Extenuating Circum Stances, Pt. 5: Cutting to the Chase

Genital cutting is deeply gendered. While the long histories of both practices revolve around ideas of perceived sexual purity, morality, and cleanliness, males across cultures are generally considered to be sexual while women are not held with esteem to their sexuality, or rather, their solo sexuality. In other words, women are considered sexual in light of their husbands. As a result, MGC is often talked about for its social benefits of reducing embarrassment, reducing instances of masturbation, increasing sexual potency and longevity, reducing the risk of sexually transmitted infections, and other sexual benefits. In only two cases, that of reducing the risk of cervical cancer in women and of women preferring the attractiveness of a circumcised penis (an argument that does not seem to have any scientific merit), do women factor into the “benefits” of MGC. Most of the perceived benefits of MGC are male-only.

On the flip side, males factor heavily into the practice of FGC. From the Western perspective, the practice is considered to be the result of a male-dominated society: FGC is social “proof” of purity for the husband; total infibulation results in a smaller vaginal opening, which increases pleasure for the male; vaginal aesthetics are improved through the removal of labia; and clitoridectomy removes the male portion of the female genitals, to name a few. With Muslim sunnat, women are not required to but may be expected to undergo the procedure to match the suffering of Mohammed and the Muslim men who undergo MGC. Additionally, sunnat is seen as a blessing that would improve a woman (Gollaher 47).

Considering only the male-female dichotomy on the surface of both practices does not allow for a complete understanding of other gender related factors. Undeniably, gender differences permeate into other spheres of influence, and these spheres, in turn, influence both MGC and FGC. Looking specifically at the public-private spheres, one can quickly discern a difference in the ways in which genital cutting practices are carried out. The public-private sphere theory asserts that, across a wide spectrum of cultures, women are confined primarily to the private, or home sphere, while men, and any associated “male” activities, exist very much in the public sphere. When women are in public, they must be pure and clean, covered up, modest, and be in the company of other women or children. In Islamic society, when a woman is no longer sexually active or able to procreate, she is allowed to mix with men in public or social settings. If a woman is seen as a sexual being in public, there is a loss of sexual purity in the matrimonial relationship. As Rodriguez states, “healthy women were not thought of as sexual beings—or rather, not sexual beings on their own, without the promptings of their husbands” (2008:332). Thus, in an effort to reduce the risk of female sexual infidelity, female sexuality, and the root of female sexuality, must be removed, or at the very least, cut. In this sense, the fear of female sexuality and an emphasis on patrilineal purity, resulting from the need for a woman to be the representation of sexual modesty and honor for her family, namely her father and brothers, may have driven the development or continuation of some practices of FGC worldwide. This same sense of purity of the patrilineal line does not exist in Western society, where smaller, nuclear families are the model.

Additionally, MGC is often compared to other common medical practices, such as tonsillectomies and wisdom tooth removal (“The Doctors” 2012; Gollaher). While this is often not how FGC is described in Western medical and social literature or media, one opinion piece written in 2001 by a male medical doctor from Nigeria living in South Carolina does contain comparisons to other forms of body cutting:

We “mutilate” the umbilical cord by cutting it off at birth and arbitrarily deciding how long the navel should be. We “mutilate” our bodies with ear rings, tongue rings, tattoos [sic], nose jobs etc... We "keep" biologically excretory products like nails and hair - and use them for beautification - and do so differently, I might add, depending on the cultural environment. Some western women (in the US) begin to shave their leg hair at age 10. Has anyone else in the world attacked them for mutilating what God put there for a reason? We use traditional marks for medicinal and symbolic purposes.... Why is that not 'mutilation' of the skin? Why not ban it? (Omoigui 2001)

Comparing the cutting of an umbilical cord, which does not contain nerve endings, and which dies upon detaching from the mother’s body, to the removal of a body part containing more nerve endings than the fingertips is hardly copasetic. Comparing either MGC or FGC to any other non-medical surgery, cutting, or piercing practice which is done with the consent of the individual also leads to problems. Consent is an important part of the social and cultural idea of personal freedom. Opponents of genital cutting, particularly FGC, take issue with the lack of personal freedom in the decision to undergo the surgery.

