Category: Parenting

Flawed Circumcision Defense: Yair Rosenberg, Part 2

In response to the AAP’s pending release of its revised policy statement on non-therapeutic male child circumcision, Yair Rosenberg repeats the mistakes in his prior analysis. He perpetuates appeals to authority, omits relevant information, and ignores inconvenient facts. One might even say he’s being obscurantist.

This isn’t just an issue of religious freedom—it’s a basic question of public health. That’s because according to the National Institutes of Health and the World Health Organization, among others, circumcision is one of the global health community’s best HIV prevention techniques. As Eric Goosby, the U.S. AIDS coordinator, has said, “Male circumcision is a highly significant, lifetime intervention. It is the gift that keeps on giving. It makes sense to put extraordinary resources into it.” To that end, anti-AIDS organizations are partnering to circumcise 20 million African men by 2015. …

Until now, the scientific consensus surrounding circumcision has driven policy in Africa, but not the United States. Today, that changes.

Individual humans make up “public health”. What is – and is not – acceptable to do to individual bodies in the name of public health is the question of ethics that Rosenberg, Goosby, the AAP, and every other circumcision advocate ignores. This is especially true because circumcision is not the least invasive or the most effective method available for reducing HIV (or any other) risk. It’s also still not particularly useful in contexts outside of parts of Africa. As I wrote in my prior post, the risk reduction is in female-to-male HIV transmission in high-risk populations. That isn’t compelling within the scope of the AAP’s focus. Context matters. Obscurantist journalists ignore that.

The importance of this [updated policy] cannot be overstated. …

It can be. Rosenberg’s post is proof.

… The AAP is a driving force behind health policy in America, and the experts involved in its new statement are already going on record in major media outlets to advocate that circumcision be covered on public health plans like Medicaid. The statement solidifies the scientific consensus behind the advisability of infant male circumcision (noting that complications are more likely to arise when the procedure is performed later in life) and places the traditional practice squarely within the realm of sound medical science.

This is only true if ethical considerations are not a part of sound medical science. It’s fine if Rosenberg or others do not wish for ethics to be applied to their own bodies. But not everyone shares that odd, limited view. Some of us appreciate the basic concept of human rights, including those of physical integrity and self-determination, and wish they had been applied to us. It’s too late for too many males, but there is never a bad time to stop violating human rights.

Also, the question of possible benefits and their applicability to any particular individual is separate from the public policy question of paying for non-therapeutic surgical interventions on non-consenting individuals. Non-therapeutic infant circumcision is an irresponsible use of funds in pursuit of subjective goals via unethical means. There is nothing good about it, regardless of how “prestigious” an organization promoting the idea is irrationally perceived to be. An organization that advocates violating human rights deserves no prestige.

This is not just good news for the United States, where obscurantist anti-circumcision groups have sought to completely ban this medically beneficial practice rather than allow families to choose whether to perform it. …

Rosenberg’s prior essay was obscurantist propaganda. Unlike his writing, I’ve acknowledged the arguments offered in favor of circumcision. I’ve explained why they’re inferior in the debate as it pertains to individuals. Mr. Rosenberg has not done the same. Instead, he offers condescending evasions:

… It’s also a powerful rebuttal to the flawed reasoning of the German court in Cologne, which ruled that circumcision generally constitutes “bodily harm,” yet made allowances for circumcisions performed for “medical reasons.” Thanks to the AAP, we can now state that all circumcisions are medically beneficial. …

The German court in Cologne ruled that non-therapeutic circumcision on non-consenting children violates their rights to physical integrity and self-determination. There is no flaw in that expression of basic human rights. The are the same rights that form the basis for prohibitions on FGC/M.

The court’s finding that circumcision constitutes bodily harm, no quotes, is consistent with permitting circumcision for medical need. The existence of a problem necessitates considering interventions. Ethically proxy consent will choose the least invasive, most effective solution. That is rarely circumcision when there is a need. But where it is necessary, the goal is an objective net benefit, that the surgery will remedy the problem. The outcome is presumed to outweigh the harm imposed to achieve it. The key is the outcome can be measured immediately and directly. Is the malady resolved?

With non-therapeutic circumcision, there is no objective net benefit because there is no malady. There is only objective harm for subjective benefits. The subjective benefits may not be valued or desired by the individual. In that case it’s objective harm to the individual for the subjective preferences of another. That is unethical. Because surgery on children involves proxy consent, medical need is required. The court was correct and consistent. The AAP is incorrect and encouraging unethical rights violations.

So, can we really state that all circumcisions are medically beneficial? Including the ones where the boy suffers a complication? If he loses his glans, is he still benefited? What about his entire penis? What about the thankfully rare instances where the boy loses his life? At least the benefits accrued over his short lifetime? Since all of these scenarios happen, even if we ignore my focus on individuals who suffer only the expected harm, isn’t it a bit obscurantist to state that all circumcisions are medically beneficial?

… If German courts continue to prosecute Jews and Muslims for practicing circumcision, then we will know that this animus is rooted not in science or fact, but in ignorance and prejudice.

I won’t say I expected his screed to end with something other than a preemptive ad hominem attack. It’s still pathetic.

Update: Walter Russell Mead uncritically endorses Rosenberg’s flawed post and makes a request:

Hopefully anti-circumcision zealots will take a deep breath and rethink their fevered stance on the issue. Beyond the fact that their bans impinge on the rights of Jews and Muslims to practice their religion as they see fit, they ought to consider that there is legitimate science pointing to the practice being beneficial to infant male health.

The only legitimate science involving infants is on UTIs, and possibly penile cancer. The former are uncommon in intact males in the first year (1%) and almost always easily treatable. The latter is more reasonably associated with other causes, with U.S. rates similar to those in mostly intact Europe. Everything else involves adult volunteers. The possibility of health benefits, or even religious benefits, does not render non-therapeutic circumcision on a child ethical.

No court in the United States endorses a right to practice one’s religion as members “see fit”. There are limits that may be imposed based on constitutional tests. Non-therapeutic child circumcision should fail that test because it is physical harm.

One Unremembered Trauma: Emphasize Trauma, Not Unremembered

Here’s a report from Jezebel on the Johns Hopkins study. It’s maddening.

