Sunday, December 10, 2023

The Importance of Unity

by David Balashinsky

One of the basic questions that every progressive organization has to consider is whether to form strategic alliances with other organizations dedicated to the pursuit of goals that may seem to be entirely different from its own but whose objectives still fall under the rubric of human rights or simply that of making the world better, fairer, healthier, safer and more habitable for everyone.  On a grand scale, this question applies to reform movements themselves.  Should climate activists and environmentalists make common cause with Black Lives Matter?  Should women's rights activists make common cause with those seeking to end poverty and income inequality?  The reality is that strategic alliances such as these are not contrivances or arranged marriages but the opposite.  For example, now that the concept of environmental racism is widely recognized, it's evident that one cannot effectively fight the totality of systemic or structural racism without addressing the problem of industrial pollution.  By the same token, one cannot combat climate change or pollution without recognizing the disparate effect these have on marginalized communities.  Similarly, the fact that more women than men live in poverty means that women's rights and economic justice are not fundamentally different objectives but, rather, fundamentally the same.  

Notwithstanding these root points of intersection, there are those who oppose making common cause with other movements or organizations.  Whether this opposition arises from mistaken notions of ideological purity or whether from overzealous single-mindedness, the result is inevitably a net loss on both sides, if for no other reason than that there is strength in numbers.

This is no less true of the genital autonomy (GA) movement, a worldwide movement that seeks to end all medically unnecessary genital cutting of unconsenting minors.  The GA movement consists of three main branches, each of which is organized around opposition, respectively, to female genital cutting (FGC, known also as female genital mutilation - FGM), male genital cutting (MGC, or nontherapeutic penile circumcision) and intersex genital cutting (IGC, which also includes a variety of surgeries that go beyond "normalizing" genital surgeries).  Like every human rights movement, the GA movement has its share of "purists" who frown on making common cause with other human rights movements and organizations.  Some want nothing to do with organizations not involved in combating genital cutting specifically while some within one or the other of the three branches of the GA movement even regard the other two branches as being beyond the scope of their concern.

At the Genital Autonomy Legal Defense and Education Fund (GALDEF), where I serve as a board member, I am happy to say that we do not share this view.  Although its purpose is to facilitate impact litigation in order to obtain a measure of justice for individual victims of penile circumcision while creating a powerful financial disincentive for the continued imposition of this harmful genital surgery on unconsenting children, GALDEF recognizes that all genital autonomy movements stand on the same philosophical foundation.  Indeed, if one accepts the premise that a medically unnecessary, nonconsensual body modification is a harm in and of itself  because it violates a person's rights to bodily integrity and self determination, it is difficult to see how can one look at FGC, MGC and IGC - practices that are identical in this fundamental respect - and not come to the same moral conclusion about them.  Ultimately, it doesn't matter what the surgery is and it doesn't matter what the sex or the gender of the victim is.  Either there is a fundamental right to bodily self-ownership that applies to everybody, regardless of sex, or there isn't.

It should be a foregone conclusion that, on the most basic level, any one form of genital cutting is morally indistinguishable from another, but the GA movement also shares important characteristics with other reform movements.  For example, there are striking similarities between the way homosexuality and the penile prepuce have been "pathologized" by the medical establishment.  A fact not generally appreciated now is that it was not until 1973 that the American Psychiatric Association (APA) formally dropped its classification of homosexuality as a psychiatric disorder.  Although it's hard to believe that gay women and men were once subjected to electroconvulsive therapy (ECT, or "shock therapy") and other "treatments," for decades the APA viewed homosexuality as a condition that needed to be "cured."  Women and men were not merely stigmatized for being gay; their homosexuality was actually defined as a pathological condition by the medical establishment.  As a result, gay people were subjected to interventions that would now be condemned as medical malpractice.  It took years of advocacy before the APA was finally persuaded to revise its official stance on homosexuality.  (The story of how gay rights activists overcame decades of entrenched thinking within the APA is movingly told in the powerful, heartbreaking yet inspiring documentary, "Cured.")

In parallel to this, during the 19th and 20th centuries, the medical establishment pathologized the penile prepuce, attributing to it a host of ailments and diseases, including that scourge of Victorian-era health and social order, "masturbatory insanity." The "cure" for being born with a normal penis, of course, is circumcision.  

In both cases, what is in fact normal, natural, healthy, good and beautiful was vilified and pathologized.  The result was that, in the case of homosexuality, untold thousands of perfectly healthy people were subjected to "treatments" they neither needed nor (in most cases) desired while, in the case of MGC, untold millions of perfectly healthy people were (and, to this day, continue to be) subjected to a surgery that they neither needed nor desired. 

Thirty years ago, GALDEF president and founder, Tim Hammond, recognized that intactivism (as the movement to end MGC has come to be known) had much in common with the struggle for gay rights.  As someone with extensive experience in both movements, Hammond believed that the LGBT community would be receptive to the idea that, as he put it, "everyone has a right to do with their own genitals what they wish."  For this reason, he argued in favor of building alliances with the gay community by participating in Pride events.  At the time, some intactivists countered that the two movements had nothing in common and, as Hammond recalls, "even warned that it would be political suicide" for the GA movement to align itself with the gay rights movement.  And yet Hammond's prescience has been vindicated.  Intactivists are now fixtures at Pride festivities across the United States.  Last July, for example, GALDEF was honored to hold its first public education and outreach event at Los Angeles Pride.  In September, the producers of "Cured" graciously made their film available to GALDEF for a special screening and fundraising event.  GALDEF was again represented - and represented the GA movement - last September at the Second Annual Riverside Pride Festival.

These collaborations amply demonstrate the utility of rights organizations forming strategic partnerships.  They also demonstrate the principle that the objectives of socially conscious movements are not trivialized nor their impact diminished when they unite and make common cause with one another.  Perhaps most importantly, they illustrate the principle that, when distilled down to their essence, most human rights movements embody the same fundamental values.  Thus, it is not their joining forces that is in any way forced or unnatural but their insisting on exclusivity from one another that is.  That is not to suggest that every organization or movement should abandon its individual focus or its specific mission.  I am simply arguing that individual organizations throughout the broad spectrum of progressive organizations should be open to forming strategic alliances in the interests of furthering the aims of all.  Ultimately, by joining forces, the efforts of all socially conscious organizations, whatever their individual goals, can only be enhanced and their collective impact magnified for the benefit of all of humanity.

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David Balashinsky is originally from New York City and now lives near the Finger Lakes region of New York. He is a licensed physical therapist and writes about bodily autonomy and human rights, gender, culture, and politics. 
He currently serves on the board of directors for the Genital Autonomy Legal Defense & Education Fund, (GALDEF), the board of directors and advisors for Doctors Opposing Circumcision and the leadership team for Bruchim.

