of their penis and they can’t think what they do if they didn’t have it. On this topic, I can only act as a referee for received opinions, as I don’t have a foreskin myself to opine about.
As for circumcised women not having orgasms, six months ago, I would have joined you in thinking that impossible. Then I wrote my first blog criticizing the American medical armada going over to Africa to circumcise men and I got so much feedback from pro and anti-circumcision folks that I had to do my own research to sort out fact from fiction and, in my trips to the UCLA medical library, I found out that circumcised women do have orgasms, lots of them. (I know. Weird, but true.) I site the research more thoroughly in my previous blog on circumcision.
The reason I want to throw light on this particular element of the circumcision debate, which most of us would prefer not to look at, is that one cornerstone of the pro-male-circumcision argument is, more or less, “Men work just fine with circumcised penises, but for women, circumcision is the sexual equivalent of a nuclear winter, so stop whining and hand over your foreskins.” What I’m trying to do is to “complicate” this element of the accepted rhetoric because it makes Americans super complacent about male circumcision.
If Americans were generally aware that women could “work” without the part of their clitoris that pokes outside the body, just like men “work” without their foreskins, would it change our collective attitude about female circumcision? Of course not. But that knowledge might weaken the argument that we’re perfectly justified in thinking of foreskins as dispensable because they leave a man functional.
I’m always assuming, when writing my blogs, that people have read my book, and know that I’ve spent the happiest hours of my life face-first in an intact vulva. The idea of anyone taking a knife to any part of my favorite part of the human body makes me throw up in my mouth. In the future, I should make this part of my position clearer.
Thanks so much for your thoughts.
Best,
Adrian
December 9th, 2009 @ 2:07 pm
Adrian,
Your post is spot-on and illustrates the basic gender blindness from which most Americans suffer. The point is not which is worse; the point is BOTH are bad. One happens not to be a large-scale issue in the US, while the other is epidemic.
You are courageous to pose the ethical question in your blog. You have a new and loyal reader.
Thanks!
TD
December 9th, 2009 @ 2:46 pm
TD, Great to hear from you. Happy that you’re enjoying. I’m going to continue my efforts to frame this issue to counter to the very effective rhetoric of the pro-circumcision folks. Lots of potholes on that road but worth the drive.
Adrian
December 9th, 2009 @ 6:49 pm
Excellent blog! – I will send it to our NOCIRC group in Pennsylvania. If you make it to the Daily Show or Colbert, please mention this issue. Your post was one of the few educated ones that recognizes “the exposed part of the clitoris.” Most people don’t understand that the bulk of this organ (the branches) are submerged in the pelvic area and surround the vaginal opening. Not that it makes FGC acceptable, but the comparisons between male and female genital cutting are often wildly inaccurate. These false perceptions allow people to rationalize MGC while expressing disgust for FGC. There is no such thing as an “inch-by-inch guide” to mutilation. Keep on speaking out for those who cannot speak!
December 10th, 2009 @ 10:00 am
Judith, you only have to look at the advice given to women undergoing vulvectomy and/or clitorectomy as a treatment for cancer to know that it doesn’t automatically or even typically prevent orgasm.
See for example
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Vulva/Livingwithvulvalcancer/Sexlife.aspx
We know also from research in Africa that women who have been cut even very harshly typically do report orgasms. This is plausible given that the internal clitoris is around 30 times more tissue and is left in situ…
So why do we suppress this information and replace it with the myth that female cutting devastates her sex life for all her life?
I’d go further than Adrian and say it’s actually racism. We’re customising the facts in order to be support a view that says people with darker skin behave in a much much more barbaric fashion.
If you’d like to read more about how Africans view our cultural imperialism I recommend the writings of Fuambai Ahmadu in the Patriotic Vanguard. She’s a Sierra Leonean Scholar at an American University who chose to be cut as an expression of pride in her culture, and is very eloquent in defending it. Unfortunately having chosen the cut for herself she now argues mothers can choose it on behalf of young daughters (and sons) which is where she goes wrong IMO…
Re the methods of female cutting being so much more dangerous – this is another myth. The reality is that where both boys and girls are cut they tend to have similar treatment. Parents want to do it in the best possible situation they can – they’re not monsters and where they can afford to and it’s available they’ll choose a doctor or at least an antibacterial swab…
The reason a total ban (outside of medical reasons) was brought in for female cutting in Egypt recently was because it had become medicalised – a majority of cuts were being done by doctors, many with general anaesthetic.
