Rejecting Majority Rule in Favor of Majority Rule

There is simply too much pro-infant circumcision talk within The Washington Post’s opinion sections recently to adequately address everything flawed within its pages. Instead, some quick hits.

From Dr. Mohammad A. Khalid:

In my opinion as a doctor, male circumcision should not be banned, and should not be in any way equated with female genital cutting (FGC).

He’s making a legal argument based on his medical degree. That is a logical fallacy The Washington Post shouldn’t have enabled. We don’t legally allow parents to cut their daughters’ genitals if that cutting will leave a “minor”, non-permanent wound. Legally, we know it is a violation of the child’s constitutionally-protected rights. The medical argument within the legal argument is settled once we approach the initial diagnosis of the child that any genital cutting would be non-therapeutic. Legally, there is no justifiable distinction to be made. That is the issue involved.

Later:

[FGC] is a violent procedure, often done in a primitive, non-medical setting and is mostly accomplished with crude instruments and performed without anesthesia.

Male genital cutting (MGC) is a violent procedure. That comparison works. The rest of the second paragraph doesn’t, but it proves nothing. No one would support FGC if parents have it performed in a modern medical setting with proper surgical tools and anesthetic. They shouldn’t, of course, because it’s wrong whenever it’s non-therapeutic and forced. But the principle is the same, regardless of gender: non-therapeutic genital cutting on a non-consenting individual is wrong. In this core, logical respect, Dr. Khalid is wrong. MGC equals FGC.

Next, from Dr. Aseem Shukla:

The data is mixed, there is no wrong or right answer. Families deal with the nebulous every day and make a decision that is right for their children. But to me, the inanity over the circumcision debate lies also in its ignorance of medical realities. If a child has had recurrent urinary tract infections or a lower urinary tract anomaly, circumcision can protect the child from the risk of renal damage by nearly 10 to 15 fold. If a child has a hypospadias, an anomaly where the urethral opening opens along the shaft of the penis rather than at the tip, then I will use the foreskin to reconstruct the urethra, and a circumcision results. And while my clinic is full of children, also, with partially done circumcisions, adhesions that have formed, and urethral openings that have narrowed after circumcision requiring additional surgery and health care dollars, my clinic is just as full of children with foreskin that is painfully infected, scarred with lichen sclerosis, ballooning, torn and tight that may necessitate a circumcision.. [sic]

Dr. Shukla is a voice of ignorance here regarding medical realities. If a child has recurrent UTIs, circumcision may be medically necessary. If a child has a hypospadias, circumcision may be medically necessary. The question is not “Should we treat patients who have medical needs”, but “Should we treat children who have no medical need?”. The issue at stake is non-therapeutic circumcision. Unless we start making a “logical” case for non-therapeutic appendectomy, cholecystectomy, or any other intervention that might solve some future problem, society abuses logic in defending non-therapeutic male circumcision. Even female genital cutting could be justified on the confusion Dr. Shukla creates by muddying the obvious distinction between therapeutic and non-therapeutic.

[As an aside, is it possible that some of the problems for the intact children he cites are created by premature, forced retraction of the normal foreskin by parents and/or pediatricians?]

Sticking with Dr. Shukla, he is arguing against a proposed prohibition that is not up for consideration:

… Any type of blanket ban on a circumcision until the age of consent so ignores the real medical necessities of circumcision in some cases, that the concept is beyond contemplation; it is medically irresponsible and dangerous.

The proposed law is not a “blanket ban on a circumcision until the age of consent”. It would prohibit non-therapeutic circumcision until the age of consent. Healthy children do not need surgery. Thus, it shouldn’t be imposed, even if that surgery might reduce the risk of some malady later. The only stance here that is medically irresponsible is Dr. Shukla’s. Until he reads the proposed law, he shouldn’t pontificate on his factual errors.

Next, from Charles C. Haynes, Director of the Religious Freedom Education Project:

The anti-circumcision referendum is both wrong and dangerous because it subjects religious freedom to a popular vote. As Justice Robert Jackson wrote in West Virginia v. Barnette (1943):

“One’s right to life, liberty, and property, to free speech, a free press, freedom of worship and assembly, and other fundamental rights may not be submitted to a vote; they depend on the outcome of no elections.”

Each healthy male child’s bodily integrity – his life, liberty, and property, as well as other fundamental rights – is submitted to a vote by his parents. If they vote “yes”, his rights are violated. Why should it be better that the vote belongs to his parents rather those who would protect his right to choose “yes” or “no” for himself? He is an equal individual, allegedly with the same liberty interests that his sisters have. Yet, his sisters are protected by law, regardless of parental wish. The use of an election here is because legislatures and courts are not doing their job to protect those rights equally for all citizens. The flaw is in the reason this method is necessary, not the method itself.

Of course, opponents of circumcision – who call themselves “intactivists” – are free to make their argument against a medical procedure they consider “male genital mutilation.” But what they should not be free to do is criminalize a religious ritual that medical authorities generally agree is not harmful.

It is harmful. It removes healthy, normal tissue and nerves. It leaves a wound that results in a scar. The only debate over whether circumcision is harmful is carried out by people who believe that subjective preferences are universal, and anyone who does not share one’s opinion is somehow misguided or uninformed. We don’t have to look for the examples of circumcision complications, including death, to understand the obvious truth that all surgery inflicts harm. Legally and medically.

As for Mr. Haynes’ implied rejection that male circumcision qualifies as genital mutilation, the World Health Organization defines female genital mutilation as follows (emphasis added): “Female genital mutilation (FGM) comprises all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons.” In other words, any surgical intervention less damaging than male circumcision, inflicted on females for the exact reasons we cite for male circumcision, would still qualify as genital mutilation. To avoid confusion, any reason for circumcising a healthy male child is non-medical. If we are to pretend that chasing potential benefits counts as a medical reason for surgery, then parents may impose any intervention they wish, unrestrained by society. We reject that, correctly, since children have rights. The only viable conclusion is that societal deference to non-therapeutic child circumcision is mistaken and should be corrected.

As a society we’re establishing that “one’s right to life, liberty, and property, to free speech, a free press, freedom of worship and assembly, and other fundamental rights may not be submitted to a vote,” unless one is a male minor. That’s what all of these individuals advocates, albeit ignorantly. They argue for a viewpoint where male children do not possess the same rights as everyone else in society, because society’s opinion is the correct norm to which male children must conform forever, if demanded by their parents. That is wrong. Each of these advocates – Dr. Mohammad A. Khalid, Dr. Aseem Shukla, and Charles C. Haynes – is wrong on non-therapeutic male circumcision.
Charles