Claimed Health Benefits
Amongst the Victorians, the mere presence of the male foreskin was believed to cause epilepsy, paralysis, malnutrition, hysteria, and other nervous disorders. Words such as “hygiene” and “sanitary” denoted cleanliness of the morals to the Victorians and not of the mind; removal of the foreskin effectively prevented masturbation and thus promoted mental purity.
The concept that circumcision is beneficial to health is not new: Philo of Alexandria (25BC – 50AD) argued that circumcision protected against the “severe and incurable malady of the prepuce called anthrax or carbuncle” (probably the ulcer of primary syphilis) and promoted the cleanliness of the whole body as befitted the consecrated order. He also recognised that it decreased pride and pleasure, hence enhancing the spiritual persona of the Israelite male. The Jewish intellectual Moses Maimoinides wrote that circumcision both quiets lust and perfects what is defective morally,
The fact that circumcision weakens the faculty of sexual excitement and sometimes perhaps diminishes the pleasure is indubitable. For if at birth this member has been made to bleed and has had its covering taken away from it, it must indubitably be weakened. In my opinion, this is the strongest of the reasons for circumcision. Jewish men, sexually subdued and readily controlled by their wives, don’t stray into mischief. The power of his member has been diminished so that he has no strength to lie with many lewd women.
The claimed health benefits for a ritual which clearly has nothing to do with promoting health continue to this day. There are some medical conditions which may be relieved by the removal of the foreskin:
- Phimosis – when the foreskin fails to separate fully from the glans. Separation is usually complete by the age of 3, but can be delayed until the age of 5 or later and affects about 1% of men at age 18. Waiting is usually the best option, but surgery is necessary in a very few cases. Phimosis is also a complication of partial circumcision.
- Balanitis and balanoposthitis – inflammation of the glans alone or glans and foreskin can result from poor hygiene, or allergies to soap, washing powders, latex or spermicides in condoms. Yeasts such as candida albicans can flourish in the warm, damp space between the glans and foreskin, particularly where there is a build-up of smegma, a collection of shed skin cells, oils and moisture. Where inflammation occurs repeatedly, circumcision may be offered although fungicides, antibiotics and steroid creams are the more usual treatment.
- In adults, an overly tight foreskin which makes sex painful.
There are other conditions which some claim can be avoided through circumcision:
- Penile cancer – this is a very rare cancer associated with poor hygiene and smoking, and with phimosis and HPV infection. There is little evidence for the claims, and countries with the highest rates of penile cancer – such as the USA – also have high rates of circumcision. Clearly, cancer cannot develop in a foreskin which has been removed, and amputation of the entire penis would provide complete protection against penile cancer.
- Cervical cancer – there is some evidence associating circumcision with the more rapid elimination of the HPV virus which can cause genital warts and cervical cancer. Circumcision can thus reduce the time during which the virus can be transmitted.
- AIDS – the surface of the glans and inner surface of the foreskin contain Langerhans cells which are targeted by the HIV virus; removal of the foreskin reduces the number of these cells and there is some evidence that this can reduce the transmission of HIV. Obviously, amputation of the entire penis would be an even more effective measure.
This evidence amounts to little more than that disorders of the foreskin can be prevented by its removal, a principle which might be applied to any organ of the body, including the brain. Circumcision also diminishes the pleasure derived from sex and thus diminishes its frequency.
Female genital mutilation was specifically outlawed by the Prohibition of Female Circumcision Act 1985. The Private Members Bill was brought by Marion Roe (MP for Broxbourne), who recalled in 2003 that she had been “called a racist and I was accused of intervening in religious freedoms, cultural traditions and so on”. At the second reading of the Bill, the Lord Chancellor, Lord Hailsham, offered his view that female circumcision was already unlawful under the Offences Against the Person Act 1861,
I must say this, because I believe that people are beginning to think that this is not against the criminal law. I can only say that I am quite sure that it is against the criminal law as matters stand. It may be an argument for the Bill; it may be an argument against the Bill. But I am simply stating what I believe to be the criminal law at the present time.
