Science

Video: Comparing Male Circumcision and FGM

Links & citations from the video plus a full transcript after the jump!

Video to which I’m responding:

Freedom0f5speech’s profile:
http://www.youtube.com/user/freedom0f5peech

PZ Myers on how these conversations often go:
http://scienceblogs.com/pharyngula/2010/05/for_the_boys_with_boo-boos.php

Citations:
http://www.who.int/reproductivehealth/topics/fgm/overview/en/index.html

http://www.who.int/mediacentre/news/releases/2006/pr30/en/index.html

http://www.jpgmonline.com/article.asp?issn=0022-3859;year=1992;volume=38;issue=3;spage=136;epage=7;aulast=McSwiney

http://www.who.int/reproductivehealth/topics/fgm/prevalence/en/index.html

http://www.path.org/files/FGM-The-Facts.htm

Hosken, F.  (1993). The Hosken Report: Genital and Sexual Mutilation of Females, fourth edition. Lexington, MA: Women’s International Network; pp. 3.

I stumbled across a video the other day by tosheatower. He was talking about circumcision, which is a topic that’s been coming up a lot on the internet lately, I think because of the recent statement by the American Academy of Pediatrics saying that they supported a certain type of female genital mutilation (or FGM) that is a ritual nick on a baby girl’s genitals. You can’t really talk about FGM) on the internet without usually men coming in and redirecting the conversation to male circumcision, probably because they think it’s related and that subject is related to FGM but a bit closer to men’s hearts, and by hearts I mean cocks.

So the video I saw was comparing FGM to male circumcision directly. tosheatower claimed that it was hypocritical for someone to be against FGM but support male circumcision. I think that’s debatable, but what he went on to say is not debateable at all. He claimed that the number of men dying due to circumcision in Africa is equal to the number of women dying in Africa due to FGM. He then suggested that FGM wouldn’t be such a big deal if it were done here in the US in a sterile environment with doctors. He concluded by comparing circumcised penises to “circumcised vaginas” and pierced ears as all being choices that a parent makes that he does not support. And to just get this out of the way I agree that male circ is pointless at best and at worst quite harmful.

In the comments on the video, I asked him to provide data to back up his statements, but he never responded. A person named drealgrin responded asking why it matters, a question that completely blows my mind. Why would the truth matter? This is the internet! It matters a great deal to me.

User freedom0f5speech did respond and sent me what data he had to support tosheatower’s claims. And thank you very much for that, freedom0f5speech I appreciate that. But the data in fact ended up supporting the opposite of tosheatower’s claims.

I’ll go into that a little bit. First let me explain for those of you like tosheatower who don’t know, the difference between male circumcision and female genital mutilation. We don’t call it female circumcision because it is nothing like what you know of male circumcision, in which some or all of the foreskin is removed from the penis.

FGM actually comes in four different flavors:

Type I involves partial or total removal of the clitoris. The clitoris isn’t like a foreskin . . . it’s actually an entire sexual organ. It’s like a tiny penis. So if it help you to see the difference, imagine that you have a very small penis, and then imagine that someone scrapes the entire thing off your body with a dull razor blade.

That’s type 1. It’s going to get worse.

Type 2 is partial or total removal of the clitoris plus removal of the labia minora, and sometimes removal of the labia majora as well. Those are the folds around the clitoris.

Type 3 is the narrowing of the vaginal opening, using the labia minora and/or majora to form a covering seal. And then when the lucky lady is raped on or before her wedding day, that orifice must be sliced open. Type 3 can also include the removal of the clitoris as well.

Type 4 is anything else, which can include the ritual pricking that the American Academy of Pediatrics recommended. And for the record that pricking is the only thing on this list that is less invasive and less damaging than male circumcision.

So let’s get back to the actual data on the number of deaths in Africa. The data that freedomofspeech sent me suggested that there are 200 deaths per year in Africa due to male circumcision and that was according to the South African Medical Journal. So if tosheatower were correct, we could expect let’s say anywhere from 100 to 300 deaths caused by female genital mutilation.

Evaluating all the stats for Africa is a bit tough, so instead let’s narrow it down to one part: the Sudan.

There are 20.4 million women in the Sudan. 90% of all women in the Sudan are estimated to be mutilated, which makes 18.35 million. Of those, according to the World Health Organisation, 1/3 die. That’s more than 6 million women.

But wait! That’s not the only way FGM can kill. Remember that type III FGM that I told you about in which the vaginal opening is narrowed…well, it’s not just that FGM can kill by blood loss or infection at the time of mutilation, it can also kill you later in life when that opening is sliced open, and particularly when a woman gets pregnant and has to give birth to babies through that opening.

Looking at the figures for women who have had FGM and had to give birth, postpartum haemorrhage during childbirth is 70% higher in women with FGM III, and it can also kill babies born to mothers with FGM. The death rate among babies born to FGM I mothers was 15% higher, 32% higher in those with FGM II, and 55% higher in those with FGM III. Altogether, a total of 10 to 20 babies per 1000 die because of FGM.