 

Thursday, September 14, 2023

No, Farida D., the reason men fear being seen as feminine is not because they fear being treated the way they treat women

by David Balashinsky

Many years ago, when I was in my late 20s or early 30s, I got into a phone conversation with a young woman who had dialed my number by mistake.  She hadn't misdialed: it was a recycled number that formerly belonged to someone she knew.  The phone call began, naturally, with my explaining that the person she was trying to reach did not live at that number.  However, a conversation ensued that seemed for all the world as though there were some flirtatious testing-of-the-waters going on at both ends.  That is the vein in which the call proceeded for several minutes until the young woman abruptly said "You sound like a fag," and hung up.

The recollection of this incident - one of about a half dozen in my life in which my sexual orientation has been mislabeled - either by mistake or intentionally but always as a way of policing my gender - was prompted by a meme that has been making the rounds on social media for several years and that appeared in my Facebook feed yet again last week.  The meme presents a quote from Farida D. and it is item number 214 in "The 2nd List of Shit That Made Me a Feminist."   Here is the quote as it appears on Farida D.'s Instagram wall:


I do not know how Farida D. comes by her special insight into the psychological lives and inmost fears of men - she describes herself simply as "an Arab gender researcher and poet."  But what I do know, as a cisgender, hetero male - what Farida D. refers to as a "cishet" - is that most men in our culture fear being seen as feminine, not just those of us who identify as cisgender or as hetero and certainly not only those men who mistreat women.  This fear is instilled in us beginning in our earliest childhoods, it is reinforced throughout our lives and it is ever-present.  It influences and even controls the choices we make about the clothes we wear, the color of the cars we buy, it determines how we walk, how we talk, how we hold our bodies, how we interact with others and which hobbies and interests - even which careers - we pursue.   For many of us who are gay or trans, it has kept us closeted.  For those of us who are not it has, nonetheless, inhibited us in our relationships with other men.  The fear of being seen as feminine is one of the defining characteristics of masculinity because, as we are taught to be masculine, so we are taught not to be feminine.  In childhood or adolescence, most of us internalize this strict gender code and, having internalized it, actively aspire to be seen as masculine just as we actively fear (dread, really) being seen as feminine.

None of this is news.  On the contrary, it's Feminism 101.  Nor does the concept of gender, obviously, apply only to men.  Women, too, have their own form of gender instilled in them.  They are expected to be feminine in both appearance and behavior; they are expected to be accommodating, indulgent and supportive of men, ingratiating ("Smile, Honey!"), conciliatory, domestic and, above all, they are expected to be fecund.

Just as masculinity is positively reinforced in men because it is rewarded, femininity in women is positively reinforced because it is rewarded - but only up to a point: the rewards that women "earn" for being feminine are not nearly so great as the rewards that men "earn" for being masculine.

And just as masculinity is both negatively and positively punished in women, femininity is both negatively and positively punished in men.  A refresher from Psych. 101: a negative punishment is "a form of operant conditioning that aims to suppress or discourage certain behaviors by taking away something valued or desired by the individual" while a positive punishment entails the delivery of an aversive stimulus in order to discourage certain behaviors.  In my phone call with the young woman, I was on the receiving end of both negative and positive punishments for sounding insufficiently masculine.  The positive punishment was being called "fag" and the negative punishment was the young woman's hanging up on me and withdrawing even the potential of our forming a relationship.  The result was one of those periodic reinforcements of my fear of being seen as feminine.

As I suggested, this is basic stuff.  That is why I was surprised to see Farida D.'s quote mindlessly shared by feminist- and pro-feminist pages and individual Facebook users.  In contrast to mainstream, even orthodox feminist analyses of gender, Farida D. presents a radically different view here.  In this view, the fear of being seen as feminine is not a behavior that is inculcated in most males but is, instead, simply the manifestation of guilt that, by definition, most men feel - since most men fear being seen as feminine - because they mistreat women.

This was news to me.  After all, despite still being prey to the fear of being seen as feminine, I don't fear being treated the way I treat women.  More than this, though, it was because I have experienced the sting of gender policing many times in my life (and not only by being called "fag") and it has always taken the form of an external force or influence (a catcall by a stranger on the street, a sneer, a reproach by a friend) which I have dutifully internalized and which has always tended to reinforce my fear of being seen as feminine.

Another example from my own experience comes to mind.  When I was about 10, some friends and I were "goofing around" (that's what we called it in those days) in the process of which we discovered a freight elevator (this was backstage at the New York State Theater).  The elevator car was huge - we had never seen anything like it - and three of its walls were covered by thick, quilted moving blankets.  Obviously, we had to ride it although we knew we were not supposed to (I think there was a sign that said "Authorized Personnel Only").  The combination of amazement, the sense of our own mischievousness, the fear of getting caught and the sheer fun we were having led to a kind of giddiness.  I think we all felt that.  "We all," I should explain, were three or four girls and me, the sole boy.  In the midst of our cackles, one of the older girls - she must have been about 12 or 13 - suddenly turned to me with a look of concern on her face and said, "David!  Stop it - you're acting like a girl."

I will never forget the impact of that.  It's not that, at that age, I had any conscious sense of being either masculine or feminine.  I was just having fun and my emotions were simply bubbling out of me in the most natural way possible.  In other words - and this is key - my emotions were being expressed in an uninhibited way.  This girl's reproach was the first time I was brought face to face with the societal expectation that an uninhibited display of joyful emotion was inappropriate in a boy and that, unless I wasn't afraid to be seen as feminine, I was not permitted to engage in it.

By no means am I the only man to have experienced gender policing like this nor am I the first person to write about it.  In a 2017 column for the New York Times, ("Talking to Boys the Way We Talk to Girls") Andrew Reiner explores the ways in which how we communicate with boys helps to shape their gender into the masculine ideal.  "Just as women's studies classes have long examined the ways that gendered language undermines women and girls," Reiner writes, "a growing body of research shows that stereotypical messages are similarly damaging to boys."

We tell ourselves we are preparing our sons to fight (literally and figuratively), to compete in a world that's brutish and callous.  The sooner we can groom them for this dystopian future, the better off they'll be.

Among the findings of the studies that Reiner cites are that "mothers interacted vocally more often with their infant daughters than they did their infant sons," that "Spanish mothers were more likely to use emotional words and emotional topics when speaking with their 4-year-old daughters than with their 4-year-old sons," that "fathers . . . sing and smile more to their daughters," and that, "[a]fter visits to the emergency room for accidental injuries . . . parents of both genders talk differently to sons than they do to daughters."

