5 10 240 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> <h1>Law, human rights, and non-therapeutic interventions on children the focus of genital integrity conference</h1> J. Steven Svoboda reports on a conference on circumcision and other genital surgeries held at the University of Keele. “Genital autonomy” refers to the principle that all children – male, female, and intersex alike – should be protected from non-therapeutic (medically unnecessary) genital cutting. The conference organizers, including David Smith of <a href="http://www.genitalautonomy.org/">Genital Autonomy (Europe)</a> and Michael Thomson, Professor of Law at the University of Keele, took a very creative approach, bringing together grass-roots anti-circumcision and child protection activists with academics and officials not necessarily associated with direct advocacy. The conference considered all aspects of genital autonomy, though focused primarily on male circumcision and secondarily on female genital cutting (FGC) and female genital mutilation (FGM). Some famous, long-standing activists against FGC spoke, including Efua Dorkenoo of <a href="http://www.equalitynow.org/fgm">Equality Now</a> on “FGM and Human Rights” and Comfort Momoh of the University of London and <a href="http://www.forwarduk.org.uk/">FORWARD</a> on “FGM -- An Overview.” The opportunity to meet the authors of two significant recent papers on circumcision and human rights were highlights of the conference. Debra DeLaet, Professor of Politics at Drake University, USA, addressed “Genital Autonomy and Children’s Rights in International Law”, while Matthew Johnson discussed “Dealing with Invasive Religious Rights: Should the National Health Service Offer Circumcision to Diminish Harm?” Paul Mason, former Children’s Commissioner in Tasmania, travelled all the way from his homeland down-under to deliver a talk entitled “So You Think Medically Unnecessary Circumcision Breaches Human Rights Law: The Other Side of the Coin.” Several young activists offered fresh perspectives. Travis Wisdom (USA) fought off illness to brilliantly analyze intactivism from a feminist perspective. Gert Van Dijk, from the Royal Dutch Medical Association, and lead author of its recent forceful <a href="http://knmg.artsennet.nl/Over-KNMG/English.htm">anti-circumcision position statement</a>, examined the relationship of the right to bodily integrity with the right to freedom of religion. Anthony Lempert of the <a href="http://www.secularmedicalforum.org.uk/">British Secular Medical Forum</a>, who was recently interviewed to stunning effect in a video available online, discussed “Conscience and Foreskins: A Medical Paradox.” Michael Thomson and Marie Fox, professors of Law at University of Keele, delivered thoroughly researched analyses of health law and genital integrity. The organizers even managed to persuade the Metropolitan Police to attend the entire conference and to present a film on FGC they had prepared. Sarah Graham discussed her experience of protecting intersex children, while John Geisheker of Doctors Opposing Circumcision did double duty, discussing last year’s <a href="https://www.circinfo.org/Protection_of_children.html">flip-flip by the American Academy of Pediatrics</a> on the acceptability of “mild” forms of FGC, and also examining the San Francisco ballot initiative to ban under-age circumcision and the ensuing court case. J. Steven Svoboda (from <a href="http://www.arclaw.org/">Attorneys for the Rights of the Child</a>) presented a well-received paper that examined concerns common to all three branches of genital autonomy, “Protecting All from Genital Cutting: Law, Human Rights, and Demedicalization.” The high quality of the presentations and the intimate, relaxed setting of the conference allowed participants to connect, share ideas, and get to know each other over the two days. To use a British word, the conference was a smashing success. The conference, “Law, Human Rights, and Non-Therapeutic Interventions on Children,” was held on 31 August – 1 September 2011 at the University of Keele, UK. J. Steven Svoboda is a lawyer and founder of Attorneys for the Rights of the Child, a US human rights group focused on protection of children. Further information: <a href="http://www.genitalautonomy.org/">Genital Autonomy Europe</a> <a href="https://www.circinfo.org/Dutch_circumcision_policy.html">Royal Dutch Medical Association Policy discussed on this site</a> <a href="https://www.circinfo.org/Helsinki_genital_integrity_conference.html">Helsinki Declaration on the Right to Genital Autonomy (2012)</a> </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Genital integrity conference “A smashing success” darby Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> The following article by Mihail Evans was published by the British Medical Journal, 19 February 2011 New legislation in France has led to more debate on whether wearing the veil amounts to the sexual repression of Muslim women. Islam’s treatment of women is a regular topic in the Western press, yet few jump to the defence of Muslim and other little boys subjected to childhood circumcision. Indeed, the circumcision of the grandson of President Sarkozy, ironically a proponent of the veil ban, made only the gossip pages in France. As a permanent surgical genital alteration, circumcision is arguably a much more serious matter. After all, a Muslim woman has, at least in theory, the option to throw away her veil. The circumcised man’s foreskin has been thrown away already. Few countries have banned male circumcision, but even symbolic alternatives to female genital mutilation are banned in almost all Western jurisdictions. While I was a student, a female academic at my institution published a piece supportive of male circumcision. This prompted a thought experiment: suppose we found a male academic supportive of the surgical modification of female genitals. Would his views be accepted? Why can a Jewish woman speak openly to defend male circumcision and a Somali man not defend female circumcision? Physiological research has undermined beliefs that the foreskin is “just a flap of skin” and shown it to be an integral part of the penis. With the foreskin considered an erogenous, multifunctional tissue, the established view of circumcision as a non-damaging excision is fatally undermined. It would be more appropriate to change our terminology, to speak of male genital mutilation rather than circumcision in the same way that we use female genital mutilation and not cliteradectomy. Finland is among the few places where male circumcision is illegal, although recent judicial decisions have backtracked on this law, making exceptions for some religious circumcisions. Bulgaria banned male circumcision in the 1980s, but more as part of a cultural war on its Muslim minority than out of any overtly humanitarian concern. My partner is Bulgarian, and it amazes me that under law in the United Kingdom I could legally take my son there and subject him to the sort of horrific circumcision recorded by a Bulgarian current affairs programme, yet my Somali neighbours would be prosecuted for attempting to appease traditional opinion by replacing female circumcision with a symbolic pinprick to the clitoral hood. The absurdity of the legal situation in the UK is exposed by the conviction of a man under child pornography legislation for possessing images of a traditional circumcision (BBC News, 21 Nov 2003, http://bbc.in/fzV3h0). Apparently images are illegal but the act is not. We rarely glimpse more than the very tip of the iceberg of the sexual and psychological damage caused by male circumcision. One symptom is the considerable number of men interested in foreskin restoration. That any man would be prepared to spend several hours a day for several years using taped, weighted, and tensioned devices to try to regrow a foreskin is testimony to the suffering caused in some cases. In browsing online forums such as www.restoringforeskin.org, you get a sense of the great missing continent of male conversations that are unspeakable in public: the Iranian brought up in the West who always feels something is missing when he sleeps with a woman, or the gay American man depressed that he does not have the penis he was born with, like his European lover. I am amazed at how male circumcision in developed countries is treated simply as a question of opinion. On online parenting sites, such as www.emmasdiary.co.uk and www.babymania.com, it is often treated as just another parental option, up there with bottle or breast. Most women in the UK do not circumcise their sons, but if a mother says she has had her son circumcised “to be like daddy” or for “tradition,” hardly an eyelid is batted. I was shocked by some comments from mothers, which seemed more callous than would be tolerated if gender roles were reversed. In one a mother wrote “LOL” (“laugh out loud”) after telling the forum that her circumcised 4 year old “wants his old penis back.” In another, a mother from South Africa says she has kept the dried foreskin “in case he wants it back later.” Elsewhere on the web, it is completely acceptable to express a preference for a “cleaner” circumcised penis on women’s sites such as www.cosmopolitan.co.uk. I cannot imagine that a man who advocated ways of making the vagina more “attractive” and “hygienic,” let alone by surgical means, would be given a moment’s hearing. Would it be acceptable for a man to say he wanted to scare girls by training as a female circumciser? Of course not, but the Times can print an interview in which the actress Isla Fisher jokes that she would like to train as a mohel to give boys a scare (“The comic world of Isla Fisher,” Times, 25 Jan 2009, http://bit.ly/hgjEdV). Legislation to outlaw male circumcision was put forward in Massachusetts, and although it was defeated campaigns continue in other states (see www.mgmbill.org). Dutch doctors also discussed a ban last year (BMJ 2010;340:c2987, doi:10.1136/bmj.c2987). But given the experience of Finland, which had to make religious exceptions after it initially banned all circumcisions, a better way to protect the genitals of young boys might simply be to use existing laws. The Tasmanian Law Reform Institute has suggested that male circumcision may breach existing child protection laws (http://bit.ly/eLfxId). And the media have hinted at the possibility of a test case in the UK (“Ritual circumcisions ‘illegal’,” Mirror, 17 Nov 2009, http://bit.ly/4GviWc). Finally, little boys in the West might be given the same rights as their sisters, but resistance is peculiarly high and comes from the most surprising quarters. Dr Evans is a former postdoctoral researcher in ethics and philosophy, University of the West of England; <a class="__cf_email__" data-cfemail="fa9793929b9396ba8893899f8f8ad4949f8e" href="/cdn-cgi/l/email-protection">[email protected]</a> Source: Brit Med J 2011;342:442 (19 February 2011) <h2>Comments from readers</h2> Manzoor Memon, Chigwell, UK As a medical student in a Muslim country, I never heard from peers or as a GP in East London any request for reversal of circumcision. The obsessive disorder with size and shapes of different parts of the body is a medical rather than ethical issue. The young boys with phimosis as a result of poor hygiene were referred for circumcision. Evans has ignored the scientific proof in BMJs (8th and 15th jan.2011) printed under short cuts or Guardian (21.6.2010) reporting 4 year study confirming male circumcision reduces HIV by 60%, hence 80% of Zimbabwean men aged between 15 and 29 are targeted in circumcision (painful stage) scheme aimed at reducing HIV infections. To outlaw circumcision in the USA (70% male circumcision) or stop vaccinations in third world is unscientific and young children should be covered by existing UN regulations on prevention of disease. Islam and Judaism recommend male circumcisions (Jesus peace be upon him was circumcised on the 8th day too). The female mutilation is cultural in some parts of Africa which predates Islam, Christianity and Judaism. Finally when woman goes in labour parity of sexes disappears. <h3>Ritualised child abuse</h3> Paquita C.B. de Zulueta, GP, Hon Senior clinical lecturer, Imperial College, London Evans courageously questions the ethical justification for male circumcision. As a GP I have often seen the raw lesions left by the surgery, the infections sometimes caused, the clear distress, and, on more than one occasion, a worrying mutilation of the penis whereby more than the foreskin had been removed. I find it odd that this practice is permitted in countries where there are no significant clinical benefits to the procedure. People cite the reduced risk of cervical cancer, but this has been addressed with the introduction of the HPV vaccine, or they cite the higher incidence of rare diseases, such as penile cancer. HIV protection is not relevant in developed countries with low incidence. But even, if for the sake of argument, it were to provide significant protection to some diseases, do we conduct other elective procedures, such as appendicectomy, on children, in case they later on develop appendicitis (the risk of appendicitis in the USA is cited as being 0.25%)? The site of the wound is also relevant: an area that is particularly sensitive, exposed to urine and faeces, and in the context of an infant who cannot make sense of his distress and who cannot give consent. Evans is quite right to refer to the fact that many men seek to restore their foreskins by drastic means in order to enjoy more satisfying sexual lives or simply to restore their bodily integrity. Googling 'Restoring foreskin' yields 703,000 entries. The issue is sensitive because of the religious context, but arguably we need to consider the differences in hygiene and medicine as well as attitudes to children that existed at the time of the religious injunction as compared to the modern day, when we now have (finally!) the Convention of the Rights of the Child. The great religions promote compassion as a fundamental tenet - where is compassion in all of this? At least it should be done when the individual is autonomous and can make the choice authentically and freely, even if the surgery is more complicated. Some fathers justify it on the grounds of wanting their sons to be 'like them'. But do we insist that our children have to have the same anatomical defects that we have? And finally is the issue of cleanliness and purity not something to do with a disgust towards our 'animal' bodies rather than being based on sound scientific evidence? <h3>Primum non nocere</h3> Antony D. Lempert, GP, Wylcwm Street Surgery, Knighton, Powys Evans highlights well the disparity in the application of guiding principles to two distinct, though related scenarios. Some make the mistake of confusing this approach with weighted comparison of the relative harm of each. Non-therapeutic genital cutting of boys and girls causes different sets of serious problems; the principle of avoiding harm remains the same. Scales of harm are as unhelpful here as, for example, when considering the varied and overlapping harms of physical or emotional child abuse. In this context, calls not to mention non-therapeutic genital cutting of boys and girls in the same sentence display unhelpful gender discrimination. Failure to fully comprehend the basic premise that adults should not even touch, let alone cut, any child's genitalia for any purpose other than cleaning, dressing, medical examination or immediately necessary surgery, leaves boys and girls similarly unprotected. The GMC provides guiding principles for doctors treating those without the capacity to make their own decisions. (1) <ul> <li>Make the care of the patient your first concern</li> <li>Maximise a patient's ability to make decisions</li> <li>Consider whether lack of capacity is temporary or permanent</li> <li>Always take the least restrictive option</li> <li>Act in the best interests of the patient</li> </ul> It seems to be an act of faith not to compare the different application of these same principles in boys and girls. The evidence of harm for 'ritual circumcision' has been well-documented (2) & (3). No medical association in the world recommends non-therapeutic childhood genital surgery. To claim supposed therapeutic benefit for non-therapeutic surgery is an oxymoron and undermines scientific integrity. Without therapeutic benefit, cutting the body of a person unable to either consent or defend himself, is a criminal assault. All children deserve protection from such serious avoidable harm. (1) GMC Consent guidance: Making decisions when a patient lacks capacity 76a-c (2) Williams & Kapila British Journal of Surgery, Volume 80, 1231 -1236, October 1993. (3) Sorrells et al BJU International 99 (4): 864-869, April 2007) <h3>Male circumcision is not comparable to female genital mutilation</h3> Eleanor F Zimmermann, 4th Year Medical Student, Peninsula Medical School In response to Ms MacDonald and Mr Dalton, I would like to urge both to reconsider their views of comparing male circumcision to female genital mutilation (FGM). Male circumcision is although largely unconsented genital surgery that carries potential health risks, female genital mutilation (FGM) has such a long list of acute and long term complications that, as Dr Clarke clearly states, brings FGM to a completely different status where risks and ethical considerations are concerned. FGM is not confined to clitoridectomy - Type III (infibulation) involves excision of part or all of the external genitalia (the clitoris, labia minora and labia majora) with stitching of the labia minora or majora to narrow of the vaginal opening. (1) Young women who have undergone this type of FGM commonly suffer from a number of complications, including difficulty urinating, dysmennorhhea and also haematocolpos (accumulation of blood in the vagina). (1) When it comes to labour, these women have to be defibulated (surgical re-opening of the scar) in order for the baby to be delivered safely. (2) Obstetric management of these women is extremely complicated, and not without risks. (2) It has also been shown that women commonly avoid normal gynaecological screening such as smear tests and STI screening due to the difficulties associated with vaginal examinations. (3) In most cultures the legs of the victims are bound together after the procedure, and there are cases where some girls have broken their limbs due to being restrained during the procedure. (1) Children who have been brought back from 'holidays' having been mutilated don't feel able to communicate about their experiences, and often suffer from not only psychological complications but also recurrent urinary tract infections and dysmenorrhea, consequently often missing a number of days in education. The guardian has published a short documentary highlighting some of these problems: http://www.guardian.co.uk/uk/video/2010/jul/25/girls-facing-female-circumcision Although FGM is illegal in the UK, there have not yet been any prosecutions, (4) and mutilation is still being performed, both through parents taking their children abroad, and through 'cutters' being flown over to perform FGM on a mass scale in communities. (3) The reports online and on Youtube claiming that FGM is healthier and cleaner are outrageous. If we analyse the article sited in these videos, (5) the authors suppose the link between reduced HIV prevalence and FGM is based on confounders such as age at circumcision, type of circumcision and ethnicity. In fact women who have undergone FGM are less likely to engage in intercourse - either they can't, or they take no pleasure in it. This would be much like publishing an article looking at congenital impotence and HIV prevalence, concluding that impotent men have a significantly lower HIV prevalence, and claiming impotence is a protective factor for STI transmission. I have no doubt such a paper would get rejected by any publisher. In comparison, Brewer et al published results from a cross-sectional study showing an increased rate of HIV in those who had undergone either FGM or male circumcision.