Circumcision: Human Rights Make No Anatomical Distinctions – By Maria

Posted by on August 11, 2012 in Featured, Guest Post, Thoughts | 29 comments

The last time I wrote a post for Martin, I focused on the psychosexual factors that contribute to the cycle of child genital cutting in the developed world. As an intactivist, I’m continually amazed at the lack of knowledge surrounding male genital cutting, among people who vehemently defend it, and the intense aversion and refusal to recognise the uncanny similarities to female genital cutting. Even suggesting FGM & male circumcision have comparable attributes, history, and psychosexual repercussions can get one called a heretic from behind a computer screen.

I invite you to read this post with an open mind, to discard your latent xenophobia & Islamaphobia at the top of this screen, and enter this article with the understanding that child genital cutting isn’t about penises or vulvas or potential yet unknown health benefits. It is about gender, sex, power, control, and children. Mostly it’s about children.

I start with this chart so we can see where foreskin excision falls on the ranking of severity. This chart is gleaned from the work of Dr. Sami Aldeeb, the only professional who has ever attempted to rank male genital mutilation, and using the World Health Organisation’s ranking system of severity for female genital cutting. Note what forms of female genital cutting fall below foreskin amputation. Hoodectomy and labiaplasty being the most notable and both widely practised forms of female cutting.

At the bottom we have the most mild form, a ritual nick. In 2010 the American Academy of Pediatrics released a report suggesting doctors be able to cut baby girls to appease parents who would otherwise leave the country to have their daughters’ circumcised. Embedded in that report, is this statement:

The ritual nick suggested by some pediatricians is not medically harmful and is much less extensive than routine newborn male genital cutting.”

It was and still is difficult for doctors to explain to parents why they may cut their sons, but not their daughters. After all, cutting children is a cultural mandate and a social surgery when done to both boys and girls. Every medical authority who has a statement on infant circumcision recognises it is a social surgery, not a medical necessity. The potential medical benefits do not warrant prophylactic amputation of healthy erogenous tissue from minors.

While most of these policy statements strongly recommend against male circumcision, the AAP’s statement is relatively neutral. However, the AAP’s position of neutrality of child circumcision & attempting to appear multi cultural is what prompted the suggestion of a ritual nick. Concerning our baby girls, even the most mild forms of genital cutting is seen as a gross violation of human rights, in the developed world, regardless of its cultural significance.

Myth: Female circumcision doesn’t have any health benefits. Male circumcision has PROVEN health benefits.

Actually there ARE studies (here & here) that show health benefits from female circumcision, namely a reduction in HIV infection among circumcised, and studies that show cut women still orgasm. Even as recent as the 1950’s in the United States, there were studies being published showing the health benefits of cutting girls. There are white, middle class, non Muslim women in the U.S. who are circumcised, and who were cut in childhood on recommendations of their paediatricians.

We could sit here and toss medical studies back and forth all day long, and the conclusion we would come to is the same as every medical authority in the world. The potential, yet unknown health benefits of prophylactic surgery removing healthy erogenous tissue is not compelling enough to recommend for minors. The difference is the studies showing health benefits of cutting girls is met with a caveat about human rights. For some reason this same caveat isn’t attached to research studies showing potential health benefits of male cutting.

Myth: female genital cutting is a vehicle to oppress female sexuality, male circumcision doesn’t oppress sexuality.

In the United States alone, circumcision has been used as a means of sexual repression, classism, racism, and reinforcing the patriarchy.

Male cutting wormed its way into medical culture in the late 1800’s through mass hysteria campaigns to vilify sex and cutting penises was a means to promote chastity and curb masturbation. Very well-known and respected doctors throughout the past 150 years (for example Alan Guttmacher), doctors who led the field in medical research and breakthroughs, promoted circumcision as a cure for insanity, paralysis, epilepsy, and various mental illness. Like all cosmetic surgery, only the well-off could afford to cut their sons’ penises, so the bald penis quickly became a symbol of class. Stigma was attached to the intact genitals as an indicator of immigrant, lower class social status.

