What do you think when you hear the terms circumcision and FGM? Do you think the male variety is acceptable, whereas the female one is impermissible mutilation? Or maybe you think that male circumcision is bad, maybe just not as bad as FGM. As we will see throughout this article, matters are more complicated, and the collapsing of unnecessary genital surgeries into perceived categories of moral acceptance based on sex, rather than harm from the procedure, is harmful and contributes to discrimination.
This is of course not to downplay FGM, which is an unethical and barbaric practice, and this is not a contest about who has it worse. I am merely trying to point out the double standard we have in the West on these two practices and encourage a solution to this dilemma that incorporates children’s rights (their right to genital integrity and informed consent) regardless of their sex genitalia. So, without further ado, let’s begin.
There are forms of FGM today that are less invasive than male circumcision, such as the ‘ritual nick,’ which are criminalized, illegal, and seen as a severe human rights violation, and yet the more severe male procedure is legal and not frowned upon as such.
Davis 2001 writes:
- “…federal and state laws criminalizing genital alteration on female minors are so broad that they cover even procedures significantly less substantial than newborn male circumcision.”
- “…a complete laissez-faire attitude toward one practice coupled with total criminalization of the other, runs afoul of the ‘free exercise’ clause of the First Amendment. There are also troubling implications for the constitutional requirement of equal protection because the laws appear to protect little girls, but not little boys, from religious and culturally motivated surgery.”
She demonstrates this brilliantly by comparing male and female genital alteration in similar circumstances to show the hypocrisy behind these legal distinctions.
Case 1:
If we “match up” a deeply religious Muslim couple who wish to have their daughter altered and who believe it is a religious obligation, and who are willing to accept the Seattle compromise, with a deeply religious Jewish couple who wish to have their son altered because they believe it is a religious obligation, it is hard to justify why the first couple’s wish is illegal and the second’s is not. If we imagine that the Muslim girl’s experience will be a tiny nick with proper pain control in a hospital context, while the Jewish boy’s experience will be a somewhat larger operation by a nonmedical practitioner without adequate pain control, the justification becomes even more difficult.
Case 2:
In this case, we could have a Jewish couple who are planning a surgical operation, without the attendant ritual, by a physician who is not a mohel. Nonetheless, if questioned about their decision they insist that it is part of being Jewish, and that leaving their boy unaltered is unthinkable; they don’t know if they will ever join a synagogue, educate the boy religiously, or have him bar mitvah, but they do know that leaving him uncut will make him look odd to his Jewish friends, may have a negative effect on his ability to marry a Jewish girl, and will bring down the wrath of their parents. Match that couple with a couple from sub-Saharan Africa who are vague about their religious beliefs but have a general feeling that to leave their little daughter uncut is somehow non-Islamic; further, they have good reason to fear that their daughter, if left uncircumcised, will be laughed at, perhaps ostracized, and have a very difficult time marrying within their culture. Again, what is the justification for respecting the first couple’s mix of beliefs and custom, but not the second?
While these cases were specifically designed as “hypotheticals,” they are realities in our current legal system which, as Dena Davis states earlier, carries: “the unmistakable taint of intolerance and double standards.”
Furthermore, another paper published by The British Journal of Medical Ethics in 2016 further unveiled the double standards between how they are viewed in American society:
- “Male circumcision is legal in USA and tolerated in most of the world, even when done by non-medical practitioners in the home. Yet comparable or less radical procedures in women are deemed misogynistic and human rights violations.”
- “..the International Federation of Gynecology and Obstetrics as well as WHO have labelled all forms of FGA as a human rights violation as it violates ‘bodily integrity in the absence of any medical benefit’ and victimises vulnerable girls. However, male circumcision is also a procedure that violates bodily integrity and up to recently was thought not to have justifiable medical benefit — but was instead tolerated due to religious and cultural freedom and the lack of long-term harm.”
The bioethicist Brian Earp has also noted:
- “There are now legally prohibited forms of medically unnecessary female genital cutting — including the so-called ritual nick — that are less severe than permitted forms of medically unnecessary male and intersex genital cutting.”
He has written about the differences in ‘khatna,’ which is the genital cutting procedures practiced for both sexes in Islam. The male procedure is more severe and yet completely legal, whereas the female procedure is criminal in all 50 states and treated as a ‘mutilation.’
