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CRImes o~ GenItal mutIlatIon

- from Pain to Pleasure .
The Truth Seeker Co., Inc.

In this issue of THE TRUTH SEEKER we are addressing the irrational forces PRESIDENT
of religion and social customs that support the torture of children (male and female) Bonnie Lange
through the mutilation of their genitals; and which oppose sexual pleasure.
There could hardly be a better issue for FREETHINKER's support and EDITOR
involvement. As science supported the truth that Galileo discovered, so too does James W. Prescott
science support the truth of the incalculable injury, pain and suffering that is
needlessly inflicted upon children through the dogma of irrational religious beliefs
that dictate genital mutilations. No religion has the right to engage in torture, GUEST CO-EDITOR
mutilation or human sacrifice, yet all of these have been justified through religious Marilyn Fayre Milos
beliefs at one time or another. Tragically, the mutilation and torture of children
continues today in "primitive" and so-called "civilized" countries through the rituals
of circumcision and other forms of genital mutilation. EDITORIAL BOARD
Gareth Branwyn, Edd Doerr
In order to bring an end to this torture and mutilation of children the First
International Symposium On Circumcision was held on March 1-3, 1989 in Ana- Robert T. Francoeur, Roger E. Greeley
heim, California. Leading authorities in these various medical, scientific, legal and John Holmdahl, Barbara Honegger
religious disciplines summarized their state-of-the-art findings that unequivocally Lillian Starr, Gordon Stein
rejected and condemned the ritual mutilation of the genitals of children.
Of particular significance was the finding that the destruction of sexual passion GRAPHIC ARTISTS
and pleasure was a common motive for genital mutilation in both tribal and David Mettey
religious belief systems. The control of sexual passaion and pleasure in both males Debbie Mitchell
and females was considered essential for personal morality and social order.
Additional scientific evidence was summarized that established a strong causal
relationship between deprivation of physical affectional relationships, including the
United Printing Services
sexual relationship, with violent and authoritarian behaviors and cultures. These
deeply rooted moral value systems were recognized as a significant barrier to social
change. A Metamorphosis from a pain/violent valued society to pleasure/peaceful ADDRESS
valued society, where women are truly equal with men, was considered essential if The Truth Seeker
the genital mutilation of children and other forms of human violence are to be P.O. Box 2832
San Diego, California 92112-2832
TH E TR UTH SEEKER is privileged and honored to be the first to publish the
core proceedings ofthis International Symposium that provides for the first time, in
a single document, the leading medical, scientific, legal and religious thinking on the SUBSCRIPTION RATES
ritual genital mutilation of children. It is through the pioneering efforts of Marilyn Single Issue: $ 4.00
Fayre Milos, R.N., Director, National Organization ofCircumicision Information Yearly: $20.00
Resource Centers (NOCIRC) that made this International Symposium possible International $25.00
and who has agreed to serve as a Guest Co-Editor for this issue of THE TR UTH
Because of the complexity of this subject matter some of the essays are more
technical than usual, as is the length of this Special Edition of THE TRUTH
SEEKER. It is the objective of this edition of THE TRUTH SEEKER to provide FRONT COVER:
unequivocal scientific and moral evidence to health professionals and political/ reli-
gious leaders of the world that would help bring an end to the genital mutilation of Circumcision was practiced in Egypt
children worldwide. Your support in this quest is invited and how you can help is as long ago as 4000 B. C. According to
outlined in "A Call For Action" and on pages 53-54. the inscription on this bas-relieffrom
the Ankh-Mahor tomb at Sakkara,
the youth balks and must be held by
the doctor's aide.
Adopted from: Sixth Dynasty bas-
relief from the tomb of Ankh-ma-hor
at Saqqara.
Freethinker's Publication Since 1873 • A Bimonthly Journal of Free Thought and Inquiry

I HAD KNOWN Marilyn Fayre Milos

Social-Cultural Perspectives:
IN CAIRO, EGYPT Mohamed Badawi

Medical Perspectives
35 FIRST, DO NO HARM George C. Denniston
46 LETTERS '" Paul M. Fleiss; David S. Bate & John A. Erickson

Legal Perspectives

EXCISION AND INCISION International Symposium On Circumcision

55 SUPERIOR MEN. Chapter IV James Hervey Johnson
- A CAll FOR ACTioN -
The greatest crime against humanity is the torture and mutilation of Hence He Who Values
children. Child abuse and neglect, particularly in its extreme forms, represents a His Body
form of torture and mutilation. Not commonly recognized as child abuse and
More Than Dominion
neglect and a form of torture and mutilation is the ritual mutilation of genitals
of children (male and female). One reason for the non-recognition of these Over the Empire
crimes of genital mutilation and torture of children is their common occurrence Can Be Trusted
and their support by religious and social traditions of various kinds. Another With The Empire
reason is the denial and/ or indifference to the pain that is being inflicted upon
these children.
He Who Loves
This edition of THE TR UTH SEEKER provides critical information on His Body
the truth of genital mutilations with dramatic illustrations of the horrors that More Than Dominion
children experience when their genitals are mutilated. The long-term devastat-
Over The Empire
ing consequences ofthis torture and mutilation upon the lives of these children
are also reviewed. Can Be Given Custody
Of The Empire
It is the intent of this edition of THE TRUTH SEEKER in conjunction
INTERNATIONAL NETWORK NEWS to inform the world of these atroci- Book One, XIII:31
ties and to bring an end to the genital mutilation of children worldwide.

Our strategy is to petition the World Court, The Hague, through a

national government, to have declared that all genital mutilations of children
are violations of Article V, United Nations Declaration of Human Rights
M ENT" (see p. 53). All professional, health, scientific and freethought organi-
zations that are concerned with the well-being of children are requested to place
this resolution on their agenda at their next annual meeting for endorsement.
These completed endorsements will be submitted to the World Court in
support of the petition to end the genital mutilation of children worldwide.
Be not ashamed, woman
A second effort will be directed at the State Legislatures to inform them of - your privilege
the child abuse nature of genital mutilations and that such genital mutilations encloses the rest,
constitute an act of torture of children. Appropriate legislation will be sought to
and is the exit,
end these crimes against children. Readers of THE TRUTH SEEKER, pro-
fessional, health, scientific and freethought organizations concerned with the of the rest;
well-being of children are urged to endorse the citizen's petition to State You are the gates
Legislatures to bring an end to the genital mutilation of children. (see p. 54). of the body,
and you are
Your individual and collective support of NOCIRC, The Womens Inter- the gates
national Network News and the National League For the Separation ofChurch
of the soul.
and State to achieve these objectives is invited.

Walt Whitman
I Sing the
Body Electric

James W. Prescott


Infant Circumcision: "What I Wish I Had Known"
by Marilyn Fayre Milos
I didn't know what circumcision was when I consented to The course of my life was changed on that day in 1979. I
hllVe my three sons circumcised. My doctor had told me the have now dedicated my life to bringing an end to this
surgery was a necessary health measure, that it didn't hurt, horrendous practice.
and that it only took a moment to perform ... like cutting the 1liJJ1liJJ1liJJ1liJJ1liJJ1liJJ1liJJ1liJJ
umbilical cord, I thought. I certainly wasn't prepared when, Copyright 1988, Reprinted with permission of the author.
in nursing school several years later, I saw the surgery for the Marilyn Milos is the mother of three circumcised boys,
first time. grandmother of one intact child and is the Director of the
We students filed into the newborn nursery to find a baby National Organization of Circumcision Information Re-
strapped spread-eagle to a plastic board on a counter top source Centers. She has spoken widely and is frequently
across the room. He was struggling against his restraints featured on radio and television shows across the United
- tugging, Whimpering, and then crying helplessly. No one States, including the Phil Donahue Show. Her work has been
was tending the infant, but when I asked my instructor if I covered by numerous newspapers and magazines, from the
could comfort him she said "Wait till the doctor gets here." I New York and London Times to small-town papers.
wondered how a teacher of the healing arts could watch On April 9, 1988, the California Nurse's Association Region 9
someone suffer and not offer assistance. I wondered about presented Marilyn Milos, R.N. with its highest honor, the
the doctor's power which could intimidate others from fol- Maureen Ricke Award, "for her dedication and unwavering
lowing protective instincts. When he did arrive, I immediately commitment to righting a wrong" and for her work on the
asked the doctor it I could help the baby. He told me to put behalf of children "to raise public consciousness about Amer-
my finger into the baby's mouth; I did, and the baby sucked. I ica's most unnecessary surgery."
stroked his little head and spoke softly to him. He began to
relax -and was momentarily quiet.
The silence was soon broken by a piercing scream - the
baby's reaction to having his foreskin pinched and crushed as
the doctor attached the clamp to his penis. The shriek intensi-
fied when the doctor inserted an instrument between the
foreskin and the glans (head of the penis), tearing the two
structures apart. (They are normally attached to each other
during infancy so the foreskin can protect the sensitive glans
from urine and feces.) The baby started shaking his head back
and forth - the only part of his body free to move - as the
doctor used another clamp to crush the foreskin lengthwise,
which he then cut. This made the opening of the foreskin
large enough to insert a circumcision instrument, the device
used to protect the glans from being severed during the
The baby began to gasp and choke, breathless from his
shrill continuous screams. How could anyone say circumci-
sion is painless when the suffering is so obvious? My bottom
lip began to quiver, tears filled my eyes and spilled over. I
found my own sobs difficult to contain. How much longer
could this go on?
Duringthe next stage of the surgery, the doctor crushed the
foreskin against the circumcision instrument and then, @@@@@@@@@@@@@@@
finally, amputated it. The baby was limp, exhausted, spent.
I had not been prepared, nothing could have prepared me, :: IF ANYTHING ::
for this experience. To see a part of this baby's penis being cut
off - without an anesthetic - was devastating. But eyen IS SACRED
more shocking was the doctor's comment, barely audible
several octaves below the piercing screams of the baby,
"There's no medical reason for doing this." I couldn't believe @ IS SACRED @
my ears, my knees became weak, and I felt sick to my
stomach. I couldn't believe that medical professionals, dedi-
Walt Whitman
cated to helping and healing, could inflict such pain and @ The Children of A dam @
anguish on innocent babies unnecessarily. @ @
What had I allowed my own babies to endure? and why?
Religious Traditions and Circumcision
by Gerald A. Larue
The second youth also stands before a squatting mortu-
Just when and why circumcision was first prac- ary priest (Figure 3). H is left hand rests on the priest's head;
ticed in the ancient Near East is not known, but the right hand is by his side. He says to the priest, "Tho-
it was widely attested in antiquity. roughly rub off what is there." The priest who holds the
penis in his left hand and is prepared to operate with the
The practice of the painful mutilation of the foreskins of large flint knife (Figure 4) held in his right hand, responds,
infant males in A merica rests upon biblical and religious "( will cause it to heal." Two separate individuals seem to
traditions plus spurious medicalfiction (prevention ofpenile be represented, but it has been suggested that perhaps two
infection, penile cancer, cervical cancer in partners of uncir- stages of the rite of circumcision are being portrayed.
cumcised males). It is my intention to examine the biblical
background for the practice of circumcision.
Just when and why circumcision was first practiced in the
ancient Near East is not known, but it was widely attested in
antiquity. Bodies from 4000 Before the Common Era
(B.C. E.) exhumed in Egypt disclose evidence of circumcision
(Breasted. 353, p.IO). Ancient Egyptian art, on those occa-
sions when the genitals of Egyptian males were depicted,
provide pictorial evidence of male circumcision. For exam-
ple, the carpenter portrayed in a Sixth Dynasty (2350-2000
B.C. E.) tomb at Saqqara with his loin cloth pulled to the rear
clearly reveals his circumcised penis. (Figure I)
A relief from the Sixth Dynasty tomb' of Ankh-ma-Hor at
Saqqara portrays the circumcision of two puberty-aged
youths. (Figure 2) A mortuary priest squats on his haunches
before one standing youth whose hands are firmly held by an
assistant. In the left hand, the priest holds the boy's penis and
in the right is what appears to be a circular flint with which he
is removing the prepuce. The priest says to his assistant, "Hold
him and don't let him faint. "The assistant responds, "I will do Figure 2: Circumcision ritual.
as you request."
A stele from the 23rd century B.C.E. indicates that Uha,
the author, was circumcised in a mass ritual. He wrote:
When 1was circumcised, together with one hundred and
twenty men, there was none thereof who hit out, there
was none thereof who was hit, and there was none
thereof who scratched and there was none thereof who
was scratched.
(Wilson, Circumcision)

However, not all Egyptians were circumcised.

The fact that one youth in the Sakkara relief is being held
suggests that it was not uncommon for a youth to faint or
perhaps to flail violently during the operation. Uha indicates
that during the mass circumcision ceremony, the participants
reacted without any untoward physical responses.
Herodatus, who visited Egypt in the fifth century B.C.E.,
reported that "they practice circumcision for the sake of
cleanliness, for they place cleanliness before comeliness" (II,
37). A mythological reference in Chapter 17 of the Egyptian
Book of the Dead states that the sun-god Ra circumcised
himself and that from the drops of blood two protective
deities came into being, so that perhaps there was a pro-
phylactic symbolism in the Egyptian practice.
However, not all Egyptians were circumcised. X-rays of
the mummy of the Eighteenth Dynasty Pharaoh Ahomse
(16th century B.C.E.) prove that he was not circumcised. It is
possible that his successor, Amenhotep I, also was uncircum-
Figure 1: Circumcised carpenter
(Col1linued on nex( page)


Religious Traditions and Circumcision (Continued)
folk-tale (written prior to Genesis 17) associated with Moses:
Circumcision was practiced Then it happened, at a stopping place along the way. that
by some Semitic groups. Yahweh met him (Moses) and tried to kill him. Then
Zipporah (M oses' M idianite wife) took a piece of Oint and
cised (Harris, Weeks, 126-130). It has also been suggested cut off her son's foreskin and touched his feet (genitals)
that although circumcision was common among the upper with it, saying. "You are my blood-bridegroom." So he let
classes and may be recognized as a puberty rite, it was not a him alone. At that time she said "blood-bridegroom" in
requirement. The poorer, common folk did not necessarily reference to circumcision. (Exod. 4:24-26).
undergo circumcision. This strange inser-
tion into the fenth cen-
Assyrians and Babylonians were not furr B.C.£. temple fic-
circumcised. Nor were the Philistines who tion about Moses sug-
are derogatively defined in the Bible as gests that circumcision
became Hebrewcustom
"the uncircumcised"... through contact with
the Midianites. Yah-
Circumcision was practiced by some Semitic groups.
weh's demonic inten-
Jeremiah, in the seventh century, included Edomites, Am-
tion to kill Moses was
monites and Moabites as among the circumcised (9:25).
magically thwarted by
Assyrians and Babylonians were not circumcised. Nor were
the rite of circumcision
the Philistines who are derogatively defined in the Bible as
performed on the infant
"the uncircumcised"(Judg. 14:3; 15:18; I Sam. 14:6, etc.) An
son (the beginning of in-
eleventh century B.C. E. ivory from Megiddo, portrays a
fant circumcision')). Pcr-
ruler, seated on his throne between cherubim (Figure 5).
haps the reference to
Among those in the approaching procession is a soldier
"blood-bridegroom" re-
leading two nude captives, presumably Semites, both of
Oects the custom of cir-
whom are circumcised. (Figure 6)
cumcision bcfore mar-
riage. Just as t he vi rgi n
N or is it possible to know for certain just why or bride would lose her hy-
how circumcision originally came into being. men. testified to by
bloody wedding-night
sheets (Deut. 22: 13-19),
the removal of the pre-
puce would be the
groom's parallel loss.
Just how the Hebrew
word for father-in-law
which means, literally,
"the circumciser" may
be related to pre-marital
circumcision is not
known. The reference
to the use of a Oint blade
in an age when copper,
bronze and iron were
known and used, sug-
gests the antiquity of
the ritual and may indi-
cate a link to the Egypt-
ian custom of using Oint
Figure 4: Flint blade from tools for circumcision.
about 3000 B.C.E. A seventh century
Figure 3: Circumcision rite B.C. E. reference to cir-
cumcision, which also refers to the use of a Oint cutting tool,
Herodatus suggested that other peoples, including the appears in biblical conquest-of-Palestine fiction:
Jews, borrowed the custom from the Egyptians (II, 104), but
there is no way to verify this statement. Nor is it possible to Yahweh's demonic intention to kill Moses was
know for certain just why or how circumcision originally magically thwarted by the rite of circumcision
came into being. performed on the infant son (the beginning of
Circumcision in the Jewish Scriptures infant circumcision?).
The earliest reference to circumcision in the Bible is in a (Conlinued on nex/I}{/Ke)


Re/(f{ious Traditions and Circumcision (Continued)

Certainly, there could be no significance to The Abrahamic covenant, invented by priests,

a massive pile of foreskins! transformed circumcision from an ethnic cus-
tom into a theological divinely ordained legal
At that time Yahweh said to Joshua, "Make yourself requirement.
flint knives and squat down and circumcise the people of
Israel for a second time." So Joshua made flint knives their inclusion in the divine promises. Failure to circumcise or
and circumcised the people of Israel on the hill of fore- be circumcised marks a breach of the covenant.
skins. (Josh. 5:2-3) The story concludes with the 99-year-old Abraham cir-
Subsequent verses form an apologia explaining that the cumcising himself, his son Ismael, who was 13 years old, and
reason the Hebrews had not been circumcised was that for all male members of his extended household. A year later,
forty years they had been wandering in the desert wilderness. when 90-year-old Sarah bore Isaac, Abraham had the boy
circumcised on the eighth day (Gen. 21 :4).
Now, in an ethnic ritual, they would affirm their cultural
During the last quarter of the fourth century S.C E., Alex-
unity as a circumcised people.
ander the Great conquered the ancient Near East and he and
The reference to the squatting or sitting position (based on
his successors introduced Greek customs and culture into the
the Greek Septuagint rather than the Hebrew Mascretic text), expanded empire. One of the innovations was the gymna-
the use ofa flint tool and the fact ofa mass circumcision, once sium. The Greeks did not circumcise and when young Jews,
again ties the custom to ancient Egypt. The site of the rite at enamoured by Greek culture, entered the gymnasium where
Gilgal may indicate a hillock where mass circumcision rituals exercises were performed in the nude, they were embarrassed
were enacted. Certainly, there could be no significance to a when their physical deformity became apparant. To con-
massive pile of foreskins! Although it is not specified, it may form, they underwent an uncircumcision process. The Mac-
be assumed that all males were circumcised at this time cabean report, which was written about 100 B.C E., reads:
- both adult and infant. They constructed a Gentile-style gymnasium in Jerusa-

Figure 5: Megiddo Ivory

A still later tradition (post-sixth centurl' S.C.E.) traced lem. They also pulled forward their prepuces thereby
Hebrew circumcision back to Abraham. According to this repudiating the holy covenant (I Macc. I: 15).
fiction, the deity made a religious-legal covenant with Abra-
ham, the father of the Jewish people, by which Yahweh
... they also hid the circumcision of their
would be the unique god oftheJews and they would worship genitals, that even when they were naked
him alone. In ancient times, covenants were sealed with they might appear to be Greeks.
marks and symbols; the seal of this covenant was the mark of
CircumCISion: The Jewish historian Josephus, who wrote during the late
... for your part, you must keep my covenant, you and first century of the Common Era (C E.), commented:
your descendants ... every male among you must be ... they also hid the circumcision of their genitals, that
circumcised. You shall cut off the flesh of your foreskin, even when they were naked they might appear to be
and that will be the symbol of the covenant between us. Greeks. (Antiquities, X II, v.I).
Throughout all your generations every male shall be Dependant upon how completely the foreskin had been re-
circumcised at the age of eight days ... (Gen. 17: 10-12). moved, it was possible to cut and pull forward the loose skin
The regulation included slaves whether Jewish or foreign. of the penis (epispasm) to form a partial foreskin. However.
Failure to be circumcised resulted in excommunication such an act, as the author of Maccabees noted, constituted a
(17: 14). denial and rejection of both their circumcision heritage and
The Abrahamic covenant, invented by priests, trans- their Jewish heritage thereby placing such persons outside of
formed circumcision from an ethnic custom into a theological the covenanted community. As we shall see, much later, when
divinely ordained legal requirement. It is not a puberty rite Christianity developed, the reversal of circumcision, while
nor a pre-marital ritual, it is a covenantal sign to be inflicted perhaps no longer common, was apparantly still practiced.
on infant males on the eighth day after birth to signify (Conlinued ol1nex' page)


Religious Traditions and Circumcision (Continued)

The first Christians were Jews and were Paul argued that "in Christ Jesus neither
therefore circumcised. circumcision nor uncircumcision
count for anything"
Anti-Judaism became a major issue under one of Alexand-
er's successors named Antiochus IV, who ruled Judea from Paul established new Christian groups in the Greek world.
Syria. He forbade circumcision and his agents killed those His pattern seems to have been as follows: he would speak in
whose infants were circumcised together with the circumcised a Jewish synagogue concerning the end of the age and Jesus
baby (I Macc. 1:48, 60f). After a bitter struggle, the Jews as the Christ and means of salvation. Some Jews would listen;
experienced a brief time of freedom, before they came under others rejected him. Among those attending the synagogue
Roman domination. were non-Jewish Greeks, attracted perhaps by the monothe-
Interestingly enough, towards the close of the second cen- istic faith and ethical ideals. Some were drawn to Christianity
tury RC.E., when the Jewish prince Hyrcanus invaded and but, when they wished to join the new group, they were
conquered Idumia, he offered the Idumenas a choice: to be informed by the conservative elements in the church that
exiled or to become Jews. They chose the latter, were circum- before they became Christians they had to become Jews and
cised, and thus became instant Jews. They were not truly be circumcised. Paul saw this demand as a stumbling block
accepted by traditional Jews, and when Herod the Great inasmuch as adult male Greeks had no intention of being
- the strongest Jewish ruler - assumed the throne, his circumcised. Therefore he wrote to the Christian church he
Idumean background earned him the label of "half-Jew." had founded in Galatia.
Circumcision was not enough. In this letter he challenged the validity of circumcision as a
Other reasons for circumcision that were advanced by criterion for membership in a Christian church. He castigated
Jewish Philosophers were to curb sexual desire. Philo, an the leaders in Jerusalem. He pointed out that Cephas (Peter)
Alexandrian Jewish Philosopher, born in the last quarter of had been two-faced in the matter by swaying to the conserva-
the 1st Century, B.C., justified circumcision to reduce sexual tive side when confronted by the circumcision party after
desire since engaging in intercourse for pleasure was being agreeing that Paul's mission was to the circumcised (Gal. 2).
"like pigs and goats;" and Moses Maimonides in The Guide Paul argued that "in Christ Jesus neither circumcision nor
ofthe Perplexed taught that circumcision would "bring about uncircumcision count for anything" (5:6), and expresses the
a decrease in sex ual intercourse and a weakening ofthe organ wish that for members of the circumcision party the circumci-
in question" ... and that "The bodily pain caused to that sion blade might slip and more than the foreskin be removed
mem ber is the real purpose of circumcision (Part III, Chapter so that they might "mutilate themselves"{5: 12).
49). The same issue appears to have surfaced among the Chris-
tians in the city of Corinth. Paul wrote a letter to this group in
which he stated:
Was anyone already circumcised when he was called (to
be a Christian)? Let him not seek to remove the marks of
circumcision. Was anyone uncircumcised when he was
called? Let him not seek circumcision. (I Cor. 7: 18).
Obviously, there were some who sought to disavow their
Jewish heritage by removing the mark ofcircumcision, just as
their ancestors had done during the time of the Maccabees.
For Paul neither circumcision nor uncircumcision counted
for anything. Ultimately the matter was referred to the Jerus-
alem council where, after serious debate, it was decided that
circumcision was not a requirement for membership in the
Christian community (Acts: 15).

For present day Jews, circumcision is both

a covenant rite and a naming ceremony.

Figure 6: Artist's enlargement of figures.
For present day Jews, circumcision is both a covenant rite
and a naming ceremony. Orthodox Jews follow ancient prac-
Circumcision in the Christian Scriptures tices. On the eighth day, the infant son is taken to the Mohel
The first Christians were Jews and were therefore circum- (the circumciser) for a rite performed according to a primitive
sised. The Gospel of Luke reported that Jesus was circum- ritual. The blood flow is stopped by wine, held in the Mohel's
cised on the eighth day (2:21). The apostle Paul was also mouth - a custom which some Jews find revolting. These
circumcised on the eighth day (Phil. 3:5). As the Christian believers are fulfilling Torah requirements. Non-orthodox
church began to move out into the Mediterranean world and Jews may have their sons "done" in a hospital setting. Even
attract non-Jews, circumcision became a problem for con- Jews who have moved away from Judaism toward a secular
verts. The issue came to a head (no pun intended!) in the or humanistic way of life, continue to have their sons circum-
Galatian controversy. (Continued on next page)


Religious Traditions and Circumcision (Continued)
cised. Christians, too, have their male offspring circumcised References:
in some cases because Jesus was circumcised but far more
often in an unthinking, uncritical way as something that is Breasted, James H, (1933): THE DA WN OF CONSCI-
done fo newborn malesAs better information regarding cir- ENCE, N.Y., Scribner.
cumcision is circulated, outmoded beliefs concerning medical Bullough, V. (1976): Sexual Variance In Societl' and History.
or health benefits will be discarded. Only ancient beliefs will Wiley: Interscience. New York.
remain as a stimulus for the continuation of this barbaric
custom. Harris, James E. and Weeks, Kent R. (1973): X-RA YING
THE PHARAOHS. Scribners, N.Y.
Maimonides, Moses (1963): The Guide 0/ The Perplexed.
Dr. Gerald Larue is professor emeritus of biblical history and (Shlomo Pines, Trans). Vols. I & II. University of Chi-
archeology at the University of Southern California and cago Press. Chicago.
chairman of the Committee for the Scientific Examination of Wilson, John (1950): Circumcision in Egypt, in James E.
Religion. A prolific author, Larue's books include Ancient Pritchard, edit, ANCIENT NEAR EASTERN TEXTS
M.I'th amI Modern Man, Sex and the Bihle, Euthanasia and RELA TING TO THE OLD TESTAM ENT, Princeton
Religion, and, most recently, Ancient M.I'th and Modern University Press, p. 326.
Lili'. He is the recipient of the American Humanist Associa-
tion's 1989 Humanist of the Year Award.


"The delusion of blood pol-

lution in the Hebrew religion
was carried over into Christian-
ity and accounts for the lew
Testament edict: 'Indeed.
according /0 the Lall', it might
almas/ be said e\'eIT/hing is
cleansed hI' h/ood and lI'i/hoUi
the shedding o/h/ood there is no
forgi\'eness. '(Hebl'l'\\'s 9:22)"

The !\'hole scheme 0/ Chris/ian

sall'a/ion is based upon the belie/
tha//he crucifi'xion a/Jesus was
a blood a/onell1el7l for the re-
demp/ion 0/ man for ha\'ing
been born in sin: "In iniquitl' I
lI'as brough/ /0 birth and 111.1'
1II0ther concei\'ed me in sin"
(Psalms 51:5).

Joseph Lewis
In The Name 0/ Hwnani/.I'

Photo Credit: Albrecht Durer From: Passion 0/ Christ

ft The Geography of Genital Mutilations ~
by James DeMeo
Northeast Africa and the Near East, with a subsequent diffu-
Genital mutilations elicit severe pain and ter- sion outward into sub-Saharan Africa, Oceania and possibly
ror in infants and children and are often very even into parts of the New World. They have generally been
transmitted from one region to another by virtue of reloca-
dangerous to health. tion diffusion, accompanied by phases of military conquest of
This paper summarizes portions of a prior study of the cultures which do not mutilate by invading cultures which do,
geographical aspects of human behavior among subsistence- or by voluntary adoption in association with other cultural
level aboriginal peoples (De Meo, 1986, 1988). Thefocus here changes of an antisexual and antichild nature. One must keep
will specifically be on the phenomenon of male genital muti- in mind the premarital, pubertal character of the mutilations
lations. Genital mutilations are often classified as a "cultural as originally practiced by most cultures, performed at a time
practice," but there is growing evidence that this benign- of otherwise great sexual interests and passion. I have dem-
sounding label merely serves to dismiss or evade the painful onstrated elsewhere that the global distributions of genital
and contractive effects the mutilations have upon the psyche mutilations are similar to that of other patrist antichild,
and soma of the child. Genital mutilations elicit severe pain antifemale, and antisexual cultural factors, such as infant
and terror in infants and children and are often very danger- cranial deformation, swaddling, the virginity taboo, vaginal
ous to health, which raises important questions how they blood taboo, male domination of kinship and inheritance,
could have gotten started in the first instance. People who do and so on (DeMeo 1986).
not engage in such practices view them almost always with Figures 1 and 2 show the overlapping distributions of
horror and disbelief, while people who do them often have various types of male and female genital mutilations, respec-
difficulty imagining life without the practice. Oftentimes, the tively, as they existed among aboriginal, subsistence-level
presence or the absence of the rites are seen as important peoples within the last several hundred years. As such, the
requirements for the selection of a marriageable partner, and maps greatly minimize or eliminate the influences of the
very powerful emotions focus upon them. Genital mutila- diffusion of European peoples within the last several hundred
tions are among the most strongly defended, or defended years. For example, the maps do not reflect the existence of
against, of all cultural practices. Among the various theories male circumcision as adopted in the USA over the last 100
developed to account for the mutilations, their geographical years; North and South American data is composed from
distribution has only rarely been discussed (DeMeo 1986). aboriginal peoples only. The various forms of the mutila-
tions, and the source for the mapped data, are discussed
Genital mutilations are among the most strongly below. A detailed discussion offemale genital mutilation will
be given later by Fran Hosken, whose work (1979) provided
defended, or defended against, of all cultural the basis for the map of female mutilations.
The global distributions of the male and female genital Circumcision only gained the status of being a
mutilations among native, non-Western peoples, along with "hygienic operation" in relatively recent times.
history and archaeology, suggest their genesis in the deserts of (Continued on next pal?e)

Figure 1: Male Genital

'10 ISO

• ~

!. ~ Indonesia

'~. • Micronesia

Western ~.• ~. IIS._.