(7) When scientifically justifying the published studies claiming a reduced HIV transmission rate amongst circumcised males and speculating on the effect of FGM, HIV target cells, especially Langerhans cells that are present in the external genitalia may offer a link. Langerhans cells are present in the foreskin of males, and throughout the genitalia, but especially in the ectocervix of females. (8) As Ms MacDonald mentions of male circumcision: "In suggesting that forced male circumcision is justified where he may (possibly) reap some future reduction in cancer, HIV or even just smegma we open the door for these people to prove their case and demand a similar excision be promoted or pushed on women and girls." Similarly, the online resources that are pro-FGM are open to misunderstanding and abuse. Male circumcision is not comparable to female genital mutilation, although I agree that consideration should be given to banning male circumcision in childhood, and allowing for adults to make a fully informed decision as to whether they want the procedure or not. 1. RCOG. Female Genital Mutilation and Its Management. Green-top Guideline. No. 53. 2009 2. Rashid M, Rashid M. Obstetric management of women with female genital mutilation. The Obstetrician & Gynaecologist. 2007;9:95-101 3. FORWARD. Female Genital Mutilation: Information Pack. 2002 4. Carroll J. Metropolitan Police Authority. Female Genital Mutilation - MPS project Azure. Report 8. 2010 http://www.mpa.gov.uk/committees/cep/2010/101104/08/ 5. Stallings, R.Y., Karugendo, E.. "Female circumcision and HIV infection in Tanzania: for better or for worse? (3rd IAS conference on HIV pathogenesis and treatment)". International AIDS Society. http://www.ias- 2005.org/planner/Presentations/ppt/3138.ppt. 7. Brewer D, Potterat J, Roberts J, Brody S. Male and Female Circumcision Associated With Prevalent HIV Infection in Virgins and Adolescents in Kenya, Lesotho, and Tanzania. Ann Epidemiol.2007;17:217- 226. 8. Decatur M. Could Female Genital Cutting decrease the risk of HIV infection in a similar manner as male circumcision and if so, what implications does this have for Female Genital Cutting eradication efforts? http://www.ucl.ac.uk/network-for-student-activism/w/Could_Female_Genital_Cutting_decrease_the_risk_of_HIV_infection_in_a_similar_manner_as_male_circumcision_ and_if_so%2C_what_implications_does_this_have_for_Female_Genital_Cutting_eradication_efforts%3F <h3>Is it really unhelpful to compare male circumcision with female genital mutilation?</h3> Paul M Mason, Barrister-at-Law, Hobart, Tasmania Ann Savage's contribution neatly highlights the central conundrum of this male/female issue, namely the tension between cultural relativism and sex discrimination. One might have thought that the bonding and sense of passage into adulthood lay in the 3 months seclusion rather than the medically unnecessary surgery. But the European "solution" she describes opted for the latter over the former, and in pursuit of a modern European educational norm. Who interfered with overseas cultures in that case? And did those teenage boys give their own free and fully informed consent? As for girls; does not the goal of eradicating FGM/C (the culturally neutral UNICEF acronym) represent a colonialist interference with cultural needs? I have heard this argument put by a Kikuyu Kenyan PhD herself cut as a child. Intact girls, in Egypt for example where 97% are cut in some degree (UNICEF/WHO figures), suffer social isolation and embarrassment analogous to that of boys with foreskins differing from their own cultural norm. The ethical constant here is patient autonomy. No one should deny a mature intelligent adult - like Ann Savage for instance - the right to seek (and pay for) medically unnecessary cosmetic surgery on any part of her body. But no Doctor should perform it on her without her own consent at the behest of her parents. <h3>Re: Circumcision in boys and girls: Why the double standard?</h3> John P Warren, Retired Consultant Physician Mihail Evans's Personal View this week on genital cutting is most welcome. It is time for a debate among society at large, and particularly ethicists, lawyers, politicians, health professionals and child welfare agencies about the subject of non-therapeutic male circumcision of children. This procedure, carried out on healthy infants and boys too young to consent, defies all the normal standards of medical ethics, and exposes children to unnecessary pain and mutilation, as well as risk of complications. It can legally be performed by individuals without any medical qualification, who may be ignorant of surgical techniques and who cannot prescribe pain controlling medication. Dr Baombe's Rapid Response of 19 February mentions the distress of uncircumcised adolescent boys in countries where circumcision is common practice, but these boys have a remedy, that is to opt for circumcision. On the other hand boys and men who have been circumcised early in life and are distressed to discover their mutilation have no effective remedy, apart from non-surgical foreskin restoration, which takes years of applying tissue expansion techniques to the remaining penile skin. Even then, the result is not the same as a natural foreskin, as the lost specialised nerve endings do not regenerate. <h3>Forced circumcision cannot be medically justified</h3> Laura J MacDonald, Norm-UK Mihail Evans is right to highlight the double standards around our response to male and female circumcision (1). The responses which suggest that the spectre of HIV justifies male child circumcision are illogical. Real world data starkly contradicts the conclusions drawn from the controlled circumcision trials (2). But this is not the point. With women at double the risk of heterosexual aquisition of HIV(3) (and male circumcision offering them no reduction in risk) the real question is: why has no research been undertaken into the STD effects of a comparable female medical excision and/or keratinisation? Labial tissue for example is already known to be at greater risk of infections than foreskin - with myconium smegmatis ten times more prevalent in women!(4) This puts the 'hygiene' issue into perspective and shows the hypocrisy of those women who prefer their boys and men surgically 'cleansed'. Female circumcision advocates around the world from Dr Fuambai Ahmadu in Chicago, to Cleansexy on youtube; to Sheikh Yusuf Al Qaradawi in Egypt; to the Assalaam Foundation in Indonesia all claim health benefits follow their preferred form of female circumcision. In suggesting that forced male circumcision is justified where he may (possibly) reap some future reduction in cancer, HIV or even just smegma we open the door for these people to prove their case and demand a similar excision be promoted or pushed on women and girls. As such those who promote forced male circumcision undermine the rights of all of us. 1.BMJ 2011;342:d978 2. USAID Report February 2009 Levels and Spread of HIV Seroprevalence and associated factors: evidence from national household surveys 3. http://www.avert.org/women-hiv-aids.htm 4. Morrison AI. Non-specific urethritis investigated by Ziehl-Nielsen staining of the urethral discharge. Br J Vener Dis 1969; 45: 55-7 <h3>Non-therapeutic circumcision denies the child's right to autonomy</h3> John D Dalton, Trustee, NORM-UK In anticipation of the howl of protest that "female genital mutilation is in no way comparable to male circumcision", the two are to an extent directly comparable. Both remove normal tissue from the genitals of someone with no disease and who gives not personal consent. Female circumcision may in some cases be more damaging than male circumcision, but that is not he point. Rather the question is how it might later be perceived by the person whose body is altered. Non- therapeutic surgery is only ethically acceptable in the case of informed consenting adults. The question remains as to why every current GMC guidance document makes an explicit exception to non-therapeutic male circumcision. In the absence of such an exception the GMC guidance would clearly preclude non-therapeutic child circumcision. Perhaps the GMC would like to explain why there should be such an exception? <h3>Comment from CIA</h3> It seems strange that people can assert that male and female genital cutting cannot be compared when many experts have in fact compared them. What these deniers seems to mean is that male and female circumcision is not the same thing, a claim that nobody has ever made. But the fact that they are not the same does not mean that they do not have features in common, nor that they cannot be usefully compared. There has been a spate of articles over the past decade explaining both the similarities and differences between male and female genital cutting, and analysing the double standard to which Dr Evans refers, and we suggest that those who still have their head in the sands on this issue ought to do a bit more homework before they come out with their outdated assumptions. <a href="https://www.circinfo.org/ethics.html">Further information of ethics page</a> <a href="https://www.circinfo.org/female.html">Further information about female genital cutting</a> </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Circumcision in boys and girls: Why the double standard? darby Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> <h3>Midwives, Greens, media columnists, mothers ...</h3> <h2>More voices call for boys to be protected from circumcision</h2> In May 2010 the American Academy of Pediatrics astonished the world by announcing a policy on female circumcision that accepted the right of parents to impose mild forms of genital cutting on girls, such as a “ritual nick” to the clitoris. The suggestion was dropped after massive protests, and reminders that even this would be illegal under United States law. But the first groups to raise objections were the American and British anti-circumcision organisations (<a href="http://www.nocirc.org/">Nocirc</a>, <a href="http://www.arclaw.org/">Attorneys for the Rights of the Child</a>, <a href="http://www.intactamerica.org/">Intact America</a>, <a href="http://www.norm-uk.org/">Norm-UK</a>, etc). These bodies are critical of any genital mutilation of children, both male and female, but are generally regarded as being more concerned with male circumcision. It was only after they had taken the lead that the mainstream organisations concerned specifically with female genital mutilation (FGM) and the obstetrical colleges spoke up. The unfolding of the affair can be followed at <a href="http://www.circumstitions.com/">Circumstitions</a> and <a href="http://www.arclaw.org/letters/AAP051010.php">Attorneys for the Rights of the Child</a>. The policy has since been dumped, but its principal advocate, Dena Davis, a professor of law at Cleveland State University, argues that it is very difficult to maintain a blanket ban on all forms of FGM when the law in nearly all countries is completely silent on circumcision of boys - a far more damaging surgical intervention than a nick - and the practice remains common. As reported by <a href="http://www.economist.com/node/16329452">the Economist</a>, Ms Davis argues that “in America at least, it is not acceptable to criminalise all female genital cutting (FGC) while adopting a relaxed stance to the male sort. She suspects that by allowing male circumcision while forbidding even a symbolic cut on girls, Western countries show respect for only those religious and cultural practices with which they are already comfortable.” <h3>Professor Davis and the question of equal protection</h3> That may be so, but if Professor Davis is so concerned with gender equity and the rights of children, why did she not begin to even up the scales by reducing the risk to boys, by (for example) advocating a “ritual nick” on their penis in place of radical amputation of the foreskin? Giving boys a fraction of the protection already given to girls would do much more for both children’s rights and gender equity than reducing the protection given to girls. The fault here may well not lie with Davis, however, but with other, less ethically-minded, members of the AAP’s Bioethics Sub-Committee. In previous publications Davis has shown herself quite sensitive to the sufferings of circumcised boys and has warned that the American policy of a blanket ban on all forms of female genital cutting and open slather on all forms of circumcision (male genital cutting) contravenes at least two clauses of the United States Constitution: the First Amendment, which prohibits Congress from making laws to establish a religion or to prevent the free exercise of religion; and the Fourteenth Amendment, which gives all American citizens equal protection under the law. The former is invoked by Jewish citizens as a guarantee of their right to circumcise boys, but why should it not also be invoked by African or Muslim parents whose religion prescribes circumcision of girls? The right to equal protection has been deployed to ensure that women share the rights and protections enjoyed by men, but it also implies that men should share the rights and protections enjoyed by women. Heard in Seattle maternity hospital Obstetrician to Pregnant Woman: "If it's a boy, do you want him circumcised?" Pregnant Woman: "Yes, and also if it's a girl." Female circumcision will never stop as long as male circumcision is going on. How do you expect to convince an African father to leave his daughter uncircumcised as long as you let him do it to his son? Sami Aldeeb, <a href="http://www.fgmnetwork.org/authors/samialdeeb/index.html">To mutilate in the name of Jehovah or Allah</a> Davis also points out, in words echoed in the AAP’s 2010 FGC policy, that US laws on FGC prohibit “procedures significantly less substantial than newborn male circumcision”, including the ritual nick or scratch that doctors in Seattle proposed as a substitute for the full circumcision demanded by Somali parents. If the American public regard even a scratch on the vulva as unacceptably harmful, they must logically regard radical amputation of the entire foreskin (a substantial part of the juvenile penis) as far more harmful. Davis is perfectly aware and highly critical of these inconsistencies, and agrees with Doriane Coleman, author of a detailed study of the “Seattle Compromise”, that the proposed symbolic scratch was far less injurious that the average male circumcision: <blockquote> If we compare the Seattle proposal to the unregulated practice of berit milah (ritual Jewish circumcision of newborn males), it appears that the latter involves more skin removed, with less likelihood of adequate pain control and no systematic reporting system for complications. The Seattle proposal was [as Coleman comments] ‘less injurious to the health, welfare and safety of girls than male circumcision is to the health, welfare and safety of boys’. The primary difference between the operation proposed in Seattle … and the one performed daily on newborn males in America is that the first is associated with ‘bizarre’ practices brought to America by strange people practising strange customs, while the other is a Western practice with which we are familiar. </blockquote> Davis not only defends the ritual scratch as a reasonable compromise between the demands of the parents and the rights of the children to “an open future”, but also makes proposals to give boys some protection against routine circumcision, including greater regulation by the state, centralised collection of data on outcomes (including “complications”) and certification of ritual practitioners. These timid suggestions hardly go far enough, and the very first rule that a genuine bioethicist would like to see is that medical personnel be prohibited from asking new mothers if they would like their perfect baby boy circumcised: the practice is too like touting for business, and gives the impression that the circumcision decision is no more significant than deciding whether you want chips or salad with your steak. Still, in the American context the suggestions are a start, and undermine the claim of some critics that Davis has no interest in the welfare and happiness of boys. In accordance with her own philosophical principles, they too possess a “right to an open future”, which must include the right to decide whether or not to have a foreskin. <h3>References</h3> Dena Davis, Genital alteration of female minors, in David Benatar (ed), Cutting to the Core: Exploring the Ethics of Contested Surgeries (New York: Rowman and Littlefield, 2006) ----, Male and female genital mutilation: A collision course with the law?, Health Matrix: Journal of Law and Medicine, Vol. 11, 2001 ----, Genetic Dilemas: Reproductive Technology, Parental Choices and Children’s Futures (London: Routledge, 2001) Doriane Coleman, The Seattle compromise: Multicultural sensitivity and Americanization, Duke Law Journal, Vol. 47 (4), 1998, 717-783 <h3>AAP admits that male circumcision is harmful</h3> The most bizarre aspect of the affair were the efforts of the American Academy of Pediatrics to justify their attempted change in policy by pointing out that the "ritual nick" to which there was nearly universal objection was far less damaging than the average male circumcision, of which there was widespread acceptance. In its aborted FGM policy it stated "The ritual nick suggested by some pediatricians is ... much less extensive than routine newborn male genital cutting" (<a href="http://pediatrics.aappublications.org/cgi/reprint/peds.2010-0187v1">AAP FGC Policy</a>, April 26, 2010); yet when it was forced to abandon the policy it stated: "This minimal pinprick is forbidden under federal law and the AAP does not recommend it to its members" (<a href="http://www.aap.org/advocacy/releases/fgc-may27-2010.htm">Retraction of AAP FGC Policy</a>, May 27, 2010). How then can the AAP condone its members performing "routine [non-therapeutic] newborn male genital cutting"? Ironically, the publicity generated by the affair has led to the raising of the very question that the circumcision diehards within the AAP wished to keep suppressed: if girls