Reiner also highlights the work of the masculine-studies researcher, Michael Kimmel, who "maintains that 'the traditional liberal arts curriculum is seen as feminizing by boys.'"  Reiner's observations during his own 20-plus years of teaching back this up:

Nowhere is this truer than in English classes where . . . boys and young men police each other when other guys display overt interest in literature or creative writing assignments.  Typically, nonfiction reading and writing passes muster because it poses little threat for boys.  But literary fiction, and especially poetry, are mediums to fear.  Why?  They're the language of emotional exposure, purported feminine "weakness" - the very thing our scripting has taught them to avoid at best, suppress, at worst.

Gender policing that reinforces masculinity (and that teaches boys and men to fear being seen as feminine) comes from all sides, not just family or schoolmates.  This continues into adulthood.  Reiner takes up this thread:

Women often say they want men to be emotionally transparent with them.  But as the vulnerability and shame expert Brené Brown reveals in her book, "Daring Greatly," many grow uneasy or even recoil if men take them up on their offer.

I can attest even to this from my personal experience.  When I was in my mid-20s, I was speaking with my then girlfriend about some very serious problems I was having in my life.  I had become somewhat stuck in a kind of feedback loop of failure, fear, despair and paralysis.  I was so upset, in fact, during this one conversation, that my emotions got the better of me and I began to cry.  This was too much for my girlfriend.  She grew impatient and intolerant and told me to "stop being so mushy."  In other words, "Man up!"

Circling back to how men are expected to communicate verbally as opposed, specifically, to how they are expected to keep their emotions in check (although, of course, the two are closely related), Reiner cites yet another study that

found that college-aged female respondents considered men more attractive if they used shorter words and sentences and spoke less.  This finding seems to jibe with Dr. Brown's research, suggesting that the less men risk emoting verbally, the more appealing they appear.  

- And the less feminine they appear.

A 2018 Harvard Business Review article ("How Men Get Penalized for Straying from Masculine Norms") concluded that "[r]esearch demonstrates that much the same way women face unfair backlash effects for being more masculine or not feminine enough, men similarly face backlash for not adhering to masculine gender stereotypes."  This article cites numerous studies that delved into a half dozen specific categories of behavior including "Showing vulnerability, "Being nicer," "Displaying empathy," "Expressing sadness," Exhibiting modesty" and, of all things, "Being a feminist or feminine."  In every one of these categories it was found that men were penalized in some way (or, in one of the categories, simply not given credit that was given to women) when they exhibited these behaviors.

The upshot of all this is that the reason boys and men fear being seen as feminine is because they are socialized from birth to conform to masculine gender and heteronormativity.  The process of instilling masculinity in boys begins when they are neonates and it continues throughout childhood, adolescence and well into adulthood.  In adolescence and adulthood, the penalties imposed on boys and men, respectively, for being seen as feminine can be severe, ranging from bullying to ostracism to rejection and ridicule to violence and death.  Boys learn at a very early age, therefore, that few things are worse than being seen as feminine.  The fear of being seen as feminine - the heavy psychological baggage that boys and men carry with them throughout much of their lives - is the result of this conditioning and comes from external influences that include both negative and positive punishments.  It does not, as Farida D. suggests, come from their guilty consciences.  The fear of being seen as feminine exists because all men - straight and gay (and transwomen, too, since, in the eyes of their persecutors, transwomen are effeminate men) know how they will be treated by society if they are seen as feminine and not because they fear being treated the way they treat women.


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David Balashinsky is originally from New York City and now lives near the Finger Lakes region of New York. He is a licensed physical therapist and writes about bodily autonomy and human rights, gender, culture, and politics.  He currently serves on the board of directors for the Genital Autonomy Legal Defense & Education Fund, (GALDEF), the board of directors and advisors for Doctors Opposing Circumcision and the leadership team for Bruchim.
 


Saturday, August 5, 2023

The Bodies That "Every Body" Forgets and the Case for Unanimity Within the Genital Autonomy Movement

by David Balashinsky

In "Every Body," directed by Julie Cohen, the plight of intersex people and the growing success of the intersex rights movement are at last receiving the attention they deserve.  It might not be an exaggeration to say that the intersex rights movement has arrived.  In the last several years, two large hospitals have announced that they will no longer perform certain types of medically unnecessary intersex surgeries.  One of them has even taken the unusual step of apologizing for having performed these surgeries in the past.  The intersex rights movement also recently has begun to achieve success legislatively.  For example, in 2021, Austin's city council passed a resolution condemning "nonconsensual and medically unnecessary surgeries on intersex children."  A half dozen mostly European nations have gone further, banning (most of) these surgeries, outright.  Now, with "Every Body" playing in theaters across the nation,  Cohen is helping to raise the public's awareness of this issue.  These developments - in medical practice, legislatively and socially - are all hallmarks of an idea whose time has come.  For all these reasons and more, "Every Body" is a hugely important film and I urge everyone - every body - to go see (or stream) it.

I have only one criticism of "Every Body" and, while it is only one, this criticism ties in to what I believe to be a serious and ongoing problem within both human rights discourse and the genital autonomy movement broadly.  Because this one flaw in Cohen's film epitomizes this problem, and without intending to detract in any way from this beautifully-made and inspiring documentary itself, I believe that the time is right - and that it's not unreasonable - to call attention to it.

The case that prompted Cohen to make her film in the first place is the tragic story of David Reimer.  Reimer was one of a set of identical twin boys who were both, at the age of seven months, diagnosed with phimosis.  It's important to understand here that, generally throughout childhood, the penile prepuce (the foreskin) remains fused to the glans, a normal condition that is known as physiological phimosis.  In infancy, true, pathological phimosis is extremely rare.  However, partly because of their unfamiliarity with intact penises, physicians frequently mistake physiological phimosis for pathological phimosis.  Consequently, in infancy, "phimosis" is almost always a misdiagnosis of what is, in fact, the natural state of the child's penis.   There is every reason to think then, that the diagnosis of phimosis that both boys received was a case of a physician pathologizing a normal physiological condition.  Not surprisingly, the boys' pediatrician recommended the treatment of choice which, at the time, was circumcision.  This was subsequently carried out by Jean-Marie Huot, a general practitioner, who opted to use, instead of a scalpel, an electrosurgical device (a Bovie cautery machine, to be precise).  In the process, David's entire penis was obliterated - literally burnt to a crisp.  Distraught, his parents turned to one of the world's most prominent sex- and gender researchers, John Money, who had been promoting his theory that gender is "malleable" for the first couple years of a child's life.  Money recommended that David be raised as a girl and that his parents do everything in their power to reinforce their son's gender as female.  The unique circumstances of David's having been born male but raised female while his identical twin brother was raised male made the twins ideal as living experiment-and-control subjectsThus, above and beyond providing a solution to the predicament the family (especially David) was faced with, the experiment would also serve to confirm Money's theory - if it worked.  It didn't.  Thanks to the courageous and diligent efforts of Doctors Milton Diamond and H. Keith Sigmundson, Money's claims, far from being confirmed, were debunked.  As for David, he never felt right living as a girl, he ultimately rejected the gender that had been imposed on him and he lived a short, troubled life that he ended himself with a shotgun blast at the age of 38.

