circumcision bannerToday is Blog Action day and the topic is Human Rights.  It seems the perfect day to announce on EP that I have taken up a new role: I am now a member of the Advisory Board for the Children’s Health and Human Rights Partnership.  What is this?  It’s a Canadian group of doctors, midwives, nurses, policy writers, IT professionals, and, well, me who agree to work to uphold the rights children have had legally bestowed on them in Canada.  Looking at the Universal Declaration of Human Rights, the United Nations Convention on the Rights of the Child, and the Canadian Charter of Rights and Freedoms, we see that the rights adopted in this country are not always respected or upheld and it is most clear when we speak of routine infant circumcision.  Yes, routine infant circumcision violates the aforementioned treaties and laws.

I have spoken about the research on the medical arguments for circumcision elsewhere (you can see all of them here).  The CHHRP has a video from it’s co-founder, Dr. Christopher Guest, which you can view here.  And there is an incredible, multi-national response to the AAP’s change in statement on circumcision which, although published in a peer-reviewed journal, is free to view and read here.  I won’t reiterate them all here, but if you believe there is a medical benefit to circumcision, please read these links.

What I want to talk about here is the parental reaction when one says that circumcision is a human rights issue and what it really means to say it’s a human rights issue in terms of advocacy.  Often I see a lot of defensiveness arise from parents that have circumcised and so I want to talk about what it means when I make my stance known.  Because I get why there’s defensiveness.  Of course there is – it’s like I’m saying you violated the rights of your child and who on earth isn’t going to be defensive about that?

First, I don’t think you’re a bad parent, a mutilator, or anything else like that.  I also don’t think you’re uneducated or didn’t look into circumcision before you made the choice.  Or rather, I don’t assume these things, because some of you may have not looked into it while some of you will have.  I will also add that I have many dear friends that circumcised.  This isn’t an issue that results in me not speaking to people in my own life.  But they also know it’s an issue I will continue to speak about.

I do like to think that if everyone had the information I had, they would come to the same conclusion as I, but I know they must also have the same cultural perspective.  It’s this latter part that I have no control over and that influences so much of how people respond to circumcision and the information about circumcision.  In Europe, most people can’t fathom why anyone would circumcise a child when it wasn’t medically indicated.  It’s incomprehensible.  Their cultural lens is one that does not have a history of circumcision being pushed for by those in power and thus it is viewed through a lens that looks at the rights of the child and sides against any procedure that does not help the child immediately or in the future.  Like circumcision.

Go to the USA, however, and it’s a different story.  Though many people seem unaware that the push for routine infant circumcision in the US started as an effort to curb masturbation amongst young men (hence the decision to remove the most sensitive part of the penis), the view of sex being bad and dirty while refraining from sex is seen as pure and clean has affected the view of circumcision.  From this original reason, the cut penis was seen as cleaner and more “godly”, in a sense.  Thus, there is a cultural lens that sees the cut penis as “cleaner” and “nicer”.  And because we are human, when we think of something as cleaner, it is also “better” and we view all the research, all the pros and cons, through the lens that the cut penis must be better.  And that lens is hard to remove.

For example, even though parents who circumcise must sign a form stating they know there are no medical benefits to circumcision, that it is purely cosmetic, people come out talking about “hygiene” issues and how uncut boys will get infections and be in pain.  Even the people doing the circumcisions are aware that’s not the case, but will sometimes subtly suggest that it’s easier to care for or better for these same reasons.  [Notably, there is an argument to be made that there are more problems in the US with hygiene because people don’t know how to properly care for an intact penis (including many doctors) and so there are problems, but the answer isn’t to cut off part of the penis, but rather to educate people on proper care (including the fact that the average age for the foreskin to retract naturally is *10* years of age).  To read on the care of an intact penis, please check this link out.]

So parents, I can see that you made a decision through your cultural lens and I don’t think you set out to hurt your child, to violate their rights, and you certainly didn’t sign up to be called names.  I get it.  But it doesn’t mean I’m going to stay quiet about the act itself or “agree to disagree” or think “to each his own”.  Because it still remains a human rights issue.

As such, the focus needs to be on those who are advocating for circumcision and performing the surgeries.  The people who are “doing the harm” so to speak.  In this I hold the individual doctors and organizations like the AAP fully accountable as violating the rights of children in their country – children who they have promised to protect and do no harm.  How?  Because they are performing cosmetic surgery on a non-consenting child.  And yes, parents can consent to necessary surgeries, but there is no medical need with routine infant circumcision, and no future therapeutic benefit strong enough to say that it should be routine.  They would never cut off a child’s fingertip or earlobe or tip of a nose with no medical reason, but the penis?  Well, that’s supposed to be different?

I also hold them accountable in not sharing accurate risks.  Is it weird that the AAP refuses to report the risk of death as a risk at all in the information they give parents?  I find that morally and legally wrong when, depending on the research, you’re looking at between 2 and 117 deaths per year due to circumcision (the large range due to what is considered “due to”).  I fail to see how parents can make informed decisions when they aren’t warned of the actual risks involved in their decision.  In fact, as pointed out by Ronald Goldman in a published response to the AAP’s statement:

[The statement on risks] ignores effects of circumcision pain on infants, two dozen surgical risks including death, functions of the foreskin, connections between circumcision and erectile dysfunction, trauma of circumcision, psychological harm to men, using condoms to prevent STDs, conflicts with its own bioethics committee, lack of true informed consent, and unknown harms that have not been studied.

In fact, because of the human rights that children are born with – even in the United States – one attorney, Mr. Peter Adler, responded (in print again) to the AAP statement with the following:

As a legal matter, the rule is that physicians cannot operate on healthy children. Boys, like girls and adults, have absolute rights under the common law, constitutional law, and human rights law to bodily and hence to genital integrity, to be free from harm, and to choose their own religion or no religion. Physicians cannot take orders from parents for reasons having nothing to do with medicine. Physicians and parents also cannot lawfully circumcise boys because men rarely choose circumcision for themselves. In fact, physicians and parents have a legal duty to protect boys from circumcision.

It all comes down to those who are performing surgeries or the governing bodies that are arguing in favour of it (notably with the push to make sure it’s covered by insurance so they can get paid).  At some point, we need these people to realize that the infant boy has as much of a right to his body as the infant girl (and I’m not talking about the extreme female genital mutilation, but the types of female circumcision that are less invasive than male circumcision yet are still disallowed).  They need to be held accountable and they need to realize they are violating law and human rights.

So parents, although I would never call you a name or suggest that somehow you don’t love your children or any other statement like that, I will ask that you look at your cultural lens.  I ask that you think about what it is about circumcision that makes you feel it’s nicer or cleaner or even acknowledge it’s about “fitting in” (though that’s something that will soon be on the decline in the USA, but cut men are a minority worldwide already).  Culture plays such a large role in our lives that when we speak of things like human rights, we still have to consider our culture.  They aren’t as universal or easily noticeable as we’d like to think.

You may still feel good in your decision to circumcise.  I’m okay with that.  But please don’t expect me to do anything less than continue to speak about a human rights issue as a human rights issue.  It’s not personal, it’s not an attack on you, but it is a statement against those who seek to violate the rights of children and systematically provide incorrect information to families.