In some cultures, it may be customary for younger children to get tattoos, have their teeth chiseled, or get piercings in their ears, lips, noses, genitals, etc. In the West, these practices are not common in children; while ear piercings are common among youth, stretching of piercings, piercings in other parts of the body, and tattoos require individuals to be of a certain age before they can be performed legally. Opponents of genital cutting would likely oppose other forms of skin cutting, piercing, or tattooing, in cases where children or women are forced, either physically or socially, to perform the body changing activities.

Comparison of either practice to surgeries that are deemed necessary for medical reasons presents additional problems. Neither tonsillectomy nor wisdom tooth extraction are quite as prevalent in the U.S. as MGC. Furthermore, tonsillectomy may be a preventative surgery in many cases, but it is also performed in response to tonsillitis. Even as a preventative surgery, the medical history of the patient and the patient’s family is weighed against current medical research on the risks of tonsillitis and options are discussed with the individual. In other words, the patient consents to a practice upon gaining information; tonsillectomies, for example, are not performed routinely on infants, nor are surgeries for actual birth defects that may or may not cause complications later in life, such as heart murmurs.

While proponents of male circumcision in the West tend to deny similarities between MGC and FGC, opponents of both practices often draw connections between the two and argue that "the cultural explanations and justifications for male and female surgeries are similar" (Bell 2007). As was discussed earlier, masturbation, sexuality purity, and personal and moral hygiene factor into both processes. In both cases, the cutting occurs primarily on children and infants, who do not have the capacity to give consent, even if they are old enough to communicate. Social pressures, including teasing and embarrassment, may also increase the likelihood that parents or children will feel obligated to have the practice performed.

Interestingly, there are differences between FGC and MGC having to do with informed consent. Western views place more emphasis on lack of consent with regard to FGC, stating that girls are forced to go through with the violent practice without being fully informed of the options or risks. Perhaps because, at least in Africa, FGC is generally carried out on girls who are no longer infants, some even in their pre-teens or teen years, the idea that long-term psychological and health problems arise from FGC that are not seen in MGC. Some forms of FGC are conducted on infants and may be less intrusive. There is often no distinction made. MGC, on the other hand, is often discussed with regard to the rights of the parents and not the rights of the infant, with the major exception being from the perspective of intactivists. It stands to reason that, considering the majority of arguments for both MGC and anti-abortion legislation come from religious groups, many of the same people who fight for the right to life of a fetus over the rights of a mother’s choice draw a line at birth and argue for the rights of the parents over the rights of the infant with regard to the infant’s genitals.[1]

Male and female genital tissue has different significance based on cultural perspectives as well. Modern Western medicine’s view of the foreskin for most of the 20th Century has held that it is a relatively worthless leftover from man’s early days. As a result, after being removed from a penis, the foreskin is tossed away. At least, that is until recently when foreskin tissue has been used by cancer and other disease researchers for a variety of practices, including testing, growing cells, and more (Gollaher 65; 165). “Ritual [MGC], in contrast, in Madagascar and many other places, holds the foreskin in talismanic esteem,” – indeed, women across many cultures exhibit unique practices regarding the use of the forskin upon removal, including storing the foreskin in jars, burying the foreskin in sand, and even swallowing them to promote fertility (Gollaher 65-66). I could uncover no information on the uses of labial, sheath, or clitoral tissue upon removal from the female; should it be discovered that the tissue be used for ritual or scientific purpose, Western opponents of the practices would react with an intensity anew.

Perhaps the least talked about example of gender division in genital cutting is the way in which the West deals with humor surrounding the practice. FGC is talked about with grave solemnity sans any humoristic tone. MGC, on the other hand, is the source is several jokes and can be discussed in social settings through the use of humor. In a 2012 episode of medical talk show The Doctors, a Pediatrician joked, “Well, you couldn’t walk for a year!” after a Plastic Surgeon jokingly stated, “I’m sure it hurt, but I don’t remember” (“The Doctors” 2012). Additionally, jokes involving over-circumcision, foreskins, and penises in general are in no short supply. A common example of such a joke is one I have heard repeated from several individuals in various forms throughout my life: “I was circumcised and they threw the wrong part away.” Indeed, humor surrounds a number of unfortunate MGC acts, including the now infamous Lorena and John Bobbitt penile castration story. If jokes exist regarding FGC, they are not known to me or Google. This is not to say that factors that play into or influence FGC, including cultural and religious traditions, male dominance, and misogyny, do not get ridiculed or become the focus for jokes. Certainly, there is no shortage of misogynistic jests and the content of such jokes may even reference female genitalia. However, the physical act of FGC, in any form, is not common in humor, at least in the West.

