Individual Preferences Need Not Be Cost-Effective

With an opening paragraph like this, I’m inclined to cheer:

A group of top world economists said Wednesday that adult male circumcision, a global priority for preventing HIV infection, is not nearly as cost-effective as other methods of prevention.

They’re economists. I generally expect sensible reasoning from economists, so this is good. Except, reading beyond this first paragraph reveals something unexpected:

The group told representatives of global organizations at Georgetown University that more cost-effective ways to prevent the spread of the disease are an HIV vaccine, infant male circumcision, preventing mother-to-child transmission of the disease and making blood transfusions safe.

Including infant male circumcision in that list is offensive. Like medicine there’s more to economics than just numbers. We cannot ignore the ethical human rights violation involved in non-therapeutic male child circumcision in favor of saving a few dollars.

To be fair, stating that (forced) infant male circumcision is more cost-effective than (voluntary) adult male circumcision is not an endorsement of the former. It will be read as such, and there may be some willingness amongst these economists to endorse that view. I don’t know, so I’m going assume the most charitable reading possible.

However, to demonstrate the importance of including ethics, consider a hypothetical: a bullet is cheaper than life-extending medical care for terminal patients. Is it reasonable (i.e. ethical) to state that euthenasia and suicide are more cost-effective than treatment unlikely to work without also acknowledging the very important ethical caveats in the cheaper solutions?

Consider this from the article:

A successful adult male circumcision effort would require “a large public campaign to get people into the clinic,” said Bjorn Lomborg, director of the Copenhagen Consensus Center, a Danish think tank focused on cost-effective public spending that commissioned the panel.

Getting men to volunteer to be circumcised would not be easy and “it could cause more risky behavior,” Lomborg said.

If it won’t be easy getting men to volunteer, and I think he’s correct, then it’s unethical to force circumcision on a child. Circumcising a child removes the choice from that male to have himself circumcised or not as an adult when we readily understand and accept that he won’t likely volunteer if left with his choice.

Also, to my knowledge, there has been no assessment of whether forced infant male circumcision is effective at preventing reducing any risk of HIV transmission. Assuming that infant and adult male circumcision are the same is unscientific.

Truth and Loaded Words

There’s currently an image floating around that states “Circumcision without informed consent is surgical rape at any age.” The visual is intriguing, but this is a bad message to push. The only people to whom it will appeal are those who already understand that non-therapeutic child circumcision is wrong. Those who advocate for circumcision will not change their minds based on this, so those who have some qualms about circumcision are the only target audience. Will they think advocats for individual choice are rational, based on this message?

Taken literally, by definition, circumcision is a form of rape and the action is surgical. But most people will not associate “rape” as “to take”, but rather will think it’s wrapped up in assault and sexual gratification. Being literal is not useful on this point, which is about marketing. This image is meant to sell genital integrity and human rights. While there must be truth in advertising, the target audience matters. We have to work with the framework of their thinking, as well. If a slogan requires a disclaimer or clarification, it’s a bad slogan.

“Circumcision is surgical rape” suggests that parents intend to rape their children. That implication is that their intent is about power, control, and sexual gratification. There is power and control inherent in non-therapeutic child circumcision, but it’s not intended as harm. And there is no sexual gratification from circumcision in the general population of advocates. Accidentally implying it of anyone who circumcises their healthy son compounds the image’s damage.

Consider this, from the judge who sentenced an Oregon mother to probation for unsuccessfully circumcising her son at home with instructions from a video on YouTube:

Multnomah County Circuit Judge Eric Bergstrom told Peterson on Monday that “the reality is you love your children and had absolutely no intent to harm your child.”

Our default assumption should be that parents love their sons, that they do not intend to harm their sons. Too many circumcision advocates think that, because of this intent, circumcision does no harm. This is wrong. Despite these parental intentions, circumcision causes harm. That’s our message. Anything that distracts from that, or suggests evil intentions, diminishes our ability to convince. Reason and facts are on our side. Let’s use them.

