Dear Dr. Axelrod,
You may recall that I wrote you a little over two years ago after I
received an email from you and NARAL Pro-Choice America. I was
on NARAL's mailing list because I support abortion rights and have
donated to this organization in the past. When I wrote you, NARAL had
recently embarked on a campaign of encouraging women who had had
abortions to "come out" and tell their stories. The point of the
campaign was to humanize the reality of abortion, since terminating a
pregnancy is among the most significant and personal decisions a woman
can make about her health, her body and her life. If politicians - most
of whom are men - have succeeded in passing laws that regulate women's
bodies, one of the reasons for their success is that abortion typically
is represented as something abstract. Conversely, abortion is also
frequently misrepresented in the most lurid terms, as is happening now *
with "late-term abortion" bans and "fetal heartbeat" laws. In either
case, putting a human face to the reality of abortion was one
way, as Kate Thomas (digital director of NARAL) wrote in the email, to
"de-stigmatize what is a very common medical procedure." As an OB/GYN and
as a woman who had made the difficult choice to terminate a pregnancy,
you were in a position of particular moral authority to speak out in
support of a woman's right to choose. You did this by sharing your personal story.
I hope you will recall that, when I wrote you, it was partly to
express my admiration not just for your courage in sharing it but for
your doing so on behalf of such an important cause.
On the other hand, if you prefer not to recall my letter to
you in 2017, perhaps it is because my other reason for writing it was to
call your attention to what I felt was a glaring double standard with
respect to your idea of bodily autonomy. This is because, in your
appeal on behalf of NARAL and in support of abortion rights, you wrote,
"It's our body and our decision." You wrote these words even as in
your professional practice - perhaps that very day - you were
depriving male neonates (and the men that they will become) of the right
of bodily autonomy (and of much more, besides) by subjecting them to
non-therapeutic penile circumcision, or male genital cutting (MGC). Frankly, I
was stunned by the contradiction between your claim of bodily autonomy
for women like yourself and your denial of that same right to men
like me.
Before going any further, I should explain why I am under the impression that you perform non-therapeutic
circumcisions.
To begin with, when I visited your clinic's website in 2017, under your name was a list of "services performed" and one
of these was circumcision. I use the quotation marks around "services
performed" because an individual who has had a major portion of erotogenic tissue cut away
from his penis without his consent and in the absence of a
medical indication is unlikely to regard himself as having been the
recipient of a "service."
Now, to be fair, your website did not specify whether the
circumcisions you perform are medically indicated or performed for
non-therapeutic reasons, the chief one of which is that MGC has become a
deeply entrenched cultural practice in the United States. However, the reality is that, currently, in the United States, the overwhelming majority of neonatal penile circumcisions
are performed without a diagnosis, hence, without a rational or
sufficient medical justification for performing them. (And, of course, 100% of them
are performed without consent.) Given
that circumcision is, in fact, medically indicated for between 0.8% and 1.6% of pre-pubescent boys while the
incidence of MGG is currently in the neighborhood of 50%, that makes it
much more likely than not that most of the penile circumcisions that you have performed (like most circumcisions performed by most medical practitioners) were non-therapeutic.
There are other circumstances that tended to confirm my
impression. First, the fact that the initials "F.A.C.O.G." follow your
name. This means that you are a fellow of The American College of
Obstetricians and Gynecologists. This is an organization that has endorsed the American Academy of Pediatrics' 2012 Technical Report
on nonconsensual penile circumcision which, in its own words, "emphasizes the primacy
of parental decision-making." To put that in plain English, the AAP
believes that a parent's right to order the removal of normal,
healthy erotogenic tissue from a child's penis for religious reasons,
for cultural reasons, for cosmetic reasons, for any reason or for no
reason outweighs that child's right to live his life with his genitals
whole and intact. ACOG happily and profitably endorses this view.
It is not an unreasonable inference on my part, therefore, that,
because you are a member of ACOG (like the majority of physicians in
your clinic), you support ACOG's pro-male-genital-cutting policy.
Added to all this is the fact that, at some point after I reached out
to you in 2017, the wording on your website was changed. It now no
longer states that you offer "circumcision" but, rather, "surgical
procedures." It is hard to avoid the suspicion that this is a
euphemism, the use of which represents your clinic's tacit acknowledgement
that routine, non-therapeutic circumcision is a discredited practice
that has been rejected by professional medical organizations around the
world and that is increasingly being condemned as the human rights
violation that it is. For example, in 2016, the Danish Medical
Association issued a statement declaring non-therapeutic circumcision "ethically unacceptable." Lise Moller, the chairwoman of the DMA, was quoted as
follows: "To be circumcised should be an informed, personal choice. It is most consistent with the individual's right to
self-determination that parents not be allowed to make this decision but
that it is left up to the individual when he has come of age."