The girl who died in 2007 to loud international outrage died of an overdose of general anaesthetic being cut by a doctor (female I think) in a clinic…
So did Raju Miah, a small British boy, ritually excised in the 1990s because of someone else’s religion.
The difference?
The difference is that his death was officially recorded as narcotic poisoning and none of the human rights charities bothered to care much about it.
You probably never even heard of it before.
December 10th, 2009 @ 11:23 am
You Sir, are an overachiever!
I’m with Greg H- when you are on the Daily Show and making the circuits, not only will you be able to talk about HTMLAC,but you’ll be able to help the cause of things you and a lot of us care about, like whether or not to circumcise, proper sex and birth control education for kids, making sex a positive thing, etc. I applaud you for leaving the corporate world all those years ago!
December 10th, 2009 @ 1:38 pm
Laura,
Wow. Thanks for all this information. It’s funny you mention the racist element, because that’s what set me on the road to writing about circumcision in the first place. My first post was a query about the possibly racist incentives behind an armada of American doctors crossing the Atlantic to collect the demon African foreskin.
In the little tornado of responses and personal communications with folks both pro and con, I roused myself to get an education on the subject and here we are.
I’ve landed at the opinion that the myth of female cutting destroying a woman’s sexuality is the absolute cornerstone of our culture’s complacency about male circumcision. After poking and prodding this issue at various angles, it seems to me that’s where the shoe is pinching, as the Indians say. Even though a great number of people think male circumcision is not a good practice, the fact that there is something seen to be infinitely worse practiced several thousands of miles away gives you a perverse permission to ignore what’s happening right under your nose.
We people are weird.
Thanks for your comment.
December 10th, 2009 @ 1:46 pm
And yes, there’s a racist element in assuming that someone cutting their child in a city in Africa or the Mid East is going to let granny charge at them with a dirty shard of glass. They’ve got hospitals.
December 12th, 2009 @ 10:13 am
Social comments and analytics for this post…
This post was mentioned on Twitter by IntactByDefault: New blog post: Think Globally, Act Locally, the Circumcision Edition http://j.mp/512S8r #i2…
December 12th, 2009 @ 8:15 pm
GOOD GOD. I feel like I’ve just gone to church. This post was a blessing. Thank you, thank you, thank you. Sometimes it feels like everyone just has their heads stuck in the sand. The MGC vs. FGC argument is one of the most exhausting exercises of circular logic I’ve come across but you succinctly and intelligently provide a rebuttal for it. You’ve got a new reader.
December 13th, 2009 @ 1:57 am
EXCELLENT blog post and sums up a lot of my feelings on the matter.
I read somewhere, I wish I knew where, but there is a form of MGM that is comparable to type 4 FGM, performed in certain aboriginal tribes apparently. They don’t stop at just the foreskin and remove all skin from the penis and scrotum. Strangely though this is not widely known about or campaigned against. I strongly feel that ALL genital cutting of minors needs to be stopped NOW. Gender is irrelevant.
December 13th, 2009 @ 9:01 am
Since FGM DOES indeed occur in North America and everywhere that it is illegal, there is one reason you could contact your legislator about it. We need to make sure any law prohibiting FGM carries a non-expiring window to prosecute, like murder usually does. As the victims are cut in secret as infants, most will not become aware of what was done until years later. The cutters most know that they will not be safe from prosecution until they are in the grave. While you’re raising this issue, you could bring up MGM of course.
December 14th, 2009 @ 9:29 am
I read of one case of a man being prosecuted for it. That’s all I could find. I couldn’t find any data on frequencies of FGC in the US. If you have pointers to that kind of data, please send them along. I’d love to be able to do a misery calculation for US genital cutting M and F.
It is your position that confuses me the most in the area of genital cutting, and I’d honestly like to initiate a dialogue about it because I want to understand. In your ideal communication to a US legislator someone could “bring up” MGC as a footnote to the main concern, which should be the complete and total eradication of FGC, even though it is already illegal here and practiced at an insanely low level.