Lastly, one view, that of psychotherapist Bruno Bettelheim, stands out as relatively unique amongst most other. Bettelheim puts a large emphasis on the female influence of MGC, claiming that “circumcision developed as a result both of man’s desire to participate in the female power of procreation, and of woman’s desire, if not to rob the male of the penis, at least to make him bleed from his genital as women do” (Gollaher 69). Of course, this view present problems in application: MGC, generally speaking, does not have any effect on procreation and certainly does not allow a male to become pregnant or give birth; MGC typically does not result in extended periods of bleeding, and in no documented cases has it led to bleeding on a monthly cycle for the majority of a male’s adult life. Conversely, FGC can lead to complications in childbirth or in sexual intercourse prior to pregnancy. If it is true, at least on a social level, that MGC allows men to “procreate” in the sense that they produce more men through the act, then certainly the same argument could be made for women and FGC, as FGC is a marker for the passage into womanhood for some cultures. This, consequently, removes the uniqueness of MGC for procreation, for if MGC is truly to mimic female genitals, we would expect to see only MGC practiced. Yet, both practices are observed occurring in the same cultural groups many times over. Furthermore, if MGC represented a deep-seated need for men to bleed from the genitals as women do, we would also expect to see universal application. This, however, is not the case. Additionally, this notion does not account for notions of duality, as is found in various cultures in Africa, such as the Dogon, the Bambara, and the Lobi of Mali. In these groups, the prepuce is considered to be the female portion of the penis, just as the labia and clitoris might be considered male.

As a result of the long history of MGC in the West, combined with the cultural, social, and other factors that have influenced opinions on MGC, attitudes differ strongly in terms of MGC and FGC. It is difficult for many to see a connection between the two, with even those who are educated in medical science refusing to allow comparisons across gender lines. As Bell put it so succinctly, “all forms of female genital cutting are seen to constitute a sexual mutilation and violation of bodily integrity, and male genital operations are dismissed as benign” (Bell 131). Opinions are subjective, based upon the religious views on MGC one was taught since birth, social factors that include the circumcision status of the parents, and ideas or assumptions about male and female sexuality. For some, if a man can get an erection, there is no harm done (Bell 127). No consideration is made for risk, scarring, sexual dysfunction later in life, or personal preference of the individual whose genitals were cut. Conversely, FGC is only considered in light of its negative consequences, with little or no consideration for the social and cultural benefits. In other words, there is a tendency to downplay the risks associated with MGC while exaggerating those associated with FGC, and at the same time emphasizing benefits to MGC that may not actually exist. When broken down, the two practices can be reduced to only two primary differences: legal status in the West; and the likelihood for severe damage is somewhat higher for FGC. Until both practices can be seen wholly in light of their gendered statuses, regardless of the other factors that affect acceptance or disapproval of either, there will continue to exist a colossal chasm of gender which impedes thoughtful analysis by the public at large.



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[1] Note that this is mere speculation based on arguments in popular news media in the absence of legitimate research into pro-MGC groups, their relationships to Right to Life groups, and their religious affiliations.


Sources:

Scholarly Books and Articles

Bell, Kirsten. “Genital Cutting and Western Discourses on Sexuality.” Medical Anthropology Quarterly, Vol. 19, Issues 2, pp. 125-148.

Centers for Disease Control and Prevention. “Trends in In-Hospital Newborn Male Circumcision, United States, 1999-2010.” Morbidity and Mortality Weekly Report. Last updated 2 Sep. 2012. Visited 4 May 2013. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6034a4.htm?s_cid=mm6034a4_w

Gollaher, David L. Circumcision: A History of the World’s Most Controversial Surgery. Basic Books: New York, 2000.

Sarah W. Rodriguez “Rethinking the History of Female Circumcision and Clitoridectomy: American Medicine and Female Sexuality in the Late Nineteenth Century.” Journal of the History of Medicine and Allied Sciences, Volume 63, Number 3, July 2008, pp. 323-347

Shoen, Edgar. “Circumcision Updated-Implicated?” Pediatrics 92 (1993), pp. 388-391.

World Health Organization. “Female Genital Mutilation.” WHO Fact Sheets. Last updated Feb. 2013. Visited 6 Apr. 2013. http://www.who.int/mediacentre/factsheets/fs241/en/index.html

World Health Organization. Female Genital Mutilation: A Joint WHO/UNICEF/UNFPA Statement. Geneva: WHO, 1997.