He added that a minor cannot give consent, and that the parents, the surgeon, the anaesthetist and the nurses involved in female circumcision would all be guilty. The proponents of the Bill persisted, however, because they wanted to send a specific message that female circumcision was unacceptable in Britain. This largely symbolic status of the Act is underlined by the fact that it never resulted in any prosecutions. In 2003 it was repealed and re-enacted as the Female Genital Mutilation Act, adding an offence of taking a child out of the country for the purposes of procuring FGM and extending the maximum penalty from 5 to 14 years. Baroness Rendell observed,
The practice is medically unnecessary, extremely painful and poses severe health risks, both at the time when the mutilation is carried out and in later life. It has no possible physical advantages; is not called for in any religion and is not limited to any religious group.
As Hailsham had, she admitted,
It is unlikely that FGM was ever legal in this country. Even before the Prohibition of Female Circumcision Act came into force, it could almost certainly have been prosecuted as an offence against the person. The purpose of the 1985 Act was to remove any uncertainty about the legality of the practice and to make it clear that such a barbaric custom has no place in our society.
The Serious Crimes Act 2015 added a Schedule 2 to the Act which further enabled a court to make a variety of Female Genital Mutilation Protection Orders. It is difficult to say what the effect of these Acts has been on a practice which had never been common and was already morally unacceptable and contrary to the law.
The 1861 Act had some holes which were closed by the Children and Young Persons Act 1933; this was designed to outlaw the “unnecessary suffering” which might be caused, albeit for benign reasons, by parents and others driven by religious belief. Under Section 1, a person commits an offence against a child if he “wilfully assaults, ill-treats, neglects, abandons, or exposes him, or causes or procures him to be assaulted, ill-treated, neglected, abandoned, or exposed, in a manner likely to cause him unnecessary suffering or injury to health (including injury to or loss of sight, or hearing, or limb, or organ of the body, and any mental derangement)”.
Although the term FGM describes a wide variety of practices across a wide range of cultures with consequences varying from the minor to traumatic disfigurement and maiming, the successful politicisation of FGM has resulted in the legal systems of western countries grouping all forms together as mutilation and forbidding them by law. This is partly because all forms of cutting into a girl’s genitals without a medical diagnosis, and without her consent are already illegal under these countries’ legal codes. Many people would agree that this is the correct approach, though there are some who argue that the more minor forms of cosmetic nicking and piercing should not be outlawed; again, most would agree that if a girl wants to do this to herself, she should wait until adulthood.
However, this is also analogous to the way in which feminism regards all forms of rape, or all forms of domestic violence as of equal severity, as manifestations of the patriarchy, and to be treated in the same way. When, for example, Justice Minister Ken Clarke dared to suggest in May 2011 that some rapes were more serious than others – in accordance with Labour’s own sentencing guidelines – he provoked a feminist backlash, such as this from Lara Williams, writing in The Guardian,
Through distinguishing “serious” and “less serious” rape, Clarke assumed a perverse gradient of suffering, a warped taxonomy of perceived victimisation.
There is no specific prohibition in English law against male circumcision, nor even a requirement that it should be carried out by medically qualified personnel in sterile conditions, and here as in many countries, such as the United States, where hairdressers and manicurists are regulated, it can be performed by anyone without training and without regulation.
The case of Re J concerned an application by an Islamic father for a specific issues order to enable the circumcision of his five-year-old son which was opposed by the non-Islamic mother. The procedure was to be performed under general anaesthetic in clinical conditions. Mr Justice Wall observed that the circumcision of boys for religious reasons was lawful, on the grounds that it was demanded by Judaism and Islam and had become an accepted practice in England, that it could take place on agreement by the parents without consideration of the child’s best interests and, thirdly, that where the parents were in conflict, the decision was the court’s. The Court had, therefore, to decide the issue according to the child’s welfare.
J suffered from none of the conditions for which circumcision is medically indicated; any other medical benefit was “highly contentious”, whereas there were clear and quantifiable risks associated with the procedure. Wall concluded that circumcision was not in the child’s best interests, and was not to be carried out; a prohibited steps order was put in place. The appeal was rejected by Lord Justice Thorpe, who observed irresponsibly that cases involving older children after their parents had separated could be avoided if the children were circumcised as infants.
Neither court was willing to bring male circumcision within the ambit of offences against the person under Section 1 of the Children and Young Persons Act 1933; It was important to the courts that circumcision was not an offence and remained a procedure which could be performed by consent; the courts also carefully avoided mention of R v Adesanya, a case about ritual scarification mentioned below, despite apparently important similarities involving associated risks, the irrevocability of the procedures and the fact that an adult might regret what had been done to him as a child.
