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Important new study on "female circumcision" (FC) - pricking/cutting of female prepuce/foreskin - performed by doctors in Malaysia. Parallels & shared excuses w mis-educated US docs who do male circ are numerous. "We" are no more "civilized" than those "we" in the West condemn:
Here is the study https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003303. First, some background on FC in Malaysia. This practice is defined by @WHO as "mutilation" & condemned as human rights violation, yet is often less severe than the male circumcision (MC) practiced in same families. In the study ... 1/
... >50% self-reported cutting by the mostly female docs who perform FC in Malaysia constitutes nicking or pricking clitoral hood (foreskin/prepuce). Now, I argue that taking ANY sharp object 2 the genitals of a healthy child is morally WRONG, eg, here: http://blog.practicalethics.ox.ac.uk/2017/08/does-female-genital-mutilation-have-health-benefits-the-problem-with-medicalizing-morality/ 2/
But it's important 2 stress: female "circumcision" in Malaysia is typically less severe than male circumcision as performed in U.S. (& Malaysia), is largely medicalized (done by doctors w/ sterile instruments) to kids <1yr, yet is defined as *human rights violation* unlike MC. 3/
Now, you might say, "MC has *health benefits* whereas FC has none, and this can explain why the latter is categorically an abuse of human rights, whereas the former is completely acceptable and not a human rights violation." But let's think through the implications of this ... 4/
First, suppose that FC *DID* have some minor health benefits that (like those attributed 2 MC by its proponents) were neither urgent nor central 2 girl's well-being & could be achieved w/o genital cutting or in ways that allow the girl to consent when older: Would FC be okay? 5/
Consider hypothetical example of performing "neonatal labiaplasty" (WHO FGM Type 2a), which, as Alex Myers & I discuss in this paper ( https://www.researchgate.net/publication/337720859_What_Is_the_Best_Age_to_Circumcise_A_Medical_and_Ethical_Analysis) may very well confer "health benefits" by reducing the surface area of tissue that could become infected or cancerous 6/
Moreover, one could even stipulate that labiaplasty performed in infancy vs. adulthood is technically simpler, safer, more cost-effective, w shorter healing time, etc., as is often claimed for MC. Would all this make "neonatal labiaplasty" no longer a human rights violation? 7/
No, it would not! See reasons below (adapted from full discussion here http://blog.practicalethics.ox.ac.uk/2017/08/does-female-genital-mutilation-have-health-benefits-the-problem-with-medicalizing-morality/). But health benefits are a red herring anyway. As Andrew Freedman, who co-wrote the @AmerAcadPeds MC policy (defending MC) admitted in an editorial ... 8/
"Most [US] circumcisions are done for religious and cultural reasons. Though parents may use conflicting medical literature to buttress own beliefs/desires, [they mostly] choose for non-medical reasons: religion, culture, aesthetic preference etc." https://pediatrics.aappublications.org/content/137/5/e20160594 9/
!["Most [US] circumcisions are done for religious and cultural reasons. Though parents may use conflicting medical literature to buttress own beliefs/desires, [they mostly] choose for non-medical reasons: religion, culture, aesthetic preference etc." https://pediatrics.aappublications.org/content/137/5/e20160594 9/](https://pbs.twimg.com/media/EmffPI_WEAUtvF2.jpg "\"Most [US] circumcisions are done for religious and cultural reasons. Though parents may use conflicting medical literature to buttress own beliefs/desires, [they mostly] choose for non-medical reasons: religion, culture, aesthetic preference etc.\" https://pediatrics.aappublications.org/content/137/5/e20160594 9/")
But those are the very same reasons given by female Muslim Malaysian doctors as to why they perform "female circumcision" on newborn girls in a hospital environment in their country. From the new study: religion, culture, aesthetics all mentioned by doctors (see below) 10/
Another finding from study: most of these female docs had, themselves, been circumcised at birth and had their own children circumcised -- also, if "we doctors" didn't do it, they say, it would just be done elsewhere! Better 2 "medicalize" & even look 4 health benefit (below) 11/
This is similar to Freedman of @AmerAcadPeds: as he said in interview, "I had my own son circumcised on my parents' kitchen table on the 8th day of his life -- but not for medical reasons, b/c I had 3,000 years of ancestors looking over my shoulder" https://jewishweek.timesofisrael.com/fleshing-out-change-on-circumcision/ 12/
So are Andrew Freedman's ancestors somehow more important than the ancestors of these Malaysian Muslims who circumcise BOTH their sons and their daughters, albeit, in the latter case, typically less invasively than the former? If not, what is the moral distinction here? 13/
It's often argued that "FC is not religious" while MC is -- for at least some groups (e.g., devout Jews). But there are SEVERAL problems with this argument, summarized in the table below (from this forthcoming paper https://www.researchgate.net/publication/343982379_Zero_Tolerance_for_Genital_Mutilation_A_Review_of_Moral_Justifications).
So a likelier explanation of categorical difference in perceived moral permissibility between FC and MC is that the former is a practice done by culturally unfamiliar "Others" whereas the latter is something "we" do in the United States. But that is illegitimate as reason. 14/
Increasingly, defenders of MC *realize* FC shares many overlapping features w/ MC, & now argue that female "circumcision" of non-consenting infant girls should be *allowed* in Western countries & performed by doctors as a "cultural compromise." See https://www.researchgate.net/publication/341965054_Why_Was_the_US_Ban_on_Female_Genital_Mutilation_Ruled_Unconstitutional_and_What_Does_This_Have_to_Do_With_Male_Circumcision 15/
I take opposite view, rather than REMOVE protection from girls against medically unnecessary cutting of sexual anatomy w/o consent, we should ADD protection 2 boys & intersex children, that is, ALL children. Otherwise what is meaning of "human" rights? https://jme.bmj.com/content/42/3/158 16/
Fortunately, this view is gaining steam, as 90+ scholars in human rights, law, anthro, medicine, and other areas recently came together for an international consensus statement that ALL children deserve protection from medically unnecessary genital cutting https://www.tandfonline.com/doi/full/10.1080/15265161.2019.1643945
