Wednesday, November 17, 2010

Circumcision: The Most Twisted Logic in the World

By Clara Franco
This article was translated by the author and editors for DrMomma.org and SavingSons.org. It is available in Spanish here



Let’s imagine for a moment the following series of situations at the doctor’s office.


Scenario 1:

-You: Doctor, now that my baby is crawling, his fingernails get SO filthy - full of dirt! Besides, it’s hard to cut them; it is so much trouble and takes so much time. Because of the dirt and bacteria getting under his nails, and then into his nose and mouth, he’s sick all the time and getting infections. What can I do?

-Doctor: Ma’am, the best solution would be to immediately schedule an appointment to cut your baby’s fingertips off. A solution to last a lifetime!

-You: What?! How can you even think I would cut off my son’s fingertips?

-Doctor: But this is very normal. Lots of moms do it now. It’s harmless, really! We only cut a little piece at the tip of the finger, a very small bit. Only the part where the nail begins to grow. His hands really work exactly the same; but you’ll spare yourself of the trouble of cleaning his nails and trimming them - forever! You won’t even need to teach him how to wash his nails when he grows up.

-You: But doesn’t that hurt?

-Doctor: Absolutely not. Babies this age cannot yet feel pain, and even if they did, they won’t remember it.



Scenario 2:

-Doctor: It’s a girl! Mrs. X, I must remind you that your health care plan will cover the expenses in case you want to perform a radical mastectomy on your baby. The sooner, the better.

-You: A what?

-Doctor: You know, to completely remove her mammary glands. Breast cancer is now the second cause of death in Mexico for women over 25, and it’s more common every day! If we do the procedure on your daughter, you’ll forever forget about that risk. You could save her life! It’s better now that she’s a baby and she won’t remember. No cancer for her - ever! It’s becoming routine to do it when they’re this young. Remember, if you choose not to get the surgery, there’s still a 1 in 10 chance that she will have cancer and need the procedure anyway. Her mammary glands really do nothing but put her at deadly risk.

Scenario 3:

-Doctor: It’s a boy! So ma’am, we’re going for the appendectomy, right?

-You: Well, do you recommend it, doctor?

-Doctor: Absolutely. Look, more or less, four in every fifty children will have appendicitis at some point in their lives. And then it is a problem because if they don’t have the surgery immediately, they may die from peritonitis or septic shock. Now many parents choose to have the surgery done right after birth, and do away with the problem forever! We’ll remove it now, and spare ourselves from a scare when he’s older.

-You: But you’ll use anesthesia, right?

-Doctor: Oh no, that’s dangerous in newborns! We don’t apply anesthesia because then it would be a high-risk intervention. Besides, what’s the point? He’s so small and he can’t feel pain yet. He won’t even remember when he grows up.


Scenario 4:

-Doctor: Mrs. X, this is the third time in two years that your girl has had a urinary tract infection due to bad hygiene. Seriously, she needs to have surgery. These infections are much more common in girls than boys. You’ll see how quickly it is done - just a little cut to the labia, where the smegma accumulates, and that’s it. All better.


Scenario 5:

-You: Doctor, what can I do to keep my son from fracturing his foot for the third time?

-Doctor: Well, clearly, to amputate his feet would be the most effective solution!



Scenario 6:

-Doctor: Well, because we are already performing surgery on your son due to his accident, how would you like us to complete an aesthetic rhinoplasty? With an nice aesthetic nose he will be so much luckier with the ladies later on!...



If any of the situations above, as absurd and ridiculous as sound, seem impossible to us, we are being completely hypocritical. Because - surprise! - this is the very same twisted and ill-conceived logic that we’ve been applying to a single body part, of a single sex: the male genitalia.

It’s a completely altered, ashtray logic that we only apply to a male infant, when we decide we have the freedom to amputate a part of his penis… in a “preventive” manner.

Sure enough, there are societies where, in more egalitarian fashion, the same logic is applied to both sexes. There are societies that practice both female genital mutilation and male genital mutilation. For example, some sections of Indonesia, Malaysia, Somalia, Mali, Egypt, Kenya, etc.

There are also societies where, of course, neither FGM or MGM is practiced at all. But what’s despicable is the medical double standard, in societies where every individual’s body is highly respected, and amputation is a last, extreme resort - reserved solely for truly severe cases. Somehow, male genital mutilation has slipped in as a common, acceptable amputation surgery that a baby boy’s parents “have the right to choose.”

Let’s stop deceiving ourselves: every circumcision is an amputation, because it irreversibly removes an organ that has a name, specific functions, and the purpose of creating a normal sexual response. It is an organ that is healthy and that will no longer exist on the individual’s body after the surgery. Words such as “removal” or “extirpation” mean the exact same: am-pu-ta-tion. We cannot disguise it. Male circumcision is an amputation. And one that should only be decided upon by the owner of the body and no one else.

Rarely does a healthy human being need an amputation of anything. And, in the rest of the medical universe, amputations are rarely practiced. The need might arise because of severe, dated infections; extended, severe and uncared-for wounds; or because of gangrene (which is often the consequence of extended, severe and uncared-for wounds). Diabetes, for example, causes circulatory failures and a certain type of gangrene in the limbs, which sometimes makes an amputation necessary. But, again, those are cases of disease - uncared-for disease that has lasted a long time.