In 1995, the Law Commission concluded that male circumcision was lawful under English common law, relying on cases such as Brown, Adesanya, Coney, Donovan and A-G’s Reference (No 6 of 80). Only the first two mention male circumcision at all (we discuss them below); the others simply refer to exceptions to the 1861 legislation. The Law Commission argued that the legality of religious circumcision should be placed beyond doubt,
Male circumcision is lawful under English common law. Male circumcision is insisted on by Islamic and Jewish law. It is generally accepted that the removal of the foreskin of the penis has little, if any, effect on a man’s ability to enjoy sexual intercourse, and this act is not, therefore, regarded as a mutilation. The traditional reason for male circumcision appears to have been a hygienic one… Since ritual circumcision is customarily carried out by someone who is not a qualified doctor, the practice of male circumcision would not be protected by a purely medical exemption.
Following Freedom of Information requests by the political party Justice for Men and Boys, neither the Home Office nor the Crown Prosecution Service has contradicted this view, but neither have they explained the absence of prosecutions.
In 1996, the British Medical Association observed that the assumption religious circumcision was lawful had never been challenged in the courts; it recommended obtaining the written consent of both parents.
Others argue that outlawing male circumcision would interfere with the Article 9 religious rights of Jewish and Muslim parents. In a Guardian Article, Adam Wagner made this point, declaring that the comparison with FGM is “flawed”, though he didn’t offer an explanation. In a subsequent article, Wagner maintained that there was insufficient evidence for a ban “in relation to the costs and benefits of the practice”; there was insufficient evidence, he said, of harm. It should be noted that Wagner is an orthodox Jew. Children have rights, however, independent of their parents, and they cannot be over-ridden by their parents’ rights.
In 2012, in Germany, the Cologne Regional Court ruled that religious male circumcision amounted to bodily injury. The Muslim doctor who was prosecuted for circumcising a 4-year-old was acquitted on the grounds that a scalpel was not a dangerous weapon in medically trained hands and the fact that he had mistaken the law was unavoidable as the law was unclear.
Germany’s 200,000 Jews and 4 million Muslims were outraged by the perceived affront to basic religious and human rights; Roman Catholic and Anglican church leaders also joined in the condemnation. The German ambassador to Israel hastily reassured Jews that the ruling was local and did not apply nationally, Angela Merkel’s government sought a way out of the embarrassment. Her spokesman, Steffan Seibert, made a statement that the performance of circumcision was a religious right. In July, the Bundestag passed a non-binding resolution for clarifying legislation. Eventually, a law was passed (by 434 votes to 100) permitting non-medical circumcision provided certain conditions were met.
Campaigners in the UK fear that careless campaigning here could trigger similar legislation, which would be the worst possible outcome.
In Sweden, where circumcision is alien to the native population, a law was enacted in 2001 permitting circumcisions to be carried out only by trained medical personnel in clinical conditions and under anaesthetic. Predictably, Jews and Muslims protested, with the World Jewish Congress melodramatically calling it “the first legal restriction on Jewish religious practice in Europe since the Nazi era”. The requirement for anaesthetic caused particular ire because native Swedes are reluctant to assist in the procedure. Five years later, a US report noted that 3,000 Muslim and 40 to 50 Jewish boys a year were still being circumcised, mostly by unqualified and uncertificated practitioners. Rather than make the practice unacceptable, the law had pushed it underground: another profoundly undesirable consequence of ill-considered legislation.
In Denmark, 87% of the population oppose the non-therapeutic circumcision of boys, while Denmark’s 29,000 doctors have declared the procedure unethical and incompatible with the Hippocratic oath to do no harm.
Other ritualistic mutilations of children are outlawed by English law: there is no cultural or religious defence. Thus, in R v Adesanya in 1983, a Nigerian member of the Yoruba people, resident in Tottenham, North London, was convicted at the Central Criminal Court under the 1861 Act of assault occasioning actual bodily harm for having made incisions with a razor in the cheeks of her two sons, aged 14 and 9 respectively, in accordance with the customs of her tribe. She received a suspended sentence. The judge insisted there was a distinction between this assault and male circumcision on the grounds that the razor on the face posed a greater danger.
