Circumcision is such an insanely inflamed topic in moms-of-baby-boys circles that, as someone who neither buys the medical arguments for circumcision nor thinks that circumcising infant boys is a terrible ethical breach, I've spent years trying to avoid the topic online. So I thoroughly enjoyed this episode's deep dive into Internet Bull…
Circumcision is such an insanely inflamed topic in moms-of-baby-boys circles that, as someone who neither buys the medical arguments for circumcision nor thinks that circumcising infant boys is a terrible ethical breach, I've spent years trying to avoid the topic online. So I thoroughly enjoyed this episode's deep dive into Internet Bullshit: The Circumcision Edition. Great research and presentation, Jesse. And this was probably Katie's funniest sign-off ever.
When I was still hospitalized after the birth of my baby boy, my Southern mom asked me if I was going to have him circumcised. (Circumcision was nearly universal among white Southerners when I was growing up, I'd guess for reasons that started with 19th-century beliefs about hygiene and turned into a "Let the boy look like his father" tradition over time.) I said no, I wasn't, and she said, "You know he'll always have terrible recurrent infections until you circumcise him." I wanted to ask her if she thought that ~70% of the world's men and boys were going around getting recurrent penile infections all the time, but I chickened out and just said, "My baby, my decision."
Fast-forward a few weeks to my attempt to meet other moms at the local La Leche League meeting in my lefty town. Somebody asked if I'd had my baby circumcised, congratulated me for not having done it, and added, "Men who don't have foreskins lose sensitivity and thrust more violently during sex." I guess I could have asked her if she thought ~30% of the world's men were going around having violent sex all the time, but I chickened out and got the hell out of there.
Thank goodness my kids are older and I can now talk to the other parents about uncontroversial issues like sex ed and gender identity.
While I really wanted a son, I stopped short of forming a full opinion on this and counted it as a small blessing that along with "The Football Question" I'd probably never have to make this decision. (I ended up with a house full of girls and an entirely different bucket of concerns)
However, I do lean a bit towards "if there's not overwhelming evidence, leave well enough alone" when it comes to body modification for, supposedly, medical reasons and particularly with something as critical to well being as genitals.
The one thing that really gets under my skin though is when the Intactivists (god, what a great word) try to compare circumcision with FGM / clitorectomy. They are not even remotely the same and I feel it trivializes the severity of the later by comparing to something as minimally impactful on life as circumcision seems to be.
FGM/clitorectomy is more akin to penectomy or castration.
It's worth mentioning that there is more than one form of FGM and one of the more common forms is the removal of the clitoral hood which is very similar to make circumcision.
Additionally, botched circumcisions where part or all of the glans are removed or where severe infection leads to even more severe damage, do happen. Probably about as frequently as the most severe forms of FGM given how common circumcision is. In some countries, like South Africa, death and infection leading to the loss of the penis is common as a result of ritual circumcision.
So yeah FGM is often a horror show that can be far more severe than a successful circumcision performed in a western hospital, but that discounts A: unhygienic, unskilled forms of male circumcision, and also the thousands of botched procedures done in hospital. When you perform millions of circumcisions, even a small error rate maims an awful lot of people in really horrible ways for really no reason.
So I don't think you're making a fair comparison here.
There are 4 classifications of FGM defined by WHO. The most common, 1-3, include clitorectomy and significant alteration of labia. The 4th is a catch all. WHO lists examples of this category, but doesn’t mention hoodectomy.
Circumcision complications like you speak of are in the .04% range. I agree even that is too much if there’s no medical benefit.
However, your description of FGM implies the harm is mainly due to not being performed professionally and if so would be closer to circumcision.
This is fundamentally incorrect. FGM procedures are intrinsically harmful. They permanently eliminate the ability to orgasm, cause life long problems with urination, pain, and medical issues. Not due to complications…due to the direct consequences of the changes made.
This seems like a willful misinterpretation of what I said.
>However, your description of FGM implies the harm is mainly due to not being performed professionally and if so would be closer to circumcision.