Inquiry Is Better than Insinuation

Rabbi Gary Creditor wrote an essay in the Richmond Times-Dispatch on the subject of circumcision, laws, and anti-Semitism. The title assigned is “Circumcision ban is veiled anti-Semitism.” The premise is absurd because it accepts no nuance into the discussion. It’s possible (and common) to oppose non-therapeutic child circumcision and anti-Semitism. The former can be expressed in clear principle without the latter. If Rabbi Creditor will make an effort to look, he will find examples.

Instead, this, after significant buildup:

Throughout history, those who sought to destroy the Jewish people always forbade brit milah, usually upon penalty of death. They thought that if they could eradicate the sign of the covenant, they could eliminate the covenantal people. They failed.

To the extent that I can (i.e. intellectually), I understand his concern. But this is not that. There is no effort to destroy Judaism or Jewish people. Any male may consent to circumcision when he is able. The proposed law would’ve set the age he could consent at 18, but I do not believe that is required. At whatever age he could consent, that would be acceptable. The focus is consent.

The proposed law would’ve established criminal penalties. That makes sense given that the fact involved is that non-therapeutic circumcision is (well-intentioned) battery, which violates the rights of the child. We criminalize female genital cutting on minors that causes less damage. There is nothing abhorrent about the proposed penalties. They would’ve very rarely, if ever, been enforced. That’s politics. But to connect a proposed year of imprisonment with capital punishment is inexcusably unfair.

That’s Rabbi Creditor’s premise. He exposes the flaw in his reasoning that demonstrates the principle of human rights and bodily integrity with his next paragraph (emphasis added):

That is the issue that reverberates these days in San Francisco with the attempt through legislation to ban all circumcision. It is a thinly veiled attack upon Judaism and the Jewish people. Anyone who objects to this ritual has the democratic right not to participate in it. Yet as parents with a religious persuasion, we make decisions on behalf of our children. One of those is the perpetuation of the faith. This is how we do it. This attack is not new — just its method. It violates core American principles.

I had a right not to participate in circumcision. I would exercise that right if I still had my choice. My parents (and the doctor) violated my right and my body when they circumcised me without medical need. Every human, male or female, possesses that basic right. Rabbi Creditor is mistaken. Society incorrectly fails to protect that right for male children, which violates core American principles. The core American principle is individual liberty, not collective “liberty” to permanently impose one’s beliefs on the physical body of another.

Forgiving (and Ignoring) Bullies

I was bullied as a child for being poor and having red hair. Both were out of my control, with the latter being normal and part of who I am. My childhood would’ve been easier if neither fact had been my reality. A postcard in today’s PostSecret shows why I don’t mind either.

Forgiving Bullying

The argument that healthy children should be circumcised to avoid being mocked in the locker room is flawed because such mockery is neither guaranteed nor as (permanently) harmful as circumcision. (It’s even less likely now that more children are being left intact.) If the child is mocked for being normal, it doesn’t have to be damaging. Good parenting works better than circumcision at building self-worth.

The other side of the postcard is here.

Control: “to exercise restraining or directing influence over”

When I argue against non-therapeutic child circumcision, I’m strictly interested in protecting the child’s right to decide for himself. I do not seek conditions or expectations on what he “should” choose, or why. Everyone is an individual with his own preferences independent of what his parents prefer. The two may be similar, or even identical. In the case of ritual circumcision, I suspect that possibility is much more likely than not. But the two may not be similar. That’s what matters.

There is usually significant resistance to the statement that non-therapeutic child circumcision is mutilation. It is mutilation because it fits both the definition of the word and its consideration within the context of female genital cutting. In that context all non-therapeutic cutting is classified as mutilation. However, I do not suggest that the application of an accurate description implies anything about intent. I oppose forcing the surgery on someone who doesn’t need it and can’t consent, even though I accept that its imposition is well-intentioned. The problem is the cognitive dissonance involved.

