Comparisons Between Female Genital Mutilation and Male Circumcision are False and Dangerous

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By: Dr Zuhdi Jasser, Dr Waqas Khan, and Dr Shaaz Mahboob, in partnership with America Matters

The comparison between Female Genital Mutilation (FGM) and male circumcision on a medical basis is false and endangers women who are subjected to it.

Introduction

The April 2017 federal indictment of multiple Muslim physicians for the crime of female genital mutilation (FGM) in Michigan is spurring honest conversations in the United States about the nature, origins, and criminality of FGM. Dr Jumana Nagarwala, a former Henry Ford Medical Center physician, along with clinic owners, Dr Fakhruddin Attar and Farida Attar, will stand trial in 2018 for their crimes against at least two young girls, who were brought to the Attars’ Detroit-area clinic one evening, after the clinic was officially closed to patients. While many activists believe the case will be an easy win for those in favour of the minor girls due to the egregious nature of the harm, arguments to normalise the practice in the U.S. will make the legal battle more difficult than many human rights advocates realise.

Female Genital Mutilation, Jumana Nagarwala

Dr Jumana Nagarwala. Image Credit: Henry Ford Hospital

To most women’s rights advocates, anti-FGM leaders, and even the World Health Organization (WHO), any non-medical procedure done to young girls’ genitals is a form of FGM.[1] This includes the most supposedly minimal procedures, such as pin pricks on the clitoral hood, which the American Medical Association (AMA)[2] agrees can leave lasting emotional and physical scars on survivors. Yet, some supporters of the defendants, including prominent attorney Alan Dershowitz, have sadly spoken in favour of this conveniently-called  ‘compromise nicking procedure’. They do this by falsely equating FGM with male circumcision, often using a moral and religious freedom narrative.[3] But from a medical standpoint, the two procedures are not the same.

As Muslim doctors, we are invested in the landmark Detroit FGM trial, which has brought the medical community at an intersection with faith and culture. FGM has been performed for many centuries, across many cultures, and in many different regions of the globe. Some people use religious justification for the procedure, but the heart of it is based on gender-violence and inequality that anchors women to future burdens, including forced marriage and domestic violence. Since these procedures are ostensibly being performed under the sanction of physicians, we feel ethically obligated—as doctors, Muslims, and human rights advocates—to speak out and set the record straight about the realities of FGM, and how it is medically different any form of male circumcision. Through this knowledge, we aim to stop FGM. We are not advocating for or against male circumcision.

Understanding the Difference Between the Two Procedures

Male Circumcision

To fully understand the medical differences between male circumcision and FGM, we first need to compare the anatomy of the male and female genitalia. Both male and female sexual organs have an extensive supply of circulation and sensory nerve endings that make them one of the most sensitive biological systems within our bodies. But out of the entire genitalia, there is one specific area in males and females, which is the most sensitive—the female clitoris and the male glans penis, or the tip of the penis. The extreme sensitivity of the clitoris and glans penis plays a vital part in both sexual arousal and achieving orgasm.

Male circumcision is an elective surgical procedure that involves the full or partial removal of the foreskin (prepuce). It does not have anything to do with the glans penis, and the methods used in procedure make it almost impossible to injure it in the foreskin procedure.[4] Thus, when done properly, male circumcision does not affect a man’s sexual function and health[5], which is in contrast to FGM (see Female Genital Mutilation below).

 The American Academy of Pediatrics (AAP) Male Circumcision Task Force concluded in 2012 that “the health benefits of newborn male circumcision outweigh the risks; furthermore, the benefits of newborn male circumcision justify access to this procedure for families who choose it.”[6] The bio-ethical and medical sanction of male circumcision is predicated by a valid, long established and tested medical tradition. As noted by the AAP Task Force, male circumcision may have medical benefits,[7]including better and easier hygiene, decreased risk of urinary tract infections, sexually transmitted diseases and even penile cancer.[8] It is important to note that most of these benefits are more prevalent in developing countries, in areas with limited access to medical care, compared to Western populations.[9]

There is brief, albeit, severe pain involved in male circumcision when the foreskin is removed. Other short-term complications include bleeding, infection, and injury to the penis. The rates of these problems are incredibly low, occurring in 1.8 out of every 1,000 patients, or fewer.[10] Long-term health effects may involve incomplete circumcision, excessive skin removal, adhesions, narrowing of the urethra, phimosis, and cysts.[11] For these reasons, the AAP strongly recommends that male circumcision is performed with the use of pain relievers, and by a medical professional, as the instances of complication increase outside of these parameters.[12] The Centers for Disease Control (CDC), and World Health Organization (WHO) recommend male circumcision in certain regions of the world based on its purported health benefits, which includes reducing the transmission of some sexually transmitted diseases. This includes a possible 60 percent reduction in HIV transmission in some countries where the disease is prevalent.[13] [14]

Female Genital Mutilation

FGM comprises all procedures that involve partial or total removal of the clitoris—the most sensitive female sexual organ—and other parts of the external female genitalia.[15]

WHO categorizes FGM into four types:

Type I: Partial or total removal of the clitoris and/or the prepuce (clitoridectomy).