have total protection, why don't boys have any? The most positive effect of the affair has been to provoke a variety of new voices to speak up for gender equity and to argue that boys should also be given at least some protection against genital mutilation. In recent weeks British midwives, Australian Greens, a British columnist and an American mother have all argued that boys are entitled to protection from circumcision, just as much as girls from FGM. See also the <a href="http://org2.democracyinaction.org/o/5922/p/salsa/web/common/public/content?content_item_KEY=2741">Open Letter published by Intact America in the Washington Pos</a>t, criticising the American Academy of Pediatrics for its double standards and sexism when dealing so inconsistently with male and female genital cutting. <h3>Analysis finds AAP motivated by non-medical considerations and political pressure</h3> Robert Van Howe. The American Academy of Pediatrics and Female Genital Cutting: When National Organizations are Guided by Personal Agendas. <a href="https://www.ethicsandmedicine.com/2011/09/ethics-medicine-volume-273-fall-2011/" rel="noopener" target="_blank">Ethics and Medicine, Vol. 27 (3), Fall 2011</a>. ABSTRACT The Committee on Bioethics of the American Academy of Pediatrics released a policy on female circumcision on April 26, 2010 proclaiming that some forms of genital cutting in minor females were permissible, particularly nicking the clitoris. The policy was quickly met with opposition and “retired” by the Academy on May 27, 2010. This paper explores the changes in policy from the Academy’s 1998 position and the possible implications of the changes. It is argued that these changes were driven by the personal agendas of members of the Committee and of the author of the policy. The short-lived policy failed to recognize the basic human right to bodily integrity that applies to all humans, including infants and children, placing the Academy outside the mainstream of how ethicists currently view the rights of children. <h2>Midwives condemn male genital mutilation</h2> Female genital mutilation is a frequently discussed topic by midwives and policy-makers alike, but British midwife Ann Higson highlights the often-ignored subject of enforced circumcision of male children. For some time now the issue of female genital mutilation (FGM) or female circumcision has been a hot topic of conversation within midwifery circles. It is an unnecessary abuse inflicted onto children in order to control their sexuality and promote chastity. FGM is illegal in the UK. Male genital mutilation (MGM) or male circumcision has been largely ignored. It is an unnecessary abuse inflicted onto children in order that they may conform to religious or cultural beliefs. MGM is legal in the UK. The Universal Declaration of Human Rights states that every man, woman and child should have equal rights without discrimination (United Nations, 1948). These rights should have meaning within our everyday lives and aim to protect all people from injustice. FGM is considered a violation of human rights by the World Health Organization (WHO, 2001). Their only concern regarding MGM is that local communities should make it freely available for neonates and children as research has shown that in countries where AIDS is rife, it can reduce transmission by up to 60% (Auvert, 2005). Tobian et al (2009) found a significant reduction of human papillomavirus (HPV) in their circumcised group. HPV transmission during sexual intercourse can cause cervical cancer (Muñoz et al, 2003). These are impressive results and they will certainly give credence and support to parents who wish their children to be circumcised. However, children are not sexually active until they become aware of their sexuality. Delaying male circumcision until the child can make an informed choice would reduce violations of his human rights. The British Medical Association (BMA, 2006) sit on the fence with this issue and can only recommend that MGM be carried out by a competent person and that consent is gained by both parents. They believe that it is up to society to put restraints on parental choices. However, they do conclude that parents do not have the right to demand that medical professionals carry out unnecessary surgical procedures on their children. According to Glass (1999), Jewish law requires that male neonates undergo circumcision on the eighth day following their birth. This is generally carried out without any form of analgesia, although one Jewish mother told me that her son would be given a ‘taste of wine’ before the ceremony. The Koran does not require MGM, though it is generally accepted that Islamic males should be circumcised. This is seen as a rite of passage into the Islamic faith and is usually carried out before puberty (Adamec, 2007). Analgesia is used with children, but not neonates. FGM is seen by the Islamic faith in general as a ‘barbarous cultural practice that pre-dates Islam’ (Maqsood, 2008). It has now been accepted that neonates are capable of feeling pain (Anand et al, 1987). Performing MGM on a neonate without analgesia can therefore be assumed to be a painful experience (Wellington and Rieder, 1993). Research has also shown that circumcised males show a higher behavioural pain score several months after MGM while undergoing vaccinations (Taddio et al, 1995). This suggests that male neonates are not only suffering physically but psychologically from this early painful stimuli. Morbidity rates are estimated to range from 0.1% to 35%, according to the American Academy of Family Physicians (AAFP) (2007). The most common complications are infection, haemorrhage and failure to remove enough foreskin (Kaplan, 1983). Rare complications include: <ul> <li>Necrotising fascitis – inflammation due to bacterial infection</li> <li>Meatitis – inflammation of the urethral opening</li> <li>Meatal stenosis – abnormal narrowing of the urethral opening</li> <li>Urethral fistula – abnormal opening within the penile tissue</li> <li>Penile necrosis – death of some or all of the cells of the penis</li> <li>Penile amputation – surgical removal of all or part of the penis (AAFP), 2007).</li> </ul> The mortality risk of MGM is 1:500,000 (AAFP, 2007). Some countries have passed laws to stop non-medical individuals from performing MGM on infants, and in Australia, a few states have stopped the practice of non-therapeutic male circumcision in public hospitals. Put together, these two sanctions would both be needed to protect neonates within the UK. Unless the act of performing MGM becomes a child abuse issue in the UK and therefore illegal, male children will continue to be denied their human rights. It seems unfair that girls are protected against FGM by law, while boys are left to suffer. Perhaps using the word ‘mutilation’ to describe female circumcision helped society to recognise the harm done to young girls by this practice? By penning the term ‘male genital mutilation’, a similar response could be hoped for, in order to find a solution to what is at present a very sensitive issue. <h3>References</h3> American Academy of Family Physicians. (2007) Circumcision: position paper on neonatal circumcision. See: www.aafp.org/online/en/home/clinical/clinicalrecs/circumcision.html (accessed 16 April 2010). Adamec CW. (2007) Islam: A historical companion. Tempus Publishing: Gloucestershire. Anand KJS, et al. (1987) Pain and its effects in the human neonate and fetus. New England Journal of Medicine 317(21): 1321-9. Auvert B, et al. (2005) RCT of male circumcision for reduction of HIV infection risk. PloS Medicine 2(11): 1112-22. British Medical Association. (2006) <a href="http://www.bma.org.uk/ethics/consent_and_capacity/malecircumcision2006.jsp">The law and ethics of male circumcision: guidance for doctors</a>. Glass JM. (1999) Religious circumcision: a Jewish view. BJU International 83(1): 17-21. Kaplan GW. (1983) Complications of circumcision. Urol Clin North Am 10: 543-9. Maqsood RW. (2008) Need to know? Islam. Harper Collins: London. Muñoz N, et al. (2003) Epidemiologic classification of human papillomavirus types associated with cervical cancer. New England Journal of Medicine 348: 518-27. Taddio A, et al. (1995) Effect of neonatal circumcision on pain responses during vaccination in boys. The Lancet 345(8945): 291-2. Tobian A, et al. (2009) Male circumcision for the prevention of HSV-2 and HPV infections and syphilis. New England Journal of Medicine 360(13): 1298-309. United Nations. (1948) The universal declaration of human rights. See: www.un.org/en/documents/udhr (accessed 16 April 2010). Wellington N, Rieder MJ. (1993) Attitudes and practices regarding analgesia for newborn circumcision. Pediatrics 92(4): 541-3. WHO. (2001) FGM: integrating the prevention and the management of the health complications into the curricula of nursing and midwifery. WHO: Geneva. <a href="http://www.rcm.org.uk/midwives/features/whos-looking-after-the-boys/" rel="noopener" target="_blank">Midwives Magazine</a> (UK), June/July 2010 <h2>Australian Greens defend the rights of the child</h2> Circumcision and the rights of children by Laura Ealing On May 28, it was reported that the Royal Australian and New Zealand College of Obstetricians and Gynaecologists was considering allowing a certain form of female circumcision, involving “ritual nicks”. RANZCOG later said it was a misrepresentation, and that “anyone suspected of performing such genital mutilation should be reported to authorities”, the Sydney Morning Herald said the same day. But if we reject all forms of female circumcision, why is it that male circumcision remains so acceptable? Circumcision of girls often entails absolutely brutal practices, such as the total removal of the labia and the clitoris, particularly in Northern Africa — although many countries are trying to stop it. It often takes place without any anaesthetic and with non-sterilised instruments. It is not uncommon for girls to die due to infection, but for those who do survive, a lifetime of pain and suffering awaits them, as well as a loss of sexual sensitivity. Such mutilation has rightly been decried as a terrible practice. Clearly these practices also entail a greater level of violence than male circumcision does. But at the other end of the extreme, female circumcision may involve nothing more than a superficial “nick”; this could be viewed as being less significant than the total removal of the foreskin in males. According to RANZCOG president, Dr Ted Weaver, “Child protection legislation is about stopping [such ‘nicking’] happening ... all of the states have legislated in this way so it is illegal in Australia”, the SMH said . Tasmanian Commissioner for Children Paul Mason, has questioned whether it is actually legal — let alone ethical — to conduct male circumcision, a non-therapeutic procedure. In every other circumstance, Mason says, it is legally considered assault to perform a non-therapeutic surgery without consent. According to him, it should be banned, along with female circumcision and gender assignment operations on intersex infants, until the person in question is old enough to make an informed decision about their body. Supporters of circumcision focus on hygiene and health concerns for uncircumcised boys. There is also credible evidence suggesting circumcision reduces the likelihood of transmitting diseases such as HIV/AIDS. We shouldn’t ignore this. But in Australia, should we be focusing our energies on getting boys circumcised, or just making sure that they use condoms? Condoms are ultimately substantially more reliable than the absence of a foreskin in preventing the spread of STDs. Moreover, if the medical evidence is so solid, then why is it against hospital policy to perform non-therapeutic male circumcision in public hospitals in Tasmania, New South Wales, Victoria, South Australia and Western Australia? Most leading medical associations across the world and in Australia agree that there is not enough medical evidence to support routine circumcision. Indeed, many studies suggest that, like most parts of the body, the foreskin may serve a purpose. Though disputed, studies have shown that the foreskin appears to be highly innervated and enhances sexual pleasure. Perhaps reflecting a growing awareness of these factors, male circumcision is decreasing in Australia. In the 1970s, close to 90% of baby boys were circumcised. Today, it is just 12%. Despite this, the federal government continues to pay a medical benefit for the procedure! Taxpayers are paying parents money so that they can have their infant boys’ foreskins chopped off. Historically, male circumcision has been a spiritual or religious ritual. Any moves to ban it would probably be interpreted as restricting religious freedom. But in a secular society we must base laws on a consistent set of values. We must consider the rights of children above the rights of parents to their religious expression. When it would be illegal to carry out any other non-therapeutic, invasive and irreversible surgery on a child, we need to ask ourselves why male circumcision has fallen through the gaps. This is not a value judgement about circumcision, or making all circumcisions per se illegal. This is about protecting children’s rights and giving them a choice in a matter that fundamentally affects their body. The Tasmanian Law Reform Institute discussion paper on the law and ethics of non-therapeutic circumcision <a href="http://www.law.utas.edu.au/reform/">is available here</a>. <a href="https://www.greenleft.org.au/node/44360" rel="noopener" target="_blank">Green Left</a>, Sunday 6 June 2010 <h2>British columnist calls for boys to be protected from circumcision</h2> It’s time to protect boys as well as girls from the barbaric practice of circumcision by Christina Odone Let the squeamish look away now: this blog post is about male and female circumcision, a subject that’s raising controversy again. Why is female circumcision abhorrent but male circumcision kosher? I blame our cultural hypocrisy. The practice of female genital mutilation is widely embraced by African and Middle Eastern tribes (Muslim, Christian, animist alike) while male circumcision is a Judeao-Christian tradition widely practised in the Middle East but also in America. We associate the former with deepest darkest Africa, tribal violence and misogyny; while the latter speaks to us of Abrahamic and Puritan traditions and elderly men with flowing white beards, all of which we are much more comfortable with. The World Health Organisation warns that three million girls are at risk each year of some kind of female genital cutting. In certain African countries (Somalia and Egypt) over 95 per cent of women have undergone some kind of circumcision. “Some kind” covers incisions ranging from a superficial cut of the clitoral prepuce, done under medical supervision, to the deep cut to the clitoris that a village woman will perform with a piece of broken glass. Defenders of the practice claim it is religious in nature – though you will have noticed that no Christian cleric in Europe has ever called for this barbarity. Critics counter that female circumcision is a patriarchal means of controlling women’s sexuality, as the operation is supposed to curb female sexual appetite and pleasure. Their claim is undermined by the lucrative industry that has sprung up in Beverly Hills (and elsewhere): Western women are going in for labioplasty, the de-hooding of the clitoris to lengthen and increase sexual pleasure. Male circumcision affects about 750 million males, according to the WHO. As in female circumcision, the range of procedures ranges from the surgeon’s careful incision to the village imam or rabbi operating on the child without anaesthetic. Our forefathers cut the foreskin invoking religious reasons; but theirs too was a puritanical obsession: they believed it would stop masturbation, curb sexual pleasure, and reduce appetite. They were right, up to a point: the circumcised penis is less sensitive than the uncircumcised one, as an article in the BMJ recently revealed. Defenders of THIS practice claim it stems the spread of HIV and some sexually transmitted diseases – though sexual relationships are many years down the line for those infants being ritually (literally) abused. Children of both sexes should be spared these barbaric practices. But while preventing female circumcision is a global political campaign, embraced by feminists of all faiths and none, no one seriously addresses the issue of male circumcision. Dena Davis, the legal consultant for the American Academy of Paediatrics, criticises this policy as nonsense. It reflects, as she told The Economist this week, cultural prejudice rather than medical knowledge. It would seem that although we cannot understand cutting a little girl, we can watch someone cutting an infant boy’s foreskin, and feel we are not leaving our comfort zone. <a href="http://blogs.telegraph.co.uk/news/cristinaodone/100043247/its-time-to-protect-boys-as-well-as-girls-from-the-barbaric-practice-of-circumcision/" rel="noopener" target="_blank">Daily Telegraph</a> (UK), 12 June 2010 <h3>There have been numerous comments on the article, including this one:</h3> This female vs male circumcision argument is tiresome. The fact that some forms of female circumcision are worse than male circumcision is not an argument for the procedure. Cutting of a person’s entire leg is worse than cutting off their pinky toe but that doesn’t make cutting off a pink toe right. Cutting off a toe and a leg without consent are both equally a violation of a person’s human rights. This is the point. They are both wrong. Female and male circumcision both violate the child’s human rights. The WHO says about FGM “It is nearly always carried out on minors and is a violation of the rights of children. The practice also violates a person’s rights to health, security and physical integrity, the right to be free from torture and cruel, inhuman or degrading treatment, and the right to life when the procedure results in death.” Does anyone here think that boys and girls should have different rights? Does male circumcision not carry the risk of complications and death? Even when performed in the west by competent doctors? It should also be noted that a huge reason why people have this misconception of FGM=bad and male circumcision=good is because they are looking at a surgery performed in the west vs a surgery performed in sub-Saharan Africa. A quick Google search shows two articles just published this week about the “horrors” of male circumcision as well. “Seven youths have died of botched circumcision in the past nine days, said departmental spokesperson Sizwe Kupelo. The health department was “extremely concerned” about the deaths and the high number of casualties involved, with 24 initiates in hospital, some of them since March. Last year alone, 91 initiates died and hundreds were hospitalised in the province.” Another article: “Another youth has died at a circumcision school in Mthatha, bringing to nine the number of initiation-related deaths in the past ten days, the Eastern Cape health department