Australia Eastern o

II Incision
\:J IV . 40


~ ~li~~~n~Clsion, '°1'--+---t,°,;;--"'90,-----,'!;;2°,-----;7lS""°-....,11Ob:---:f,SO.------:',f;;20:---.::0'-----,..0~-.-/'0



The Geography of Genital Mutilations (Continued)
Male Genital Mutilations ies were developed: Northwest Australia, specifically the
Kimberly region, was identified as a location where genital
Incision, the least harsh of the male genital mutilations,
skin stripping was performed, and some beheved that cir-
consists of either a simple cut on the foreskin to draw blood,
cumcision and subincision spread into Australia from that
or a complete cutting through of the foreskin i.n a singl.e place
region, diffusing to the east and south. C?n .the other hand,
so as to partly expose the glans. Incision eXisted pnmanly
independent development of the traits WithIn Austraha has
among peoples of the East African coast, in Island Asia a~d
been argued, based upon the observation that the most
Oceania, and among a few peoples of the New World. Cir-
intense forms of subincision occurred in the desert center of
cumcision, a harsher mutilation where the foreskIn of the
the continent, being absent in a few border regions where only
penis is cut or torn away, was and is practiced across much of
circumcision was practiced (DeMeo 1986).
the Old World desert belt, and in a number of Sub-Saharan,
The Ethnographic AtlasofG.P. Murdock (1967) provided
Central Asian and Pacific Ocean groups. When performed
most of the data for Figure l. Murdock's A tlas also contains
during pUbert~, circumcision was largely a premarital rite of
raw data on the age at which the mutilations were customar-
pain endurance. . . .
ily done among a globally-balanced sa~ple of 350 cultures: A
Circumcision only gained the status of beIng a "hygienic
map of that data which I constructed Indicated that genital
operation" in relatively recent times, although the most recent
mutilations possessed a widespread distribution, centered on
and best medical evidence has in fact shown that routIne
Northeast Africa and Arabia. Furthermore, the greater the
circumcision has neither short nor long-term hygienic benef-
distance from those central regions, the older was the male at
its; indeed, it has mild to severe negative psychological and
the time of the mutilation (DeMeo 1986, p. 159). As one
physiological effects. Particularly in the bush,. under less than
moves farther and farther east from Africa and the Near East,
sanitary conditions, the circumcised boy mfant or chIld
would have been at greater risk than the uncircumcised boy.
The most severe male genital mutilation, a form of skin- genital mutilations possessed a widespr~ad dis-
stripping, was practiced along the Red Sea coast in Arabia tribution, centered on Northeast Africa and
and Yemen at least into the 1800s. Here, In an endurance Arabia.
ritual perfo;med on a potential marriage candidate, skin was
the males are progressively older at the time of the mutilation.
flayed from the entire penile shaft as well as from a regIOn of
Furthermore, the practices occur less frequently and undergo
the pubis. The community blessing would only be bestowed
a gradual dilution of harshness as distance from those cen~ral
upon the young man who could refrain from expreSSIng
regions increases. Genital skin stripping, t~e harshest mutIla-
emotion during the event (DeMeo 1986). . . .
tion was centered on the Red Sea region, and was sur-
Another harsh ritual, subincision, was practiced pnmanly
among Australian aborigines and on a few Pacific Islands. It
rou~ded by a region practicing only male circumcision. Cir-
cumcision, in turn, gives way to the less harsh practice of
consisted of a cutting open of the urethra on the unde.fSld~ of
incision as one moves eastward across the Pacific. Genital
the penis down to as far as near the s~rotum? the subIncIsIOn
mutilations were not practiced at all among most of the
ritual was generally preceded by a CircumCISion ntual. The
aboriginal peoples of the Americas or Eastern Oceania. It was
practice did not confer any contraceptive adv~ntage, an? no
precisely in these regions of mutilation absence where the
claims as such were made for it by the Austrahan abongmes.
decorative "penis tops" were most frequently found aJ?ong
The geographical aspects of the Australian genit~l mutila-
native peoples, indicating a similar interest in the genltaha,
tions has been studied previously, and two competIng theor- (Continued on nexl page)

Figure 2: Female Genital Mutilations (After Hosken 1979 and Montagu 1945)




20 \ )!1.
• Infibulation ~\\J'

~ Excision
·0 .0
Present, 70~---";;---t)O"---bO;:;'----Q\"",-----,;t20'-~'5;oO-"t;'0:-----';1500
D but type unclear


The Geography of Genital Mutilations (Continued)
but only in a decorative and pleasurable sense. mads, and culturally transformed around 3100 BC These
invaders, who possessed Asian and Semitic characteristics,
Genital mutilations were not practiced at all ushered in an era of divine kings, ritual widow murder, a
among most of the aboriginal peoples of the military and priestly caste, massive graves and fabulous grave
wealth, temple architecture, and other trappings of extreme
Americas or Eastern Oceania. patriarchal authoritarian culture (De Meo 1986, p.218-294).
From the standpoint of the pain involved in circumcision As discussed below, cultural tendencies of a similar direction,
as a puberty or premarital rite, the easterly decline in mutila- but of lesser intensity, are positively correlated with genital
tion frequency and dilution of the rite towards less painful mutilating cultures of more recent times.
methods, and to older ages, makes perfect sense if we also
assume that the emotional attitudes, beliefs, and cultural According to biblical scripture, the Hebrews
institutions which originally mandated the painful ritual were institutionalized the mutilations after the Exo-
likewise diluted as they were carried eastward from a North- dus from Egypt, and it thereafter became a spe-
east African or Arabian point of origin (DeMeo 1986). With cial mark of the tribe.
the social and emotional root reasons for the rituals becom-
ing diluted with time and distance, less painful methods According to biblical scripture, the Hebrews institutional-
such as incision were substituted, or it was put off as long as ized the mutilations after the Exodus from Egypt, and it
possible, certainly well past the period just before marriage, thereafter became a special mark of the tribe. The mutilations
preferably into the period of old age. Or it was relinquished appeared widely across the Near East prior to the eruptions of
altogether. In the Near Eastern desert regions where the Moslem armies in the 600s AD, but were subesquently spread
social institutions and emotional roots for the ritual re- wherever Moslem armies ventured. While neither male nor
mained, but where the pain of the mutilation was feared as a female genital mutilations have any specific Koranic man-
puberty / premarital rite, it was occasionally shifted into date, Mohammed thought them to be "desirable," and they
infancy, or adopted as such from the start. predominate in Moslem areas. Still, there are regions of
There have been several phases of diffusion of the mutila- non-Moslem Africa and Oceania which possess the mutila-
tions. Egyptian bas-reliefs give the earliest known unambigu- tions as a probable diffusion from ancient, pre-Moslem
times. Diffusion from these earliest periods may also yet
it seems probable that genital mutilations, were account for isolated, rare examples of the traits in the ew
World (DeMeo 1986, p. 358-426).
introduced before 2300 BC, when the Nile Valley
was invaded by militant pastoral nomads, and Male genital mutilations were never adopted
culturally transformed around 3100 Be. widely in Europe, European Australia, Canada,
ous evidence of male genital mutilations, performed as a Latin America, in the Orient, or by Hindus,
puberty rite during the early Dynastic era, about 2300 BC Southeast Asians, or Native Americans.
(Paige 1978, Montagu 1946). However, it seems probable
Male genital mutilations were never adopted widely in
that genital mutilations, were introduced before 2300 BC
Europe, European Australia, Canada, Latin 'America, in the
when the Nile Valley was invaded by militant pastoral no~ (("omint/I'd on nl'.n page)

Figure 3: 110 ISO

Areas Influenced or Occupied by Arab Armies Since 632 AD (after Pitcher 1972). The Islamic empire spread genital mutilations into
many new areas of the globe, and reinforced it in others. However, genital mutilations had spread into sub-Saharan Africa, Oceania, and
the New World, prior to the Islamic period, notably among caste, high god, and warrior-emphasizing peoples.


The Geograpl7l' of Genital Mutilations (Continued)
Orient. or by Hindus, Southeast Asians, or 'ative Ameri- High narcissism index
cans. The spread of the rite of infant circumcision to the Slavery and Castes are present
United States during the late 1800s and early 1900s is a most Class stratification is high
recent phenomcnon not reOected on the maps. Circumcision Land inheritance favors male line
gained in importance in the USA only after allopathic medi- Cognatic kin groups are absent
cal doctors, playing upon prevailing sexual anxieties, urged it Patrilineal descent is present
as a "cure" for a long list of childhood diseases and "dis- Female barrenness penalty is high
orders, "to include polio, tuberculosis, bedwetting, and a new Bride price is present
syndrome which appeared widely in the medical literature Father has family authority
known as "masturbatory insanity, " Circumcision was then Polygamy is present
advocated along with a host of exceedingly harsh, pain- Marital residence near male kin
inducing devices and practices designed to thwart any vestige Painful female initiation rites are present
of genital pleasure in children (Paige 1978). Segregation of adolescent boys is high
Oral anxiety potential is high
Reich saw the real purpose of circumcision, and Average satisfaction potential is low
other assaults upon the child's sexuality, to be Speed of attention to infant needs is low
High God present, active, supportive of
the reduction of the child's emotional fluidity human morality
and energy level, and their ability to experience One cannot extract a list of correlated prochild, profe-
maximal pleasurable genital excitation later in male, or sex-positive traits from Textor's work as cultures
life ... which mutilate the male genitalia do not generally possess
such characteristics. Male genital mutilations are found
Freud and other psychoanalysts have discussed male geni- present in a cultural complex where children, females, and
tal multilations as inducing a form of "castration anxiety" in weaker social ethnic groups are subordinated to elder,
the child by which the taboo against incest and parricide is dominant males in rigid social hierarchies of one form or
pathologically strengthened (DeMeo 1986). Montagu (1946) another. While the cross-cultural analysis contrasted only
and Bettleheim (1962) have discussed their connections to the aboriginal, subsistence-level cultures, many of the factors
male fear of vaginal blood, where menstruation is imitated identified in the above list are or once were applicable to
(subincision), or where the male must be ritually absolved of the USA, where male circumcision predominates. It must
contact with poisonous childbirth blood (infant circumci- be noted, however, that many or most of those patristic
sion), or hymenal blood (pubertal circumcision). Reich iden- characteristics may be present in cultures where genital
tified genital mutilations as but one, albeit a major one, of a mutilations are absent, but which can be accountedfor by
series of brutal and cruel acts directed toward infants and deprivation ofphysical affection in the maternalinfant and
children which possess hidden motives designed to cause a adolescent sexual relationships (Prescott, 1975, 1979,
painful, permanent contraction of the child's physical and 1989).
emotional self. Reich saw the real purpose of circumcision,
and other assaults upon the child's sexuality, to be the reduc- The underlying psychology of genital mutila-
tion of the child's emotional Ouidity and energy level, and tions is anxiety regarding sexual pleasure, main-
their ability to experience maximal pleasurable genital excita- ly heterosexual genital intercourse,
tion later in life, a major step in, as he put it, transmuting
Homo sapiens into armored Homo normalis. Reich argued Summary:
that parents and doctors blindly advocated or performed the The underlying psychology of genital mutilations is anx-
genital mutilations, and other painful shamanistic medical
iety regarding sexual pleasure, mainly heterosex ual genital
procedures, in proportion to their own emotional armoring
intercourse, as indicated by the associated virginity taboos
and pelasure-anxiety, in order to make children more like
and ritual absolutions against vaginal blood. In the final
themselves: obedient, docile, andreducedin sexual vigor and
analysis, these mutilations say more about predominant
emotional vitality (Reich 1967,1973).
attitudes regarding sexual pleasure than anything else.
These ideas, as disturbing as they may be, find support in
cross-cultural comparisons of cultures which mutilate the
genitals of their males, Textor's Cross-Cultural Summary female infibulations and other forms of female
(1967) demonstrates positive correlations between male geni- genital mutilation persist in accordance with the
tal mutilations and the following other cultural characteris- arranged marriage system, and other vestiges of
tics (also see Prescott 1975, DeMeo 1986): a powerful and hysterical virginity taboo.
Given their similar distributions, similar cross-cultural
Male genital mutilations are found present in a aspects, and similar psychological motifs, the time and
cultural complex where children, females, and location of origins of male and female genital mutilations
are probably identical, the use of each being mandated and'
weaker social ethnic groups are subordinated to widely expanded by groups where dominance of the sexual
elder, dominant males in rigid social hierarchies lives of children by adults, and of females by males, was
of one form or another. most extreme. The use of eunuchs has died out over the last
(Continued on ney( fJa~e)


The Geography of Genital Mutilations (Continued)
100 years with the decline of the harem system, but female Pitcher. D. (1972): An Historical Geography oj the Ottoman
infibulations and other forms of female genital mutilation Empire, E.J. Brill, Leiden, Map V.
persist in accordance with the arranged marriage system, and Prescott, J. W. (1975): "Body Pleasure and The Origins of Violence,"
other vestiges of a powerful and hysterical virginity taboo. The Futurist. April, p.64-74.
Prescott, J. W. (1979): Deprivation of Physical Affection As A Prim-
The urge to mutilate the genitals of children ary Process In The Development Of Physical Violence. In:
Child Abuse and Violence. (David G. Gil, Ed). AMS Press
stems from deeply ingrained cultural anxieties New York pp 66-137.
regarding sexual pleasure and happiness. Prescott, J.W. (1989): "Affectional Bonding for the Prevention of
Violent Behaviors: Neurobiological, Psychological and Reli-
The genital mutilations of young males and females are gious/Spiritual Determinants. In: Violent Behavior Vol. I:
major examples of cultural "traits" or "practices" which, on Assessment and Intervention. (Hertzberg, L.J., et aI., eds)
deeper analysis, reveal roots in severe pleasure-anxiety, with PMA Publishing Corp. New York 1989, p.109-142.
sadistic overtones. The parent or tribal elder who cuts the Reich, W. (1967): Reich Speaks oj Freud. Farrar, Straus & Giroux,
genitals of young children, was subject to the rite himself as a p.27-31.
child, and is made very anxious or angry when confronted Reich, W. (1973): Ether. God & Devil. Farrar, Straus & Giroux,
with a child whose genitals are not mutilated. This incapacity p.67-70.
to tolerate pleasurable movement or feeling in others (plea- Textor, R. (1967): A Cross-Cultural Summary. HRAF Press, New
sure anxiety) was first identified for Homo sapiens by Reich, Haven.
who also identified the role that social insititutions play in
demanding a systematic recreation of trauma and damage in
each new generation; primatologists have identified similar
processes of abuse transmission at work in monkeys deprived
of maternal love in infancy (DeMeo 1986). Prescott (1975)
previously confirmed many of these relationships in a cross-
cultural manner. The materials summarized here in geograph-
ical form further confirm these processes which possess his-
torically identifiable roots in specific regions. The urge to
mutilate the genitals of children stems from deeply ingrained
cultural anxieties regarding sexual pleasure and happiness.
Genital mutilations always exist within a complex of other
social institutions that provide for the socially sanctioned
expression of adult sadism and destructive aggression to-
wards the infant and child, with unconscious motivations
aimed at destroying or damaging the capacityfor pleasurable
emotional/sexual bonding between mothers and babies, and
between young males and females. In the absence of such
deeper motivations, genital mutilations would not be wel-
comed or championed by parents or birth attendants.
James DeMeo, Ph.D., earned his doctorate at the University of
The village women splash water on seven year old Adizetu's wound
Kansas and has served on the Faculty of Geography at Illinois State
University and the University of Miami. He is currently the Director after the exisor has performed the clitoridectomy.
of the Orgone Biophysical Research Laboratory, P.O. Box 1395, EI
Cerrito, CA 94530, Editor ofthe environmental journal, Pulse oJthe
Planet. and author of The Orgone Accumulator Handbook.

Bettleheim, B. (1962): Symbolic Wounds. Collier Books, NY.
DeMeo, J. (1986): "On The Origins and Diffusion of Patrism: The
Saharasian Connection," Dissertation, U. of Kansas, Geo-
graphy Department. University Microfilms, Ann Arbor; see
section on "Male and Female Genital Mutilations," p. 153-178.
DeMeo, J. (1987, 1988); "Desertification and the Origins of Armor-
ing: The Saharasian Connection," 1. Orgonomy, 21(2): 185-213,
22(1): 101-122,22(2):268-289.
Hosken, F. (1979): The Hosken Report on Genital and Sexual
Mutilation oj Females. 2nd Edition, Women's International
Network News, Lexington, Mass.
Montagu, A. (1945): "Infibulation and Defibulation in the Old and
New Worlds," Am. Anthropologist. 47:464-7.
Montagu, A. (1946): "Ritual Mutilation Among Primitive Peoples,"
Ciba Symposium, October, p.424.
Murdock, G.P. (1967): Ethnographic Atlas. Pittsburgh, HRAF
Infibulated girl, external genitalia and normal vaginal orifice have
Paige, K. (1978): "The Ritual of Circumcision," Human Nature.
May. been obliterated. Photos from: James DeMeo


Genital Pain vs. Genital Pleasure:
Why The One and Not The Other?
by James W. Prescott

Male circumcisions is not primarily a medical The key to understanding this pain and violence
issue but rather has its roots in deeply held is to be found in understanding its converse, i.e.
religious beliefs and social customs that defy pleasure and peace ...
rational and humane understanding.
the salvation of the soul and society.
Genital mutilations of both males and females have been a This understanding of the reciprocal relationship between
common practice in many cultures and have existed from the pain and pleasure; our tolerance and support for the torture
earliest days of recorded history. These excruciating painful and mutilation of the human body and intolerance for the
procedures have been inflicted upon newborns and adoles- physical pleasures of the body involves profound issues of
cents for a variety of reasons. Religious beliefs and social- moral philosophy of good and evil, of the moral theology of
cultural customs, particulary "rites of passage ceremonies" pain and pleasure; and how these morClI value systems
have been historically the primary reasons for both male and become encoded in the developing human brain and thus,
female genital mutilations. Only recently has one form of behaviors which includes the social-moral values and ideolo-
genital mutilation, male circumcision, come under a different gies of human culture. In brief, it is my contention that the
rubric of justification, i.e. modern medicine. ultimate resolution of the circumcision issue and other forms
It is a major thesis of this presentation that male circumci- of male/female genital mutilations will involve primarily the
sion is not primarily a medical issue but rather has its roots in ethical, moral and neuropsychological issues involved in tor-
deeply held religious beliefs and social customs that defy ture and mutilation and less in the presumptive medical and
rational and humane understanding. The devastating practi- social benefits of genital mutilations.
ces and consequences of female genital mutilation that have Before proceeding with a summary of the religious, philo-
been so well documented by Fran Hoskin (see page 22 in this sophical and scientific data in support of this thesis, I would
conference report) provides a context for understanding the like, to comment very briefly on two medical studies that
religious forces of toleration and support for male genital purport to provide statistical medical evidence for the prac-
mutilations, i.e. circumcision. Why is it that certain elements tice of circumcision and which raises serious ethical/ moral
of the medical profession can offer support for male genital issues when findings from presumptive pathological groups
mutilation (circumcision) but not female genital mutilation are generalized to healthy groups to justify surgical proce-
that is so widespread in other cultures of the world? dures on healthy groups in the guise of"preventive medicine."
And why have the medical professions, until very recently, First, is the study of Dr. William Cameron of the Univer-
ignored and denied the extraordinary and excruciating pain sity of Manitoba where it was reported in a sample of292 men
that the newborn experiences when part of its skin (the who had patronized prostitutes in Nairobi, Kenya that 20%
foreskin) is shredded and cut from the rest of its body? of uncircumcised men became infected with AIDS virus,
This indifference to human pain and suffering of the cir- whereas, only 3% of circumcised men became infected with
cumcised newborn is not confined to the medicalprofession the AIDS virus. It was also reported that 85% of the prosti-
but is widespread throughout many cultures, particularly tutes were infected with the AIDS virus. Some have sug-
where other forms of male and female genital mutilations are gested that circumcision may offer a degree of prevention
practiced. In this psychologist's opinion, all forms of genital against the AIDS virus.
mutilation that are inflicted upon unconsenting children are Assuming that circumcision vs. non-circumcision, and not
de facto acts of torture and mutilation which are in violation other variables, can account for this difference, how can the
of Article 5 of the United Nations Universal Declaration of grossly negligent and irresponsible sexual behaviors andpoor
Human Rights which states that "NO ONE SHALL BE personalhygienepractices ofOTHERS be used to justify the
SUBJECTED TO TORTURE OR TO CRUEL, genital and sexual mutilation of the INNOCENT? Another
INHUMAN OR DEGRADING TREATMENT OR example of the the misuse of statistical inference from medi-
PUNISHMENT." cal data is provided by the studies of Dr. Thomas Wiswell.
This position statement has been unanimously approved as In one of Dr. Wiswell's studies where he evaluated the
a resolution by the General Assembly of this Conference incidence of Urinary Tract Infections (UTIs) in 422,238 boys
(see page 53). born to Army families he found a ten-fold increase in UTls in
It is my conviction that the acts of newborn and adolescent uncircumcised vs. circumcised boys. The incidence was 1.1 %
torture and mutilation which occurs in ritual male and female vs .. 11 % respectively, where one third of the 1.1 % later deve-
genital mutilations must be understood within the broader loped serious medical complications. This finding of 1.1 %
context of human torture, mutilation and violence against the and/ or the .034% serious medical complications in uncir-
human body which is pandemic throughout the world. The cumcised newborns is now being used to justify the routine
key to understanding this pain and violence is to be found in genital mutilation of 99% of healthy male newborns who do
understanding its converse, i.e. pleasure and peace where not develop UTIs. Since female infants were found to have a
physical pleasures of the body, particularly sexual pleasures, 0.57% incidence of UTls which is 50% of the uncircumcised
are considered inherently dangerous by many fundamental- males (1.1 %) it is clear that there are other variables unrelated
ist/ orthodox religious traditions which they believe threatens (Continued on next page)


Genital Pain vs. Genital Pleasure (Continued)
to circumcision that contribute to UTIs. I will leave to other tures that have High Gods. In general, these cultures are
investigators the exploration of these other uncontrolled var- patrilineal, subordinate women to men, have low nurturance
iables that contribute to UTIs. of children, are sexually repressive, punish abortion, are
violent and have a high god that supports human morality.
Early Sensory Influences Upon In summary, the confounding ofpain and pleasure in the
Brain Development and Behavior developing brain provides the neuropsychological founda-
tionfor individuals who must experience pain to experience
There is a well established body of scientific data that pleasure, or who derive pleasurefrom the experience ofpain.
documents the role of sensory stimulation and deprivation One of the most recent studies that is particularly germane
upon brain development and emotional-social, psychological to this thesis was reported by Jacobson, et. al in Acta pSI'chi-
and mental development. From the perspective of the devel- atr. scand. (2987:76-364-371), entitled Perinata! Origin o{
opmental neuropsychological sciences there can be little Adult Self Destructive Behavior. The summary of this study
question that the extraordinary pain experienced by new- is provided by the abstract which reads as follows:
borns, children and adolescents who are subjected to ritual The studl' was undertaken to test ,\'hether obstetric proce-
genital mutilations has a profound influence upon the brain dures are o{ importance for eventua! adult hehavior u{the
and later behaviors. It is this writer's conviction that the newborn, as eculogical data from the United States seem to
extraordinary pain and trauma experienced through genital indicate. Birth record data were gathered fur 412 forensic
mutilations - an organ and brain system that is designed for victims comprising suicides, alcoholics and drug addicts hum
the experience of sexual pleasure and the expression of sexual in Stockholm afier 1940, and who died there in 1978-1984.
love - has permanently altered normative brain develop- The births o{the victims were uneven!\' distributed among six
ment for the normal expression of sexual pleasure and love. It hospitals. Comparison with 2,901 contro!s, and mutual com-
is proposed that this genital pain has long-term developmen- parison o{categuries, shu wed that suicides invu!ving asphl'x-
tal consequences for the ability of such individuals to differ- iation were closely associated H'ith asphl'xia at hirth. suicides
entiate pain from pleasure in love relationships and to b\' viulent mechanical means were associated \\'ith mechani-
develop intimate sexual relationships. c~1 birth trauma and drug addiction was associated with
It is not without psychobiological consequence that the opiate and/ or barbiturate administration to mothers during
brain system which is designed for the experience of pleasure lahar. Irrespective o{the mechanism trans{erring the hirth
and the expression of sexual love is first encoded with trauma to adulthood - which might he analoguus to
extraordinary and excruciating pain. In such individuals, all imprinting - the results show that ohstetric procedures
subsequent acts or experiences of genital pleasure are expe- should be careful/\' evaluated and possihl\' modified to pre-
vent eventual selfdestructive behavior.
rienced upon a background of genital pain that is now deeply
Specifically, the authors reported that a perinatal event of
buried in the subconscious/ unconscsious brain.
Asphyxia (a lack of oxygen) carried a risk factor for suicides
It is this developmental neuropsychologist's conviction from hanging, strangulation, drowning and gas poisoning
that these early experiences of genital pain contribute to the that was five times greater than for controls; for perinatal
encoding of the brain for sado-masochistic behaviors. The mechanical trauma, e.g. breech presentations, forceps deliv-
brain system that has been designed for pleasure has first and ery and multiple nuchal loops, the risk factor for suicides
foremost become saturated or encoded with pain that now from hanging and other mechanical injuries was twice as
limits and qualifies all subsequent experiences of pleasure. great as controls; for perinatal events of opiate/ barbiturate
When these early experiences of genital pain are followed by a use the risk factor for drug addiction was approximately
developmental deprivation of physical affectional pleasure in three times greater than the controls.
the maternal-infant relationship and in the adolescent sexual In an earlier study of 52 adolescent suicides, Salk, et. aI.,
relationship, then violent destructive behaviors are the inevit- (1985) reported three prenatal/ perinatal risk factors that sig-
able outcome. nificantly discriminated the suicide group from the two
Equally significant is the prediction that the cumulative matched non-suicide control groups. These were: I) respira-
consequences of these developmental experiences of genital tory distress for more than one hour at birth; 2) no antenatal
pain and affectional deprivation precludes the possibility of care before 20 weeks of pregnancy; and 3) chronic disease of
realizing the spiritual dimensions of human sexuality. These the mother during pregnancy which were found in 81 % of the
relationships have been discussed elsewhere and need not be suicide cases. These authors were quite uncertain as to the
repeated here. Suffice it to note that it has been possible to mechanisms by which prenatal/ perinatal birth trauma were
linked to suicidal behaviors.
predict with 100% accuracy the torture, mutilation and kil-
David Levy in a 1945 study on the "Psychic Trauma of
ling of enemy captured in warfare in 49 primitive cultures
Operations in Children" reported on three cases of male
from the two variables of deprivation of physical affection in
circumcision at ages 12 months (2 cases) and 6 % years. Psy-
the maternal-infant relationship and in the adolescent sexual chological trauma included the development of night terrors,
relationship; and that brain dysfunction underlies this SAD temper tantrums and rage. In the 6% year old, suicidal
(Somatosensory Affectional Deprivation) induced violent impulses developed. Levy reports:
behaviors. (Prescott, 1975, 1979, 1989; Heath, 1975). (See "... a circumcision at the age 0{6 years 7 months. was
March/ April issue of The Truth Seeker) preceded by a struggle o{ the patient with his father and the
Tables I and II summarize the social-behavioral character- anesthetist before they overpowered him. Immediatelvafter
istics of primitive cultures that engage in male and female the anesthesia wure off, he said over and over, 'They cut my
genital mutilations. Tables III and IV provide a similar sum- penis. I wish I were dead. .The rest a/the day the patient never
mary for those cultures that punish pre-marital sex and extra- left his mother's side. Thereafter his previous temper tantrums
marital sex. Similarily, for Table V which characterizes cul- (Continued on page 17)


