This article offers a critique of the recently revised BMA guidance on routine neonatal male circumcision and seeks to challenge the assumptions underpinning the guidance which construe this procedure as a matter of parental choice. Our aim is to problematise continued professional willingness to tolerate the non-therapeutic, non-consensual excision of healthy tissue, arguing that in this context both professional guidance and law are uncharacteristically tolerant of risks inflicted on young children, given the absence of clear medical benefits. By interrogating historical (...) medical explanations for this practice, which continue to surface in contemporary justifications of non-consensual male circumcision, we demonstrate how circumcision has long existed as a procedure in need of a justification. We conclude that it is ethically inappropriate to subject children—male or female—to the acknowledged risks of circumcision and contend that there is no compelling legal authority for the common view that male circumcision is lawful. (shrink)

INTRODUCTIONIs the non-therapeutic circumcision of infant males morally permissible? The most recent major development in this long-simmering debate was the 2012 release of a policy statement and technical report on circumcision by the American Academy of Pediatrics . In these documents, the US paediatricians’ organisation claimed that the potential health benefits of infant circumcision now outweigh the risks and costs. They went on to suggest that their analysis could be taken to justify the decision of parents to choose circumcision for (...) their incompetent children.1Circumcision and ‘health benefits’The AAP's pronouncement unleashed a firestorm of commentary, much of it censorious. In this issue, human rights attorney J Steven Svoboda and Professor of Clinical Paediatrics Robert Van Howe take the AAP to taski for committing numerous significant errors, both in their analysis of relevant evidence and in basic medical-ethical reasoning.3 In addition, an independent international panel—composed of 38 leading paediatricians, paediatric surgeons, urologists, medical ethicists and heads of hospital boards and children's health societies—has likewise condemned the findings of the AAP. Writing in the journal Pediatrics, these authors state: "Only one of the arguments put forward by the American Academy of Pediatrics has some theoretical relevance in relation to infant male circumcision; namely, the possible protection against urinary tract infections in infant boys, which can easily be treated with antibiotics without tissue loss. The other claimed health benefits, including protection against HIV/AIDS, genital herpes, genital warts, and penile cancer, are questionable, weak, and likely to have little public health relevance in a Western context, and they do not represent compelling reasons for surgery before boys are old enough to decide for themselves.4"My own analysis of the AAP documents—and of ‘health benefits’ defences of circumcision generally—can be found elsewhere.5 Let me turn my attention in this editorial, then, to …. (shrink)

Despite global and local attempts to end genital mutilation, in their various forms, whether of males or females, the practice has persisted throughout human history in most parts of the world. Various medical, scientific, hygienic, aesthetic, religious, and cultural reasons have been used to justify it. In this symposium on circumcision, against the background of the other articles by Hutson, Short, and Viens, the practice is set by the author within a wider, global context by discussing a range of rationalisations (...) used to support different types of genital mutilation throughout time and across the globe. It is argued that in most cases the rationalisations invented to provide support for continuing the practice of genital mutilation—whether male or female—within various cultural and religious settings have very little to do with finding a critical and reflective moral justification for these practices. In order to question the ethical acceptability of the practice in its non-therapeutic forms, we need to focus on child rights protection. (shrink)

The contentious topic of female circumcision brings together medical science, women’s health activism, media, and national and international policy-making in pursuit of the common goal of eradicating such practices. Referring to these diverse and heterogeneous practices as ‘female genital mutilation’ (FGM), eradicators have then condemned them as ‘barbaric’ and medically harmful to female bodies and sexuality. In presuming that bodies can be separated from their cultural contexts, the anti-FGM discourse not only replicates a nature/culture dualism that has been roundly questioned (...) by feminists in science studies and cultural studies, but has also perpetuated a colonialist assumption by universalizing a particular western image of a ‘normal’ body and sexuality in its quest to liberate women and girls. I use my own story as a circumcised woman to highlight the entanglements of body and culture as presented in these feminist theories of female bodies. (shrink)

Debates about female genital mutilation/cutting have polarized opinion between those who see it as an abuse of women’s health and human rights, to be ‘eradicated’, and those who may or may not oppose the practice, but see a double standard on the part of western campaigners who fail to challenge other unnecessary surgical interventions — such as male circumcision or cosmetic surgery — in their own communities and cultures. This article interrogates these debates about FGM/c in the context of measures (...) to reduce it in the UK over recent decades. It does not suggest that FGM/c is a legitimate practice, seeing it, rather, as an abuse of women’s and children’s rights that should be combated using a combination of measures. However, it argues that reduction strategies are undermined by inconsistencies in the law and the failure to back up the law with research and education. (shrink)

The decision of the German regional court in Cologne on 26 June 2012 to prohibit the circumcision of minors is important insofar as it recognises the qualitative similarities between the practice and other prohibited invasive rites, such as female genital cutting. However, recognition of similarity poses serious questions with regard to liberal public policy, specifically with regard to the exceptionalist treatment demanded by certain circumcising groups. In this paper, I seek to advance egalitarian means of dealing with invasive rites which (...) take seriously cultural diversity, minimise harm and place responsibility for the burdens and consequences of beliefs upon those who promote practices. (shrink)