Tuesday, June 1, 2010
Gender Bias and Circumcision
9:46 PM
This is a presentation done by Yvonne Hightshoe and used with permission. Read to the end to find out how her professor and classmates reacted! (Also, if this confuses you, Google the definition of 'satire')
Every
year in the United States many newborn baby boys are blessed with a
circumcision which will benefit both their physical and mental health for the
length of their lives. While the
American Academy of Pediatrics doesn’t endorse routine infant circumcision for
every baby, they do recognize that there are potential benefits of removing the
foreskin (American Academy of Pediatrics). Removing the foreskin, also called the
prepuce, is said to create a cleaner penis by stopping the collection of
smegma, and reducing the rate of urinary tract and yeast infections (Christakis).
Contraction of some STD’s such as HIV has in addition been found by some
research to be drastically reduced by amputation of the prepuce (Auvert).
Girls also have a prepuce on their genitals, and are sometimes
circumcised in other countries; however the federal government has made this
medical procedure illegal in the United States (Federal Prohibition of Female
Genital Mutilation Act of 1995). While female circumcision is unused due to
cultural bias, it could benefit the mental and physical health of society, and
not allowing both sexes to benefit from infant circumcision is an undeniable
form of sex discrimination.
First and foremost, let me be clear on the type of female
circumcision I am endorsing as there are four categorical types of circumcision
and some are more severe than others (World
Health Organization). The most
poignant form, Type III also called infibulation, removes the clitoris and labia
minora, sewing together the labia majora and only leaving a small hole for
urine and menstrual flow. Other types,
such as clitoridectomy and excision, remove the clitoris and labia minora. Forms of female circumcision that do not fit
into these categories and are less severe are usually categorized as Type IV
female circumcision. I am by no means
suggesting removing the clitoris, or any other severe form of genital cutting
in the least bit more severe than its male counter-part. My proposal is to remove the female prepuce,
also known as the clitoral hood, and to trim the labia minora on female
infants.
American Federal Government as of 1996, made female
circumcision of a minor in any form a federal crime, stating: “Whoever
knowingly circumcises, excises, or infibulates the whole or any part of the
labia majora or labia minora or clitoris of another person who has not attained
the age of 18 years shall be fined under this title or imprisoned not more than
5 years, or both.” (Federal Prohibition of Female Genital Mutilation Act of
1995). This seems ironic considering
that somewhere between seventy-five and ninety percent of men in the United
States are circumcised, most of whom were circumcised during the neonatal
period (World Health Organization). In fact, at least sixty-one percent of
newborn boys were recorded in 2000 to be circumcised before even leaving the
hospital after birth (World Health Organization). On April 26th 2010 The American
Academy of Pediatrics released a statement regarding female genital cutting
which alleges that mutilation is an inflammatory term that disregards the self
image of women whom have undergone the procedure, suggesting female genital
cutting, a more culturally sensitive term, instead (Commitee On Bioethics). The statement went on to say “...the ritual
nick suggested by some pediatricians is not physically harmful and is much less
extensive than routine newborn male genital cutting.” Proposing an amendment to
federal law to allow for type IV female circumcision for cultural and religious
reasons.
Certainly
if it benefits the male sex to have their prepuce removed, it makes sense that
there could also be benefits to removing the female prepuce. Unfortunately, due to cultural bias regarding
the morality of the procedure, there is little to no research specifically
regarding whether or not circumcision benefits women and much of the research
that has been done usually involve much more severe forms of female
circumcision, because of this my research is largely based upon knowledge
regarding how the female genitals work and research concerning female health
complications of the genitals.