said. “It is a traumatic experience to see a young boy losing his genitals in one day. Our nurses are finding it hard to deal with,” said spokesman Sizwe Kupelo. The latest death was on Monday.” Another article that came out this week says: “Three Transkei boys have been admitted to Mthatha’s Nelson Mandela Academic Hospital with gangrenous penises following illegal circumcisions, says the Eastern Cape health department. Kupelo said it had emerged that a 14-year-old arrested last week for performing illegal circumcisions on his age-mates, was responsible for previous botched operations that had already resulted in nine penis amputations.” Hmm. Nine deaths in 10 days. Countless gangreen penises that have had to be amputated. Last summer alone over 90 boys died in under two months from being circumcised. When conditions are similar, so are the outcomes. Take a step back and try to picture for a moment that western countries had never started routinely circumcising infant boys. Now try to think what our reaction would be hearing these kinds of stories. We would be JUST as opposed to this being done to males as females. Do you think men with amputated penises have an easy time having sex or urinating or reproducing? Comparing the “horrors” of female circumcision in Africa to male circumcision in sterile hospitals by surgeons is like comparing the risks of brain surgery here to a brain surgery performed in a hut. Both are wrong, both can have horrific life ending complications, and both should be illegal to perform on infants. For further details of circumcision death and injury in South Africa, see the <a href="https://www.circinfo.org/africa.html">Africa page of this site</a> and <a href="http://www.circumstitions.com/">Circumstitions.com</a> <h2>An American mother decides not to circumcise</h2> Everything about this pregnancy was different. My previous two pregnancies happened soon after we began “trying,” with two years between, as planned. This one happened soon after we began discussing preventing more pregnancies, six years after my second child was born. Despite it being my third, this was my smallest pregnancy - most people didn’t even realize I was pregnant until my third trimester. My two previous births were induced at a convenient mid-day time and lasted about 10 hours, with me succumbing to an epidural in both cases. This time I went into labor naturally, ignorantly waiting until 3 a.m. to leave for the hospital. Since it seemed too late to call friends, we took the kids with us. I howled intermittently as my husband sped down Duke Street, the minivan hopping with each well-known dip in the road. In between contractions, I alternated between yelling at him to slow down and pleading with him to get there in time for an epidural before this thing happened. At 3:36 a.m., I leapt out of the car and ran into the hospital. I quickly pushed my bag through the scanner, buckling under another contraction while I asked the security guard if there was an anesthesiologist in the house. A woman arrived with a wheelchair, but I refused to sit down, begging her ineffectively to show me to the delivery room ASAP. We had to check-in first, during which I tried, in the diminishing spaces between contractions, to impart the desperate need for speed. Given my obvious distress, I couldn’t understand why everyone was smiling, until I got to the delivery room, where - within minutes - my water broke and my doctor informed that the baby was crowning. Aligned with the romantic notions of nearly every mom, I had wanted a natural, drugless birth with my first child; but now I knew better, and I WANTED AN EPIDURAL! This sentiment only brought more smiles from the doctor and nurses. When they absolutely refused to let me give birth standing up (and to give me an epidural), I finally lay down and immediately gave birth at 4:01. “I guess we ought to buy some diapers now,” my husband said as we looked at the beautiful, bruised face of our newborn son. The next day, our doctor asked if we wanted our son circumcised. We took for granted that our first son would be circumcised like nearly every other American, consenting to the procedure before really thinking about it. This time we had talked about it but still hadn’t decided, though we leaned toward circumcision, if for no other reason than our two sons would look the same “down there.” Fortunately, our doctor called us on this “easy way out” and engaged us in the lengthy and informed discussion we needed. The earliest circumcision record dates to about 2200 BC in Egypt, where it was a spiritual right of passage. It was later adopted by nearby Semitic peoples (including Jews and Muslims). According to Genesis, God commanded Abraham to circumcise himself and his household as a covenant. The Greco-Roman courts considered circumcision evidence of Judaism, prompting many Jews to hide their circumcisions and even undergo surgeries to restore the appearance of being uncircumcised. In the 1st century Jewish circumcision was thought to benefit health, cleanliness, and fertility, while reducing pleasure. It was recommended the procedure be performed as early as possible, as it was unlikely to be done by someone’s free will. During the Renaissance, non-Jewish Europeans did not practice male circumcision, and the Catholic Church ordered against it. Although other European countries considered arguments for circumcision unfounded, by the early 1900s English-speaking countries performed the procedure primarily for medical reasons, specifically cleanliness (Encyclopedia Britannica). Regarding religious reasons, the encyclopedia points the reader to “Mutilation” and “Deformation.” Indeed, most developed countries abhor the practice of ‘female circumcision’ (also originating in Ancient Egypt, though now performed mostly in Asia and Africa), primarily due to the lack of patient consent. Currently the major medical societies in the United States, Britain, Canada, Australia and New Zealand do not recommend routine non-therapeutic infant circumcision. Nonetheless, physicians in nearly half of neonatal circumcisions (2006, American Medical Association) “did not discuss the potential medical risks and benefits of elective circumcision prior to delivery. … Deferral of discussion until after birth, [and] the fact that many parents’ decisions about circumcision are preconceived, contribute to the high rate of elective circumcision.” In a 1987 study, most American parents chose circumcision due to “concerns about the attitudes of peers and their sons’ self concept,” rather than medical reasons. Our doctor informed that circumcision had no proven medical benefits, except perhaps for a slightly lower HIV risk in third-world countries with high HIV incidence. Furthermore, an uncircumcised boy was no more difficult to clean, if simply cleaned in the same manner as a circumcised boy. It should come as no surprise that we chose not to circumcise our second son, or that we chose without question to circumcise our first, for that matter. We feel fortunate to have made a conscientious decision this time, and glad for the objective doctor-patient discussion regarding circumcision that our society has apparently finally begun. <a href="http://www.thedurhamnews.com/2010/06/16/202336/the-2nd-time-around.html" rel="noopener" target="_blank">Melissa Rooney, The 2nd time around</a>, The Durham News (North Carolina, USA), 16 June 2010 <h3>See also:</h3> <a href="http://www.restoringtally.com/blog/2010/03/fathers-talk-his-son-about-infant-circumcision" rel="noopener" target="_blank">A circumcised father explains circumcision to his uncircumcised 10-year old son</a> </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource American female circumcision boo-boo ignites calls for equal treatment darby Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> <h1>Where is the voice of the man the child will become?</h1> <h2>Defending the child's right to an open future</h2> Letter from Doctors Opposing Circumcision on case of Boldt v. Boldt In the Fall 2009 issue of the Journal of Clinical Ethics, the authors of papers from a panel discussion at the 2008 Annual Meeting of the American Society for Bioethics and the Humanities reported on a common quandary in clinical ethics, made more challenging by the age of the child-patient. This was the case of “Misha” (Jimmy) Boldt, an Oregon child who faced, for five years, uninvited conversion, including circumcision, occasioned by a religious epiphany his custodial father claimed to have undergone. Each of the authors on the panel had a different perspective: Dena S. Davis, JD, PhD, [1] was the originator and moderator of the panel Janet L. Dolgin, PhD, JD, commented on the legal/sociological aspects; [2] Douglas S. Diekema, MD, MPH, commented on the medical/clinical aspects; [3] and Noam Zohar, PhD, commented on the religious/philosophical issues. [4] Our international physicians’ organization, Doctors Opposing Circumcision (D.O.C.), filed two amicus curiae (friend of the court) briefs in the case, [5] and attended a hearing on 22 April 2009 during which the child, by then 14, testified under oath and on the record in an Oregon court that he did not wish to convert to Judaism (his father’s newly adopted religion), he did not wish to be circumcised, and he did not wish to live with his father any longer. [6] The child’s testimony showed courage and took a risk that he would be ignored, as children too often are. Because it would have been far easier for Misha to accede to his custodial father’s wishes than to defy him in public, perhaps it can be assumed his testimony was truthful. Indeed, the child returned home with his father that day. In September 2009, facing a custody hearing he was likely to lose, the father voluntarily agreed to give up physical custody of Misha to his mother, with court approval. The child’s proposed circumcision, at one point only hours away, remains judicially prohibited. None of the amicus groups that supported the father’s legal position all the way to the U.S. Supreme Court — and back to Oregon — appeared at the hearing on 22 April 2009 to hear the child’s actual “voice” (nor did they express any written sympathy for the plight of the child throughout the proceedings). [7] Our international physicians’ group was pleased to read that Diekema and Zohar stated that the child’s preference must be sought. [8] In this instance that would have been problematic, because there was no way to determine whether the father, who had full custody of the boy for many years, had not systematically steeped the child in his own beliefs. This is a common and challenging scenario in pediatric bioethics. There was, our physicians’ group believed, another voice that needed to be heard — that of the man Misha would soon become. Thus we were stung by the suggestion of Dolgin in ICE that we had ignored the voice of Misha, [9] and so did him a disservice for our own ideological reasons. We did urge the court to protect the child from an irrevocable decision he might later regret — but only if Misha supported his father reflexively. In that sense Dolgin was half correct — and only in the short-term It is overly simplistic to frame this ethical puzzle as fully solvable by merely listening attentively to the voice of the child. Our entire rationale in this case was not only to defend, cautiously, the voice of the child — which might potentially have been manipulated by adults — but also to give a voice to the man this boy is soon to become. That voice, or any voice from within the child, was entirely missing until the end of the five-year litigation. But it may be found throughout our two voluminous briefs on Misha’s behalf. [10] In all, four attorneys eventually contributed more than $80,000 in pro bono legal time to hear the voice of Misha, the future man, and, by inference, others in his situation. Contributions poured in from a half-dozen countries. Even so, ultimately Misha did the heavy lifting, finding within himself the beginnings of his forthright adult voice. We live the bulk of our lives — 60 or so years — intellectually independent from our birth families, even if we are emotionally tied to them, as autonomous individuals with the right to determine our own beliefs and the responsibility to extend the same freedom to our children. The late philosopher Joel Feinberg said that children are entitled to an “open future,” one whose options are not foreclosed by whimsical (or even pious, heartfelt) decisions of their parents, and who ought to be protected from decisions of their own that they may come to regret. [11] The cosmetic surgery or tattoo that a discontented young adolescent might crave, as Diekema warns, comes to mind. [12] Misha/Jimmy Boldt now has an open future; he can schedule his own circumcision at age 18 for religious reasons — or for no reason at all. He can study to become an observant Jew if he wishes, which would be much more credible for being his personal choice. Following the path of millions of secular Jews worldwide, he could also become an agnostic or an atheist, or anything in between. Indeed, we have no way of knowing what personal beliefs a child will develop. We would argue further that parents have no right to force a child to adopt their beliefs merely to reaffirm their own choices. Beyond issues of belief, do we, as parents, acquire a derivative right to mark our child’s body with an indelible symbol of our own belief? For example, in some quarters of fundamentalist Shiite belief, parents slash their child’s forehead three times during Ashura, so that blood flows down the child’s face to memorialize the death of the martyred saint Imam Hussein, beheaded by Sunnis in the year 780. The child is said to be protected from pain or harm by his or her faith. The ritual is repeated each year, even with toddlers. [13] Should Shiite parents be credited with honest piety and their toddlers with independent belief? Or should we attempt to forbid this practice (in North America, anyway), as it presents risks to children whose beliefs cannot yet be determined and whose scars, physical and psychological, may be permanent? One reason this particular religious practice may seem repellent is that, like female genital cutting, it is unfamiliar. Richard Dawkins, DPhil, Oxford University, has suggested that raising a child in a specific religion, to the exclusion of exposure to other beliefs including skepticism, constitutes child abuse.” [14] Perhaps that is too drastic, but it is a provocative thought in a world that includes too many young suicide bombers. Thus there is a lesson in Misha’s case to guide pediatric care-providers: the voice of the child, as Diekema touches upon but does not elaborate, may be the product of many sources: whims of the child, whims of the family, remnant memes of culture the child has been taught to parrot. Thus care-providers will do well to ignore the clamor and remain focused on what is best for the child qua future adult, preserving, when possible, all of the child’s options to be exercised, autonomously, later. That logically eliminates all occasions in which the child’s options are foreclosed, without therapeutic justification, for reasons the child-now-an-adult may regret. In the medical setting, that means avoiding procedures that humor the family at the expense of the child, who is the only patient and an adult-in-process, whom we are charged to protect. Examples include therapeutically premature, cosmetic “normalization” surgeries like otoplasty or blepharoloplasty (changing an Asian double eyelid), or precipitous gender assignment of the intersexed, when these could wait for the adult child’s expressed preference. Respect for a child’s right to an open future fully obviates the merely cultural, non-therapeutic, surgical modification of minors, including cosmetic labioplasty (alas, on the rise), [15] cosmetic piercing or reduction of the labia or foreskin, tattooing, scarification, circumcision of either gender, and the like. All reduce a child’s options and brand the child as the possession of the parents, with no regard to his or her autonomy as a future adult. Without proven therapeutic justification and pressing necessity, none enhance the child or credit his or her right to an open future or the right to choices — including physical appearance and sexual functioning — of his or her own. Finally, we were disturbed and dismayed by a footnote in Dolgin’s article that could be seen to suggest that the president of Doctors Opposing Circumcision, George C. Denniston, MD, may be anti-Semitic, which is entirely unfounded. [16] In closing, children who are welcomed, gently, into their birth communities have been given the gift of Joel Feinberg’s “open future.” They may embrace their community or they may eventually drift away; there is no way to tell, in advance, what they will choose. But, importantly, their options are left open, and none of their body parts will have been surgically modified or removed — without their consent — prior to the moment when we will be able to hear the voices of the adults they will become. John V. Geisheker, JD, LLM Executive Director, General Counsel Doctors Opposing Circumcision 2040 Westlake Avenue North, Suite 420 Seattle, Washington 98109 <h3>References</h3> 1. D.S. Davis, “Boldt v. Boldt,” The journal of Clinical Ethics 20, no. 3 (Fall 2009): 241-3. 2. J.L. Dolgin, “Where Is the Child? Circumcision and Custody in Boldt v. Boldt,” The Journal of Clinical Ethics 20, no. 3 (Fall 2009): 244-50. 3. D.S. Diekema, “Boldt v. Boldt: A Pediatric Ethics Perspective,” The Journal of Clinical Ethics 20, no. 3 (Fall 2009): 251-7. 4. N. Zohar, “Circumcision, Conversion, and Deciding for a Minor: Some Jewish Perspectives,” The Journal of Clinical Ethics 20, no. 3 (Fall 2009): 258-61. 5. “Boldt v. Boldt: Brief of Amicus Curiae, Doctors Opposing Circumcision, in Support of the Petition for Review,” http://www.doctorsopposingcircumcision.org/ pdf/2007-04BoldtReview.pdf, p. 3, accessed 13 November 2009, and as a record of the State of Oregon Court system; “Brief on the Merits of Amicus Curiae, Doctors Opposing Circumcision,” http://www.doctorsopposingcircumcision. org/pdf/2007-04BoldtReview.pdf, p. 2, accessed 13 November 2009, also as a record of the State of Oregon Court system. 6. In the Circuit Court of the State of Oregon, County of Jackson, In the matter of the marriage of James H. Boldt and Lia Boldt, Case 98-2318-D3(8), Judge’s Order signed June 2, 2009, filed and received June 3, 2009. 7. Through their lawyers, the American Jewish Congress, the American Jewish Committee, the Anti-Defamation League, and the Union of Orthodox Jewish Congregations of America. 8. Zohar writes, “Since the validity of the conversion will depend on the eventual assent of the young man, it seems nothing much would be lost by waiting with the ritual until he reaches the age of competence, at which point he shall be able to decide for himself, both with regard to the circumcision and to the conversion as a whole.” Zohar, see note 4 above, p. 261. 