It's also important to keep in mind here that, like physiological phimosis, ambiguous or indeterminate genitals - "intersex" - occur naturally and, in most cases, do not pose a problem for the individual who is born intersex.  Consequently, the surgical modification of the genitals of intersex children that became standard protocol during the 1970s is, like the treatment of physiological phimosis, simply a case of physicians having pathologized and then "treating" what is in fact a natural and benign condition.

The David Reimer case is not merely relevant to the practice of intersex surgery but foundational to it.  Before being discredited and even since, Reimer's putative "successful" transition from male to female through surgery, hormonal treatments and social conditioning was cited as proof of the efficacy of surgical sex- and gender-assignment and used, therefore, to justify the subsequent genital- and body-modifications to which who-knows-how-many intersex children were subjected.  A considerable portion of "Every Body," therefore, is appropriately devoted to the David Reimer case. 

But before there was intersex surgery there was penile circumcision.  And before David Reimer's sex, gender and identity were tampered with, his penis was.  It bears repeating here that the botched circumcision in this case was prompted, in all likelihood, not by a pathological condition but by a physician's having pathologized a normal one.  The problem, then, was not that Reimer's attempted circumcision was botched but that it was attempted in the first place.  The circumcision itself that was imposed on David Reimer, therefore, was the prime mover: the first in a concatenation of events that led, through diverging paths, to the disastrous outcomes in David's own life, to numerous unwanted and unnecessary intersex surgeries on other children, to the rise of the intersex rights movement, even to the making of Cohen's film.  I take it as axiomatic that, when connecting dots, the first dot is the most important and yet it is this dot that Cohen fails to connect to all the others.  It's not that Cohen fails to mention Reimer's circumcision - it would be impossible not to.  But Cohen seems to regard the original attempted surgical modification of David's penis as incidental: relevant to her subject only because its untoward and catastrophic results led to his being raised as a girl and because his allegedly successful sexual reassignment was then used to justify subsequent intersex surgeries on other children.  Thus, Cohen treats David's circumcision as something that stands apart, conceptually, from the equally unnecessary intersex surgeries that her film documents (and implicitly condemns).  As a result, this can leave the viewer with the impression that the problems that David faced in his life and that so many other intersex people would face in theirs did not begin at the moment the decision was made to subject David to circumcision but only after the decision had been made to subject him to sex- and gender-reassignment.  That is the one conceptual flaw in Cohen's film.

I want to be clear that I fully respect the right of a filmmaker to focus on whatever topic she chooses and, in presenting that topic to her viewers, to circumscribe her camera's field of view as narrowly as she deems appropriate.  Viewed strictly as a documentary about intersex people, intersex surgery and the intersex rights movement, it might seem unfair to criticize "Every Body" for not going far enough and to criticize Cohen for not connecting all the dots.

But "Every Body" is about much more than chromosomes and gonads.  To view it superficially, as though that were all there is to it, would be to miss its larger point.  The deeper message of "Every Body" - its fundamental truth - is that every body has an inherent right to exist as nature made them.  This is the guiding principle against which every norm, every injustice and every harm documented in the film stands in opposition, from what was done to David Reimer, to the imposition on intersex children of a socially-constructed and strict binary view of human sexuality (two absolute and mutually exclusive sexes, with nothing in between), to the imposition on transgender individuals of a parallel and equally rigid view of gender, to "bathroom bills" - and, especially - to physicians surgically "fixing" bodies that they themselves have needlessly pathologized.  More than anything, then, "Every Body" is an unequivocal condemnation of the practice of pathologizing naturally-occurring but harmless anatomical features - especially genitals - of human bodies and surgically altering them without consent in order to make them conform to socially-constructed standards of appropriateness or normalcy.  Nota bene: that is not just a description of intersex surgery - it is the very essence of routine penile circumcision. That is why Cohen's failure at least to acknowledge as much in her film is disappointing.

Again, I'm not faulting Cohen for failing to make a movie about circumcision. There are already several important films - "Whose Body, Whose Rights?""Cut - Slicing Through the Myths of Circumcision" and "American Circumcision" - that have attempted to do for people with penises what Cohen has now attempted to do for people with intersex traits. But it's impossible to view intersex surgery accurately, both in theory and in practice, without contextualizing it within medicine's long history of pathologizing natural and harmless conditions (homosexuality and the penile prepuce are prime examples) and within its long-established practice of using these contrived pathologies as a justification for administering treatments that are neither needed nor desired and, especially, as a justification for performing medically unnecessary surgeries on the genitals of unconsenting children.  By the time surgical modification of the genitals of intersex children became standard protocol, medical professionals in the United States already had been performing surgical modifications to the normal genitals of infant males for decades.  In fact, at that point, most fully and normally developed infant penises were being operated on.  With a precedent like that, what chance might the anomalous genitals of the 0.5 to 1.7 percent of the population that is intersex stand?

Viewed this way, David Reimer's circumcision is neither extraneous nor even incidental to the story that, in "Every Body," Cohen seeks to tell.  That fact that his circumcision, in all probability, and like the vast majority of the million-plus infant circumcisions that are still performed every year in the United States, occurred for no other reason than that Reimer's penis had been patholgized, and because the surgery was therefore both medically unnecessary and imposed on Reimer without his consent makes it, in every way that matters, not just similar in its particulars but morally indistinguishable from the intersex surgeries that are the main focus of Cohen's film.

It is not only in large ways - that is, in principle - but in small ones, too, that nontherapeutic penile circumcision is identical to at least a major portion of intersex surgeries.  I do not know what the statistics are - intersex surgeries run the gamut from clitoral reduction to the removal of internal testes - but these would be those surgeries that are intended to "normalize" the external genitalia of intersex children in order to make them appear more stereotypically "male" or "female."  As a report by Human Rights Watch explains, 

"Intersex," sometimes called "Disorders or Differences of Sex Development (DSD) in medical literature and by practitioners, encompasses around 30 different health conditions that affect chromosomes, gonads, and internal and external genitalia.  In many cases, a significant factor motivating surgical intervention - and often the primary rationale for it [my emphasis] -  is the fact that these conditions cause children's genitalia to differ from what is socially expected of men's [again, my emphasis] and women's bodies.