Personally, I don’t give a care what kind of a penis any grown man currently has, because I am not in the business of telling people what to do with their genitals, or judging whether anyone’s genitals are “right” or “wrong.” That said, if I had a boy-baby, I think I would probably circumcise him (not, like, with my bare hands, but you know), because I can’t imagine one unremembered trauma could be more painful than a lifetime of a nasty, unfair, pervasive stigma. But that’s just me.

Did you catch that? She’s not in the business of telling people what to do with their genitals, except she would probably have her son’s normal genitals permanently altered. That is definitely tell someone exactly what he can’t do with his genitals.

That also reads like judging “right” and “wrong” to me. What someone else might say to her son could direct her to parent with a scalpel. Thinking with assumptions like this – that a parent can’t educate their children that the problem rests with the person who would stigmatize – creates the self-perpetuating cycle that parents “have” to cut to make their sons normal common to protect them from possible ridicule. This is especially ridiculous if we’re honest, because children will find ways to taunt, and about anything. If it’s not genitals, it’s hair color or fashion or ears or pimples or freckles or weight or whatever. We don’t expect parents to surgically alter other aspects of their children to avoid this temporary, not-guaranteed harassment. Normal genitals should be no different. Non-therapeutic genital cutting is an abdication of parental responsibility.

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Post Script: The predictable chaos ensued in the comments, apparently. I didn’t read them because I don’t read comments sections. But it’s obvious since the first comment addresses it. The Jezebel writer, Lindy West, replied:

Hey, screaming people. First of all, male circumcision and female genital mutilation are not equivalent. …

Ms. West is wrong.

(Advocates for genital integrity should not be screaming, literally or figuratively, in comments sections. I wish that didn’t need to be repeated.)

Doctors Aren’t Cultural Actors

I may have more to say on this story about circumcision as “the ultimate parenting dilemma. Understood, it isn’t a dilemma. But we have to deal with reality, not the world we should have. For now, this:

“You are doing a procedure on someone who cannot make a decision for himself – it’s a difficult choice for both parents and physicians,” says Dr Marvin Wang, co-director of the Newborn Nurseries at Massachusetts General Hospital, who has conducted hundreds of circumcisions.

It is, he says, more a “cultural decision” than a medical one, and therefore, for parents to decide, while he advises on the pros and cons.

Wang says most parents come in with fervent beliefs – and what a doctor says makes little difference.

“The bottom line is… they stick to their guns. They choose the pieces of information that bolster their argument and run with that.”

What a doctor says makes little difference. Having conversed with people who support circumcision for irrational reasons, I am not surprised. However, what a doctor does can make all the difference. Or, rather, what a doctor does not do. There is no obligation to participate in non-therapeutic circumcisions on minors. There is an ethical duty to not participate. If doctors refused to perform the surgeries, the numbers would decline. Not to zero, but it would signal a critical truth to parents who intend to make their son’s choice.

Flawed Circumcision Defense: Charlotte Allen

Charlotte Allen has an editorial in today’s Los Angeles Times about circumcision and intactivists. She doesn’t understand either. She begins:

The “intactivists” — anti-circumcision people who are trying to get the practice outlawed in the U.S. and elsewhere — …

This is off to a terrible start. The effort is to prohibit non-therapeutic circumcision on non-consenting individuals. That’s an ethically significant difference. While I suspect she thinks that her words mean what I just wrote, they don’t. Her claim is what’s being repeated, as if this effort is the same as seeking a complete prohibition on religious circumcision for everyone of any age. When arguing against something, the first requirement is to fairly and accurately state the opponent’s position. She fails at that in the first half-sentence.

Intactivism, a movement of the last 20 years or so, got a boost recently when a German judge ruled that non-therapeutic circumcision of children amounted to “bodily harm” and must henceforth be outlawed. …

First: intactivism in its current form has been going on for at least twice as long as she claims. (e.g. Van Lewis)

Re: the court’s ruling. The issue of bodily harm, which is objective, appears only here. She will not directly address this again. She mentions sensitivity, as though that’s the extent of possible harm, and draws an incorrect conclusion by selectively quoting a press release. (More on that in a moment.)

The tagline attached to Ms. Allen’s essay is this:

‘Intactivists’ are trying to get the practice outlawed in the U.S. and elsewhere. But how bad can it be?

There is bodily harm in every circumcision. But to the question, it can be very bad. This bad. Or this bad. Or the worst case scenario. Those are thankfully rare, but they occur. Those males are (or were) individuals with human rights. They are not merely statistics to ignore.

The intactivists like to paint circumcision in lurid colors. The phrase they use to describe it — “male genital mutilation” — evokes the barbaric practice of female genital mutilation. But the two have almost nothing in common. …

Mutilation is an accurate description for non-therapeutic male circumcision without the child’s consent. And it has considerably more in common with female genital mutilation than Allen understands.

She continues:

… Female genital mutilation is invasive and ghastly, and results in long-term health risks for women subjected to it, not to mention the diminution or elimination of the ability to feel sexual pleasure. …

Usually, yes, but that doesn’t justify male circumcision. As I’ve said elsewhere, a punch to the face is not acceptable because a knife to the gut is worse. The difference should be in punishment, not prohibition.

Apart from the valid aspects of the comparison of non-therapeutic genital cutting on a non-consenting individual, male or female, male circumcision is unethical on its own.

Male circumcision involves snipping off about three-eighths of an inch of skin. It hurts, briefly, but so do the shots that babies routinely receive. And according to the World Health Organization, it “reduces the risk of heterosexually acquired HIV infection in men by approximately 60%.”

That three-eighths of an inch of skin will grow into a larger structure if left in place. It also removes the nerve endings within that three-eighths of an inch, and leaves a scar. But with that argument, the clitoral hood, or even the clitoris, is a tiny structure in infants. Does that render it ethical to remove either of these from a healthy infant? She’s offering a ridiculous defense of non-therapeutic genital cutting on a non-consenting individual.

For the HIV statistic, she cites this page. She failed to quote pertinent information beyond the first sentence. She should’ve included the part that says “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.” Not one of those three criteria matches a Western nation. It isn’t compelling. Citing it as a justification for infant circumcision is an empty defense, which is worsened by additional arguments against this reason for circumcising infants. (Anything other than circumcision with the voluntary consent of the individual where those scenarios apply is still unethical.)

The notion that circumcision reduces a man’s sexual sensitivity has little basis in fact. Two medical studies, in 2003 and 2007 — one presented to the American Urological Society and the other published in the Journal of Sexual Medicine — found that circumcised and uncircumcised men experienced the same levels of response to touch and pain during sexual arousal. A press release issued by the 2007 study’s chief researcher, at McGill University in Montreal, stated: “This study suggests that preconceptions of penile sensory differences between circumcised and uncircumcised men may be unfounded.”