9. Dolgin writes, “The assumptions behind that convergence of opinion reflect a model of childhood … on which the parents and the amici curiae all relied — a model here referred to as “traditional” … between the traditional model of childhood and the individualist model, society and the law have etched a third model of childhood. Referred to here as the “transforming” model of childhood, it bears incidents of each of the other two models and differs from both. This model recognizes the autonomy and individuality of some children, in some settings, to some degree, and it defines some children, in other settings, as dependent and unequal.” Dolgin, see note 2 above, p. 247. 10. At no time did any staff member of Doctors Op¬posed to Circumcision, legal or medical, have even the slightest contact with the mother or the child, lest we be accused in open court of influencing the child’s “voice” ourselves, risking our neutral amicus status. We urged the Oregon Supreme Court to bifurcate and analyze separately the issues of custody and the claimed legality of the impending circumcision, whether unwanted or not (issues the court eventually commingled, unfortunately). At no time did we take any position with respect to which parent might be the better custodian for the child. See: “Boldt v. Boldt: Brief of Amicus Curiae,” note 5 above. 11. J. Feinberg, “The Child’s Right to an Open Future,” in Whose Child? Children’s Rights, Parental Authority, and State Power, ed. W. Aiken and H. LaFollette (Totawa, N.J.: Littlefield, Adams, 1980); also in Freedom and Fulfilment: Philosophical Essays (Princeton University Press, 1992), 12. Diekema, see note 3 above, p. 255. 13. Some recent photos of toddlers commemorating Ashura are posted at http://atlasshrugs2000. typepad.com/ atlas_shrugs/2009/01/islam-celebrate.html, accessed 13 November 2009. 14. R. Dawkins, “Childhood, Abuse, and the Escape from Religion,” in The God Delusion (New York: Houghton Mifflin, 2006), 309 et seq. 15. See, for instance Liao LM, Michala L, Creighton SM, Labial surgery for well women: A review of the literature, British Journal of Gynecology 117 (1) January 2010, 20-25: “Medically non-essential surgery to the labia minora is being promoted as an effective treatment for women's complaints, but no data on clinical effectiveness exist”. Abstract at http://www.ncbi.nlm.nih.gov/pubmed/19906048, accessed 13 November 2009. 16. Dolgin, see note 2 above, note 41, p. 249 Journal of Clinical Ethics (New York), 21 (1), Spring 2010, 86-88 </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Boldt case: Letter to Journal of Clinical Ethics darby Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> <h3>The case of Boldt v. Boldt</h3> A long-running legal saga in the United States was finally resolved in late 2009, when courts in the state of Oregon ruled that a parent could not compel a child over which he had custody to get circumcised against the boy’s will. The case is of considerable interest in its potential to limit the power of parents to impose circumcision and similar physical alterations on children and in its implicit recognition that children have their own rights – to physical integrity and freedom of conscience and religion – independently of their parents’ belief. <h2>Background: A messy custody case</h2> The Boldt case was a custody battle, and like all custody battles, it was a complex story, but the basic facts are that the Boldts were adherents of the Russian Orthodox Church and had one child, Mikhail James, whom the mother called Misha and the father Jimmy. After a bitter divorce, custody of the boy was eventually given to the father. Some time after this the father decided to convert to Judaism and tried to take Misha (then aged 9) with him, a transition that necessarily entailed arranging for him to be circumcised. The boy’s mother obtained a temporary court injunction prohibiting the circumcision, and filed an application for custody. The father testified that Misha himself wished to convert and undergo the operation, but that even if he did not his wishes were irrelevant because the custodial parent had complete authority to make what he called “medical decisions” for a child. The mother testified that Misha did not want to be circumcised and was afraid to contradict his father. After a lengthy series of hearings and appeals, by which time the boy was 12, the Oregon Supreme Court decided that “although circumcision is an invasive medical procedure that results in permanent alteration of a body part and has attendant medical risks, the decision to have a male child circumcised for medical or religious reasons is one that is commonly and historically made by parents,” and it concluded that the custodial parent’s rights in this respect were not fettered by the views of the non-custodial parent. But because this was a custody, rather than a right to circumcise, case, the court ruled that forcing the boy to get circumcised would damage his relationship with his father, and sent the case back to the trial court to determine the boy’s own views. When Misha, by now aged 14, finally got the opportunity to express his own opinion (at a hearing in judges’ chambers in April 2009) he made it clear that he did not wish to convert to Judaism, and he most definitely did not want to get circumcised or to remain with his father. Accordingly, the court issued an order that he was not to be circumcised and returned him temporarily to his father while child custody officials worked out the details of how to return him to his mother. <h2>Involvement of Doctors Opposing Circumcision</h2> Although the original trial court ruled that a decision to circumcise was a legitimate power of the custodial parent and refused to hold a hearing on the matter, it issued a stay pending the outcome of an appeal by the mother. The Court of Appeal agreed with the trial court and refused to order a hearing, at which point the mother appealed to the Oregon Supreme Court and requested the American human rights group, Doctors Opposing Circumcision, to intervene in the case as amicus curiae (friend of the court – a role performed by those with no personal interest or standing in a case, but who can assist the court through its expertise in the technical questions raised). DOC filed two briefs in the case, one in support of the petition for review, and then, following the Oregon Supreme Court grant of certiorari (the right to appeal), a second brief on the merits. Parental and child rights were considered under the constitutions of Oregon, Washington (the child’s state of residence), the United States, and even a Supreme Court of Canada decision on parental duties under the Canadian Charter of Rights and Freedoms. DOC’s briefs were limited to arguments against circumcision on medical, legal, and human rights grounds, and did not take a position on the issue of custody. These were matched by three influential American Jewish organisations that submitted their own amicus curiae briefs in support of the father’s claim of an unfettered right to circumcise his son. At no point in their submission did they show the slightest sympathy for the plight of the child or show any interest in his preferences in the matter. They and the father claimed an absolute right to circumcise the boy under the “Free Exercise” clause of the First Amendment to the United States Constitution, which bars Congress from establishing any religion or prohibiting the free exercise thereof. Although the Oregon Supreme Court, in obiter dicta (a passing observation, not related to the legal issues that decided the case), paid deference to a custodial parent’s right to make a decision about circumcision, it remanded the case back to the trial court with an order that it should determine the view of the child. The child was then twelve years of age. <h2>Court recognises that child’s preferences must be considered</h2> The father then petitioned the United States Supreme Court for certiorari (right to appeal), which was denied, and the case returned to the Circuit Court of Jackson County, Oregon, where a hearing was held on 22 April 2009, before Judge Lisa Greif. At that time, Misha, now 14 years of age, testified in her chambers, on the record, that he did NOT want to be circumcised, he did NOT want to convert to Judaism, was afraid of his father and wanted to live with his mother. The court then issued an oral order from the bench that the child NOT be circumcised. The court then followed that with a written order on 2 June 2009, in which the court found that a substantial change of circumstances had occurred and ordered an investigation by an independent child custody evaluator for a future evidentiary hearing. In the meantime, the boy remains in the custody of his father, but under protective orders against circumcision. <h2>Significance of the Boldt case</h2> Despite the Oregon Supreme Court’s remark about the decision to circumcise a child being “commonly and historically made by parents”, the case remained a custody battle throughout, and no determination was ever made as to whether parents did in fact have the right to make such a decision, and if so with what qualifications. Since the question does not seem be as settled in law as the court’s confident words suggest, the observation may be regarded as no more than an obiter dictum. In a similar case, a divorced mother having custody of a nine-year-old son remarried, this time to a Jewish man, and sought to have the boy circumcised at the behest of her new husband. The father objected, and when the matter came to court the judge dismissed the mother’s claim of medical necessity and ordered that the boy be protected from circumcision until his 18th birthday, at which point he would be free to make his own decision. (Schmidt vs. Niznick, Cook County Illinois, 00D18272, cited in Doctors’ Opposing Circumcision, Amicus Curiae Brief on Boldt, 26) In denying that the non-custodial parent had no prerogatives with respect to medical decisions about a child, the Oregon Supreme Court certainly did not mean that the child had no say in the matter; indeed, in directing that the trial court discover Misha’s own views it implied quite the contrary. The significance of the case is in establishing a precedent that a parent’s authority to circumcise a child is not unlimited and may not even exist. Although the court took account of the boy’s age (twelve), recognising that it might be difficult to get a boy of that age to lie down submissively in a doctor’s surgery, it is hard to see why the principle of physical integrity would not apply to a child of any age. There is no obvious reasons why a child has the right to physical integrity at 12, but not at 8 years, 4 years, 6 months or 2 weeks. By the age of 12 Misha certainly knew that he wanted to keep his foreskin and was confident enough to make his views heard, and (this being the case) we may reasonably infer that if an infant or young child too young to be capable of expressing an opinion on the matter were able to do so, he would say NO, or at least ask that the operation be delayed until he was old enough to inform himself as to the pros, cons and harms of circumcision and make his own decision. A <a href="https://www.circinfo.org/news.html#chong">recent study in the USA</a> found that even if circumcision were proved to be effective insignificantly lowering the risk of HIV infection, only 0.7 per cent of adult men would be willing to get themselves circumcised. The clear implication is that if an infant or child were asked if he wanted to get circumcised, and he was capable of giving a rational answer, the answer would be “No way.” This alone is a sufficient reason why circumcision should not be imposed on minors. <h2>Age not the issue:</h2> <h3>All humans have autonomy and the right to physical integrity</h3> Some commentators on the Boldt case have suggested that while a 12 or 14-year old might be mature and competent enough to reject circumcision, younger boys and especially babies must just accept whatever their parents think best for them. This position makes no sense at all, for reasons set out clearly in the Canada Medical Association Journal a long time ago: The performance of unnecessary surgery on minors who have no say in the matter does not sit well with many people who consider circumcision a denial of basic human rights specifically an infant’s right to the respect and autonomy fundamental to Canadian law. … Removal of a normally function healthy body part without medical indication has also been viewed as a violation of the Hippocratic oath, falling under the United Nations’ definition of genital mutilation. As such, circumcision is seen as being against the Universal Declaration of Human Rights and the UN Convention on the Rights of the Child. … In BC [British Columbia], the Infants Act stipulates that a child should be accorded the same protection under law as adults: if an adult male cannot be forced to undergo circumcision in adulthood, it follows that he shouldn’t be forced to have it in infancy simply because he is too small to resist. (Eleanor LeBourdais, Circumcision No Longer a “Routine” Surgical Procedure, 152 CANADIAN MED. ASS’N. J. 1873-4 (1995) The fundamental problem with the idea that circumcision of an adult requires informed consent but circumcision of a minor can be accomplished at the wish of a parent is that childhood is a temporary condition but circumcision a permanent one. A person soon ceases to be a child, but no matter how old he gets he will not get back what has been taken away; as an adult the person has the same mark or absence that his parents were entitled to effect by the mere fact of his being a minor. There is thus no significant difference between forcible circumcision of an adult (which is illegal) and circumcision of a minor, since the result in adulthood, when the parts affected are most needed, is the same in each case. To make an adult’s right to physical integrity meaningful it must be respected in infancy and childhood, implying that irreversible bodily alterations should not be performed. By defining respect for autonomy as “requiring that persons with the mental capacity to make certain medical decisions have these decisions respected”, the parental authority school drastically reduces the scope of autonomy and effectively denies it to children and incompetent adults. This is a radical departure from accepted principles of bioethics [1] and a succession of legal judgements in the USA, Britain and Australia [2] that restrict the power of adults to make medical decisions on behalf of incompetent family members. Lack of mental capacity, neither in infancy nor in adulthood, does not negate a person’s right to physical integrity; if parents are determined to violate this right, the state is entitled to intervene in defence of those who lack the capacity to defend their own interests. <h2>Parental authority and the child’s right to an open future</h2> The following principles would also appear to have been endorsed by the outcome of this case. (1) Parental rights are an extension of, and derivative from, parental responsibilities to the child. Parental rights exist as against outsiders or strangers to the family; they are not rights of the parent against or over the child, who is held in trust during his minority. Behind every assertion of a parental ‘right’ must be a discernible concern for the independent co-relative rights and well-being of the child as a separate person and individual in his own right. (2) The child has an independent right to his own religious beliefs or non-beliefs. These rights are stated clearly in the foundation documents of the modern human rights framework: The Universal Declaration of Human Rights; the International Covenant on Civil and Political Rights; and the Convention on the Rights of the Child. These treaties give all people the right to freedom of religion and conscience and to physical integrity, irrespective of age or gender. To mark a child permanently and physically as a member of any religion deprives him of his own right to religious freedom and personal choice. To take an unfamiliar example, many Shiite Muslims believe they have the right to slit their children’s foreheads each year on the festival of Ashura, commemorating the death, by beheading, of their sainted Imam Hussein. [3] Even if performed by a doctor under sterile conditions, it is hard to believe that Western law or custom would accept this practice as an appropriate exercise of the religious freedom of the parent. (3) In his paper “The Children We Abandon: Religious Exemption to Child Welfare and Education Laws as Denials of Equal Protection to Children,” [4] James Dwyer has argued that far too often Anglophone law has abridged the child’s more fundamental rights to health and even life itself, to accommodate mere beliefs, even whims, of the parent. It is to be hoped that the Boldt case marks the beginning of a more child-centred tradition. (4) As argued by the late legal philosopher Joel Feinberg, children have a “right to an open future”, that is, one in which all options for the future development of the child as an adult-to-be are protected and retained. [5] This applies not only to affection, food, shelter, and education, but also to freedom from irrevocable parental choices of which circumcision is a permanent, palpable and entirely unnecessary example. For these reasons and many others, we should make sure that we maintain a sharp focus on the rights of the child as an independent entity distinct from his parents, one whom they hold in trust and cannot treat as property, and who is entitled to human rights of his own, of which the right to a set of intact genitals is surely one of the most fundamental. <h3>Documents relating to the case available here</h3> <a href="http://www.doctorsopposingcircumcision.org/pdf/2007-04BoldtReview.pdf">Doctors Opposing Circumcision, Brief of amicus curiae in support of the petition for review</a> (PDF, 184 kb) <a href="http://www.doctorsopposingcircumcision.org/pdf/2007-07BoldtMerits.pdf">Doctors Opposing Circumcision, Brief on the merits of amicus curiae</a> (PDF, 102 kb) <a href="http://www.doctorsopposingcircumcision.org/info/appeal.html" rel="noopener" target="_blank">Summary of early phases of case at DOC website</a> <a href="https://www.circinfo.org/DOC_Boldt_case.html">Letter from Doctors Opposing Circumcision to Journal of Clinical Ethics</a> <h2>References</h2> 1. Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics (Oxford University Press, 1977) As set out in this basic text, the fundamental principles of bioethics are: Beneficence — Does the proposed procedure provide a net therapeutic benefit to the patient, considering the risk, pain, and loss of normal function? Non-maleficence — Does the procedure avoid permanently diminishing the patient in any way that could be avoided? Proportionality — Will the final result provide a significant net benefit to the patient in proportion to the risk undertaken and the losses sustained? Justice — Will the patient be treated as fairly as we would all wish to be treated? Autonomy — Lacking life-threatening urgency, will the procedure honor the patient’s right to his or her own likely choice? Could it wait for the patient’s assent? Medically unnecessary circumcision of male minors violates every one of these principles. 