Here is an example of cognitive dissonance by Rabbi Mark S. Glickman, commenting on proposed prohibitions on non-therapeutic child circumcision:

I know that the idea of circumcision may sound barbaric. But the practice is not. It is a loving way […]. … Unlike female genital mutilation, Jewish circumcision is not a way to limit or control the child, and it does not destroy sexual desire.

First, this opinion is not unique to religious circumcision. Every circumcision in America occurs under the mistaken assumptions that FGM is always ill-intentioned, that parental intent determines the outcome without regard for the action, and that male circumcision is not about control. These alleged distinctions have been repeated so many times that they’re incorrectly accepted as facts. They are not facts.

As the first excerpt suggests, the focus here is about intent. Rabbi Glickman claims that circumcision is not a way to limit or control the child. Yet, the next two sentences he writes are as follows:

Many find the practice troubling, I believe, because it so dramatically distinguishes religious values from commonly accepted modern American ones. America idealizes nature; Judaism and other religions try to control it and improve it. …

I’m confused about how trying to “control [his nature] and improve it” is not an attempt to control the child.

Here’s another example commenting on tweets from Russell Crowe:

That Crowe, who won stardom (and an Oscar) for playing a Roman gladiator, is unable to distinguish between real barbarism and a religious ritual that profits health is mildly dispiriting, especially when one of circumcision’s central aims is to curb male barbarism. Men are supposed to be reminded of God and, one could argue, moral behavior, in the very place they are most likely to betray religious ideals.

“Circumcision is the indelible symbol that a man can be more than just an animal,” Rabbi Ed Feinstein, senior rabbi at Valley Beth Shalom, said. “The fact that you seal your connection with God and with tradition into that organ makes it incredibly difficult for that organ to be used as a weapon of manipulation or destruction. For men, this is the center of being: Is masculinity to be defined in terms of power and violence, or control and strength? What you see in the news is what happens when men make the wrong choice.”

To be clear, I do not believe that circumcision as a form of control is exclusive to Jewish (or religious) circumcision. Control is inherent in every forced, non-therapeutic circumcision. Typical American reasons offered for circumcising healthy children are also control. Whether it’s to make the son “look like daddy” or to make him appealing to his future sexual partner(s), the message is clear. The way he is born is not acceptable. Someone has to make him better, a subjective concept, regardless of whether or not he wants to be made “better”.

Even circumcising to reduce his risk of certain future ailments is a form of control. It’s an indication that he isn’t capable of practicing sufficient hygiene or engaging in safe, responsible sex. It’s an unintentional declaration that “I know better than you what you need”. During childhood, that’s parenting. When it extends permanently beyond childhood, without chance for the individual to choose differently, it’s control.

Note: Title definition.

The Ideological Turing Test: Circumcision Edition

I seek to avoid political discussions here because wrapping politics into the circumcision debate makes the situation worse. The purpose of this post is not political, despite the topic’s origin as an approach to political philosophy.

Bryan Caplan is an economist at George Mason University. He is a libertarian. In response to a statement by economist and New York Times columnist Paul Krugman, Professor Caplan proposed an ideological Turing test. A Turing test is when “a computer tries to pass for human”:

A human judge engages in a natural language conversation with one human and one machine, each emulating human responses. All participants are separated from one another. If the judge cannot reliably tell the machine from the human, the machine is said to have passed the test.

Professor Caplan challenged Krugman’s assertion with this:

… Mill states it well: “He who knows only his own side of the case knows little of that.” If someone can correctly explain a position but continue to disagree with it, that position is less likely to be correct. And if ability to correctly explain a position leads almost automatically to agreement with it, that position is more likely to be correct. (See free trade). It’s not a perfect criterion, of course, especially for highly idiosyncratic views. But the ability to pass ideological Turing tests – to state opposing views as clearly and persuasively as their proponents – is a genuine symptom of objectivity and wisdom.