Literally nothing I said would lead any reasonable person to think I was implying that the harm of FGM was in the unprofessional nature of the needless maiming.
>FGM procedures are intrinsically harmful.
Yes, as is male circumcision, even if not to the same extent on a case by case basis.
>Circumcision complications like you speak of are in the .04% range.
Assuming that figure is correct, which it may be in the most developed countries in the world, but absolutely nowhere close to reality in places like the Philippines or South Africa, it's 0.04% of an extremely large number. Hundreds of millions of people X 0.04% is a massive number of people. Hence my point about raw numbers of extremes like the loss of the glans, the penis itself, or lack of function or death.
>There are 4 classifications of FGM defined by WHO. The most common, 1-3, include clitorectomy and significant alteration of labia. The 4th is a catch all. WHO lists examples of this category, but doesn’t mention hoodectomy.
Clitoridectomy in the data is not distinguished from the removal of the clitoral hood. Both are covered in type 1, even though one or the other may be performed. The removal of the clitoral hood is analogous to male circumcision.
The most severe forms of FGM are also the most commonly practiced in many countries. This is betraying a serious lack of knowledge about the extent and damage of FGM.
That's not even accurate. The most common forms are pricking, the removal of the clitoral hood, and the partial or complete removal of the clitoris. The prevalence of the latter three is only known collectively because that's how the data is collected. The most severe form, where the vaginal canal is sewn shut, is by far the least common procedure.
In any case, I'm strongly opposed to all of it and think it's all barbarous. What I am saying is, that a lot of FGM is not totally distinct from male circumcision in terms of harm. Even the most severe forms have their analogue with male circumcision, though not intentionally. But in developing countries it's shockingly common for boys to have part of their glans removed, or lose their penis to severe infection. Is losing your penis less bad because it wasn't on purpose but instead the outcome of a totally unnecessary procedure? Or do you think it's about the same for the person without a penis?
That's clearly a straw man. You made a claim, that the "most" severe forms of FGM were the most prevalent. This is not correct. That doesn't therefore mean I don't think the removal of the clitoris is serious. I consider all genital mutilation serious, and have stated that very clearly already.
The most common form of FGM is Type I, which includes type IA, which is analogous to male circumcision, and type IB, which is the full or partial removal of the clitoris. The problem with your claim, even if this was the most severe form, which it isn't, is that the data doesn't distinguish between type IA and IB in terms of prevalence. We don't actually know which of these two is the most common. It's either a procedure that is nearly identical to male circumcision, which completely undermines your entire point, or it's a more severe procedure, which at best is basically a red herring in the context of whether it's ethical to surgically alter baby's genitals electively. If people were amputating arms in China for a cleaner look, that wouldn't make male circumcision okay just because by comparison, it's less severe.
It also doesn't help that there are a lot of different forms of FGM. With some of the more mild forms, where a small amount of tissue is taken from the clitoral hood or even where the vulva is cut with nothing removed yeah, I can see the comparison. But for ones that remove the clitoris and sew the labia together? Obviously a different thing.
I always had angst over circumcision (and football) when thinking about my hypothetical future sons. It's medically unnecessary, but it's culturally encouraged and cultural expectations aren't nothing. I'm almost certain that I'd circumcise my sons if I were Jewish or Muslim. Luckily (?) for me, I married a guy who has said "no circumcision and no football." And I'm fine with that for my hypothetical future boys.
Even if you limit the comparison to the most severe forms of FGM, there are reasonable comparisons to be made, just not in terms of intent. Nobody is aiming for these outcomes with male circumcision, but some of them are nonetheless horrendous.
The most severe forms of FGM are intentional. The most severe forms of male circumcision, aren't, though are probably more numerous because the procedure is orders of magnitude more common. Nobody intentionally removes the glans in part or in full, but it happens because of botched procedures. Nobody amputates the penis altogether, but it happens because of infection. When you perform tens of millions of circumcisions, this happens. When it comes to ritual circumcision or some of the less hygienic but not totally primitive versions practiced in Asia and Africa, the rates of serious complications are astronomically high.