Suggests is not a synonym for proves. Allen seems to possess a tendency to consider only what is convenient rather than presenting all facts. This press release from McGill University about that study includes the following caveat:

Payne cautioned that though the study’s results are very promising, they are still preliminary and do not necessarily resolve many of the longstanding controversies surrounding circumcision. “This study only measures one sensation, so it questions the held notions, but it does not refute the idea that there may be some differences at some level. No one can deny the anatomical differences between a circumcised and uncircumcised penis.”

To be fair, it’s possible that the version she read didn’t include that caveat. I’m not sure why a press release from these scientists wouldn’t include such a caveat, but I don’t know what her source is. However, a simple bit of thinking reveals the inherent flaw in drawing such a broad conclusion from research like this. This basic fact can be confirmed by reading the study itself:

… It is possible that the uncircumcised penis is more sensitive due to the presence of additional sensory receptors on the prepuce and frenulum, but this cannot be compared with the absence of such structures in the circumcised penis. …

To state the obvious: the foreskin is removed during circumcision. Comparing that in circumcised men is impossible. The study does not demonstrate what Allen claims it demonstrates.

It’s obvious that Allen has not considered anything beyond her limited understanding of circumcision. At best, she presents lazy thinking with minimal research. Or worse, she started with her conclusion and created a fortress around her mind to protect myths and block facts. Whatever the reason, she is wrong. Her defense of non-therapeutic circumcision on children is pathetic.

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Post Script: Unsurprisingly, more errors exist in Allen’s analysis. I included them in the original version of this post. I deleted them because they weren’t egregious in the way the above excerpts are. I’ll include one bit in the comments. The above is what I think should be the critical argument against her propaganda.

Flawed Circumcision Defense: Wesley J. Smith

The Norwegian ombudsman for children’s rights recently stated about ritual circumcision:

[Pediatrician] Dr. Anne Lindboe told the newspaper Vart Land last month that circumcision in boys was a violation of a person’s right to decide over his own body. “Muslim and Jewish children are entitled to the same protection as all other children,“ she said. She added that the practice caused unnecessary pain and was medically unbeneficial.
…

The children’s ombudsman is an independent governmental institution entrusted with safeguarding the rights of minors.

Yes. Her statement is similar to the ruling from Cologne that non-therapeutic child circumcision violates the child’s rights to bodily integrity and self-determination.

That logical statement is meeting resistance. Over at Secondhand Smoke, which claims to be a “24/7 Seminar on Bioethics and the Importance of Being Human”, Wesley Smith revealed that he doesn’t much understand how non-therapeutic circumcision involves bioethics¹ or that having a normal anatomical body part is part of being human. In response to Dr. Lindboe, he wrote:

First, circumcision after the start of puberty is far more risky and complicated than infant circumcision. …

Perhaps. It’s also unlikely to be necessary later. The real consideration is between guaranteed pain and harm from the unnecessary surgery on an infant and it being riskier and more complicated as an adult in the unlikely event it’s needed. If a male chooses non-therapeutic circumcision, ritual or not, as an adult, he is expressing that he values the possible benefits more than the risks. Consent is the issue. (There are also advantages to waiting, such as not needing to forcibly separate the foreskin from the glans and having a larger penis to better measure how much skin to remove.)

He continues:

… But more fundamentally, religious liberty is one of the world’s most important freedoms. …

Yes, but there are other freedoms, such as the rights to bodily integrity and self-determination. They’re also important. And children possess their own individual right to religious freedom.

… For you secularists who don’t care, it seems to me that means that you only care about liberties you want for yourselves–which isn’t freedom at all.

First, that’s ad hominem. Second, he’s wrong. It’s possible to care about many freedoms at the same time, and for all people equally, including children. It’s possible for secularists to care about religious liberty possessed by parents while recognizing the ethical flaws inherent in non-therapeutic child circumcision that place the surgery outside the scope of individual religious liberty for parents.

The attack he perceives is misunderstood. (See also.) An attack on religious freedom would require an effort to prohibit religious circumcision, full stop. The current facts have been presented that way, which is incorrect (for whatever reason that misrepresentation occurs). The effort here is to prohibit non-therapeutic circumcision on a child who can’t consent. It aims to leave each child with his choice. He retains his right to have himself circumcised for religious (and/or non-religious) reasons. He may exercise his freedom of religion rather than having it exercised for him by his parents.

This necessary change will require religion to accommodate a different understanding of religion’s interaction with individual civil rights. That can and should be debated. As evidenced by Mr. Smith’s words, he hasn’t engaged that debate yet.

But if we believe that religious liberty is fundamental–it is, after all, a core part of the Universal Declaration on Human rights–then Jews and Muslims have a right to circumcise their children. [ed. note: males only?] Indeed, it is a religious imperative. …

It’s consistent to believe that religious liberty is fundamental and that no one has a right to circumcise their healthy children. It may be an imperative, but that alone grants no right.

Here is another core part of the Universal Declaration of Human Rights (emphasis added):

Article 1.

  • All human beings are born free and equal in dignity and rights. They are endowed with reason and conscience and should act towards one another in a spirit of brotherhood.

Article 2.

  • Everyone is entitled to all the rights and freedoms set forth in this Declaration, without distinction of any kind, such as race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status. Furthermore, no distinction shall be made on the basis of the political, jurisdictional or international status of the country or territory to which a person belongs, whether it be independent, trust, non-self-governing or under any other limitation of sovereignty.

Article 3.

  • Everyone has the right to life, liberty and security of person.

Mr. Smith writes as if other rights aren’t implicated by the exercise of religious freedom. The rights expressed earlier, and clearly, in the Universal Declaration of Human Rights are strikingly similar to those expressed by the District Court of Cologne and Dr. Anne Lindboe. It is clear that he is wrong rather than those with whom he disagrees.

To close he cites this essay by David P. Goldman, which deserves a post of its own rather than an analysis here. After the excerpt, Smith writes:

It doesn’t matter whether the Norway ombudsman or any of us agree. Circumcision is a sacred duty for Jews, a rite that brings the infant into the community. I assume the same is true for Muslims. In the name of freedom, government must leave it alone.