Var. Social- Behavioral Characteristics % P N Var. Social-Behavioral Characteristics % P N
01 Castes Are Present 78 .0000 304 01 Community size is larger 73 .0003 80
02 Weaving By Males 78 .0000 100 02 Societal complexity is high 87 .01 15
03 Games of Strategy 75 .0000 168 03 Class stratification present 60 .01 III
04 Metal Working Is Present 71 .0000 238 04 Slavery is present 59 .005 176
05 Exclusively Patrilineal 69 .0000 325 05 Low female income 71 .09 24
06 Slavery Is Present 65 .0000 314 06 Personal crime is high (392) 71 .05 28
07 High Bride Price 56 .0000 322 07 Incidence of theft is high (392) 68 .07 31
08 Husbandry Is Present 51 .0002 325 08 Kin group exclusively patrilineal 62 .04 114
09 High God Supports Human 09 Kin groups patrilineal or double
Morality 64 .0007 086 descent rather than matrilineal 64 .002 62
10 High God is Present 54 .0009 257 10 Small extended family 70 .008 63
II Class Stratification Is Present 56 .003 316 II Wives are "purchased" 54 .02 114
12 Leather Working By Males 65 .005 081 12 Women have property rights 100 .008 9
13 Polygamous Rather Than 13 Longer post-partum sex taboo 62 .03 50
Monogamous 60 .004 321 14 Extramarital sex is punished 71 .005 58
14 High Exhibitionistic Dancing 57 .03 082 15 Sex disability is present 83 .004 23
15 Totemism Is Present 65 .04 026 16 Castration anxiety is high 65 .009 37
16 Early Infant/ Child Satisfaction 17 Bellicosity is extreme 68 .04 37
Is Low 69 .06 035 18 Killing, torturing, mutilating is high 69 .07 35
17 Longer Post-Partum Sex Taboo 67 .06 124 19 High God in human morality 81 .01 27
18 High Oral Socialization Anxiety 63 .06 048 20 Narcissism is high 66 .04 38
19 Exclusive Mother-Son Sleeping- 21 Exhibitionistic dancing 65 .04 66
I year 67 .07 042
20 High Incidence of Theft 66 .06 035
21 Patrilineal Cultures 58 .06 137 TABLE IV
23 High God Active 55 .08 155
24 Wife Lending and Exchange 71 .09 028
25 Infanticide Is Present 63 .09 030 Var. Social-Behavioral Characteristics % P N
TIME OF CIRCUMCISION: A) 1st & 2nd months: 4 eullures; 01 Slavery is Present 67 .002 83
B) 2 months to 2 years: 4 ('ullures; C) 2 to 5 years: 7 ('ullures; D) 6 02 Personal Crime is High 80 .02 20
to 10 years; 23 ('ullures; E) II to 15 years: 2/ ('ullures; F) 16-25 03 Theft is High 81 .008 21
years; 7 ('ullures. 04 Abortion is Highly Punished 76 .05 17
05 Premarital Sex Strongly Punished 71 .005 58
TABLE II 06 Castration Anxiety is High 87 .0001 30
07 Military Glory Emphasized 62 .002 53
08 77 .002 43
09 78 .002 42
10 Aggressive Supernaturals 79 .02 19
Var. Social-Beha vioral Characteristics % P N
01 Male Genital Mutilation Present 83 .006 36
02 High Bride Price 61 .01 38 TABLE V
03 Cultures Are Exclusively Patrilineal 79 .02 38
04 Segregation of Adolescent Boys 75 .02 28
05 Youth Sex Expression Restricted 80 .03 20 CULTURES WHERE A HIGH GOD IS PRESENT
06 High Mother-Child Households 78 .04 27 Var. Social-Behavioral Characteristics % P N
07 High Child Anxiety Over Nurturant
Behavior 91 .05 II 01 Caste System Present 52 .0004 244
08 Torture, Mutilation & Killing of 02 Slavery is Present 60 .0002 251
Enemy 70 .07 20 03 Patrilineal Rather Than Matrilineal 68 .0006 167
09 Incidence of Theft Is High 85 .08 13 04 Wives Purchased 65 .0015 258
10 Low Infant Protection From 05 High Aggression Socialization
Environment 75 .08 13 Anxiety 71 .01 45
NOTE: Initiation Rites Mandatory For All Girls Between 8th & 06 High Infant Pain By Caretaker 63 .08 57
20th Years, Does Not Include Betrothal Or Marriage Customs. 07 Early Independence Training 69 .06 29
From: R.B. Textor. A Cross-Cullural Summarr. (1967) HRAF 08 Male Genital Mutilation Present 54 .0009 257
PRESS: New Haven. 09 Premarital Sex Strongly Punished 59 .05 149

The % column reflects the percentage of cultures that share in common the behaviors listed; the P column states the probability level of
statistical significance, e.g. a value of .003 means that the probability that the behavioral relationships being compared could occur by chance
is 3 times out of a thousand; and the N column indicates the number of primitive cultures involved in the comparison of the paired behaviors.


Genital Pain vs. Genital Pleasure (Continued)
developed into destructive rages. During the treatment he process or mechanism which can acount for the linkage
played numerous killing games. in which his/ather was the between prenatal/ perinatal trauma and suicides that have
principal victim. The operation represented a castration by been reported by Salk, et aI., and by Jacobson, et. al.
his/ather. "(p.IO). Specifically, Somatosenory Affectional Deprivation (SAD)
Questions must be raised as to the extent to which rage and theory is based on the nature of brain processes where it has
suicidal behaviors are engendered by the assaults of circum- been well established that activation of the pleasure circuits of
cision whether conducted during the newborn or child/ pre- the brain inhibit the activity of the violence circuits of the
pubertal periods. (There are approximately a third more brain. This normative reciprocal relationship ceases to func-
suicides than homicides in the U.S.). Is there a link between tion when the neuronal circuits of the brain that mediate
circumcision and the willingness to kill oneself or others for pleasure are insufficiently developed - a form of brain dys-
one's religious/ national beliefs, particularly when circumci- function/ damage - due to sensory deprivation of physical
sion occurs at the age of puberty, as it does in the Muslim affectional pleasure, specifically, somesthetic (touch) and ves-
cultures? The willingness of many Muslim men to die or kill tibular (movement) sensory stimulation. Gentle touch and
for their religious beliefs is well known, e.g. the cases of rocking of the infant are powerful sensory stimuli for plea-
Salman Rushdie and Sirhan Sirhan may be representative sure, comfort and a sense of"basic trust"for the infant/ child.
here. When these sensory stimuli are absent and, in addition, are
Jacobsen, et. al (1987) noted in their study that hypoxia replaced by painful sensory stimulation, then the neurobio-
during birth might cause minimal brain damage that could logical foundations for depressive, addictive and violent
result in destructive behaviors. However, these authors ques- behaviors are established.
tioned whether neurological injuries due to hypoxia could be In brief, the emotional pain of affectional deprivation (the
the main factor, "since altogether rather few victims suffered failure of love in the maternal-infant and parent-child rela-
from asphyxia during birth. None of the 86 suicides from tionships, and in our sexual relationships) seeks relief
poisoning by solid or liquid substance and none of the 53 through drugs, alcohol and violence - in the rage of our
alcoholics were reported to have been asphyxial." physical assaults against others; beatings, rape, homicide and
assaults against our own bodies where the final solution is
There is a delayed "time bomb" of brain damage suicide - one of the leading mental health problems of our
that occurs long after the initial injury or insult. children and youth. Why should our children and youth be
committing suicide in such great numbers - a 112% increase
There are several points to be made concerning these two from 1980 to 1985 for children aged 10 to' 14 years? Does
studies. First, Faro and Windle (1969) in their experimen- genital mutilation and sexual abuse in combination with
tal asphixal studies in monkeys documented both imme- SAD facilitate suicidal and assaultive behaviors?
diate and delayed brain damage by as much as 10 years in
these monkeys. In short, there is a delayed "time bomb" of It is for these reasons that the pain of genital
brain damage that occurs long after the initial injury or mutilation is tolerated and supported and why
insult. It would appear that later stages of brain develop-
ment are dependent upon earlier stages of brain develop- the pleasure of genital stimulation is forbidden
ment which must be normal if later stages of development - with all the developmental neuropsychologi-
are to be normal. Secondly, there are a variety of traumas/ cal and moral consequences that such events
injuries that can simulate or mimic asphyxial effects. have upon the individual and culture.
For example, sensory deprivation (like asphyxia) can
damage the sensory receptors and sensory pathways of the A further correlate to the above relationships and why
brain. This neuronal damage from sensory deprivation certain postnatal traumas are tolerated (e.g. genital mutila-
prevents normal sensory stimulation of the brain which is tions) is to be found in our cultural mores that places a high
essentialfor normal brain development andfunction. This moral value on pain, suffering, deprivation; and immorality
is why the experiencing of sensory pleasure - physical upon the physical pleasures of the body, particularly the
affection and sexualpleasure - is essentialfor normative sexual pleasures of the body. It is for these reasons that the
brain development, function and behavior. pain of genital mutilation is tolerated and supported and why
The effects of sensory deprivation or altered and abnor- the pleasure of genital stimulation is forbidden - with all the
mal sensory environments upon brain development and developmental neuropsychological and moral consequences
behavior are well documented. This is the mechanism that such events have upon the individual and culture.
which I will now focus upon since it is my conviction that a I will now review the real reasons for circumcision as given
by certain moral traditions and the anti-pleasure ethic that is
variety of early traumatic events of pain, deprivation and
endemic to many religious traditions that supports the pain-
stress, including asphyxia, damage the affectional neuro-
pleasure reciprocity principle and provides the linkage to
nal systems of the brain. It is this damage that compro- violent behaviors.
mises or prevents the development of affectional bonds of
pleasure since these brain systems for pleasure have been
damaged by these early insults and injuries. This thesis PHILOSOPHICAL/RELIGIOUS BASES FOR
constitutes the neuropsychological foundation of my SAD GENITAL MUTILATIONS
(Somatosensory Affectional Deprivation) theory of alie- It is well recognized that circumcision in the Jewish reli-
nation, depression, addictive and violent behaviors. gious tradition represents a covenant with God (see Gerald
It is for these reasons that SAD is proposed to be the Larue's article in this issue). It is less well recognized that the
(Continued on next page)


1Befo1re (9i1rcumcision
The charge that circumcision is
either unnecessary or harmful must
confront contemporary evidence.
While the 1971 report ofthe American
Academy of Pediatrics ruled circum-
cision unnecessary, it is important to
note that the Academy is reviewing its
earlier decision because of new evi-
dence. Of fifty thousand known cases
of penile cancer in North America only
nine have occurred in circumcised
males. Urinary tract infections occur
Peaceful, Blissful and Trusting - Credit: Marilyn F. Milos, R.N., NOCIRC less frequently when the foreskin is
removed. And ninety-five times as
many uncircumcised males contract
Afre1r (9i1rcumcision AIDS as do the circumcised. If all
these assertions are true, then the pain
and trauma, if they indeed exist, may
be worth enduring ...
Quite frankly, the fury of many
anticircumcision militants is out of
proportion to the provocation. Given
the horrendous proportions of child
abuse, a little foreskin removal (which
may, in the end, turn out to be benefi-
cial) hardly deserves the hostility it
- Sherwin T. Wine
Rabbi, First Humanistic Jewish
Congregation, Birmingham Temple.
Farmington Hills, MI
From: Circumcision. Humanistic
Judaism 1988 (Summer), V.XVI
Number III
Pain, Fear and Betrayal- Credit: Marilyn F. Milos, R.N., NOCIRC

It is almost impossible to believe

that parents who love their children
"As TIiE body is pRioR iN oRdER of GENERATioN TO TIiE soul, so TIiE iRRATiONAl
could stand by and see them so unmer-
is pRioR TO TIiE RATioNAl. TIiE pRoof is TIiAT ANGER ANd wisliiNG ANd dESiRE ARE
cifully tortured for a religious purpose.
iMplANTEd iN cliildREN fROM TIiEiR VERy biRTIi, bUT REASON A~d UNdERSTANd- Can religion so stultify the brain that it
iNG ARE dEVElopEd AS TIiEy GROW oldER. WIiEREfoRE, TIiE CARE of TIiE body even makes us callous to the cries of
oUGIiT TO PRECEdE TIiAT of TIiE soul, ANd TIiE TRAiNiNG of TIiE AppETiTiVE pART our loved ones when being so outrage-
sliould follow; NONE TIiE lESS OUR CARE of iT MUST bE fOR TIiE sAkE of TIiE ously assaulted?
REASON, ANd OUR CARE of TIiE body fOR TIiE SAkE of TIiE soul." - Joseph Lewis
ARiSTOTlE, 1Jolitca
From: In The Name Of Humanity.
1949, p. 120.


Genital Pain vs. Genital Pleasure (Continued)
diminution of sexual pleasure is another major reason for On Masturbation
circumcision in the Jewish religious tradition. This reason is
clearly stated by Moses Maimonides in the Guide G!f The 9. The traditional Catholic doctrine that masturbation con-
Perplexed (1190) which merits its full reproduction: stitutes a grave moral disorder is often called into doubt or
ON CIRCUMCISION expresslv denied today. It is said that ps\'cholog.l' and sociol-
"As regards circumcision, I think that one ofits objects is to ogy show that it is a normal phenomenon oj"sexual develop-
limit sexual intercourse, and to weaken the organ ofgenera- ment, especialll' among the young. ... This opinion is contra-
tion asfar as possible, and thus cause man to be moderate. dictory to the teaching and pastoral practice ofthe Catholic
Some people believe that circumcision is to remove a defect in Church. Whatever theforce oj"certain arguments oj"a biolog-
man's!ormation; but everyone can easily reply: How can ical and philosophical nature, which have sometimes heen
products of nature be deficient so as to require external used by theologians, in fact both the Magisterium oj" the
completion, especially as the use oftheforeskin to that organ Church - in the course o/a constant tradition - and the
is evident. This commandment has not been enjoined as a moral sense of thefaithful have declared without hesitation
complement to a deficient physical creation, but as a means that masturbation is an intrinsicalll' and seriousll' disordered
for perfecting man's moral shortcomings. The bodily injury act.
caused to that organ is exactly that which is desired; it does Elsewhere, the Roman Catholic church affirms the moral
not interrupt any vitalfunction. nor does it destroy the power value of pain and suffering in The Spiritual Exercises of St.
of generation. Circumcision simply counteracts excessive Ignatius of Loyola (the founder of the Society of Jesus):
lust; for there is no doubt that circumcision weakens the "The third kind ofpenance is to chastise the bodl', that is to
power of sexual excitement, and sometimes lessens the natu- inflict sensible pain on it. 771is is done by wearing hair shirts.
ral enjoyment; the organ necessarily becomes weak when it cords, or iron chains on the bod\', or h\' scourging or wound-
loses blood and is deprived ofits coveringfrom the beginning. ing oneself, and by other kinds G!f austerities" (1541).
Our Sages say distinctly: It is hardfor a woman, with whom Many other examples could be cited, the most significant of
an uncircumcised had sexual intercourse, to separate from which is the Crucifixion itself. God the Father's Divine Plan of
him. This is, as I believe, the best reason for the command- Incarnation for his Son: "So the Word was made flesh;" (J ohn
ment concerning circumcision. " I: 14); and "I did not come of my own will; it was He who sent
(Part III, Chapter 49) me" (John 8:42) was a plan for the mutilation, torture and
Elswhere in the Jewish religious tradition clear warnings murder of His only-begotten Son on the cross (euphemisti-
are given concerning the dangers of sexual pleasure. The cally called "sacrificed") - for the ulterior motive of human
following quotations are taken from the Code ofJewish Law: salvation! The ultimate psychopathology of this event is equat-
Chapter 150 ing this mutilation, torture and murder with LOVE! Clearly,
The Sin of Discharging Semen in Vain Christian Love is as much an expression of pain and suffering
as pleasure. It is this fusion of pain and suffering with love that
I: It isforhidden to discharge semen in vain. This is a graver
sin than an)' other mentioned in the Torah. Those who forms one of the roots of sado-masochism which is so preval-
practice masturbation and cause the issue of semen in vain, ent in monotheistic and patristic cultures.
not onll'do they commit a grave sin, but they are under a ban, Given the violence that this Father inflicted upon the
concerning whom it is said (Issiah 1:15):" Your hands arefull Son He loved (and others), is it so surprising to find so much
0/ blood, " and it is equivalent to killing a person. See what violence of other Fathers inflicted upon their sons (and
Rashi wrote concerning Er and Onan in the Sidrah of Vaye- daughters)? If "Man" is made "Unto the Image and Likeness
shev (Genesis 37), that both Er and Onan diedfor the com- of God," then the violence of "Man," becomes more under-
mission ofthis sin. Occasiona/~l', as a punishmentfor this sin, standable. Remember, it is this same God the Father that
children die I"..hen young, God forbid, or grow up to be demanded the torture of helpless male newborns through the
delinquent. while the sinner himself is reduced to poverty. ritual mutilation of their genitals, called circumcision - a
Chapter 151 practice that continues today in many monotheistic cultures.
Laws of Chastity Why was pain and violence and not pleasure and peace
selected as the primary path for establishing the "bond"
17. Semen is the vitality G!fman's body and the light of his
between God and Man and for human salvation? In all His
e\'es. and when it issues in abundance, the bod\' weakens and
Wisdom, Power and "Love" could He not have found a
life is shortened. He who indulges in having iniercourse, ages
different solution to the enigma of human "salvation"? The
quickly, his strength ebbs, his eyes grow dim, his breath
answers to these questions lie elsewhere.
becomesfoul, the hair of his head, eyelashes and brows fall
It should be recognized that the roots of the morality of
out, the hair G!fhis beard, armpits andfeet increase, his teeth
pain and suffering and the immorality of physical sensual/-
fall out. and many other aches besides these be/all him. Great
sexual pleasure antedate the Crucifixion and the rise of
physicians said that one out of a thousand dies from other
monotheism. These basic concepts existed in parallel civiliza-
diseases, while nine hundred and ninety-nine die from sexual
tions where, for example, the ancient Greek philosophers
indulgence. Therefore, a man should exercise self-restraint. provided a clear metaphysical theory of good and evil that
The Roman Catholic Church is equally affirmative on the was directly related to a moral theology of pain and pleasure.
moral dangers of masturbation whose only purpose is sexual Greek Metaphysical Dualism provided the following
pleasure. In the Vatican's "Declaration on Sexual Ethics," equations:
published by the Sacred Congregation For The Doctrine Of MATTER=Bo~\', Evil, Wickedness, Darkness, Chaos=FEMALE;
The Faith (December 29, 1975), formerly the Holy Office of FORM=Soul, Goodness, Godlike. Lightness. Order=MALE;
The Inquisition, the following is stated: (Continued on next page)


Genital Pain vs. Genital Pleasure (Continued)

MATTER = Body, Evil, Wickedness, Darkness, Chaos = FEMALE; ~

FORM = Soul, Goodness, Godlike, Lightness, Order = MALE;

It was Pythagoras (c.582-c.507 B.C.) who provided the sex down upon man every impelfection and corruplion; He
gender equivalents of maleness with goodness; and female- granted it - I mean the human/arm - power, dominion.
ness with evil: rule, and control over maUer, in order that it subjugate it,
"There is a Kood principle which has created order. light quell its impulses, and bring it back to the best and mosl
and man; and a bad principle which has created chaos, harmonious slate Ihat is possible (111.'8, pp. 430-432).
darkness and woman." (Part lll, Chapter 8)
Given this formulation is it so surprising to find thefollow-
ing in Ecclesiasticus (25:33): "From the woman came the Ecclesiasticus (25:33): "From the woman came the
beginning of sin, and by her we all die." And in Paul, I beginning ofsin, and by her we all die. "... in Paul. I
Corinthians (7: I); "Now concerninK the thinKS whereofyou
wrote me: It is Kood/or a man not to touch a woman. .. Many Corinthians (7:1); "Now concerning the things whe-
other examples could be mentioned that are too numerous to reofyou wrote me: It is goodfor a man not to touch a
cite which reflect this absurd and most erroneous dualistic woman."
moral theory of human nature, gender and behavior.
Moses Maimonides has perhaps provided the clearest Perhaps it is now more clear how philosophical and theologi-
exposition of these metaphysical/ moral/ gender relationships cal moral dualism has conspired against the human body,
in The Guide Of The Perplexed (When the word "matter" particularly the female body and the sensual/ sexual pleasures
occurs think "female," when the word "form" occurs think that they represent. This moral dualism of Western Civiliza-
"male"): tion is one of the great roots of violence against the human
"All bodies subject to generation and corruption are body and the female body in particular. And these moral
auained by corruption anI\' because o.ftheir maUer; with traditions are not confined to the cultures of Western Civili-
reKard to/ann and with respect to the lauer's essence, they zation which subordinate female to male; assures the continu-
are not auained by corruption. but are permanent . .. ing inequality of woman to man and supports the violence of
Similarll' every living being dies and becomes ill solely man against woman and her children. (Reich, 1971).
hecause ofits maUer and not because a/its/arm. All man's This fundamentalist/ orthodox morality of Western Civili-
acts of disohedience and sin are consequent upon his zation requires that the sensual/ sexual pleasures of the body
maue~ and not upon his/arm. whereas all his virtues are must be extremely limited if not destroyed to achieve "salva-
consequent upon his/arm . .. consequent~v it was neces- tion of the soul" (re, the "virtues" of celibacy, virginity and
sary that man's very noble form, which as we have chastity). What better place to begin than with the mutilation
explained, is the image of God and His likeness, should be and destruction of the genitals which are designed to exper-
bound to earthy, turbid and dark matter, which calls (Conlinued on nexi page)

Pain and "Salvation"

"The third kind ofpenance is to chastise the
hodI'. Ihat is 10 inf7ict sensihle pain on il. This
is done hy H'earinK hair shirts. cords. or iron
chains on the hodI'. or hy scourKinK or
woundinK oneself, and hy other kinds of
austerities. "

On "Good" Friday the Crucifixion and

scourging/flagellation of the body are com-
monly re-enacted in many primitive Catholic
cultures throughout the world. This moral
theology of pain and suffering is a major root
cause of supporting and tolerating violence
against the human body.

Quote: St. Ignatius of Loyola

The Spiritual Exercises

Photo Credit: Ingmar Bergman

The Seventh Seal


Genital Pain vs. Genital Pleasure (Continued)
ience sensual pleasure and share sexual love? Hosken. FP. (1979): Female Sexual MWilatio/ls: The FaclS and Prop-
It is not without reason that the monotheistic religions osals For Action. Women's International Network News. Lexing-
(Judaism, Christianity, Islam) have carried the/r religions on ton, MA.
the edge of the sword - the same sword that cuts the genitals Ignatius of Loyola (1556): The Spiritual Exerci.\l's oj SI. Ig/latius or
of children (male and female); and which mutilates their LOl'ola.
souls. Jacobson. B.. Eklund, G .. Hamberger. L. Linnarsson. D.. Sedvall. G ..
It is clear to this writer that before genital mutilations of and Valverius, M. (1987): Perinatal origin of adult sclf-destructive
behavior. AC/ll PSl'chiatrica Scatlllil/{I\·ia. 76.364-371.
our children can cease; before male violence against women
Levy, D.M. (1945). Psychic Trauma Of Operations in Children.
can end; and before human violence can be eliminated that a
American Journal Of Diseases Of Children (January) 69, (I). 7-25.
moral revolution must take place. Pain rT1USt be declared
Lewis, J. (1949). In The Name Or Humanit.". Freethought Press. San
immoral and pleasure must be declared morally necessary if
we are to become moral persons. In the words of Walt Maimonides. Moses (1963): The Guide or The Perplexed. (Shiomo
Whitman: Pines. Trans.) Vols I & II. University of Chicago Press. Chicago.
"IF ANYTHING IS SA CRED Porter. F.L.. Miller. R.H. and Marshall. R.E. (1986) Neonatal Pain
THE HUMAN BODY IS SACRED" Cries: Effect of Circumcision on Acoustic Features and Perceived
In summary, the dualistic/theistic moral foundations of Urgency. Child Del'elopmel1l 57,790-802.
Wester~ Civilization must be transformed if human equality, Prescott, J.W. (1975): Body Pleasure and The Origins of Violence. The
compassion, justice and love are to be realized; and if the Fwurisl. April 1975.
human species is to survive. Prescott, J. W. (1979): Deprivation of physical affection as a primary
process in the development of physical violence. In (,hild A huse
and Violence (Gil. D.G .. Ed). AMS Press New York pp 66-137.
REFERENCES Reich. W. (1971): The Mass PITcholog.!' ol'Fascism Farrar Straus Gi-
roux New York.
Anand, K.J.S. and Hickey, P.R. (1987) Pain and its Effects in the
Salk. L, Lipsitt. LP .. Sturner. W.Q .. Reilly. B.M. & Leva!. R.H. (1985):
. Human Neonate and Fetus. The Nell' England Journal of Medi-
cine (Nov. 19). V 317 0.21. Relationship of maternal and perinatal conditions to eventual
Bullough, V. (1976) Sexual Variance in Socien' and Histor.!'. Wiley: adolescent suicide. The Lancet March 15. 1985.
Interscience, New York. Textor. R. B. (1967): A ('ros.I·-('ultural SUII II 1101'.1' Human Relations Area
Bullough, V. and Bullough, B. (1987) Women and ProstitUlion. Prome- Files (H RAF) Press: New Haven.
theus Books, Buffalo. Vatican. The. (1975): Declaration on Sexual !:'thics. Sacred Congrega-
Faro, M.D. and Windle, W.V. (1969): Transneuronal degeneration in tion For The Doctrine of The Faith. (December 29. 1975). United
brains of monkeys asphyxiated at birth. Experimel1lal Neurologl'. States Catholic Conference. Washington. D.C
24, 38-53. Wiswell, T E. and Roscelli. J. D. (1986): Corroborative evidence for the
Ganzfried, S. (1963). Code 0/ Jell'ish Lall' (Holdin, H.E.. Translator). decreased incidence of urinary tract infections in circumcised male
Hebrew Publishing Company Brooklyn. infants. Pediatrics. V. 78, No. I. July 1986.
Heath, R.G. (1975): Maternal-social deprivation and abnormal brain
development: Disorders of emotional and social behavior. In Brain
Function and MalnUlrition; Neurops.!'chological Methods ofAsses-
sment. (Prescott, J. W., Read, M.S .. & Coursin, D.B.. Eds.) John
Wiley New York.

Genital Pain As
For Genital
Figure I: A man's scrotum is
being nailed to a public
bench for committing the
"sexual sin" of fornication.

From: A 17th Century Woodcut.