In another case, R v Zaidi, a devout Muslim father had allowed his sons, aged 15 and 13, to flagellate themselves as part of a ritual; his appeal against the conviction failed,
 … the Appellant had let his sons take part against the advice of the Mosque Elders. Still he failed to understand the approach of the law or to accept any culpability. The judge accepted that his behaviour was likely to have been affected by fervent religious belief and desire to participate in the ritual. Albeit the boys were not forced to take part, the law protected them from themselves.
It is the medical benefits of circumcision, though contentious and at best limited, which are held by the law to counter the risks, which are viewed as minor. It is thus considered necessary to lay to rest the myths of medical benefit and to make clearer the risks and irrevocable consequences. The experiences of Germany and Sweden, however, suggest that the real obstacle – especially in a country with a growing Muslim population – is the fear of offending religious groups, and that the medical argument is just a smoke-screen.
The barrister James Chegwidden has argued that male circumcision does constitute a crime under existing UK law; this is comparable to the position taken by Lord Hailsham in reference to female circumcision. Male circumcision is manifestly contrary to the Offences Against the Person Act 1861 and the Children and Young Persons Act 1933; it is contrary to a strong common law principle which holds as inviolate a person’s bodily integrity, establishes it independently of his parent’s rights, and confirms that it cannot be overturned by religious considerations.
Against that is a series of cases in which judges have stated without argument or evidence that male circumcision is lawful.
The case of R v Brown involved a group of sado-masochists who were convicted of “unlawful and malicious wounding” and “assault occasioning actual bodily harm”. The Court concluded that even consensual sado-masochistic homosexual encounters which occasioned actual bodily harm to the victim still constituted assaults, and were thus contrary to s.47 of the 1861 Act, and constituted unlawful wounding, contrary to s.20 of that Act. If an act is unlawful, it cannot be rendered lawful because the person to whom it is done consents: no one can give another license to commit a crime.
In a remark which was obiter dicta and possibly per incuriam, Lord Templeman then chose to exclude from the ambit of the Act tattooing, ear-piercing, violent sports and ritual circumcision. This was merely his opinion, without legal justification, but it has helped to establish ritual circumcision since as a lawful procedure. Tattooing a child under the age of 18 is illegal in the UK, but cutting flesh from a baby’s penis without anaesthetic or medical competence is not specifically prohibited by the law and is wholly unregulated.
Re J in 1999 established the legal position that circumcision is one of the decisions which requires the consent of both parents, and especially the mother’s where the father does not have parental responsibility. Where the parents cannot agree, the matter must be decided by a court. Circumcision was not medically indicated and free neither from pain nor from risk.
In SS (Malaysia) v Secretary of State for the Home Department, Lord Justice Moore-Bick expressed his view that male circumcision—
is usually, though not invariably, carried out at a very young age when the child is unable to understand what is involved or to express any view about it. Although invasive in nature and not commanding universal approval, it is regarded as an acceptable practice among communities of all kinds, provided it is carried out under appropriate conditions.
He repeated the commonplace dogma that “It cannot be compared to other cultural or religious practices, such as female genital mutilation, which involve a far more serious violation of the physical integrity of the body and an expression of subservience”, and referenced Baroness Hale’s observations in K v Secretary of State for the Home Department, which we discuss below.
In Re B and G, a local authority sought to take two children (a boy and a girl) into care on the grounds that the girl had been illegally circumcised. The LA failed to prove its case, and the evidence of the expert witness Dr Momoh MBE was dismissed as “remarkably shoddy” and “exceedingly unsatisfactory”. The irony was that the degree of FGM alleged in this case, had it been proved, would have been relatively minor and, on the scale of severity, some way below that of a typical male circumcision. The boy would, in due course, have been circumcised, but there was no suggestion by the LA that this would have resulted in an application, and yet, had the far less traumatic injury to his sister been proved, he, too, would have been taken into care, despite the total absence of any risk to him.
Lord Justice Munby began his judgment by highlighting this profound legal anomaly, but then sought to rationalise it. The question he had to answer was how FGM – in any form – transgressed the “significant harm” threshold established by Section 31 of the Children Act 1989 while male circumcision did not. Munby went so far as to accept that “In my judgment, if FGM Type IV amounts to significant harm, as in my judgment it does, then the same must be so of male circumcision.” So far, so good.