There are two important ways that all this ties together. By "all
this," I mean the right to obtain a timely, safe and legal
abortion (on which we both agree), the right not to be subjected
to genital cutting (on which apparently we do not agree), and the power
of personal narrative.
To take up this last thread first, I want to emphasize that I was
not only moved by your abortion story but gratified to see such
powerful, first-person advocacy on behalf of the right of women to own
and control their own bodies - a right I have long supported. (I was
out in the streets demonstrating in support of a woman's right to choose
probably while you were still in elementary school - possibly before you were born.) Above and beyond all
this, your story inspired me. It brought home to me the power of
personal narrative. Law, social policy, culture itself can be
unyielding. Progress in all of these domains can be glacially slow. Sometimes, the best way to reach hearts and minds and to effect change
is by speaking one's truth not to the
ether but directly to one's fellow human beings.
Here is my truth and I am speaking it to you: Involuntary
circumcision deprived me of the right of bodily autonomy. It deprived
me of the right of bodily integrity and the right to experience the full
range of my innate human sexuality. I cannot imagine that I would
ever willingly have chosen to have such an important part
of my penis cut off but, even if I would have made that choice, the fact that this "choice" was made "for" me, without my consent, means that I was denied my right to choose.
This brings me to the other major thread of this letter: the
principle of bodily autonomy or, as I prefer to express it, bodily
self-ownership. In the case of your own abortion, you explain that the
fetus you were carrying had developed severe abnormalities and would
not have survived past delivery. This factored crucially in your
decision to terminate the pregnancy. Equally crucial to the
abortion-rights debate is the fact that legislation being passed now by
anti-choice legislators would ban abortions during the second
trimester, which, as you point out,
"often involve medical complications." Although I acknowledge that
abortion is a valid and sometimes necessary medical procedure, my
support of abortion rights transcends any specific medical
justifications for abortion. I believe that girls and women have a
right to choose abortion because I believe that they own their own
bodies. It's that simple. The right to obtain an abortion does not
need to be justified on the basis of severe developmental abnormalities
of the fetus or on the basis of medical necessity for the girl or woman.
It is sufficient that, because it is her body, it is a pregnant
person's right to terminate her pregnancy. It does not follow
from this that every abortion is ethical, nor that every reason for
abortion is morally valid (such as in the case of sex-selection abortion, which I find morally abhorrent). Yet the right to terminate a
pregnancy is as fundamental to basic human rights as any other right
that is predicated on the principle of bodily self-ownership.
That principle - bodily self-ownership - applies no less to males
and to male bodies and to intersex bodies than it does to females and to
female bodies. It applies no less to bodies with penises than it does to bodies with uteruses. And it applies no less to the practice of nonconsensual penile circumcision, which is incompatible with it, than it does to abortion
rights, which are supported by it. As you, yourself, wrote in NARAL's
email: "It's our body and our decision."
One of the goals of personal narrative - coming-out stories, like yours - is to foster constructive and civil
dialogue. I see this personal narrative - this open letter to you - as a way for me to extend a hand in order to
help you across what I believe to be the cultural chasm that divides us.
On your side of the chasm, nonconsensual penile circumcision is a normalized, entrenched cultural practice that has been gilded with counterfeit legitimacy through decades of
medicalization. On my side, nonconsensual penile circumcision is a human rights violation. This is
why: Because it is medically unnecessary. Because it causes needless pain and trauma. Because it is a theft
from an individual of a body part that he has a fundamental right to keep. Because it removes densely innervated erogenous tissue, the loss of which necessarily
impairs sexual function, sensation, intimacy and satisfaction.
Above all, because it deprives people with penises of their
right to choose.
If you believe, as your clinic's website led me to assume you do,
that nonconsensual penile circumcision is a legitimate and ethical practice, you and I remain light
years apart on this issue. If, on the other hand, you believe, as I'm
sure you do, that bodily self-ownership is a fundamental human
right, you are one small step away from recognizing that the right to
obtain an abortion and the right not to be subjected to genital cutting
stand on the same moral foundation.
*Update: Since this open letter was published, the Supreme Court has overturned Roe v. Wade. See my post on the significance of the Dobbs decision here.
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