100 to 140 million women are living with FGM. If each of them attempts to have just one child, that means there will be 10,000 dead babies thanks to FGM alone.

To get back to drealgrin’s question, does it matter? Both boys and girls are hurt by mutilation, and neither male circumcision nor fgm can be supported by anything other than cultural or religious dogma. Both should be ended. But yes, it matters that we recognize the difference, because every time you falsely compare male circumcision to fgm with zero facts to back you up, you are not just making a case for ending male circumcision. You are belittling and undermining efforts to end a much more terrible problem.

I support the end of male circumcision, but not at the expense of people writing off the mutilation of millions of women.

Rebecca Watson

Rebecca Watson

Rebecca leads a team of skeptical female activists at Skepchick.org. She travels around the world delivering entertaining talks on science, atheism, feminism, and skepticism. There is currently an asteroid orbiting the sun with her name on it. You can follow her every fascinating move on Twitter or on Google+.

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59 Comments

  1. June 3, 2010 at 12:12 pm —

    Thanks for responding to the Youtube video so that we don’t have to. Egads. I have long wondered about people who thought that circumcision and genital mutilation were really comparable.

    There is one comment you made that I have to wonder about, though: “You can’t really talk about FGM) on the internet without usually men coming in and redirecting the conversation to male circumcision”

    I have met very few men who get worked up over circumcision, but I know a huge number of women who wish to inform me of the evils of it on the chance that I ever have a son. It may be a quirk of where I live, but I find that it is usually me or another man who is trying to convince someone that FGM and circumcision aren’t comparable, rather than me or another man trying to compare them to each other.

  2. June 3, 2010 at 12:22 pm —

    I feel lucky. My parents just had a flame tattoo put on my penis. That’s Unitarians for you.

  3. June 3, 2010 at 12:33 pm —

    @davew: COTW, because I can’t believe you made me laugh at a topic so heinous!

    I have nothing much to say except that I totally agree with you. When I read Ayaan Hirsi Ali’s account of her own FGM, I was horrified. Especially when she told about the women who “proudly” proclaim how smooth they are down there and how pure that must make them. gross.

  4. June 3, 2010 at 12:40 pm —

    Try telling an infant boy that having his foreskin removed isn’t as traumatic as a girl having her clitoris removed. This downplaying of circumcision is insidious.

    The effects later in life for a girl are undoubtedly worse, but the initial barbaric act is equally as painful and distressing for the child.

    Why have a separate campaign for female genital mutilation, why not a campaign against infant genital mutilation.

    • July 16, 2011 at 6:29 pm —

      I agree. They should both be stopped. It’s disappointing that there are not more articles on this website about MGM.
      Many American women have been brainwashed in to thinking it’s okay.

  5. June 3, 2010 at 12:46 pm —

    I was wondering if someone could clarify- I’ve seen Type I refer to both the removal of the clitoral hood and as removal of the removal of the hood and clitoris. I can definitely see comparing the removal of the hood as analogous to male circumcision, but that’s the only “type” that I can see making that comparison well. Is Type I universally restricted to removal of the clitoris or are there differing definitions for the types in existence?

  6. June 3, 2010 at 12:49 pm —

    The clitoris isn’t just “like” a tiny penis. It’s the direct anatomical homologue in females. It develops into the penis.

    Male circumcision involves removal of the prepuce, but that also has a female homologue: the clitoral hood. If it were just the clitoral hood that was removed, this wouldn’t be such an issue.

    FMG is more like a penectomy.

  7. June 3, 2010 at 12:56 pm —

    Comparing male circumcision with FGM is bad enough. I’ve heard conservative spokespeople put down using the term FGM. They insist on the term female circumcision.

  8. June 3, 2010 at 12:59 pm —

    “Why does the data matter?” Which is more horrifying, the barbaric acts or the disrespect for reality that enables them?

    The whole topic is fraught with so many levels of wrongness, starting with the basic premise that women are property and anything their owners do to prevent other people (i.e. men) from stealing them is fair game. It’s enough to make me ashamed of my whole gender. The fact that many women in these cultures seem to buy into it and enable (and actually enage in) mutilating their daughters makes me ashamed of my whole species.

    End-of-morning-rant. Have a nice day!

  9. June 3, 2010 at 1:01 pm —

    I’m a little lost on the correlation between increasing degrees of FGM and infant death.. Isn’t it likely these statistics correlate because locales that are more likely to carry out Type 3 FGM are also less likely to have adequate neonatal/postpartum medical care? Or is there a way it directly affects them?

  10. June 3, 2010 at 1:06 pm —

    @PeteK: OMGWTF. There is no comparison between the circumcision of a male newborn and the genital mutilation of a child age 10 and above(http://www.who.int/mediacentre/factsheets/fs241/en/) at the time, immediately afterward, or later.

    Forget an infant boy, I’ll explain it to you right now would you
    1)like to cut off your penis and maybe some of the surrounding skin or
    2)have the foreskin removed?

    Do these two things seem the same to you?