I think this is fantastic and relevant to the circumcision debate. A large problem we have in trying to convince others that non-therapeutic child circumcision is wrong rests with the inability of our opponents to correctly state our position. The recent (justified) uproar over “Foreskin Man” issue 2 is an example, since it then gets applied universally to all activists. Those who support non-therapeutic child circumcision should be able to correctly state or summarize our position. They rarely do.

We have no power to make someone debate fairly beyond the power of our words. I don’t present this concept to demand that our opponents attempt it. I wish they would, but I expect nothing. I present this because it’s important for us to pass the test. We must be able to accurately restate the position of those who advocate for circumcision. When we promote conspiracy theories about doctors, we fail the test. When we promote conspiracy theories about religious individuals, we fail the test. When we deny the possibility of benefits from non-therapeutic circumcision, we fail the test. We must be able to accurately explain why people advocate for circumcision, including when the facts are superficially against us. When we don’t, we give those people an excuse to dismiss everything we say, even if one misstatement of their position is our only misstatement.

For example, I can counter the potential benefits from circumcision as separate to the application of circumcision to a healthy child. But when activists state that there are no benefits, that they’re all lies, people stop listening to everything we say. They assume circumcision opponents don’t care about facts, not the subtle way in which we might disagree on interpretation or the application of facts. We need to care about accuracy so we may convince others of the legitimate ways to apply the facts involved. Once we can recite their position, then we can demand they be able to recite ours.

Flawed Circumcision Defense: Harold Witkov

When I first read this essay by Harold Witkov, I assumed it was just an offensive smear without research. On my second reading, it has to be a satire of how a non-thinking conservative views opposition to non-therapeutic child circumcision. I know it’s the former, but it’s also accidentally the latter.

After a brief description of a bris he attended recently, he writes:

Just prior to the blessed ritual, the Rabbi got everyone’s attention with a joke. He began, “We Jews are a team. Once you make the first cut you are on the team for life!”

Sad to say, there are some misguided Americans who would love to break up the Jewish team. They are the intactivists (as in keep the penis intact), a generic term for the activist opposition to infant circumcision. They have succeeded in getting a proposed ban on male circumcision on the San Francisco ballot this November, and are working hard to get similar ban proposals across the nation.

I do not wish to “break up the Jewish team”. Although I do not refer to myself as an “intactivist”, I advocate for the principle that all children have a right to be free from non-therapeutic genital cutting to which they do not consent. It’s a principle that everyone respects for female children. There is no justification sufficient to overrule that for healthy males. If a male reaches an age of consent (not necessarily the age of consent) and wishes to be circumcised for any non-therapeutic reason, he should be able to do so. I expect an overwhelming majority of males raised in Judaism would undergo the procedure. Wonderful, nothing would stop them. But the elective rate would not be 100 percent. That is why this individual right to reject the surgery must be protected.

So far, Mr. Witkov is wrong, but he’s barely dancing on the border of ridiculous. From this point forward, he’s abandoned logic in favor of the absurd and ad hominem.

Intactivists are twisted-minded do-gooders who are trying to convince the masses that a law to ban circumcision is as commonsense as a law that mandates car seats for infants. They are dangerous thinkers who have organized. While grossly exaggerating medical risks and denying the medical benefits of circumcision, the intactivists oppose male circumcision, citing it as an unnecessary cruelty and mutilation imposed upon an unwilling baby. While they hide behind their false front of grave concerns, I have figured out who they are and what makes them tick.

“Twisted-minded” is interesting. In what way? By demanding equal protection of existing law for male minors under the same principle? That’s not twisted, unless one ignores the reality of circumcision. Again, it’s non-therapeutic genital cutting on a non-consenting individual. There is nothing twisted in suggesting that no one should have normal, healthy, functional body parts removed without their consent. If protecting that right is pejoratively “doing good”, so be it.