Like circumcision news today, if a doctor made a claim about the benefits of circumcision, every medical journal published it as irrefutable fact. Dr. Remondino was a huge proponent of circumcision. He criticised anti-circumcision activists in the early 1900’s as ‘ignoring science’ (sound familiar?) while claiming circumcision prevented blindness, hip and bone disease and was the solution to the ‘Negro rape problem.’ Because, you know, people of colour and their insatiable and uncontrollable sex drives.

Sexual repression, classism, racism, and oh yes, the patriarchy.

Miriam Pollack has an excellent paper on how circumcision defines and perpetuates the patriarchal power structure, and I have to completely agree with her analysis.

In brief, the mother is denied her primal maternal instincts to protect her young, indeed they are ever minimalised, by handing her male child over for ritual harm. The male child is then severed, literally, from his bond with his mother, and initiated into the community of men. It is a physical mark in the flesh which defines his place within the male community, separate and severed from his mother and women.

Although this dynamic of sexual identity is played out just beneath the conscious surface, these invisible needs are being expressed in the language of the circumcision decision.

All the men in my family are circumcised.
A son should match his father.
I’m circumcised and I’m fine.
His wife will thank us for circumcising him, no woman will sleep with an uncut man.
The boys at school will all be circumcised, he will be made fun of if he’s not cut.

Our genitals are central to sexual self-identity, and the need to reaffirm that sexual identity is manifested in the father’s role in circumcision. It is the father’s sexual identity, as well as the sexual identity of the circumcised male community in general, that is being reaffirmed in the cutting of a son’s penis. The complex psycho-sexual factors unconsciously drive this cutting of children, especially boys, because of the significance we as a society place on the penis and male sexual performance.

Myth: It’s just not the same, cutting girls is mutilation.

Well, actually by definition cutting off foreskin is also mutilation, according to the dictionary, if we are being technical. By removing a mobile sleeve of nerve-rich erogenous tissue, we are cutting off both external and internal sexual tissue and often the frenulum, therefore changing the form of the penis. This is genital mutilation.

For our girls, even the most mild, and relatively (physically) benign ritual nick, is seen as heinous act of sexual assault, which it is. However it is no more damaging than episiotomy, and in many cases less damaging than episiotomy. Still, when this is performed on healthy children it is a violation of bodily autonomy.

When any genital cutting is performed on healthy children, it violates their right to bodily autonomy. Human Rights trump all other rights, beliefs, religious mandates, and unspoken needs to complete a bubble of denial about genital cutting. Human Rights of vulnerable children must be fiercely protected because, by nature, children cannot protect themselves. And also by nature, childhood is incidental, so victims become perpetrators.

We cannot, without a healthy dose of denial and cognitive dissonance, accept with complicity the cutting of boy children while abhorring the cutting of girl children. That is the crux. Children are autonomous people with their own rights to healthy, whole, intact, genitals, feet, ears, nipples, and any other body part culture has mandated we modify throughout the course of human history.

We have determined that healthy intact genitals do not pose an imminent risk to the health of a child, or person in general, and therefore excising healthy body parts of non-consenting minors cannot be justified.

Humanism and much of western society has collectively reached this consensus concerning bodily autonomy, and there continues to be shifts away from harmful religious, cultural belief systems, even among believers and the deeply devout. As the world secularises, we will continue to see the gender binary and rigid definitions of sexuality blend into more egalitarian attitudes. Ending child genital cutting is paramount to this shift, as it deconstructs gender hierarchy, and honours the healthy bodies of the smallest and most vulnerable among us.

Given the current trend, the children being cut today will outlive this practise in the developed world. They will carry a physical marking in their flesh, on their most private parts, a reminder of this painful and ugly chapter in human history. A reminder that we used to cut penises.

Which side of history will you be on?

Be sure to check Maria’s blog at http://barreloforanges.com/

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29 Comments

  1. Thank you for a thoughtful and thought-provoking piece.  Very useful argument against those claiming it to be nowhere near as bad as FGM.  This is a sensitive subject for many.
    You have sort-of dismissed the health issues – there is positive feedback from African trials; strong correlation between circumcision and reduction in HIV infections.  None of which suggests that infant circumcision is permissible though – it should be delayed to adolescence when the man can be given an informed choice.  