  11. June 3, 2010 at 1:09 pm —

    Regardless of which is worse, they’re both WRONG. Children are not property and they have the same right of bodily integrity as adults do. FFS when are people going to learn that kids are PEOPLE to?

  12. June 3, 2010 at 1:16 pm —

    @PeteK: Sorry, that comment is just the kind of unsupported ignorant blathering that Rebecca was discussing above. I suggest you read the post again.

  13. June 3, 2010 at 1:35 pm —

    Shoplifting and Armed Robbery are similar crimes, but they are not EQUIVALENT crimes. I’ve seen a bris for an infant, and it was unpleasant and confounding, but frankly, if I were to witness a pre-adolescent girl being readied for genital mutilation, that might lead to violence on my part.

  14. June 3, 2010 at 1:41 pm —

    I have to throw my hat in the ring here, having just had a showdown of sorts on my Facebook page. In the interest of scientific accuracy, adult male circumcision has been shown to reduce the transmission of HIV in penile-vaginal intercourse. This means that in places like Africa, where the preponderance of HIV infections occur in heterosexual men and women, being circumcised as an adult actually can help reduce risk. Of course, the surgery still carries risks of its own.

    I must add that I am staunchly anti-circumcision, and of course horrified that there is an argument comparing it to FGM. I agree that all mutilation (frankly, even ear piercing) of children should be against the law.

    I just thought you should know that there are instances in which circumcision, though not infant circumcision, is potentially beneficial. Thanks for tackling this one!

    • July 16, 2011 at 6:33 pm —

      If I were a male, I don’t think it would be “beneficial ” to choose a safe sex method which removes tens of thousands of highly erogenous nerve endings and has a 60% effectiveness rate.
      I would much rather keep my genital integrity , have more sensitivity and have a 99% effectiveness rate by using condoms.

  15. June 3, 2010 at 1:44 pm —

    Being a male, and having being circumcised at birth (I assume, I don’t recall), all I can say about it is “meh”. I don’t know what I’m missing, and the head of my penis is still quite sensitive and I can have a lot of fun with it. I would think the only comparable thing to FGM (type 1) would be the removal of the entire head of the penis. FGM sounds nothing like circumcision to me.

    What drives me crazy is that people who are often opposed to circumcision are so dramatic about it, see PeteK’s post above. “OMG! It was the most horrible thing I don’t even remember!” Please, get over your damn self.

    I had never heard of type 2 or 3, I always assumed all FGM was type 1. While type 1 is really bad and unjustifiable, I have to ask, who the fuck came up with those other ideas? That’s just sickening.

  16. June 3, 2010 at 1:51 pm —

    @PeteK: I honestly don’t know how an infant experiences pain, nor how pain experienced by an infant before the ability to form and retain memories affects adult life.

    To me, comparing the pain experienced by an infant boy undergoing circumcision and the pain experienced by an infant girl undergoing clitorectomy is a nonsensical comparison. The subjects cannot effectively communicate the severity of the pain, nor can any one person undergo both procedures for a personal comparison. Even if someone could, as a preverbal infant they wouldn’t be able to effectively communicate the comparison.

    My understanding is that there are some cultures which traditionally use circumcision as a manhood right as well as clitorectomy/labiectomy/reductive vaginoplasty as a womanhood right. In this case, when the procedures are done on pubescent children it is potentially possible to compare the pain levels, but the difference in scope, symbolism, and overall damage done is also very evident.

  17. June 3, 2010 at 2:06 pm —

    I’m totally on board with Rebecca’s point here, but I’m really doubting the figures that she threw out about 6 million females dying in the Sudan because of FGM (with the 1/3 death rate). That sentence makes it sound like the 1/3 death rate figure comes from the WHO, but I haven’t been able to find anything claiming a death rate of that magnitude on the WHO’s pages relating to FGM. Now, in the PATH article that Rebecca linked, there’s a passage that reads, “The actual number of girls who die as a result of FGM is not known. However, in areas in the Sudan where antibiotics are not available, it is estimated that one-third of the girls undergoing FGM will die.” – but that quote goes back to a Women’s Policy Inc. paper relating to some legislation. Perhaps there’s some actual hard data backing that claim up, but I have my doubts, especially where they mentioned “areas in the Sudan where antibiotics are not available”, which has now been transformed into “the entire country of Sudan”.

    Again, I’m not saying that FGM isn’t a barbaric practice – just that we, as skeptics, need to make sure not to let our statements go beyond what the data can back up. That just allows our opponents an easy target.

  18. June 3, 2010 at 2:29 pm —

    Another point that should be made is that, especially in the States, most male circumcision is done on infants. FGM is usually performed on girls nearing adolescence. Neonates don’t have a fully developed nevous system and aren’t necessarily completely innervated. The readily apparent distress could be as much from the surprise of the experience as the amount of pain associated with it. Like so many things with the no-pain-ever HOMG! parenting movement, there are all kinds of psychoses being attributed to suppressed traumas from infant circumcisions. It’s bullshit.