In the name of freedom, a legitimate government must protect the rights of all citizens equally. Because non-therapeutic child circumcision violates various rights of the child and inflicts permanent physical harm in every instance, prohibition is the only means to promote individual freedom. That is the proper role of government.

¹ The issue is more complicated than parental intent or imperative because there are competing rights. It’s further complicated because very few advocates of circumcision acknowledge what the surgery does to the (healthy) child.

Procedures that Intentionally Alter or Cause Injury

In Reverse the Approach, I had in mind the numerous blog posts like this I’ve encountered:

In this installment of things that should not be compared as equal, we’ll discuss how female circumcision is not the same as male circumcision. …

There’s the subtle difference I discussed. When I make the comparison, it’s to compare male circumcision to female genital cutting. That method allows for the relevant comparison, as well as the opportunity to discuss how the comparison is limited. Trying to compare FGC/M to male circumcision hinders the goal, which should be an accurate analysis of male circumcision. Society has already assessed the ethics against FGC/M. No one wants to re-open or challenge that when using the valid, limited comparison of the two interventions.

The blogger, Lindsay Marie, finishes her introduction with more fence-sitting than her post demonstrates before moving into the comparison:

How they’re similar:
For one, they’re both called circumcision (this isn’t entirely accurate… I’ll get to that in a bit). For another, both involve cutting off a part of the person’s genitals.

Basically, yes. I wouldn’t start with the name, though. It’s semantically inaccurate for females, but it’s hardly a point to compare the two acts. They can both be mutilation while calling one mutilation and the other anything else. A consensus on nomenclature tells us something without proving anything on its own.

I would start with the principle, which she gets almost complete. Non-therapeutic genital cutting on a non-consenting individual is more accurate for what we’re describing. That applies to both females and males. There is no reasonable way to make a gendered distinction on that principle. The distinctions, which exist in practice, are relevant to punishment rather than prohibition.

She incorrectly moves on to differences at this point. As I argued, I think this results from comparing female genital cutting to male circumcision. It’s too easy to start with the most common forms, which are unfortunately also the more extreme forms. Again, that matters, but for the comparison, the validity of state intervention on male circumcision is the question for the comparison. Is there a comparison to be made between male circumcision and what the state prohibits with respect to female genital cutting? There is.

(a) Except as provided in subsection (b), whoever knowingly circumcises, excises, or infibulates the whole or any part of the labia majora or labia minora or clitoris of another person who has not attained the age of 18 years …

Any cutting, even that equal to (i.e. hoodectomy) or less destructive than male circumcision, is illegal. Those forms exist, although they are not the common forms. They are illegal. The comparison works on that limited scale, and points to other legal questions about the right to physical integrity and equal protection.

There’s also the comparison based on the WHO fact sheet for FGM (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.
…

… It is nearly always carried out on minors and is a violation of the rights of children. The practice also violates a person’s rights to health, security and physical integrity, the right to be free from torture and cruel, inhuman or degrading treatment, and the right to life when the procedure results in death.

There is no reason to exclude males from that protection of rights, even though FGC/M is almost always more physically damaging, and to a significant degree. Males suffer injury in every case, and worse in some cases, including extremes such as amputation and death. The implicated rights are the same.

There are differences, of course. I’ve acknowledged them here, to some extent, but I’ll reiterate that most female genital cutting is more extensive, with more extreme and lasting consequences. It is evil and should be eradicated as much as possible.

With that stated, she continues (language warning):

How they’re different:
In every other fucking way. Male circumcision is practiced widely in developed countries as a way of preventing specific health issues in both men and women. Male circumcision is usually performed by a trained professional (almost always a doctor, but some religious parents ask a trained Rabbi to perform the procedure) in a sterile medical setting with the latest tools and effective healing techniques to eliminate infections and reduce pain. Male circumcision is performed on days-old infants who will not remember or even realize what happened and almost always with anesthetics to reduce pain. Pardon the comparison, but breeders clip dog tails at the same age and in a similar way, and zoo keepers clip bird wings at the same age and in a similar way. I don’t agree with clipping dog tails, but if it’s going to happen it might as well happen when they’re too young to realize.

First, I don’t want to put too much emphasis on widely, but it’s confusing. If it should be attached to “as a way of”, which is how I read it upon a second pass, I disagree because most circumcision is cultural. The science is a pretty way of making people feel better about doing something indefensible they wish to do for their own subjective reasons. If widely is meant to describe “in developed countries”, that’s inaccurate. It’s widely practiced in the United States and Israel. It’s been widely practiced at some point in the past in the UK, Australia, and Canada.

To the point, where it is intended as a prophylactic, it is practiced as an attempt to prevent specific, unlikely health issues. Statistics show that most circumcisions in the developed world prevent nothing for most males because most males will not develop a foreskin-related problem. When they do, it’s usually associated with some other corresponding behavior. (e.g. Does he get HIV because he has a foreskin or because he didn’t wear a condom?) People get incorrectly impressed by the relative risk differences between intact and circumcised when the absolute risk of foreskin-related issues is small. Even the most dedicated propagandist, Prof. Brian Morris, only claims that the risk of a foreskin-related issue requiring some form of medical attention (i.e. not just circumcision) within the male’s lifetime is 1 in 2 or 1 in 3, depending on where he’s writing. (I will not provide links to his propaganda. Use Google.) Imposing the most invasive solution on a healthy individual is unethical.

As for the sterile operating theater with modern techniques and equipment, I’m unconvinced. As her post makes clear later, she wouldn’t support female genital cutting conducted in a similar setting. That’s the correct stance, but if it’s not support for one, it isn’t support for the other. As the WHO’s fact sheet states, “more than 18% of all FGM is performed by health care providers, and this trend is increasing.” Defending it for male circumcision will likely lead to further justification from proponents of female genital cutting because they’ve modernized a cultural ritual.

The “he won’t remember it” defense is also not compelling. We wouldn’t be any more convinced that a little female genital cutting would be okay if inflicted on girls too young to remember it. We must judge the act on its own. Would we excuse a punch to the face of a child who won’t remember it? It is unlikely to leave a permanent alteration. Corporal punishment for children even has a biblical basis. At some point, the rights of the individual must matter more than peripheral arguments.