Dr. Prescott's personal col-


Female Genital Mutilation - Strategies For Eradication
by Fran P. Hosken

According to a conservative estimate, at least 84 There is no doubt, and anecdotal evidence

million womenanrl girls are mutilated today in exists, that immigrants from Somalia, Sudan,
Continental Africa and similar operations are Ethiopia, or certain ethnic groups of Kenya,
practiced along the Persian Gulf and the south- Nigeria, etc., are having their small daughters
ern part of the Arab Peninsula. mutilated in the U.S.
Female Genital Mutilation - the descriptive terms for the None of these conditions exist where these operations are
different types of operations are "Excision" and "Infibula- done in Africa and the Middle East on struggling, screaming
tion" - continues to be practiced in large regions of Africa children held down byforce on the ground, in dark huts, with
from the Red Sea Coast to the shores of the Atlantic. Accord- crude knives or any other cutting tools. What is done in
ing to a conservative estimate, at least 84 million women and reality is cutting away whatever the operator can get hold of,
girls are mutilated today in Continental Africa and similar part or all of the clitoris and often part of the labia minora
operations are practiced along the Persian Gulf and the (small lips).
southern part of the Arab Peninsula. In Indonesia and Excision or clitoridectomy, the operation most frequently
Malaysia, less drastic forms of "female circumcision" are done throughout Africa, consists of the removal of the entire
practiced by some of the Moslem populations of this region clitoris, usually together with the adjacent parts of the labia
and sporadic occurrences have been registered among other minora (small lips) and sometimes all of the external genita-
mainly Moslem groups. lia, except parts of the labia majora (large lips). Some opera-
tors make additional cuts to enlarge the opening of the vagina
With increasing mobility of African and Middle as this is believed to make childbirth easier. (The opposite is
Eastern immigrants to Europe, the U.S. and also true.)
to Australia, these mutilations are being export- Infibulation or pharaonic circumcision (excision with
infibulation) means that the entire clitoris and the labia
ed all over the world. minora are cut away and the two sides of the labia majora are
partially sliced off or scraped raw and then sewn together,
With increasing mobility of African and Middle Eastern
often with catgut. In Sudan and Somalia, thorns are used to
immigrants to Europe, the U.S. and also to Australia, these
hold the two bleeding sides of the vulva together, or a paste of
mutilations are being exported all over the world. Indeed,
gum arabic, sugar and egg is used. The introitus or entrance
Britain had to pass special legislation recently to prohibit the
to the vagina is thus obliterated which is the purpose of the
operations (which were carried out by obliging physicians for
operation, except for a tiny opening in the back to allow
a high fee). In France, the Criminal Courts had to finally
urine, and later menstrual blood, to drain. The legs of the girl
initiate proceedings against African fathers and families after
are tied together immediately after the operation, and she is
three little girls died as a result of the operations performed in
immobilized for several weeks until the wound of the vulva
France. One father brought to court had "operated" on his
has closed, except for a small opening that is created by
baby daughter with a pocket knife - the child bled to death.
inserting a splinter of wood or bamboo.
In most European countries and also in Australia, health
services have been alerted to warn people and especially
immigrants. In the U.S.,immigrants from affected African
The objective of infibulation is to make sexual
countries have not been warned by immigration services that intercourse impossible. At present, infibulation
these mutilations are categorized as gross child abuse and is practiced mostly by Moslems, according to all
would result in having children removed from parents by the available sources, because ofthe importance and
Social Services. There is no doubt, and anecdotal evidence value they attach to virginity.
exists, that immigrants from Somalia, Sudan, Ethiopia, or
certain ethnic groups of Kenya, Nigeria, etc., are having their The mortality of girls and women due to all these opera-
small daughters mutilated in the U.S. tions no doubt is high; but no records are kept anywhere.
A systematic survey has yet to be done to document the Primary fatalities are not recorded and death in childbirth,
facts on how many children are involved or are at risk - and due to obstructed labor, is never related to genital operations
this is long overdue. (See below.) anywhere. But the terrible psychological trauma that is life-
But first, the medical and health facts need to be established. long has never been investigated from a woman's view.
The medical literature describes Circumcision or Sunna- The objective of infibulation is to make sexual intercourse
circumcision as the removal of the clitoral prepuce and the tip impossible. At present, infibulation is practiced mostly by
of the clitoris. "Sunna" means tradition in Arabic. But to Moslems, according to all available sources, because of the
remove the prepuce of the clitoris, which is a very delicate importance and value they attach to virginity. Infibulation is
operation especially if done on a child would require great performed to guarantee that a bride is intact - the smaller
skill, good light, surgical tools, an anesthetized, motionless her opening, the higher the bride price. A girl is often
body, quite aside from a thorough knowledge of anatomy. (Continued on next page)


Female Genital Mutilation - Strategies For Eradication (Continued)
blamed. Rather, it is claimed that an evil spirit is responsi-
Women who are infibulated have to be cut open ble or the ritual was not performed properly according to
to allow sexual intercourse and more cuts are the wishes of the ancestors - or the girl herself is at fault
needed for delivery of a child. because she had sex before she was operated on.
Infibulation or pharaonic circumcision is practiced in
inspected by the female relatives of the husband-to-be before the Sudan and adjoining areas throughout Somalia, parts
the bride price is paid. The bride price, whereby the husband
or his father pays the father of the girl a considerable sum in All girls, without exception, must undergo this
cash or kind, is still a marriage requirement almost every-
mutilation as it is a requirement for marriage.
where in Africa and the Middle East.
Infibulation may also occur spontaneously by adherence of Ethiopia, Southern Egypt and Northern Kenya and in
of the wounded sides of the labia, especially where extensive some areas of West Africa for instance, Mali. Infibulation or
excision operations are performed. For instance, in parts of pharaonic circumcision is the most drastic and damaging
Mali and Burkina Faso as well as other areas of West Africa. operation. It is called "Pharaonic. as the operation according
Women who are infibulated have to be cut open to allow to historic documents was already recorded in ancient Egypt
sexual intercourse and more cuts are needed for delivery of a more than 2000 years ago in pharaonic times.
child. Wives, traditionally, are re-infibulated, for instance in The term infibulation is derived from fibula which means
the Sudan, after the baby is born; and when the child is clasp or pin in Latin and goes back to the old Romans: a
weaned, they are opened again for intercourse. During her fi bula was used to hold toget her the folds of t he toga - the
reproductive life, a woman used to go through this process loose garment all Roman men wore. The Romans also fas-
with each child; and in some areas it still continues today. tened together the large lips of slave girls to prevent them
In West Africa infibulation is usually not done by sewing from having sexual intercourse as becoming pregnant would
or other fastening devices but by tying the legs of the girl hamper their work.
together (after the operation) in a crossed position, the same Here is an eyewitness description of an operation In
results are achieved. On a visit to Ouagadougou, Burkina Somalia:
Faso in 1977 while I was at the maternity hospital, a woman "With the Somalis, the circumcision olgirls takes
in labor with her first child was brought in; she could not place in the home among lI'omen relati\'e,\ and neigh-
deliver; she was almost completely closed. There was nothing bors. The grandmother or an older lI'Ollwn officiates.
at all left of her external genitalia. She had evidently con- A t each occasion. usual/I' onll' one little girl. or att illles
ceived through a tiny opening. tll'O sisters are operated; hUl aI/ girls, lI'ithoUl excep-
All the operations are performed on the ground, under tion. must undergo this mUlilation as it is a requirement
septic conditions, with the same knife or tool used on all the for marriage.
girls of a group operation, which is still the custom among . The operation itself is not accompanied hI" an.r
many ethnic groups in rural areas. In cases of fatalities, ceremonr or ritual..
neither the operator nor the operation are ever
The child. completell' naked. is made 10 sit on a lOll'
stoo!. Several lI'oman take hold 0/ her and open her
legs lI'ide. A/tel' separating her outer and inner lips. the
operator, usual/I' a woman experienced in this proce-
dure, sits dOl\'l1/acing the child. With her kitchen kl1l/e
the operatorjirst pierces and slices open the hood a/the
clitoris. Then she hegins to CUI it OUI. While another
lI'oman lI'ipes on' the Mood with a rag, the operalOr
digs II'ith her sharpjingernail a hole the length a/the
clilOris to detach and pul/ oUlthe organ. The lillIe girl.
held dOH'n bI' the II'omen helpers, screams in extreme
pain; but no one pays the slightest al/ention.
The operatorjinishes thisjob bl' entirelr pulling OUI
the clitoris, cUl/ing it to the bone lI'ith her kl1l/e. Her
helpers again I,ripe all the spurting blood with a rag.
The operator then removes the remaining flesh. dig-
ging with her ./i"nger to remove ani' remnant a/the
clitoris among the/lowing blood. The neighbor lI'omen
are then invited to plunge their.fingers into the bloodl'
hole to verifl' that even' piece o./the clitoris is removed.
BUI this is not the end. The most important part 0./
Figure 1: Tribal Genital Mutilation. The nude girls legs the operation begins onl.r now. A/tel' a short moment.
are forcibly held apart at the thighs as her external the 1I'0man takes the kni/e again and cuts offthe inner
genitalia are being cut away by a sharp instrument. No lips (labia minora) a/the victim. The helpers again wipe
anestheitc or antiseptic is used. From a "freeze-frame"
the blood with their rags. Then the operator, with a
of a 16 mm. file documentary.
(Cominued onnex' page)


Female Genital Mutilation - Strategies For Eradication (Continued)
The successor of Kenyatta, President Arap Moi categori-
Most often, men refuse to marry girls who are cally prohibited female genital mutilation operations in 1982.
not excised. Since marriage is still the only career He also alerted the Health Services that no more operations
for a woman in most of Africa and the Middle may be done in hospitals, which shows that the Kenyan
East, the operations continue. Health Services were involved in the mutilations. Unfortu-
nately, there has been no follow-up, teaching or educating the
mOlion 0/ her knife, begins 10 scrape Ihe skin from Ihe people against the mutilations. As a result, they have gone
inside ollhe large lips. underground.
Wilh Ihe abrasion o/Ihe skin compleled, according 10
Ihe rules. Ihe operalOr closes Ihe bleeding large lips and Excision, by cutting out the most sensitive
fixes Ihem one againsllhe olher wilh long acacia Ihorns. tissues of a woman's body, extinguishes sexual
Allhis slage oflhe operalion Ihe child is so exhausled
sensitivity, pleasure and response to touch. The
Ihal she slaps crying. bUI often has convulsions. The
women Ihen/orce down her Ihroal a concoclion olplams. elimination of female sexual pleasure is the rea-
The operalor's chiel concern is 10 leave an opening no son most frequently given for the genital mutila-
larKer Ihan a kernel ol corn or jusl big enoughl 10 allow tions, which is to keep "moral behavior of
urine. and laler Ihe menslrualflow. 10 pass. Thefamilv women in society" and "to assure the faithfulness
honor depends on making Ihe opening as small as possible
because wilh Ihe Somalis, Ihe smaller Ihe arlifical passage of women to their husbands" - who usually
is, Ihe grealer Ihe value ollhe girl and Ihe higher Ihe bride have several wives.
When Ihe operalion isJinished, Ihe woman pours waler Excision, by cutting out the most sensitive tissues of a
over Ihe genilal area 0/ Ihe girl. and wipes her wilh a rag. woman's body, extinguishes sexual sensitivity, pleasure and
Then Ihe child. II'ho was held down all Ihis lime. is made 10 response to touch. The elimination of female sexual pleasure
sland up. The u'omen Ihen immobilize her Ihighs by lying is the reason most frequently given for the genital mutilations,

Ihem IOgelher lI'ilh ropes 0/ goal skin. This bandage is which is to keep "moral behavior of women in society" and
applied/rom Ihe knees 10 Ihe waisl oflhe girl. and is left in "to assure the faithfulness of women to their husbands" -
placelor abOUilwo weeks. The girl muSI remain Iving on a who usually have several wives. In many ethnic groups, for
matfor Ihe enlire lime, while all Ihe excremem evidem/l' instance in Mali and Francophone West Africa, the opera-
remains wilh her in Ihe bandage. tion traditionally is performed just before marriage, as a
Afier Ihal lime. Ihe girl is released and Ihe bandage is puberty rite; it is claimed that a woman can be accepted into
cleaned. Her vagina is now closed. and remains so umif adult society and get married only after she is operated upon. ,
her marriage. Comrary 10 whal one would assume, nol
many girls die from Ihis IOriure. There are, of course, Women who do not have their genitals
various complicalions which frequemlr leave Ihe girl mutilated are considered to be prostitutes.
crippled and disabled/or Ihe reSI a/her life. "
Many colorful myths are related all over Africa as reasons In the Sudan and the Middle East, and in Moslem socie-
for the operations. Though all the myths are still believed by ties, for instance in Somalia, it is said that a woman is
the ethnic groups involved in the rural areas, many of the incapable of controlling her sexuality - hence she must be
reasons are contradictory, and none of them are compatible excised or infibulated or she will disgrace her family. Women
with biological facts. who do not have their genitals mutilated are considered to be
Most Africans who practice these operations believe that prostitutes.
excision is a custom decreed by the ancestors; therefore, it
must be complied with. Most often, men refuse to marry girls It is said that women's external genitalia are ugly
who are not excised. Since marriage is still the only career for and must be removed to make her acceptable to
a woman in most of Africa and the Middle East, the opera-
tions continue. "No proper Kiku.l'u would dream ofmarrying
a man.
a girl who has nol been circumcised. "slaled lama Kenyalla, Excision is also perceivedas a way to increase/ertility; and
Ihe revered leader ol Kenya in his book. "Facing Mount the wish 0/ most women is to have as many children as
Kenya," which was wrillen in Ihe 1930s and cominues 10 be possible, especially sons, on which their status in society
published and is also sold in lOurisl shops in Nairobi. depends. The biological facts about reproduction are un-
As President of Kenya for life, Kenyatta had great influ- known or ignored. It is widely believed, for instance, in Mali
ence on Africans well beyond the borders of Kenya, and his and Burkina Faso, and all over West Africa, that the clitoris
much quoted statement is responsible for the mutilation of connotes maleness, and the prepuce of the penis, femaleness.
many thousands of helpless little girls and untold suffering Hence, both have to be removed before a person can be
and deaths. accepted as an adult in his/ her sex and society. It is also
believed that a girl who is not operated on will run wild and
The successor of Kenyatta, President Arap Moi disgrace her family. In Egypt, aesthetic reasons are some-
categorically prohibited female genital mutila- times cited for the operation, and this is occasionally said in
other areas of Africa as well. It is said that women's external
tion operations in 1982.
(Conlinued on next page)


9{g:turaf 115. Infi6ufation




Cutting away the exterior genital organs and infibulating a girl can start bleeding that cannot be stopped and may kill your
child. Dangerous infections may also result that may make your daughter very ill. Later, it may prevent her from having
children of her own. The damaging operations cause much needless suffering.




Infibulation - cutting a way the external genital organs and then closing the opening to the vagina by scarification - is a very
dangerous operation that causes many life-long health problems. It interferes with a woman's natural sexuality. In the top
row, you see the natural genitals of a girl and a woman. In the pictures below, you see a girl bleeding after the operation and a
woman who is infibulated: only a tiny opening is left.
From: The Universal Childbirth Picture Book;
by Fran P. Hosken; pictures by Marcia L. Williams, published by Women's International Network News.


Female Genital Mutilation - Strategies For Eradication (Continued)

The Catholic Church has sanctioned the genital

mutilation of all female children of its converts
on those grounds since the 17th century when
the Pope sent a medical mission to Ethiopia.
genitalia are ugly and must be removed to make her accepta-
ble to a man.
Hypertrophy of the clitoris - by which is meant an unus-
ual enlargement of that organ - is cited as reason for exci-
sion in Ethiopia and also in parts of igeria. The Catholic
Church has sanctioned the genital mutilation of all female
children of its converts on those grounds since the 17th
century when the Pope sent a medical mission to Ethiopia.
Health reasons are often cited, especially in urban areas
where the traditional myths are forgotten. Cleanliness is the
reason given also by middle class women in areas as far apart
as Cairo and Bamako.
A Iso, in Sudan, genital mutilations are connected with
Figure 2: Tribal Genital Mutilation. A later scene from
cleanliness and is called "Tahur" which in Arabic means
Figure 1 showing the raw bloody flesh of the excised
purity. A woman is considereddirty andpolluted unless she is genital area.
mutilated The same is often said in Somalia.
and political leaders where many of the men have been to
Obviously, all of the myths are designed to European or Western universities. The reasons given by these
justify and continue the female genital mutila- men are "tradition" - yet the men have rejected all African
tions, from which men derive power and con- traditions for their own Westernized personal lives.
trol over women as a group. The patriarchal family structure and ideology of
Many of the reasons given by local populations are quite male supremacy supported by religion provides
similar, though they have been arrived at quite independ- the under-pinning for genital mutilations both
ently, as no connection or communication exists between the past and present.
population groups involved. Most of these myths are pro-
moted by men, which once more documents the amazing The patriarchal family structure and ideology of male
world-wide similarity of male attitudes concerning female supremacy supported by religion provides the under-pinning
for genital mutilations both past and present. It is wellrecog-
nized that religious beliefs are invariably cited to support the
Obviously, all of the myths are designed to justify and
"necessity" for having the genitals of daughters excised
continue the female genital mutilations, from which men
and/or infibulated. The operations are practiced by animists
derive power and control over women as a group. This is, - those who believe in ancestor worship - stating that "the
of course, the real reason why these operations continue ancestors decreed these operations and their wishes must be
today, and why they are being rapidly introduced into the followed." They are practiced by Moslems - indeed in the
modern sector throughout the African continent with the Sudan and also in West Africa the local sheiks and mara-
collusion of Western men, and especially the male-domi- bouts claim that excision or infibulation is a required or
nated health system. Though the social rites and ceremo- "preferable" Moslem rite. But Egyptian Moslem religious
nies are minimized or forgotten, the surgery continues: and authorities at the recognized El Azhar University state there is
a lot of money can be made from this. no requirement for female genital mutilation in the Koran.
The genital mutilations are now performed on much Male circumcision, however, is an absolute command.
younger children especially in the towns, as it is feared by Excision and infibulation are practiced by Christians of all
men that the girls will resist once they go to school. Even in denominations. As stated earlier the Papacy of the Roman
areas where traditionally the operations were a coming-of- Catholic Church has officially supported the genital mutila-
age custom, they are now done on very young children, tions ever since a medical mission was sent from Rome to
sometimes a few years old, or even shortly after birth. The Ethiopia in the 18th Century which declared that genital
stated purpose of the operation - introduction to adult mutilations are "necessary."
life - has disappeared. Nevertheless, the mutilations con- (Continued on next page)
tinue to be practiced even in families of government officials
But Egyptian Moslem religious authorities at
The genital mutilations are now performed on the recognized EI Azhar University state there is
much younger children especially in the towns, no requirement, for female genital mutilation in
as it is feared by' men that the girls will resist the Koran. Male circumcision, however, is an
once they go to school. absolute command.


Female Genital Mutilation - Strategies For Eradication (Continued)

Over the centuries and due to their isolation,

women have come to believe that the mutilation
of their genitals are "necessary."
done all over the world. Thus, they are accepted as "natural."
Some African women even now cannot believe that the
operations are not done in other parts of the world.
The wholesale support ofcultural traditions by anthropol-
ogists without critical evaluations of the often terrible dam-
age done to the most vulnerable members ofeach community
- children, especially female children and women - is
completely irresponsible. There is hardly a major develop-
ment program in Africa by the U.S. Agency for International
Development - especially in health -that does not consult
an anthropologist. I have frequently run into those "devel-
opment advisers" who impose their ethnocentric views on
multi-million dollar health programs in Africa. As a result,

Figure 3: Tribal Genital Mutilation. The pain and shock the terrible health damage done to girls and women by tradi-
of a young girl as she stands up after her external tional practices is ignored because it is the "culture." I testified
genitalia have been cut away. repeatedly before Congressional Committees - especially
those concerned with appropriations for Foreign Aid to
Thefollowers of the Ethiopian Christian Church and the attract attention to the health needs of women, especially in
Copts in Egypt (more than 7 million adherents) have Africa, about the modernization of female genital mutila-
always mutilated the genitals of their female children. tions which are a violation of human rights.
Indeed, all religions (with the exception of the Scottish
I stated in my Congressional testimony, "My research in
Protestant Church in Kenya in the 1920s) have actively
Africa shows that genital mutilations are increasingly per-
supported or tolerated the mutilation of girls to make them
formed in the modern sector in Africa, including hospitals,
pliable subjects of the dominant patriarchal community
often on small babies, stripped of all traditional rites. This is a
that vests all rights in the males. There is no doubt that
genital mutilation does permanent life-long physical and gross abuse of modern medicine. As Editor of WIN NEWS,
psychological damage to women. The full impact of the I must advise this Committee that frequently health equip-
often terrible psychological consequences have never been ment, tools and training contributed by the U.S. and other
systematically investigated though it is known that numer- Western donors is used to mutilate female children. Speaking
ous young women commit suicide, asfor instance reported for American women and taxpayers, I strenuously object to
in Burkina Faso. the use of U.S. monies and contributions to carry out sexual
castrations - that is clitoridectomies and infi bulations - on
Patriarchal Religions - there are no others in non-consenting children in Africa and the Middle East."
Africa/The Middle East - provide the intellec-
tual basis for men to keep their power and privi- African women have now started to organize to
leges in society. Who is going to question "the fight against these terrible genital mutilations in
hol~ religious beliefs expressed by men? a systematic way.
Patriarchal Religions - there are no others in Afri- The desire for modernization and especially all kinds of
ca/The Middle East - provide the intellectual basis for imported equipment and tools, especially by men, provides
men to keep their power and privileges in society. Who is a unique opportunityfor men to teach their African broth-
going to question "the holy religious beliefs expressed by
ers that these genital mutilations are not acceptable. Only
men can reach their African counterparts on this subject
men? Certainly not women - the vast majority in Africa
- especially since sexuality is involved, to teach them the
and the Middle East are still illiterate (in some countries up
biological facts in a persuasive way and from their own
to 90%). And men from Western countries especially those
experience. Unfortunately, no one has ever really tried to
concerned with development, have been warned by the reach African men who make all the decisions in each
militant male politicians to keep hands off their "culture" family about the truth regarding female genital mutila-
which in Africa and the Middle East sanctions polygamy, tions. Men also have been left out where family planning
wife beating (the diameter of the stick is specified in some programs are concerned - which are all imported by
countries), the bride price (selling of young girls into mar- Development and Population experts. As a result, family
riage by their fathers), unilateral divorce, child marriage planning in Africa has and is failing.
and female genital mutilations. It is up to the male development and health advisers and
Over the centuries and due to their isolation, women all those who have contact with African men - for
have come to believe that the mutilation of their genitals instance, the way many students from Africa at Western
are "necessary." Indeed, many women think that they are (Continued on next page)


Female Genital Mutilation - Strategies For Eradication (Continued)
Universities - to talk to them about excision and infibula- tioners of traditional medicine, to demonstrate the
tion and to explain to them why these genital mutilations are harmful effects of female circumcision, with a view to
unacceptable. But unfortunately, such educational programs enlisting their support along with general efforts to
have not been tried. abolish this practice.
African women have now started to organize to fight The Inter-African Committee, formed in 1984 at an inter-
against these terrible genital mutilations in a systematic way. national meeting and headed by Berhane Ras-Work, by now
The Inter-African Committee was created in 1984, five years has affiliated National Committees in 14 African countries
after the ground breaking seminar, organized by WHO, on and has offices in Addis Ababa (at the ECA - Economics
the "Traditional Practices Affecting the Health of Women Commission of Africa) and Geneva. They held several over-
and Children" held in Khartoum, Sudan. flow meetings at the 1985 UN Decade Conference for
As a temporary adviser to WHO - the sponsor of the Women in Nairobi and have published an "Action Plan"that
meeting - I provided an overview of female child genital provides an excellent set of guidelines for the National Com-
mutilations around the globe. This meeting opened up the mittees to follow - who have held meetings in many African
international discussion on female genital mutilations which countries.
had been a tabu subject until then. That was in 1979. The A ground breaking International Seminar on "Strategies to
seminar attracted world-wide attention with delegations and Bring About Change" was held in June 1988, in Mogadishu,
observers from the health departments of nine African and to draw world attention to the Somalian 01mpaigne to Erad-
Middle Eastern countries, as well as many Sudanese physi- icate Infibulation - which was started two years ago.
cians and health officials. Unfortunately, limited action fol- The SWDO (Somali Women's Democratic Organization),
lowed this seminar. jointly with AIDoS (The Italian Association for Women in
Development) has organized a national campaign, fully sup-
ported by the Somalian Government, to eradicate these dam-
aging traditional practices. Indeed, every department of the
Somalian Government is involved in this national initiative
led by the outspoken president of the S W DO, Muraio Garad
Ahmed, who wields considerable political power.
AIDoS, led by Daniela Colombo and with the assistance
of the Italian Government, has worked jointly with the
SWDO in Somalia to develop viable strategies and extensive
teaching aids for all different kinds of programs addressed to
different sectors of the population.
The secrecy surrounding infibulation has only recently
begun to be lifted in Somalia. It took considerable courage
for the SWDO to take up this issue. Thanks to the persever-
ance of its leadership, it now has become a national campaign
supported not only by the health ministry, but also by all
other ministries, especially education. The campaign to erad-
icate female child genital mutilation is going on in all the
schools; it is discussed on the radio and TV. Indeed, no
Figure 4: Tribal Genital Mutilation. A pre-pubertal male occasion is missed to create awareness among the population
has his foreskin stretched far over the glans where the about the damage done by infibulation. All families are urged
tip of the foreskin is cut away. This form of circumci-
to stop having their daughters "done."
sion is one of the more benign procedures which pro-
duced little blood flow (as could be detected from the This international seminar had been preceded by a national
film) and is substantially less painful and traumatic meeting which had developed a program of action for the
than the genital mutilation of the pre-pubertal girls. joint SWDO-AIDoS Information Campaign. At the interna-
tional seminar in Mogadishu, many influential national and
Four recommendations were unanimously voted by the
international leaders gave speeches at the opening and closing
delegates at the end of this fateful meeting: sessions in the great hall of the Parliament. The speakers
• Adoption of clear national policies for the abolishment included a representative of the President of Somalia, the
of female circumcision; Minister of Health, the SWDO President, the Italian Ambas-
• Establishment of national commissions to coordinate sador, representatives of UNICEF, WHO, AIDoS and
and follow up the activities of other bodies involved others.
including, where appropriate, the enactment oflegisla- Delegates from several African countries, including Egypt,
tion prohibiting female circumcision; Sudan, The Gambia and igeria presented outlines about the
• Intensification of general education of the public, successful campaigns and strategies to eradicate female child
including health education at all levels, with special genital mutilations in their countries. Egypt, with a program
emphasis on the dangers and the undesirability of sponsored by the Cairo Family Planning Association, led by
female circumcision; Aziza Kamel, has the most extensive experience in conduct-
• Intensification of education programs for traditional ing a multitude of successful grassroots initiatives. From
birth attendants, midwives, healers and other practi- (Continued on next page)


Circumcision: The Legal and Constitutional Issues
by Charles A. Bonner and
Michael J. Kinane

INTRODUCTION 921,928.] However, this parental duty and right is subject to

Circumcision has origins dating back 4,000-5,000 years, to limitations "if it appears that parental decisions will jeopard-
a time before Abraham and his covenant with God to circum- ize the health or safety of the child, or have a potential for
cise his people. Through the ages, civilization has witnessed significant social burdens." [Wisconsin v. Yoder (1972) 406
numerousforms of child abuse enjoying significant popular- U.S. 205, 234; Peoplev. Privitera, supra, 703; In re Roger S.,
ity, including sterilizations, female circumcision, infanticide, supra, 928.] If these conditions are present the state may
ritual sacrifice, binding of the feet, and ritual piercing and assert important interests in safeguarding health and safety
mutilations. While almost 80% of the world's populations and in maintaining medical standards. [Roe v..Wade (1973)
have ceased or avoided the ritual of circumcision, nearly 60% 410 U.S. 113, 153-154; People v. Privitera, supra, 703.] In
of American infant males and the majority of Moslems and Privitera, the Supreme Court recently held that when impor-
Jews still suffer this mutilation. tant interests of health and safety are involved the State's
regulations shall be tested under the rational basis test. [Peo-
ple v. Privitera, supra, 702, fn. 2, 703.]
With the exception ofJews, for whom circumci- A parents' right to consent to medical treatment is not
sion has long been a tribal sign, widespread cir- statutory in California, butl rather derives from the common
cumcision in the United States appears to be law. In Kate's School v. Department of Health (1979) 155
largely a late nineteenth-century development. Cal. Rptr. 529, - a case regarding a parents' right to pres-
cribe their treatment of choice for their mentally disordered
Anthropologists, psychologists, and psychiatrists have children, the court held that "the regulation of intrusive and
offered a variety of explanations for the practice: enhanced possibly hazardous forms of treatment of mentally disor-
sexual performance, decreased sexual pleasure to prevent dered children, such as involved in behavior modification
moral degeneration, social prestige, sacrifice to fertility gods, therapy through corporal punishment, is a proper exercise of
tribal signs, tests for endurance, reincarnation, and hygienic the states' police power and bears a rational relation to the
reasons. However, with the exception of Jews, for whom state's interest in the protection of the health and safety ofthe
circumcision has long been a tribal sign, widespread circum- children ... " This decision establishes that parents' rights to
cision in the Unit.ed States appears to be largely a late consent to treatment are not unlimited. Surgical removal of
nineteenth-century development. For non-Jews, it serves an infant'sforeskin, without medicaljustification, presents a
neither as a~means of tribal integration, or separa.tion and more serious threat to the health and safety of the child than
identification, nor as an initiation rite to establish male iden- corporalpunishment, thereby justifying exercise ofthe state's
police power.
tity. The customary justificationfor malegenital mutilation is
In an unpublished 1987 decision of the Court of Appeal,
hygienic, but it seems to have been primarily grounded in
1st District, No. A032040, London v. Glassner et aI., petition
anti-masturbation hysteria of the late 1800s andjlourished for review denied, parental consent to "any . . . medical
following mass military circumcisions during WWlI. (23 treatment" is found to be without apparent limitation, regard-
FAML 337). less of purpose. Civil Code §25.8 cited as authority for this
decision provides: "Either parent if both parents have legal
CONSTITUTIONAL AND LEGAL ISSUES custody, or the parent or person having legal custody or the
Circumcision, as an unnecessary medical treatment, raises legal guardian, of a minor may authorize in writing any adult
four major legal issues, beyond the traditonal malpractice person into whose care the minor has been entrusted to
cause of action for a negligent procedure. consent to ANY X-ray examination, anesthetic, MEDICAL
1. Do parents have the authority, constitutional or statu- OR SURGICAL diagnosis or TREATMENT and hospital
tory, to consent to unnecessary medicalsurgeryfor theil care to be rendered to the minor under the general or special
infant son? supervision and UPON THE ADVICE OF A PHYSICIAN
2. What is the extent of the State's interest in protecting AND SURGEON licensed under the provisions of the Medi-
cal Practice Act or to consent to an X-ray examination,
children from unnecessary surgery?
anesthetic, dental or surgical diagnosis or treatment and
3. What is the standardfor thirdparty consent to intrusive
hospital care to be rendered to the minor by a dentist licensed
surgery? under the provisions of the Dental Practice Act." (emphasis
4. What civilor criminalremedies are available to victims of added.) This court then held "(a) circumcision is a medical,
circumcision? surgical treatment," rejecting plaintiffs public policy argu-
ment that children should be protected from suffering unjus-
LIMITATIONS TO PARENTS' CONSENT tifiable pain or risk - based on the premise that parents
Decisions regarding child rearing, care and education have cannot consent to surgical procedures which have no medical
been recognized as being entitled to protection as a funda- purpose." While this section does not specifically grant any
mental right of personal liberty under the Constitution. direct authority for parental consent, the trial court found the
[Walen v. Roe (1977) 429 U.S. 589,599-600; Peoplev. Privit- legislative history was to extend the common law/authority
era (1979) 23 Cal. 3d 697, 702; In re Roger S. (1977) 19 Cal. 3d of parents. (Continued on next page)