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    •  @kmcharleston 

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    •  @kmcharleston The HIV trials were all fraught with methodological errors. Look up a paper written by Lawrence Green called ‘Circumcision isn’t the HIV vaccine we’ve been waiting for’, where he details everything wrong with those studies and why they’re not to be trusted.

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    •  @kmcharleston Thank you for your comment. I did breeze over the medical benefits, because we can very quickly and easily be sucked into the game of sharing contradictory medical studies. You give me a study that shows cutting reduces HIV & I’ll show you three that say otherwise. You give me a study that shows circumcised boys have lower rates of UTI’s and I’ll give you three that say the opposite. It’s an endless game that leads us to the conclusion that medical benefits of removing foreskin is inconclusive. 
       
      The infamous Africa Studies that you reference have been criticised and refuted many times over. For example:
      here http://jme.bmj.com/content/36/12/798.abstract
      Here http://www.ncbi.nlm.nih.gov/pubmed/20965388
      Here http://www.ajol.info/index.php/samj/article/viewFile/14003/2617
      and a critique at Oxford Practical Ethics blog http://blog.practicalethics.ox.ac.uk/2012/05/when-bad-science-kills-or-how-to-spread-aids/
       
      Further, since male circumcision became medicalised in the late 1800’s, every medical benefit of circumcision has been refuted, disproved, and then replaced with new *miracle cures.* Which makes me wonder, as a skeptic, if the inherent bias of trying to justify male cutting as leading us to unfounded justifications.
       
      Compare this to the studies showing lower HIV among circumcised women. The researchers EXPECTED to find lower rates of HIV among intact women, and were surprised to find that circumcision actually reduced HIV prevalence. 
       
      I’m inclined to posit, it’s the psycho-sexual needs being reaffirmed in perpetually trying to find new cures and benefits of male cutting. 

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      •  @mariaRB Let me make this clear – ethically, I believe circumcision without informed and understood consent is criminal mutilation.  Most ‘medical benefits’ from the past have been spouted with no evidence.  
         
        However – we live in an age where we can study these things.  And I live in South Africa, which has one of the highest incidences of HIV and AIDS.  
         
        I think you dismiss the studies too simply.  After all the WHO stance is very different “WHO/UNAIDS recommendations emphasize that male circumcision should be considered an efficacious intervention for HIV prevention in countries and regions with heterosexual epidemics, high HIV and low male circumcision prevalence.”  http://www.who.int/hiv/topics/malecircumcision/en/ 
         
        There are plenty of rebuttals to the points above – but Nathan Geffen of the Treatment Action Campaign, and a fellow sceptic of medical claims,  does a good job here: 
        http://www.quackdown.info/article/getting-circumcision-science-right-media/ 
         
        It isn’t clear to me how you propose the mechanism by which it is understood that circumcision to reduce HIV infection in circumcised men would be expected to work in women?

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        •  @kmcharleston The WHO’s position is based on the faulty HIV trials I mentioned previously, along with a lot of lobbying by some very vocal Jewish doctors.

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        •  @LucidWombat Your assertion without evidence can be dismissed without evidence.  When you can provide argument/evidence about the trials which is not refuted by the content at the link I provided – I may consider your opinion. 

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        •  @kmcharleston Lovin’ the Hitchens quote, and here you go: http://www.circumcisionandhiv.com/files/mcnotavaccine.pdf. Here is another paper detailing the lack of external validity of the studies:
           
          Green, L.W. (2010). “Male circumcision and HIV prevention insufficient evidence and neglected external validity”. American Journal of Preventive Medicine (0749-3797), 39 (5), pp. 479.
           