With male circumcision, it’s not “going to happen”, as her defense of “too young to remember” implies, unless we take the validity of parental choice as a given. I don’t. There is a risk, as with all normal body parts, male or female. But the chance of needing circumcision are very low. Most males left with their choice never need or choose circumcision. The “he won’t remember it” defense requires an assumption that he will either need or choose circumcision eventually. If it merely assumes he wants circumcision but will be too afraid of the pain, then he values not experiencing pain more than he values being circumcised. There is no reason to assume an infant thinks differently. This is related to female genital cutting more than it may seem. Like father, like son, so like mother, like daughter?

Next, she links to a comment on Reddit that discusses the issue of intent.

… One of the best explanations for the difference between male circumcision and female genital mutilation comes from a user called superdillin:

I think the intent and damage differences between male and female genital mutilation does need to be pointed out. What we do to our baby boys, often with no medical reason, is bad. Very bad and we should stop. BUT, what was done to OP’s girlfriend was done to take away her sexuality, and to control her. It has put her life at risk at worst, and at best has taken away her most sexual pleasure organ, and it was done with the intention of her becoming a breeding cow to be used for a man’s needs for the rest of her life.

What we do to our boys is due to misinformation about health and hygiene, combined with unhealthy aesthetic expectations and tradition. What some cultures do to their girls is deliberate, controlling, life-threatening and inherently sexist. [Her emphases.]

I agree with that, which differs somewhat from the blogger’s post. And I’ve already acknowledged the damage differences in the most common forms. Beyond that experience of the mutilated women described in the Reddit thread, there is evidence that some mutilated females retain some ability to orgasm, which just suggests that the issues and how they relate are more complicated than the idea that male circumcision somehow isn’t bad because female genital cutting is usually worse. (That evidence changes nothing on the ethical question. FGC/M remains evil.)

It is not clear that the intent for each exist as polar opposites. The motivations can have certain similarities. For FGC/M a (possibly overwhelming) majority of the cutting seems to be motivated in the way the West perceives. Sometimes it’s more complicated. But even with the best intentions, which apply to almost every male circumcision, they still aren’t enough. The act matters first. Non-therapeutic genital cutting on a non-consenting individual is wrong. We can’t get past that, ethically, so everything else is important but irrelevant to the validity of prohibiting unnecessary surgery on a child, regardless of gender.

The first key fact in the WHO’s fact sheet states that FGM “includes procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons.” (See footnote¹.) The intent that matters is the intent to act, not the intent to act for good or bad reasons. “Good” and “bad” are subjective, to some extent, anyway. Do the parents intend to alter the child’s normal, healthy genitals? Yes. It’s about the act and the objective harm that results.

Back to the word circumcision: I’ve noticed an increase in groups publicly opposed to male circumcision (part of this was seen during our recent Gay Pride parade), and some argue that male circumcision should be called male genital mutilation, to more closely align itself with female genital mutilation. Although circumcision in both sexes involves the cutting of the genitals, and both procedures can be unnecessary at best, only female circumcision can actually be called butchering because of how it’s performed and what its purpose is. It’s called “circumcision” to make it seem more acceptable and to hide what it really is. (Hell, even the Wikipedia page for female circumcision is titled “female genital mutilation.”)

I don’t believe use of the term male genital mutilation is primarily meant to more closely align the two. It does that, but the intent is to stop pretending that circumcision is so innocuous that it should remain a parental choice for the parents’ subjective, preferred reasons. Some forms of female genital cutting don’t reasonably constitute “butchering”, yet we still outlaw those forms. When does the individual who will live with the modified genitals get to offer input on whether it constitutes mutilation?

From this brief interview with Sister Fa (Fatou Diatta), a musician from Senegal who is a victim of genital mutilation.

Rebellion is in the words. You are dealing with issues such as forced marriage, female genital mutilation. How important is this for you?
“It’s more than important. But my struggle is not against Female Genital Mutilation (FGM, ed.). Me, I do not even use the word “mutilation,” because mutilate means cutting with the intention to hurt. I say ‘cutting’. I’m campaigning so that people would know that it is important that we can educate a child without going through certain practices that may harm his/her health. I’ve been a victim of this practice and I know its effect. It hurts.”

Again, this is so much more complicated than the world so many imagine we live in. The word mutilation is definitionally accurate for both genders, tied to outcome, regardless of parental intent. Whether to use the term or not is a marketing question, not an applicability question.

I wouldn’t publicly advocate one way or the other for male circumcision because there are benefits and consequences of the procedure that must be taken into consideration. I can, however, speak from the only experience I have, which is as a woman who has had sex with both circumcised and uncircumcised men. My experience taught me that male sexual pleasure has absolutely nothing to do with having been circumcised as an infant and that my own sexual pleasure had nothing to do with whether or not my partner was circumcised. However, if asked my opinion I might point out that even the cleanest of males can be less hygienic and more likely to spread a disease or infection with their foreskin intact, which from a female standpoint is a huge concern since an infection inside the vagina can be much worse than a topical penile infection. It seems to me like male circumcision has more benefits for a male’s sexual partner than for the male himself.

Perhaps, but that isn’t a defense for circumcising children. It’s a defense for encouraging and empowering women to stand up for themselves in sexual relationships and to choose their sexual partners and practices consciously. Ask the male to shower. Refuse to have sex if he won’t wear a condom. It’s also a defense for voluntary adult male circumcision.

I truly believe, when performed by a surgeon or urologist in a hospital with the proper tools, that male circumcision should be an option and that parents of sons should educate themselves on whether or not to do the procedure. But I also believe that even if female circumcision were to be performed in the exact same situations as male circumcision (on infants, by medical professionals in a sterile setting) that it would be genital mutilation. The intent automatically makes it wrong and the way a female’s body is designed opens the poor girl up to dozens of complications, many of which are life threatening. Male circumcision and female genital mutilation are not the same thing.

She’s wrong. Intent matters, but outcome matters first and most. An individual’s healthy body is permanently altered without the individual’s consent. The invasive act violates the individual’s right to physical integrity (and right to self-determination). In that core analysis, female genital cutting/mutilation and male circumcision are the same. They are both indefensible.

¹ Non-therapeutic “medical” male circumcision is a misnomer. It’s medicalized circumcision, which merely indicates that it’s performed in a modern, sterile operating theater. That is condemnable in its limited focus, but it is not enough to render the non-therapeutic surgery ethical. The patient’s consent is also necessary. The pursuit of possible benefits (i.e. reduce risk of UTIs or female-to-male HIV transmission in high risk populations) is speculative and may not be necessary for – or desired by – the individual himself. There are all sorts of interventions we could perform that might reduce the risk of some future malady. Society does not open those up to parental choice because they’re also harmful. They’re ethically wrong. Circumcision is the same.