Type II: Partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (excision).

Type III: Narrowing of the vaginal orifice with the creation of a covering seal by cutting and appositioning the labia minora and/or the labia majora, with or without excision of the clitoris (infibulation).

Type IV: All other harmful procedures to the female genitalia for non-medical purposes, for example pricking, piercing, incising, scraping and cauterisation.”[16]

Male circumcision has never needed to be medically divided into “types” to understand the extent of foreskin removal, let alone genital destruction, involved. All FGM types involve some type of female genital destruction with the risks being far higher than any falsely claimed benefits.

Male circumcision does not destroy sexual function or sensory satisfaction, but FGM does, in fact, impair girls and women in these ways. Therefore, the physical/medical comparison between male circumcision and FGM falls apart at every level.

In contrast to circumcision in males, medical authorities, like the National Health Service in Britain, have stated that women derive no medical benefit from the procedure. Instead, women and girls experience profound physical and psychological harm from FGM, regardless of how minor or extensive the procedure[17]. The nicking of the clitoral hood (Type IV FGM) is often equated with male circumcision by proponents of FGM, and both the proponents and opponents of male circumcision.

But even this procedure, which is only millimetres away from the clitoris, can easily cause scarring or injuries with unacceptably high complication rates.[18] This includes extensive bleeding, infection, permanent scarring, disfigurement, dyspareunia (pain associated with sexual intercourse), and the inability to experience orgasm. Survivors experience other long-term problems, including increased risk of childbirth complications, menstrual problems, and, most significantly,  psychological trauma that can impact every aspect of their lives. Indeed, a study comparing Senegalese women who had experienced FGM found “the high rate of PTSD of more than 30% in this group [FGM survivors] is comparable to the rate of PTSD of early childhood abuse.”[19] Those who lobby to end FGM, such as ourselves, do so based on these horrific physical and mental traumas the practice inflicts on young girls and women.

Some supporters of FGM claim there are benefits to Type IV FGM, such as heightened sexual arousal[20] [21], but we can find no medical evidence that adult women require reduction procedures of their clitoral hoods to optimise their sexual experience. Such a claim is absurd and an insult to survivor’s humanity given the harm of the procedure.

Our Oath To Do No Harm

Physicians’ central professional ethics and teaching is to promote good (beneficence) and do no harm (nonmaleficence). Ethical analyses of any medical procedure are predicated and assessed by the actual intent and necessity of any procedure itself, and then framing the risks and harm within that initial construct. No doctor can become a vehicle for any ritual that is medically unsound, and whose intent is morally questionable.

Physicians are trained not to impose their moral standards upon patients; however, autonomous practitioners must find the reasoning to be ethically sound and, at a minimum, not abhorrent when asked to impose a procedure upon another human being by parents. It is unquestionable that physicians should not be complicit in this practice. FGM inflicts severe physical harm and psychological trauma and has no benefits for young girls and women. The analysis makes it clear that FGM is a form of gender violence. No religious reasoning, or otherwise, can justify its practice in the medical community.

Conclusion

The stated equivalency of male circumcision and FGM by some people is medically false and is a dangerous attempt to normalise obvious gender violence toward women. As Muslim physicians, we often hear advocates of FGM cite theological arguments, as well as the defence of religious freedom to push their agenda in the United States. Although not mandated by the Quran, some communities such as the Bohra Muslim sect in Islam firmly believe FGM is a religious obligation,[22] while others defend the procedure as a legitimate way to tame a woman’s ‘hypersexuality’.[23] The FGM procedure, therefore, can also facilitate a tribal culture of subjugation and inferiority for young girls. It is done ‘to’ them by a patriarchal family, tribe, and culture to keep their ‘inferior’ psyche in check lest they ever seek sexual, and in essence human, equality or autonomy. Thus, even the moral intent of the practice requires questioning.

Physicians must lead the way for reforms against all of the underpinnings of FGM. As doctors, we can advocate for education within our profession, such that medical practitioners know the physical and emotional signs survivors may exhibit; and, have the proper cultural sensitivity training to have honest and caring conversations with survivors and the community. As Muslim physicians, we can have a significant impact within the populations that practice FGM. When we speak to families about FGM we can educate them on the negative physical and emotional effects the procedure has on young girls and help them separate (what they view as) a theological mandate for purification from the procedure.

It is incumbent upon Muslim physicians, and community leaders of conscience from all backgrounds, to make clear the physical and emotional damage FGM causes young girls, and to call for an end of this horrific practice once and for all.

References:

[1] Female Genital Mutilation. WHO Fact Sheet. February 2017. (http://www.who.int/mediacentre/factsheets/fs241/en/ accessed 01 Oct. 2017)

[2] American Medical Association, Board of Trustees. Annual Meeting Minutes. 2017. Pages 43-46

[3] Jasser, M. Zuhdi. Female Genital Mutilation: American Muslim Physician Says Stop Defending the Abuse of Girls and Women. Gatestone Institute. June 26, 2017. (https://www.gatestoneinstitute.org/10585/female-genital-mutilation-american-muslim accessed 01 Oct 2017)

[4] Mayo Clinic Staff. Male Circumcision: Why it’s done. 15 February 2015. (https://www.mayoclinic.org/tests-procedures/circumcision/basics/why-its-done/prc-20013585 accessed 22 October 2017).