    But, pain isn’t really the point. Pain is quite justifiable if the procedure served a purpose, and as neonates face much greater risks from pain supression than adults and are subjected to a number of seemingly heinous procedures with no pain relief, the pain is not the biggest issue. Even if the pain and emotional trauma associated with the initial procedure were actually homologous, the risks associated are not.

    I believe it’s quite true that FGM done in a sterile environment is a very different matter. But, that only mitigates some of the initial risks. I also believe that if all other types of FGM were defeated and only the removal of the prepuce were maintained in practice, the world would be a happier, shinier place. And, we could also have this discussion in a much more meaningful way. I also hold the unpopular opinion that the “prick” might be helpful to wean immigrant families from this practice and protect individuals from being shipped off to have it done. But, that has since been retracted, and, even as it stood, hardly qualified as a recommendation or support.

    In the mean time, we get a bunch of white males (circumcision rates are much higher in whites) with generally perfectly functional penises whining, as KeithLM said, about something they don’t remember and can’t really compare. Oh, and also informing those of us who sleep with them that we’re getting the short end of the stick, ideal-human-coitus-wise. Oy. Right, and there’s some kind of magical ideal human coitus that’s not subject to complication by individual shape and preference differences. lol.

    I get the bodily integrity argument, and I agree with it and will behave accordingly should it ever actually be my decision. But the rest of it is really hard to take seriously.

  19. June 3, 2010 at 2:33 pm —

    @BarelyKnitTogether: The notion that circumcised men are safer from std’s is really moot. The statistics show that circumcised men have at best a marginally better outcome when having *unprotected* sex. When you add proper safe sex techniques into the mix, the difference is dwarfed. In short an uncut man with a rain coat is just as safe as a cut man.

    That said, I feel really sad that some men make the comparison to FGM. I’m a man, but that’s just obviously not the same thing to me. I would rather see FGM wiped off the face of the earth and never get rid of circumcision than the other way around… and I’m a man. I just wish they both go away.

  20. June 3, 2010 at 2:34 pm —

    Regarding male circumcision:

    I remember watching several videos on fora.tv, where what seemed to be very legitimate doctors and scientists claimed significantly reduced rates of STD transmission (HIV among them, but not limited to HIV) with male circumcision.

    So even if this came originally from some ancient religious BS, perhaps this should not be condemned so easily, especially in a continent where STDs are raging like wildfire?

    I do agree though that perhaps general anaesthesia would make this slightly more pleasant for the patient :-)

    Regarding FGM, thank you Rebecca for so clearly explaining what it’s about and why it’s so different.

    @rubbsdecvik:
    Do you have a link to those statistics?

  21. June 3, 2010 at 2:49 pm —

    I posted the original article regarding the American Academy of Pediatrics decisions about the “nick” on my facebook and a coworker originally from Somalia came up to be infuriated that the AAP would condone that.

    She explained that in Somalia, almost every woman she knows has FGM. She also said that it’s mainly the women pushing it because of tradition as opposed to the men. Her mother had FGM and vowed never to have it done to my coworker and felt that if her mother hadn’t died when she was a baby she would have never allowed it. My coworker’s mother swore that no mother should ever have it done to their own daughter.

    She also told me that when she goes back home and uses a public restroom, the women freak out when they hear her empty her bladder because they are so mutilated that they can’t release a full stream of urine.

    So sad and completely incomparable.

  22. June 3, 2010 at 2:52 pm —

    As a male who was circumcised, I find it especially heinous that anyone would compare it to FGM. The only similarities between the two are that they both involve genitals. My penis is fully functional.

    … This is way more information than you need, but I almost never get to chance to talk about the functionality of my penis in a conversation, so I’m going to take advantage of it.

    “I remember watching several videos on fora.tv, where what seemed to be very legitimate doctors and scientists claimed significantly reduced rates of STD transmission (HIV among them, but not limited to HIV) with male circumcision.”

    The foreskin can become dry and crack leading to small cuts that allow infections an easier path to enter the body.

    The last I read on the matter said the benefits were statistically significant, but not so much so that the AMA would recommend everyone do it.

    “I do agree though that perhaps general anaesthesia would make this slightly more pleasant for the patient”

    I think you mean local. Any time you go under, you could die. Not worth the risk.

  23. June 3, 2010 at 2:58 pm —

    http://journals.lww.com/aidsonline/Abstract/2003/01030/Acceptability_of_male_circumcision_as_a_tool_for.12.aspx

    Not exactly what I was saying, but the conclusion seems to say that you shouldn’t feel safe due to circumcision.

    http://journals.lww.com/jaids/Abstract/2007/12150/Circumcision_Status_and_HIV_Infection_Among_Black.17.aspx

    Says that amongst gay blacks and latinos circumcision status made no difference in HIV contractiblity.

    http://journals.lww.com/jaids/Abstract/1995/01000/Male_Circumcision,_Sexually_Transmitted_Disease,.12.aspx

    This one seems to say that there is a difference and circumcision should be considered but only when other alternatives such as condoms are restricted.