Examples of the Need to Reverse the Approach

Following on yesterday’s post, The Guardian posted four letters from readers about Catherine Bennett’s excellent essay against non-therapeutic male circumcision. Three of the letter-writers believe they’ve found a weakness in her argument. They’re mistaken, and in odd ways. (I’m omitting points that are mistaken but beyond the comparison.)

First:

Female genital circumcision implies the removal of the clitoris, sometimes with the inner labia, sometimes infibulation. It is often practised with blunt razors or knives and without anaesthetics. The risks: fatal haemorrhaging, cysts, urinary and vaginal infections, chronic pain, obstetrical complications.

This supports my last post. This writer didn’t figure out how the comparison might work. She assumed it doesn’t. She started with FGM and worked back to discredit it.

The larger question is the relevance of the remaining facts in that paragraph. If those didn’t happen, and FGM occurred in a clean hospital room, I don’t believe her objection to it would change. She’s arguing for a distinction that doesn’t matter to the initial ethical question or the fundamental comparison. (It only matters to individual practices, which is still important to understand and change.)

She continues:

… There is no evidence whatsoever to support the notion that it affects function, sensation or satisfaction.

It’s incorrect to claim that there is no evidence that circumcision affects function, when the form changes. There is more to function than the ability to orgasm and impregnate. On that crude basis, an argument could be made that FGM doesn’t change function. Just limit “function” to whatever begs the question. (The latter two are subjective to the individual, which is also on the ethical point.)

Next writer:

Catherine Bennett is incorrect in describing female genital mutilation (FGM) as the “equivalent” of circumcision. Granted, both procedures involve a surgical modification of the external genitals of a non-consenting child. Both are, in my view, unacceptable.

That’s the key comparison. I don’t understand why this bizarre tangent follows:

There are, however, great differences: female genital mutilation is illegal in the UK and in many other countries worldwide, including in Africa. Circumcision is lawful. So campaigners against circumcision need to get into dialogue with the Jewish and Muslim communities and press for a change in the law.

Of course. But how is that relevant? The legality of an action doesn’t speak to its validity. Here, numerous historical examples could disprove that “correlation equals causation” mistake. Ms. Bennett made no error in comparing the acts.

This writer provides another paragraph, but it’s more helpful to move on to the next writer:

With reference to Catherine Bennett’s polemic on male circumcision, she should give more attention to the WHO’s statement that male circumcision can be a positive boon in relation to sexual cleanliness. …

This comment demonstrates the idea that one’s own subjective view should somehow be everyone’s objective view. It’s the idea that anyone against circumcision simply hasn’t considered some aspect allegedly in favor of circumcision. If the opponent would just think of benefit X valued by someone else, it would all be clear.

It doesn’t work that way. Much of the debate is subjective to the individual affected. That’s a reason the choice belongs only to the male himself. Me, I prefer to bathe properly and engage in safe sex practices. The so-called “positive boon” to “sexual cleanliness” is irrelevant to me. Ethically, we’re left with the objective facts from a non-therapeutic surgery.

… That hidden space underneath the flap of foreskin is indeed a fertile breeding ground for bacteria and disease. …

That just as accurately describes female genitalia. I don’t imagine the letter-writer thinks that’s a ringing endorsement for female genital cutting.

… The German court’s ban on male circumcision has rightly been overturned by its parliament. …

They did not overturn the court’s decision. They passed a resolution showing support for circumcision as a parental choice. The resolution is essentially a promise to address the issue in the legislature in the fall. The letter-writer erred on a simple, verifiable fact.

… Babies and young children are not able to make rational decisions as to their welfare: their parents have to decide how they are fed; what names they shall be known by; what schools they will go to; to which religion they will be directed; all of which decisions have a significant effect on their later life. …

Parents make decisions for their children. Circumcision is a decision. Therefore, parents may circumcise their children. That’s flawed logic. It assumes that a decision is just merely based on parental choice. Surely the letter-writer sees the negative implications of that. One such implication would be that parents may also cut the genitals of their healthy daughters. The silliness of the argument is that parents may make many decisions, and they all apply to their children, except this one so-called parental right that only applies to their sons. If they make this decision for their daughters, we incarcerate them. It’s incomprehensible in a rational analysis.

… The only effect of male circumcision on their later life is enhanced cleanliness and hygiene.

Taking the statement at face value, because the male still has to bathe, the claim is rather silly. The only basis on which it works as support for non-therapeutic child circumcision is with the assumption that the male will not undertake the minimal additional effort to bathe himself properly if left with his normal foreskin. Without that (offensive) assumption, the choice must be left to the male to decide whether he values his foreskin or saving a tiny bit of effort in the shower.

The larger problem is that this posited benefit isn’t the only effect. The male loses a normal, functioning part of his anatomy. He loses his foreskin, and suffers the damage to the nerve endings that remain. He is left with a scar that he may not find aesthetically appealing. He is left without the mechanical gliding action of his foreskin, so sex becomes a matter of friction rather than pressure. That’s not a valid parental choice.

Reading the Cologne Court’s Words

Since the recent ruling against non-therapeutic child circumcision by the Cologne district court, many have spoken out against it and claimed various and potentially extreme results that will flow from it. Some of these complaints are legitimate. As I previously wrote, there are issues offered by proponents of ritual child circumcision that deserve to be taken seriously. Asking people to let go of something they intensely value is asking them to bear costs, even if it should be clear that avoiding objective harm to the child must be stressed more. (That post is coming.)

Still, what I haven’t seen yet is the opposite view. I haven’t seen a single example of someone who supports legally-protected ritual child circumcision accurately acknowledge the court’s ruling as it was written, rather than using a selective reading, to defend the practice. (If someone has seen an example of a proper acknowledgement, please link it in the comments.) The closest I’ve seen comes from Chief Rabbi Lord Sacks, but he only built and defeated a straw man. Near his conclusion, he wrote:

That is what the court in Cologne has done. It has declared that circumcision is an assault on the rights of the child since it is performed without his consent. It ignored the fact that if this is true, teaching children to speak German, sending them to school and vaccinating them against illness are all assaults against the rights of the child since they are done without consent. The court’s judgement was tendentious, foolish and has set a dangerous precedent.