In my opinion, this is the exact attitude that keeps MGC alive and well in the US: the idea that one clitoris is worth a million, a billion, a trillion, a gajillion foreskins, and that opponents of MGC should shut up until there is a level of absolutely zero FGC practiced in this country if not the whole world. I would think that anyone so passionately against female cutting would be strongly against any kind of genital cutting. The math just confuses me.
If you’re flat for MGC, I totally understand and if your more comfortable carrying on a conversation offline, rather than in this forum, I completely understand. My email is acolesberry@yahoo.com.
December 15th, 2009 @ 6:39 am
Claire, you may be thinking of an article which appeared in the Economist magazine (and which can still be found online behind a paywall) here: http://www.economist.com/sciencetechnology/displaystory.cfm?story_id=E1_TTVSJTTQ
The article mentions the Australian aborigines’ custom of “subcision” which actually punctures the boy’s urethra at the base of the penis, making semen and so forth leak out. Very drastic and apparently done to help prevent cuckolding.
“Jun 19th 2008
From The Economist print edition
Mutilating male members may mar men’s mischievous matings
CIRCUMCISION and other forms of male-genital mutilation are commonplace in many societies around the world. The origin of these practices, however, puzzles anthropologists and evolutionary biologists. They wonder what benefit they could bring, especially given the obvious risks of infection and reduced fertility.
Explanations have ranged from the pragmatic (a ritual that marks the beginning of adulthood and bonds men together) to the Freudian (having something to do with the pain of the separation from the mother). However Christopher Wilson, a neurobiologist at Cornell University, has a different idea. In a recent paper in Evolution and Human Behavior he suggests that male-genital mutilations are actually intended to prevent younger men from fathering children with older men’s wives.
Dr Wilson takes his cue from sperm-competition theory, which suggests that males of promiscuous primate species have evolved features that maximise their own sperm’s chances of fertilising an egg they might have to compete for. These features include large testicles which produce more sperm, and morphologically complex penises. Males of monogamous primate species, on the other hand, have smaller testicles and simpler penises. Human genitals are somewhere in between, perhaps reflecting the fact that people generally form pair bonds, but are susceptible to occasional bouts of promiscuity.
Some forms of genital mutilation have obvious effects on fertility. For instance, several African and Micronesian societies practice testicular ablation—the crushing or cutting off of one testicle. Some Australian aborigines engage in subincision, which exposes part of the urethra and thus causes sperm to leak out of the base of the penis. Circumcision does not have quite such clear-cut effects. But there are several ways it may affect fertility: most obviously, the lack of a foreskin could make insertion, ejaculation or both take longer. Perhaps long enough that an illicit quickie will not always reach fruition.
Older men are in a position to form alliances with younger men—passing on knowledge, lending them political support and giving them access to weapons. By insisting that the young undergo genital mutilation of some form as a quid pro quo, an older married man can seek to ensure that even if he is cuckolded, he will still be the father of his wives’ children. Of course, the older man has probably undergone genital mutilation too, and seen his own fertility reduced. But that, if anything, increases his incentive to make certain that the young bucks are similarly handicapped. And if all the older men in a society conclude this is a good thing, it will rapidly become a socially enforced norm.
To test this theory, Dr Wilson made several predictions. Among them, he suggested that mutilation is more likely to be practised in polygynous societies (since a man with several wives is more vulnerable to cuckoldry), and is especially likely in those polygynous societies where a man’s co-wives live in separate households from their husband. It should also take place in a public ceremony watched by other men, to avoid cheating or free-riding. And there should be a strong stigma against men who refuse it.
To test his predictions, Dr Wilson looked at a database of 186 pre-industrial societies. Some 48% of the highly polygynous ones practised a form of male-genital mutilation, and the number rose to 63% when co-wives kept separate households. By contrast, only 14% of monogamous societies practised mutilation. Moreover, and also as predicted, the mutilations were almost always carried out in public, often as part of a coming-of-age ceremony at puberty, with strong stigma attached to unmutilated men.