Sources from Popular Media

American Academy of Pediatricians. Where We Stand: Circumcision. Last updated 28 Jan. 2013. Visited 12 Apr. 2013. http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-Circumcision.aspx

Brady, Brittany. “Babies’ herpes linked to circumcision practice.” CNN Health. Last updated 8 Apr. 2013. Visited 6 May 2013. http://www.cnn.com/2013/04/07/health/new-york-neonatal-herpes

Connolly, Kate. “Circumcision ruling condemned by Germany’s Muslim and Jewish Leaders.” The Guardian. Published 27 Jun. 2012. Visited 6 Apr. 2013. http://www.guardian.co.uk/world/2012/jun/27/circumcision-ruling-germany-muslim-jewish

D’Arcy, Janice. “’Intactivists’ furious at new AAP circumcision policy.” Washington Post. Published 30 Aug. 2012. Visited 9 May 2013. http://www.washingtonpost.com/blogs/on-parenting/post/intactivists-furious-at-new-aap-circumcision-policy/2012/08/29/67ccd6d0-f235-11e1-adc6-87dfa8eff430_blog.html

Goldman, A.J., Donald Snyder, and Nathan Jeffay. “Circumcision Controversy Endangers Fight To Keep Rite Legal in Germany.” The Jewish Daily Forward. Published 6 May 2013. Visited 9 May 2013. http://forward.com/articles/175915/circumcision-controversy-endangers-fight-to-keep-r/

Halperin, Mordechai. “Metzitzah B’peh Controversy: The View from Israel.” Jewish Action Online. Last updated 6 Mar. 2012. Visited 9 May 2013. http://web.archive.org/web/20120306221308/http://www.ou.org/jewish_action/article/8987

The Huffington Post. “Circumcision Controversy Brings Yona Metzger, Israel Chief Rabbi, to Germany.” Published 21 Aug. 2012. Visited 9 May 2013. http://www.huffingtonpost.com/2012/08/21/israel-chief-rabbi-in-ger_0_n_1816735.html

Omoigui, Nowa. “OPINION.” Vanguard Daily (Lagos). Visited 12 Apr. 2013. Available at http://www.circumstitions.com/FGM-defended.html

Rosenblum, Emma. “Jewish But Don’t Want to Circumcise?” New York Magazine. Published 18 Oct. 2009. Visited 10 May 2013. http://nymag.com/health/features/60149/

Schwartzman, Richard. “The Emotional Consequences of Circumcision.” Beyond the Bris: Questioning Jewish Circumcision. Published 20 Feb. 2013. Visited 9 May 2013. http://www.beyondthebris.com/2013/02/the-emotional-consequences-of.html 

Extenuating Circum Stances, Pt. 4: FGC

FGC has a significantly less widespread occurrence, particularly in the West. In the early 1970s, during the second wave of feminism, FGC began to garner a lot of public attention. It became a cause for many in the West to rally against as a completely violent form of oppression for women. According to the WHO, “female genital mutilation is universally unacceptable because it is an infringement on the physical and psychosexual integrity of women and girls and is a form of violence against them” (WHO 1997). As some activists point out, FGC is similar to MGC in that it involves violence in the form of genital mutilation without consent. However, the language in Western literature and media concerning FGC is far more expressive in terms of violence, mutilation, and negative effects of the practice.

Historically, neither male nor female genitals have been fully understood and the question remains whether or not they are fully understood today. Female genitals, in particular the clitoris, have been assigned a wide variety of attributes, many seen as negative by authoritative bodies, and, as a result, have been victimized through a wide variety of practices. Throughout time, the clitoris has been considered equivalent to the male glans, the seat of female sexual pleasure, the root of female sexual impurity, the residence of immature female sexuality, the source of many emotional and psychological disorders in women, necessary for procreation, and not at al necessary for procreation, amongst other things (Bell 2005; Rodriguez 2008). Curing masturbation was a particular focus for the practice of FGC in the U.K. and the U.S. The act of masturbation was seen as unnatural because “the object of desire was not real but rather a product of the imagination; masturbation was not socially engaged… and the desire and ability to masturbate was potentially endless” (Rodriquez 2008: 331).