Similarly and in parallel, social acceptability and meeting cultural expectations about the appearance of a child's genitals are also often the primary rationales for surgically altering a child's penis from an intact one to a circumcised one ("so he won't be made fun of in the locker room," "so his future sex partners won't be turned off").  By the same token, conformity with culturally-determined anatomical standards is embodied in that other stand-by justification for nontherapeutic penile circumcision: "so he will look like his father."

The more sinister aspect of cultural expectations, of course, is the body shaming by which they are enforced.  Alicia Roth Weigel, one of the intersex activists profiled in "Every Body," makes this point

We are told by doctors from the moment that we are born that our bodies are shameful and that they are a problem and need to be fixed and oftentimes we undergo nonconsensual surgeries. . . .  We all have different physical traits or . . . sex traits that maybe some people aren't accustomed to but we are fighting for the message that diversity is a beautiful thing. . . .

What I would tell Weigel, if I had the opportunity, is that there are millions of people with penises in this country who can relate, to one degree or another, with this statement.  The harsh truth is that it is not only intersex people - those with visibly atypical genitalia - whose genitals have been pathologized by the medical establishment.  The medicalization and normalization of penile circumcision have created a culture in which the penile prepuce has been utterly stigmatized.  Body-shaming of people with intact penises continues to be rampant and socially acceptable.  As a result, every person with a penis - whether circumcised or intact - grows up with the perception that they were born with a congenital "deformity" of their penis that either was "corrected" through circumcision or, if it wasn't, ought to have been.  And every time a physician performs a medically unnecessary circumcision, that physician contributes to this body-shaming culture.

Yet another similarity between intersex surgeries and penile circumcision is that both have been and continue to be rationalized on the basis of their putative benefits and prophylactic value.  But, in both cases, the evidence to support these claims is scant and, even when present, the anticipated health benefits - which may not be realized for years or even decades to come, if ever - do not justify depriving people of their right to make such personal medical decisions for themselves.  This is a point that is argued forcefully by Weigel.   In an interview with Terry Gross on Fresh Air (NPR), Weigel explains how the internal testes with which she was born came to be surgically removed when she was less than one year old:

Doctors . . . told my parents that I had internal testes . . .  and that my internal testes could become cancerous one day and so they recommended removing them as soon as possible.  And here's the kicker: anyone who is born with testes could get cancer one day; that is true.   What we now know . . . is my risk of getting cancer is only somewhere between one and five percent and much later in life; that cancer never happens in childhood for people born like me, or very rarely if it ever does.  And so because of a somewhere between one and five percent risk of cancer they decided to remove my hormone-producing organs without asking me. . . .  Essentially, by trying to fix something that wasn't even broken, they created problems. . . .  By trying to fix me, they broke me.

This is how many circumcision survivors feel.  (I'm sure it's how David Reimer felt, too.)  And, by way of comparison, the risks of developing any of the diseases its boosters claim that neonatal circumcision can help prevent are also comparably low.  As Frisch et al. point out

. . . [about] 1% of boys will develop a UTI [urinary tract infection] within the first years of life.  There are no randomized controlled trials (RCTs) linking UTIs to circumcision status.  The evidence for clinically significant protection is weak, and with easy access to health care, deaths or long-term negative medical consequences of UTIs are rare.  [Morever,] UTI incidence does not seem to be lower in the United States, with high circumcision rates compared with Europe with low circumcision rates. . . . Using reasonable estimates . . . for every 100 circumcisions, one case of UTI may be prevented [but] at the cost of two cases of hemorrhage, infection or, in rare instances, more severe outcomes or even death.

So with penile cancer ("one of the rarest forms of cancer in the Western world"), STIs, HIV & AIDS:

. . . only one of the . . . arguments has some theoretical relevance in relation to infant male circumcision; namely, the questionable argument of UTI prevention in infant boys.  The other claimed  health benefits are also questionable, weak, and likely to have little public health relevance in a Western context, and they do not represent compelling reasons for surgery before boys are old enough to decide for themselves. . . .

The importance of allowing individuals to exercise informed consent - to decide for themselves which parts of their bodies they are permitted to keep - that Frisch et al. are asserting here with respect to penile circumcision is mirrored exactly in the sentiments expressed by intersex rights activists.  Here's Weigel, again: 

[A]n analogous example I like to give  . . . [is] the BRCA gene. . . .  The BRCA gene is a genetic variant that confers with it a high risk of breast cancer and ovarian cancer and the risk of cancer if someone is born with the BRCA gene is much, much, much, much, much higher than my one-to-five-percent risk of testicular cancer ever would have been.  But you don't see them force-removing little girls' ovaries who are born with the BRCA gene because they could get cancer one day.  They wait until the girl is a certain age where she is able to make an informed decision with her consent. . . .  
We have suffered these nonconsensual and medically-unnecessary surgeries that everyone from the United Nations to the World Health Organization condemn as torture - they call it genital mutilation - and entire countries have banned these practices. . . . Unfortunately, they happen every day in accredited hospitals in the United States. 

I do not know how often an intersex child is subjected to a medically unnecessary surgery in the United States but even once per day is once per day too often.  At the same time, it's worth remembering that medically unnecessary penile circumcisions occur more than three thousand times every day in accredited hospitals in the United States.

If one accepts the premise of "Every Body" that intersex surgery is a medically unnecessary, nonconsensual body modification that is unethical in and of itself because it violates a person's rights to bodily integrity and self determination, it is difficult to see how can one look at the practice of nontherapeutic penile circumcision (let alone at what happened to David Reimer) and not come to the same conclusion about it, not form the same moral judgement about it, and not be as outraged by it. 

My own view is that, as an abstract principle, any medically unnecessary surgery (that is, a surgery not urgently necessary to save life or limb) that is imposed on someone without that person's consent is unethical.

Keeping that principle in mind, it doesn't matter what the surgery is and it doesn't matter what the sex or the gender of the victim is.

Keeping all of this in mind, all of the particulars of David Reimer's case - not just some of them - matter and are therefore inseparable from the premise of "Every Body."  A more appropriate way to have presented David Reimer, then, would be not merely as an unfortunate victim of happenstance or of medical incompetence who subsequently became a victim of medical malpractice but, rather, as the man whose very life (and, likely, death) represents the nexus between medically unnecessary penile circumcision and medically unnecessary intersex surgery.  