While
men benefit from circumcision, women suffer considerably more from health
problems regarding their genitals, and because of this have a greater possibly
for health benefits. The clitoral hood
and the foreskin have virtually the same function, to cover the most sensitive
part of the genitals, on men the head of the penis, on women the clitoris. An important factor in the similarity between
male and female genitals is the sebaceous glands. While the sebaceous glands are present all
over the body, except the hands and feet, they are the most plentiful on the
face and anogenital surfaces, producing an oily
substance called sebum which is associated with conditions such as acne and
dandruff (Stollery, Youn). The function
of sebum is still ardently debated by scientists, as some believe it to be a
functionless evolutionary left over, while others believe it to be an important
protective substance (“Human Skin”). The
foreskin, clitoral hood, and labia minora all release high levels of sebum, and
when sebum is allowed to accumulate in the genital region it creates a nasty
looking white cheesy substance called smegma (“Human Reproductive System” ). Usually when someone mentions smegma a
person will more often than not think of an uncircumcised penis and shudder
with disgust; however, that white substance that accumulates around the female
genitals and under the clitoral hood, is also smegma.
If
smegma is not cleaned frequently it can harden and become a painful irritant to
both the female and male genitals. The
clitoral hood, even more so than the foreskin, often proves to be very
difficult and even painful area to clean under, particularly so for parents
with small children that will not allow them to clean their genitals. I know this from personal experience as my
daughter will not allow anyone to clean anywhere near her genitals and will
scream like a banshee if you try to touch her there; as a result she often has
accumulated large amounts of smegma around her labia. The accumulation of smegma can result in
genital adhesions. Baby girls are
particularly notorious for having their labia fuse during infancy and because
of this every time we take our daughter to her “well baby” checkups her
pediatrician always checks for adhesions.
Because the clitoral hood is particularly difficult to clean under,
smegma often accumulates here and can result in complications such as clitoral
hood adhesion, similar to adhesion of the foreskin which occurs on
uncircumcised males. While there is
research being done and new experimental procedures attempting to stretch the
clitoral hood to ease the pain and discomfort of a clitoral hood adhesion, the
only treatment to truly cure clitoral hood adhesions is partial or total
circumcision (Paniel). Doctor C.F. McDonald became interested in the
health benefits female circumcision when he noticed that many girls suffered
the same genital complications as uncircumcised males, stating in a 1959
medical journal, “The signs and symptoms caused by contaminated smegma,
retained smegma or smegmaliths usually clear up when the cause is removed. The
same reasons that apply for the circumcision of males are generally valid when
considered for the female.” As the
labia minora is responsible for the most signifigant amount of sebum production
on females and the levels of sebum excretion are the highest during the neonatal
period and puberty, certainly we could avoid all these complications later in
life, if we routinely removed both the prepuce and trimmed the labia minora of
infant girls.
Male
circumcision boasts the benefits of lowered urinary tract and yeast infections,
but women are more prone to yeast infections and thirty times more likely to
develop a urinary tract infection (Cunha).
In fact, a study from the Department of Pediatrics, Brooke Army Medical
Center, found that the declining rate of male circumcision may be changing the
male to female urinary tract infection ratio during the first three months of
life, weighing it more evenly than previously
(Wiswell). While it is generally
accepted that women get urinary tract infections more easily than men because
the female urethra is shorter, these infections cannot happen without the
introduction of bacteria to the urethra.
It is common knowledge that hygiene plays in important role in avoiding
urinary tract infections, and as I have already covered keeping the female
genitals clean can be a daunting task.
The labia and clitoris are in close quarters with the urethra, and
smegma that is allowed to remain in these areas can lead to bacterial growth,
also referred to as contaminated smegma.
If a women doesn’t wipe from front to back bacteria from the anus can
contaminate the genital region and eventually make its way into the
urethra. The labia minora is very
moist, and yeast thrives in moist areas.
While often female yeast infections do originate as an imbalance of
natural yeasts within the vagina often due to antibiotics, they can also occur
on the labia minora and around the clitoris in infections such as vulvovaginal
candidiasis and vulvovaginitis (Eckert). Clearly
if we remove all this excess moist tissue where bacteria and yeast is allowed
to grow in infancy, these infections would be avoided for many girls throughout
their lives.