[5] Technical Report: Male Circumcision. Pediatrics. Vol. 130: No. 3, September 2012. (http://pediatrics.aappublications.org/content/pediatrics/130/3/e756.full.pdf accessed 1 Oct. 2017)

[6] Technical Report: Male Circumcision. Pediatrics. Vol. 130: No. 3, September 2012. (http://pediatrics.aappublications.org/content/pediatrics/130/3/e756.full.pdf accessed 1 Oct. 2017)

[7] Mayo Clinic Staff. Male Circumcision: Why it’s done. 15 February 2015. (https://www.mayoclinic.org/tests-procedures/circumcision/basics/why-its-done/prc-20013585 accessed 22 October 2017).

[8] Technical Report: Male Circumcision. Pediatrics. Vol. 130: No. 3, September 2012. (http://pediatrics.aappublications.org/content/pediatrics/130/3/e756.full.pdf accessed 1 Oct. 2017)

[9] Voluntary Male Circumcision for HIV Prevention. WHO Fact Sheet. July 2012. (http://www.who.int/hiv/topics/malecircumcision/fact_sheet/en/ accessed 01 Oct 2017).

[10] Neonatal Circumcision. American Academy of Family Physicians. 2013. (http://www.aafp.org/about/policies/all/neonatal-circumcision.html accessed 09 Nov 2017)

[11] Neonatal Circumcision. American Academy of Family Physicians. 2013. (http://www.aafp.org/about/policies/all/neonatal-circumcision.html accessed 09 Nov 2017)

[12] Technical Report: Male Circumcision. Pediatrics. Vol. 130: No. 3, September 2012.   (http://pediatrics.aappublications.org/content/pediatrics/130/3/e756.full.pdf accessed 1 Oct. 2017)

[13] Voluntary Male Circumcision for HIV Prevention. WHO Fact Sheet. July 2012. (http://www.who.int/hiv/topics/malecircumcision/fact_sheet/en/ accessed 01 Oct 2017).

[14] HIV and Male Circumcision. CDC. 2011. (https://www.cdc.gov/healthcommunication/toolstemplates/entertainmented/tips/hivcircumcision.html accessed 09 Nov 2017)

[15] Female Genital Mutilation. WHO Fact Sheet. February 2017. (http://www.who.int/mediacentre/factsheets/fs241/en/ accessed 01 Oct 2017)

[16] Eliminating Female Genital Mutilation. An Interagency Statement (OHCHR, UNAIDS, UNDP, UNECA, UNESCO, UNFPA, UNHCR, UNICEF, UNIFEM, WHO). 2008. http://apps.who.int/iris/bitstream/10665/43839/1/9789241596442_eng.pdf accessed 01 October 2017).

[17] Female Genital Mutilation: The Facts. June 16, 2016. (http://www.nhs.uk/Conditions/female-genital-mutilation/Pages/Introduction.aspx Accessed 01 Oct 2017).

[18] Female Genital Mutilation. WHO Fact Sheet. February 2017. (http://www.who.int/mediacentre/factsheets/fs241/en/ accessed 01 Oct 2017)

[19] Behrendt, A. et al. The American Journal of Psychiatry. 2005; 162: 1000-1002.

[20] Female Circumcision in Islam. Muslims in Calgary. 2017. (http://muslimsincalgary.ca/female-circumcision-in-islam/ accessed 09 Nov 2017)

[21] (http://torontosun.com/2017/09/05/female-genital-mutilation-defended-in-article-on-muslims-in-calgary-website/wcm/e9b82a54-21dc-43b8-b2a6-ad52bcc6fad7 accessed 13 Nov 2017)

[22] Johari, A. What can Bohras learn from a new report on the global status of female genital cutting? Sahiyo. October 2016.  (https://sahiyo.com/2016/10/16/what-can-bohras-learn-from-a-new-report-on-the-global-status-of-female-genital-cutting/ accessed 13 Nov 2017)

[23] MEMRI “Virginia Imam Shaker Elsayed Endorses Female Circumcision (FGM): It Prevents Girls from Becoming Hypersexually Active”. Clip No. 6043. https://memri.org/tv/dar-al-hijrah-mosque-fairfax-virginia-fgm-prevents-hypersexuality/transcript (accessed 01 October 2017)

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25 Comments

  1. Why can I cut my son’s foreskin but not my daughter’s foreskin?

    We should be suspicious of Muslim (and Jewish) physicians who claim “potential health benefits” when defending their religious custom that predates both modern medicine and child protection laws. They need to find modern excuses to defend imposing such a painful and invasive act that permanently alters the form and function of a child’s penis. Their agenda is to ensure that the tradition continues, is covered by insurance, and is protected under the guise of “freedom of religion”.