Circumcision: The Legal and ConstitutionaHssues (Continued)
443 U.S. 622 (1979); Carey v. Population Service Interna-
Infants, legally mentally incompetent, are there- tional, 431 U.S. 678 (1977). Ibid. The essence of the Prince
fore protected from nonrequired medical treat- decision is captured in the statement that "parents may befree
ment under the Probate Code. to become martyrs themselves. But it does notJoUow they are
Jree . .. to make martyrs oj their children beJore they have
The London decision is unsupported and contradicted by reached the age oj full and legal discretion when they can
the California Supreme Court's decision in Conservatorship make that choiceJor themselves. " Prince, supra, 170. Under
of Valerie N. v. Valerie N. (1985) 219 Cal. Rptr. 387). The case Yoder, supra, 234, parental authority and discretion may be
deals with the rights of parents of a mentally incompetent challenged "if it appears that parental decisions will jeopard-
adult to consent to sterilization, a recognized medical treat- ize the health or safety ofthe child ..." This demonstrates that
ment. The court found that the parents as "conservators, were the child's right to safety overcomes parental constitutional
not entitled to have conservatee, who was unable to consent rights.
to sterilization, sterilized inasmuch as there was neither evi-
dence of necessity ... nor sufficient evidence that less intrusive "The preservation of one's bodily reproductive
means were not presently
functions is a fundamental right, and the termi-
available to conservatee." This ~ourt further holds "... as to
those medical procedures permitted after court authorization nation thereof constitutes a serious invasion of
the Legislature has required ajudicial determination that the the sanctity of the person."
condition of the conservatee 'require the recommended
course of medical treatment'" as provided in Cal. Probate In California, Valerie N., supra, the court held that "The
courts have ... recognized individual Liberty in things of the
Code section 2357, subd. (h)(I). Infants, legally mentally
body as a touchstone," (Note, Due Process Privacy and the
incompetent, are therefore protected from nonrequired med-
path of progress (1979) U.III. L. Forum 469, 504-505, 515; see
ical treatments under the Probate Code.
Union Pacific R. Co. v. Botsford (1981) 141 U.S. 250,251-
252 (common law right of personal injury plaintiff to be free
The State's interest in an infant's First Amend- of compulsory physical examination), cited in Roe v. Wade
ment constitutional rights of Safety, Liberty, (1973) 410 U.S. IB, 152; Schmerberv. California (1966) 384
Privacy, and Happiness exceed the State's inter- U.S. 757, 778-779 (dis. opn. of Douglas); Breithaupt v.
Abram (1957) 352 U.S. 432, 441-442 (dis. opn. of. Warren,
est in protecting parents' constitutional rights. C.] .); Id., at 443-443 (dis. opn. of Douglas,].). "The preserva-
tion of one's bodily reproductive functions is a fundamental
THE STATE'S INTEREST IN right, and the termination thereof constitutes a serious inva-
CIRCUMCISION sion of the sanctity of the person." Guardianship of Tulley
(1978) 83 Cal. App. 3d 698, 705. "Liberty means more than
The State's interest in circumcision, beyond financial con- freedom from servitude, and the constitutional guarantee is
siderations of Medi-Cal coverage and the maintenance of an assurance that the citizen shall be protected in the right to
ethical medical standards and procedures, involve the protec- use his powers of mind and bpdy in any lawful calling." Smith
tion of an infant's constitutional rights to Liberty, Privacy, v. Texas (1914) 233 U.S. 630, 636. "Although the Court has
Safety, and Happiness under the California Constitution not assumed to define 'liberty' with any great precision, that
Article I, the Federal protection against arbitrary deprivation term is not confined to mere freedom from bodily restraint.
of Due Process and Equal Protection under the Fourteenth Liberty under the law extends to the full range of conduct
Amendment, and the violation of criminal statutes against which the individual is free to pursue, and it cannot be
child and sexual abuse. restricted except for a proper governmental objective." (BoI-
The State's interest in an infant's First Amendment consti- ling v. Sharpe (1954) 347 U.S. 497, 499-500. There is no
tutional rights to Safety, Liberty, Privacy, and Happiness proper government objective which justifies restricting the
exceed the State's interest in protecting parents' constitu- infant's right to keep his bodily parts intact and enjoy a full
tional rights. range of use of his sexual organs.
Parental rights to the custody and control of their minor
children are as old as civilization itself. Modern judges refer There is no proper government objective which
to parents' custodial rights as "sacred," as a matter of"natural justifies restricting the infant's right to keep his
law" and as "inherent natural rights, for the protection of bodily parts intact and enjoy a full range of use
which, just as much as for the protection of the rights of the of his sexual organs.
individual to life, liberty, and the pursuit of happiness, our
government is formed." 23 ]FAML 337. The generalized In the California discussion of sterilization of mental
claims of parental constitutional rights have not been without incompetents, Valerie N., supra, it cites with approval In
challenge; courts aLall levels of the judicial hierarchy have Matter of Guardianship of Hayes (198) 93 Wash. 2d 228
occasionally intruded into the family relationship to protect where the Washington court concluded: "In the rare case
children. Ibid. The most important Supreme Court cases sterilization may be indeed in the best interest of the retarded
reflecting state and judicial intervention are Prince v. Massa- person ... However, the court must exercise care to protect
chusetts, 321 U.S. 158 (1944), and the cases involving the the individual's right ofPRIVACY, and thereby not unneces-
rights ofteenage females to have abortions, Bellotti v. Baird, (Continued on next page)


Circumcision: The Legal and Constitutional Issues (Continued)
sarily invade that right. Substantial medical evidence must be Neonatal circumcision shares sufficient characteristics
adduced, and the burden on the proponent ... will be shown with sterilization of mental incompetents to justify utilizing
by clear, cogent and convincing evidence that such a proced- the same standards to approve third party consent. Both
ure is in the best interest of the retarded person." Valerie N., practices remove a natural, healthy part of the anatomy
supra, goes on to find that it is necessary to "preserve the right without therapeutic necessity, in an irreversible procedure.
... to be free of intrusive medical and surgical procedures ... " Both restrict the full and complete enjoyment of the repro-
The State's interest in protecting an infant's rights to due ductive organs. Both have a tradition of government sup-
process and equal protection is derived from the incompe- ported abuse. Both force the acceptance of an involuntary
tency of his age and the accident of birth, his sex. To deprive a risk of surgical complications and death. Both restrict the
patient's individual constitutional rights to Privacy, Liberty,
baby boy of his constitutional rights of Liberty, Safety, Pri-
Safety, Happiness, Due Process, and Equal Protection.
vacy and Happiness must serve a "compelling state interest."
The primary difference between thirdparty ~onsent in the
While ensuring the constitutionalrights ofparents in care and cases ofneonatal circumcision and involuntary sterilizations
child rearing is an important state interest, that interest is of incompetents is that infants will one day be competent to
subordinated to the child's when the parental discretion may make their own choices.
jeopardize the health or safety of that child A reasonable
method to protect a child's due process rights, would be to This justification for granting third party
provide for ajudicial hearing, with the child represented by a consent for circumcision can not survive review.
disinterested guardian ad litem, to insure the necessity of a
medical procedure risking the health and safety of the incom- The court in Valerie, supra, 448, justifies the necessity of
petent minor. See Hayes, supra. In order to justify routine granting a third party consent for mental incompetents to
circumcisions for male infants which are not required or protect their constitutional right to procreative choice. "We
allowed for femakinfants, requires a "compelling state inter- do not pretend that the choice of the (incompetent's) parents,
est" to meet established equal protection analysis require- her guardian ad litem, or a court is her own choice. But it is ...
ments. No state interest ofany kind is served by the policy of one designed to further the same interests she might pursue
sexually discriminatory routine circumcisions, and it there- had she the ability to decide herseIf." In re Grady, supra, 426
fore violtiLes both the State and Federal Equal Protection A.2d at 481. This justification for granting third party consent
clauses of the Fourteenth Amendment. for circumcision can not survive review.

An operation or medical procedure

without valid consent constitutes battery
STANDARD FOR THIRD PARTY and false imprisonment.
Hayes, supra, cited with approval in Valerie N., supra,
provides a reasonable framework establishing a standard for
third party consent to intrusive medical and surgical proced- Critical to the issue of civil liability, absent medical neg-
ures. While Hayes and Valerie concern cases of sterilization is ligence, is the lack of actual or "informed consent." The
medically indicated as the last and best resort for the individ- well recognized legal incompetence of an infant precludes
direct or personal consent. An operation or medical proced-
ual. Can it be shown by clear, cogent and convincing evi-
ure without valid consent constitutes battery .and false im-
dence, for example that other methods of birth control are
prisonment. (See Rainer v. Community Memorial Hospital.
inapplicable or unworkable?" ... "The decision can only be
(1971) 18 Cal. App. 3d 240, 255; City of Newport Beach v.
made in a superior court proceeding in which (I) the incom- Sasse (1970) 9 Cal. App. 3d 803, 810.) Third party consent to
petent individual is represented by a disinterested guardian ad a surgical procedure can be granted with validity, conditional
litem, (2) the court has received independent advice based upon the circumstances, by a parent, guardian ad litem, or the
upon a comprehensive medical, psychological, and socia' courts. (See Valerie N., 219 Cal. Rptr. 387) The substituted
evaluation of the individual, and (3) to the greatest extent consent doctrine is often invoked to permit consent by
possible, the court has elicted and taken into account the view parents or guardians for surgery on an incompetent conserva-
of the incompetent individual." "Within this framework, the tee or minor. (See Probate Code §2353, 2355,2357) However,
judge must first find by clear, cogent and convincing evidence "even as to those intrusive medical procedures permitted after
that the individual is (I) incapable of making his or her own court authorization, the Legislature has required a judicial
decision ... , and (2) unlikely to develop sufficiently to make determination that the condition of the conservatee 'RE-
an informed judgement ... in theforseeablefuture." "Next, it QUIRES THE RECOMMENDED COURSE OF MEDI-
must be proved by clear, cogent and convincing evidence that CAL TREATMENT.'''(emphasis added) (Valerie N., Supra,
there is a need ..." "Finally, there must be no alternative ... 452.) Civil Code §25.8 which generally provides a right for
The judge must find clear, cogent and convincing evidence (I) parents to extend consent for any medical treatment ren-
all less drastic .. methods, ... have been proved unworkable dered, UPON THE ADVICE OF A PHYSICIAN AND
or inapplicable, and (2) the proposed method ... entails the SURGEON must meet the same standard as specified under
least invasion ofthe body of the individual. Valerie N., supra, the Probate Code, that is the child "requires the recom-
mended course of medical treatment."
(Continued on the next page)


Circumcision: The Legal and Constitutional Charles A. Bonner, J.D. is in private practice in San Fran-
Issues (Continued) cisco, California, with a -speciality in personal injury and
medical malpractice.

The Code of Medical Ethics prohibits Michael J. Kinane is a law student at the Hastings School of
Law, San Francisco, California.
a physician from advising unnecessary
medical or surgical treatment.
The Code of Medical Ethics prohibits a physician from
advising unnecessary medical or surgical treatment. The
AA P has declared there is "no absolute medical indication for
routine circumcision." Certainly, ifthere is a recognized med- The Politics of
ical indication for an individual neonatal circumcision, the
attending physician would have no difficulty advising that the
procedure is required. This medical determination and advice
would allow the parents, guardians, or court to make a valid
"informed consent" on the part of the minor, for the surgical
procedure of circumcision. Absent a recognized medical indi-
cation and physician advice, no third party would be in a
position to make a valid "informed consent." Absent a valid
"informed consent" the physician and those assisting (par-
ents, staff, hospital) in the non-consensua~ intentional con-
finement and operation on a minor can be held liable for Karen Ericksen Paige
battery and false imprisonment.

The civil law presently offers more

and Jeffery M. Paige
fruitful avenues of approach to
prevent genital mutilations.
"The single most important work
Suits for damages against surgeons, hospitals, and con- on the subject to date."
ceiva bly parents, are possible because malice in the sense of iii - Morris Zelditch, Jr.
will or a desire to cause injury is not essential to sustain a
recovery for intentional wrong doing. It is enough for the
plaintiff to show that the defendant knowingly and intention-
ally did the act which caused the damage and that damage
was substantially certain to follow. The limitation posed by
suits for negligence in this area is grounded in societally "A welcome addition. They argue that rituals
determined assumptions and expectations. which are slowly of reproduction in preindustrial societies are
changing to recognize circumcision as mutilations. (See 23 essentially political. In these societies, they say,
JFAML 337) men need to control the reproductive power of
Once it is shown that a childhas been subject to an injury to
his sexual organ, without valid "informed consent" or medi- women in order to establish political power;
calnecessity, a case may be madefor enforcement ofexisting where there is no law or central government,
state laws prohibiting assault and battery, conspiracy to ritual is used as a way of gaining control. The
assault and batter, childabuse, andsexualabuse. However it
type of ritual will vary, they conclude, accord~
will be extremely difficult to get a conviction, since circumci-
sion is not culturally acknowledged as child abuse at the ing to the economic base of the society ... for
present time. Additionally, in some jurisdictions it may be those who are interested in the subject, this
difficult to establish the requisite criminal intent. For this book is indispensable. Its thesis is challenging
reason, the civil law presently offers more fruitful avenues of
approach to prevent genital mutilations. and the documentation is excellent. Paige and
Perhaps a promising approach would be a civil rights Paige have made an essential contribution to a
classdaction against hospitals designed to prevent routine long debate, and their theory is sure to stir new
neonatal circumcisions, that is, in cases where circumcision is
and lively controversy." _ Science Digest
not medically warranted. A class action suit wouldfocus on
the individuals most culpable since competent surgeons are
aware that routine neonatal circumcision is not goodmedical University of California Press
practice. It would also avoid the constitutional issues of Berkeley - Los Angeles - London
parental rights, as well as religious issues, since the Orthodox
Jewish circumcision ceremony is not normally performed in Berkeley, CA 94720
medical centers by medical personnel. (23 JFAML 337) $11.95
by John Duffy

least one extreme case, at the request of a desperate patient

It was not until the second half of the who feared for his sanity, his physician castrated him. The
19th century that masturbation became physician in his report of the case declared that the patient
one of general concern. was gaining weight, somewhat lethargic, but morally sound.
Reprehensible as was masturbation among males, it was
I In the early 19th century perceptive physicians were
becoming increasingly dubious of the traditional medical
an even graver problem among Victorian females, who were
viewed as delicate, sensitive, frail, and emotional creatures. In

I theories and began turning to clinical experience. Unfortu-

nately, lacking an understanding of physiology and with no
response to an article in a local paper urging the medical
regulation of prostitutes, the editor of the New Orleans Medi-
knowledge of bacteriology, they were frustrated in their cal and Surgical Journal began by pointing out that the
attempts to prevent or cure disease. In desperation physicians morality of American women was much higher than that of
intensified their use of the traditional therapeutics - bleed- women in other countries. Most prostitutes in New Orleans,
ing, blistering, vomiting, purging and sweating, heroic ther- he observed, were foreigners. Having settled this point, he
apy which only served to increase public suspicion of the turned to "onanism" or masturbation, a practice "very injudi-
profession. Seeking to compensate for their inability to deal cious to the health of both males and females." Men, he
with disease, physicians increasingly began assuming the role wrote, occasionally admitted to it, but the case with women
of moral leaders. In the process they seized upon issues such was far different.
as abortion and masturbation.
The prudishness of Victorians and veil of silence they cast "In my opinion, neither theplague, nor war, nor
over sexuality is well known, but what is not so well known is
smallpox, nor a crowd of similar evils have
their preoccupation with masturbation. Little attention had
been given to masturbation until late in the 18th century, and resulted more disastrously for humanity, than
it was not until the second half of the 19th century that the habit of masturbation: it is the destroying
element of civilized society. "
\ masturbation became one of general concern. It first came to
public attegtion through the efforts of a few moralists, but it
( was not until the medical profession, seeking to bolster its
status in society, transformed the moral question of mastur-
To ask for or expect information from adult females about
this practice, he wrote, "is altogether useless and vain,
bation into a medical condition that it became a significant although many of their diseases, as leucorrhoea, uterine hae-
issue. morrhage, falling of the womb, cancer, functional disorders
In the case of males, the apprehensions about masturba- of the heart, spinal irritation, palpitation, hysteria, convul-
tion were engendered by a widespread assumption that the sions, haggard features, emaciation, debility, mania - many
loss of semen endangered the brain and nervous system. In symptons called nervous - un triste tableau. have been
America the superintendent of the Massachusetts Lunatic referred to masturbation as the cause." Even ifthese disorders
Asylum gave credence to this belief when in his 1848 annual did not originate in masturbation, he continued, "its practice
report he asserted that 32 per cent of admissions were for would certainly aggravate them." The editorial concluded
"self-pollution," one of several euphemisms for masturba- with a quote from a French physician: "In my opinion,
tion. Reflecting in part the Victorian preoccupation with neither the plague, nor war, nor smallpox, nor a crowd of
sexuality, by the late 19th century medicaljournals in Europe similar evils have resulted more disastrously for humanity,
and America were attributing almost every conceivable med- than the habit of masturbation: it is the destroying element of
ical condition to this "secret vice." civilized society." 2

Loss of semen was considered a Dr. Isaac Brown Baker, who claimed success in
real danger to males ... treating epilepsy and other nervous disorders in
female patients by excising the clitoris.
Since loss of semen was considered a real danger to males,
then it followed that nocturnal emissions were equally
J hazardous. To solve both ofthese problems, a whole array of
In 1866 an American medical journal discussed the work of
a British physician, Dr. Isaac Brown Baker, who claimed
mechanical devices were constructed. They included such success in treating epilepsy and other nervous disorders in
items as strait jackets, genital cages, and penis rings with
female patients by excising the clitoris. After noting that the
sharp points on the inside. Most of these objects were devised
great mass of English medical opinion was strongly opposed
by laymen, but the medical profession, which has generally
to Baker's ideas and had "unqualifiedly condemned" his
reflected prevailing beliefs, was not to be outdone. Young
men driven by guilt who sought a physician's help, or who operation, the American editor concurred with the English
confessed to masturbation under close questioning by their medical profession, declaring that to remove the clitoris "to
physician, were treated with blistering agents, mild acid solu- allay sexual irritability is about as unphilosophical as to
tions, or leeches applied to the genitals. Bloodletting and remove the analogous organ of the male." 4
cutting the foreskin were also used in serious cases. 1 In at (Continued on next page)


Clitoridectomy: (Continued)

"SexuaIPervers;on;n the Female" (1894) refer-

red to female masturbation as a "moral leprosy. "
While the clitoridectomy was only rarely performed in the
English-speaking nations, the subject of female masturbation
continued to intrigue the public and the medical profession.
As the century drew on, more articles on the subject began
appearing in medical journals and the clitoridectomy was
revived. In 1889 Dr. Joseph Jones, a former president ofthe
Louisiana State Board of Health and a medical professor,
stated that "hopeless insanity" was one of the many conse-
quences of masturbation and that the child of a masturbator
was liable to hereditary insanity. 8
Dr. A.J. Bloch of New Orleans in an article entitled "Sex-
ual Perversion in the Female" (1894) referred to female mas-
turbation as a "moral leprosy. "In one of his cases, he des-
cribed how a schoolgirl of fourteen suffering from nervous-
ness and pallor had been cured by "liberating the clitoris from
its adhesions" and by lecturing the patient on the dangers of
masturbation. 10
As far as can be ascertained, Dr. Bloch was one ofthe last
American surgeons to report taking such drastic measures.
By this date medical studies were beginning to demonstrate
that masturbation caused no serious functional disturbances
and that the psychological problems involved arose from the
social attitude towards the practice rather than the act itself.
As these ideas gained medical acceptance during the next
thirty years, the subject of masturbation in normal individu-
als gradually disappeared from medical journals.

I. Haller, John S. and Robin M., The Physician and Sexu-
ality in Victorian America, Urbana, Chicago, and Lon-
don, 1974, pp. 195,207-209.
2. Editorial: Review of European Legislation for Control of
Prostitution, New Orleans Medical Surgical Journal
1I: 700-705, 1854- I855. ACTION GVIDE Published by WINNEWS
3. Castellanos, J.: Summary Prepared from French Jour- $5.00 per copy prepaid,
nals, South J Med Sci 1:495-96, 1866-1867.
4. Editorial: Clitoridectomy, South J Med Sci 1:794, please add $2.00 for air abroad.
5. West, D.C.: Clitoridectomy, Brit Med J 2:585, 1866. This ACTION GUIDE is based on
6. DownJ., and Langden, H.: Influence of Sewing Machine research of the:
on Female Health, New Orleans Med Surg J 20:359-360,
1867-1868. Hosken Report: Genital/Sexual
7. Comment: New Orleans Med Surg J (new series) 9:67, Mutilation ofFemales.
1881-1882. Published by WIN NEWS
8. Jones, J.: General Medicine - Diseases of Nervous
System, Trans La Med Soc 1889, pp. I7o-I7I. 117.00per copy prepaid,
9. Tait, L.: Masturbation, Med News 53:1-3,1888. please add 15.00 for air abroad.
10. Block, A.J.: Sexual Perversion in Female, New Orleans
Med Surg J (new series) 22:1-7,1894-1895. Please sendyour order to:
II. Duffy, J.: Masturbation and Clitoridectomy. The Jour-
nal of The American Medical Association. October 19, WIN NEWS, Fran P. Rosken
1963, Vol. 186, pp. 246-248. 187 Grant Street
Lexington, MA 02173 U.SA.
John Duffy, Ph.D. is Clinical Professor Emeritus, Tulane Uni-
versity School of Medicine and Professor Emeritus of History,
University of Maryland. Dr. Duffy is a medical historian with WIN IS A NON-PROFIT
some nine published books and 80 articles. His newest book is CHARITABLE ORGANIZAnON
The Sanitarians: A History ofAmerican Public Health. Univer- Contributions to WIN are tax deductible.
sity of Illinois Press to be released in February 1990.


Social-Behavioral Characteristics Of Affectionate/Nurturant
And Non-Affectionate/Non-Nurturant Primitive Cultures
by James W. Prescott


I. Martrilineal I. Patrilineal
2. Polygyny has low incidence 2. Polygyny has high incidence
3. Women's status not inferior 3. Women's status inferior
4. Low avoidance of In-Laws 4. High avoidance of In-Laws
5. Low incidence of Mother-Child households 5. High incidence of Mother-Child households
6. Small community size 6. High community size
7. Low societal complexity 7. High societal complexity
8. Large extended family 8. Small extended family
9. Wives are not purchased 9. Wives are purchased
10. Slavery absent 10. Slavery present
II. Grand-parental authority over parents is absent II. Grand-parental authority over parents is present
12. Subsistence is primarily by food gathering 12. Subsistence is primarily'by food production
13. Low class stratification 13. High class stratification
14. Political integration at community and family level 14. Political integration at state level
15. Metal working is absent 15. Metal working is present

16. High infant physical affection 16. Low infant physical affection
17. Low infant physical pain 17. High infant physical pain
18. High infant indulgence 18. Low infant indulgence
19. High reduction of infant needs 19. Low reduction of infant needs
20. Immediate reduction of infant needs 20. Delayed reduction of infant needs
21. Low infant / child crying 21. High infant / child crying
22. Prolonged breast-feeding over 2% years 22. Breast-feeding less than 2% years
23. Low child anxiety over performance of 23. High child anxiety over performance of
responsible behavior responsible behavior
24. Low child anxiety over performance of 24. High child anxiety over performance of
obedient behavior obedient behavior
25. High smiling, laughter, humor 25. Low smiling, laughter, humor
26. Low anxiety over transition: infancy/childhood 26. High anxiety over transition: infancy/childhood
27. High number of food taboos during pregnancy 27. Low or no food taboos during pregnancy
28. Abortion permitted 28. Abortion highly punished
29. Strength of desire for children is low 29. Strength of desire for children is high


30. Premarital coitus permitted 30. Premarital coitus punished
31. Extramarital coitus permitted 31. Extramarital coitus punished
32. Post-partum sex taboo less than one month 32. Post-partum sex taboo greater than one month
33. Sex disability absent 33. Sex disability present
34. Castration anxiety is low 34. Castration anxiety is high
35. Low sex anxiety 35. High sex anxiety
36. Narcissicism is low 36. Narcissism is high
37. Low exhibitionistic dancing 37. High exhibitionistic dancing


Social-Behavioral Characteristics of Primitive Cultures (Continued)
38. Low adult physical violence 38. High adult physical violence
39. Low or no warfare 39. High warfare
40. Low military glory 40. Military glory emphasized
41. Bellicosity is low 41. Bellicositiy is extreme
42. Low or absent killing, torture, mutilation 42. High killing, torture, mutilation
43. Low personal crime 43. High personal crime
44. Incidence of theft is low 44. Incidence of theft is high

45. High God is mainly absent 45. High God is present
46. Low or no religious activity 46. High religious activity
47. Superordinate justice absent 47. Superordinate justice present
48. Supernaturals are benevolent 48. Supernaturals are aggressive
49. Fear of humans rather than fear of supernatural 49. Fear of supernatural rather than fear of humans
Belief in reincarnation absent
Low ascetecism in mourning
Belief in reincarnation present
High ascetecism in mourning
52. Witchcraft low or absent 52. Witchcraft highly present
53. Religious specialists are part-time 53. Religious specialists are full time \

NOTE: The above social-behavioral characteristics of male and female fertility; and use of children as economic
primitive cultures have been derived from: R.B. Textor
(1967) A Cross-Cultural Summary, HRAF Press New
Haven. Matrilineal cultures are those where inheritance fol-
resource, thus, its linkage with abortion being punished.
Presence of a Supernatural (High God) with high religious
activity in low affectionate/nurturant cultures reflects the
lows the female line; Polygynous cultures are those where need for "divine love" when human love is absent or signifi-
men have several wives and is a measure of sexual exploita- cantly diminished. Similarily, God is made unto the image
tion and control of women by men; High desire for children is and likeness of man - violent cultures have violent Gods;
a measure that reflects exploitation of children: high value of peaceful cultures have peaceful/ benevolent Gods.

James W. Prescott is a developmental neuropsychologist and a

cross-cultural psychologist who received his doctorate in psycho-
logy from McGill University, Montreal, P.Q. Canada. He served as
Assistant Head, Physiological Psychology Branch, Office of Naval
Research (1963-1966); as Health Scientist Administrator, Devel-
opmental Behavioral Biology Program, National Institute of Child
Health and Human Development, NIH (1966-1980); and President,
Maryland Psychological Association (1970-1971).
He was the recipient of the "Outstanding Contributions To Psy-
chology Award, Maryland Psychological Association (1977); the
CINE GOLDEN EAGLE AWARD for his contributions, as
Scientific Director, to the award winning Time-Life film, "Rock A
Bye Baby" (1971); and has given expert testimony on the origins of
human violence, particularly domestic violence, before the Senate
of Canada; the U.S. Congress; and many other legislative and
professional organizations.
Dr. Prescott is currently President, BioBehavioral Systems;
Director, Institute of Humanistic Science; Editor, THE TRUTH
SEEKER; and is residing in San Diego, CA.