2. J.S. Svoboda et al, <a href="http://www.cirp.org/library/legal/conundrum/">Informed consent for neonatal circumcision</a>, esp. 80-81, 87, 89-90; Gregory Boyle et al, <a href="http://www.cirp.org/library/legal/boyle1/">Circumcision of Healthy Boys: Criminal Assault?</a>, 7 J Law Med 301 (2000); Frank Bates, <a href="http://www.cirp.org/library/legal/bates1/">Males, Medical Mutilation and the Law: Some recent Developments</a>, 9 J Law Med 68 (2001) 3. The theory is that young men slash only their own foreheads, but there are plenty of pictures available on the web that show adults doing it to young children: see “Ashura observed with blood streams to mark Karbala tragedy” at <a href="http://www.jafariyanews.com/2k5_news/feb/20ashur.htm">Jafariya News</a> and <a href="http://atlasshrugs2000.typepad.com/atlas_shrugs/2009/01/islam-celebrate.html">Atlas Shrugs</a>. 4. James Dwyer, The Children we Abandon: Religious Exemptions to Child Welfare and Education Laws as Denials of Equal Protection to Children of Religious Objectors, 74 N.C.L. Rev. 1321 5. Joel Feinberg, The Child’s Right to an Open Future, in Freedom and Fulfilment: Philosophical Essays (Princeton University Press, 1992). See also Dena Davis, Genetic Dilemmas: Reproductive Technology, Parental Choices and Children’s Futures (London and New York: Routledge, 2001), and idem, Genetic Dilemmas and the Child's Right to an Open Future, 28 Rutgers Law Journal 549 (1997) </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource American legal precedent confirms child’s right to reject circumcision darby Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> Recent public statements from Germaine Greer, one of Australia's most famous expatriates, and Paul Mason, Commissioner for Children Tasmania, show that there is growing support for children's rights and deepening concern that Australia is not doing enough to protect children from physical harm. <h2>Paul Mason: Children should be treated as fully human</h2> The following speech was given by Paul Mason, Commissioner for Children, Tasmania, at the joint FORWARD-NORM-UK press conference, in London, on 3 September 2008. <img alt="" class="image-right" height="421" src="https://www.circinfo.org/images/cliphiswings_000.jpg" width="300"/> Thank you everybody. The commissioner of children, like your commissioners of children in the United Kingdom, is a body independent of elected government and created under statute that deals with child protection. It does not import the rights of children from the United Nations Convention on the Rights of the Child (CRC) into domestic Tasmanian law. It says these are the guiding principles. So when I came into the job a year and a half ago, I was looking at a wide range of issues. I stumbled across FGM (Female Genital Mutilation), and I will be glad to talk to Naana [Otoo-Oyortey MBE, Executive Director of FORWARD] about this later. In Tasmania and Australia we do have government programs to educate, assist and support families who feel the pressure to conduct genital mutilation on the girls. We are devising various ways of assisting those families around the very problems Naana is talking about. We also have legislation like your legislation in the UK that criminalizes the procedure and criminalizes parents traveling out of the jurisdiction in order to have the procedure conducted on their daughters. I will start my speech by referring to the person in Tasmania who leads the bicultural teams in Tasmania. When I first talked to her about FGM a year ago she said, “You know what? 100% of the time, when we hear through the grapevine that a family is contemplating a procedure on a girl or is contemplating leaving for Indonesia to have the procedure done there, 100 per cent of the time they say to us, “You do it to boys! You DO NOT tell us not to do it to girls!” And she said meeting this response is like walking into a brick wall. We have not yet come up with an answer for that. So I said to this bicultural leader, “I think I can help you. I think I can help you, if we can work together, yourself as a professional and myself as an independent advisor to the government to try and turn around the eyes of government.” What needs to be changed? Marilyn [Milos] told me she’d been working within this organization and Steven [Svoboda], John [Geisheker], David [Llewellyn] and other people have been slugging away at this issue for decades before I stumbled upon it last year. I think there can be an element of navel gazing in the movement, with everybody sitting around congratulating each other for their views. And the reason I have come halfway around the world from a tiny rocky island town in Australia is because I really do want something to happen. I want our message to be heard in the larger world. My British grandfather always talked about the “golden thread” of British law, the presumption of innocence. The golden thread in the circumcision issue is the rights of the child. All of the arguments of the proponents for FGM and for male circumcision revolve around the needs of adults. They all revolve around religious needs of adults, cultural needs of adults, traditional needs of adults and the epidemiological studies by adults about adult sexually transmitted diseases. Adults are saying these are appropriate things to do to children. My perspective as Tasmania’s Commissioner for Children is that I am responsible for 117,000 children out of Tasmania’s total population of 480,000. My approach to my job has always been to lower the camera angle and look at the world from about table height. What do you see? The world looks enormously different from down there. Cars are a lot bigger and faster. Parks are a lot more beautiful, and your body is much more connected with yourself and who you are. That has been my perspective and my approach to this whole issue and I think that’s the easiest way to respond to the HIV trials in Africa. The most recent information from the World Health Organization (WHO) is that genital modification surgeries are being botched and need to be done properly in order to achieve a good outcome. That is all very well and I might enter the debate of what adults want to do with adults and what adult health promotion programs want to do with adults. But WHO should take great care regarding non-emergency surgery on children. I am concerned about children and I am concerned about the voice of the voiceless. Human rights for children are a new thing. Children in history have been treated as chattel for disposal. They have been treated as slaves. In later times, they have been treated as cheap labor. Only in the very end of last century did they start to be seen as people. In 1948, the United Nations Declaration of Human Rights, which includes a reference to personal integrity, does not refer directly to children. It does talk about people. It took until 1989, when the CRC was created, for the U.N. to clear up this particular dilemma and say maybe we ought to have rules for children as well because people seem to be overlooking that fact that children are people. The rights that were protected under the United Nations Declaration of Human Rights in 1948 were being ignored when it came to the little people. We got a new set of rules in 1989. The march of children toward full humanity continues. I see all the people involved in intactivism as being involved with the march of history towards protecting the humanity of children. This is what it is about. This is why I am optimistic. It may not be in my lifetime, but I know there are cultures that perform mutilation on the boys and girls in their own cultures that used to do other things in their own histories that they no longer do. All cultures change. That is good news for us. It is good news for all the people living in those cultures. I am interested to hear Naana report that women do not think that circumcision is a good idea for their sisters, aunties, mothers, and girls. That voice is a voice that emerged from this century and at the end of last century. That voice was not present 150 years ago. So history marches forward. Germaine Greer said she was not concerned about the setbacks for feminism. She said history marches two steps forward and one step back. That is a wonderfully direct view of history. I acknowledge Germaine for that. I have to acknowledge Australia for that; she is possibly the most famous Australian. (<a href="https://www.circinfo.org/ChildProtection.html#greer">See Germaine Greer's remarks on male and female genital mutilation below</a>.) It is often said that parents have a right to decide what surgery their children undergo. But the other change that emerged from the twentieth century is the understanding that the rights of person A cannot trump the rights of person B. The rights of children are discrete. They exist on their own. If you ask children, they will agree with you. If you ask parents, they tend to get a little funny about questions of whether or not they have the right to hit “their” child, to whip “their” child, to wound “their” child or to ask a doctor to wound “their” child on their behalf. I think one of the ways this movement is going to broaden its message is to tackle the medical profession, not primarily on medical grounds but on the human rights issues and the financial issues. I am here to bat for the children of Tasmania who are still at risk of genital mutilation and of injury by corporal punishment in the home. I have come all this way because I believe that no one who champions the rights of children can support the practice of routine neonatal circumcision. If a child grows up and wants to have a circumcision for any reason, I respect that. But the child who is a neonate can not make that decision. Article Two of the Convention on the Rights of the Child says the child has the right to have a voice in decisions that are made about the child. There is no urgency to circumcision. So my message about circumcision is that it can wait. I call on all congress-people and all commissioners of children in every jurisdiction around the world to work together to eradicate this practice and to eradicate all non-medically indicated surgical practices on children of all kinds. Source: <a href="http://www.arclaw.org/">ARC Newsletter</a>, Vol. 7 (3), Fall 2009. <a href="http://www.forwarduk.org.uk/">Forward</a> is the UK organisation concerned with female genital mutilation and<a href="http://www.norm-uk.org/"> Norm-UK</a> the organisation focused on male circumcision. <h2> <a id="greer" name="greer"></a>Germaine Greer on male and female genital mutilation</h2> Germaine Greer was in the news recently, speaking at the Festival of Dangerous Ideas in Sydney, where she attacked treatment of children and criticised Australia’s failure to protect them from many forms of physical harm, including circumcision. She made the point that in most states dogs enjoy better legal protection from cruel treatment than boys. Speaking under the banner that freedom is the most dangerous idea of all, Dr Greer said children are the least free of all, and are owned like pets or slaves. “They can be mutilated with impunity,” she said. “No baby asks to be circumcised, or baptised for that matter. … We don’t recognise protest in children … against the conditions in which they are being raised, against a culture that is deeply hostile to children and frightened of them. Now in case that sounds like one of my madder and more exaggerated sayings, just think about it.” (<a href="http://www.smh.com.au/articles/2009/10/04/1254590909543.html">Sydney Morning Herald, 5 October 2009</a>) Greer made further critical comments on the common double standard whereby female genital mutilation (circumcision of girls or women) is regarded as a hideous abomination while circumcision of male infants or boys (male genital mutilation) is tolerated, approved or regarded as a suitable subject for coarse humour. In her book The Whole Woman she writes: “Any suggestion that male genital mutilation should be outlawed would be understood as a frontal attack on the cultural identity of Jews and Muslims. Notwithstanding, the opinion that male circumcision might be bad for babies, bad for sex and bad for men is steadily gaining ground. In Denmark only 2 per cent of non-Jewish and non-Muslim men are circumcised on strictly medical grounds; in Britain the proportion rises to between 6 and 7 per cent, but in the US between 60 and 70 per cent of male babies will have their foreskins surgically removed. No UN agency has uttered a protocol condemning the widespread practice of male genital mutilation, which will not be challenged until doctors start to be sued in large numbers by men they mutilated as infants. Silence on the question of male circumcision is evidence of the political power both of the communities where a circumcised penis is considered an essential identifying mark and of the practitioners who continue to do it for no good reason. Silence about male genital mutilation in our own country combines nicely with noisiness on female mutilation in other countries to reinforce our notions of cultural superiority”. She also comments: “Male genital mutilation is considered trivial; female genital mutilation is considered devastating even if it involves nothing more than nicking the prepuce of the clitoris to provoke ritual bleeding.” She also claims: “The American Academy of Pediatrics recommends that clitorises of more than three-eighths of an inch should be removed from baby girls before they are fifteen months old. Five such procedures are performed every day in the United States; such “reconstructive surgery” is not included in world statistics which estimate that 120 million women alive today have suffered genital mutilation.” The source for this claim appears to be Martha Coventry, “The tyranny of the esthetic: Surgery’s most intimate violation”, in On the Issues: The Progressive Woman’s Quarterly, Summer 1998, p. 16 <h3>Comment</h3> In these passages Dr Greer is most interested in attacking double standards. Her point is that if Jews and Moslems are allowed to do it to boys, why shouldn’t Ethiopians and Somalis be allowed to do it to girls? She is actually inclined to defend female circumcision in tribal cultures, though it is not entirely clear whether this defence extends to forcible mutilation of girls, or whether it is limited to situations where mature women voluntarily seek it. If the latter, she reaches a position similar to that of <a href="http://www.cirp.org/library/legal/mason1/">Christine Mason in Exorcising excision</a>: that forcible circumcision of minors of either sex should not be permitted, but that elective circumcision of either sex after the age of consent should not be restricted. We would regard Martha Coventry’s claim with scepticism, though it is undoubtedly true that there are cases (in both the U.S.A. and Australia) where doctors have cut the clitorises of girls at the request of parents. For details of one woman’s experience, see Patricia Robinett, The Rape of Innocence: One Woman’s Story of Female Genital Mutilation in the U.S.A. (Eugene, OR: Aesculapius Press, 2006.) It is also true that many doctors (and not only in the U.S.A.) regard “excessive” foreskin length as yet another reason for circumcision. Source: Germaine Greer, The Whole Woman (London: Doubleday, 1999), pp. 94-96 </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Paul Mason and Germaine Greer on the rights of children darby Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> A regional appeals court in Frankfurt am Main, Germany, found that the circumcision of an 11-year-old Muslim boy without his approval was an unlawful personal injury. The Sept. 20 decision opened the way toward financial compensation for the boy. The case may have repercussions for the practice of ritual circumcision in Germany by Muslims and Jews. The court suggested, in part, that it was a punishable offense to subject one's child to teasing by other children for looking different. The boy, now 14, plans to sue his father for 10,000 Euro (about $14,000), according to a report by the <a href="http://www.ddp.de/" style="font-weight: 400;">German DDP Press Agency</a>. Reportedly, the boy, whose parents are divorced, was visiting his father during a vacation when his father forced the ritual circumcision. The boy lives with his mother, who had always rejected circumcision. Muslim boys are traditionally circumcised at elementary school age. According to the court, circumcision can "be important in individual cases for the cultural-religious and physical self-image," even if there are no health disadvantages involved. So the decision about whether or not to go through with a circumcision is "a central right of a person to determine his identity and life." The court did not give an age minimum at which their parents must seek a child's permission to perform a circumcision . The amount of damages depends, said the court, on the extent to which the boy suffered long-term physical or emotional damage, or "whether his peers would tease him for looking different." <a href="http://www.jta.org/cgi-bin/iowa/breaking/104271.html" style="font-weight: 400;">JTA breaking news, 21 September 2007</a> </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Frankfurt court finds circumcision an unlawful personal injury darby Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> The following article by Geoff Hinchley was published in the British Medical Journal in December 2007. <h2>Is infant male circumcision an abuse of the rights of the child? Yes</h2> Improved understanding of the normal anatomy of the infant foreskin means there is now rarely a therapeutic indication for infant circumcision, [1] and the procedure is not supported by international medical opinion. [2] Ritual (non-therapeutic) male circumcision, however, continues unchecked throughout the world, long after female circumcision, facial scarification, and other ritual forms of infant abuse have been made illegal. The law and principles pertaining to child protection should apply equally to both sexes, so why do society and the medical profession collude with this unnecessary mutilating practice? Ritual male circumcision is an ancient religious rite for Muslims and Jews, and the crux of this debate revolves around the primacy of parental religious conviction versus the primacy of the human rights of the child, the preservation of its bodily integrity, and its right of self determination. In addition to religious justification, there have been many spurious and now unsupported health claims for circumcision — including the prevention of penile cancer, masturbation, blindness, and insanity [3] — most of which, like reduction in HIV transmission identified more recently, relate to adult sexual behaviour and not to the genital anatomy or best interest of a child. There may be a case that male circumcision reduces HIV risk in sexually active adults, but the decision about whether to have this procedure