The issue of consent is only part of the court’s ruling. The child’s lack of consent factored because of what was being done to him. The court evaluated the act first. From an English translation of the ruling, found here:

… since the parents’ right to religious upbringing of their children, when weighed against the right of the child to physical integrity and to self-determination, has no priority, and consequently their consent to the circumcision conflicts with the child’s best interests. …

Circumcision violates the child’s (right to) physical integrity. Consequently, parental consent conflicts with the child’s rights, including his right to consent or to refuse. Contrary to Chief Rabbi Lord Sacks’ statement, the court did not imply parenting is now illegal. It made the necessary distinction to limit the ruling to non-therapeutic child circumcision.

… There was consent by the parents, but this was not capable of justifying the commission of the elements of bodily harm.

And:

… The parents’ fundamental rights under Article 4 (1), 6 (2) of the Basic Law (Grundgesetz, GG) in turn are limited by the fundamental right of the child to physical integrity and self-determination under Article 2 (1) and (2) sentence 1 GG. …

There are two rights involved. The right to physical integrity and the right to self-determination (i.e. consent). A complete attempt at a rebuttal requires acknowledging both.

An insufficient response such as that by Chief Rabbi Lord Sacks is not unique. Consider:

Muslim leaders joined the Jewish groups in their condemnation of the ruling. Ali Demir, chairman of the Islamic Religious Community in Germany, described circumcision as “a harmless procedure that has thousands of years of tradition and a high symbolic value.

There are also Christian (and probably secular) advocates who mistakenly defend circumcision as a parental right based on, but not limited to, their religious freedom. However, they all ignore, minimize, or fail to understand that circumcision, like all surgery, is not physically harmless to the child.

As the court stated, “the child’s body is permanently and irreparably changed by the circumcision.” Harm and its link to consent are the issues. Circumcision¹ inflicts harm, despite the presumed good intentions of parents. Only the individual directly affected can evaluate whether or not this objective physical harm is good, bad, or neutral for himself, permanently. Only he can decide whether or not he consents to this intrusion on his physical integrity. That is what the court ruled, not the convenient straw men floating around as a defense against the equal rights of children.

¹ Here I refer only to ritual and non-ritual non-therapeutic circumcision. Proxy consent for therapeutic circumcision requires further analysis and can be justified, although it also inflicts harm.

Strong and Non-Conflicting Evidence

A few days ago in the Huffington Post Canada, Sheryl Saperia defended non-therapeutic male child circumcision against the German court ruling. The title of her essay is “Male Circumcision is Not Mutilation, Period.” She is wrong.

After a bit of setup, she states:

For instance, neither the right to security of the person nor to gender equality should operate in such a way as to proscribe male circumcision on the grounds that it is comparable to the justifiably prohibited custom of female genital mutilation (FGM).

The two are ethically comparable. They are both non-therapeutic genital cutting on a non-consenting individual. That’s the comparison. It applies to every scenario.

But ignore the comparison. She’s jumping to the “FGM is worse, so male circumcision is okay” defense. Truncate her statement to the minimum necessary facts to understand male circumcision and the content of the ruling. Do male infants have the right to security of person? Assuming she answers correctly, that males possess this right, then non-therapeutic circumcision violates that. It is surgery, and without the recipient’s consent. It inflicts harm. Sometimes that harm is greater than what is expected, and in thankfully-rare instances, it can be fatally so. But it always involves harm. The right to be secure in one’s person should include protection from unnecessary, unwanted harm for all children.

She continues:

FGM is sometimes termed female circumcision, but this is a misnomer as it implies a minor operation equivalent to male circumcision. According to Doriane Coleman, a Duke University law professor whose expertise is children and the law, “This analogy can and has been rejected as specious and disingenuous, as the traditional forms of FGM are as different from male circumcision in terms of procedure, physical ramifications, and motivation as ear piercing is to a penilectomy.”

The term female circumcision is a misnomer for semantic reasons, but also because, as she indicates, it fails to fully explain what FGM does. However, semantic accuracy of male circumcision does not prove that male circumcision cannot also be mutilation. Saying it’s not FGM isn’t enough.

Contrary to Professor Coleman, the analogy is neither specious nor disingenuous. It is not based on merely the traditional forms. The traditional form of FGM differs across cultures. The question of which version we should use exposes the flaw in the tradition approach. The varying extent of damage can be reflected in the codified punishment for violations.

It makes more sense to start with the principle involved. Again, non-therapeutic genital cutting on a non-consenting individual is wrong. The principle does not require equivalent damage for both to violate the principle. Anyway, the anatomical analogy to mnale circumcision is a hoodectomy. The latter is illegal, which brings in the topic of equal rights. The law does not protect the rights of male minors that it protects for female minors.

The motivations aren’t as different as suggested, either.

Next:

The World Health Organization is also clear that:

“FGM has no health benefits, and it harms girls and women in many ways. It involves removing and damaging healthy and normal female genital tissue, and interferes with the natural functions of girls’ and women’s bodies.”

I prefer my fact sheet because it deals with principles and equality rather than outcomes. Still, even on the appeal to authority she begins here, she’s wrong. Within its fact sheet, WHO states:

FGM has no health benefits, and it harms girls and women in many ways. It involves removing and damaging healthy and normal female genital tissue, and interferes with the natural functions of girls’ and women’s bodies.

To repeat myself, would WHO rebrand female genital mutilation to “female genital cutting” and declare it an acceptable parental choice if some health benefits were found? I find the possibility doubtful, at best. So why shouldn’t we also apply the basic logic of harm as “removing and damaging healthy and normal genital tissue, and interferes with the natural functions of bodies” to males? It’s okay to do this without their consent because we’ve pursued a “health benefits” justification for enough years, even though almost every claimed benefit can be achieved with less invasive preventions and/or treatments?

Ms. Saperia quotes a 1997 joint statement from several groups declaring “FGM to be universally unacceptable, as it is an infringement on the physical and psychosexual integrity of women and girls and is a form of violence against them.” Even if we pretend that there is no psychosexual violation to males, there is the clear infringement on their physical integrity. (She returns to this point later, although she furthers her error.) Circumcision is a form of violence against males. It inflicts some level of harm in every instance.

Instead of acknowledging this connection, she quotes the WHO to push the irrelevant facts about circumcision being a long-standing practice and that many reasons exist for its imposition on healthy children. And then the predictable argument about HIV, which is easily refuted, and also countered with the truth that condoms are still necessary after circumcision.