  2. The foreskin and frenulum (also typically lost to circumcision) – not the glans penis – are the most richly innervated erotogenic parts of male anatomy. They contain specialised fine-touch receptors found nowhere else on the penis. In the female they are located not in the clitoral hood, but in the clitoris itself. The male foreskin is essential to the fluid biodynamics of sexual activity (both masturbation and copulation) and delivers sexual benefits to both the man and his partner. Foreskin amputation is implicated with a range of sexual dysfunctions (including anorgasmia – in both the man and his sexual partner). Risks of foreskin amputation include penilectomy and death. “Routine” complications include a diverse range of psychosexual sequelae, lasting a full lifetime. There is no legal or ethical basis for making a distinction between male, female and intersex genital mutilation. All forms of non-therapeutic, non-consensual genital cutting are abominable crimes against the person, humanity, and nature.

  3. What argument does this article make? Every person who doesn’t want to see women harmed agrees that involuntary FGM is a horrible practice that ought to be stamped out wherever it exists, because it inflicts trauma on the personhood of the victim.

    That in no way exonerates inflicting unnecessary suffering on male infants by sexually mutilating them. In either case, the result is similar, a deep psychic scar that continually reminds the victim that he or she is helpless at the most tender, vulnerable level of their bodies.

    Even if we acknowledge that FGM is more physically damaging than male circumcision, we cannot deny that both are wrong, or use one value of wrongness to justify another.

  4. It seems that FGM is performed for the purpose of making it impossible for a female to enjoy sex. After reading a couple of articles about MGM, I am understanding that it is performed for health benefits to the male. Being a Christian, I know that God is the one who instituted male circumcision. It was to set apart His chosen people from the rest of mankind, at that time. This would not have been done for the purpose of harming males. Could a male be harmed in the performance of this surgery? Yes. The surgery is only as good as the surgeon. Are their benefits for male circumcision? Dr. Jasser gives excellent reasons of why he believes there are. From Dr. Jasser, I also believe he is saying that a male has the choice of circumcision. He also talks about the option of making circumcision less painful. I do not know if this has to be requested at the time of circumcision, or if it is standard operating practices. I have not had any children, so I have never been in the situation of having a male child and do not know how the procedure is addressed. I do not know why male circumcision is a common practice in the USA.

    With females born into the religion of Islam, the reasoning for FGM does not appear to be a command of Islam, but the choice of the male in the home, and the reasoning seems to be for the purpose of keeping a female under control, like the mandate of wearing many types of coverings over the female body from a scarf covering the hair of the head to the women’s body being encased in clothing so that only the eyes can be seen, albeit through cloth. My understanding of the purpose for this clothing is for the protection of females from males. The only males they are protected from are of their own religion. Christianity and Judaism do not find the need to protect their female population from themselves. What is it about the males of Islam that their females need to be protected? From what I read about Muslim refugees settling into other nations is that rape is a constant fear among the female population? Why is that? Are the males of Islam taught that rape is an acceptable way to behave among any female population? The many other ways that the females of Islam are treated is a mystery to me. Why would the males want to harm their females? Men are allowed to have many wives, but the wives can only have one husband. It appears that everything in the religion of Islam is geared against the female population. In Christianity and Judaism, women are held in high esteem by men. They are protected by the men, deeply loved and cared for by the men. Respected above men. Am I being naive in what I understand about the differences among the three religions of the world? Is anyone else as confused by the way females are treated by Islam as I am?

    • Edward von Roy on

      Islamic FGM: khitan al-inath (ختان الإناث) “female circumcision”, or: khitan al-banat (ختان البنات) “circumcision of the daughters”, other terms: ḫafḍ (خفض ) or ḫifaḍ (خِفَض ), (literally “lowering” or “deepening”), Dawoodi Bohra (Shia muslim sect) khatna, Indonesian: sunat perempuan (khitan wanita)

      .

      Hadith.
      The Prophet said to Umm Atiyya, or: to Umm Habiba:

      أشمِّي ولا تنهَكي
      ašimmī wa-lā tanhakī
      [Cut] slightly and do not overdo it

      Or Muhammad said:

      اختفضن ولا تنهكن
      iḫtafiḍna wa-lā tanhikna
      Cut [slightly] without exaggeration

      .

      There’s no such thing as ‚mild‘ FGM.

      Zero Tolerance to Female Genital Mutilation (FGM) =
      zero tolerance even to the less invasive forms of FGM

  5. I take it most of those commenting against male circumcision failed to read or respect the article. Male circumcision doesn’t impact male sexual repsone or sensation as the glans isn’t removed or harmed during male circumcision. There’s absolutely no scientific proof that the foreskin is more sensitive than the glans and is simply the extension of the penile shaft skin.

    • Its common knowledge that parts of the foreskin especially the frenulum contain sensitive tissues, if not some of the the most sensitive tactile regions of the penis. This information is easily accessible, though it is forgivable that people dont ask themselves this because of not even possessing the organ anymore due to infant circumcision.

      To ignore this is to have a narrow glans-centric view of the penis. Additionally, the erogenous zones synergize with eachother through the mobile skin system of the foreskin. The human foreskin is quite unique in its mechanically mobile skin system including erogenous zone configuration. This differs in an unprecedented way in contrast to our primate cousins.