Fair. I tend to focus on the intent piece, since bad outcomes are always a risk with any surgery. But I can see an argument that intent is less important when you're talking about the number of individuals who could be hurt.
Intent matters in terms of how you treat the perpetrator, it's almost irrelevant to the victims of whatever the act is. So I would agree if the context was what ought to be done about people performing FGM vs male circumcision, that intent was really important. But the context is the effects on the people who are being circumcised, so I think overall harm in terms of outcome is more relevant to that side of the issue.
I feel more certain about no football than I do circumcision. I played football my entire life, but the evidence is just too significant at this point...
Oh my goodness, moms/mom groups are a total minefield! When my friend was pregnant with her first child, her OBGYN gave her two pieces of great advice. The first was just to neutrally agree with whatever parenting advice gets thrown at you and then do whatever you want.
"Letting your baby cry it out is barbaric!"
"Yeah, I've heard that"
"The only way your child will ever sleep is if you use the cry it out method"
"Yeah, I've heard that"
The second piece of advice was to imagine that she had an umbrella over her and envision all the unsolicited noise about parenting as raindrops dripping off the umbrella.
In the 1990’s we just avoided in general talking about these divisive subjects that always make people feel defensive by asking our doctors, discussing it with the father’s of the children and in general deferred to the father’s opinion unless the doctor had really good arguments on the other side. I asked my three grown sons later if they were glad they were circumcised and they all answered in the affirmative. I definitely thought about it and researched the topic and knew that there were good arguments on both sides of the issue. Like everything in life, it was a very nuanced topic with no clear cut answer. But we just didn’t hyperventilate over the decision. “Our baby, our decision”!
How is unnecessarily removing part of an infant's sex organ not a "terrible ethical breach" if there Is not medical justification?
Like sure, it's not as bad as amputating a limb, but in the absence of some health benefit, which you acknowledge isn't likely to be present, it's highly unethical.
Circumcision is such an insanely inflamed topic in moms-of-baby-boys circles that, as someone who neither buys the medical arguments for circumcision nor thinks that circumcising infant boys is a terrible ethical breach, I've spent years trying to avoid the topic online. So I thoroughly enjoyed this episode's deep dive into Internet Bullshit: The Circumcision Edition. Great research and presentation, Jesse. And this was probably Katie's funniest sign-off ever.
When I was still hospitalized after the birth of my baby boy, my Southern mom asked me if I was going to have him circumcised. (Circumcision was nearly universal among white Southerners when I was growing up, I'd guess for reasons that started with 19th-century beliefs about hygiene and turned into a "Let the boy look like his father" tradition over time.) I said no, I wasn't, and she said, "You know he'll always have terrible recurrent infections until you circumcise him." I wanted to ask her if she thought that ~70% of the world's men and boys were going around getting recurrent penile infections all the time, but I chickened out and just said, "My baby, my decision."
Fast-forward a few weeks to my attempt to meet other moms at the local La Leche League meeting in my lefty town. Somebody asked if I'd had my baby circumcised, congratulated me for not having done it, and added, "Men who don't have foreskins lose sensitivity and thrust more violently during sex." I guess I could have asked her if she thought ~30% of the world's men were going around having violent sex all the time, but I chickened out and got the hell out of there.
Thank goodness my kids are older and I can now talk to the other parents about uncontroversial issues like sex ed and gender identity.
While I really wanted a son, I stopped short of forming a full opinion on this and counted it as a small blessing that along with "The Football Question" I'd probably never have to make this decision. (I ended up with a house full of girls and an entirely different bucket of concerns)
However, I do lean a bit towards "if there's not overwhelming evidence, leave well enough alone" when it comes to body modification for, supposedly, medical reasons and particularly with something as critical to well being as genitals.
The one thing that really gets under my skin though is when the Intactivists (god, what a great word) try to compare circumcision with FGM / clitorectomy. They are not even remotely the same and I feel it trivializes the severity of the later by comparing to something as minimally impactful on life as circumcision seems to be.
FGM/clitorectomy is more akin to penectomy or castration.