should be left until the person is old enough to make his own informed healthcare choices. Male genital mutilation is not a risk-free procedure. There are potential anaesthetic risks, and the short term risk of bleeding and infection associated with any surgical procedure. [4] Longer term potential complications include pain on erection, penile disfigurement, and psychological problems. [5] A recent report shows that the non-circumcised adult penis is more sensitive than the circumcised penis, largely because the five most sensitive areas, identified in the study, are removed during circumcision. [6] This implies a reduction in future sexual sensitivity for circumcised adults. Far from being a harmless traditional practice, circumcision damages young boys. <h3>Legal protection</h3> Article 24(3) of the UN convention on the rights of the child commits all ratifying states to "take all effective and appropriate measures with a view to abolishing traditional practices prejudicial to the health of children" and article 19(1) says: "States shall take all appropriate legislative administrative social and educational measures to protect the child from all forms of physical or mental violence, injury or abuse." [7] UK courts have interceded in the past to protect the best interests of children whose parental belief systems have put children at risk. However, male circumcision remains lawful if both parents consent. [8,9,10] Since the Human Rights Act has been implemented, however, single parental consent has been found to be insufficient to show that the procedure is in the child’s best interest. [11] As far as female genital mutilation is concerned, in the United States the Federal Prohibition of Female Genital Mutilation Act states that in applying the law, "no account shall be taken . . . that the operation is required as a matter of custom or ritual." These terms are closely mirrored in the UK Female Genital Mutilation Act 2003. Both the US and the UK legal systems therefore discriminate between the sexes when it comes to protecting boys and girls from damaging ritual genital mutilation. The UK’s General Medical Council abdicates all responsibility for male circumcision to society as a whole, [12] but in June 2007 the BMA, which had previously offered general guidance, [13] decided that "any decision to provide medical or surgical treatment to a child, or any decision to withhold medical or surgical treatment from a child, should: consider the ethical, cultural and religious views of the child’s parents and/or carers, but without allowing these views to override the rights of the child to have his/her best interests protected.” [14] Male circumcision was not specifically mentioned, but it cannot be in the best interest of a child to be subjected, without its consent, to an irreversible surgical procedure, often without anaesthetic, which will provide no medical benefit but which has proved adverse consequences both in terms of potential complications for some and reduced penile sensation in adulthood for all. <h3>Religious perspective</h3> Some faiths view male circumcision, often done by people who are not medically qualified, as important for entering a covenant with their God. However, given the age of the children involved it cannot be said that this covenant is freely entered into by the individual concerned. In the US, elements of the Jewish community are beginning to rethink this issue. [15] They suggest bringing Jewish boys into the covenant symbolically, with the potential for the child to be circumcised when old enough to consent to the procedure himself. Muslims already circumcise boys at an older age, and further delay to allow the child to consent could equally be considered. How much stronger would that covenant be, when entered into by a fully competent young man with full knowledge of its religious implications and the potential risks involved. The unpalatable truth is that logic and the rights of the child play little part in determining the acceptability of male genital mutilation in our society. The profession needs to recognise this and champion the argument on behalf of boys that was so successful for girls. <h3>References</h3> 1. British Association of Paediatric Surgeons, Royal College of Nursing, Royal College of Paediatrics and Child Health, Royal College of Surgeons of England and Royal College of Anaesthetists. Statement on male circumcision. London: RCS, 2001. 2. Hofvander Y. Circumcision in boys: time for doctors to reconsider. World Hosp Health Services 2002;8(2):15-7. 3. Smith J. <a href="http://www.cirp.org/library/legal/smith/">Male circumcision and the rights of the child</a>. Netherlands Institute of Human Rights, 1998. 4. Williams N, Kaplia L. <a href="http://www.cirp.org/library/complications/williams-kapila/">Complications of circumcision</a>. Br J Surg 1993;80:1231-6.[Web of Science][Medline] 5. Peterson SE. <a href="http://www.historyofcircumcision.net/index.php?option=content&task=view&id=93">Assaulted and mutilated. A personal account of circumcision trauma</a>. In: Denniston GC, Hodges FM, Milos MF, eds. Understanding circumcision. New York: Kluwer Academic, 2001;271. 6. Sorrells ML, Snyder JL, Reiss MD, Eden C, Milos MF, Wilcox N, et al. <a href="http://www.cirp.org/library/anatomy/sorrells_2007/">Fine touch pressure thresholds in the adult penis</a>. BJU Int 2007;99:864-9.[CrossRef][Web of Science][Medline] 7. United Nations. Convention on the rights of the child. 8. Re J (A Minor) (prohibited steps order: circumcision). [2000] 1 FLR 571. 9. <a href="http://www.cirp.org/library/legal/Re_J/2000.html">Re J (child’s religious upbringing and circumcision)</a>. [2000] 1 FCR 307. 10. Re J (specific issue orders: Muslim upbringing and circumcision). [2000] 52 BMLR 82. 11. Re S. (Children) (Specific issue: circumcision) [2005] 1 FLR 236. 12. General Medical Council. Guidance for doctors who are asked to circumcise male children. London: GMC, 1997. 13. BMA. <a href="http://www.bma.org.uk/ethics/consent_and_capacity/malecircumcision2006.jsp">The law and ethics of male circumcision — guidance for doctors</a>. London: BMA, 2006. 14. BMA. Annual representative meeting policies, June 2007. Ethics and professional responsibilities. 15. Moss L. <a href="http://www.nocirc.org/symposia/second/moss.html">The Jewish roots of anti-circumcision arguments</a>. Second international symposium on circumcision, San Francisco, California, 30 April-3 May 1991. The author is an accident and emergency consultant at Barnet and Chase Farm NHS Trust, Enfield, Middlesex EN2 8JL. Email: <a class="__cf_email__" data-cfemail="86e1e3e9e0e0a8eeefe8e5eeeae3ffc6e4e5e0a8e8eef5a8f3ed" href="/cdn-cgi/l/email-protection">[email protected]</a> <a href="http://www.bmj.com/cgi/content/full/335/7631/1180" rel="noopener" target="_blank">British Medical Journal 2007;335:1180</a> (8 December 2007) </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource British Medical Journal debates ethics of non-therapeutic circumcision darby Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> With the proclamation of the South African Children’s Act in April 2010, South African boys now have a significant level of legal protection against unwanted circumcision. The act gives children the right not to be subjected to social, cultural and religious practices detrimental to their well-being, and prohibits circumcision of male children under the age of sixteen except in cases where there is a valid religious reason, or if the operation is medically necessary for therapeutic purposes. Although these are significant loopholes, the act still gives South African boys considerably greater legal protection than is enjoyed by boys in Australia or most other countries. The relevant sections of the act are printed below. <h2>Republic of South Africa, Children’s Act 2005 (No. 38 of 2005)</h2> <h3>Chapter 2, General Principles</h3> Best interests of child standard 7. (1) Whenever a provision of this Act requires the best interests of the child standard to be applied, the following factors must be taken into consideration where relevant, namely – … (l) the need to protect the child from any physical or psychological harm that may be caused by (i) subjecting the child to maltreatment, abuse, neglect, exploitation* or degradation or exposing the child to violence or exploitation or other harmful behaviour; or (ii) exposing the child to maltreatment, abuse, degradation, ill-treatment, violence or harmful behaviour towards another person. Best interests of child paramount 9. In all matters concerning the care, protection and well-being of a child the standard that the child’s best interest is of paramount importance, must be applied. Social, cultural and religious practices 12. (1) Every child has the right not to be subjected to social, cultural and religious practices which are detrimental to his or her well-being. (8) Circumcision of male children under the age of 16 is prohibited, except when – (a) circumcision is performed for religious purposes in accordance with the practices of the religion concerned and in the manner prescribed; or (b) circumcision is performed for medical reasons on the recommendation of a medical practitioner. (9) Circumcision of male children older than 16 may only be performed – (a) if the child has given consent to the circumcision in the prescribed manner; (b) after proper counselling of the child; and (c) in the manner prescribed. (10) Taking into consideration the child’s age, maturity and stage of development, every male child has the right to refuse circumcision. * NOTE: The Act defines “exploitation”, in relation to a child, as “all forms of slavery or practices similar to slavery, including debt bondage or forced marriage; sexual exploitation; servitude; forced labour or services; child labour prohibited in terms of section 141; and the removal of body parts." <h3>Comment</h3> As you can see, although this is a great step forward, it is not without problems. For a start there is gross gender discrimination, in that girls are given blanket protection against any kind of harm, but boys have to make do with qualified and limited protection. The exception for “religious purposes” allows practising Jewish and Muslim parents to circumcise without constraint, but the failure to specify the religions accorded the exemption provides a loophole for anybody who wants to invent his own religion – as occurred <a href="http://scienceblogs.com/pharyngula/2009/10/aaaah_horrible_wretched_wicked.php">in a recent Canadian case</a>, where the father decided that the religion he had just invented allowed him to circumcise his four-year-old. Even more seriously, the reference to “medical reasons” fails to define what they are. If what is meant is a situation where circumcision is necessary to treat an injury, deformity or disease that has failed to respond to conservative treatment after reasonable efforts, that is one thing, and the provision will provide a significant level of protection. If, on the other hand, what is meant is circumcision performed in the belief that it will reduce the risk of contracting diseases to which the child may be exposed at some later date (i.e. prophylactic or precautionary circumcision), that is quite another, and the provision will provide no protection at all against the circumcision promoters. Most non-religious circumcision is prophylactic circumcision, but it should not be confused with therapeutic circumcision (i.e. treatment for an existing problem). It is significant that in its paper on the legal status of circumcision of male minors the <a href="http://www.law.utas.edu.au/reform/">Tasmania Law Reform Institute</a> is careful to explain that prophylactic circumcision is not therapeutic. Still, South Africa is way ahead of Australia and most developed nations in making some attempt to crack this difficult nut. <h2>“Unethical and illegal”: South African Medical association rejects circumcision of infants</h2> In a letter dated 23 June 2011, the South African Medical Association has stated that it does not support the practice of circumcision of infants as a means of preventing HIv transmission and that it considers circumcision of infants to be both unethical and illegal. The letter was signed by Ms Ulundi Behrtel, Chairperson of the Human Rights, Law and Ethics Committee. The full text of the letter follows: 23 June 2011 Mr Dean Ferris, Co-Director National Organisation of Circumcision Information Resource Centres South Africa Dear Mr Ferris CIRCUMCISION OF BABIES FOR PROPOSED HIV PREVENTION We refer to the above matter and your email correspondence of 16 February 2011. The matter was discussed by the members of the Human Rights, Law & Ethics Committee at their previous meeting and they agreed with the content of the letter by NOCIRC SA. The Committee stated that it was unethical and illegal to perform circumcision on infant boys in this instance. In particular, the Committee expressed serious concern that not enough scientifically-based evidence was available to confirm that circumcisions prevented HIV contraction and that the public at large was influenced by incorrect and misrepresented information. The Committee reiterated its view that it did not support circumcision to prevent HIV transmission. We trust that you will find this in order. Yours faithfully Ms Ulundi Behrtel Head: Human Rights, Law & Ethics unit Obo Chairperson: Human Rights, Law & Ethics Committee SA Medical Association A pdf of the letter is available on request. <h2>South Africa Children’s Act fails to protect boys from circumcision</h2> A correspondent in South Africa has sent a long letter explaining that, despite its apparent prohibition of circumcision, the South African Children’s Act does not protect boys from circumcision, but actually makes it easier for parents and government authorities to get them circumcised. This is disturbing news, revealing that massive violations of human and child rights are occurring in South Africa, with the connivance of the United Nations and without any protests from international human rights bodies. The only groups that seem to be protesting are anti-circumcision organisations such as <a href="https://www.facebook.com/NocircSouthAfrica" rel="noopener" target="_blank">Nocirc South Africa</a>, and (surprisingly) the <a href="https://www.circinfo.org/africa.html">South African Medical Association</a>, which has consistently rejected schemes to promote circumcision as a response to South Africa’s high prevalence of HIV infection. The letter shows circumcision is now being promoted by an authoritarian government, with a high level of propaganda, bullying and other coercion. With regard to the information on your website about the South African Children’s Act, it is not accurate that South African law protects boys from unwanted circumcision, especially minor boys. I am a South African, and it is clear to me that parents take boys for circumcision up to the age of 16, whether they like it or not. Section 8 of the Children’s Act states that circumcision of male children under the age of 16 is prohibited, except when (a) circumcision is performed for religious purposes in accordance with the practices of the religion concerned and in the manner prescribed. But there is no regulation to determine how religious a parent is or which religions can legitimately circumcise. An atheist can say “I believe in Allah” and there is no contest: that is sufficient, as attendance at Mosque, church or any participation is not required for the circumcision to be categorised as religious. Any person can say they circumcise because they are Jewish, or like a friend who said she was Israeli, but a Christian rather than Jewish. The Zulu people used not to circumcise, but they have decided to start circumcising, and suddenly claim that it is their culture and 100% legal: all the Zulu king had to say is “I support Circumcision”, and now it is mandatory for all Zulus to be circumcised. Sub-section (b) allows an exception for circumcision to be performed for medical reasons on the recommendation of a medical practitioner. But this is not interpreted to mean that there is a medical condition requiring circumcision: HIV prevention is recognised as a medical reason, and there are no guidelines to limit which medical reasons may be appealed to. It is confirmed that HIV prevention is a valid reason. South African authorities accept that circumcision reduces the risk of HIV infection and therefore that it is “medical reason”. Furthermore any person who is registered under Health Professions Act 1974 (including dentists) is a medical practitioner by law. Even a dentist’s recommendation is valid under this law, which does not require a recommendation to come from the child’s GP. Another popular misconception is the meaning of Section 10: “Taking into consideration the child’s age, maturity and stage of development, every male child has the right to refuse circumcision.” This section requires the child to be of sufficient “age” and “maturity“ and “well developed” to be entitled to refuse. Because of the word AND, all those criteria must be met before his right to refuse is valid. There is no legal definition of maturity or stage of development, and on this point there are two schools of thought: some say the age of consent is 12 for medical procedures, meaning that the boy must be at least 12 to refuse or to be legally recognized in a medical procedure. Others reason that the law makes special provision for consent for circumcision at age 16 and older. The right to refuse means the right to withhold consent, which is applicable only when the boy turns 16. If a parent or guardian provides surrogate consent for a boy under 16, then the medical practitioner may circumcise him, and no consent from the boy himself is required. This makes it difficult to determine whether a boy under 16 can actually refuse to consent or whether his consent is required. It is likely that circumcising a boy under 16 against his expressed wishes will still be legal, while it is certainly legal to circumcise a boy under 12 against his will. To take an example, let say the boy is 13 and has still has a non-retractable foreskin. The doctor say he has incurable phimosis and must be circumcised or he will be at risk of cancer later. The boy refuses because he is scared and does not understand the seriousness of the problem. Would that mean the parents no longer have any say because he chooses to refuse? Of course not: in that case the parents can consent, and whether he likes it or not that phimotic foreskin must be removed. But the law does not make any distinction between a phimosis and HIV prevention. In terms of the circumcision law “medical reasons” mean that one is as valid as the other. Both are medical reason deemed beneficial to the child’s interest. Social pressure Another aspect is social pressure, with schools and the media promoting circumcision. When a parent wants a boy circumcised, he is already conditioned to think that its expected and it is the right thing to do, so he is unlikely to resist even if he does not like the idea. Parents tell