Cancer
is a serious threat in today’s society and circumcision plays an important role
as a preventative measure against penile cancer
(Maden). Consider this: in 2006
penile cancer claimed the lives of 280 men in the United States; however,
vulvar cancer resulted in the death of 880 women that same year (American Cancer Society). Common sense tells us that if we remove this
unnecessary tissue ahead of time, it cannot develop cancer. Research has also been done which has found
smegma to be carcinogenic; of course it’s totally irrelevant that many of these
studies were done over fifty years ago by injecting human and sometimes horse
smegma into the genitals of mice (Howe).
There is speculation that smegma may be responsible for many cases of
cervical cancer, and in addition is an agent for the spread of sexually
transmitted infections (Heins). Based on
all this evidence you can see, female circumcision could save the lives of
hundreds of women every year. Not too
long ago doctors routinely removed other nonessential organs such as the
tonsils and appendix to avoid the possibility of infections, potentially saving
lives. It’s a shame they don’t do that
anymore.
Interestingly
enough, while studies in Africa have found a significantly reduced risk for HIV
infection, most of the research appears to show the opposite effect for
women. However, if you look at the
research more closely you will notice that infection is often associated with
complications in the healing process due to poor hygiene, and use of unsterile
equipment during the procedure (Brandy).
Also what is not considered is that uncut women are more likely to have
young sex partners where as cut women are more likely to have older sex partners,
and the older men have a higher rate of HIV infection (Yount). There was, however, a study done in Tanzania
where the researchers were shocked to find that circumcised women there were at
a decreased risk of HIV infection, even with all possible factors adjusted for
(Stallings).
The
medical benefits aside, circumcising our daughters after birth could also
benefit them in their social, emotional and sexual life. While female genital
cutting is not currently culturally normal, as is male genital cutting, wide
spread implementation of female infant circumcision could benefit our daughters’
emotional well being. Remember a century
ago male circumcision was not common in the United States either, so we could
easily make circumcised female genitals just as commonplace and socially
acceptable (World Health Organization)! Many teenage girls suffer from poor body
image; they should not have to also worry about whether or not their genitals
look normal. I worry everyday about
whether or not my daughter will grow up to feel that her body is not good
enough. What if she goes to school and
other girls in the locker room tease her because her labia are longer than
theirs? She could be emotionally scarred
for life. If all infant girls had their
genitals cut in the same way, then they would all look alike and have no reason
to tease each other. All we have to do
is circumcise about 90% of females in one generation and all of the generations
to follow will believe it is culturally normal and acceptable as well.
Certainly
even her future sexual partner(s) would greatly appreciate her having tidy,
clean and sexy genitals, preferring them over an intact woman’s dirty and messy
looking saggy lips. It is estimated that
thousands of women are turning to plastic surgery procedures such as
labiaplasty, also called labial reduction or labial beautification, and
hoodectomy, also called clitoral unhooding, to obtain the ideal female
gentitals. While some have the procedures
done because of their labia causing them discomfort and hygiene problems, the
vast majority of women who undergo the procedure cite cosmetic appeal for their
reasoning (Cormier). Doctor Bernard Stern, a labiaplasty surgeon
in Florida, claims that the procedures he performs can save marriages and
change lives. Why not save our daughters
the mental anguish of having to live their lives not feeling their genitals are
good enough, and have these procedures performed on them when they are infants? This way they will be too young to even
remember the painful healing process of the procedure and will not have to
undergo such hardships as an adult.
Whether
male or female, circumcision is an extremely personal choice unique to each
family. I’m the parent and if I believe
that this is what is best for my daughter then I should be able to have my
daughter circumcised. Other parents put
their infants through the painful process of having their ears pierced, which
has no health benefits, for cosmetic and sometimes social reasons. As I have already proven, circumcision has
the potential to benefit our daughters’ mental and physical health the same as
it does our sons. Even though it’s
irreversible and it’s her genitals I’d be having cut and not mine, I’m the parent and I feel this choice is my
right to make for my daughter, the same as it’s another mother’s right to
choose it for her son. We claim cultural reasons for circumcising our sons, and
yet ignore the cultural reasons of other cultures wishing to circumcise their
daughters’ in the way their religions require.