          On top of the points that Green et al mention in the above editorial there is another that I’ll just copy and paste from my blog:
           
          – for the most widely cited study (Auvert & Taljaard, et al. (2005) Randomized, Controlled Intervention Trial of Male Circumcision for Reduction of HIV Infection Risk: The ANRS 1265 Trial. PLoS Med 2(11): e298.), the conclusion of a 60% protection rate was derived from comparing 20 infections in the circumcised group and 49 infections in the intact group (1 – 20/49). Forgetting for the moment that this sample size is far too small to draw such a conclusion, this is only a relative difference *across* the two groups. The actual calculated protection rate is only 2.25% (3.74% infected in control vs. 1.49% in experimental). Compare this to a condom with a 99.97% protection rate. Due to the short time of the study, and the other errors involved in the trial, 2.25% is safely within error bars and therefore not significant.
           

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        •  @LucidWombat Green’s article  http://www.davidwilton.com/files/ajpmgreenetal2010-pub1.pdf) repeats the same arguments he made in 2008 – for which the FutureMedicine article referenced on the QuackDown site  remains a reasonable rebuttal (http://www.futuremedicine.com/doi/full/10.2217/17469600.2.5.399). The editorial also adds nothing new to the argument.  
           
          The Quackdown article also refers (poorly linked) to this http://pag.ias2011.org/Abstracts.aspx?SID=43&AID=4792%20 where the same Auvert & Taljaard (et al) say: 
          “Without the intervention, if no men were circumcised, HIV prevalence among all men aged 15 to 49 would have been 25.1% (95%CI: 13.1%−39.1%) higher, and HIV incidence among all men aged 15 to 34, 61.0% (95%CI: 23.0%−152%) higher.  Conclusion: This study shows for the first time that the roll-out of MMC in Southern and Eastern Africa, can, if successfully promoted, markedly decrease the spread of HIV in endemic communities.”
           
           

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        •  @LucidWombat Do you have any evidence of the “lot of lobbying by some very vocal jewish doctors”?  I find that quite distasteful and dismissive of a large number of talented and dedicated medical researches working hard to reduce the number of deaths due to HIV/AIDS.  
           
          I have no evidence that the composition of the trial researchers “in countries and regions with heterosexual epidemics, high HIV and low male circumcision prevalence” are of any particular race or religion.  Do you?  
           
          Your conflation of the two indicates something less than lucidity, and I can see how easily that can happen.  My own anger at having been circumcised as an infant for no obvious reason sometimes gets in the way of rational thought on the subject.  

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        •  @kmcharleston I appreciate your position, and it’s definitely something that should be explored more, and hasn’t been adequately studied, with longitudinal case studies that follow consenting adult men over several decades. In my opinion, before we start promoting cutting off sex parts (of men or women) as a viable fight against any epidemic, we need good, verifiable, vetted, strong evidence. The burden of proof is on the people who want to promote genital mutilation.
           
          In my opinion, and looking at the evidence, the promoters of circumcision have failed to make a case in which all parties benefit from cutting off foreskin. A recent studied published in the Lancet was halted because it was considered futile. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60998-3/abstract Translation: they weren’t finding what they were looking for.  Recently a survey in Zimbabwe has shown an increase among circumcised. http://www.voazimbabwe.com/content/report-says-hiv-prevalence-in-circumcised-men-high-in-zimbabwe-161827125/1476902.html 
           
          Even with HIV prevention in the appropriate populations, we are still the same place we’ve always been: the evidence isn’t clear, and appears to be largely muddled by psycho-sexual socio-cultural factors.
           
          If we want to promote genital mutilation for health benefits only for consenting adults, as a skeptic, I want good solid evidence that it works. 

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        •  @kmcharleston Here is the Lancet study, appears the link was broken http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60998-3/abstract

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  2. Way to go Maria. Your right on with this piece & many many boys have or will have you to thank for the fact that their parents decided to end the cutting after reading your articles. Your twitter feed is also full of insightful commentary on circumcision too. Anyone still considering where they stand on this issue, do yoursf a favor & follow Maria here @BarrelOfOranges thanks again for this well thought post. – Attached Family

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  3. IF circumcision were truly a mechanism by which males could avoid HIV transmission……how is it that so many circumcised men have died in the United States?  In the 1980’s, nearly all of the Aids deaths consisted of circumcised men.  No one can explain this, because circumcision is NOT going to help African men avoid HIV transmission!  If it didn’t help the circumcised men, how on earth could it help to continue circumcising men?  IT makes no sense.

