By Lillian Dell’Aquila Cannon
Recently, there was an article in the New Times Broward-Palm Beach about circumcision, in which pediatric ethicist Dr. Doug Diekema suggested that the new AAP statement on circumcision would be more favorable towards circumcision. This has intactivists worried, as one of the major points against circumcision is that no medical organization recommends circumcision. I don’t think we need to worry, though, considering the flap over the AAP’s 2010 statement on female circumcision alternatives.
In a policy statement issued April 26, 2010, the AAP proposed physicians could offer a ritual nick to the clitorises of baby girls in order to satisfy the immigrant parents who would otherwise go abroad for a more “complete” circumcision. In this statement, the AAP revealed its bias:
“The ritual nick suggested by some pediatricians is not medically harmful and is much less extensive than routine newborn male genital cutting.”
“Health educators must also be prepared to explain to parents from outside North America why male genital alteration is routinely practiced here but female genital alteration is routinely condemned.”
There is no instruction on how, exactly, doctors were supposed to explain the discrepancy. What a pity: I would have liked to see them try. I am sure that many “uneducated” parents could have given them a quick dose of comeuppance: “Tell me exactly why it is terrible to do to a girl but fine to do to a boy?”
This is just another example of the cultural blinders we all wear, including well-educated people like physicians: a nick or a pinprick that would not have removed any tissue nor caused any damage is just too terrible to do to a baby girl, but removing all of the foreskin, ridged band, dartos muscle and frenulum from a baby boy is just fine?
When and if the AAP committee’s political wrangling that has been going on for years over a new policy statement on circumcision comes to a head, even if it is more pro-circumcision, it won’t carry much moral weight. Their lack of adherence to their own policy statement on parental desires and proxy consent exposes their hypocrisy:
“Thus “proxy consent” poses serious problems for pediatric health care providers. Such providers have legal and ethical duties to their child patients to render competent medical care based on what the patient needs, not what someone else expresses. Although impasses regarding the interests of minors and the expressed wishes of their parents or guardians are rare, the pediatrician’s responsibilities to his or her patient exist independent of parental desires or proxy consent.”
Source: Informed Consent, Parental Permission, and Assent in Pediatric Practice. Committee on Bioethics, American Academy of Pediatrics. Pediatrics. 1995 Feb; 95(2):314-317.
Genital cutting is genital cutting, and when people focus on comparing degrees of damage it obscures the underlying, undeniable truth: every human being has a right to his or her whole body, no matter how little another person, including his or her parents, may value that body part. Circumcision is done to babies here in America because they cannot resist. Very few men would choose circumcision for themselves; that is why it must be forced on them when they cannot refuse.
What, exactly, makes people in our culture think that female circumcision so much worse than male circumcision? The common response is that female circumcision is so terrible because it hampers or destroys female sexual response and/or because it hurts or injures the girl because of the unhygienic and barbaric manner in which it was done. If male circumcision hampered or destroyed male sexual response, or if it caused pain and other injuries besides the injury of having healthy tissue removed, would we then begin to see male circumcision as also obviously morally wrong? Many people would not – their cultural indoctrination completely blinds them.
What if some female circumcisions were performed hygienically, by a doctor, with a minimum of pain and tissue removed? Would that make them okay? Judging by the response to the AAP’s abortive statement, it would not, but that is actually the way female circumcision happens in countries in which it has been medicalized (just as male circumcision is here.) Here are some Malaysian mothers discussing their infant daughters’ circumcisions:
“yah… i also dont know how to explain how its done although i witnessed both my gals’ procedures myself
both done at different clinics by female Muslim doctors…
dont think it’s like the cutting for boys…. it’s more minimal…. baby can recover by the next day?”
“very nice clinic – they have a surau, play area with slides and comfortable waiting area, good service and they have couple of doctors as well. We only waited about 10-15 minutes and the procedure was a mere 3 minutes and that’s it! She only cried a little bit because she just didn’t like people holding her legs. Once done, she stared at the doc and smile…good girl!”
The more you read these stories, the more obvious it becomes that female and male circumcision are exactly the same thing: a human rights violation. Both are the non-consensual removal of healthy tissue that can result in sexual dysfunction, infection or death. Both are culturally-indoctrinated practices. Both have become medicalized, which have aided their persistence and longevity.
So go ahead, AAP. Bring on a new statement, be it pro-circumcision or not. Just be prepared to be raked over the coals for your hypocrisy. And don’t be offended when I accuse you physicians of wearing cultural blinders, because it’s the only defense you have left. Without it, you are just unethical, immoral and in constant violation of the Hippocratic Oath to first, do no harm.