To cross the threshold, however, significant harm must be accompanied by care of the child “not being what it would be reasonable to expect a parent to give”; this gave Munby his opportunity to establish clear water between the two practices. There is no claimed medical justification or benefit for FGM, so it can never be part of reasonable parenting; MGM, however, is tolerated by society and the law and claimed by some people to confer medical benefits, so it can be consistent with reasonable parenting.
This, for Munby, established a “very clear distinction” between the two customs.
Munby is wrong, however, on both counts. He believes that only the circumcision of boys is demanded by religion but, as we have seen, some Islamic traditions require it. He believes, too, that only male circumcision is claimed to have medical benefits, but similar claims are made for female genital mutilation. Dr Haamid al-Ghawaabi, for example, says,
The secretions of the labia minora accumulate in uncircumcised women and turn rancid, so they develop an unpleasant odour which may lead to infections of the vagina or urethra. I have seen many cases of sickness caused by the lack of circumcision.
Circumcision reduces excessive sensitivity of the clitoris which may cause it to increase in size to 3 centimeters when aroused, which is very annoying to the husband, especially at the time of intercourse.
Another benefit of circumcision is that it prevents stimulation of the clitoris which makes it grow large in such a manner that it causes pain.
Easily dismissed medieval twaddle, perhaps, but no more so than many of the claims made of male circumcision. But watch what happens when researchers stumble over some genuine medical benefit of FGM. Do they promote it, as they would for male circumcision, and use it to argue for more mutilations? Inconveniently, two studies have shown that women who have undergone FGM have a significantly reduced risk of HIV infection than those who have not.,  Embarrassed and apologetic, the researchers have sought to find an alternative explanation for their findings, concluding it is due to “irreducible confounding”. Even if the correlation is true, it can never justify an abhorrent practice.
If it is not compatible with reasonable parenting to subject a girl to genital mutilation, however sincerely the parents believe it is demanded by their religion, or that it has therapeutic value, then male genital mutilation cannot be compatible with reasonable parenting either. Munby cannot have it both ways, merely based on the sex of the victim.
The usual argument against making male circumcision illegal is the same as for abortion: that it would drive parents who insist on the procedure to use unregulated providers where complications and infections would be much more likely. This argument is not used so often with regard to female circumcision, although it was raised in 1985 and quickly dismissed: making the practice socially unacceptable was more urgent.
The campaign for legal reform is further hampered by strong resistance from those who campaign against FGM and insist that the two practices must never be compared. In the debates on the Female Genital Mutilation Bill in 2003, Baroness Rendell emphasised, “FGM is not in any way comparable to the accepted practice of male circumcision”; Anne Clwyd said, “FGM is in no way like male circumcision. It is much more harmful, and there is no medical justification for it”; Baroness Findlay turned it into a specifically feminist issue, “This is a major issue for male education to alter men’s attitudes and to safeguard the lives of girls”. But it wasn’t men who were performing the ritual.
Any mention of MGM in the comments on articles about FGM in the Guardian newspaper will swiftly be removed by the moderator. My purpose in presenting the comparatively low figures of FGM performed on UK soil is not to minimise the barbarity of this practice, nor the effects on the girls concerned, but to demonstrate the huge preoccupation with the issue of FGM compared with the utter disregard for the more than 12,000 boys we know suffer MGM every year and about whom we are probably in a better position actually to do something. Feminists, who place such emphasis on their inalienable right to make decisions about their own bodies, have no respect for boys’ bodily integrity.
This position is difficult to comprehend until you realise that for feminists, female genital mutilation is a specifically feminist matter; this was expressed in 2005 by UNICEF,
In the case of girls and women, the phenomenon is a manifestation of deep-rooted gender inequality that assigns them an inferior position in society and has profound physical and social consequences. This is not the case for male circumcision, which may help to prevent the transmission of HIV/AIDS.
If male circumcision were a real problem it would contradict the feminist position, so it has to be dismissed as medically beneficial. Baroness Hale, the former feminist academic Brenda Hoggett, quoted the UNICEF report with approval in the case Secretary of State for the Home Department v K,
As can be seen, almost all FGM involves the removal of part or all of the clitoris, the main female sexual organ, equivalent in anatomy and physiology to the male penis.