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    •  @Mare54 So you are saying that the evidence from current trials in near-poverty situations in Africa makes no sense because the number of HIV deaths among men with very different lifestyle-choices in the USA in the early 80’s consisted primarily of circumcised males?  Try harder.  The men dying of AIDS in the early 80s were born during the  period of the highest rate of circumcision in the USA.  http://www.circs.org/index.php/Reviews/Rates/USA.  The likelihood of them not being circumcised is minimal.  

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  4. I’m aware that comparing the U.S. to Africa makes no sense…..except that what happened in the U.S. at the height of the Aids epidemic shows that being circumcised does not protect anyone from HIV!  The circumstances might be very different, but the outcome will be the same….or worse, it might very well make the HIV problem worse in Africa.  Even the CDC will not credit male circumcision as a “magic bullet” against HIV transmission…..and warns that condom use will be vital.  The problem is that the African people have been mislead…..and the condom part (which is vital…..)  has not been highlighted.  Only the circumcision part has been highlighted which is very unethical and does not really inform the men who are volunteering to have their genitals altered in the name of “HIV prevention”!  Take a look at the huge posters to push circumcision that are all over Africa thanks to the U.S.A. and the Bill and Melinda Gates foundation….and look for the very fine print on the bottom that mentions condoms (that most likely is not being read!!!)  My point is that even the CDC has stated that there are many reasons that Africa has suffered the HIV epidemic….and they have even said that since vaccines are expensive…..this is the best they can do.  They have even listed the ways in which HIV transmission could be handled…..(clean water; better sanitation; better nutrition; public education; a clean blood supply;  adequate medical care…….all of which is highly expensive….) so promoting male circumcision is the best they can do right now, although they also mention that medication and vaccines are available, but just not to Africa…).  This is the travesty of this whole thing and African men will pay the ultimate price because it’s simply “cheaper”.  However, there are people making a ton of money in this huge circumcision push…..yes, follow the money!

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    •  @Mare54 Don’t set up straw-men. No-one is suggesting that circumcision is a magic bullet.  No-one is suggesting that the USA is an area with low MMC and high HIV incidence – so there would be absolutely no reason for the CDC to suggest MMC as a solution.  
       
      Your description of HIV transmission is ridiculous – access to clean water and better nutrition have nothing to do with it.  HIV is transmitted through exposure to infected blood – the likelihood of sanitation being involved is extremely unlikely.  
       
      Your assertion (without evidence) that ‘African men will pay the ultimate price’ is ridiculous.  The studies, and their recent follow-up, show no reduction in condom usage, and no increase in risky-behaviour.  As an adjunct to an ABC program (which has not had massive success on its own) MCC is a reasonable approach when following the WHO guideline:  
       
      Your panning of the Gates’ foundation efforts and vapid ‘follow the money’ jibe is a plainly ridiculous and irrational response to philanthropic efforts to get a reasonable message and treatment opportunities to areas which have neither.  
       
       

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  5. Just follow the money…..it will always take you to the source.

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  6. The 1st paragraph in the final section, first 2 sentences. In the next paragraph, its final sentence. Good stuff.
     
    The rest almost talked me out of even that.

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  7. I completely disagree.  I have read articles from Africa about men actually calling circumcision an “invisible condom”…. so you don’t know what you are talking about except that you seem to only want to believe what lies are being told about what is happening in Africa.  Look beyond what you are being fed as facts and look into the articles about “real” African men and how un informed they are about the whole thing!  I wonder why the Gates foundation didn’t invest in more education and condoms and spend money cleaning up their blood supply??  Instead they are pushing a ridiculous mass cutting on men who are not properly informed!  I guess you don’t want to believe that, but it’s true!  What you don’t understand is how much money is wrapped up in circumcision, here in the U.S. and in Africa…..take the blinders off and follow the money, it doesn’t lie.