Female Genital Mutilation - Strategies For Eradication (Continued)
London, Stella Efua Graham, a native of Ghana and Presi-
dent of FOR WARD (the Foundation for Women's Health),
outlined her educational work among African immigrants to
the U. K. A doctor from Indonesia discussed how female
circumcision in Indonesia had now been changed into a
purely symbolic rite. Berhane Ras Work, the president of the
Inter-African Committee (lAC) on "Traditional Practices
Affecting the Health of Women and Children" founded in
1984, talked about its work all over Africa.
Women's International Network (WIN) was represented
at the Seminar by Fran P. Hosken, who spoke about the
actions against female child genital mutilations all over the
world, and about the UNIVERSAL CHILDBIRTH PlC-
TU RE BOOKS with additions to prevent excision and infib-
ulation that WIN has developed and introduced all over
Africa with much success. The books are currently being
translated into Somali and will be used by the SWDO for
their campaign, by the Family Planning Program, the Health
Ministry, etc. Figure 5: Tribal Genital Mutilation. The excised
tip of the foreskin is placed on the toe of the boy
as a symbol of the completed puberty ritual.
These damaging traditions of genital mutila- Again, no blood on this foreskin could be detect-
tions must be eradicated as a prerequisite for ed in the film of this circumcision.
normal healthy development and to protect have their daughters' genitals mutilated and to teach their
the basic human rights of children and women. family and neighbors about the damage done by these mutila-
tions. We offer books to anyone who is willing to sign such a
The successful joint SWDO-AIDos education cam-

) paign, highlighted by this international meeting, should be

an example to both governmental and non-governmental
organizations that the time has come to address these
The success of this grass roots initiative has been remark-
able. We are mailing more and more small packages of books
and many of the requests, as well as letters describing their
problems, and to provide more international support for efforts to teach in their own communities against excision,
the eradication of these harmful, traditional, cultural prac- are from men. Excerpts of some of the letters received are
tices. These damaging traditions of genital mutilations printed in several issues of WIN NEWS.
must be eradicated as a prerequisite for normal healthy
development and to protect the basic human rights of
It is possible to create a network of participants
children and women. Most importantly, it is the wish of
African women and men concerned about their children's and of support groups much like Amnesty
health and future. International has successfully done. Such a
man-to-man consciousness-raising network is
Men must become involved in this interna- long overdue. This suggestion will, I hope,
tional campaign to end the genital mutilation encourage men to use their imagination and to
of female children. support this world-wide goal to end female geni-
African women are working, supported by women tal mutilations.
worldwide, to protect their daughters and to eradicate
Professional men in the u.s. should contact male profes-
these damaging traditions of female genital mutilations
sionals and leaders in Africa in affected countries and help
that have no place in our world. But where are the African
them to organize and speak to the issue publicly - to make it
men and other men in the rest of the world to support those
known that, as community leaders, they reject these female
African men who are openly opposing thesb mutilations?
genital mutilations and that they do not practice them in their
Men must become involved in this international campaign
own families. This can also be done without going to Africa,
to end the genital mutilation of female children.
without raising large amounts of money first, but on a per-
WIN NEWS has been sending Childbirth Picture Books
sonal basis. It is possible to create a network of participants
(C B PBs) with the Additions to Prevent Excision and
Infibulation to midwifery schools all over Africa, to com- and of support groups much like Amnesty International has
munity health workers, secondary schools, indeed to all successfully done. Such a man-to-man consciousness raising
who write for copies. The CBPBs are now circulating on network is long overdue. This suggestion will, I hope,
the grass-roots level- as our growing correspondence and encourage men to use their imagination and to support this
requests for more books confirms. In each book with the world-wide goal to end female genital mutilations. Genital
A ddition to Prevent Excision. we enclose a short note to mutilations are a violation of human rights.
ask the receiver to write a short statement that they will not (Conlinued on nex[ page)


Female Genital Mutilation - Strategies For Eradication (Continued)
Women's International Network News (WIN NEWS) publishes Investigation of Genital Mutilation
a column on "Female Circumcision/Genital and Sexual
Mutilation" in every issue (quarterly) since 1975, where
Practiced in USA by Immigrants
information - including names and addresses - contacts WIN NEWS has a proposal for a systematic investiga-
are reported from all over the world. For subscriptions tion to be conducted by members of each ethnic com-
write to: WINNEWS, 187GrantSt., Lexington, MA02173 munity to research and record the facts. For more
The Hosken Report: Genital/Sexual Mutilation of Females by
information, please write to Fran P. Hosken, Editor,
Fran P. Hosken (Third Revised and Updated Edition),
WIN NEWS, 187 Grant Street, Lexington, MA 02173
Published by WIN NEWS, Winter 1982/83, 344 pages,
with case histories from: Sudan/ Egypt/Somalia/ Kenya/
Ethiopia/Nigeria/Mali/Upper Voltajlvory Coast/Sene-
gal/ Sierra Leone/ Arab Peninsula. Asia: Malaysia/ In-
donesia. The Western World.
Female Genital Mutilation in the World Today: A Global
Review, by Fran P. Hosken, International Journal of
Health Services, Editor-in-Chief: Vincente Navarro, Johns
Hopkins University, Baywood Publishing Co., 120 Marine ON Crime and Punisfimmt
St., P.O. Box D, Farmingdale, NY 11735 (Vol. II, No.3,
You. cmmot separate thejust jium the tu9ust
1981, pp. 415-530).
The Childbirth Picture Books: by Fran P. Hosken, pictures by aru! the 900c! jium the wicWi
Marcia L. Williams, published by WIN NEWS, 187 Grant For thty staIu! t!J9et11er 6efore thefaa 'ifthe sun. even as the 6fack
St., Lexington, MA 02173. Available in English/French/ tftmu{ aru! the wfiite. are woven t!J9etFter.
Arabic with Additions to Prevent Excision and Infibu-
lation/ and Spanish. Printed in India by CHETNA, 2nd And wlien the 6fack tIiread &reaRs, the weaver sliaf[ fook. inW the
Floor, Drive-in Cinema Bldg., Thaltej Road, Ahmedabad wlioCe c£otFt, aru! lie sliaf[ e;wmine the foam l1&J.
380054, in Hindi and other Indian languages. 'I1ie Propliet
Inter-African Committee: Africa Hall, Room 605, P.O. Box 1(aIiBI (jiDran
3001, Addis Ababa Ethiopia. Or: 147 rue de Lausanne,
CH-1202 Geneva, Switzerland. A Newsletter is available in
English or French (2x year). f
Copyright@ 1982 Fran P. Hosken


Epidemiology of Female Sexual Castration In Cairo, Egypt
by Mohamed Radawi

INTRODUCTION their husbands or a male figure. Women who willingly partic-

In 1985 a group of 350 urban Egyptian women were ipated in this study were either alone or accompanied by a
selected to self-report on their recall of their female sexual younger person of a lesser age or in the presence of another
castration (FSC) which they experienced as children. Two woman.
years of field observations of female genital mutilations in
Cairo have resulted in a wealth of quantitative, qualitative
In this study, a majority of women reported being sub-
and photographic information on the various aspects of
jected, at least once, to genital mutilations Almost 8 out of 10
female genital mutilations, as observed and practiced through
(81.6%) Egyptian women reported being subjected to genital
1985. mutilations. This incidence is in agreement with findings
The purpose of this pilot study was to provide preliminary from other investigations that have been made over the past
baseline information for a future epidemiological study of 12 years. The average incidence of FSC in these studies is
female genital mutilations and its relationship to female fertil- 80.5% (See Table I). Although these surveys are not without
ity and psychological trauma, particularly psychosexual methodological problems, they are all reasonably consistent
functioning. This report summarizes selected descriptive find- in their report of the prevalence offemale genital mutilations.
ings from the pilot study that was conducted in Cairo, Egypt A true national survey has yei to be conducted on the inci-
in 1985 and were reported at the First International Sympo- dence and characteristics of female genital mutilations.
sium on Circumcision held at Anaheim, CA (1989). This pilot
study has provided some insights into the public health Almost 8 out of 10 (81.6%) Egyptian women
aspects of female genital mutilations; the social- religious reported being subjected to genital mutilations.
factors that compel these practices; age, socio-economic and
other factors that place children at risk for FSC; nature and
circumstance of genital mutilations; and the personal psycho-
logical trauma experienced from these genital mutilations. OF FEMALE GENITAL MUTILATIONS
The social-behavioral characteristics of female sexual cas-
METHODOLOGY tration in Egypt with respect to age, place, agent and form of
A non-random sample of women were selected from var- genital mutilations are summarized in Table 2. The majority
ious communities and socio-economic sectors in Cairo, offemale genital mutilations occur between 6-11 years of age:
Egypt. Participants were not drawn from clinical patient 81.2%; 4.5% occur under 6 years of age; and 14.3% occur after
age of II years. Virtually all genital mutilations occur before
populations. The characteristics of the female participants
the age ofmenstration, i.e. it is a pre-menstrual or pre-fertility
that were interviewed are summarized as follows:
AGE (Years): <l20: 16%; 20-29: 60%; 30-39: 16%; 40-49:
5%; 50+ 3%. The majority offemale genital mutilations occur
RELIGION: Muslim: 94%; Coptic: 6%. between 6-11 years of age: 81.2%;
MARIT AL STATUS: Single: 59%; Married: 37%;
Divorced: 2%; Widowed: 2%. The home of the girl is the primary place for genital
mutilations where 79.3% of genital mutilations occur; 13.5%
EDUCA nON: High School: 52%; College: 27%;
occur in clinics; 4.1% in street booths, and 3.0% in hospitals.
Elementary: 8%; Illiterate: 2%.
WORK: Employed: 46%; Housewife: 27%; Student: 27%. The home of the girl is the primary place for
INCOME: <lL.E. 100 Month: 78%; L.E. 100-500 Month: genital mutilations where 79.3% of genital muti-
19%; L.E. 1,000+ Month: 3%. lations occur;
In brief, the female sample studied can be described as
young, Muslim, single, educated, employed and of lower The primary person that inflicts the genital mutilations is
incomes in Cairo. the midwife - Daya (60.9%); followed by physicians
The data was collected during a single interview with each (22.9%); and then barbers (16.2%). It must be emphasized
female participant with no follow-up interviews. A three page that physicians who perform these genital mutilations are not
following medical procedures that are taught in the medical
semi-structured questionnaire developed by the author was
schools; and that they are violating their medical oath and
used to obtain information in the following areas: a) person-
ethics that prohibit unnecessary medical practices. These
al/ family data; socio-economic status; conditions and char-
physicians have abused and exploited their medical knowl-
acteristics of the genital mutilation experience; and its effects
edge and skills to compete with traditional healers for the
upon their psychological and psychosexual functioning. people's limited money.
The data collected was coded and edited to protect the
privacy of each participant. Computer encoded data included The primary person that inflicts the genital
no references to the identity of the participants. 93% of the
mutilations is the midwife - Daya (60.9%);
subjects completed the interview. Women who refused to
participate in this study were almost always accompanied by (Continued on nexi paxe)


Epidemiology of Female Sexual Castration In Cairo, Egypt (Continued)
I have personally observed over 100 completed female LIKE THE REST OF YOUR SISTERS, YOU
genital mutilations with photographic documentation. The ARE NO EXCEPTION"
genital mutilation technique almost always involves the rem-
oval of the clitoris and labia minora and to a lesser extent "/ was terrified to say No"
slashing the labia majora when it is bulky and protruding. In "/ dare not say NO"
practice there is a wide range of technical variation of genital
"/ wasn'tfully comprehending what was happening to me.
mutilations which differ within the same practitioner across
time, instrumentation used, and with the socio-economic / wanted someone very much to explain what was being
status, age, location, traditionalism, and ethnicity of the child done to me in vain. "
and her family. This issue of variation of degrees of genital "/ was shocked and never was I able to comprehend until it
mutilations has yet to be systematically studied and was over.
documented. "Please don't make me remember what happened, / am
INFORMED CONSENT trying to forget"
The majority of children (77.4%) subjected to genital muti- "/ cried and screamedfor help and no one helped"
lations were never informed as to what they were being "/ cried like mad, shouting YOU ALL CHEATED ME ..
subjected to, let alone given the opportunity to give informed " (then the respondent wept silently with a choking
consent. The women reported that they were deceived, voice).
assaulted, chased and violently immobilized to be forced to
have their genitals mutilated. The remaining percentage of
women (22.6%) reported that they were deceived, misin- REST OF YOUR SISTERS, YOU ARE NO
formed, and misled as to the imminent danger of physical EXCEPTION"
violence and genital mutilation. Their "consent" was not "They attacked me by surprise"
"informed" in any legal sense of the word. "I saw the Daya holding a razor, then she hurt me"
"I couldn't believe my mother was with them; they all
attacked me one early morning while I was still sleeping"
The above are some of their emotional recalls of what had
happened to them. The intensity of their recall, as I remember
well, was very strong and vivid and commonly associated
with weeping and remembered pains and humiliation. The
lifelong psychological effects of these genital mutilations
needs to be systematicaly studied.

"I couldn't believe my mother was with them;

they all attacked me one early morning while I
was still sleeping"


The effects of genital mutilations upon responses to sexual
stimulation was examined in a subset of FSC women com-
pared to non-mutilated (normal) women. There were 133
FSC women and 26 normal women who were compared with
respect to sexual excitement in response to stimulation of the
clitoris or clitoral area; stimulation of the labia areas; and
It was found that 7.7 times as many normal women expe-
Figure 1: An Egyptian girl shows shock, pain, trauma rienced sexual excitement to stimulation of the clitoris/
and angUished disbelief as she views her genitals being clitoral area than did the genitally mutilated women. Mas-
mutilated. The shock In her eyes cannot be shown In turbation (involving labia as well as clitoral areas) was the
order to protect her Identity. method of choice for sexual satisfaction that was 2.2 times
more frequent in normal women than in the genitally muti-
PERSONAL RESPONSES TO FEMALE lated women. Manual stimulation ofthe clitoris/clitoralarea
GENITAL MUTILATION resulted in the experience of orgasm in 50% of the normal
The following personal comments were recorded from women and in 25% of the genitally mutilated women.
the women who were interviewed: (Continued on next page)


Epidemiology of Female Sexual Castration In Cairo, Egypt (Continued)

Mothers are directly responsible for arranging There is no clear and definite statement in the
the genital mutilation of their daughters. Koran, the principal religious authority of Islam,
that supports the practice offemale genital muti-
There are two notable findings from this preliminary sur-
vey. The first is that only 50% of normal (non-mutilated) lations.
women experienced orgasm with manual stimulation of the
in the Southern regions of Egypt (upper Egypt which is closer
clitoris; and as much as 25% of the genitally mutilated women
to African Cultures), whether Muslim or Coptic. are at a
were able to experience orgasm in response to stimulation of
higher risk for genital mutilations and other forms of reli-
the clitoral area. The extent to which orgasmic potential in
the mutilated women is related to the nature and degree of gious physical mutilations than are Muslim or Coptic women
genital mutilation is a subject for future research. located in the Northern or coastal regions of the country
(lower Egypt). Finally. there is no clear and definite statement
SUMMARY in the Koran, the principal religious authority of Islam. that
In overview, the majority of women with genital mutila- supports the practice of female genital mutilations.
tions came from modest and low socio-economic family
status (SES); illiterate and partially educated parents (al- Religious institutions and ancient social customs
though the majority of daughters who were subjected to are primarily responsible for the genital mutila-
genital mutilation had a high school or college education
(79%); and came from rural regions, particularly southern
tion of female children.
communities. Girls of urbani rural areas (living in urban
areas but raised in rural areas) remain at a higher risk for CONCLUSIONS
genital mutilation than urbani urban girls. Girls of rural( ru- Female genital mutilation is a common and popular prac-
ral families remain at the highest risk for genital mutilation. tice throughout Egypt where every day thousands of young
Regional factors involving peer and ancestral pressures influ-
girls are subjected to this torture and mutilation. Religious
ence the family's decision to have their daughter's genitals
institutions and ancient social customs are primarily respon-
sible for the genital mutilation of female children. The full
social and psychological consequences of mutilating the geni-
Religious beliefs are a strong predisposing factor tals of female children have yet to be evaluated. Preliminary
for female genital mutilations. evidence, however, suggest that the psychological conse-
quences of female genital mutilation is very similar to that of
Mothers are directly responsible for arranging the genital rape victims.
mutilation of their daughters. However, without a male
What can be done to bring an end to female genital mutila-
authority (marital dissolution, separation, sickness, labor
tion in Egypt and other countries? The use of force would
migration and death), mothers are likely to have second
only drive it underground and increase the resistance to
thoughts about subjecting their daughters to genital mutila-
cultural change. Educational programs that are directed to
tion. Also, daughters of financially independent mothers are
seldom exposed to genital mutilation, as a mother's financial Egyptian families; the agents that perform the genital mutila-
independence seems to allow her parity in family decision- tions (midwives. doctors. barbers); and the social-political
making. and religious leaders on the harmful and devastating effects
Religious beliefs are a strong predisposing factor for that these procedures have upon women will contribute sig-
female genital mutilations. A large percentage of women nificantly to the elimination of female genital mutilations.
whose genitals are mutilated are affiliated with the Islamic Specific attention must be given to the effects of genital
religion despite the fact that female genital mutilation is not mutilations upon reproductive processes, the birth of the
prescribed by the Islamic religion. Female genital mutilation child and the marital sexual relationships. Men need to
is apre-Islamic religious practice with its roots in the officially understand that their maritalsexual relationships and happi-
banned Africanfaiths and practices which dominated Egypt ness will be significantly enhanced when the female genitals
for thousands of years in pre-historic times. are not mutilated. Finally, the education of women must be
In the dawn of monotheism - Judaism, Coptism and accelerated if these objectives are to be realized.
Islam - many Egyptians who converted to monotheism
have assimilated their predominant traditional (African)
beliefs and practices with their chosen monotheism. To a BIOGRAPHICAL NOTE
keen observer, many features of "Muslim" Egyptian faith
lifestyle and religious practices (such as ancestral worship, MOHAMED BADAWI, M.D., M.P.H., is a graduate of
Zar cults, circumcision and many other forms of blood and Cairo University, School of Medicine (1973); a graduate of
flesh sacrifices) meet earlier African faith standards and not the University of Michigan, School of Public Health (1981);
current monotheistic beliefs (except for Judaic male a graduate of AI-Azhar University School of Medicine, Cairo
circumcision). (1985); and is currently completing a doctoral program at the
By understanding African religions and faith practices Johns Hopkins University School of Public Health. This
many of the traditional religious behaviors of "monotheistic" pilot study was supported by the personal funds of Dr.
Egyptians become meaningful. Forexample, women located Badawi.
(Cuntinued unnexi page)


Epidemiology of Female Sexual
Castration In Cairo. Egypt (Continued)
Assaad, M. (1980) Female circumcision in Egypt. Studies in
Famill' Planning, January II (I): 3-6.

Baasher, T. (1982) Psycho-social aspects of female circum-

cision. In: Baasher, T., Bannerman, R., Rushwan, H.,
Sharaf, I. (Eds). Traditional Health Practices AffeCling
The Health of" Women and Children. WHO Regional
Office for the Eastern Mediterranean. EHO EMRO
Technical Publication. 2(2): 162-180. and

PS.I'chological Aspects of Female Circumcision WHO

East Mediterranean Regional Office, Alexandria (1977). Figure 2: Female Sexual Castration (FSC) and Circumcision
Booth. This unlicensed booth is located on one of the busi-
est streets in Cairo. Although, most FSCs occur in the home,
EI-Saadawi, N. (1977): Women and Sex. Madbouly some FSCs are conducted in the booth since a public decla-
Publishers. ration of the daughter's FSC is desired by the family. Male
circumcisions are commonly performed in these booths. If
Smith, E. (1980) Female Circumcision in £,'{I'Pt. Higher Insti- complications occur, the operators disclaim all knowledge
of the event.
tute for Nursing (Unpublished).

(1985) (1980) (1979) (1979) (1977)

Percent* 81.6% 77% 90.8% 70.0% 81.8%

Sample Size n=350 n=125 n=54 n=70 n=160
Population General Students Patients Patients Patients
Location Cairo Alexandria Cairo Alexandria Cario
*80.5% is the average of female genital mutilation in the above studies.

AGE: <16 YEARS 6-8 YEARS 9-11 YEARS 12 YEARS +
PERCENT 4.5% 38.7% 42.5% 14.3%


PERCENT 79.3% 13.5% 4.1% 3.0%


PERCENT 60.9% 22.9% 16.2%




by George C. Denniston

Physicians are, for a fee, cutting off a normal Figure 1

body part. They are causing newborn American
boys incalculable pain arising in their most sensi-
tive pleasure organ.
Now that more and more men are willing to express their
feelings about their own circumcision, lawmakers, doctors,
third party payers, and certainly parents will want to take a
new look at this procedure.
The small number of A merican doctors who still perform
circumcision are violating the first rule ofgood medical care
-PRIMUM NON NOCERE-First, do no harm! Physi-
cians are, for a fee, cutting off a normal body part. They are
causing newborn American boys incalculable pain arising in
their most sensitive pleasure organ. They are doing it without
the consent of the person being operated on. And they often
do it without the full understanding and consent of his

Circumcision is truly foreskin amputation.

The penis at eight weeks. Illustration from R. Hunter

Most parents are not fully informed about circumcision

gins to develop two downward growing folds of tissue. like
before it is performed on their newborn son. Circumcision is
the twin hulls of a catamaran. (Fig. 2) By the 15th weck these
truly foreskin amputation. If they really understood this,
folds have fused at the bottom creating a tube within the
would they really want to convey to him that this is the way
glans. (Fig. 3) Now the urethra is extended to the tip*
those who love him are going to treat him? Do they really
want to permit someone else to inflict excruciating pain in his
most sensitive organ? The painful message of circumcision Figure 2
can stay with him throughout his life, according to many
scientists, and some of the victims.

The painful message of circumcision can

stay with him throughout his life,
Being fully informed about circumcision includes having
both parents watch a videotape as it will be performed on
their son. There is no other way that they can know what is ~ .

actually being done. Without this actual witnessing, there .:,\).! '<Cj
cannot be informed consent. . )
Few doctors really understand what they are doing when
they amputate the foreskin, for they have never studied how
./; I! ... !
the penis develops before birth.'
The penis begins its development as a microscopic protub- -il'/
erance in the male fetus six weeks after conception. As it }. '--II hi
grows outward, a thick layer of epithelial cells, which will '7..-. :J
become skin, piles up at the base in folds during the next two
Cross-section near tip of penis - 10 weeks
weeks. (Fig. I) At this stage, the tube within the shaft, the
Illustration from R. Hunter
urethra, has developed only part of the way down the shaft.
With further growth of the shaft and of the glans penis, the
Few doctors really understand what they are skin comes forward to completely cover it by the 15th week.
doing when they amputate the foreskin, for they (Fig. 4)
(Co/1/inlled on neXf page)
have never studied how the penis develops
before birth. */fthis sfep.fails to take IJlace, a conditiun knoll'n as 17.I'fJospa-
dias, lI'here the lIrethra upens shuI'! ufthe tip, lI'il/ he presel1l at
Then, at the 10 week horizon, the glans, seen head on, be- hirth.


First, Do No HannI (Continued)

Beginning around the 15th week and continuing Figure 5

gradually for as long as 17 years, a process be-
gins which ultimately separates the foreskin
from the glans.

From the 15th week on. the skin covers the glans com-
pletcly, with a small opcning at the tip. A distinct layer of cells
attaches the skin most firmly to the entire surface of the glans.
This skin is the skin of the glans penis. It has not yet separated
to create two distinct organs. the glans and the foreskin.

Figure 3

Whorl of cells between foreskin and glans

Illustration from R. Hunter

cess begins with the flattening of some cells in the area

between the glans and the foreskin. These flattened cells
round up into a ball, containing many layers of cells. The
central cells are necessarily cut off from nutrients, and die,
forminga space filled with the products of dead cells. (Fig. 5)
'\ /11
Many such whorls of cells form in this area between the glans
and the foreskin. and create spaces; these spaces coalesce. and
I., (j eventually create the preputial space, permitting full retrac-
') /1
/N\ tion of the foreskin from the glans.
Cross-section near tip of penis - 15 weeks
Illustration from R. Hunter At birth, virtually all males have a glans penis
covered with skin. In almost all of them (96%),
Beginning around t he 15th week and continuing gradually this skin is still attached to the glans like normal
for as long as 17 years, a process begins which ultimately
skin. Only 4% have a fully retractable foreskin at
separates the foreskin from the glans. This fascinating pro-
Figure 4
At birth, virtually all males have a glans penis covered with
skin. In almost all of them (96%). this skin is still attached to
the glans like normal skin. Only 4% have a fully retractable
foreskin at birth. 2
The implications of this finding are enormous. Any doctor
or other person who inserts a probe into this space between
the foreskin and the glans thinking that he is breaking adhe-
sions is mistaken. Anyone who attempts to forcibly retract
the skin is tearing the skin off an extremely sensitive organ.
This person is literally skinning tht penis alive. The facts of
penis development tell us so.
lt is not until the third year of life that 90% ofyoung boys
have fully retractable foreskins, and it is not until seventeen
years of age before virtually all boys have fully retractable
foreskins. 2
Anyone who attempts to forcibly retract the skin
is tearing the skin off an extremely sensitive
organ. This person is literally skinning the penis
Penis at 15 weeks (wax plate reconstruction) alive. The facts of penis development tell us so.
Illustration from R. Hunter
(Co/llil1l1ed 017 l7e,I'I page)


First, Do No Harm! (Continued)

Since the penis is used for procreation only a few "There's something very wrong and very fright-
times in the entire life of the individual, sexual ening about a society that systematically tortures
pleasure must also be one of it's major functions, and mutilates babies. "
and the foreskin is an integral part ofthat sexual stability ofthe pairbond. Surely it is not the aim ofdoctors to
pleasure. interfere in matters of such vital importance.
The facts of penis development demonstrate to us that an
unusual process separates the foreskin from the glans in its "Butchers!"
own good time, covering the infant glans tightly to protect it
Listen carefully to what men have to say about their own
from fecal contamination; covering the glans to protect it
circumcisions. These are direct quotes, compiled by John
when, while its owner is a child, it is not required for procrea-
Erickson and Jeffrey Wood.
tion; and finally, freeing up the cover when it is needed for
reproduction. There is no reason to interfere with this natural "I think I could have accepted a deformity that was an
accident of nature, but I can't accept that someone did this to
What is the most important function of the foreskin? To
answer that, it is first necessary to look at the function of "My feelings about the doctor who circumcised me are too
another organ - the penis. The penis has two obvious main violent to describe."
functions. It is used for urination and for procreation. But the "I have never been able to accept the fact that when I was a
penis is not required for urination. Witness the female of the baby someone cut part of my penis off. The sheer monstrous-
species. She does not have a penis, and yet she is perfectly ness of it haunts every waking moment of my life. Sometimes
capable of urination. The penis may be a convenient organ I'm beginning to make some sort of adjustment to it, but then
I see an unmutilated man in a shower or magazine and I
for urination, but it is certainly not required.
become overwhelmed by uncontrollable feelings of outrage
We can then say that the major function of the penis is
and disbelief that I was made the victim for life of something
procreation - the perpetuation of the species including sex-
so sick."
uallove. Without the penis, there would be no more humans.
"There's something very wrong and very frightening about
The penis cannot procreate nor engage in sexual love in the a society that systematically tortures and mutilates babies."
relaxed or flaccid state. It must be erect, engorging with
"I am Jewish and I hate the tradition that robbed me of my
blood, to perform its major functions. With this change in
best part."
condition, from flaccidity to rigidity, comes an increase in
length of approximately 50% Now where does this enlarged "I was circumcised when I was five - seventy years ago. I
felt rage then and I still feel rage now."
erect penis obtain skin to cover its elongated shaft? From the
foreskin! "The worst thing about circumcision is that it produces
In the relaxed state, the tip of the penis of the intact adult circumcisers. "
male is covered by the foreskin, which consists of a long "I wish I could circumcise every uncircumcised man in the
tubular fold of skin. As the shaft of the penis elongates with world, so they'd all be like me. I don't have a foreskin and no
erection, this double fold of skin becomes a single layer which one else should have one either."
covers it. "Butchers!"
Some have tried to argue that the foreskin does not have a "I was circumcised by force when a child, and it has ruined
function. When I was a medical student, several decades ago, my entire life as far as I'm concerned."
it was thought that the appendix was the one organ without a "Fear, pain, crippling, disfigurement and humiliation are
function. I was taught that the appendix was a vestigial the classic ways to break the human spirit. Circumcision
organ, left over from the remote past. We now know that this includes them all."
is not true. The appendix functions as part of the immune Despite the foreskin's important functions, the amputa-
system, producing large numbers of lymphocytes. Since the tions continue. Doctors who do them try to justify their
known parts of the body have a function, the probability of actions. Prevention of cancer of the penis and prevention of
the foreskin not having one is low indeed. urinary tract infections in infant males are now cited as
The foreskin covers the elongated shaft of the penis during possible reasons for amputating the foreskin.
erection; at other times it protects the sensitive glans penis.
The foreskin contains many minute muscle fibers which give "Fear, pain, crippling, disfigurement and humi-
it tone. This helps it to cover the glans snugly, and helps liation are the classic ways to break the human
prevent the glans from developing a thick, many layered
epidermis, which happens in the absence of the foreskin. This
spirit. Circumcision includes them all"
thickened epidermis reduces sensitivity. Since the penis is There is general agreement that the hygiene of men who
used for procreation only a few times in the entire life of the develop cancer of the penis has been poor. If the simple act of
individual, sexual pleasure must also be one of it's major cleaning beneath the foreskin could prevent cancer of the
functions, and the foreskin is an integral part of that sexual penis, doctors could wait until the man is of age, and let him
pleasure. Many psychologists and anthropologists believe choose!
that sexualpleasure with an available mate contributes to the (Continued on next page)