      This is all before including how individual’s nervous tissue and penile growth responds their unique circumcision style as they grow past puberty. The glans can get affected in some cases, numbness for a variety of physiological reasons related to or directly in response to infant circumcision are quite common but not publicly realized (because circumcising cultures like to keep the discussion in the dark by omission.)

  6. “But even this procedure, which is only millimetres away from the clitoris, can easily cause scarring or injuries with unacceptably high complication rates. This includes extensive bleeding, infection, permanent scarring, disfigurement, dyspareunia (pain associated with sexual intercourse), and the inability to experience orgasm.”

    So… on one hand you try to convince us that you can safely remove the entire male foreskin, even though that also happens “millimeters away from the glans”, and on the other hand, it’s magically worse when you only nick the female foreskin?

    How does that work?

    Are you, perhaps, comparing male circumcision in modern hospitals with female circumcisions in nonmedical settings and pretending that’s a completely valid comparison to make?

    It’s funny how every culture that practices genital cutting is staunchly convinced that what they’re doing is not that bad, what everyone else is doing is so much worse!

    • This isn’t even going into the fact the foreskin is fused to the glans in newborns, and requires the use of a probe to rip them from eachother to perform a circumcision (and this is often the case in circumcisions on older children, as the foreskin does not separate from the glans in most children until around puberty). And the foreskin still has to be covering the glans to be removed in a circumcision. No matter which technique or tool you are using, you are removing tissue that is right by the glans.

      To your “perhaps”, that’s part of it, but what they’re doing is essentially treating the clitoris as the only part of the vagina relevant for sexual functioning (and the glans with the penis), and ignoring how most of it’s internal and is ultimately far, far harder to damage than the head of the penis. Their concern over ritual nicking of the clitoral hood seems to revolve around potential damage to the clitoris- does that mean the clitoral hood itself isn’t relevant for sexual functioning? Maybe, but since there’s no medical benefit to it, then it’s wrong- unlike a male circumcision, where it can be removed as soon as they’re born.

      But the article doesn’t address that on medical grounds- it says this:

      “but we can find no medical evidence that adult women require reduction procedures of their clitoral hoods to optimise their sexual experience.”

      Well, women might not necessarily need reductions of the clitoral hood to improve sexual function, but some might, and report heightened sexual satisfaction afterwards, such as the study “Aesthetic labia minora and clitoral hood reduction using extended central wedge resection.”, which finds “Central wedge reduction with lateral clitoral hood reduction is a safe, effective procedure with few complications and high patient satisfaction.”, and 71% of recipients finding improved sexual satisfaction.

      Even more common is labiaplasty, which is also documented to often improve sexual satisfaction and even health and cleanliness.

      But what’s key here is that these are (mostly- preteen and teenage girls have been known to undergo these) done with informed consent on the part of of the women in question, with recognition that the labia and clitoral hood are important pieces of sexual anatomy. A dramatic contrast to male circumcision, where it can be done as soon as a boy is born, because it’s useless.

      So is clitoral hood reduction indefensible on the basis it doesn’t improve sexual functioning? But what about other health benefits? Does it have any of those or not? The article isn’t defending male circumcision on the basis of improvements in sexual experience either, just that it has no negative effect on it and it has other supposed medical benefits. And it’s not decrying clitoral hood reduction on the basis of non-sexual medical benefits.

      “Magical” is apt, because that’s the only way you can justify double standards like this and expect them to hold up- and of course, the many years worth of propaganda and cultural conditioning/bias that allows comparisons like this to make sense in people’s minds.

    • Clearly you have no idea, whatsoever, about the female anatomy. None. Otherwise you would not have said what you just said. Bah hahahahaha!!

  7. Edward von Roy on

    Rituals can include singing, dancing, and certainly also religious devotions, but no operations on the body of a child (a child is a human being below the age of eighteen years).

    We should not cut or circumcize (i. e. mutilate) genitals, neither of male nor of female human beings. Male circumcision is male genital mutilation. Concerning the sensitivity (corpuscles respectively free nerve ends of the types: Merkel, Ruffini, Vater-Pacini, Meissner), the male foreskin has its equivalent not in the female (clitoral) foreskin, but in the clitoris itself. In other words, the foreskin, not the glans, is the most sensitive part of male genitals.

    Everyone has a right to intact genitalia. Here, children are dependent on our protection. We as the adults in this world must enforce that a child under the age of 18 years, girl or boy, is protected from any form of genital cutting.

    As is well known, Islamic institutions such as the Indonesian Fatwa Council (MUI – Majelis Ulama Indonesia) or the Department of Islamic Development Malaysia (JAKIM – Jabatan Kemajuan Islam Malaysia) do not call the “mild” forms of girls’ circumcision a mutilation (FGM). We see that differently. Even the least invasive form of girls’ circumcision has to be overcome, worldwide. And of course boys deserve the same protection as girls.

    There is no such thing as “light FGC”, or “light FGM” etc. Any kind of FGM, for example the “mild Sunna” or any other forms of Sunna “circumcision” (FGM) on girls (sunat perempuan; khitan al-inath; khatna), must stop. My real concern is that Europe, and the USA will soon legalise some “mild” forms of the Classification of FGM.