  24. June 3, 2010 at 3:00 pm —

    PS. I could miss interpret the above results, so please feel free to call me out. I try to be a good scientist and change my views if others come up with different ones.

    Just seems that most studies that studied this subject seem to say that it is a difference, but not enough to recommend it… and is not nearly as effective as safe sex techniques such as condoms.

  25. June 3, 2010 at 3:02 pm —

    C.S.Strowbridge: “I think you mean local. Any time you go under, you could die. Not worth the risk.”

    I guess I’m a wimp but I would actually prefer a general anesthesia :-)

    After all, the risk of dying is small (IMHO risk increases with age, and I don’t think many grandpas will opt for this kind of procedure…

    Also, I won’t even notice it when I die, will I ;-)

  26. June 3, 2010 at 3:03 pm —

    I think there’s a point that’s often missed in these discussions.
    First, to be redundant, in comparing FGM with circumcision…there is no comparison. FGM is horrifically worse by many orders of magnitude. Removing of any part of the clitoris is indeed the same as removing the penis. Period. End of story.

    However: IF the discussion is about the doctor-performed nick the hood (and I’m assuming that pediatric board was talking about the hood; if not, the rest of this is moot), bringing in the subject of male circumcision is completely appropriate. Both are then equally stupid modification done for culturally religious reasons.

    There’s no question that the subject of nicking the hood is charged with incredible emotion far beyond the subject of male circumcision, and rightfully so! The nick has more direct ties to the active and widespread barbarism of FGM whereas male circ’ has no actively equivelent horror going on in the world.

    FGM is a crime against humanity that must end, violently. No debate. And when the subject of FGM is the active topic of discussion, anyone bringing up male circ’ is at best an idiot. But if the topic of discussion is hood nicking, male circ’ should be equally addressable.
    IMO

  27. June 3, 2010 at 3:12 pm —

    @rubbsdecvik, thank you for the links, a few comments:

    Link 2: This study deals with gays and therefor is not that relevant because for they supposedly (also heard that on fora.tv) usually swap “roles”, so there is no “one” partner who can benefit from the circumcision.

    Link 3 (also Link1): “Uncircumcised men had a relatively low-risk profile in that they reported fewer lifetime sexual partners and prostitute contacts than circumcised men and were more likely to live in rural areas with lower HIV prevalence rates. ”

    Hm, I guess when behavior differences influence the outcome this much, little evidence remains about what positive effects you could perhaps find :-)

    One thing I should really clarify:
    I do TOTALLY agree with you that circumcision should in no way make you feel safe and condoms are absolutely needed for “real” protection. Still, it’s an additional layer of protection (only for the men though, not for the women) and aside from a one-time painful operation I don’t see that much of a downside here.

  28. June 3, 2010 at 3:13 pm —

    @anybody: sorry forgot to add your name I responded above to your request for links. It’s not the best, but it’s what I could find on short notice.

  29. June 3, 2010 at 3:28 pm —

    @anybody: looks like these two studies say there may be some other complications other than the one-time operation. Sensitivity and erectile functionality seems to decrease. Oddly, the satisfaction seems to increase. I wonder if this is due to social pressures. I’m not sure. I’m not saying it’s a slam dunk argument, just that I don’t think the benefits of circumcision outweigh the possible issues (all surgery is risky).

    http://www.jurology.com/article/S0022-5347(05)65098-7/abstract

    http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowAbstract&ProduktNr=224282&Ausgabe=230970&ArtikelNr=000085930

  30. June 3, 2010 at 4:02 pm —

    I don’t understand why medical studies even need to enter this debate. Sexual mutilation is performed by adults on children below the age of consent. So it’s assault. Point.

  31. June 3, 2010 at 4:25 pm —

    @sowellfan: I had the same reaction to the 1/3 and 6 million numbers so I did a bit of digging, and I thought I would share what I was able to find.

    I was not able to find the Women’s Policy Inc article. I was able to find another article that gave the one-third figure, Erika Sussman, Contending with Culture: An Analysis of the Female Genital Mutilation Act of 1996 (http://heinonline.org/HOL/Page?handle=hein.journals/cintl31&div=11&g_sent=1#201). On page 198, it says
    “Doctors in Sudan estimate that, in areas where antibiotics are not readily available, the procedure is fatal for approximately one-third of all girls subjected to the more extreme forms of female circumcision.” For this claim, they sight: (1983), Hanny Lightfoot-Klein, “Pharaonic Circumcision of Females in the Sudan,” Medicine and Law, 2, 353-60. I can’t find this paper either. (If somebody can find this source, that would be great!) But given this I think the one-third figure for all female genital manipulation in the whole of Sudan is probably off but I don’t know by how much. The one-third number seems to be for the case where antibiotics are not available, and for “extreme forms” of female circumcision, which appears to mean type 3 in this context.

    Another article by Efua Dorkenoo, Combating Female Genital Mutilation: An Agenda for the Next Decade (http://www.jstor.org/stable/40003401?seq=5), disputes the “90% of all women in the Sudan are estimated to be mutilated” claim in the “Gaps in Knowledge” section.