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    •  @Mare54 I live in South Africa.  In a country with one of the highest incidence of HIV and AIDS. Through men’s groups, I engage with men in communities in Khayelitsha here in Cape Town.The Treatment Action Campaign has been at the forefront of fighting the SA Government’s hypocrisy and   denial-ism about AIDS treatment.  They have been actively interested and involved in the trials being run in SA, and have firmly come down on the side the MCC as an option – where practical.  Your views are parochial, and misguided.  Please engage with the facts and not emotional responses that misrepresent what is actually happening on the ground.   http://www.futuremedicine.com/doi/full/10.2217/17469600.2.5.399 

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      •  @kmcharleston Circumcision is not an option, when condoms must be used to actually avoid transmission.  It doesn’t matter if you are cut or not, HIV can still be transmitted, so that makes no sense.  I don’t care where you live, I have seen the posters and reviewed the FB sites of Africans who are questioning this massive push to cut….and they are not being fully informed.  I have no problem with a man choosing to do that to himself if he is actually informed, but I know the CDC has already written articles that outline plans to cut babies because it would be “easier”, since they can’t run or object.  To me, that is a violation of human rights.  You really should check you arrogance at the door !!!!!!

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        •  @Mare54 In all of your comments you have made one emotional assertion after the other.  Not a single shred of evidence.  So if you know the CDC has written articles that “outline plans to cut babies because it would be easier” – publish links to them. In the light of the WHO’s statement on the matter – that would indeed be an outrageous statement for the CDC to make.  
           
          Your feelings on the matter are clear, and there’s nothing wrong with having strong feelings.  What is wrong is asserting those feelings as matters of fact – unless you have the evidence to support it.   Show me the evidence.  

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        •  @kmcharleston  @Mare54 At the bottom of this thread is my comments concerning the legitimacy of medical benefits, insofar as we have asserted and refuted throughout history, including the current HIV benefits, as it relates to appropriate populations. 

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        •  @mariaRB  @kmcharleston throughout history?  Kellogg is the one who made circumcision mainstream way back when…..and what was it to cure?  Masturbation!  Then there is a long line of proposed “benefits”…..like epilepsy for example…..oh yes, circumcision has always been a “cure” just searching for a disease!  HIV you say?  Oh yes, it is a magic bullet (as African men call circumcision the invisible condom….)..YET, it is only one option that also requires the consistent use of a condom.  If a condom is necessary, what is the point of genital alteration?  HIV can be transmitted whether a male is intact or cut.  It’s more about healthy decisions and education….and lots of condoms.  The medical benefits you cite, don’t have any relationship to an infant’s needs….UTI’s are uncommon in male infants and girls are much more prone to them and I don’t see any advocating for cutting female infants…usually an antibiotic is prescribed.  STD’s are a theory benefit, as there is no way to know if that baby will be a male at risk for one of those…..and it is years and years down the road, when education should dictate whether a male might be at risk for an STD and can take proper precautions…..Penile cancer is the most ridiculous since it is rare and affects mostly older men so it hardly relates to an infant’s immediate needs.  Foreskin is not a birth defect and it has functions designed by nature and it belongs on a male.  Why is it that so many people are ignorant about normal, natural, functional male sexual anatomy?

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        •  @kmcharleston Use common sense……..common sense tells you clearly that foreskin is not a birth defect and it has multiple functions.  In fact, a male being born without a foreskin has a birth defect.  Look it up and while you are at it, educate yourself on the natural functions of the male foreskin.  If you are advocating for it to be cut off……you should at least be educated on it’s functions!  I looked over the CDC site and read that article, go look for yourself.  The article said that the goal was to circumcise all African babies…..because it would be easier than trying to get men into their clinics and it also mentions that it is “cheaper”!!!

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  8. What’s really “irrational” is cutting perfectly normal natural body parts in order to push a “theory” that the studies have been shown to be flawed!!!!!  Now that’s irrational!!!

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  9. Fantastic article, thank you for writing this. Excellent.

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  10. The proper form of female circumcision aka hoodectomy (where only the prepuce
    of the clitoris is removed) can benefit women, both in terms of hygiene
    and sexual pleasure. See this lovely piece:

    http://www.anvermanatunga.net/english/female-circumcision-the-hidden-truth-by-asiff-hussein/

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