For this very reason, the most appropriate way to honor David Reimer's memory is to take from his case the lesson that the campaigns to end all medically unnecessary, nonconsensual genital (and other, non-genital) surgeries are, fundamentally, one and the same.  It is high time that the movements to end nontherapeutic penile circumcision, medically unnecessary intersex surgeries and female genital cutting (FGC) made common cause with one another and formed the strategic alliances that moral consistency and common sense demand.  The failure of these three pillars of the genital autonomy movement to unite on the basis of their shared logical, philosophical and ethical foundations is the ongoing problem within the genital autonomy movement, and within human rights discourse, more broadly, of which "Every Body" is, I began by observing, a good, if unwitting, illustration.  

I am not suggesting that it is somehow wrong for intersex rights activists to focus primarily on banning medically unnecessary intersex surgeries, for anti-FGC activists to focus primarily on banning FGC, or for anti-MGC (male genital cutting) activists to focus primarily on banning MGC, just as I am not suggesting that it was wrong for Cohen to make the intersex rights movement the primary focus of her film.  But I do think that it would be beneficial to all of these groups to present a united front to the world and to support one another by at least acknowledging their shared values and objectives and by treating one another as respected and valued allies.  Similarly, organizations concerned with promoting human rights more generally and with promoting the common good should be morally consistent and adopt a position of inclusion when condemning harmful practices that violate the rights of children.  Too often, however, the opposite has been the case.

Sometimes this is a failure of omission but sometimes, one of commission.   Equality Now, for example, used to have a "fact sheet" (and I use the quotation marks advisedly) on female genital mutilation (FGM) in which the author or authors went out of their way to differentiate FGM from nontherapeutic penile circumcision, representing the former as abhorrent and never justifiable and the latter as benign. This fact sheet included the eye-popping statement that "circumcision is the removal of foreskin and does not affect the male sex organ itself."  (The male foreskin, or prepuce, is, of course, an integral part of the penis - as integral to the penis, in fact, as any part of the external genitalia, including the female foreskin, is to the vulva.)   In contrast, the statement continued, "FGM damages the sex organs, inhibiting pleasure and causing severe pain and complications for women's sexual and reproductive health." It's a small but encouraging sign that Equality Now has since scrubbed from its site language denying the critical erogenous function of the penile foreskin and dismissing the human rights violation that necessarily occurs when it is surgically removed without consent.

But Equality Now is not the only organization that has gone out of its way to distinguish female genital cutting from male genital cutting.  The World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS have gone even further, explicitly promoting male genital cutting while, at the same time, condemning female genital cutting.  

The reluctance by these organizations and others within the anti-FGC movement to recognize the similarities between FGC and MGC is hard to fathom.  Likewise, their apparent aversion to accepting the banning of nontherapeutic penile circumcision as a valid human rights concern.  Both campaigns to end genital cutting (that is, of penises and vulvas), like the intersex rights movement, rest on the same ethical and philosophical foundation: the right of every individual to bodily self-ownership - the right to control one's own body.  Yet, paradoxically, there appears to be a notion among some within the anti-FGC movement that the movement risks becoming trivialized or diluted by making common cause with the anti-MGC movement.  The thinking seems to be that, because FGC is so much worse, MGC can't be all that bad.  Or perhaps there is an apprehension by some that the true horrors of FGC can only adequately be characterized by distinguishing it from MGC.  But, even allowing that, in certain cases (but by no means all) FGC is more harmful than MGC, that is like reasoning that it's okay to cut off a boy's hand simply because cutting off a girl's arm is so much worse.  Both are wrong and it is morally inconsistent and ultimately counterproductive for opponents of FGC to view opponents of MGC as competitors in a zero-sum game.

An example of the failure of some to acknowledge others within the genital autonomy movement through an act of omission (although someone who is pessimistic about human nature might also view this as an act of commission) would be the post by Organisation Intersex International Europe last year in which it made a point of linking FGM and IGM (intersex genital mutilation) conceptually and strategically while conspicuously omitting male genital mutilation (MGM).  The meme, which was posted on Twitter, depicts a flower suspended between two hands, each coming from opposite ends of the image.  Next to one hand is the caption "#EndFGM" and, next to the other, the caption "#StopIGM."

Other notable examples can be found outside the genital autonomy movement.  The WHO, the United Nations and several other important human-rights- and physicians' organizations, including Physicians for Human Rights, the American Academy of Family Physicians, Human Rights Watch and Amnesty International, "have condemned medically unnecessary surgeries on intersex youth" while remaining silent on equally unnecessary genital surgeries on children with penises.

Still another example of this failure has been the subject of much of this essay: Julie Cohen's film, "Every Body," in which the original pathologizing and medical mismanagement of David Reimer's genitals are passed over and implicitly treated as being fundamentally distinct from the pathologizing and medical mismanagement of the genitals of intersex people.

In contrast to these exclusionary approaches to genital autonomy is the work of bioethicist Brian D. Earp and others who argue for a unified, ethical approach to solving the problem of genital cutting in all its various forms.  On the question, "Female Genital Mutilation (FGM) and male circumcision: Should there be a separate ethical discourse?," Earp concludes,

It is . . . to be welcomed that ethicists, activists and other stakeholders have been campaigning to protect the rights of girls to be free from non-therapeutic, nonconsensual cutting into their genital organs.  I cannot state enough that I am in support of such efforts. . . .  My argument has been that they should not be stopping there.  Female, male and intersex genital cutting . . . should be done exclusively with a medical indication or with the informed consent of the individual.  Children of whatever gender should not have healthy parts of their most intimate sexual organs removed before such a time as they can understand what is at stake in such a surgery and agree to it themselves.

A model of promoting unity and emphasizing the shared objectives of the three branches of the genital autonomy movement is the Worldwide Day of Genital Autonomy (WWDOGA).  Although WWDOGA commemorates a judicial ruling vindicating the rights of a victim of male, or penile, genital cutting, the creators and organizers of this annual event have taken pains to deliver a message of universality on behalf of all victims and potential victims of genital cutting.  WWDOGA calls for "protection for all children from non-therapeutic genital interventions" and "Genital self-determination regardless of sex traits, gender, religion, tradition or where you come from."  Additionally, WWDOGA endorses The 2012 Helsinki Declaration of the Right to Genital Autonomy which states, in part,

Whereas it is the fundamental and inherent right of each human being to security without regard to age, sex, gender, ethnicity or religion as articulated in the Universal Declaration of Human Rights, the International Covenant on Civil and Political Rights, and the Convention on the Rights of the Child[,]

Now we declare the existence of a fundamental right of each human being a Right of Genital Autonomy, that is the right to:

* personal control of their own genital and reproductive organs; and

* protection from medically unnecessary genital modification and other irreversible reproductive interventions. 

