Circumcision: Rewind to 2010
Any day now the American Academy of Pediatrics is expected to release its new policy statement on male circumcision. As I’ve already written, because of data suggesting that circumcision reduces the risk of males acquiring HIV through heterosexual intercourse, the AAP is expected to move from a neutral position to a more encouraging one. I can predict how the news coverage will read: a paragraph or two explaining the new position and its rationale, a few choice quotes from intactivists, comments from physicians and maybe a mohel. All pretty standard stuff.
This will be a walk in the park for the AAP, particularly compared to last spring. That was when the AAP released its policy statement on female circumcision, which repeatedly decried all forms of female genital cutting. Wisely, however, the AAP also recognized that female genital cutting is a cultural and religious practice and hence won’t disappear just because it is made illegal or because medical organizations reject it. The AAP therefore left open the possibility that doctors, in a hospital and with anesthetic, might make a ritual nick on girls whose parents request it. The goal was twofold: (1) give parents an alternative so that they would not send their daughters back to their native countries for far more drastic forms of genital cutting; and (2) begin to change cultural norms within certain immigrant communities. As for how this all played out, suffice to say that the AAP retracted the policy statement a few weeks later to make certain, as the AAP’s president explained, that “the world health community understands the AAP is totally opposed to all forms of female genital cutting, both here in the U.S. and anywhere else in the world.”
The contrast between that brouhaha and the yawn that is likely to herald the new statement on male circumcision should prompt a re-examination of American attitudes toward male genital cutting. Because there are so many degrees of female circumcision—each increasingly horrific and terrifying to Western observers—it’s easy to put male and female circumcision into separate mental compartments. In the “mildest” form of female circumcision, however, the clitoris is left intact and the clitoral prepuce (which is homologous with the male foreskin) is removed. Consistency would demand that anyone who supports the parental choice to cut off a son’s foreskin also support the parental choice to cut off a daughter’s clitoral prepuce. But very few Americans hold consistent views about male and female circumcision.
Those of us with inconsistent views cannot satisfactorily justify them by pointing to the health benefits of male circumcision. Even if all the medical authorities agreed that male circumcision had no health benefits, it is inconceivable that cutting off the male prepuce (also known as the foreskin) would be criminalized in the same way that federal law criminalizes cutting off the clitoral prepuce. Put differently, even if cutting off the clitoral prepuce reduced the risk of urinary tract infection and of contracting HIV, the AAP wouldn’t recommend it and American parents wouldn’t do it. This is because circumcision is a cultural practice and not a medical one.
Lest I be misunderstood, I am not suggesting that we resolve these inconsistent views by endorsing or in any way supporting female circumcision. I do think, however, that last Spring’s firestorm and the anticipated quiet reception of the AAP’s new policy statement on male circumcision reveal more than a little hypocrisy about our own cultural practices.