This is not true either: though Hale wouldn’t necessarily know it, an analogy between the clitoris and foreskin is more apt. It is characteristic of feminism to present female genital mutilation as the equivalent of castration, but this is true only of the most extreme forms.
The underlying purposes of doing this are to lessen the woman’s sexual desire, maintain her chastity and virginity before marriage and her fidelity within it, and possibly to increase male sexual pleasure.
For Hale, FGM is driven by the mythical patriarchy and male desire.
Women themselves are brought up to believe in this as strongly as men. Sometimes, and not surprisingly, women themselves perform the operation as part of an elaborate initiation ceremony… Patriarchal societies have often recruited women to be the instruments of the continued subjection of their sex.
In fact, FGM is usually performed by other women, and the explanation for it, as for male circumcision, is quite other than as Hale imagines.
The existence of male circumcision is a real problem for feminism and conflicts with their narrative; no opportunity is missed to trivialise it, or to present it as beneficial to the unfortunate victims.
Those who write about non-therapeutic male circumcision – as Margaret Somerville, founder and director of the McGill Center for Medicine, Ethics and Law in Montréal, did in 1990 – are condemned for detracting from the greater horror of female circumcision. For these critics, it is necessary to see FGM as a barbaric practice, an expression of male power and domination, inflicting great pain and leading to life-long mutilation and complications, equivalent to castration or penectomy, while male circumcision is dismissed as a minor procedure which is hygienic and beneficial. The feminist narrative is that FGM is carried out at the behest of men, to reduce women’s sexual pleasure, to enable men to control them. The reality is that FGM is performed by women on women – usually by female members of the girl’s family – and this helps to explain the absence of successful prosecutions.
Outlawing FGM has been relatively straightforward: the practice had never taken root in the UK with very few procedures actually being performed here; most women who present with complications were circumcised by tribes such as the Igbo of Nigeria which are easy for campaigners to dismiss as barbarous. It was a cultural rather than a religious practice and banning it has not offended any significant religious groups. It had never moved out of the grimy, unhygienic conditions of the third world into the shiny, sterilised hospitals of the west. It is straightforward to condemn because no one has ever plausibly claimed any medical benefits from it. The campaign to ban it was an integral part of the feminist campaign to end violence against women and girls (VAWA) which receives enormous support from the government and funding from the tax-payer. There is an uncomfortable sense that the legislation has been enabled not because FGM was an abuse of infant girls, but because it was a patriarchal crime against the sisterhood.
The move to put an end to male genital mutilation enjoys none of these advantages. Male circumcision has long been established in the UK within an influential Jewish community, amongst many Roman Catholics and some Anglicans, and amongst the upper classes, including the Royal Family; it is respected as a traditional cultural practice and protected as a religious one. It is likely that a substantial minority of the judiciary and of both houses of parliament have been circumcised and have circumcised their sons. The myth of medical benefit has allowed circumcision to be performed in clinical conditions and provides its continuation even if the ritual practice were to be banned. Feminism has ensured that while a woman’s or girl’s genitalia are sacrosanct and ever vulnerable to male abuse, a man’s or boy’s are the target of comedy and ridicule; their loss is of no consequence.
Male circumcision is child abuse. It really is as simple as that. It is sexual, physical and psychological abuse. It is a breach of the child’s human rights, a violation of his body, discrimination on the grounds of his sex. It is a breach of both national and international law. It is horribly painful, permanently disfiguring and disabling. It is the sacrifice by others to their god of that which it is not theirs to give. It has no place in our society.
In a brief submitted to the Law Commission, solicitor Christopher Price wrote,
Rejoicing, rightly, in our being a multi-cultural society does not… mean that we should be blind to practices, whatever their source and motive, which are themselves abusive and discriminatory of others, and which directly and inevitably diminish the freedoms, the human rights, the integrity and the dignity of others.
What Baroness Rendell said in the 2003 debate on the Female Genital Mutilation Bill applies no less to male genital mutilation,
There is now much greater awareness of the practice of FGM and people are perhaps less inclined to believe that cultural beliefs are sacrosanct. We must of course respect other cultures and traditions, but that does not mean accepting the unacceptable. FGM is a brutal practice. It cannot be supported on cultural, medical or other grounds.
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