A law to ban circumcision is common sense because circumcision is a form of harm inflicted on children. Think of it this way. A law mandating car seats is designed to protect children from harm. But how many infants are involved in accidents? Most infants would be fine if their parents didn’t use car seats because their parents don’t get into accidents. They would never be harmed by riding unsecured in a car. Yet, we know that illogical approach is flawed. The harm to all infants from being a passenger without being in safety restraints is the risk of harm from an accident. They probably won’t be in an accident, but they might be. We don’t know who will be the unlucky victims, so we protect every infant from the harm, to the extent possible.

The same applies to circumcision. Every circumcision involves objective harm, of course, which is neither an exaggeration nor a denial of potential benefits. But for the comparison to car seats, every circumcision involves the risk of harm beyond what is inevitable from the surgery. These include excessive bleeding, infection, skin bridges, meatal stenosis, partial or complete amputation, and death. Thankfully the more extreme complications are rare, but they occur. Any individual infant could be affected by such an outcome. So, yes, it’s common sense to protect all children from unnecessary, non-therapeutic surgery and the permanence and risks it involves.

Now, for Mr. Witkov’s ad hominem:

First and foremost, intactivists are anti-Semites. I do not use this accusation lightly. But what better term can be used for a group that advocates fines and imprisonment for those who follow one of the most important precepts of their Jewish faith? Intactivists have no respect for the covenant of Abraham and his descendants. By seeking to outlaw it, they have meddled with the primal forces of Judaism and declared war on it.

Is someone who opposes in civil law other actions prescribed in religious texts anti-religion? Of course not. There is a principle involved. The burden to prove anything about circumcision should rest with those who wish to impose it. Our society is flawed, so the burden is on me to prove that my position is stronger. I can and will. But to accuse all who advocate against child circumcision of being anti-Semites is an attempt to shut down the conversation. The language of the law is generally applicable and promotes a legitimate state interest. Any advocacy will attract its share of people on the fringes who hold offensive, incorrect beliefs. The anti-Semitic actions of a few are not useful as a blanket description of those who advocate against non-therapeutic child circumcision on principle.

Intactivists are a bunch of hypocrites. They see nothing wrong with a pregnant woman choosing to annihilate her fetus. Yet, they feel compelled to ban infant circumcision due to the suffering it inflicts. I wonder if they would be agreeable to circumcision in the womb?

Mr. Witkov is conflating opposition to non-therapeutic child circumcision with adherence to liberal politics. That’s incorrect. I am not a liberal/progressive. I have not stated my opinion on abortion here, so his sweeping claim can’t be proven. He does not know whether I’m a “hypocrite” or not. Regardless of one’s position on abortion, though, it’s clear that children, once born, have rights. That is the focus here. Abortion is a red-herring that distracts from the discussion. (I’m sensing a trend in Mr. Witkov’s non-rigorous methodology.)

Intactivist men and women are part of the far-left movement and are a threat to the American system designed by our founding fathers. Their mission is a big brother government that removes individual choice and imposes the will of their self-anointed elitism. Leftists, in most cases, love government-imposed regulations, are anti-Israel, are pro-abortion, and pine for the day the United Nations can regulate every human activity on the planet. Leftists believe in uniformity. They have no room for the individual, for non-Jewish parents who want circumcision for their sons, or for Jewish religious exemptions. Intactivistits [sic] are far leftists who embrace uniformity to such an extreme they want to regulate penises!

Again, I’m not a liberal/progressive. As a defender and promoter of individual rights, including the rights of children, I’m hardly a “threat” to the American system designed by our founding fathers. I don’t seek a big brother government that removes individual choice. The only ones in this debate who remove individual choice are those who remove their sons’ foreskins without his consent. In my view, every individual retains his choice, even if he chooses what I wouldn’t. In Mr. Witkov’s view, every individual male gets the choice of his parents. Unlike Mr. Witkov I don’t pretend to know what is appropriate for other individuals, which is why I want the decision left to each individual to choose – or reject – for himself. Mr. Witkov is defending individual choice over another, permanently.