    Each form of FGM should be banned everywhere.

    Edward von Roy, social worker

  8. The Society for Pedriatic Urology just published:
    CONCLUSIONS: The incidence of post-circumcision complications at 2 years is much higher than expected at 11.5%, but does not appear to be influenced by age at circumcision, healthcare setting or a rural vs. urban location. A minority of subjects needed reoperation during the ensuing 2 years.
    http://spuonline.org/abstracts/2018/P21.cgi

  9. It’s disgusting that you would defend circumcision of either sex. As your article states, this woman used the fact that MGM is so common as an excuse to perform FGM. And they will continue pointing out this gender bias until MGM is ended by being made illegal. You conveniently move the goal post by saying that FGM is divided in to types but male “circumcision” is not. You fali to mention that NO ONE is claiming that harsher forms of FGM, like removing the glans, or the clitoris itself, are equitable to circumcision. Female circumcision is the removal of the clitoral hood, which is the DIRECT ANALOGUE to the foreskin. MGM can absolutely be divided up into types. Cutting off the penis is most certainly worse than cutting off the foreskin. No one is saying there isn’t a difference there. People are saying that the removal of the female prepuce no better or worse than removing the male prepuce.

    And you dare cite the Hippocratic oath when you are condoning removing more than a dozen functions routinely on infants at birth? You should be ashamed.

    norm.org/lost.html

    • “And you dare cite the Hippocratic oath when you are condoning removing more than a dozen functions routinely on infants at birth? You should be ashamed.” – BRAVO! Not only ashamed, but locked up so they can do NO MORE HARM!

  10. What a bunch of Religious Racism behind false pseudo science promoting genital mutilation to children. There are Zero benefits through any genital mutilation. Yet purposefully attempting to claim any biological or medical rights to mutilate one sex of a child ,vs another is tantamount to insanity. Certainly unethical .There is very little difference biologically speaking between the functions of the female external skin tissues ,than the male tissues covering their internal/external sexual and reproductive organ. Either admit it ,or perhaps one should not even be attempting to speak in any scientific nor biological perspective on the issue of genital mutilation. This is certainly a case also for when Religion attempts to exploit science to corroborate itself in doing the wrong things . For all the wrong reasons .

  11. Dangerous is condemning the genital mutilation of one gender, while endorsing it for the other, it leads to a false sense of moral superiority. The natural body of both the male and female are not born defective in urgent need of surgery. Any physician that cuts a healthy, normal and functional part off another human being without medical emergency should be incarcerated!

  12. Putting aside the fact histological analysis has constistently shown the glans is technically the least sensitive part of the penis (it’s actually the foreskin), it’s remarkable that this article would equate the glans and clitoris in importance when international “human rights” organizations and the federal laws of many countries, when it comes to “FGM”, views any non-therapeutic, unconsenting, harmful procedure performed on any part of a girl’s vagina is considered “female genital mutilation.” Why focus on the clitoris when every part of a female’s genitals is considered integral and important in the view of much of the international community? Because the true underpinning of arguments and comparisons like this is the fact every part of a female’s anatomy is important and deserving of protection from harm, while the male foreskin is completely useless and can be removed immediately at birth on the basis of “medical benefits” (and the status it holds in two religions.)

    When describing how circumcision is done, you claim it’s almost impossible to injure the glans in the procedure, but the link provided says nothing about that. While the majority of “properly” performed circumcisions do not injure the glans, some techniques are far more associated with it than the others- the Mogen Clamp, for example, is associated with a much higher rate of glans injury than devices like the Gomco. In fact, the manufacturers of the Mogen clamp went into bankruptcy following a massive lawsuit over a Mogen injury that amputated an infant boy’s glans.

    When citing the AAP (an American medical organization, the only country on Earth that still practices routine infant circumcision for primarily medical reasons, and one of the only developed countries where circumcision is still the norm), it’s remarkable how every medical benefit listed is it “may”- but everywhere else in this article, you treat them as proven fact. And the citation under [8] notes that in regards to penile cancer, it would possibly take 909 to 322,000 infant circumcisions to prevent 1 case of penile cancer. They ultimately state it’s difficult to measure against the potential complications of the procedure, and they’re likely to decrease with increasing rates of HPV vaccinations- and there’s vaccines and antibiotics for UTI’s and many of the other things circumcision is supposed to prevent, and of course, basic hygiene.

    There is no brief pain associated with male circumcision. No form of anesthetic can completely eliminate pain in an infant surgical procedure. Most American men alive today were circumcised without any anesthetic, and a medical worker is under no obligation to use anesthetic of any kind, or wait for it to take effect. Some infants go into a sort of shock from the overwhelming pain; others exhibit extreme agony during the procedure. Parents to this day report their infants experiencing profound pain, and it has been well documented to potentially interfere with bonding, breastfeeding, and infants to exhibit symptoms months later. Some circumcision procedures, like the plastibell, cause persistent pain for days onwards. This isn’t even going into the boys and men across the middle east and africa who are circumcised without anesthetic, that the international community doesn’t really seem to care about.
    On the topic of complications, the article cited doesn’t actual cite anything, but the CDC and AAP do claim “catastrophic complications” as occurring in only 0.2-2% of all infant circumcisions. Since around 1 million infant circumcisions are performed per year, that means 2,000-20,000 of these complications per year. Over an average lifespan of 78.74 years in the US, this means there are 157,480-1,574,800 men in the US who’ve been subjected to “catastrophic complications”. And even the cited article claims the rate at which late complications occur is not well defined.