    I am still skeptical about the 6 million figure. Not that this has anything to do with how horrible the practice is nor does it refute the claim that the death rate is several orders of magnitude higher for FGM than male circumcision in Sudan.

  32. June 3, 2010 at 4:29 pm —

    @anybody: If you’re going to wear condoms anyway, what would be the upside: a small reduction in an already tiny risk? Pretty pointless.

    And if you’re not going to wear condoms you’re a liability, regardless.

    It’s a bit like saying everyone who drives must drink coffee beforehand to reduce the dangers of drink-driving.

    [ETA: Ok, I won’t contribute any more to the derail!]

  33. June 3, 2010 at 4:54 pm —

    @anthroslug says “I have met very few men who get worked up over circumcision”

    Many men are in denial that their infant circumcision has left them with less than a complete penis. This is comparable to many women from cultures that practice FGM who say that life is better after genital mutilation. See http://www3.interscience.wiley.com/cgi-bin/fulltext/123192872/PDFSTART

    But, with the Internet as an educational resource, many young men are angry that their parents had their sex organ cut at birth. Many of these men are restoring their foreskin in an attempt to regain what was taken from them. Unfortunately, that option is not available for women.

    I just wish everyone could agree that cutting the genitals of any child is wrong. Every child deserves to grow up with all their body parts.

  34. June 3, 2010 at 5:40 pm —

    @rubbsdecvik & @anybody I was pretty clear that the protection is only statistically significant in penile/vaginal (yes, unprotected – should have said that) intercourse, and as such is not relevant in the U.S., where most sexually transmitted cases are transmitted via anal intercourse between men.

    And I used to argue vehemently about this, because I didn’t understand the mechanism by which transmission would be easier. It seemed counterintuitive, but I’ve since learned that the mucus membrane below the foreskin is better host than the dry skin of a circumcised penis.

    I only wanted to point out an important piece of information that Rebecca seemed unaware of, because I feel strongly that we need to be extra vigilant about accuracy, and she stated that “neither male circumcision nor fgm can be supported by anything other than cultural or religious dogma,” which is not the case.

    I hope I don’t draw ire for this. I am really appalled about the idea of “nicking” genitals or any kind of mutilation, unless it truly leads to the eventual end of this activity, however, I have no hopes that it would. The physical and psychological trauma of it must stop, and I’m talking about FGM, not male circumcision. Unfortunately, the idea behind it is far from ending. The idea that women are to blame for being sexual, that they are too tempting for men to control themselves and must cover their faces and hair, and that they can be “owned” by their husbands and are of no value unless they are virgins (why type 3 exists – pretty obvious when a girl has had intercourse), are at the heart of all this idiocy. Good luck correcting that.

    Please don’t hate me. :)

  35. June 3, 2010 at 5:48 pm —

    I disagree with Rebecca on her specific point that “there is no comparison” here. If we’re going to discuss this topic, we need to be very careful about defining our terms completely clearly.

    As I discussed with another Skepchick on the previous post concerning this issue from a couple weeks ago, there are actually two subtypes of FGM type I. Usually referred to as FGM type I subtype A and subtype B, where subtype A involves removal of the clitoral hood or prepuce only and subtype B involves removal of the clitoris and the prepuce. Insofar as I can tell, FGM I subtype A is anatomically, homologously analogous to conventional male circumcision.

    While I do not have prevalence data for these individual subtypes, the general trend of prevalence for a particular type of FGM being inversely proportional to the severity of the procedure (eg. the most horrendously severe FGM type IV is the least common overall, from what I gather) would suggest that it is likely to be one of the most common types. This fact, taken along with the fact that not all male genital mutilation procedures merely involve removal of the foreskin (some procedures, especially in the Muslim world, involve insertion of foreign objects, such as pebbles, to initiate the formation of nodulous scar tissue) suggests to me that the comparisons between MGM and at least some types of FGM are not unwarranted at all and despite the casuistry and irrationally belittling nature of PZ Myers’ post, this is a serious topic that no one is raising in effort to “derail the conversation” or diminish the seriousness of FGM.

    I do not believe it is putting too fine a point on things to want to clarify things in this way.

    Also, as an aside, can we please PLEAAASE agree that any type of child genital mutilation, even if it is proven to have wildly beneficial effects in terms of STD infection reduction in later life, is still WRONGGGG to do to an non-consenting infant!? If this research showing diminished STD infection for circumcised individuals is correct, FINE, get the procedure done to yourself when you’re AN ADULT.

  36. June 3, 2010 at 5:55 pm —

    Oops, I meant “the most horrendously severe FGM type III” in my third paragraph, rather than type IV.

  37. June 3, 2010 at 5:56 pm —

    Just so it’s clear – my original post did specify ADULTS, and not in this country.

  38. June 4, 2010 at 12:01 am —

    RE: removal of clitoral hood only (type I, subtype A) vs circumcision, I still think these two practices are analogous, simply because the penis and the clitoris are both used differently in the sex act.

