Tuesday, January 28, 2020

On Stigmatizing the Male Prepuce and Male Body Image: An Open Letter to Cara Natterson, M.D.

by David Balashinsky

Several weeks ago, I attempted to engage Cara Natterson, M.D. in an online conversation about the two topics named in the title of this open letter.  The impetus for this was her recent Times essay, "The Beauty Myth for Boys."  Although Natterson's essay reflects what I believe to be an overdue corrective to popular notions about young men's body image, I also believe that what she says and what she does represent an irreconcilable conflict between two fundamentally opposing principles.  That is because she argues on behalf of male body positivity on paper but performs non-therapeutic neonatal circumcisions (male genital cutting, or MGC) in practice.  I was stunned by this contradiction (not to say hypocrisy).  And yet, because of what she wrote in her essay, I was encouraged to hope that this is someone whose thinking I might be able to influence on the topic of genital autonomy.  As far as MGC is concerned, if there is a problem with Natterson's essay, it is that it starts down the right path but stops before reaching the right destination.  If one genuinely cares about how males view their own bodies, can this lead to any conclusion other than that it is wrong to surgically alter their genitals without their consent?  The premise of Natterson's concern for male body image is that what males think about their bodies matters.  The premise of the practice of forced circumcision is that what males think about their bodies doesn't matter. How, I wondered, does someone simultaneously entertain such mutually exclusive ideas?  It seemed to me that, like most people possessed of the pro-genital-cutting mindset, Natterson wasn't evil: she simply hadn't thought this through.  That is why it seemed that she would be an ideal person with whom to share an exchange of ideas in a forum intended to fulfill the promise of the internet - constructive dialogue - as opposed to what has proved unfortunately to be the internet's ugly reality: invective and "echo-chamber" affirmation of entrenched positions.  I reached out to Dr. Natterson, therefore, with these goals in mind. Unfortunately, despite several attempts to elicit her participation, my letter has gone unanswered.  In order to rescue it from the dead-letter bin, where it would likely remain forever, I am posting it here (with one or two very minor alterations), on my blog.


Dear Dr. Natterson,

Your recent essay in the New York Times, "The Beauty Myth for Boys,"  both struck a chord and hit a nerve with me.

First, insofar as social pressures regarding their bodies are concerned, while there may be some similarities between the experiences of girls and boys and women and men in our society, young men certainly are not subjected to the relentless sexualization and objectification of their bodies that young women are.  Nor is the male experience even remotely comparable to the female experience of constant bombardment with demeaning and sexist imagery.  But, leaving that aside, and allowing that the problem you cite is real, the disparate attention paid to these twin sets of pressures is at least in part due to a vibrant feminist movement that has struggled hard to combat the undeniably greater pressures placed on girls and women in this regard (hence, Naomi Wolf's book), and it is reasonable that that is where feminism should focus its efforts.

Yet it has also long been recognized that patriarchal culture harms both sexes, albeit differently. The ways that males (of all ages) are expected to look and, especially, to comport themselves in our society is as much a construct as the ways that females are.  For both sexes, these expectations are intrinsic to the construction of gender.  Key attributes of masculine gender are stoicism, strength, fearlessness and taciturnity.  When society's expectations conflict with a boy's authentic nature (whatever it may happen to be) and when the inevitable emotional and social difficulties result, he is supposed to "man up," "stop whining and just deal with it."  Our society still discourages males from acknowledging, let alone exhibiting, weakness and pain, whether the pain be physical or psychological.  It seems to me, therefore, that before we can address the body-image problems of boys, we need to address the problem of gender and how it warps human nature to the detriment of both sexes.  To your point, then, about the importance of encouraging boys to communicate their feelings, boys (and men) must first be permitted to express their feelings without being ridiculed, having their masculinity, heterosexuality or even their sanity questioned, or having their sexual orientation or gender identification (or non-identification) attacked.

From everything I have written up to this point, you might suppose at least some concord between us on the question of boys' and young men's body-image problems.  And yet, it is because we are likely on opposite sides of a related philosophical divide that I am reaching out to you in the spirit of constructive dialogue. You see, it is my belief that, to the extent that boys do have body-image problems, one of the ways that our society contributes to them is through the practice of non-therapeutic circumcision, or male genital cutting (MGC).  You, on the other hand, have publicly acknowledged performing neonatal circumcisions.  While I do not believe that you ever intended or desired to cause deliberate harm to the boys and future men whose genitals you irreparably altered without their consent, I do think that you need to hear from at least one man whose perception of his own circumcision (performed long before you started doing these surgeries) is that he was harmed by circumcision.  You make much in your Times essay about valuing the male perspective and getting adolescents to open up about how they feel about their bodies.  While I am no longer an adolescent, I am still connected to the adolescent that I was by an unbroken chain of days lived within this male body.  And expressing myself both as a male and as a victim of MGC, I would like you to understand that what was done to my body without my consent was a violation of my fundamental human rights.  Involuntary circumcision deprived me of the right to bodily autonomy, the right of bodily integrity, and the right to experience the full range of my innate human sexuality.

It also occurred to me, when reading your essay, that there was not just a conflict between our views on body image (let alone bodily autonomy) but an inherent contradiction between your own professed views on the importance of boys having a healthy body image and your practice as someone who performs involuntary circumcisions.  While your support for male body-positivity and your validation of the male experience come through loud and clear, involuntary circumcision is a complete negation of those very principles.

It is universally acknowledged that neonatal male circumcision is not medically necessary. MGC is, in fact, performed primarily for cultural and "aesthetic" reasons.  Social conformity - "so he will look like his father" and "so he won't be made fun of in the locker room" - are among the most common rationalizations offered by parents for having their sons circumcised.  More broadly, because we live in a culture in which MGC has been normalized, many if not a majority of Americans conceptualize a surgically-reduced penis as "normal."  Thus, they tend to regard a healthy, intact penis as abnormal, ergo, deformed.  It remains common, therefore, for intact boys and men to be mocked for the natural anatomical structure of their genitals (hence the concern about locker rooms).  Isn't this the very sort of harmful social pressure exerted on male psyches about male bodies that you criticize in your essay?  Think what a toll this social pressure takes on the body image and self-esteem of intact boys. 

The problem, however, for such boys and young men is not that their penises are intact but that their prepuces have been pathologized by our society.  Thus, it is the very act of MGC and the normalization of this practice that have created a culture in which the male prepuce has been stigmatized.  As a result, every boy - whether circumcised or intact - grows up with the perception that he was born with a congenital "deformity" of his 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, she or he contributes to this body-shaming culture.

While I congratulate you, therefore, on your Times essay and welcome your effort to bring to the attention of the public the body-image problems faced by boys and adolescents,  I would respectfully suggest that a serious and comprehensive discussion of this phenomenon must also take account of the practice of MGC and its harmful effects on male body image and self-esteem.

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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 and as Director of Outreach for the Genital Autonomy Legal Defense & Education Fund, (GALDEF), he serves on the board of directors and advisors for Doctors Opposing Circumcision and serves on the leadership team for Bruchim.
 

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