Another modest but nonetheless important example of inclusiveness and support for its sibling movements by an organization created primarily to eradicate nontherapeutic, nonconsensual penile circumcision can be found in the Values Statement of the Genital Autonomy Legal Defense and Education Fund (GALDEF) which begins with these words: 

GALDEF promotes solidarity with female and intersex victims of genital cutting and we recognize that some transgender people have also been harmed by penile circumcision. 

(Full disclosure: I serve on the board of directors of GALDEF.)  Most recently, GALDEF has issued a public statement in support of the International Day of Zero Tolerance for Female Genital Mutilation.

There are several reasons why the three pillars of the genital autonomy movement should view and honor one another as allies, and these include not just philosophical reasons but strategic and practical ones as well.  Above all, it's the right thing to do.

A good illustration - and a good example of making common cause - is, again, provided by Alicia Weigel, herself.  (If I have given an unfair amount of space here to Weigel, it's because she is featured prominently in "Every Body" and is a prominent spokesperson for the intersex rights movement.  Additionally, it is because her comments, not surprisingly, are so relevant to the cause of banning nontherapeutic penile circumcision.  Beyond all this, she also happens to be tremendously quotable.)  Weigel, who also serves as a Human Rights Commissioner for the City of Austin, was asked by Terry Gross (in the Fresh Air interview, linked above) what she thought are the strengths and potential drawbacks of intersex people being included with the other communities represented respectively by the initials "LGBTQIA," with the "I," of course, standing for "intersex."  As Weigel explained,

We share so many common experiences.  Just like people who grow up gay, grow up often feeling ashamed  simply for existing, or might have undergone conversion therapy whereas intersex kids also undergo conversion therapy just using surgeons and scalpels, instead of electric shocks.  We also hold a lot in common with the trans community in that we often have had surgeries that change our bodies' gender presentation. . . .  So there's so much natural overlap and allyship between our experience that I think it makes total sense to include us in that community.  Just like there are some gay people who are closeted and not out, there are some intersex people who I think also don't consider themselves part of the LGBTQI+ community - and maybe it's because they're straight in terms of their sexuality; or the choice of their gender was not wrong.  But, for me, including us as part of that community helps all the other letters of the acronym feel compelled to stand up for us; just like the gay community was so vital in the trans folks finally getting a platform to stand up for their needs, we are now asking on all of our brothers, sisters and comrades in the broader queer and trans community to now fight for us, too.  Because, just like I showed up to help kill the bathroom bill, even though it wouldn't necessarily have affected me - it already says "female" on my birth certificate and I pee in the women's room - I was there to really help my trans friends that day, we really hope our gay and queer and trans friends will stick up for us as well, understanding that all of our liberation is intricately bound up in one another's progress [my emphasis].

The intersectionality expressed in this statement can, of course, be expanded even further.  There are literally millions of people with penises who have the exact same anger and resentment about what was done to their bodies that intersex people have about what was done to theirs.  I hope, for this reason, that Weigel may come to look upon these people with these bodies too as her natural allies and that they, in turn, will view and support Cohen's film and embrace Weigel, the other courageous stars of "Every Body," Sean Saifa Wall and River Gallo, and the entire intersex rights movement as allies. 

Another prominent intersex rights advocate, and one who has publicly made the connection between the movements to ban all forms of genital cutting (and other forms of medically unnecessary intersex surgeries), is Mx. Anunnaki Ray Marquez.  Marquez (who is also tremendously quotable: my favorite is "When you've met one intersex person, you've met one intersex person.") is the first person in the state of Colorado to receive (retroactively, and after fifteen months of fighting for it) an intersex birth certificate.  Marquez truly embodies the spirit of intersectionality and of making common cause with all movements to ban genital cutting.

Ultimately, the right to bodily integrity and the right to genital autonomy rest on the foundation of bodily self-ownership, no matter whose body we're talking about.  Either there is a fundamental right to bodily self-ownership that applies to every body, regardless of sex, or there isn't.  And, if there is, that means that that right is not just fundamental but universal.

This ties in to the underlying concept of Cohen's film just as it does to Weigel's comments about inclusion.  Importantly, the demands for justice and equality by any one group within the abbreviation "LGBTQIA" are not trivialized or diminished by the inclusion of any other group within that assemblage.  The cause of advancing gay rights, for example, is not undermined by linking it conceptually and strategically to the cause of advancing intersex rights.  By the same token, the right of intersex people and people with vulvas to autonomous control over their bodies (especially their genitals and reproductive organs) is not diminished, trivialized or threatened by acknowledging that that same right belongs no less to people who happen to have been born with penises.  On the contrary: that right can only be strengthened by recognizing its universality.  It's self-evident that a morally consistent principle is more powerful than one with a carve-out that omits 50% of the population.  Hence, the campaigns to end female genital cutting and medically-unnecessary intersex surgeries can only be strengthened by joining forces with the campaign to end male genital cutting.  Establishing the right to be free from nonconsensual genital surgery on a universal right of bodily self-ownership rather than on a right narrowly tailored to protect only people with vulvas or only people with intersex traits will help secure and guarantee this right for Every Body.


 

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David Balashinsky is originally from New York City and now lives near the Finger Lakes region of New York. He is a licensed physical therapist and writes about bodily autonomy and human rights, gender, culture, and politics.  He currently serves on the board of directors for the Genital Autonomy Legal Defense & Education Fund, (GALDEF), the board of directors and advisors for Doctors Opposing Circumcision and the leadership team for Bruchim.


 

 

 


Tuesday, August 1, 2023

"Cured": What the Gay Rights Movement Can Teach Us About Grassroots Campaigns to Change Medical Practice

by David Balashinsky

In the history of the gay rights movement, certain events stand out as milestones.  First and foremost is the Stonewall uprising in 1969.  Another is the termination by Congress of the Defense Department's "Don't Ask - Don't Tell" policy in 2010 allowing lesbian, gay and bisexual people to serve openly in the armed forces.  Still another is the Supreme Court's 2015 decision in Obergefell v. Hodges recognizing the right to same-sex marriage.  

Less well known by the general public is the decision in 1973 by the American Psychiatric Association (APA) to drop its classification of homosexuality as a psychiatric disorder.  Although it's hard to believe now that gay women and men were once subjected to electroconvulsive therapy (ECT, or "shock therapy") and other "treatments," for decades the APA viewed homosexuality as a condition that needed to be "cured."  Women and men were not merely stigmatized for being gay; their homosexuality was actually defined as a pathological condition by the medical establishment.  As a result, among other interventions that would now be condemned as medical malpractice, gay people were institutionalized, subjected to"aversive therapy" (a technique that involved, in the case of gay men, exposing them to pictures of nude or semi-nude men while administering electric shocks) and even subjected to lobotomies - all in an effort to "cure" them of their gayness.