For Federal law to condemn female genital cutting of minors, and yet
allow it for males is incredibly sexist and done solely because of cultural
biased surrounding female circumcision."
I presented this topic in power point form for an oral presentation in my Critical Thinking class. I went in very nervous about how receptive people would be on the topic. While there was some giggling when I started talking about smegma, I felt it was received well and the reactions for most people were very reflective. Several people even opened up to me more about how the subject affected them personally. My professor’s response was actually to ask if it was it was still a common practice. She mentioned to me after class that her father had thought it was a barbaric practice, so I would assume since it wasn’t normal in her family, she had no idea they still did it.
An older woman in the class, whose children are grown up now, told me about how traumatizing it was for her that her ex-husband forced her to have her son circumcised when he was three months old. She told me she had always felt as if she has mutilated him, and that it still haunted her today.
The guy that has sat next to me all semester started talking to me after class about the topic. He told me he has no idea they did that to girls before I had mentioned it in the class. He went on to tell me that his mother has had both he and his brother snipped because she had heard that it was cleaner. It wasn’t something that bothered him and he didn’t consider himself “mutilated”, but he had always wondered why they would cut off a piece of a baby’s penis.
While I did sense skepticism from some of my audience, who didn’t believe that female and male circumcision, were comparable, many people remarked during or after class “Wow. I never thought of it that way before.”
Works
Cited
American Academy of
Pediatrics. "American Academy of Pediatrics: Circumcision Policy
Statement." Pediatrics 103
(1999): 686-693. Web. 8 May. 2010
American Cancer Society.
"Cancer Facts and Figures 2006." 2006. Web. 9 May. 2010
Paniel, B.J. and R
Rouzier. Ridley's the Vulva. Ed.
Fiona Lewis Sallie Neill. Vol. 3. Hoboken: John Wiley and Sons, 2009. Web. 12 May. 2010
Bertran Auvert, et
al."Randomized, Controlled Intervention Trial of Male Circumcision for
Reduction of HIV Infection
Risk: The ANRS 1265 Trial." PLoS Med (2005): 2.
BRADY, MARGARET. AIDS Patient Care and STDs. DECEMBER 1999,
13(12): 709-716. doi:10.1089/apc.1999.13.709. Web.
17 May. 2010
Christopher Maden, et al."History of
Circumcision, Medical Conditions, and Sexual Activity and Risk of Penile Cancer." Journal of the
National Cancer Institute 85.1 (1993): 19-24,.
Commitee On Bioethics.
"Policy Statemen Ritual Genital Cutting of Female Minors." Pediatrics
(2010): 6. Web. 8 May. 2010.
Cormier, Zoe. "Making
the Cut." Shamless. 2005. Web. 8
May. 2010.
Christakis, Dimitri A., et
al.""A Trade-off Analysis of Routine Newborn Circumcision." Pediatrics.
105 (2000): 246-249. Web. 13 May. 2010.
Cunha, Burke A., MD, “Urinary Tract Infection, Males” emedicine.
WebMD. 2009.
Web. 8 May. 2010
Eckret, Linda O. MD. et
al."Vulvovaginal Candidiasis: Clinical Manifestations, Risk Factors,
Management Algorithm."
Obstetrics & Gynecology 92.5 (1999).
Federal Prohibition of Female Genital Mutilation Act of 1995. Pub. L. 104-208, div. C, title VI, Sec. 645(b)(1), Sept. 30, 1996, 110 Stat. 3009-709. Web. 10, May. 2010.
Federal Prohibition of Female Genital Mutilation Act of 1995. Pub. L. 104-208, div. C, title VI, Sec. 645(b)(1), Sept. 30, 1996, 110 Stat. 3009-709. Web. 10, May. 2010.