Most literature on FGC revolves around the practice as it takes place in Africa and parts of the Middle East and Asia. Western feminists largely support the WHO and other organizations that describe the practice as violent towards women and a violation of human rights. However, the practice is largely supported and performed by women who have either had the procedure done themselves or who support the practice within their own culture. Western ethnocentric ideals lead many to ignore the cultural and social histories of the various forms of FGC in certain regions of the world, making it difficult for them to view the practice as anything but mutilation. As a result, Western imperialism in the form of intellectual and informational authority and activism are forcing a changing of cultural values in the non-Western world. This topic alone can warrant a entire thesis, let alone a separate research article, and has been discussed and debated by many already.[1]


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[1] See Obermeyer 2003; Gruenbaum 2001;Shell-Duncan and Hernlund 2000; Dirie and Miller 1999; Dorkenoo 1994; and El Sadaawi 1980 for reference.

Extenuating Circum Stances, Pt. 3: Science and Tradition

Since the 1970s, routine MGC has seen a steady increase in opposition. According to social anthropologist Kirsten Bell, “the anticircumcision movement began to gain ground in the 1980s, with the publication of Edward Wallerstein’s (1980) respected Circumcision: An American Health Fallacy.” Since Wallerstein’s work, several groups have sprouted in the U.S. dedicated to eradicating unnecessary MGC, such as the National Organization of Circumcision Information Resource Center, or NOCIRC,[1] and the National Organization to Halt the Abuse and Routine Mutilation of Males, or NOHARMM.[2] Both organizations claim that they are aiming to make the world safer for children through education and activism. In more recent years, the word intactivism has been used to represent those in the U.S. who oppose routine neonatal MGC. Many intactivists argue that the procedure is not only unnecessary, but that the practice is child abuse in the form of genital mutilation, and that it denies the child of his inherent right to an intact penis (D’Arcy 2012). Additionally, others may stress the significant physical and emotional trauma that occurs as a result of the procedure (Schwartzman 2013).

MGC presents a unique meeting place for science and tradition. In other fields of medicine, scientific inquiry and research results tend to influence practice. As evidence accrues for a particular outcome, old practices are discarded and new, and hopefully safer, practices take their place. Oddly enough, this model does not fit the history of MGC in the U.S. Instead, the American Association of Pediatrics (AAP) has gone back and forth on their views of circumcision over the years, resulting in confusion both in the medical community and the public at large. MGC became a standard practice for the prevention of disease, included among them the practice of masturbation, starting in the mid to late 19th Century. By 1920, the practice had become so standardized it wasn’t questioned and was considered standard practice without parental consent in many American hospitals (Gollaher 2000:172). Under pressure from opposition in the 1970s, the AAP reviewed what little evidence there was and decided that there was no absolute medical reason to circumcise (Bell 2005: 128). The AAP maintained this position, with some slight variations across the years, until mid-2012, when the group released the following stance: “A recent analysis by the AAP concluded that the medical benefits of circumcision outweigh the risks” (AAP 2013). The group stopped short of actually endorsing the practice of routine neonatal MGC, but its change in position incited fury amongst those who oppose MGC. The change in statement also meant that the AAP’s position now stands in opposition to the positions of national programs in other medically advanced societies including Canada, the U.K., Sweden, and Australia.

Additionally, the AAP’s stance seems to go against the evidence of modern medical research. While there is a positive correlation of MGC with a reduction in penile cancer rates in clinical research, worldwide rates of such cancer are so low, that the results are mixed. The majority of Swedish men, for example, are uncircumcised and have some of the lowest rates of penile cancer in the world. Additionally, penile cancer is so rare, that using it as justification for prepuce removal is a less rational argument than encouraging the removal of breast tissue to prevent breast cancer in females. As medical TV show co-host and pediatrician Jim Sears stated, “More babies die from getting circumcised than men die from getting penile cancer.” To risk not pointing out the obvious: penile cancer is a skin cancer; surely removing one-third to one-half of the total skin of the penis reduces the risk of contracting the disease.

In 1993, Edgar Shoen of the AAP stated the MGC should be considered “analogous to immunization in that side effects and complications are immediate and usually minor, but the benefits accrue for a lifetime” (Shoen 1993). This statement was made in direct relation to “conclusive evidence” that MGC resulted in a reduction of the risk of urinary tract infection (UTI) in males. While this appears to be the case, UTIs are much less common in men than women – “By one year, UTIs become ten times more common in girls… [and between] twenty and fifty years of age, women’s incidence of UTIs is fifty times greater than men’s” (Gollaher 155) – and the AAP does not recommend genital cutting of females for prevention.