Dr Wilson’s paper does not definitely prove that sexual competition is at the root of male-genital mutilation. But it does provide a plausible explanation for a puzzling practice. It is not likely, however, to have much effect on attitudes toward circumcision. The men who enforce and undergo the rituals are no more aware of the underlying evolutionary motivations than of why their testicles are the size they are. Those who engage in the practice for religious reasons will surely continue to do so. Otherwise, most of the Western world has already largely abandoned routine neonatal circumcision, which is seen as an outdated and unfortunate medical fad.
The exceptions are America, where more than half of newborn boys are still circumcised, and Africa, where circumcision helps to stop the transmission of HIV, the AIDS-causing virus. There, infection really is a far greater threat to the number of children a man might have than the loss of his foreskin.”
December 15th, 2009 @ 6:47 am
Pardon me while I go on an anti-war rant:
That study from the economist, along with seeing a picture of Donald Rumsfeld shaking hands with Saddam Hussein back in the 80′s, really made me realize how much older men try to control and use younger men’s bodies with a variety of social-control methods. Either through mopping up their foreign policy problems with the blood of young men (I’m talking about the draft) or just outright controlling people’s bodies through imprisonment, wage slavery, or involuntary mutilation at birth. Every time I look at our prison statistics, or hear about our treatment of highschoolers engaging in consensual sex, or see US soldiers dying to clean up the messes created by the last generation’s patriarchs, it really makes me angry.
Regime change begins at home!
December 15th, 2009 @ 7:26 am
What a brilliant comment.
December 16th, 2009 @ 7:11 am
If you consider the number of people maimed or killed by circumcision, men would far out number the women.
December 16th, 2009 @ 7:35 am
I would like to remind people about the more extreme forms of MGM..
Subcision–the slicing of the penis down the length of it.
Yemen circumcision–the amputation of the foreskin AND flaying of the skin from the navel to the scrotum.
How do these compare to the various forms of FGM?
December 17th, 2009 @ 9:18 pm
Thanks very much for your insightful post.
This chart also shows the cultural similarities involved in genital cutting of children, male or female. http://www.circumstitions.com/FGMvsMGM.html
I am so glad there are other intactivists out there
December 18th, 2009 @ 6:43 am
That article also upsets me because it implies at the end that circumcision prevents the spread of HIV, which is often offered up as an excuse to devillify the mass genital mutilation of African males. In fact, circumcision does not prevent HIV transmission, condoms prevent HIV transmission.
It is sad to me that our American culture has been brainwashed into believing it’s okay to slice bits off of the genitals of our infant sons.
If God had wanted our sons to have foreskins, they’d be born with them.
December 19th, 2009 @ 7:29 am
This is a great series of posts Adrian. I really think that we are slowly seeing a change in the US it’s agonizingly slow but I think it’s happening. I wanted to add some information about FGM, you mentioned some studies that showed little sexual effect. Here is another two studies done by labiaplasty surgeons in the US who do these for ‘cosmetic’ reasons, this can of course be considered a type of FGM:
http://www.labiaplastysurgeon.com/labiaplasty-clinical-study.html
Could you link to some of the articles you listed?
December 19th, 2009 @ 8:46 am
What a terrific article. Thanks for posting.
December 19th, 2009 @ 11:11 am
I completely agree with your upset about the mass circumcisions in Africa. It was the Africa connection that started my interest in writing about circumcision: here and here.
Love your signoff.
December 19th, 2009 @ 4:28 pm
Sorry to not have included the links in the original. Here’s the article about the orgasm rates of cut women:
http://www.ncbi.nlm.nih.gov/pubmed/17970975
Here’s a study suggesting that female circumcision would “protect” against AIDS in the same way that male circumcision “protects” against it. It’s not the same kind of controlled trial that they did three of in Africa with male circumcision. There’s not a committed, pro-circumcision medical industry with a government behind it that’s willing and able to spend millions to promote female genital cutting like we are willing and able to spend millions to promote male cutting.
http://www.ias-2005.org/planner/Abstracts.aspx?AID=3138
These are just abstracts. It looks like you’re associated with a university, so I’m sure they subscribe to these journals. You can get the full texts from there. It’s the full texts that are so interesting.