    The clitoris can be very painful if there is direct stimulation. Not being a guy, I have no idea what would happen if someone were to vigorously rub against the penis tip, but I would imagine that it would hurt? Or at least be uncomfortable?

  39. June 4, 2010 at 12:55 am —

    @BeardofPants, your assessment is correct. The male glans is subject to irritation until the mucous membrane keratinizes. With the constant rubbing of the glans against underwear and clothing , a calloused layer grows and somewhat protects the glans. After I restored my foreskin the glans returned to its normal mucosal state. It is painful for me to expose my glans the same way as before I restored.

  40. June 4, 2010 at 1:28 am —

    @ rubbsdecvik: “Just seems that most studies that studied this subject seem to say that it is a difference, but not enough to recommend it… and is not nearly as effective as safe sex techniques such as condoms.”

    There’s also just regular old infections. Nothing to do with sex.

  41. June 4, 2010 at 1:39 am —

    @BeardofPants: “The clitoris can be very painful if there is direct stimulation. Not being a guy, I have no idea what would happen if someone were to vigorously rub against the penis tip, but I would imagine that it would hurt? Or at least be uncomfortable?”

    There are some who say because the skin of a circumcised penis isn’t protected, the nerve endings become desensitized and therefore sex is less pleasurable. However, this is crap, as there’s no way to do a double-blind study on this. Besides, you can do actual damage to these nerves just my masturbating with too tight a grip or by doing those fake penis-lengthening exercises.

    On a side note, there is absolutely no way to lengthen your penis. Not even through surgery.

    I would compare male circumcision with removing the appendix as a child, just in case. Except, removing the appendix is a hugely invasive procedure, while circumcision is not.

  42. June 4, 2010 at 3:02 am —

    @sak: @sowellfan: Thanks guys, you’re absolutely right that I misspoke and confused my sources. Thanks for digging into the numbers a bit more . . . I’ll check it all out today and hopefully have an updated post on it soon!

  43. June 4, 2010 at 5:47 am —

    Ok, I’m in full agreement with Magnus here, so I guess I don’t have much to contribute to the discussion as a whole, but I would like to say one thing.

    I’m a circumcised man, it didn’t happen when I was an infant, but when I was a (still quite small) child. I was in Primary school (for anyone not aware read: Elementary school) and it was, I believe, when I was 10. I actually forget the exact year and my age because time has passed and I only remember certain things.

    For one thing, some of you may be asking “Why aged 10? That’s a bit messed up.” Well, it wasn’t a religious, societal or aesthetic reason, it was medical. I won’t go into detail, but suffice to say a number of doctors considered it necessary to get me snipped, so off I went for my operation.

    I distinctly remember being in hospital and still being drugged up to the eyeballs, in absolutely no pain whatsoever and feeling very happy about the fact it obviously went well. I left, still high on anaesthetic and got into my mothers car to take me home. The drugs wore off in the car.

    All I remember clearly was absolute blinding pain, screaming at the top of my voice and crying simply because the rather soft cotton of my underwear was touching the head of my penis. It was excruciating to wear clothes, and it hurt to touch it, or get it wet. In the end, I had to wear a sports cup stuffed with a very soft lining to school just so I wasn’t screaming and bawling throughout the school day.

    I’m aware that children and infants feel things rather differently, so I’m not sure if my experience is in any way analogous to circumcision shortly after birth, but I do know that it really REALLY hurt like hell when I had it done, so I’d not be quite so eager to state that it can’t have been that traumatic an experience.

  44. June 4, 2010 at 7:15 am —

    I agree with Rebecca’s point in the video.
    FGM and male circumcision are clearly not the same and while Male circumscision is pointless for the most part and should be stopped, its not nearly as much of a problem as FGM.
    However I object to the way you support your claim.
    I feel that if you use data to support that FGM is more harmful, you can’t just compare the absolute number of deaths in each group without mentioning the number of afflicted people or putting them into proper context.

    It’s like comparing absolute deaths of Polio and Flu, or like when fox news compared the deaths in California with the deaths in the Iraq war, on the grounds that Cali and Iraq are similar in size.
    I mean it’s conceivable that the reason that there are only 200 deaths due to male circumcision is that nobody does it anymore, because every single male to be circumcised gets instantly sucked into a dimension of horror and torment, before dying a terrible and unloved death.
    Unlikely perhaps, but how do you know unless you compare the number of deaths to the actual number of circumcisions.

    Of course, as it turns out complications in male circumcision are estimated at about 1% with the upper limits maybe at 10%. Of these only about 20% are as bad as an infection (this is in nigeria), and I cant readily find numbers on deaths right now, so I am just assuming its going to be rather small.

    I know I am nitpicking here and I’m sorry. :-/
    I just feel it’s really important to compare the numbers in context even if it makes no difference to the conclusion.

  45. June 4, 2010 at 7:28 am —

    @Agranulocytosis: While I agree that context is great, I was responding to a specific claim made in another video = that the number of deaths is equal, an assertion that’s frankly absurd.