It's worth mentioning that there is more than one form of FGM and one of the more common forms is the removal of the clitoral hood which is very similar to make circumcision.
Additionally, botched circumcisions where part or all of the glans are removed or where severe infection leads to even more severe damage, do happen. Probably about as frequently as the most severe forms of FGM given how common circumcision is. In some countries, like South Africa, death and infection leading to the loss of the penis is common as a result of ritual circumcision.
So yeah FGM is often a horror show that can be far more severe than a successful circumcision performed in a western hospital, but that discounts A: unhygienic, unskilled forms of male circumcision, and also the thousands of botched procedures done in hospital. When you perform millions of circumcisions, even a small error rate maims an awful lot of people in really horrible ways for really no reason.
So I don't think you're making a fair comparison here.
There are 4 classifications of FGM defined by WHO. The most common, 1-3, include clitorectomy and significant alteration of labia. The 4th is a catch all. WHO lists examples of this category, but doesn’t mention hoodectomy.
Circumcision complications like you speak of are in the .04% range. I agree even that is too much if there’s no medical benefit.
However, your description of FGM implies the harm is mainly due to not being performed professionally and if so would be closer to circumcision.
This is fundamentally incorrect. FGM procedures are intrinsically harmful. They permanently eliminate the ability to orgasm, cause life long problems with urination, pain, and medical issues. Not due to complications…due to the direct consequences of the changes made.
They simply are not in the same category at all.
This seems like a willful misinterpretation of what I said.
>However, your description of FGM implies the harm is mainly due to not being performed professionally and if so would be closer to circumcision.
Literally nothing I said would lead any reasonable person to think I was implying that the harm of FGM was in the unprofessional nature of the needless maiming.
>FGM procedures are intrinsically harmful.
Yes, as is male circumcision, even if not to the same extent on a case by case basis.
>Circumcision complications like you speak of are in the .04% range.
Assuming that figure is correct, which it may be in the most developed countries in the world, but absolutely nowhere close to reality in places like the Philippines or South Africa, it's 0.04% of an extremely large number. Hundreds of millions of people X 0.04% is a massive number of people. Hence my point about raw numbers of extremes like the loss of the glans, the penis itself, or lack of function or death.
>There are 4 classifications of FGM defined by WHO. The most common, 1-3, include clitorectomy and significant alteration of labia. The 4th is a catch all. WHO lists examples of this category, but doesn’t mention hoodectomy.
Clitoridectomy in the data is not distinguished from the removal of the clitoral hood. Both are covered in type 1, even though one or the other may be performed. The removal of the clitoral hood is analogous to male circumcision.
The most severe forms of FGM are also the most commonly practiced in many countries. This is betraying a serious lack of knowledge about the extent and damage of FGM.
That's not even accurate. The most common forms are pricking, the removal of the clitoral hood, and the partial or complete removal of the clitoris. The prevalence of the latter three is only known collectively because that's how the data is collected. The most severe form, where the vaginal canal is sewn shut, is by far the least common procedure.
In any case, I'm strongly opposed to all of it and think it's all barbarous. What I am saying is, that a lot of FGM is not totally distinct from male circumcision in terms of harm. Even the most severe forms have their analogue with male circumcision, though not intentionally. But in developing countries it's shockingly common for boys to have part of their glans removed, or lose their penis to severe infection. Is losing your penis less bad because it wasn't on purpose but instead the outcome of a totally unnecessary procedure? Or do you think it's about the same for the person without a penis?
Sorry, if we're not considering removal of the clitoris severe FGM I think we're done here.
That's clearly a straw man. You made a claim, that the "most" severe forms of FGM were the most prevalent. This is not correct. That doesn't therefore mean I don't think the removal of the clitoris is serious. I consider all genital mutilation serious, and have stated that very clearly already.