It took years of advocacy and even direct confrontation before the APA was finally persuaded by gay rights activists (from within but mostly outside the organization) to revise its official stance on homosexuality.  The story of how these activists overcame decades of entrenched thinking within the APA is movingly told in the powerful, heartbreaking yet inspiring documentary, "Cured."

Anyone who cares about human rights should watch this film.  Anyone who cars about the rights of LGBTQIA+ persons should watch this film.  And anyone who cares about ending all forms of forced genital cutting should watch this film.  Why?  Partly because the gay rights movement has been phenomenally successful and there is always something to learn from a successful human rights movement.  But, more particularly, because the battles for gay rights that have been fought over the past 60 years and more have been waged within the social sphere, within the legal domain and within the realm of medical practice.  It is precisely in this respect that the gay rights- and genital autonomy movements have so much in common.

It goes without saying that both movements represent quests for fundamental human rights.  What right is more fundamental, after all, than the right not to have healthy, erogenous tissue surgically removed from one's body without consent?  At the same time, there are other rights perhaps not as crucial as the inviolability of one's physical boundaries but that are still important enough to be regarded as fundamental.  Chief among these is the right to equal protection.  The aim of the gay rights movement is for gay people to have the same rights to housing, employment, marriage, services and public accommodations, government benefits, healthcare and the myriad other rights that (some - not all) hetero people take for granted (rights that, at least, exist on paper).  These particular rights are typically legal rights: that is, they are either codified in statutes or they are rooted even more deeply in the texts of constitutions.  Additionally, an important aim of the gay rights movement has been and continues to be for social acceptance: not just of homosexual relationships but of homosexuality itself, as something intrinsic to an individual's identity.  Gay people want what all of us want: the right to live openly as themselves and without apology for who they are.  A third domain in which gay people have had to fight for their fundamental rights is the subject of "Cured": their treatment (in both senses of the word) by the medical profession.  All of these specific rights can be distilled down to fundamental human rights but it is significant that the struggle to achieve them has taken place within each of these three domains: the law, society, and medical practice.

This is exactly the case with the movement to end nontherapeutic penile circumcision (male genital cutting, or MGC), which comprises one of the three major pillars of the genital autonomy movement (the other two being the FGM-eradication movement and the movement to end the medically unnecessary surgeries that are imposed on intersex children in a misguided attempt to "normalize" their bodies).  Just as the gay rights movement has done, the MGC-eradication movement is pursuing its aims within each of these three spheres.  For example, the groundwork is now being laid for the pursuit of creative and effective legal strategies to redress individual cases of harm while creating impact litigation that will have a positive deterrent effect more broadly on the practice of subjecting unconsenting minors to medically unnecessary, irreversible and life-altering genital surgery.  That is the focus and raison d'être of the Genital Autonomy Legal Defence and Education Fund (GALDEF).  At the same time, campaigns within the social sphere to normalize intactness and to destigmatize the penile prepuce are gaining momentum.  Within the medical sphere, more and more physiciansphysicians' organizations and other healthcare providers and medical ethicists are publicly stating their opposition to the practice of MGC. 

Notwithstanding these encouraging developments, the penile prepuce continues to be disparaged and worse by the medical profession.  It is particularly within the realm of medical practice, therefore, that the penile prepuce bears such a striking similarity to the state of being gay.  Both the penile prepuce and homosexuality have an overlapping history of explicit pathologizing by the medical establishment.  Both have been regarded, therefore, by medical professionals as conditions that warranted aggressive interventions for the well-being of the "patient."  In both cases, the goal of these interventions was the same: the elimination of the offending pathological condition.

It's worth bearing in mind that none of the three domains discussed here - law, society and medical practice - is entirely walled off (or "siloed") from the other two.  There is an active interplay between all of them as the prevailing normative values of each influence and, in turn, are influenced by the others.  That is partly why the problem of MGC has proved so intractable.  The unwarranted privilege it has enjoyed within the legal realm is unquestionably due to its persistent social acceptability and the gloss of legitimacy that it continues to receive from the medical profession.  By the same token, the medical profession continues to cite societal acceptance of MGC (including parental preference and prerogative) as justifications for its continued availability (and for third-party payment for it).  And the fact that legal sanctions have yet to be imposed upon any physician for performing what is nevertheless universally understood to be a medically unnecessary surgery - in contrast to other cases in which physicians have been prosecuted for and even convicted of performing medically unnecessary surgeries - surely indirectly reinforces the continued acceptance within the societal and medical realms for MGC.  By failing to prosecute medical professionals and others for performing any medically unnecessary penile circumcision - an act that, were it to involve any other body part, would be considered not just malpractice but battery - the state implicitly bestows its imprimatur on MGC and does so explicitly in those states (and there are still 34 of them) in which Medicaid Funds are used to pay for it.

But if each one of these three domains supports the other two and, together, all of them undergird the practice of nontherapeutic penile circumcision, it is also true that, like a three-legged stool, without any one of them, the stool must inevitably fall down.  Therein lies cause for hope.  That is why it is imperative that the struggle to eradicate MGC be waged in the legal sphere (in courts and in legislatures), in the public sphere (through media and online forums, through one-on-one engagement and through public protest) and in the medical sphere (through outreach to medical school faculties and students and to medical professionals, through efforts to defund nontherapeutic circumcision by eliminating third-party payments for it, such as Medicaid, through education aimed at new parents and through vociferous advocacy with medical organizations and regulatory bodies).  

Fortunately, not only has exactly this sort of three-pronged approach been employed before but it has succeeded.   To see how, we need only look to the gay rights movement.  In particular, the medical prong - the campaign by gay rights activists targeting the APA's pathologizing of homosexuality - is a paradigm of effective grassroots advocacy.  That is the story told by "Cured," which is why this documentary is must-see viewing for those who support the cause of genital autonomy. 

 

 

This post was originally published as a promotion for a fundraising event to benefit GALDEF that took place on 17 September 2023 which included a special screening of "Cured."  It has now been revised, accordingly. You can learn about distribution efforts for "Cured" by following it on FacebookInstagram and X.  If you're interested in contacting the flimmakers, they can be reached at "Cured"'s website.  The producers of "Cured" have also created a Resource List.  Finally, if you would like to learn more about GALDEF or donate, please visit our website.


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David Balashinsky is originally from New York City and now lives near the Finger Lakes region of New York. He is a licensed physical therapist and writes about bodily autonomy and human rights, gender, culture, and politics.  He currently serves on the board of directors for the Genital Autonomy Legal Defense & Education Fund, (GALDEF), the board of directors and advisors for Doctors Opposing Circumcision and the leadership team for Bruchim.