His last two paragraphs are comedic proof of his accidental satire of a non-thinking conservative, with a nod to Godwin thrown in. I won’t bother highlighting them further. But in doing a moment of research, which is more than Mr. Witkov apparently did, I encountered this essay he wrote about being dismissed over his fear of a one-nation Islamic Middle East in the future. I am bemused that he opened with this:

Because I am a conservative, as far as the left is concerned, I am assumed guilty of several psychological disorders. I am, just to name a few, a sexist, a racist, and a homophobe.

Because I’m an intactivist, as far as the right is concerned, I am assumed guilty of several psychological disorders. I am, just to name a few, an anti-Semite, an elitist, and a hypocrite.

Interesting.

Flawed Circumcision Defense: LZ Granderson

The editorial I analyze in this post is several weeks old now, but it’s been referenced elsewhere a few times. It’s worth a response.

LZ Granderson wrote an editorial at CNN on the proposal in San Francisco to prohibit non-therapeutic male child circumcision. It’s an embarrassing piece, largely because Mr. Granderson never considers the healthy child as an individual who might not want to be circumcised.

Once he gets going:

Besides the measure having no provision for religious practices — thereby making it unconstitutional — …

This is armchair lawyering, and easily refuted. There are the merits of the First Amendment and parental rights, which are summarized quite well in these two posts at The Volokh Conspiracy from last week. The religious freedom to act on another is a lot more complicated than simply claiming a religious requirement. There are competing rights involved, including a right to be free from unnecessary harm that is not yet adequately (or equally) protected. Mr. Granderson’s dismissal is flawed. It doesn’t disqualify his opinion, but it suggests the level of research he has (not) performed on this topic.

We chuckle, but from interracial marriage to masturbation, politicians have been trying to tell us what to do with our genitalia for centuries. …

Here, parents are telling their sons what to do with their genitalia. If the male does not want his genitals altered, his genitals are still altered. Since his body has been violated, what difference is it to him that his parents did it than if his government had ordered it? The proposed government involvement leaves that choice to individuals rather than dictates how he must be, which is what parents have been doing for more than a century in the U.S. Proposals like this that protect individual rights possess the stronger liberty position.

I get the science behind not having the procedure done: There are nerve endings that are being severed during the procedure, and it is normally not medically required. But generally speaking it has not been proven to be medically harmful either, though there have been rare occasions of infection and excessive bleeding requiring stitches.

Surgery is harmful. How can Mr. Granderson acknowledge that in sentence one and then deny it in sentence two? In the space between writing those two sentences, did severing nerve endings become not harmful? It’s more frustrating because his denial includes examples of medical harm. Other, more severe, outcomes are possible, too, including death. Mr. Granderson seems determined to believe what he wants to be true, regardless of facts.

Besides being an important aspect of some religions, circumcisions improve hygiene, …

Access to proper hygiene facilities is not a modern American problem in significant numbers. The same hygiene that females use to maintain their bodies works for males. To think that surgery is justified is simply begging one’s own question.

… which is effective in limiting urinary tract infections and the transference of STDs. …

The same treatments we use for UTIs in females work for males. For STDs condoms work better. Not all males engage in unsafe sex, so the potential benefit is useless for them. It is unethical to impose it because it may not be desired.

…And speaking of sex, having a circumcised penis saves the young man of the potential embarrassment of having a new partner look at his nude body and say “What in the hell is wrong with your… penis.”

Or something like that.

Maybe.

A recent study conducted by a Centers for Disease Control and Prevention researcher suggests the number of circumcisions performed dropped from 56% in 2006 to 33% in 2009. So chances are you or someone you know is uncircumcised, a fact that is really none of the business of complete strangers — government officials and busy-body voters alike. Why someone would sign a petition making it their business is beyond me.

