Critiquing circumcision: in search of a new paradigm for conceptualizing genital modification

Abstract

In this article, I advance two separate but related critiques of current approaches to classifying and analyzing culturally, socially, and medically motivated genital modifications: first that the widely employed categories of female circumcision and male circumcision separate these practices in gendered terms that are inconsistent with both the reality of these practices and fundamental social scientific principles, and second that the practice of neonatal male circumcision that emerged from Anglophone medical practice to become an entrenched social norm in the United States merits a critical evaluation beyond that which it has heretofore been subjected. These critiques lead me to propose an alternative approach to the conceptual classification of genital modification practices, one in which the extent of the modification, the meanings of the practice to those involved, whether it is motivated by a group or individual desire, and the developmental stage of the individual form a framework for analysis, rather than the geographically and gender-based approaches that have resulted in the profoundly ethnocentric exceptionalism that characterizes most current research, writing, and activism on the matter. The differential attention paid to male and female circumcision fails to reflect the cultural sensibilities of those whose practices are in question and creates a de facto exceptionalism by which US practices are exempted from the same scrutiny afforded by others. I address specifically the gendered approach to African circumcision practices, including the recent attention that male circumcision has received as a potential anti-HIV intervention, and I argue the need for a much more vigorously critical scholarly attention to US circumcision practices. My approach is influenced by critical medical anthropology, which frames its inquiries around a focus on the human body and which does not accept biomedical knowledge as factual a priori, but rather seeks to contextualize it within the socially and culturally relevant system of knowledge that has produced it. I draw also on the history of circumcision, campaigns for both its promulgation and elimination, and my own ethnographic work with US parents on how they make the decision whether to circumcise their newborn sons.

Genital Cutting as Gender Oppression: Time to Revisit the WHO Paradigm

“…This appears to be the case, for example, in many Muslim communities throughout South and Southeast Asia, where religiously-inspired circumcision (i.e., cutting of the genital prepuce; see Box 2) is a gender-inclusive rite, where both forms have been largely medicalized, and where the female form is often less physically substantial than the male form (Rashid et al, 2010;Rogers, 2016;Bhalla, 2017;DBWRF, 2017;Bootwala, 2019;Rashid and Iguchi, 2019;Wahlberg et al, 2019;Dawson et al, 2020;O'Neill et al, 2020;Shweder, 2022aShweder, ,b, 2023. 9 In short, the harms of genital cutting vary widely, both within and between cultures, and they do so in a way that is not reliably predicted by the sex of the affected child (Androus, 2013). That FGC in Global South settings can be medically dangerous, and sometimes deadly, is well-documented and commonly known (Obermeyer, 1999(Obermeyer, , 2003(Obermeyer, , 2005WHO, 2008;Berg and Denison, 2012;Berg and Underland, 2013;Berg et al, 2014).…”

“…Scientifically, the tendency is questionable because in many countries at least two, and sometimes all three, forms of cutting are carried out together within the same cultural contexts or institutions; in these cases, the practices are often tightly symbolically linked, serving complementary or mutually reinforcing social functions. These functions-for example, maintaining gendered social divisions and associated power hierarchies-cannot adequately be understood, much less appropriately addressed, by studying each practice in isolation (Caldwell et al, 1997;Junos, 1998;Toubia, 1999;Lightfoot-Klein et al, 2000;Abu-Sahlieh, 2001;Knight, 2001;Robertson and James, 2002;Boddy, 2007;Merli, 2008Merli, , 2010Fox and Thomson, 2009;Androus, 2013;Reis, 2013;Svoboda, 2013;Ahmadu, 2016a;Prazak, 2017;Johnsdotter, 2018;Earp, 2020a).…”

“…Legally, the tendency is questionable because it may lead to discriminatory treatment of different persons or groups based on constitutionally forbidden criteria, such as sex, gender, race, religion, ethnicity, or national origin (Coleman, 1998;Bond, 1999;Price, 1999;Davis, 2001;Mason, 2001;Somerville, 2004;Dustin, 2010;Johnsdotter and Essén, 2010;Askola, 2011;Adler, 2012;Merkel and Putzke, 2013;Fusaschi, 2015;Arora and Jacobs, 2016;Rogers, 2016Rogers, , 2022Svoboda et al, 2016;La Barbera, 2017;Shahvisi, 2017;Munzer, 2018;Notini and Earp, 2018;Pardy et al, 2019;Möller, 2020;Carpenter, 2021;Ahmadu and Kamau, 2022;Bootwala, 2022;Earp, 2022a;Rosman, 2022;Shweder, 2022b). And ethically, the tendency is questionable because, in practice, it privileges the customs of more powerful stakeholders (Gunning, 1991;Lewis, 1995;Obiora, 1996;Tangwa, 1999Tangwa, , 2004Toubia, 1999;Androus, 2004Androus, , 2013Chambers, 2004;Njambi, 2004;Bell, 2005;…”

Comparative Politics of Circumcision Bans in Western Europe: A Causal Narrative

“…German court's controversial decision on 7 May 2012 led to a slew of publications, which, although specifically motivated by the Cologne decision and its aftermath, allowed scholars to (re)articulate their positions in opposition to or in favor of the prohibition of infant males' circumcision in general (Androus 2013;Banai 2013;Levey 2013;Shweder 2013;Van Howe 2013). The overwhelming majority of the works on male circumcision, including arguments both in favor and against, remain within the legal and medical scholarship.…”

Child genital cutting and surgery across cultures, sex, and gender. Part 1: female, male, intersex—and trans? The difficulty of drawing distinctions

“…We are proud to introduce this special collection of papers on child genital alteration practices spanning the Global North and South and transcending conventional boundaries of sex and gender. It is increasingly recognized that there is an urgent need to evaluate all forms of genital cutting or surgery, especially those carried out on presumptively pre-autonomous persons, in a systematic way [1][2][3][4][5][6][7]. It is necessary both to clarify what is known about these practices medically and scientifically, but also to work through the cultural, legal, and ethical implications of performing such significant operations on persons who are generally presumed to be incapable of providing morally valid consent to them on their own behalf.…”