She proceeds into the illogical “no real harm”:

In the absence of strong and non-conflicting medical evidence that male circumcision regularly causes substantial harm to young boys, the arguments against the procedure are severely weakened. …

Substantial is a subjective word. What one person finds substantial, I might not. And vice versa. The core question is whether or not there is non-conflicting medical evidence that non-therapeutic male circumcision causes harm. There is. It causes harm, in every case. Normal, healthy tissue is removed. Nerve endings are severed. The resulting scar provides further proof, and the mechanical functioning is altered. I accept that many people think this trade-off is acceptable for the possible benefits. But only the individual male is qualified to make that evaluation for himself.

… Since male circumcision and FGM are simply incomparable, gender equality should not demand the banning of the former just because the latter is illegal. [ed. note: Again, they’re comparable in principle (and to an extent within FGM Type IV). The law should reflect that.] And while the right to security of the person is certainly implicated by circumcision, the low risk of harm (and the fact that most complications are extremely minor) means that this right should be balanced against other compelling rights, such as religious freedom.

There is not a “low risk of harm”. There is a 100% risk of harm. There is a low risk of complications, of unexpected outcomes. Those harms are not the same. There is no implication. The guaranteed harm of non-therapeutic circumcision violates the child’s right to security. That should be balanced against competing rights, but as the court found, a child’s right to physical security outweighs his parents’ supposed right to practice their religion. From an individual rights perspective, the parents’ religious freedom ends where the child’s body begins. The child also possess a right to religious freedom.

After a paragraph praising the unity the three major religions are showing in their criticism, she writes:

According to the German court, the right to religious freedom “would not be unduly impaired” because the child could later decide for himself whether to have the circumcision. Aside from the court’s interference with a religious precept that the ritual must take place long before adulthood, the judgment could ironically cause greater harm to one’s bodily integrity because circumcision for adolescents and adults, as compared to infants, is more complicated and has a higher rate of adverse effects.

First, civil law already interferes with many religious precepts because they involve harm to others. Interference is not necessarily improper.

To her point, the issue is consent to the harm inflicted. The right to bodily integrity involves the ability to consent to harm. Or not. If a male wishes to get himself circumcised, he can decide for himself that whatever benefits he values from non-therapeutic circumcision outweigh the harm and risks of further harm. Or not. The perceived increase in difficulty in adults is not an ethical argument in favor of infant circumcision.

Within the religious context, we need to evaluate the number of teens and adults who would volunteer for ritual circumcision if left intact from birth. I assume that number would be very high. I do not believe it would be 100%, at which point the implications to individual rights should become obvious. More on this in a moment.

Outside the religious context, the number of teens and adults who would volunteer for cultural circumcision if left intact at birth would be very low, as it is now. I also assume the number of medically necessary circumcisions would increase, but only on a volume basis. The percentage would likely stay low, apart from the consequences of unnecessary fiddling with the non-retractable foreskins of children by doctors and parents.

While there appears to be the difference between infant and adult circumcision Ms. Saperia cites, there are other differences. Consent is the largest, but there is also the ability to say how much skin the individual wants removed, if he consents. Does he want to keep his frenulum? As an adult, he can have greater amounts of pain management medicine, as needed. The case isn’t as convenient to their argument as proponents seem to believe.

Ms. Saperia’s conclusion calls for a recognition of community rights, within limits, to support multicultural acceptance and integration. This is lacking on medical grounds because it is objective harm for non-therapeutic reasons. It is lacking on legal grounds because analogous surgical interventions are treated unequally in law. It is lacking on moral grounds because it lacks the consent of the recipient. Every proof she attempted failed to demonstrate that non-therapeutic circumcision on non-consenting children should be permitted.

Coercion Negates Self-Determination

The German court ruling involves many issues, so I expect it to be an ongoing source for posts for the foreseeable future. I’m building my thoughts on the opposition, which is a complex issue. For this post, though, there are a few comments worth mentioning. The full article contains many quotes based on faulty logic, but this comment¹ encapsulates the problem with balancing parental religious freedom with a child’s right to be free from harm:

The Evangelical Church’s Hans Ulrich Anke said: “Religious freedom and parents’ right to choose how to educate their children have not been weighed against the fundamental right of the child to bodily integrity”.

Parents don’t have the right to educate their children with the blade of a scalpel. This is as true about male circumcision as it is for any other surgery, including religiously-argued female genital cutting. The right to be free from obvious, objective harm without one’s consent is not a right that begins upon reaching a society’s arbitrary age of majority. It’s especially fallacious to imagine that this right doesn’t exist from birth for male minors only, as laws against non-therapeutic female genital cutting imply. The fact that male circumcision is proscribed in religious texts demonstrates nothing about the legitimacy of its imposition on a healthy, non-consenting child in a civil society. There are many religious dictates that we do not allow under this expansive view of religious freedom because the actions violate the rights of others. A balancing test is necessary. Where there is a conflict, religion must change, not our protection of the rights of all citizens, equally.

This post by Iain Brassington at the Journal of Medical Ethics blog deftly addresses this conflict for what it is. (Mr. Brassington cites this news story.)

The president of Germany’s Central Council of Jews, Dieter Graumann, called it “an unprecedented and dramatic intervention in the right of religious communities to self-determination”.

That’s telling. The rights of the child give way to the right of a community to cut him. Can communities have rights anyway? I’m not at all sure. If they can, and if self-determination is one of them, does that always have to come out trumps? Again, I’m not at all sure. It’s strange to see rights-talk brought to the table in defence of unconsented, irreversible, and non-therapeutic body modification. If a boy decides that it’s important to get himself circumcised later in life, then that’s a different matter entirely: good for him. But without any choice? I may have missed something, but I don’t understand how the claim is supposed to work. Can anyone help out?

Mr. Brassington succinctly identifies the conflict. The argument is for community “rights” at the expense of individual rights. Effectively, children are property. I suspect critics of protecting a male child’s right to bodily integrity expect opponents to retreat on the basis of some form of fallacy to render reconsideration of existing norms unjustified and offensive. Unfortunately, but with reason for optimism, this is part of the path to achieving full protection of bodily integrity for all individuals.

¹ It’s possible to read that in a different context from the rest of the article. That subtlety may be what he meant, which would rather likely side closer to my view than with the other comments in the article. I will consider it in the context of the rest of the article, as criticism of the court and an attempt to support non-therapeutic child circumcision as a parental religious right.