First, Do No Harm! (Continued)

Cancer of the penis is very rare - one case Dr. Spock recently retracted his support of cir-
in 100,000 - usually in older men. cumcision and expressed the wish that he had
had the foresight to recommend against circum-
Cancer of the penis is very rare - one case in 100,000
- usually in older men. Even if circumcision could prevent cision in earlier editions.
it, 100,000 foreskin amputations would be necessary to pre- The irony is that this mutiliation is perpetuated by a small
vent one cancer of the penis. One hundred thousand infants percentage of the doctors in America - perhaps five or six
would be mutilated, and several infants would die to prevent percent. The vast majority of doctors have nothing to do with
that one case of cancer. Who could scientifically advocate it, and most do not approve of it. Yet those few who continue
foreskin amputation for this reason? the outdated practice are giving the entire profession a bad
The same argument applies to the alleged prevention of name. Operating on a human being without a medicaljustifi-
urinary tract infection in male infants. 3 The largest number of cation and without his consent is indeed malpractice.
infections that could be prevented by foreskin amputation,
according to the author Dr. Thomas Wiswell, is 20,000 per
year in the United States. So we should do 1,500,000 foreskin Operating on a human being without a medical
amputations to prevent infections, now treatable with antibi- justification and without his consent is indeed
otics, in less than 2% of these infants? malpractice.
Circumcision, or foreskin amputation, is big business.
In an intact infant, the Each one costs over $100, divided between the doctor and the
proper care is to do nothing. hospital. At its peak, there were over one million a year. This
added up to well over 100 million dollars every year. Those
Besides, this type of infection may well be caused by two
who decide how our health care dollars will be spent should
improper medical procedures. Swedish scientists from the
identify circumcision as unnecessary surgery, and refuse to
Karolinska Institute in Stockholm claim that such infections
pay for it.
are caused by colonizing the newborn infant with foreign
bacteria from the hospital nursery. They recommend strict
rooming-in to permit colonization of the infant by its own Circumcision, or foreskin amputation,
mother which would thus prevent these infections. 4 is big business.
Second, Wiswell's colleagues taught the mothers in the
study to retract the foreskin - perhaps tearing the skin off References:
the glans - in the mistaken belief that this was proper care. I. Hunter, Richard H (1935): Notes on the Development of
This raw surface may then become a good site for the growth the Prepuce, J. Anal., 70:68-75.
of bacteria which can ascend the urethra causing urinary tract 2. Gairdner, Douglas (1949): The Fate ofthe Foreskin, Brit.
infection. In an intact infant, the proper care is to do nothing. Med. J., 2:1433-1437.
If the infants who had not been circumcised had been left 3. Wiswell; T.E., Smith F.R., Bass J.W. (1985): Decreased
alone, they might not have developed nearly as many urinary incidence of urinary tract infections in circumcised male
tract infections. infants. Pediatrics, 75:901-03.
4. Winberg, Jan et al (1985): The prepuce: a mistake of
It is sometimes argued that removal of the fore- nature? Lancet, 1:598-9 Mar 18.
skin prevents masturbation. Dr. Leonard Marino
points out that only coma prevents masturbation! George Clinton Denniston; M.D., M.P.H., specializes in
Preventive Medicine and Gynecology and has published
It is sometimes argued that removal of the foreskin pre- extensively in his field of speciality. He has produced a
vents masturbation. Dr. Leonard Marino points out that
number of medical training films and documentaries and has
only coma prevents masturbation! Dr. Benjamin Spock, in
served with many medical and professional organizations. He
the early edition of his influential book on child-rearing,
was formerly Associate Medical Director of Planned Parent-
recommended circumcision for appearance and to help pre-
vent masturbation. Dr. Spock recently retracted his support hood, Federation of America, New York. He is currently
of circumcision and expressed the wish that he had had the Medical Director, Population Dynamics, Seattle, W A; Pres-
foresight to recommend against circumcision in earlier ident, Population Dynamics and Consultant, Alaska
editions. Womens Health Service.
Virtually all European males are intact. Europeans recog-
nize that there are no medical indications for routine neonatal
circumcision. The American Academy of Pediatrics has also
been saying that for 18 years, and they continue to say it, even
though in their most recent pronouncement in March 1989, M
they hedge a bit. This latest pronouncement seems to be an
attempt to protect those doctors who have failed to follow
their recommendations these past two decades.


The Problem of Circumcision in America
by James L. Snyder

"First, do no harm. " Contrary to the recommendations of the

American Academy of Pediatrics, circumci-
In the matter of circumcision of newborn males, it must be
recognized that the child is normal as born, and that circum-
sion continues to be performed in rates vary-
cision inflicts loss of a normal body part and leaves a scar. ing from 50% to 90% of newborns in various
This is contrary to the motto of medicine which is "First, do parts of the country.
no harm."
benefits, continues to be ignored by physicians and to be
"There is no absolute medical indication unknown to the lay public. As a result, and contrary to the
recommendations of the American Academy of Pediatrics,
for routine circumcision of the newborn. " circumcision continues to be performed in rates varying from
50% to 90% of newborns in various parts of the country. Just
In the United States alone of industrialized societies, and in
why this is tragic is what I propose to show. Initially, it must
the two generations born since about 1940, routine newborn
be recognized that the statement of the AAP, "There is no
circumcision has become such an accepted routine in the
absolute medical indication lor routine circumcison of the
process of birth and delivery that for some people it is a
newborn, "has been perceived to mean that, while circumci-
surprise to discover that there is controversy over the desira-
sion is not necessary, it is perfectly all right to continue to do
bility of the procedure. In 1975, The American Academy of
it. Therefore, physicians who would refuse to give a child an
Pediatrics (AAP) published the report of a committee formed
unnecessary shot of penicillin simply because it was requested
to study circumcision, whose opinion was that "There is no
by parents are continuing to perform an operation on the
absolute medical indication for routine circumcision of the
request or by the compliance of parents.
newborn. " This statement is contained in the body of the
Report of the Ad Hoc Task Force on Circumcision from the
Committee on Fetus and Newborn of the AAP (Published in Sadly, there have even been instances when a
Pediatrics, Vol. 56 No.4, October 1975, and modified in child was circumcised without the parents'
March 1989). The body of the report addresses most of the wishes or consent.
commonly voiced concerns, such as phimosis, hygiene, care
of the penis, cancer, balanitis and venereal disease, surgical It must be acknowledged that there are numerous reasons
risks, and contraindications to circumcision. The Report also why circumcision continues to be performed upon children.
called for "true informed consent" and a "... program of Some parents request the operation because of the influence
education leading to continuing good personal hygiene offamily or friends and find that their physician will comply.
(which) would offer aI/the advantages of routine circumci- Some physicians continue to insist that th'e operation be
sion without the attendant surgical risk. " And finally stated, performed on children in their care and persuade young and
"Therefore, circumcision ofthe male neonate cannot be con- impressionable parents that they have no choice, or that it is
sidered an essential component of adequate total health in the child's best interest. Sadly, there have even been instan-
care. ces when a child was circumcised without the parents' wishes
or consent.
"Circumcision of the male neonate cannot be In the case of adult circumcision, the operation is never
performed unless the individual seeks the procedure for
considered an essential component of adequate genuine medical need or for his own aesthetic reasons. This is
total health care. " a choice that less than 10% of uncircumcised adults will ever
make. In Europe, more than 90% of men who are fortunate
Almost immediately the American College of Obstetri-
cians and Gynecologists and the American Urological Asso- enough to have their normal anatomy willfind no reason to
ciation - medical specialty societies with an immediate seek a circumcision.
interest in the question - published positions which in very The proponents of circumcision in recent years have pub-
nearly the same words supported the position of the AAP. lished articles which are claimed to show as a scientific fact
The expected result should have been an immediate drop in that uncircumcised males are at greater risk of acquiring a
the number of newborns subjected to routine circumcision. number of benign diseases and one rare malignancy. It has
The procedure would have been discarded or, at least, physi- been stated, for instance, that circumcision would reduce the
cians who continued to perform significant numbers of cir- opportunity to acquire syphilis, gonorrhea, herpes, venereal
cumcisions would have been under the same critical review as warts, urinary infections, and other benign conditions. The
those who continued to perform large numbers of unneces- fact is that circumcision confers no immunity to any of these
sary tonsillectomies when that operation fell into disrepute. diseases, which any physician treating large numbers of cir-
Curiously and, in some instances, tragically, no such thing cumcised American men - as in the military services - can
occurred. Even today, more than thirteen years after the readily observe, If all men were circumcised, only circumcised
AAP made its findings known, the Report, only slightly men would contract these diseases, for most of which there
modified in March 1989 to emphasize balance of risks versus (Continuned on next page)


The Problem of Circumcision in America (Continued)

The fact is that circumcision confers Circumcision must be recognized as an'equally

no immunity to any of these diseases, serious mutilation of men with equally insub-
stantial justification for continuing the practice.
are satisfactory antibiotic treatments. Most recently, there
has been speculation that circumcision would offer protec- seriously advocates removing the breasts of female infants to
tion from infection by Human Immunodeficiency Virus, the prevent this more common malignancy of breast cancer.
suspected causative agent of the disease AIDS. The stated Almost certainly such a proposal would be greeted by howls
basis for this is the observation of the AI DS infection pattern of outrage over such a mutilation of women to prevent breast
in a small number of African men who frequented AIDS cancer. Circumcision must be recognized as an equally
infected prostitutes. The proponents of this speculation serious mutilation of men with equally insubstantialjustifica-
choose to ignore the obvious fact that AI DS infections were tion for continuing the practice.
first recognized in American homosexual men who were
overwhelmingly Caucasian, middle class, and circumcised.
The child who simply has been cut too short will
Thousands of men with AIDS fill the hospital beds of our
major cities and are testimony to the failure of circumcision then become a sexually dysfunctional adult.
to offer any degree of immunity to AIDS infections. The risks of newborn circumcision are ail underreported
and ignored factor in this argument. Most often a poor
Circumcision is the only surgery which surgical result is not recognized until years after the event.
is used to prevent disease. By the time a child reaches the age of maturity and discov-
ers how he has been mistreated, the surgeon cannot be
The most significant argument that has been put forth for found, and parents may be beyond the age of interest in
circumcision is that it prevents cancer of the penis. This may such matters. The child who simply has been cut too short
be true, but even proponents of circumcision admit that there will then become a sexually dysfunctional adult. Some of
have been occurrences of penile cancer in men circumcised as the men who have realized that they have been deprived of
infants. Cancer of the penis occurs, on average, in men aged a normal part of their bodies have sought plastic surgical
55 years, and is one of the least common malignancies in men, procedures to reconstruct their bodies with the same moti-
representing Y2 of I % of all cancers in men and occurringat a vation as persons who have lost other portions of their
rate of less than one case per 100,000 per year in the United bodies by accident or disease, and who have sought to
States. This is the same incidence as in the countries of regain normal bodily integrity. The more serious complica-
Northern Europe, where infant circumcision is almost un- tions of circumcisions are increasingly being reported in
known. Proponents of circumcision would like to have the the lay press:
public believe that the low incidence of penile cancer in the
United States is due to infant circumcision, but they ignore The Des Moines Register (Iowa) Saturday, Nov. 201982,
the fact that the population of American men born before reported a grand jury investigation of the bleeding
death of a Des Moines infant after circumcision.
1940, who are now in the over 50 age group at risk for this
cancer, is a group of predominantly UNCIRCUMCISED The East Cobb Neighbor (Marietta, Georgia) of Nov.,
men. It is known that the rate of occurrence of penile cancer 1985, reported that "In September, two male infants
in the men of India, China, and the Caribbean areas (where were burned and horribly mutilated in a 'routine cir-
circumcision is not customary and where sanitary facilities cumcision' at Northside Hospital (Atlanta). One of
are primitive) is 20-30 times more common than in the uncir- the infants has had a necessary sex change operation
cumcised men of Northern Europe. Therefore it is apparent and the other is still under doctors' care. "
that the variable of circumcision or non-circumcision is not
The Lake Charles A merican Press (Louisiana) of Wednes-
the primary variable influencing the occurrence of penile
day, May 28,1986, reported a $2.75 million award in
cancer. Referring again to the Report of the American
the case of a young boy whose penis had to be ampu-
Academy of Pediatrics, it must be concluded that " . . .
tated after it was severely burned during a routine
continuing good personal hygiene . .. "may be a significant
factor protecting the uncircumcised men of Europe and
A merica from penile cancer. The Times Picayune (New Orleans, Louisiana) of Thurs-
day, May 15, 1980, reported on a Mineola, N.Y. boy
No-one seriously advocates removing the who was mistakenly circumcised four days after his
birth in 1976. It was reported that the family had not
breasts of female infants to prevent this more
wanted the circumcision performed, and that the hos-
common malignancy of breast cancer. pital officials tried to "cover-up" the error by falsifying
records to show that the circumcision was done for
Circumcision is the only surgery which is used to prevent
"medical reasons." An out-of-court settlement for
disease. In contrast, consider that in absolute numbers over a
$ I5,000 was reported in a suit over the matter.
ten-year period (1943-1953) the Danish Cancer Registry
reported 25 I cases of penile cancer and for the same period The above reports, drawn from the lay press, almost
reported 10,000 cases of breast cancer in women. Yet, nobody (Continued on next page)


The Problem of Circumcision in America (Continued)

On balance, circumcisiun is an unjustifiable

preventive for penile cancer with an unaccepta-
ble number of serious complications.
certainly represent only a small part of the number of unfa-
vorable results of routine newborn circumcision, as most of
the families in such incidents shun publicity.
My own personal experience as a urologist with nearly 25
years of practice has included two children who must be
numbered in these tragedies and are likely to be genital
cripples. In Florida, in 1976, I was called to see a newborn
immediately after his circumcision with a Gomco clamp. This
child had suffered complete removal of the skin of the penile
shaft, but the surgeon had left the foreskin in place. In panic,
he had discarded the skin and tried to conceal the mishap.
The obviously raw surface of the penile shaft required an
urgent surgical procedure to cover its surface by grafting (for
a similar child see Figures I and 2.) In 1982, I was called to see
a Virginia infant who had been circumcised using a Gomco Figure 1: illustration of a surgical repair of a circumci-
clamp and electrocautery. The result was complete loss of the sion In which excessive penile skin was removed.
glans and shaft of the penis due to a full thickness burn. After
this child's penis fell off at the level of the scrotum, he
underwent a series of surgical procedures at major medical
In summarizing the complications of
centers which have created a tube for urination through a
pedicle skin graft. There is, of course, no tissue to create an circumcision accidents, I would like to
erection and no nerves for genital sensation in this graft (see state that they are not uncommon.
Figure 3) Although this child's tragedy cannot be measured in
dollars alone, he will recover $1 million in the out-of-court newly diagnosed penile cancer, two of which were in men
settlement of a lawsuit. He will never fully recover his sexual of truly advanced years or who died within a year of other
functions, which had been destroyed in the circumcision causes. On balance, circumcision is an unjustifiable pre-
tragedy. ventive for penile cancer with an unacceptable number of
These two personal experiences in the career of one physi- serious complications.
cian, together with a number of lesser complications of cir-
cumcision should be compared with the fact that in the same In summarizing the complications of circumcision acci-
period of time I have only encountered four patients with dents, I would like to state that they are not uncommon.
Because of their sensitive and confidential nature, how-
ever, they are usually unrecognized by outside parties and
they have not been seriously studied in the medical litera-
ture except on an occasional or anecdotal basis. I believe
that the cases I have presented in this paper represent only
the tip of the iceberg in terms of the size of this problem.

The adverse long-term consequences of infant circumcis-

ion on the sexual health of American men must be recog-
nized by physicians, parents, and legislators. The con-
tinued practice of infant circumcision must be recognized
as the unjustified mutilation of the bodies of children
largely for the cosmetic or aesthetic gratification of other
persons - a serious assault and battery on children who
are poweless to resist.

The adverse long term consequences

of infant circumcision on the
sexual health of American men
Figure 2: Showing the completion of the surgical repair must be recognized by
in Figure 1. Even though this child's own skin has been physicians, parents, and iegislators.
replaced, he will have scarring which will likely make
him a genital/sexual cripple.
(Continued on next page)


The Problem of Circumcision
in America (Continued) Ethical and Legal Issues
Religion plays an important role in the growth and devel-
opment of many children and families. However, when par-
ental practices have potentially harmful consequences for the
child, state intervention may be warranted.
The boundary between parental freedom in child rearing
and the interest - or even basic rights - of the child is
unclear. However, the constitutional guarantees of freedom
of religion do not sanction harming another person in the
practice of one's religion, and they do not allow religion to be
a legal defense when one harms another.
The American Academy of Pediatrics recommends that all
pediatricians, pediatric surgeons, and AAP state chapters
vigorously take the lead to (I) increase public awareness of
the hazards to children growing out ofreligious exemptions
to child abuse and neglect legislation; (2) support legislation
in each state legislature to correct statutes and regulations
that permit harm to children under the shield of religious
Figure 3: This child suffered the complete loss of the
exemption; (3) work with other child advocacy organizations
glans and shaft of the penis due to a full thickness burn
from a circumcision using a Gomco clamp and electro- and agencies to develop coordinated and concerted public
cautery. A pedicle skin graft creates the appearance of and professional actions for recision of religious exemptions.
a penis. In this graft there Is no tissue to create an The Academy must unequivocably defend the rights of all
erection and no nerves for genital sensation or pleasure. children to the protection and benefits of the law and medi-
cine when physical harm - or life itself - is in the balance.
J ames Leigh Snyder, M. D., F.A.C.S., is a 1961 graduate of
the Jefferson Medical College of Philadelphia, a member Committee on Bioethics, 1986-1987
of the Alpha Omega Alpha Honor Medical Society, and a Norman C. Fost, MD, Chairman
Fellow of the American College of Surgeons. He is a William G. Bartholome, MD
diplomate of the American Board of Urology and past William Reed Bell, MD
President of the Virginia Urologic Society. He holds the Alan R. Fleischman, M D
rank of Commander in the Medical Corps of the United Arthur F. Kohrman, MD
States Naval Reserve and practices Urology in Clifton William B. Weil, Jr, MD
Forge, Virginia. Liaison Representative
Kenneth J. Ryan, M D
AAP Section Liaison
Anthony Shaw, MD
Having conducted dozens of discussions on this From: Religious Exemptions From Child Abuse Statutes.
subject. I have found one reaction typical among Pediatrics January 1988
Jewish physicians. I will paraphrase their comments:
"I agree that there are no health benefits. 1 even feel
that it may be wrong to do it. Yet, if 1 have a son, 1 CiRCUMCisioN SyMposiUM
will have him circumcised. Please don't ask me why. I
am not in the least bit religious. 1 know it is irrational,
but 1 will do it." One Hour Summary of Highlights ($29.95)
Will the liberal rabbinate, in view of the impending
Send Brochure On Titles of Video Tape Lectures
changes in the medical approach to nonreligious
(Each Video Tape is $29.95)
circumcision, also suggest changes in the Jewish Write: NOCIRC, P.O. Box 2512, San Anselmo, CA 94960
ritual? Let us hope that sanity, not hysteria, will pre-
vail in approaching this potentially vexing problem. Name _

From: Edward Wallerstin. Address

Circumcision and Anti-Semitism:
An Update. Humanistic Judaism
Winter 1983. State/Zip _


Cultural Bias and The Urinary Tract Infection (UTI)
Circumcision Controversy
by Martin S. Altschul

It is first necessary to understand that child- We are a long way from understanding the
hood UTI is in general a difficult and confus- relationship, if any, between infant UTI and
ing diagnosis. circumcision.
Recently much discussion in the circumcision controv- technical nature, a controversy erupted over Wiswell's
ersy has centered on the issue of infant urinary tract infec- result, and Wiswell responded with more data by doing an
tions (UTI). This is largely a technical question but it has indirect review of all available hospitalized Army cases.
some bearing on the larger ethical and social issues of This review also showed a twenty-to-one ratio between the
routine newborn circumcision. two groups of boys but with different rates (1.0% and
In order to discuss infant UTI intelligently, it is first 0.05%). I then did a similar review in Northwest Perma-
necessary to understand that childhood UTI is in general a nente Hospitals.1 found not a single confirmed case of UTI
difficult and confusing diagnosis. If a careful physician and in a normal male infant. A II of the confirmed cases
an adult patient have a telephone conversation that leads to occurred in infants who had clear-cut urinary birth defects.
the diagnosis of UTI, the diagnosis will usually, though not Not only is my result dramatically different from Wis-
always, be correct. But if the same conversation passes well's, my result is perfectly consistent with "common
between the physician and the parent of a healthy pre-school knowledge." Now "common knowledge" can be wrong
girl, the UTI diagnosis has, in my experience, an 80% chance - flat earth and so on. But we should never jump to the
of being wrong. The comparable figures for a pre-school boy conclusion that it is wrong without hard evidence. In the
approaches 95% present case, we have some unconfirmed evidence of
infants with bacteria in their urine. The evidence that the
Even if the child is examined and a urine specimen is infants are actually harmed by these bacteria is practically
obtained, UTI misdiagnosis rates are stillsubstantial because nonexistent. Indeed, if Wisell's 4% figure was correct, there
of the difficulty of obtaining "clean" urine specimens from would have been 80 uncircumcised infant boys with UTI in
small children. The physician who wishes to avoid mistakes my study. What happened to these patients if they never
either of over- or under-diagnosis must be prepared to make got diagnosed? They didn't die, they didn't turn up with
the best possible initial diagnosis (UTI or not UTI) and then sepsis (blood poisoning) or meningitis, they didn't have
mistrust his (her) first impression sufficiently to make the kidney transplants. It might be supposed that the undiag-
correct diagnosis in the end. This caveat applies both to nosed babies turn up as adults with urinary problems, but
individual clinical cases and to research projects. neither scientific evidence nor "common knowledge" sup-
This brings us to newborn circumcision, a surgical ports this notion.
procedure that is now alleged to prevent UTI. Until It is "common knowledge"that girls who have recurrent
recently the state of medical "common knowledge" regard- UTI in childhood and are "lost to follow-up" in adoles-
ing infant male UTI was as follows: cence sometimes turn up in adulthood with serious kidney
problems. The closest we get to this in the medical lore of
In all age grou ps except earll' infancy, females have a
the male is that middle-aged men often suffer urinary
much higher rate of UTI than males. Male infants
problems due to teen-age gonorrhea.
are more likely to be born with abnormalities of the
We are a long way from understanding the relationship,
urinary tract. Although such abnormalities are rare,
if any, between infant UTI and circumcision.
they are the predominant cause of infant UTI. Infant
The incidence of UTI seems to vary widely depending on
UTI is therefore a serious condition that often
whether the investigator passively collects cases or goes
requires surgical correction of an underlying cause.
fishing for them. How then can this confusing and ambig-
Now enter Dr. Thomas Wiswell, Army pediatrician who
uous scientific question be factored into the larger social
did a prospective study of UTI in infants, targeting the role,
and ethical controversy over the legitimacy of routine
if any, of circumcision. The result, which drew widespread
newborn circumcision. I believe one must start by estab-
attention both inside and outside the medical community,
lishing a basis for discussion that is free of cultural bias.
was that the uncircumcised boys appeared to have twenty
Although the numbers vary somewhat, the U.S. is about
times as many UTI's as the circumcised ones (4% YS. 0.2%). 75% circumcised in the post-war period. However, white
Obviously this result does not fit with our "common middle class "baby-boomers" are almost all circumcised. It
knowledge." A condition with 4% incidence is no longer is not so long since the "routine" circumcision was "Rou-
rare. And perhaps more disturbing, the crucial connection tine" with a capital "R," done without discussion or paren-
between UTI and urinary birth defects is broken. Circum- tal consent. Many parents still expect it to be done this
cision could conceiveably prevent UTI but it cannot pre- way. Also, the (male) physicians in the U.S. who discuss
vent birth defects without violating Einstein's Law of Rela- this issue are almost all circumcised. It is therefore inevit-
tivity. Because of these concerns and others of a similar (Continued on next page)


Cultural Bias and The Urinary Tract Infections (UTI) Circumcision Controversy (Continued)

It is therefore inevitable that these circumcised circumcision was introduced into this country
physicians have an "I'm OK, you're OK" atti- not as a physical hygiene measure but as a men-
tude about the state of being circumcised. tal hygiene measure - it was supposed to pre-
vent masturbation.
able that these circumcised physicians have an "I'm OK,
you're OK" attitude about the state of being circumcised. I the procedure. But to prove safety, it is necessary to prove
can vividly recall seeing a Hispanic boy with an intact that circumcison does not interfere with the sexual func-
foreskin exactly 30 years ago. I though he had a weird tioning of the penis. In the "I'm OK, you're OK,"
abnormal growth. Bible stories notwithstanding, it took culturally-biased discussion, this point is easily overlook-
me a couple of years to figure out the truth. In an attempt ed. For example, one hears the following argument:
to escape this bias, I have put newborn (male) circumcision
The foreskin may have been useful to early man who ran
on a list of primitive cultural practices that can be discussed
naked through the brambles but modern man wears
together. Starting with the most obnoxious:
clothes and has no need of the thing, so he might as well
I. Castration
get rid of it and cut down the cancer risk.
2. Foot binding
3. Radical female circumcision or infibulation My response to this argument is a slight change in the
4. Scarification wording:
5. Ubangi lip stretching Breasts may have been useful to early woman who had
6. Limited female circumcision no choice but to suckle her babes. But modern woman
7. Male circumcision has many infant feeding options and therefore has no
8. Mayan head deformation absolute need of breasts. She might as well get rid of
9. Maori tatooing them and cut down the cancer risk.
10. Ear and nose piercing Incidentally, breast cancer is 5,000 times more common
It takes awhile for the white middle class American than foreskin cancer. Ounce for ounce, the rate might be
physician to digest the fact that newborn (male) circumci- the same.
sion fits on this list. It also takes awhile to digest the fact
that circumcision was introduced into this country not as a Incidentally, breast cancer is 5,000 times more
physical hygiene measure but as a mental hygiene measure common than foreskin cancer. Ounce for ounce,
to prevent masturbation. In this context, male circumci-
sion was promulgated in the same breath with clitoridec- the rate might be the same.
tomy (removal of the clitoris) and frontal lobotomy.
When an American physician says that circumcision Finally, what is the relationship between the cultural
prevents UTI or cancer of the penis, he is sincere. But, it is bias in this country and the religious aspect of circumci-
like a medieval Chinese physician saying that foot binding sion? The history of religious circumcision contains some
prevents flat feet. If someone asks me, "What rate ofpre- positive elements. It appears that circumcision spread in
ventable UTI wouldjustify male circumcision?"I respond the early Hebraic period as part of a campaign of religious
by asking, "What rate of preventable UTI would justify reform that suppressed pagan religions that practiced
routine female circumcision?" The second question is pat- human sacrifice. Medieval Jewish writings specifically
ently absurd unless one's cultural bias allows a sympathetic denied any hygienic function for circumcision. Jewish phy-
view of female circumcision. Therefore, the first question sicians were forbidden by law to perform "secular" circum-
can be only slightly less absurd. cison of gentiles. Therefore the promulgation of secular
To put it another way, if newborn circumcision were circumcision in this country from 1880 to 1950 cannot have
introduced as a new procedure, it would have to be proven been a "Jewish" activity.
"safe and effective." It is conceivable that circumcision
could be proven effective, i.e., that the significant UTI It is a mistake for Jews, Christians, or Mos-
prevented might exceed the significant complications of lems to buy into the notion that these secular
arguments are a legitmate part of their cultural
\\T~EREfoRE, T~E ~iG~EST Good is SOME SORT of
On the other hand, the modern secular Jew likes to
explain religious law as a reflection of practical
ARE bAd, ANd, if you likE, bAd iN T~E UN9UAli- considerations:
fiEd SENSE of T~E wORd." The eating of pork was forbidden because pigs
carry Trichinosis.
ARisTOTlE, Vlichomachean ethics, This statement probably does not contain a grain of
Book 7 historical truth, but its tidy logic is appealing. So we may
just as well say:
(Continued on next page)


Cultural Bias and The Urinary Tract Infections
(UTI) Circumcision Controversy (Continued)
(1930 version)
Biblical circumcision was performed in order to
improve penile hygiene and prevent venereal
disease. Cl1rCUmC1Slon
(1890 version)
Biblical circumcision was performed in order to we have btroken a child's spitrit
prevent wicked masturbation and the mental he looked at me
illness that it causes.
Any day now I expect to see the following update in print:
befotre we began
(1990 version) and knew me fotr who i am
Biblical circumcision was performed in order to
decrease the risk of contracting AIDS. hey he said to me
It is a mistake for Jews, Christians, or Moslems to buy into in his gentle smile of trecognition
the notion that these secular arguments are a legitimate part hey you atre the same as me
of their cultural heritage.
you must be who i am
and then i held down his legs
Martin S. Altschul, MD received his doctorate as we cut off his fotreskin
in medicine from TheJohns Hopkins University
Medical School; an M.S. degree in statistics infinitely sotre tendetr life of otrgasm
from the Massachusetts Institute of Technology; we trejected his life
and is currently a staff pediatrician at the
Northwest Region Kaiser Foundation Hospital, fotrce
Salem, Oregon. powetr
he could not Aght us off
despite the fact
that he fought with all his might
American Academy of Pediatrics he gave up the Aght
Report of the Task Force his legs lay beneath the ten ton Atre
on Circumcision of my hands
and stayed thetre
with all his might dtrained
even afretr i had let him up
i cannot believe
that it does not hatrm so tendetr a life
to have his spitrit btroken
at this tendetr time hf his life
at my hands
who has ushetred in his life
Karen Hope Erlich
birth song


~ ~
Submitted by: John Erickson, Biloxi, MS


Care of The Intact Male
by Paul M. Fleiss, M.D., M.P.H.
Every newborn infant is special. Amazing is the newborn in care of his own penis. The foreskin has a function. It does
that he is born intact with eyes that see, ears that hear, a nose keep the glans of the penis warm, moist, and sensitive. It
that smells, and skin that feels. The healthy newborn infant protects from infection and it keeps the opening of the penis
has needs to be loved. to be held, to be talked to, to be adequate.
touched. He does not need to have the agonizing pain of part Complications of "routine" newborn circumcisions are
of his body surgically removed without any anesthesia grossly underreported. The medical literature does report the
inflicted upon him for non-existing health reasons. He does major mutilations, the major hemorrhages, and the major
not need to be circumcised for reasons of religion or social infections, however many males that are left with a deformed
customs or superstition. An ancient ignorance has made the gland or a meatus (opening) too small or an insensitive glans
care of the newborn's penis quite complicated when it should have never been counted. The procedure has many risks even
be quite simple, "Leave it alone" is the commandment to all when performed with the skill of the most able surgeon.
parents and health workers that should be heard around the Repeating the advice of the American Academy of Pediatrics
world. The newborn needs to be appreciated for the amazing 1984 brochure on Care of the Uncircumcised Male is good
being he is and the care of his penis should be: Do not hurt it! advice to all parents, to all nurses, doctors, and health care
Do not amputate it! Do not attempt to retract it! One may workers LEAVE IT ALONE! Let the newborn male take
wash the entire organ without attempting to pull back or care of his own foreskin when he is able to do it without any
clean the foreskin. One can easily wait until the boy can take trauma or pain. Leave the penis of the newborn infant alone.