Heins HC, Dennis EJ, Pratt-Thomas HR. “The Possible Role of
Smegma in Carcinoma of the Cervix”. Am J Obstet
Gynec. 1958: 76; 726-735. Web. 9 May. 2010.
“Human Reproductive
System." Encyclopædia
Britannica. Encyclopædia Britannica, 2010. Web. 16 May. 2010
"Human
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Encyclopædia Britannica, 2010. Web. 16 May. 2010
Howe,
Van, RS, Hodges FM. “The Carcinogenicity of Smegma: Debunking a Myth”. J Eur
Acad Dermatol Venereol
2006;20(9):1046-54. Web. 16 May. 2010
McDonald, C.F., M.D. “Circumcision of the Female “
Milwaukee, Wisconsin GP, Vol. XVIII No. 3, p. 98-99, September, 1958. Web. 9
May. 2010.
Stallings R.Y.,
Karugendo E. “Female
circumcision and HIV infection in Tanzania: for better or for worse?” International AIDS Society.
2004. Web. 17 May. 201.0
Stollery, Nigel. "Independent Nurse: Clinical - Top 50
- Seborrhoeic dermatitis." GP: General Practitioner (2005): 111-115. Health Source:
Nursing/Academic Edition. EBSCO. Web. 16 May 2010.
Thomas E. Wiswell, et
al."Declining Frequency of Circumcision: Implications for Changes in the
Absolute Incidence and Male
to Female Sex Ratio of Urinary Tract Infections in Early Infancy." Pediatrics
79 .3 (1987): 338-342.
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"Eliminating Female Genital Mutilation: An Interagency Statement."
2008. World Health Organization. 10 May
2010 <http://whqlibdoc.who.int/publications/2008/9789241596442_eng.pdf>.
World Health Organization.
"Male circumcision: Global trends
and determinants of prevalence, safety and
acceptability." 2007. World Health Organization. Web. 12 May 2010.
Yount KM, Abraham BK. “Female genital
cutting and HIV/AIDS among Kenyan women.” Department of Sociology, Rollins School of Public Health, Emory
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7 comments:
Very well put together.
Though, I did giggle at "smegmaliths".
BRILLIANT! Thank You! Signed...Mom of 2 intact boys (and 2 intact girls)
I have 2 girls. I have never considered circumcision an option...ever. Sometimes I wish I had a boy just so I had more of an excuse to tell people about why I would not choose circumcision. When I became pregnant with my first child, I told my partner that over my dead body would a knife ever come near my child's genitals. He was shocked at my reaction. He had never really given much thought as to why he was circumcised. He had just accepted it as a part of life. I began to give him information to read on the subject of male circumcision. He soon became as horrified as I was about the thought of cutting off a piece of your perfect newborn child. He even began to feel some resentment toward his mother for doing this to him. I do feel some satisfaction that he was willing to listen and consider that the dogma he had come to accept as fact was actually fiction. I have also helped a friend who has a 2 year old boy decide not to circumcise. When I initially asked her about it, she like most others was just gonna go with the flow (Doctors are the experts, right?) and now she has a completely intact little boy. Stories like this, and education are the key to spreading the enlightenment on this barbaric, and completely useless practice. Don't be afraid to speak up.
I wish you cared as much about baby boys and girls that die in their mother's womb due to abortion, as much as you do boy's foreskins.
It is so hypocritical to care about the foreskin, but forget that they are killed in the womb.
No one is more hypocritical than the anti-abortion crowd.
Their interest in defending the rights of infants ends as soon as the baby is born.
I know because I've debated several of them and they just don't care.
Great article. I am a nurse and a mother of two healthy INTACT boys. I believe it is important that we continue to educate parents about the importance of keeping our babies' bodies whole! Thanks, and keep speaking up!
Good post and this post helped me alot in my college assignement. Say thank you you for your information.
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