    And simply googling “botched circumcisions” can see what an understatemented this likely is. Damage to the glans, whether by direct cuts or injury, or by way of untreated adhesions and fusion is widely apparent. The adhesions mentioned, if left untreated, can cause irreversible damage to the glans, and this is a risk that virtually only occurs in circumcised males.

    The claim FGM has no health benefits is based overwhelmingly on the fact less invasive forms performed in sterile conditions have never been studied- this is ecludiated in the article “Are Male and Female Circumcision Morally Equivalent?” by Brian D. Earp. Various forms of “FGM” such as partial removal of the clitoral hood (forms effecting solely the clitoral hood are notably rare or absent in SS africa, where the majority of FGM research has been conducted) are classified as medical procedures in Malaysia, and “FGM” is widely performed in southeast asia in clinics and hospitals (including Singapore) by trained medical professionals. They claim it has medical benefits and have studies to back it up. Did you actually examine these studies?
    The “nicking” of the clitoral hood is often said to be less invasive than male circumcision because it is- even by the AAP, who tried arguing in favor of the legalization of ritual pricking on the basis it removes less tissue (if any) than male circumcision. Note I said “pricking”, because that is what this procedure often involves, and is possibly the most common form in southeast asia owing to international pressure. In the article “Indonesia Ignores UN Ban on Female Circumcision, Denies Mutilation”, this procedure is described as potentially involving a brief prick of the clitoral hood with a sterile sewing needle with no blood drawn. Even when this involves actual blood drawn, there’s absolutely no reason to believe this involves “unacceptably high rates” of any of the complications you describe (but I’m not justifying or defending it.) The WHO page linked to makes little attempt to differentiate forms that range from nicking/pricking all the way up to infibulation other than saying “Generally speaking, risks increase with increasing severity of the procedure.” (they also claim the entire clitoris can be removed in FGM, when no form does, as it’s an extensively internal structure.)
    This is very typical, because for years, much of the perception and understanding of FGM has been defined by an absolutely obsessive, single-minded focus on the most extreme procedures and worst outcomes (mostly associated with Type 3 FGM, which makes up 10% of all procedures and is found exclusively in east africa) as the standard for how FGM is performed. So even when forms that involve as little as nicking or pricking are acknowledged, the vagina suddenly becomes this really uniquely fragile structure where the slightest prick or cut can potentially render a woman a sexual cripple, in striking contrast to procedures done on the penis, a completely external organ.

    You also talk about PTSD- here’s what German Pediatrics says:
    “The male foreskin is a part of the skin of the organ and fulfils important functions that protect the very sensitive glans. It normally covers the glans and protects it from harmful substances, friction, drying out and injuries. It has apocrine sweat glands, which produce cathepsin B, lysozyme, chymotrypsin, neutrophile elastase, cytokine, and pheromone such as androsterone. Indian scientists have shown that the subpreputial wetness contains lytic material, which has an antibacterial and antiviral function. The natural oils lubricate, moisten and protect the mucous membrane covering of the glans and the inner foreskin. The tip of the foreskin is richly supplied with blood by important blood vessel structures. The foreskin serves as a connective channel for Berufsverband der Kinder- und Jugendärzte (BVKJ. e.V.) many important veins. Circumcision can lead to erectile dysfunction as it destroys these blood vessels. Their removal can, as described by many of those who have been affected, lead to considerable limitations to sex life and cause psychological stresses.”

    Here’s also what they say about male circumcision vs. FGM:
    “The current Federal Government’s draft legislation regarding the scope of care and custody of a child in the case of circumcision of male children unintentionally paves the way towards demands for legal circumcision for female children. The Evangelical Central Office for Questions about World Views (die Zentralstelle für Weltanschauungsfragen der evangelischen Kirche in Deutschland) pointed this out in September 2012 in a document: (http://www.ekd.de/ezw/Publikationen_2762.php). Sure enough Mohamed Kandeel (also written ‘Kandil’), professor for gynaecology and obstetrics at the University of Menofiya, Egypt, does demand a worldwide legalisation of female genital mutilation (FGM) types Ia and Ib, which means removal of the clitoral hood (clitoral prepuce) only (type Ia) or together with the clitoris (type Ib). He claims that negative consequences cannot be proven for those women affected. Therefore it is not understandable that circumcision of boys should be allowed but that of girls prohibited worldwide. Male circumcision is basically comparable with FGM types Ia and Ib that the Schafi Islamic school of law supports (http://f1000research.com/articles/female-genitalcutting-is-a-harmful-practice-where-is-theevidence/#reflist).”