This is just ridiculous. If a man reveals his normal nude body to a new sexual partner and the response he gets is “What in the hell is wrong with your… penis?”, I hope his parents will have taught him enough self-respect to treat his new partner as the person with the (hopefully correctable) defect. Would we accept that thought process if we started surgically altering girls so that they wouldn’t be shamed by their eventual sexual partners?

I could see the government getting involved in the decisions parents make about their children if there was evidence that circumcisions were a life-threatening practice — like failure to use car seats for young children. …

The standard is not whether the action is “life-threatening” or not. A punch to the face isn’t life-threatening, but it’s still wrong. Genital cutting on healthy female minors is illegal (and wrong), even where the damage is equally or less harmful than male genital cutting, which is to say, not life-threatening. (Typically.) This is once again question-begging.

Of course, some boys do die from circumcision. Circumcision is not usually life-threatening, but the risk of death exists every time it’s performed, which is why we generally avoid inflicting surgery on healthy people. Especially without their consent.

… I could see if the proposed ban was addressing a patriarchal practice such as female genital mutilation.

Male circumcision is a patriarchal practice. Aren’t many boys circumcised by their parents, at the father’s insistence that the child’s genitals match his genitals? Some doctors advise undecided parents to make the decision based on the father’s penis. Is that the rule of the male? Does it subordinate children? Mr. Granderson’s view here seems to be the mistaken belief that there is no harm if a practice is being imposed by someone onto someone else of the same gender. Do I need to link to examples of women imposing FGM on their daughters to demonstrate the fallacy of relying on this faulty standard?

This is about choice and preference and opinion and I am really tired of being subjected to ridiculous laws instituted by religious conservatives pandering to a bunch of crazy people or by meddling liberals who have nothing better to do.

This is about choice and preference and opinion? In what way? The child being circumcised does not choose. No one cares about his preference. No one waits to hear his opinion. The child is subjected to the choice, preference, and opinion of his parents. Permanently.

Seriously, if municipalities in San Francisco or Santa Monica honestly believe parents can’t be trusted to decide what’s best for their newborn’s foreskin, why on earth would they let them leave the hospital with the rest of him? It just doesn’t make sense.

California law already believes that parents can’t be trusted to decide what’s best for their newborn’s foreskin, but on the discriminatory view that only the female prepuce should be untouched without need or consent of the patient.

No wonder these anti-circumcision organizers have their sights on the rest of the country. We’re a bunch of nosy busy bodies who believe in an abbreviated version of freedom where we’re free to publicly debate what someone else should do with their private parts or the private parts of their newborn.

The status quo is the society with an abridged version of individual freedom. Again, the law in California (and most other places) already ended the public debate on what someone may do with the private parts of their daughters. Does that restrict parental “rights”? This debate is about fixing the status quo into a legitimate version of freedom where every individual, male or female, gets to decide which unnecessary genital surgeries they undergo or reject.

**********

To address a point Mr. Granderson raises, the issue of the “Foreskin Man” comic book series is relevant to the discussion. It is not the end of the discussion, as some are suggesting. That the series is embarrassing, and that issue two uses anti-Semitic imagery, is undeniable. The comic book is disgusting and has no place in the discussion by anyone advocating against non-therapeutic male child circumcision. It is a shameful mark on its creators.

That said, I hope it’s abundantly clear that only a minority of people opposed to non-therapeutic male child circumcision accept this type of filth. As the Jewish Circumcision Resource Center states, “there is no organization that controls, or could control, what individuals who oppose circumcision may say or do.” The first issue of “Foreskin Man” is probably unhelpful, but issue two is unacceptable. But it’s not reflective of the principles involved or the majority of those who support and advocate those principles. I have commented elsewhere on this, and will let that stand as my personal defense. I also recommend this post from The Volokh Conspiracy as a useful guide on objectionable material.

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