by David Balashinsky
There is a maxim that one should choose one's battles. With the apparently unending stream of blog posts and articles in parenting sites and magazines on the subject of infant circumcision, one is confronted with the by-now tiresome question: Is this worth responding to? The stakes increase when one has to create a new user name and password in order to comment. Another online ID? Most vexing of all is when one's comment is limited to 5,000 characters. Hence today's BalaBlog post. I am responding to a post in familyshare in which Ms. Amberlee Lovell reinvents the wheel yet again, and poses the novel question, "Should you circumcise your newborn?" Here's the link to her post:
If Lovell's blog post has one virtue (and it is a dubious one, as I intend to argue), it is that it at least treats the appropriateness of circumcision as an open question. Ms. Lovell certainly seems to strive for "balance" in this superficial and disappointingly un-researched post. As much as intactivists like me are baffled that there is anything still "controversial" about the assertion that it is bad medicine and unethical to amputate an important part of a baby's penis without his consent and in the complete absence of medical necessity, the fact remains that, because we still live in a male-genital-cutting culture, forced infant circumcision remains controversial. There is no denying that. That's actually a good thing because it means that our society has moved away from near universal mute acceptance and is now well on the way toward ending this barbaric practice once and for all. We are currently in the controversy stage of that process. For that reason, I think it's unfair to come down too hard on Lovell for attempting to consider "both sides" of this controversy, just as it is unfair to criticize too harshly women who have been subjected to female genital mutilation and in turn want to impose it on their own daughters. Lovell is in and of our own male-genital-cutting culture and that, more than anything else, is what is reflected in her attempt to strike a balance in her post between the pros and the cons of circumcision.
There comes a time, however, when ignorance can no longer be used as a defense. As numerous commenters at the site in which Lovell's post appears who arrived there before I did have pointed out, Lovell cites thoroughly discredited sources in support of forced infant circumcision which even the most rudimentary sort of journalistic research should have prompted her to dismiss. For example (and this is not the only example - not by a long shot), Lovell recycles the claim that circumcision can reduce the risk of penile cancer with nary a mention of the fact that the American Cancer Society itself has stated that "circumcision is not of value in preventing cancer of the penis" and that not smoking cigarettes would have more of an effect in reducing a man's chances of getting penile cancer than being subjected to forced genial cutting would.
For me, the ethical dimension to the question of forced genital cutting makes all other considerations irrelevant but, in the interest of taking up the gauntlet thrown down by those who obdurately attempt to justify routine infant circumcision as a medically valid procedure, I will merely point out that, as with any medical treatment, the burden of proof does not rest with those who oppose the treatment but with those who advocate it. It is highly significant, therefore, that despite hundreds of studies, even its most ardent professional supporters, the membership of the AAP (whose impartiality is highly suspect inasmuch as these physicians benefit financially from the performance of circumcision to the tune of several hundred million dollars annually) concedes that there is insufficient evidence to warrant recommending RIC. At what point does a lack of supporting evidence for a treatment cease to constitute a justification for practicing it? For the advocates of forced infant circumcision, the answer, apparently, is never.
This really brings us to the crux of the matter: Are there really even two sides to this debate? At what point in a society's development and in its concomitant transition from acceptance of a cultural practice to holding that practice in universal opprobrium is it no longer socially acceptable to treat these countervailing impulses evenhandedly? At what point is it no longer acceptable to confer legitimacy upon the cultural inertia that clings to ancient customs by granting it equal status with the movement toward a more ethical society? I would like to suggest in response to Lovell's post that that time has come. As one who has not herself been subjected to genital mutilation, Lovell writes from a position, at least in that one respect, of privilege, and so she has the luxury of regarding the science and the ethics of forced infant circumcision as an "open question." For me, however, as a victim of male genital mutilation, I do not consider this an open question. Knowing what we now know about the history of circumcision, particularly in the United States - how it was promoted during the 19th century as a way to prevent boys from masturbating and as a panacea for numerous other ailments, how it metamorphosed from nineteenth-century pseudoscience into a twentieth-century cultural norm and has persisted as a cure desperately in search of a disease, and how its boosters and defenders routinely inflate its alleged benefits while completely dismissing its harms - to regard the medical validity of forced genital cutting, strictly from a scientific standpoint, as an open question is comparable to climate-change deniers' claim that "the jury is out" on whether climate change is caused by the burning of fossil fuels. It is like the claim of religious fundamentalists and biblical literalists that evolution "is only a theory" and that the Earth is really only 7,000 years old. There actually is broad scientific consensus on these questions. Circumcision is no different. That is why not a single national professional medical organization on Earth recommends RIC whereas several such organizations outside of the United States not only discourage it but have condemned RIC as a human rights violation.
There is simply no getting around the fact that RIC - or more properly, male genital mutilation (MGM) - is a medically unnecessary surgery that violates four of the most basic and important principles of medical ethics. First, not to do harm. Second, not to provide a treatment in the absence of a medical problem (such as a disease or harmful congenital deformity). Third, to opt for the least invasive or aggressive treatment available when there is a disease or other medical problem. And, fourth, to obtain consent from the patient before rendering care unless the patient is incapable of providing consent and the treatment is required urgently to save life or limb. Routine infant circumcision violates every one of these principles.
From a moral standpoint, to treat involuntary genital cutting as an open question is comparable to putting slavery up for debate and claiming that there are two sides to this question and that "people of good will can have an honest disagreement" about whether the benefits of involuntary servitude to society as a whole outweigh the harms (or "risks," to adopt the euphemistic language of forced-circumcision advocates). It is amoral and pure sophistry to cloak a human rights violation in the mantle of medical legitimacy for the purposes of academic debate. An act that is manifestly harmful and that deprives a human being of the right to control his or her own body cannot be considered in a moral vacuum. That is the essential ethical problem in which the pro-circumcision versus pro-human rights debate is entangled and thus, despite paying lip service to this fundamental question, Lovell's post ultimately fails in that it treats what is in fact an egregious human rights violation as an open question.
Lovell asks, "Should you circumcise your baby?" I ask, How many millions more males and intersex infants must have their most basic human right violated before our society universally acknowledges that every human being is born with an inalienable right not to have a body part amputated or surgically altered for reasons of custom or cosmesis in accordance merely with the predilections of that child's parents?