boys that they must be circumcised because of the benefits (“It’s better, girls like it more” etc) and scare him with stories of what will happen if he doesn’t cooperate. That also causes boys not to resist and to believe they have to cooperate. Furthermore, boys generally lack knowledge and are easily intimidated by the authority of parents, thus leading them not to question or argue. For this reason a friend of mine who is a nurse says that minor boys are queued at hospitals for circumcision regardless of whether they like it or not. A boy who protests falls under the category of “All children are scared of medical procedures, even the dentist, so just try to keep him calm so that we can proceed”. For practical reasons Section 10 places no limits on parental power when boys are under 16. The only area where the laws on circumcision are often enforced is with illegal non-medical practices and forced circumcision of boys older than 16. But these legal actions are very few. There has never been a case where the law has been invoke to protect or avenge a boy under 16. It is a professional opinion of a legal practitioner that; prior to the new law there was no law protecting parents who circumcise boys or protection for practitioners or for government to promote circumcision in formal ways. Government cannot promote it and parents cannot insist on it if the legal position is uncertain. Under the new legal framework circumcision is now officially legal, there are less risk for both parents and practitioners to circumcise boys as long as it is within the law. This seems to increase the incidence of circumcisions rather than decrease it. Furthermore the age for consent for medical procedures is 12, but they made special exception with male circumcision to set it at 16. This will cause boys not to be able to consent when under 16. This was also done to upscale circumcision by allowing parents to circumcise boys up to older ages without their consent being required. Pressure from World Health Organisation and aid agencies The next consideration is that the Children’s Act was written in 2005 – before it became official policy that circumcision reduces the risk of HIV infection, and before the South African government committed itself to the United Nations’ requirement to circumcise 80% of men by 2015. The legal framework helps to mobilize government to encourage circumcision officially, as there is a legal position for it which gives legal and official sanction to mass circumcision programs, while schools and teachers preach the benefits of circumcision for school boys and girls. This sort of pressure leads boys to give in to circumcision more easily, and encourages girls to put pressure on boys to get circumcised in order to be cool or accepted as manly or sexy. While circumcision was always a 100% male thing as a native tradition, only 30% of men support it, compared with 80% of women. By having circumcision legal in terms of the law and to give parents right to consent on the boys’ behalf now gives mothers the legal right to decide on circumcision for their boys. With 90% of single parents being mothers they are in a stronger position to make that decision than men. Further, the rights of the biological mother applies also give her more decision making power. Only if a father can prove in court that circumcision is harmful for the boy would her ability to consent not apply anymore. While the law recognizes circumcision as legal and beneficial it is unlikely that any court would take away the mother’s right to consent. The law also requires all circumcision to be done medically and formally, which means that gender equality laws apply. This means that at least 50% of doctors and nurses who perform these circumcisions must be women. This helps to empower women and stop female exclusion from the practice. Professors at universities even speculate that the law may be amended to accommodate South Africa’s commitment to upscale circumcision, as the current law was drafted before the commitment to circumcise 80% of men. The only restrictions on circumcision being contemplated relate to the non-medical (bush) circumcisions performed by the Xhosa. While many used to escape circumcision on account of the high death rate, calling it unsafe and thus giving more voice for intactivists and other circumcision critics, the new law ensures that boys are circumcised by doctors or nurses in clinics or hospitals. This makes the operation safer and undermines the arguments of anti-circumcision critics. This also increases the incidence of circumcision. The circumcision rate in South Africa is growing rapidly, and the pressure on men and boys to be circumcised is greater than ever before. Organisations such as USAID, UNAIDS, UNICEF, MRC, WHO, CDC, Brothers for life, Engender Health, Section27, PEPFAR all sponsor and promote the upscaling of circumcision. Hundreds of millions of dollars are now invested in mass circumcision programs, and circumcision clinics are popping up like mushrooms. Circumcision is here to stay and will become the new norm. If anything the Children’s Act helped to upscale male circumcision and to turn it into a cultural norm more than anything else. The upscaling of circumcision is driven international aid agencies. WHO requires 14 African countries to upscale circumcision to 80% of men between ages 15 and 49, and many practices target boys around 14. The South African government is supporting it, and even TV and radio ads are aired all the time to encourage it, while big billboards encourage men to get circumcised and the benefits of circumcision is also tough at schools. This is South africa’s HIV prevention program. Similar policies are being urged or followed in Rwanda, Tanzania, Swaziland, Zimbabwe, Zambia, Uganda, Kenya, Botswana, Ethiopia, Malawi, Namibia, Lesotho, Mozambique. Basically, according to the WHO, all African countries who do not normally circumcise, have to start circumcising men now. Details at: http://www.who.int/hiv/topics/malecircumcision/male-circumcision-info-2014/en/ The Bill and Melinda Gates foundation and PEPFAR have been two major sponsors of circumcision in South Africa. For details see: http://www.bpmcc.co.za/research.htm http://southafrica.usembassy.gov/us-government-partners-with-higher-education-medical-male-circumcision-campaign2.html In South Africa, every province has created a number of circumcision clinics where men and boys can be circumcised for free. As mentioned, the Xhosa people in South Africa practice circumcision of late teenage boys as a rite of passage. The Zulu people did not, but in 2006 the king made it a compulsory part of their tradition. The government’s major concern is that about 100 boys die each year as a result of this practice. The main focus of the Children’s Act now is not to stop circumcision, but to make it safer and ensure that it is done medically. The reason so many boys die is because guys from the townships take boys into the bush and use pieces of glass or old blades to circumcise them. Often these guys are not even experienced, let alone qualified. The boys are initiated and have to live without food and water in the bush under harsh conditions. Many end up with dehydration that causes death, or infections or injuries that causes many to loose their genitals completely. Therefore, the first priority is to ensure that no boy goes into the bush and get circumcised with pieces of glass, but rather has it done by a doctor or nurse. If it is done medically in hygienic conditions the risk of complications is much lower. The law allows circumcision, but now makes it a criminal offence now for unqualified thugs to go around kidnapping boys and cutting them in dangerous ways. All boys must have it done in a medical setting. Further information http://www.news24.com/SouthAfrica/News/Botched-circumcision-death-toll-rises-20140704 New medical practices for mass circumcision program in Africa: (1) All bush circumcision becomes medicalised circumcision. (2) All-male practices becomes practices with both male and female medical practitioners. http://www.cdc.gov/globalhealth/countries/southafrica/partners/winnie.htm http://www.ubuzimabwacu.com/inama/4664/rwanda-bugesera-male-circumcision-encouraged-reduce-hivaids-stds-infections/ http://thepump.jsi.com/reducing-the-spread-of-hiv-through-voluntary-medical-male-circumcision-jsis-experience-in-east-central-uganda/ Bill boards like this pop up everywhere to promote circumcision http://www.aidscirc.org/2012/07/how-circumcision-solution-in-africa.html http://www.avert.org/voluntary-medical-male-circumcision-vmmc-hiv-prevention.htm http://www.eurojewcong.org/News%20and%20Views/10273-circumcision-as-defence-against-hiv.html http://blogs.scientificamerican.com/guest-blog/2011/04/04/whats-the-deal-with-male-circumcision-and-female-cervical-cancer/ Women are encouraged to encourage their partners and sons to get circumcised; some of the media looks like this: http://www.c-hubonline.org/sites/default/files/resources/main/SMC%20Stand%20Proud%20Get%20Circumcized_Billboard%201.jpg http://www.c-hubonline.org/sites/default/files/resources/main/SMC%20Stand%20Proud%20Get%20Circumcized_Billboard%202.jpg http://www.c-hubonline.org/sites/default/files/resources/main/SMC%20Stand%20Proud%20Get%20Circumcized_Disruptive%20Poster.jpg http://www.c-hubonline.org/sites/default/files/resources/main/SMC%20Stand%20Proud%20Get%20Circumcized_Rural%20Poster%201.jpg </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource South Africa passes law to restrict circumcision darby Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> A parallel case to the Bundaberg scandal is that of Riad Sattouf, a boy born in France to a French mother and a Syrian father, who later took the family back to his home village in the Middle East. There he was affected by the traditional habits of the past and decided that he ought to get his son circumcised. Riad's account of this episode vividly evokes the magical world of a typical 8-year old, his terror at the approaching roue de douleur (wheel of pain), as his cousins refer to the event, the agony of the operation, his horror at the outcome, and his slow physical and mental recuperation. Despite the humorous approach and comic-strip presentation, the result is a sobering indictment of the tyranny of custom and of parental cruelty. <h2>Riad Sattouf: Comics serve as perfect medium:</h2> <h3>26-year-old writer to release autobiographical bombshell: My Circumcision</h3> <img alt="" class="image-right" height="305" src="https://www.circinfo.org/images/Sattouf3.jpg" width="201"/> PARIS France is paradise to the comic book lover. Close to 1,500 new BD books (BD stands for bande dessinee, or comic strips) are produced each year to satisfy the incessant appetite of mainstream and alternative audiences. Each year, the International Bande Dessinee Festival in Angouleme hosts up to 400,000 fans. Accordingly, if you write and illustrate BDs, France is the place to be. Comics are considered an art form, and cartoonists are worshipped. It's hard to know if Riad Sattouf would have written and illustrated comic books had he grown up somewhere else, but it's clear that this baby-faced 26 year-old has a lot to say, and comics are the perfect medium for him. Sattouf burst into the world of BD's last year with the publication of the Manuel du Puceau (Handbook for a Virgin) for adolescents, and Les Jolis Pieds de Florence (Florence's Pretty Feet) which won the prestigious 2003 Rene Goscinny prize for best BD writer. His Manuel du Puceau, which does away with any notion of the politically correct, recounts the trials and tribulations of a pimply teenager with a raging libido. Les Jolis Pieds de Florence introduces the adult reader to Jeremie, a Franco-Libyan nerd who creates video games and is hopelessly in love with Florence, a co-worker in his office. Nothing besides his name and a few vague allusions to the Arab world could prepare the reader for Sattouf's next book, which can be termed a tragi-comic autobiographical bombshell. Ma Circoncision (My Circumcision) came out this year in a collection for teenagers but could very well be for adults. Funny and terrible, it is the gruelling tale of an 8-year-old boy who lives in a Syrian village and is faced with his impending circumcision. How much of Ma Circoncision is autobiographical? "One hundred percent," said Sattouf. The son of a French mother and Syrian father, Sattouf was born in Paris but lived until age 11 (except for two years in Libya) in Ter Maaleh, a small village near Homs, in Syria. (Sattouf describes Homs as resembling the spaceport city of Mos Eisley, in Star Wars). In Ma Circoncision, Sattouf recounts how one day his cousins notice that he isn't circumcised. He is immediately accused of being an Israeli, the worst insult the children can think of. Sattouf, who was blond as a child, lies in bed wondering if he is adopted. "Perhaps I really was Israeli?" "From the very first day my difference was apparent. I was the only foreigner in the village ... I went to the Muslim school and studied the Koran. We travelled to France sometimes so I knew there was another way of life. But the village was a place out of time, in a parallel dimension." Sattouf, 8, lives in a fantasy world in which he and his cousins are Cimmerian warriors (they've seen a video of Arnold Schwarzenegger in Conan the Barbarian countless times). Corporal punishment at school is common and children are subjected to beatings on the soles of their feet. Their teacher, who looks like a "degenerate James Dean," rants to the children that "France and Europe are friends to the Israelis." The classroom brutality and ignorance described by Sattouf is such, that the publisher's lawyer strongly recommended at the beginning of the book, a disclaimer which reads: "This book tells a true story, situated in a country in which the totalitarian regime formats children to a single mode of thought. It is against circumcision. It is not an incitement to racial hatred but bears witness to the way a society produces racial hatred." Sattouf writes that his father decides his son should be circumcised. The next pages are a countdown until the unhappy event. The fateful day rolls around and the circumciser looks like Conan the Barbarian. "How many Syrians look like Arnold Schwarzenegger?" writes Sattouf. "Only one, no doubt, and he was in my living room!" After a long and painful recovery, Sattouf finds out from his father that Israelis are circumcised as well. Sattouf, who has not seen his father in 14 years, portrays him in Ma Circoncision as a harsh, unfeeling man. " Of course my father was more human than in the book. His moods alternated but there was a certain inflexibility about him, he never doubted his behavior." His father was a university professor with two doctorates from the Sorbonne. He was "very open-minded and totally emancipated. He never prayed, ate pork, but then his past caught up with him." Sattouf's father became deeply religious after a stint of teaching in Saudi Arabia. "I do have a kind of nostalgia for the village. There was little joy and people were very unhappy. They were conscious of living in misery. I can almost understand why at 50 my father went crazy. The weight of his family's history fell upon him and mowed him down." Sattouf's French mother "didn't speak Arabic and couldn't stand life in the village anymore. She separated from my father and moved back to France." Sattouf was catapulted from his village in Syria to the city of Rennes, in Brittany. Again, he was considered different. "In secondary school kids called me a dirty Arab. But somehow it didn't affect me as much as when I was called an Israeli in Syria. The biggest difference for me was being in school with girls! Later when I was in art school one of my teachers didn't like Arabs and said that work that wasn't done properly was called Arab work," Sattouf recalled. As a child Sattouf drew constantly, and avidly read the BDs that his French grandmother sent him to Syria. He says he always knew that he wanted to draw. After art school in Nantes Sattouf attended the Gobelins School for animation in Paris and hasn't left the drawing board since. He began to illustrate BDs while still a student until he broke out on his own and created his character Jeremie, who is in large part autobiographical as well although "all my characters are me, even the girls. It's pretty personal." Joann Sfar, one of France's star cartoonists, who illustrates and writes mainstream and alternative BDs worked in the same atelier with Sattouf and encouraged him to write Ma Circoncision, among other books. "I'd tell him stuff about my childhood and he couldn't believe it. I realized most people hadn't lived what I had lived. I decided to rid myself of this stuff and make some money, too!" Sattouf's particular brand of self-mockery in his libidinous anti-hero, Jeremie, (who one French critic termed as having "pathetic grandeur") but also in his childhood character in Ma Circoncision, has allowed him to evacuate many of his painful childhood experiences. In Jeremie the zany humor keeps the BD reading light. In Ma Circoncision, although the same humor is present, there is an undertone of real seriousness. It has also brought Sattouf full face with his feelings of identity. He says he no longer speaks Arabic but that he still reads and writes it. <img alt="" class="image-left" height="161" src="https://www.circinfo.org/images/sattouf1_000.jpg" width="180"/> "I'd like to take up Arabic again to be closer to my past and come to terms with it. People just can't believe that I'm from Syria. But I think I'm much more of an Arab than a kid who is originally from the Maghreb." On the path to stardom in the BD world, Sattouf is juggling several projects at once. He is working on a series of comics for children, more Jeremie adventures, and stories from his Syrian childhood, which he'll publish this time in books for adults. While he doesn't feel "particularly at home in France", it is without a doubt the place for Sattouf to be. No other country would have published a BD as brutally funny and scathingly critical as Ma Circoncision. By Olivia Snaije, The Daily Star (Lebanon), 16 April 2004 Source: <a href="http://www.dailystar.com.lb/article.asp?edition_id=10&categ_id=4&article_id=2258">The Daily Star (Lebanon)</a> "Goldorak" is a Superman-type hero popular throughout the French-speaking world, including those portions of the Arab world formerly under French control, such as North Africa, Lebanon, and Syria. Riad Sattouf's Ma Circoncision is published by l'Association. You may be able to get a copy from <a href="http://www.abebooks.com/">abebooks.com</a> and <a href="https://www.amazon.fr/">Amazon France</a>. The French in this frame reads: "G ... Good bye. I would have liked to get to know you better." A Spanish translation is forthcoming; what is needed is an English version. <a href="http://www.riadsattouf.com/" rel="noopener" target="_blank">Riad Sattouf's website</a> </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Man tells of forced childhood circumcision in Syria darby