Looking at the arguments for MGC and the prevention of other diseases, including HIV, cervical cancer, and gonorrhea, the evidence is problematic at best. Within certain regional or cultural groups, men who have undergone MGC may show lower rates of HIV and other sexually transmitted infections (STIs), but this does not hold looking across or comparing between cultural groups. For instance, the U.S. has higher rates of MGC and STIs compared to European countries such as Germany and the U.K. Additionally, cut men tend to have more partners and perhaps even participate in more adventurous sexual activity, which increase risk the of contracting and spreading STIs. This makes finding a direct causal relationship with MGC tenuous.

MGC’s secular history in the U.S. is rooted in the late Victorian era when a number of doctors and other medical professionals endorsed the practice as a cure for many things, among them masturbation. The inventor of the corn flake, John Harvey Kellogg, is an important player in both MGC and FGC practices in the U.S., as one of the staunchest defenders of both practices for moral hygiene. He also advocated for the surgery to be administered without anesthesia, so the patient associated pain with his or her genitals (Bell 2005; Gollaher 2000). Attitudes about masturbation, and the wide array of mental and emotional disorders that genital cutting was believed to cure, have evolved significantly since the late 19th Century, and while the practice of clitoral cauterization and other forms of FGC have disappeared in the U.S. over time, MGC remains a tradition of birth medicine.

Despite the lack of conclusive evidence that MGC has any medical benefits that would justify its persistence, the U.S. stance on circumcision emphasizes placing trust in the hands of the medical establishment. This becomes an issue when doctors and surgeons are seen as having authoritative knowledge, yet when discussing this surgery, they stress the benefits and not the risks. Where scientific authority has failed to confirm the benefits, they place the onus on the parents, who turn back to the medical establishment for guidance. This vicious cycle benefits no one and may result in the continuation of an unnecessary surgical practice.

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[1] http://www.nocirc.org/
[2] http://www.noharmm.org/

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

Extenuating Circum Stances

I'm in the process of conducting some new anthropological research on the controversies surrounding male and female genital cutting. Note, I am choosing not to use the term circumcision where avoidable, instead relying on the more neutral phrase "genital cutting" as circumcision tends to denote only male foreskin removal and does not account for the wide range of surgical procedures performed on female genitals worldwide. Additionally, the phrase "genital mutilation," which is commonly used in the West to refer to female genital cutting (FGC) draws attention to the horrors of FGC, while not accounting for the less drastic acts of clitoral and clitoral hood "shaving" or "clipping" and FGC that only involves piercing. Not all FGC is as drastic as some groups make it out to be, which involves total infibulation, or the complete removal of the clitoris, outer and inner labia, and is followed up by the sewing shut of the vaginal opening leaving only a small hole for menstrual fluids and urine. While this does occur, if you read the posts to come, you will no doubt see that this is not the only form of FGC.

As a brief intro, I will include the abstract from my research here. I will be posting my introductory section within the next two weeks, followed, hopefully, by a section per week.

Abstract: To cut, or not to cut? That is the question. The arguments for circumcision, both male and female, while often coming from religious or ethical groups, state medical benefits that arise from removing the foreskin, clitoris, or labia. For many years, however, arguments have been made against circumcision denying those same benefits. Opponents of male circumcision often cite its barbaric nature and argue that the medical benefits are largely overstated. A common argument is that while the American Academy of Pediatrics (AAP) stated in 2012 that a decline in male circumcision could result in higher rates of urinary tract infections, HIV, and HPV in men, the AAP neglects to account for the lower overall rates of such issues in European and Asian countries with larger populations of uncircumcised men. Regardless of such arguments, the cultural and religious views of many individuals in the United States and many third world countries, particularly those with significant Abrahamic religious influence, continue to result in traditional infant male circumcisions. At the same time, in the United States, female circumcision and clitoridectomy are rare and may be considered by many to be heinous acts. This begs the question, then: what is the difference between male and female genital mutilation and why is one considered to be more cultural acceptable than the other? Additionally, what are the cultural beliefs that allow one group to not only largely accept genital mutilation but encourage it? The controversy surrounds the notion that genital circumcision, both male and female, particularly when concerning children and infants, is a human rights issue. This notion, however, is deeply divided along gender lines, along with economic, social, and religious lines.