The most common form of FGM is Type I, which includes type IA, which is analogous to male circumcision, and type IB, which is the full or partial removal of the clitoris. The problem with your claim, even if this was the most severe form, which it isn't, is that the data doesn't distinguish between type IA and IB in terms of prevalence. We don't actually know which of these two is the most common. It's either a procedure that is nearly identical to male circumcision, which completely undermines your entire point, or it's a more severe procedure, which at best is basically a red herring in the context of whether it's ethical to surgically alter baby's genitals electively. If people were amputating arms in China for a cleaner look, that wouldn't make male circumcision okay just because by comparison, it's less severe.
It also doesn't help that there are a lot of different forms of FGM. With some of the more mild forms, where a small amount of tissue is taken from the clitoral hood or even where the vulva is cut with nothing removed yeah, I can see the comparison. But for ones that remove the clitoris and sew the labia together? Obviously a different thing.
I always had angst over circumcision (and football) when thinking about my hypothetical future sons. It's medically unnecessary, but it's culturally encouraged and cultural expectations aren't nothing. I'm almost certain that I'd circumcise my sons if I were Jewish or Muslim. Luckily (?) for me, I married a guy who has said "no circumcision and no football." And I'm fine with that for my hypothetical future boys.
Even if you limit the comparison to the most severe forms of FGM, there are reasonable comparisons to be made, just not in terms of intent. Nobody is aiming for these outcomes with male circumcision, but some of them are nonetheless horrendous.
The most severe forms of FGM are intentional. The most severe forms of male circumcision, aren't, though are probably more numerous because the procedure is orders of magnitude more common. Nobody intentionally removes the glans in part or in full, but it happens because of botched procedures. Nobody amputates the penis altogether, but it happens because of infection. When you perform tens of millions of circumcisions, this happens. When it comes to ritual circumcision or some of the less hygienic but not totally primitive versions practiced in Asia and Africa, the rates of serious complications are astronomically high.
Fair. I tend to focus on the intent piece, since bad outcomes are always a risk with any surgery. But I can see an argument that intent is less important when you're talking about the number of individuals who could be hurt.
Intent matters in terms of how you treat the perpetrator, it's almost irrelevant to the victims of whatever the act is. So I would agree if the context was what ought to be done about people performing FGM vs male circumcision, that intent was really important. But the context is the effects on the people who are being circumcised, so I think overall harm in terms of outcome is more relevant to that side of the issue.
I feel more certain about no football than I do circumcision. I played football my entire life, but the evidence is just too significant at this point...
Oh my goodness, moms/mom groups are a total minefield! When my friend was pregnant with her first child, her OBGYN gave her two pieces of great advice. The first was just to neutrally agree with whatever parenting advice gets thrown at you and then do whatever you want.
"Letting your baby cry it out is barbaric!"
"Yeah, I've heard that"
"The only way your child will ever sleep is if you use the cry it out method"
"Yeah, I've heard that"
The second piece of advice was to imagine that she had an umbrella over her and envision all the unsolicited noise about parenting as raindrops dripping off the umbrella.
Genius OB/GYN. I'm stealing this advice for my younger friends.
Obligatory:
Only rule you'll ever need to learn in parenting: The "Don't Do Fucked Up Shit" Rule of Parenting.
https://slate.com/human-interest/2018/03/parenting-doesnt-matter-that-muchas-long-as-you-dont-do-anything-super-weird.html
In the 1990’s we just avoided in general talking about these divisive subjects that always make people feel defensive by asking our doctors, discussing it with the father’s of the children and in general deferred to the father’s opinion unless the doctor had really good arguments on the other side. I asked my three grown sons later if they were glad they were circumcised and they all answered in the affirmative. I definitely thought about it and researched the topic and knew that there were good arguments on both sides of the issue. Like everything in life, it was a very nuanced topic with no clear cut answer. But we just didn’t hyperventilate over the decision. “Our baby, our decision”!
How is unnecessarily removing part of an infant's sex organ not a "terrible ethical breach" if there Is not medical justification?
Like sure, it's not as bad as amputating a limb, but in the absence of some health benefit, which you acknowledge isn't likely to be present, it's highly unethical.
Flagrant violation of the Hippocratic oath is a fairly obvious severe ethical breach.