  46. June 4, 2010 at 9:11 am —

    I’m against any kind of involuntary genital mutilation & made it a point that neither of kids underwnt it – I wish I’d had a say in it about myself way back when.

  47. June 4, 2010 at 9:59 am —

    OMG. I had no idea how bad FGM is and had thought they were sort of comparable with circumcision. That is friggin terrible.

  48. June 4, 2010 at 12:51 pm —

    @BarelyKnitTogether: Sorry, didn’t mean to make you think I hated you ;) . I was just joining into a side discussion. I ended up somewhat derailing the convo a little. You brought up valid points. And I even had to change my own thinking to accommodate some of the studies I found while searching for the ones I linked with.

    To go back on topic, FGM is deplorable. The notion that even clitoral hood removal is comparable isn’t really being honest. The reasons behind each are totally different. As you and others have said, FGM is just a physical manifestation of blaming women for being human. It’s a cowards solution to blame victims for being “too sexual.”

    Thanks for the discussion it was interesting.

  49. June 4, 2010 at 2:07 pm —

    I would like to point out that using terminology like “equating one to the other” is quite the false dichotomy. This particular statement sounds as if there is only one type of MGC, one type of FGC, and FGC is always worse. There are at least 12 kinds of FGC & at least 4 kinds of MGC (technically, there are more). Not all types of MGC are less invasive than all types of FGC. Take care not to paint with a broad brush.

    I made a video reply, which you can watch here:
    http://www.youtube.com/watch?v=aOk-rZTk0Rc

  50. June 4, 2010 at 2:44 pm —

    More science, Circumcision and HIV infection: review of the literature and meta-analysis. That study actually points to male circumcision being detrimental if you want to prevent AIDS.

    I’ll agree that male circumcision isn’t as bad as female. But, it’s still fucking bad. But, the thing that bothers me is that if females were given the equivalent of male circumcision, it would still be classified as mutilation. As the WHO puts it “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. “ This would include the clitoral hood, the equivalent of the foreskin. If we were to apply the same standards for both sexes either the definition of FGM is too broad or male circumcision is genital mutilation.

    Oh, and a minimal and ambiguous benefit with STDs that isn’t even relevant when a man wears condoms isn’t exactly a medical reason. Not to mention that’s a rationalization for it. The real reason is cultural.

  51. June 5, 2010 at 1:10 am —

    freedom0f5peech’s video is WELL worth its viewing time to anyone still reading this thread. Quality skeptical reasoning.

  52. June 5, 2010 at 3:26 am —

    @freedom0f5peech: I assume you’re not talking about me here, since I was quite clear in my video that there are several types of FGM and not all are more damaging than male circumcision.

  53. June 7, 2010 at 4:59 pm —

    This reminds me a bit of an article I read a few weeks ago.
    http://sfappeal.com/news/2010/05/good-vibrations-and-the-clitoris-saving-alien-cult.php

    Reading about clitoraid at goodvibes showed me a chink in my skeptical armor, you could say. I totally would have just donated without thinking twice.

  54. June 7, 2010 at 6:15 pm —

    @Restoring Tally: I read an article a while ago about a woman named Dr. Marci Bowers that brought tears to my eyes. She has spent years working on a technique to restore a woman’s lost labia and clitoris with some success, changing some women’s lives in incredible and dramatic ways.

    Besides the work she does in her own practice, she also works with this charity: clitoraid which I heartily endorse.

    Caveat: Awesome cause, some Raelian woo involved.

  55. June 18, 2010 at 9:29 am —

    The video is an awesome distillation of the points of non-comparison between the two procedures. I’m going to use it in a few days on my blog.

    In preparation for a discussion about FGM and the nicking business, I started a thread about male circumcision. One of my five readers responded, and we had an interesting discussion. My opinion is provisional, but here’s my understanding of infant male circumcision: setting the ethical considerations aside for a second, the medical benefits are well-established. The controversy lies in whether they warrant the risks of the procedure, and here’s where the ethical arguments factor in.

    A quick pubmed search of “benefits of infant male circumcision” hit a bunch of studies purporting medical benefits. A search of “risks of infant male circumcision” found studies about obvious risks inherent in the procedure itself, and I didn’t find anything refuting the established medical benefits.

    I think ultimately the arguments against male circumcision are strongest when they are confined to the very legitimate ethical concerns.

  56. December 10, 2012 at 12:10 pm —

    I am the “Drealgrin” of the “Why does it matter?” question. I only recently found this by googling myself.

    “But yes, it matters that we recognize the difference, because every time you falsely compare male circumcision to fgm with zero facts to back you up, you are not just making a case for ending male circumcision. You are belittling and undermining efforts to end a much more terrible problem.”

    Much more terrible problem? It’s only “Much more terrible” because it’s not legal. Legalize FGM and you’ll find a whole slew of new inventions making it “safer” requiring “less time” and “no anesthetic”.

    In the end, You can’t end either without ending both. Neither are worse than the other because both represent the same thing.

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