11 May 2013

Extenuating Circum Stances, Pt. 1: Introduction

As the father to both a daughter and a son, I was struck by the oddity that, while I was asked by several people, including medical personnel and non-medical, interested parties, whether or not I was going to have my son circumcised, not a single person asked if I was going to have my daughter circumcised. Indeed, some people assumed that I was having my son circumcised without asking, as if leaving him uncircumcised was not an option. What is the basis for this assumption? Is it based on social, political, economic, religious, medical, or a combination of factors? And why is there not a similar assumption, or even a question, regarding circumcising our daughters? In order to answer these questions, an examination of circumcision must account for social, economic, religious, cultural, and other factors that have shaped the history and development of the practice, and the controversies that ensue, along the binary lines of gender.

While routine male circumcision is not seen as medically necessary by most medical associations in the world – more on this to come – routine, non-medical circumcision rates in the United States remain high. In fact, routine male circumcision remains the most common surgery in the United States[1] with over 1 million boys being circumcised each year. There is a decline in routine neonatal circumcision; the Centers for Disease Control and Prevention released a report in 2011 that showed a drop in newborn male circumcision from 62.5% in 1999 to 56.9% in 2008 using data from the National Hospital Discharge Survey.[2] Still, the United States stands alone as the last medically advanced nation to routinely perform this surgery on infants. In this sense, male circumcision is a uniquely American phenomenon with a complex history that intersects religious, social, political, economic, and scientific domains. The primary arguments for the widespread continuation of circumcision today tend to come from religious and social points of view, while the arguments against come primarily from scientific views, but economics also finds itself playing a unique part in the reduction of circumcision, particularly in the Western U.S., where immigration of Mexican and other Latin American individuals is high and some states have removed Medicaid coverage of the surgery.[3]

When it comes to the female genitals, however, the United States stands nearly as a whole at the opposite side of the spectrum. The majority of the world’s female circumcision occurs in Africa and several countries in Asia and the Middle East. The World Health Organization has estimated that about 101 million girls aged 10 and older have undergone female genital cutting (abbreviated FGC) in Africa alone.[4] The practice is largely encouraged for religious and social reasons, including ensuring chastity and proving the sexual purity of a girl to her husband. In the West, most opponents of FGC belie any notion of social benefits, insisting that the consequences for FGC far outweigh any possible benefits. And this is the essence of the controversy, what I refer to as “The West versus the Rest,” though, admittedly, this may not be the most accurate description. The debate over FGC is not simple by any means; on its surface it is a about female genitals, but deep down it is about culture, ideology, social status, and, indeed, gender relations.

For the purposes of remaining as neutral as possible while discussing the practices, controversies, and analysis of both male and female genital modification surgery, I have chosen to refer to both practices with the phrase “genital cutting.” While male circumcision is rarely referred to as male genital cutting (MGC), this phrase will be used to avoid confusion and to better compare it to the genital cutting practices of FGC. FGC, meanwhile, will be used to avoid underrepresenting the risks, procedures, or complications resulting from cutting female genitals (i.e., female circumcision) or overstating the horrors typically only associated with the more sever forms of FGC (i.e., female genital mutilation, or FGM). As will be discussed below, different groups prefer different terms depending on the specific cutting practice and its significance to their ideology or tradition.
[1] http://academicdepartments.musc.edu/surgery/divisions/pediatric/procedures/circumcisionhttp://academicdepartments.musc.edu/surgery/divisions/pediatric/procedures/circumcision
[2] http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6034a4.htm?s_cid=mm6034a4_w
[3] Bell 2005:129
[4] http://www.who.int/mediacentre/factsheets/fs241/en/index.html

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