When is an amputation necessary?

• Malignant tumors
• Gangrene
• Severe frostbite (which is somewhat similar to gangrene: the organ or limb dies because the tissue is destroyed)
• Severe damage or trauma. For example, if one nearly loses an arm in an accident. If the arm remains only linked to the body by a very small part, and there is no way to recover it, amputation may be wise if the arm will only remain there as an infected limb.


No one in the medical establishment ever uses amputation as:

• A method of prevention
• Prophylaxis (as supposed “hygiene”)
• A first solution for treating infections
• A first solution for treating tight skin
• A first solution for treating anything

…Unless we are talking about the male prepuce. It is the only body part that we have not conceded the same respect to. Why are we getting carried away by such fallacy, such twisted logic? Why do we respect female genitalia, which by the way is more prone to infection and harder to clean than male genitalia, and yet we never, ever, cut away parts of it? In fact, in some nations (like the U.S.) there are federal laws in place to protect the female genitalia of minors from unnecessary cutting!

Something very similar has happened to our country’s medical establishment. We’ve ended up seeing this amputation (only this one, and exclusively this one), as something normal, desirable, "decidable by parents," aesthetic, hygienic, healthy. This is the only little loophole where no one seems to remember the Hippocratic Oath, or the need to use amputation only as a very last resort in rare and severe cases. We have conceded this amputation a sort of respect that it does not deserve. We have placed it into its own category within medical practice. (Look in many Healthcare Insurance Plans pamphlets: male circumcision really does have its own chapter).


The case becomes shamelessly lunatic when we realize that, today, many studies have been conducted concerning HIV and other sexually transmitted diseases which seek to legitimize the practice of male genital amputation on healthy individuals. These studies hold amputation as a starting point, and not the illness itself. How did we ever let this happen? What other medical study has ever started from the premise of amputation, and then tried to prove its use for something? To first push for genital mutilation, and then attempt to prove it to be good disease prevention.

Let’s imagine that an orthopedic surgeon performs a similar study:

“Medical research conducted by Doctor A. Smith, using experimental samples of individuals from Tanzania, has concluded that foot amputation definitely bears a positive effect in the prevention of various diseases and conditions; such as foot fractures, athlete’s foot and other kinds of fungi, ingrown toenails, and foot wound infections. When performed on newborns, amputation can also completely prevent accidents concerning “hair tourniquets,” a dangerous condition that happens when a hair or fine thread gets wrapped strongly around a toe, cutting blood supply. Out of 1,000 analyzed individuals, those who had feet amputations performed had a 95% lower chance of presenting ANY of these conditions, diseases and accidents!”

Doctor A. Smith is not lying. Amputating body parts does keep us from potentially having any trouble with those parts later. Because if we amputate, these organs or limbs no longer exist. Just as killing my neighbors would help me avoid any trouble with them in the future...

But that is such twisted logic that no one in their right mind would use. The body deserves respect. The body deserves treatment options. And it deserves integrity. It deserves our realization that every one of its amazing parts bears an important function - each and every one present to do something vital for normal health and funcitoning.

Would we support similar HIV studies if they were seeking to conclude that FGM is good disease prevention? No, we would probably dismiss such "research" as being unethical, and possibly a bit insane. As western women, we have been whole and healthy for centuries, knowing how to prevent and treat disease without resorting to amputation. By the way, these studies on women do exist. And yes, the results were that circumcised women had a lower chance of getting infected with HIV. Now who said there was no equality among the sexes...?

Unfortunately, too many of us allow ourselves to be sold nonsense justifications for amputation, for the most hollow and false reasons. Those of us sold on the surgery have an easier time if we also buy into the lies - "babies feel no pain" and "it won't hurt." If circumcision actually were helpful in reducing HIV, or sexually transmitted infections, or the latest "disease of the decade" then all our clinical trials would work the other way around. We would analyze the illness, and then conclude that it is solely and exclusively caused by this one body organ, and that amputation is truly the only way. But because this has never been, and likely never will be the case, we continue on in our desperate attempts to keep up with the myths and reinvent the latest "need" for prepuce amputation.


Clara Franco is the director of the National Organization of Circumcision Information Resource Centers Mexico chapter. Read more from Franco (in Spanish) at Mexico Intacto, follow at Mexico Intacto on Facebook, or find Franco's work in English also at:

Is the Pain of Circumcision Truly "Brief"?

Intactivists: Those Uncommon Activists

Related items: 


Routine Toe Removal Has Health Benefits

For further resources on the prepuce, circumcision, and intact care, see: Are You Fully Informed?


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2 comments:

  1. You should put medical emergency on the list of reasons we amputate (for example when someone's appendix ruptures) Love this article, it's so true!

    ReplyDelete
  2. Lars Callahan11/01/2012 3:07 AM

    I have often thought the exact same things. Thanks for posting this; it makes total sense to me!

    ReplyDelete