Friday, November 12, 2010

Circumcision: Already Illegal?

By Jennifer Coias

I often come across parents who do not agree that circumcision should be illegal. They usually argue by saying it is a parental decision like vaccination, homebirth, etc. Here is my response:

Vaccines cannot be compared to a cosmetic surgery that removes healthy organs for non-therapeutic purposes. This is like comparing apples to oranges. Let's stick with comparing other actions that are considered bodily 
modificationsof non-consenting minors when contemplating the legality of circumcision.

Piercing is a body modification, but because it does not alter the function of a body part, nor does it remove any tissue or organs, it is generally accepted within reason (earlobes, for example).

Tattooing is much more extreme in that it is permanent, yet it still does not remove any organ or alter the functions of any healthy body parts. However, most people agree that parents should not be able to tattoo their infants or children. In fact, a Florida family was recently charged with cruelty to children for tattooing their 6 kids.

And then you have circumcision - a genital surgery which 
does alter the function of the primary sex organ, doesremove otherwise healthy tissue and the prepuce organ, does alter appearance forever more and is permanent. If you aren't allowed to tattoo your children, why on earth would you be legally able to remove healthy, functioning tissue from your son's genitals?

Besides being creepy that a parent would have the say over the cutting of their child's genitals, circumcision of children violates all our current laws concerning alterations of a child's body. In our country we have laws in place that are designed to 
protect the bodies of children. These laws state that no parent can request to alter their child's body unless: A) it is medically indicated and B) a more conservative treatment has failed to correct the medical problem that exists. These laws are in place because bodily integrity (an intact body) is considered a basic human right in our society.

Human rights are granted to every single person regardless of gender, age, nationality, culture or religion. Furthermore, doctors caring for patients who are under the age of 18 are
 not legally permitted to perform any surgery on a minor unless there is clear medical need and more conservative treatment has failed . This is basic medical ethics, and yet somehow circumcision has become the exception to this well established legality. A parent cannot ask a doctor to remove a fingernail, an earlobe, a toe, or any other part of the body. A parent cannot remove the clitoral hood of their daughter (which is the female foreskin - the prepuce). A parent cannot even pin prick their daughter's genitals without it being a federal crime punishable under the FGM Bill. Basically, every square inch of a child's body is protected by bodily integrity laws and medical ethics laws -- every square inch, that is, aside from the infant male foreskin. How can this be?

Now one can try to argue that circumcision is in some way a form of preventative medicine, however, in doing so, we will run into trouble arguing this because we are no longer living in a day and age where amputation is considered preventative medicine. In modern medicine, amputation is always a LAST resort when conservative methods have failed. The only reasons amputation would be considered a first choice would be in the case of gangrene, malignancy, frostbite, or serious trauma to that body organ.

In addition, when you amputate any part of the body you remove the off-chance that something can go wrong with that part. After all, it no longer exists! That isn't rocket science. The male foreskin, however, is no more pathological than any other part of the body. In fact, the intact female genitals are more likely to cause its owner problems than any intact man will ever experience on behalf of his foreskin. 65% of American women will have a bacterial vaginal infection in their lifetime, 40% of women will have yeast infection in their lifetime, and girls are six times more likely to suffer from a 
urinary tract infection (easily treated with antibiotics). Each of these health concerns for girls and women far out number any problems a boy or man may have with his foreskin at any point in life, yet somehow we find a way to treat women without amputating genital organs. In the unlikely event that a man has a foreskin problem, he can enjoy the same conservative methods of treatment that are allotted to women. Studies conducted in countries that do not routinely circumcise have found that less than 1 in 6,000 men will ever need circumcision surgery for medical reasons.

We must attend to the fact that no medical organization in the entire world recommends routine infant circumcision. Each and every organization has made a statement that the potential benefits do not outweigh the risks and guaranteed negative consequences. This alone is proof to the absurdness of using circumcision as preventative medicine.

The final, last ditch effort to arguing for circumcision would be the very controversial study that was performed in Africa. Even if you believe this study, which is loaded with methodological errors, you'd only have a reduction in female-to-male sexual transmission of HIV. In our country 88% of HIV is transmitted through male-to-male intercourse and/or IV drug use. Circumcision has proven 
no benefit for male-to-female transmission, male-to-male transmission, or IV drug use.

In reviewing 
The Nuts and Bolts of HIV in the USA and Why Circumcision Won't Protect Men you will see that a heterosexual American man who engages in moderately risky sexual activity will have a less than .03% chance of catching HIV over a 60 year period...not exactly a reason to routinely circumcise all infant boys. Aside from this statistic, we can all agree that infants and young boys don't engage in sexual activity until they reach an age where they can make an informed decision as to whether or not they want to amputate their precious foreskins.

All this, and I still haven't even mentioned that a 5-year review of this so-called 'study' in Uganda reported that 
the circumcised group and their female partners began to acquire HIV at alarmingly higher rates. Rates so high, in fact, that the study ended early due to ethical concerns. These results (circumcision increasing HIV transmission in Africa) were not formally published because the study ended early. There are several studies in the last decade that have reported no reduction in sexually transmitted infections or HIV among circumcised males. Several studies report higher rates among circumcised men. Our nation's track record should be testimony to an already failed circumcision experiment. We are, after all, the only developed nation in the world who routinely circumcises boys and we also happen to have thee highest STD and HIV rates of any other developed nation.

Last but certainly not least, there was a recent study of circumcised females which reported a 50% reduction in HIV among circumcised women. Shall we also suggest that women be circumcised based on the findings of this study? This is all moot point, however, because we do have effective protective methods against HIV and all sexually transmitted infections: condoms. Condoms are over 98% effective and do not involve any genital reduction surgery on non-consenting persons.

So there you have it.

Circumcision violates our human rights laws, which are designed to protect the bodies of minor children.

Circumcision violates our medical ethics laws that state a doctor can only perform procedures on a minor when there is clear medical need and a more conservative treatment has failed.

Circumcision is not good preventative medicine because amputation is always a last resort to conservative treatments.

Circumcision on babies cannot be considered a good prophylactic measure against sexually transmitted infections.

And last but not least, because baby girls 
are protected from even the most minor genital surgery (even a pin prick), circumcision is a violation of the equal protection clause of the Constitution of the United States which states that, "all persons shall receive equal protection under the law" regardless of sex.

Case closed, circumcision is technically already illegal. The question is not then whether or not it is 
legal to circumcise a child - we have already established that the male foreskin and its removal exists outside our legal and medical norms. The real question is, when will our government recognize that they have failed to apply the law accordingly and, in doing so, they have failed to protect our most innocent and most fragile of citizens?

For more on the legality of MGM in the United States, visit the 
MGM Bill homepage, stay up to date on research at the Circumcision Public Health Policy site, and join with physicians from around the world who stand up for human rights and ethical legal and medical practices atDoctors Opposing Circumcision.
 Hear Dr. Dean Edell discuss the latest research in Africa on circumcision and HIV. Explore more of thehistory behind FGM (female circumcision) in the United States.

Additional articles by Jennifer Coias:
The Phony Phimosis Diagnosis
The Nuts & Bolts of HIV in the USA and why Circumcision Won't Protect Men

Basic Care of an Intact Child

Painful Urination During Prepuce Separation

Who Are you Calling an Intactivist? 
Turn Your Crib into a Co-Sleeper

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