Rolling Doughnut

I finally figured out how to explain the flaw in the thinking I challenged last week, the flaw that believes male and female genital mutilation are not morally equivalent. The path to missing the truth is clear. The blogger who claimed that gender is a valid surgical distinction assigned his entry to a category – “Medicine” – that misses the point. It’s a category that he would explicitly refuse to assign any discussion of female genital mutilation. He would file any such post to “Ethics”. That’s where he should’ve posted Wednesday’s entry.

In his mind, and in every encounter I’ve had on this topic, the assumption informing the lapse in reason always rests on the mistaken notion that the claimed potential benefits from male genital mutilation inform the ethics of imposing the procedure on another. It can be helpful, so it is acceptable. Obviously it’s desirable for the patient. Obviously. Also obvious, because it’s now acceptable and presumptively desirable, it must be desired by the patient. We assume that every male who can’t consent would consent if given the option, so there’s no need to bother with waiting. Waiting only increases the likelihood that one of the scary possibilities from being intact will affect the male.

But that misses the subjectivity of potential benefits and the evaluation each individual might undertake if he retains his normal choices. There is no medical need at the imposition of the surgery. Ethics must dictate a refusal to impose unnecessary surgical procedures, which is most often nothing more than tradition and conformity masquerading as medicine. The key word is impose. That requires legitimate ethical consideration, a test that cultural and ritual male child genital mutilation fail.

With female genital mutilation, our society recognizes no potential medical benefits. We do not consider the silly idea of chasing any. We assume no benefit and understand the obvious harm. We invoke only ethics, rejecting any hypothetical encroachment of speculative, preventive medicine into the ethics. Everyone in western society accepts that it is morally objectionable to impose unnecessary genital modification on a healthy individual who can’t consent, if the healthy individual is female. We know females would not consent to genital modification. Yet, we have evidence that seems to contradict this in societies that practice FGM. In the United States some adult females willingly choose cosmetic surgical alteration of their genitals. We refuse to accept the former and willfully ignore the latter.

This adherence to a gender-based relativism is the ethical myopia that leads to the mistaken belief that male and female genital mutilation are not the same immoral human rights violation. They are morally indistinguishable because humans possess human rights, not just female humans. Society errs every time it sanctions parents imposing surgical genital modification on their healthy child. We’ve reasoned our way to the proper understanding of female genital mutilation. We need to stop rejecting reason the same proper understanding of male genital mutilation.

I want to add a thought to last night’s post on whether or not male genital mutilation is morally equivalent to female genital mutilation. (It is.)

Is domestic violence perpetrated by a woman against a man morally equivalent to domestic violence perpetrated by a man against a woman?

The latter occurs far more frequently. Men are generally stronger than women. These do not matter in judging the immorality of the violence because the attack violates the individual. The outcome informs the decision on punishment, but it does not change the original fact that a crime occurred.

What’s the difference with male genital mutilation, if not gender and tradition? Neither are effective counter-arguments against facts and individual – human, not just female – rights. Each person owns his or her body from birth. We must permit proxy consent to maximize liberty. Liberty isn’t much good if the child dies. But the possibility of future medical problems is not the existence of a medical problem warranting the exercise of proxy consent to surgical intervention.

Any claim that current and future religious/cultural problems may result from normal human genitalia fails the test for permitting the exercise of proxy consent to surgical intervention. Fails it miserably.

A post at denialism blog claims that male and female genital mutilation are not morally equivalent. After some buildup, the gist of the entry:

Independent of how you may feel about male circumcision, it does not normally, or even more than very rarely, lead to long-term medical consequences. FGM nearly always does. FGM is not usually as “simple” as a pinprick. And who performs it is irrelevant. If women are co-opted into torturing each other by the dominant male culture, that is most emphatically not a mitigating factor, but a sign of how deeply disturbed gender relations in the culture are.

There are many long-term medical consequences that are discounted or ignored. Scarring is a long-term (permanent) consequence. An asymmetrical incision is a long-term consequence. But those are not what the author implies, so I’ll consider it on his strict terms that those should be ignored. Would the removal of too much skin constitute a long-term medical consequence, since it leads to painful erections? Or are we just considering a negative result such as loss of the glans and other extreme outcomes?

Regardless of the answer, the ethical question looms larger. Who decides which medical consequences matter? Risk aversion and personal preferences are subjective to the individual. If the decision-maker is someone other than the individual whose body is altered, the intervention must be medically necessary. Otherwise, the surgery is immoral. Gender is irrelevant.

Notice, too, how the margins are ignored. Some male genital modification results in devastating consequences. Some female genital modification is physically insignificant. Those cannot be tossed aside as irrelevant. They inform the discussion. Why is it that the latter is legally prohibited under all non-medical circumstances, yet the former is considered an acceptable risk in the same non-medical circumstances? We do not get to dismiss inconvenient details.

The last part about who performs the mutilation flows into the author’s next paragraph, which I’ll break into segments:

Male circ is not a method of controlling males and their sexuality.

This is incorrect. Genital mutilation – of males and females – began in America as a method to prevent masturbation, among many grand claims by its advocates. Today we have the constant defense of the practice for males¹ based on a reduced risk of female-to-male transmission of HIV. What is the justification for modifying the genitals of infant males if it is not an attempt to control their sexuality? The undeniable assumption is that they will not be competent enough to practice safe sex. Remember that the studies from Africa involved only voluntary, adult circumcision. Transferring such findings to infants requires assumptions.

Also consider two very common defenses given for mutilating infant boys in America. Proponents claim that circumcised men take longer to orgasm than intact men. First, consider what that suggests about the long-term consequences on male sensation from the foreskin and the loss of the foreskin. Although I am not making the claim here that this is true, advocates of circumcision always deny this logical conclusion. But it is very clearly meant as the preferred expression of male sexuality. And it is most often imposed on infants. Second, the assumption is that he wouldn’t last long enough, however long that might be, without the removal of his foreskin. Another decides for him. I refuse to redefine the concept of control.

The other common claim is that women prefer the circumcised penis. A male’s future partner’s assumed preference matters exclusively, even though he may prefer to be intact and might choose to reject any woman who would reject him for having the body he was born with. Think of the corrollary. If men prefer large breasts and we forced breast implants on females, would we view that as an attempt to control female sexuality? What is this, if not control?

Continuing:

In nearly every culture that has ever existed (and one might argue that this is even more true of cultures that circumcise), males are dominant. FGM is always—always—a method of controlling women and their sexuality.

If we’re establishing that societal attempts to control an individual’s sexuality through surgical alteration is immoral, and we are, then we’re done. We can wrap potential benefits around the procedure for males, but it is not the least invasive option for any of its claimed benefits. The conclusion is the same. The surgical alteration of a healthy, non-consenting individual’s genitals is immoral. Gender is irrelevant to the fundamental moral claim. The extent of the damage is irrelevant to the fundamental moral claim. We may decide that legal punishment should differ based on actual results (including the uncommon extremes for each, which means minimal punishment for lesser forms of FGM), but the act itself is immoral. Every victim – female or male – is a victim.

For a similar analysis applied to religious male genital mutilation, see this entry from my archives.