- “The Bohras practice what they call “khatna” — an Arabic word for circumcision — on both girls and boys within their community…In the female case, “a pinch of skin” is typically cut or removed from the clitoral hood, often leaving no visible sign of alteration. In the male case, the entire penile foreskin is removed, leaving an unmistakably altered sexual organ. According to the ruling by Friedman discussed in the previous section, the less severe female procedure is already illegal in all 50 states — as a criminal assault. It might seem, then, that the more severe male procedure must also be a criminal assault. In fact, that has been a dominant view among legal scholars who have addressed the issue since 1984. However, the male procedure continues to be treated as legal regardless of jurisdiction, including in its more dangerous forms.”
The double standards don’t stop there. There is a procedure that ultra-Orthodox Jews perform called ‘metzizah b’peh’ which is an ancient, unhygienic form of male circumcision where the “mohel” (traditional circumciser) tears the immature foreskin from the penile glans, typically without pain control, and then takes the baby’s penis into his mouth to staunch the blood and supposedly “cleanse” the wound. This has been known to have caused many cases of herpes and led to two cases of serious brain damage and two deaths in one year alone. Not only is this practice not treated as illegal — it isn’t even regulated. City officials ultimately dropped even an informal plan to require that parents sign a consent form.
However, any forms of female genital cutting, including ones done in sterilized and anesthetized manners, are seen as illegal and criminal, full stop.
Now, some might respond with something to the degree of: “Circumcision has health benefits whereas FGM has none.”
Well, the question I would ask is: “If FGM was demonstrated to have health benefits, would you concede your position that it is a moral wrong?” Presumably not, and this is merely a moral red herring.
The removal of any body part is likely to contribute to some form of ‘health benefit.’ Tissue that has been excised can no longer host a cancer, become infected, or pose any other problem to its erstwhile owner. But as the bioethicist Eike-Henner Kluge has noted, if this logic were accepted more generally, “all sorts of medical conditions would be implicated” and we would find ourselves “operating non-stop on just about every part of the human body.”
With regards to female genital alteration, there have been some research which has suggested: “a lower risk of vaginal cancer … fewer infections from microbes gathering under the hood of the clitoris, and protection against herpes and genital ulcers.” — Source 1, Source 2
Moreover, at least two studies by Western scientists have shown a negative correlation between female genital cutting and HIV. The authors of one of the studies, both seasoned statisticians who expected to find the opposite relationship, described their findings as a “significant and perplexing inverse association between reported female circumcision and HIV seropositivity.”
Again, no one would ever consider making FGM legal based on these potential prophylactic health benefits.
Finally, I would like to end by bringing to your attention something known as ‘cosmetic’ female genital cutting. This typically consists of medically unnecessary procedures involving partial or total removal of the external female genitalia or other alterations to the female genital organs for perceived cosmesis — widely practiced in Western countries and generally considered acceptable if performed with the informed consent of the individual. These consist of the same procedures that are typically classified as FGM.
Given that there is overlap (or a close anatomical parallel) between each form of WHO-defined ‘mutilation’ and Western- style ‘cosmetic’ female genital cutting, neither of which is medically necessary, one must ask what the widely perceived categorical moral difference is between these two sets of procedures. Controlling for clinical context varies across the two sets and is often functionally similar — the most promising candidate for such a difference appears to be the typical age, and hence presumed or likely consent-status, of the subject. But if that is correct, it is not ultimately the degree of invasiveness (which ranges widely across both sets of practices), specific tissues affected, or the precise medical or non-medical benefit- to-risk profile of medically unnecessary (female) genital cutting that is most central to determining its perceived moral acceptability. Rather, it is the extent to which the affected individual desires the genital cutting and can consent to it. This suggests that the core of the putative rights violation is the lack of consent regarding a medically unnecessary intervention into one’s sexual anatomy. This consideration applies regardless of the sex or gender of the non-consenting person.
In summary, it is our duty to ensure that everyone gets equal protection under the law regardless of their sexual anatomy and to do this, we cannot carry on applying selective zero tolerance towards genital mutilation and unnecessary and arbitrary interferences with people’s autonomy. We cannot fully progress as a society unless this is done.
Thanks for reading!