    One will find similar statements from the RACP, who’ve acknowledged the foreskin contains the most sensitive parts of the penis, and on their current infant circumcision form, claim infant circumcision can be considered a violation of individual rights- but decline to make absolute conclusions on the sexual effects, given the variable experience of men circumcised as adults.

    Finally, the claims that FGM is always done out of patriarchal control is simply false- the article “Seven Things to Know about Female Genital Surgeries in Africa” illustrates this well with how FGM is typically performed in Africa, and also touches upon the health and psychological outcomes- that most of the health complications are exceptional, and that FGM generally does not interfere with sexual activity (but this is not an endorsement of it, and similar things can be claimed with male circumcision in such societies.) This also completely ignores the origins of “medical” male (AND female) circumcision as a masturbation preventative in Victorian medicine, or the justification in Medieval Judaism as a way of curbing libido. But these things have long been ignored in comparisons of FGM and circumcision and how they’re supposedly different because the former is done for different purposes.

    Making FGM and male circumcision incomparable is what harms women. It does this by ignoring how often they occur together, how they have often been done for similar purposes and are justified with remarkably similar reasons (noted FGM researcher Hanny Lightfoot-Klein, who was as against male circumcision as she was FGM, has noted this), and the kinds of warped, amoral thinking that occurs when you send the message you can cut one gender but not the other- this was seen with the AAP’s attempt at legalizing ritual pricking, and how far more minor forms of “FGM” have become entrenched and medicalized in southeast asia and defy attempts by international groups to stamp out. This is shown by the ways in which traditional African women flagrantly resist attempts to stamp out FGM, because in traditional African culture, it is expected by both genders the opposite be circumcised- and since male circumcision is promoted by the UN and the WHO, women who subscribe to traditional beliefs are still obligated by this. Or, to put it this way: https://www.facebook.com/notes/james-ketter/equality-now-declares-some-people-are-more-equal-than-others/1922373364682466/
    “By tolerating one form of genital mutilation, and condemning the other, we are leaving open a pathway to the very disturbed individuals who desire to split hairs as much as they wish to cut the sex organs of the innocent.”

    And of course, doing this harms men- because it ignores the fact male circumcision is harmful, and leads to the appalling, inexcusable disregard of the suffering of boys and men across the world, whether men in America circumcised as infants or boys circumcised in traumatizing tribal and religious rituals across Africa and the Middle East.

    This article is nothing more than a propaganda piece. It relies almost entirely on “research” (often without even properly citing it) from American medical organizations, with absolutely no consideration of the history and frequency of the procedure in America, and how other health organizations where circumcision is not entrenched view it. It relies heavily on the WHO’s dishonest definitions of FGM. And of course, the authors on 4 separate occasions state that they’re Muslim- given how incredibly common male circumcision is in Islam, one can’t help but sense some religious bias. FGM is much less common in Islam than circumcision, and there are international efforts to demand muslim countries drop FGM and stamp out the practice, which have often been successful. And whenever bans on circumcision are attempted in Western countries, muslim groups are often at the forefront (along with Jewish groups)- and they’ve so far been always successful in helping to prevent bans on the basis of “religious freedom.”

    It’s debatable whether circumcision is even demanded in Islam (especially whether there’s even a set age, given the wide variation it occurs in Islam), and so for that this article is likely just an attempt to enforce a majority practice in the muslim world that goes unchallenged by the international community, because of the monstrous double standard that the slightest pinprick done to a girl is an abomination, but the removal of an entire part of the genitals of a boy is A-OK, because of “medical benefits”/religious pressure/perpetual, flagrant denial of the harm done.

  13. Mohamed Fahmy on

    It is difficult to discuss this issue globally, the situation is different in different cultures, discussions should be focused, in my opinion about the difference between male and female circumcisions, this will be helpful tool to fight against FGM, the difference between both sex is not only anatomical but it is also embryologically and technically, in this way we may convince those practising FGM to stop it.
    Simply if you wish to do female circumcision like what you are doing in male you have to have a circular complete prepuce encircling the clitoris, which it is impossible to have, and you should cut only a part of a circular hood and not any piece of the clitoris.
    If their is any rational behind practising circumcision it is only for men and not for female at all.

    • “Simply if you wish to do female circumcision like what you are doing in male you have to have a circular complete prepuce encircling the clitoris, which it is impossible to have, and you should cut only a part of a circular hood and not any piece of the clitoris.”

      Are you saying that women don’t have a prepuce completely covering/encircling the clitoris? They do. The clitoris is not always exposed in women. It is much like the male foreskin when in an unaroused state.

      Now are you ok with female circumcision? I hope so, because if not, you’d just be adhering to the kinds absurd logical contortions and staggering anatomical illiteracy that underlies separating comparison between the two, that revolve more around ideological commitment, cultural bias and incredible sexism than anything else.

  14. I know that there can be religious sensibilities at play too, but in Islan it’s optional / cultural and some Jews argue it can be replaced by some symbolic action instead. What’s more or seems the original Jewish version involved removing the tip of the foreskin only. Not that I think there is justification for that either. I’m sorry but ethics evolve over time and saying ‘it’s a tradition’ isn’t good enough. We could say wife beating is a tradition and allowed in the Qur’an, for example, but we still punish it.

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