Circumcision Is Fascism? Circumcision Of Infants

Yes. a not her "circumcision" letter. This is in response to
the responders whose letters you printed Dec. 8,1988. I am Misguided
shocked and amazed by what passes for intelligence in our
most compassionate profession. In my view, these opin- The American Academy of Pediatric's recent statement
ions are at best idiotic, at worst fascist. (The Sun Herald. March 6) about infant circumcision
What these folks are supporting is the expenditure of misses the point with a precision that can only be
hundreds of millions of dollars to torture newborn babies deliberate.
(of thei r own sex) because, as a society, we are too morally
bankrupt. disorganized. and/ or lazy to teach little boys The foreskin is a highly specialized, uniquely sensitive,
and their parents how to wash a penis, or to conduct multifunctional organ of touch.
thorough sex education. We are told that all little boys
When you cut off a baby's foreskin, you are cutting off
should have a mutilating and excruciating experience in
one of his means of perceiving, experiencing, sharing and
their first days of life, to prevent a few men (who have the
enjoying his existence. You are literally censoring his life.
understanding to deal with the operation and the guaran-
tee of receiving anesthesia) from having cancer or YO, The vast majority of males who are not circumcised
which can be prevented in cheap and painless ways. value their wholeness and keep their foreskins intact, for
One can only guess at the sort offundamental emotional the same reason they keep the rest of their body intact.
outlook which can calmly rationalize this cold-blooded,
wholesale cruelty. And isn't it amazing how often people When you circumcise a baby, in other words, you are, in
turn to the Old Testament to support violence and intoler- effect, cutting his foreskin off by force.
ance - certainly not the best of use of the highest wisdom
of a people. Many males circumcised as babies see themselves as
I applaud the resolution of ACOG (the American Col- harmed by that amputation - regardless of the reason
lege of Obstetricians and Gynecologists) to oppose this they were circumcised.
recurrent atrocity. I encourage all of us to look to the
society we continue to create; we show little or no respect The endlessly debated "health benefits" of infant cir-
or understanding for children nor for the lessons they begin cumcision are therefore a false issue and would not justify
to learn, so early in life, about the treatment they will depriving a baby of his foreskin even if they were real.
receive at the hands of those who love them. Those who
If the American Academy of Pediatrics isn't aware of
consider this "much ado a bout nothing" have stepped over
those considerations, why isn't it? If it is aware of them,
the boundary separating responsible intellect from hubris-
why does it remain silent?
prone ego, leaving humility and compassion behind. How
much woe comes from that little step! John A. Erickson
David S. Bate, M.D. Biloxi
Skyland, N.C.
Letter To The Editor, Medical Tribune Letter To The Editor, The Sun Herald
23 February 1989,30:6 March 27,1989


by Richard W. Morris
and carrying plaintiff from one location in the Medical
This was strictly an issue of law since the physi- Center to another location within the Medical Center
cian's own form stated that circumcision had no for the sole purpose of committing mayhem and muti-
medical purpose, all we had to argue about was lation of the body of plaintiff in violation of California
Penal Code Section 207.
whether or not a parent can consent to surgical VIOLATION OF MAYHEM STATUTE (Penal Code
procedures which had no medical purpose. 203) Defendants, and each of them, committed a tort
The first case to challenge circumcision anywhere, the by willfully, unlawfully and maliciously depriving
United States or any other country, was the Adam London plaintiff of his foreskin and of permanently disfiguring
case. The challenge was decided first in the Superior Court of plaintiffs penis in violation of California Penal Code
California, Marin County, then heard by the Court of Section 203.
Appeal. A petition to have the California Supreme Court The defendants brought a motion to have all of these
review the rulings of the lower courts was summarily rejected causes of action stricken. The court struck all except the
by the Supreme Court. This is the story of the issues and the battery and the kidnapping and false imprisonment causes of
happenings. action. A -decision then had to be made as to whether to
The lawsuit was begun by Adam's mother, as guardian ad appeal at that time or go forward on the remaining two causes
lileJl1 for Adam (the plaintiff). Just before the circumcision, of action. The decision was made to proceed on the two.
she had signed an "informed consent" form provided by the The defendants then brought a motion for summary
medical facility. On the form it stated that there was no judgment saying that all of the facts were agreed to and that
medical purpose for circumcision. She does not remember the mother's consent excused both the charge of battery and
the form or having signed it. She was upset at the time of kidnapping and false inprisonment.
regarding the circumcision. Adam's father did not sign the The case now revolved around this sole issue: DOES A
The lawsuit against the physician who performed the cir- TO A SURGICAL PROCEDURE WHICH HAS NO
cumcision (and the medical facility where it was performed) MEDICAL PURPOSE?
alleged eight separate causes of action. I will list them with a The Superior Court ruled in the favor of the defendants
short explanation. without ever really dealing with the only issue in the case. We,
COM MON LAW BATTERY In that without the knowl- of course were faced with how to give an enlightened response
edge and consent of plaintiff, they forcibly removed the to judicial absurdity. The case now had to go to the Court of
foreskin from plaintiff's penis by cutting the foreskin Appeal. This was strictly an issue of la w since the physician's
completely off. own form stated that circumcision had no medical purpose,
VIOLATIO OF WILLFUL CRUELTY STATUTE all we had to argue about was whether or not a parent can
(Penal Code 273a), in that in doing the circumcision consent to surgical procedures which had no medical purpose.
they inflicted unjustifiable physical pain upon plaintiff In the Court of Appeal we fared no better. The brief was
in violation of California Penal Code Section 273a. extensive. You may obtain a copy of it from Marilyn Milos.
VIOLATION OF INFLICTION OF PAIN STATUTE During the oral argument one of the Justices of the Court of
(Penal Code 273d) in that in doing the circumcision Appeal asked me if the Court ruled as I argued would it not
they inflicted unjustifiable physical pain upon plaintiff infringe upon religious freedom. My response was the
in violation of California Penal Code Section 273d. "Cocker Spaniel" answer.
VIOLATIO OF WILLFUL CRUELTY STATUTE A cocker spaniel is born a cocker spaniel and will remain a
[Health and Safety Code 11165, Penal Code Section cocker spaniel all of its life. A human being is not born as a
273a( I) and Penal Code Section 273a(2)] in doing the Christian, a Moslem, a Jew, or any other religion. The fact
circumcision they willfully inflicted unjustifiable physi- that the child is born from parents of a particular religion
cal pain upon plaintiff in violation of California Health does not make the child a member of that religion by choice.
and Safety Code, Section 11165, subparagraph (c), Yet it is by choice that a person selects either the religion of
subsection (2), sub-subsection (d), in violation of Penal the child's parents, some other religion, or no religion at all.
Code Section 273a, subsection (I) and Penal Code The issue then, is not the religious freedom of the parents as
273a, subsection (2). presented by the Court but the religious freedom of the child.
VIOLATION OF CHILD ABUSE STATUTE (Health Keeping in mind the religious freedom of the child, some
and Safety Code 11165) that in doing the circumcision religions (such as Hindu) ostracize or prohibit a male who is
they committed a tort of willfully inflicting unjustifia- circumcised to become a member ofthe religion. However, if
ble physical pain upon plaintiff in violation of Califor- (Conrinued on nex[ paKe)
nia Health and Safety Code, Section 11165, subpara-
graph (g). . The issue then, is not the religious freedom ofthe
VIOLATION OF KIDNAPPING STATUTE (Penal parents as presented by the Court but the reli-
Code 207) in that when they took Adam to the circum-
gious freedom of the child.
cision room they committed a tort Of willfully taking


The First Circumcision Case (Continued)
ties cited herein and this Court's ruling is necessary because
The issue here deals only with the limitation an important question of law is at issue herein requiring
placed upon the legal power of parents to con- settlement by this Court.
sent to surgical procedures to be conducted 3. INTRODUCTION
upon their children. Both the Superior Court and the Court of Appeal appar-
ently understood the case of Appellant to be that of arguing
the child (for example) was born of Jewish parents and
the merits of circumcision. That is not, and was not the issue,
elected at the age of majority to become a member of the
Jewish religion, he could then cut off his foreskin to join.
The relative merits of the surgical procedure are to be
Asfar as the religiousfreedom ofthe parents is concerned,
argued at the trial court after the presentation of evidence.
they could do a symbolic ritual of circumcision rather than
The issue here deals only with the limitation placed upon
the actual circumcision (as they do for other religious cerem-
the legal power of parents to consent to surgical procedures to
onies), This would leave the child free to choose which reli-
be conducted upon their children.
gion, if any, the child would like to choose when the child
became of the age to do so.
The three Justices of the Court merely chuckled, looked at
Section 25.8, however, permits parents to con-
each other, and moved on. We received a ruling from the sent to any surgical procedure, regardless of
Court that the lower court's Summary Judgment was sus- purpose.
tained, and an opinion that a parent could do whatever the
Appellant here desires only a statement on the law of the
parent wanted to do to the child.
State of California by petitioning this Court to answer one
We then moved onward, and upward, to the California
Supreme Court. Here is what we argued to the Supreme
To the Honorable Chief Justice, and to the TO CONSENT TO A SURGICAL PROCEDURE
Honorable Associate Justices of the WHICH HAS NO MEDICAL PURPOSE?
Supreme Court of the State of California: 4, SUMMARY OF FACTS
J.STATEMENTOFISSUEPRESENTEDFORREVIEW Respondent Mark Glasser, acting within his scope of
Does a parent have the legal power to consent to a employment as an employee of Permanente Medical Group,
surgical procedure which has no medical purpose? removed the foreskin from Appellant Adam London's penis.
Appellant brought an action for assault and battery,
2. PETITION FOR REVIEW among other causes of action, against Respondents.
Appellant London hereby petitions for review of the deci- Respondents defended on the sole ground that the parents
sion of the Court of Appeal of the State of California, First of Appellant consented to the removal of the foreskin.
Appellate District, Division Four, filed in this action on May The Superior Court granted a motion for Summary
20,1987, affirmingthejudgment of the Superior Court of the Judgment based upon the consent of the parents.
Suite of California in favor of Respondents.
A copy of the decision of the Court of Appeal showing the It is the position of Appellant, that to grant a
date of its filing is set forth herein as Appendix I. parent the legal power to consent to a surgical
Review by this Court is necessary on the ground that the
decision of the Court of Appeal is not in line with the authori-
procedure which has no medical purpose is to
grant a parent an unlimited license to abuse their
The Court of Appeal affirmed the Superior Court, stating
the "Plaintiffs public policy argument - that children should
A MAN'S MiNd STRUcilEd by A NEW idEA be protected from suffering unjustifiable pain or risks - is
based on the premise that parents cannot consent to surgical
procedures which have no medical purpose. Section 25.8,
diMENSiONS. however, permits parents to consent to any surgical proce-
dure, regardless of purpose.'"
OliVER WENdEll HolMES Appellant disagrees with the Court of Appeal, and con-
tends that parents do not have the legal power to consent to
any surgical procedure regardless of purpose, and that the
U.S. SUpREME COURT JUSTiCE purpose sets the limit upon the parental authority.
(Col1/inued on nex{ paKe)


The First Circumcision Case (Continued)
The Court of Appeal holds that Civil Code Section 25.8 Since parental autonomy is not absolute, what defines the
grants to a parent the legal power to consent to surgical limit?
procedure upon their children "regardless of purpose." Appellant's position is that the limit must be defined by the
It is the position of Appellant, that to grant a parent the definition of medical treatment, not mere "procedures."
legal power to consent to a surgical procedure which has no Appellant's safety was placed at risk. and Appellant was
medical purpose is to grant a parent an unlimited license to permanently deformed, by the circumcision in violation of
abuse their children. the Constitution of the State of California, Article I. Section
For example, amputation is a surgical procedure. Appel- I, and in violation of the Civil Code, Section 43.
lant finds it impossible to believe that any court would grant POINT 2
to a parent the legalpower to consent to the amputation ofall
the healthy limbs of a child, making a healthy, normal, child
into a quadriplegic. A parent's legal power to consent to acts to be done to their
In other words, Appellant contends that there are limits children must have limits. The limits have been defined by
upon the power to consent to surgical procedures, and that other courts as being limited to the power to consent to
the limit should be the power to consent to surgical procedure medical treatment.
only for medical purpose. The Texas Court of Appeal faced this very same issue in
the context of a kidney transplant. A 14 year old. mentally
incompetent but otherwise perfectly healthy, daughter ap-
POINT I plied (through a guardian ad litem) for an order authorizing
APPELLANT HAS SUFFERED A LOSS OF the mother to consent to the removal of a kidney from the
HIS CONSTITUTIONAL RIGHT OF daughter's body, for the purpose of transplanting the kidney
SAFETY AND PRIVACY to the body of a son who was suffering from endstage renal
The Constitution of the State of California, Article I, Section disease.
I, provides: The Texas court held: NO. The court, in so ruling. stated:
I. Inalienable rights. "Significantly, however, for our purposes, this power of par-
Section I. All people are by nature free and independent ents ... to consent to surgical intrusions upon the person of
and have inalienable rights. Among these are enjoying the minor ... is limited to the power to consent to medical
and defending life and liberty, acquiring, possession, and 'treatment. '" Little v Little, 576 S. W.2d 493. at page 495.
protecting property, and pursuing and obtaining safety, This is the very same rule Appellant asked the Court of
happiness, and privacy." Appeal, and now asks this court to rule. This Review of the
This constitutional principle has been implemented in Court of Appeal is not concerned with arguing the merits of
Civil Code Section 43: the particular surgical procedure involved in Appellant's
case: that is an issue for the trial court.
43. General personal rights.
Appellant contends that the error of both the Trial Court
The right of safety and privacy must necessarily limit the
and the Court of Appeal is they concerned themselves with
power of parents to consent to surgical procedures which
the merits of the surgical procedure itself and not with the rule
have a medical purpose.
of law which must first be addressed before the evidence
Appellant's individual constitutional right of safety must
regarding the merits of the surgical procedure can be
be paramount to all rights ofparents regarding their children.
Parental autonomy is not absolute. The Court of Appeal of
Other than the Little case in Texas, only one other appel-
the State of California has so ruled. 2 late level court has, to the knowledge of Appellant, even
considered the issue of defining the limits of parental power
to consent to surgical procedures. That other court was the
Louisiana Court of Appeal.
Again, the Court was dealing with whether or not a guard-
"However, the constitutional guarantees of ian could consent to a surgical procedure to remove an organ
from a healthy child and have that organ transplanted to an ill
freedom of religion do not sanction harming child. The surgical procedure had no medical treatment value
another person in the practice ofone's religion, for the healthy child.
The Louisiana Court ruled that the surgery could not take
and they do not allow religion to be a legal place, and that the Court owed "protection to a minor's right
defense when one harms another."
All courts have held that the surgical removal of
C90mmittee on 13ioethics any normal, healthy, non-diseased, uninjured
..American ..Academy of1Oedicatrics part of the body is not treatment.
"Pediatrics, " January /988 (Conlinued on next page)

1. Opinion of the court of Appeal, page 42

2. In Re Phillip B, 92 Cal.App.3d 796, 801. Cert. Denied as
Bothman v. Warren B., 445 U.S. 949.


The First Circumcision Case (Continued)
to befree in his personfrom bodily intrusion to the extent of
the loss of an organ unless such loss be in the best interest of
the minor." In re Richardson 284So.2d 185, at page 187.
This, again, is the same rule Appellant asks this Court to
Rule. Medical treatment defines the limits of a parents power Newborn Circumcision:
to consent. Black's Law Dictionary. (Rev. 4th Ed., St. Paul:
West Publishing Co. 1951) p. 1673, citing cases. Medical Necessity Or
Medical treatment is universally defined as: "A broad term
covering all the steps taken to effect a cure of any injury or
disease; the word including examination and diagnosis as
Useless Mutilation?
well as application of remedies. "3
The Little case adopted this very definition, saying: "Even
ascribing to the word 'treatment' its broadest definition, it is,
- Resolution -
nevertheless, limited to the steps taken to effect a cure of an
injury or disease ... including examination and diagnosis as
well as application of remedies." 4 WHEREAS The California Medical Association is
To be termed "treatment," all courts require that there be a looked to by Californians for authoritative
disease, an injury, or an abnormality of some sort which is medical advice and
sought to be corrected. The process of that correction is
"treatment. " WHEREAS the responsibility of the CMA is to give the
All courts have held that the surgical removal of any public the most enlightened, factual, evi-
normal, healthy, non-diseased, uninjured part of the body is dence-supported modern medical advice
not "treatment. "
available and
Whether or not the circumcision in Appellant's particular
case was or was not "treatment" is an issue for the court to
WHEREAS newborn male circumcision is a procedure
determine after hearing evidence.
It was the function of the Court of Appeal to set forth a without factual, demonstrable, supporta-
clear rule defining the limit of the legal power of parents to ble medical indications in the overwhel-
consent to surgical procedures by setting the limit at medical ming majority of cases and
The error of the Court of Appeal is that it specifically ruled WHEREAS newborn male circumcision has many
that a parent has the power "to consent to any surgical complications rarely communicated to the
procedure, regardless of purpose." Even if there is no medical parents and
treatment connected with the purpose of the surgical
Appellant contends that this is not, and should not be, the WHEREAS most medical authorities worldwide feel
law of the State of California. That a parent has the legal that newborn males have a right to remain
power to consent only to surgical procedures which have a "intact" except in rare instances,
medical purpose, and that the standard is, and should be: "If
it ain't broke, don't fix it." RESOLVED: That the CMA withdraw its 1988 endor-
The California Supreme Court denied our Petition for sement (305-88) of newborn circumcision
Review. This was done without comment as to why it was as an effective public health measure and
denied There is now only one place to go: The United States
state that newborn circumcision is mostly
Supreme Court. The only problem was that there was no
money left to pay for the filing fees and the printing of the unnecessary and contraindicated, and
brief We had come to the end of the line. wherever done be accompanied by a par-
ents' informational brochure or video and
3. Black's Law Dictionary, (Rev. 4th Ed., St. Paul: West Publishing an informed consent.
Co. 1951) p. 1673, citing cases.
4. Little v Little, supra.

Resolution submitted by
John W. Hardebeck, M.D.
March 4-8, 1989
Richard E. Morris is an Attorney-at-Law
in private practice,
San Diego, California.


by James L. Snyder

Mr. Chairman, Delegates and Guests, thank you. My In 1983, another Virginia child suffered a degloving with his
name is James L. Snyder. I am a Fellow of the American circumcision, requiring skin grafting.
College of Surgeons from Virginia and the past President of In 1984, a Louisiana child's penis was destroyed by a cir-
the Virginia Urologic Society. cumcision and sex-change surgery was advised.
In 1986, I presented to the Virginia Urologic Society two In 1985, two children in an Atlanta hospital suffered des-
infants who had been circumcised with disastrous results. truction of their penis at circumcision. One under-
One had suffered a degloving injury with loss of all the skin of went sex-change surgery.
the penile shaft and required further surgery. The second In 1986, an Alaska child's infected circumcision led to con-
infant suffered gangrene and necrosis of the entire glans and vulsions and massive brain and kidney damage.
penis due to electrocautery. I was called as a consultant to see Numerous children are cut so short that their sexual func-
both of these infants within hours of their injuries and can tell tioning is compromised and recently the medical literature
you that both of these children will be lifetime genital crip- and the lay press have reported on significant numbers of
ples. adult men who were so displeased with the fact of their
As a result of this presentation, the Virginia Urologic circumcisions that they have sought and submitted to plastic
Society adopted a unanimous resolution against routine surgical reconstruction of their penis.
newborn circumcision. Gentlemen, I bring before you documentation of these
Imagine my surprise to learn the the California Medical facts by photographs, articles from the press and the medical
Association had adopted a resolution endorsing newborn literature, and by the personal testimony of individuals and
circumcision as a measure to prevent herpes, syphilis, gonor- parents of seriously injured children.
rhea, chancroid and lymphogranuloma venereum. Each of The part of the baby that we have been throwing out with
these diseases has a known etiologic agent and as a physician the bathwater is the birthright of the child and should not be
in the United States Navy I have treated circumcised Ameri- destroyed by the collusion of physicians and parents.
can servicemen for each of these conditions, using specific
and effective antibiotics to cure what circumcision did not In parting, I would like to paraphrase the words of the
prevent. Emperor Charles V who viewed the destruction of the Great
Mosque of Cordoba and said "What you have done could be
Recent speculation that routine newborn circumcision can done anytime - but what you have destroyed can never be
reduce urinary tract infections or prevent infection due to the replaced."
A IDS virus stretches reason. PRESENTATIO
Over 95% of male children never have urinary tract infec- TOTHE
tions - regardless of the state of their foreskins. CALIFORNIA MEDICAL ASSOCIATIO
The article on AIDS by Simonsen, et aI., cites the expe- SCIENTIFIC AND EDUCATIONAL
rience of 38 African men who became infected with the AI DS ACTIVITIES COMMITTEE
virus after consorting with AIDS-infected prostitutes. Dele- 118TH ANNUAL SESSION AND
gates, American parents do not want to hear speculation WESTERN SCIENTIFIC ASSEMBLY
about 38 African men and their prostitutes. American par-
ents want to know why thousands of their children, brothers, ANAHEIM, CALIFORNIA
and cousins in Los Angeles, San Francisco, New York, and MARCH 4, 1989
Miami were not protected from AIDS infections by the fact
that 60-90% of them have been circumcised at birth since
1940. Dr.spocft
Routine newborn circumcision has failed to prevent each
of the conditions for which it has been proposed as a cure
On Circumcision
- even masturbation.
"I usel! to ltan towan! routine circumcision. at 6irth.
If there is any condition that merits consideration it is
Now that circumcision. is not T'eCOITUtlDUfed to stop
penile cancer. The proponents of this practice themselves
admit to the occurrence of penile cancer even in men circum- mastwfution ant! now that the tfteory a60ut cervicaC
cised early in life. After almost 25 years of urologic practice, I cancer lias 6een. disproved; there is no excuse for the
have seen only four penile cancers de novo. My general operation - except as a rellgious rite. So, 1 strollgo/
surgical colleagues, however, see many more women with
reconunenl! feaving the j"orfsfdn alOnL"
breast cancer, a disease equally preventable by minor surgery
on unconsenting infant girls.
- '.BfJI.'.B'Y MfP CJiIDIJ CMt;£
Since my two personal experiences witnessing tragic infant (1985)
circumcision, I have gathered data which I bring here before
you on other tragic results of infant circumcision.
In 1982, an Iowa infant bled to death after circumcision.


DEClARATioN C9i1fcumcision Vlightma1fe
We recognize the inherent right of all human beings
to an intact body. Without religious or racial prejudice,
we affirm this basic human right.
We recognize the foreskin, clitoris and labia are nor-
mal, functional body parts.
Parents and/ or guardians do not have the right to
consent to the surgical removal or modification oftheir
children's normal genitalia.
Physicians and other health-care providers have a
responsibility to refuse to remove or mutilate normal
body parts.
The only persons who may consent to medically unne-
cessary procedures upon themselves are the individuals
who have reached the age of consent (adulthood), and
then only after being fully informed about the risks and
benefits of the procedure.
We categorically state that circumcision has unrec- June 25, 1989
ognized victims. Dear Jim:
In view of the serious physical and psychological
consequences that we have witnessed in victims of cir- It's so hard for me to put my thoughts down, just tell your
cumcision, we hereby oppose the performance of a sin- readers the truth. Our son will grow to be a man in a
gle additional unnecessary foreskin, clitoral, or labial wheelchair, he is blind, he may never speak, he may never
amputation procedure. say "Mommy, Daddy," or "I love you."
We oppose any further studies which involve the
performance of the circumcision procedure upon uncon- Sincerely,
senting minors. We support any further studies which Parents of "John Doe"
involve identification of the effects of circumcision.
Physicians and other health-care providers do have a
responsibility to teach hygiene and the care of normal In a lawsuit filed in the Superior Court for the State of
body parts and explain their normal anatomical and Alaska, August 28, 1987, parents claim that circumcision
physiological development and function throughout constitutes an assault and battery upon their son's body.
life. Allegedly, the baby's wound became infected by bacteria
We place the medical community on notice that it is while he was in the hospital. He was returned to the
being held accountable for misconstruing the scientific hospital for treatment of the acute infection, developed
database available on human circumcision in the world toxic shock, which led to seizures, and was improperly
today. treated. By virtue of the medical negligence and delay in
Physicians who practice routine circumcisions are proper treatment, the suit claims the baby sustained pro-
violating the first maxim of medical practice, "PRI- found brain damage, retardation, palsy, lack of brain
MUM NON NOCERE," "First, Do No Harm," and growth, damage to his vision and other related damages.
anyone practicing genital mutilation is violating Article To add to the horror of the story, the boy was born with a
V of the United Nations Universal Declaration of condition that requires circumcision not be done. The
Human Rights: parents say the boy would not have been circumcised had
"NO ONE SHALL BE SUBJECTED TO TORTURE they been told that the surgery is not necessary, causes
OR TO CRUEL, INHUMAN OR DEGRADING pain, and has risks.
Adopted by the General Assembly
First International Symposium on Circumcision From: NOCIRC NEWSLETTER, Fall 1988
March 1-3, 1989, Anaheim, California Vol. 3, No. I, page 2


WHEREAS, the Geneneral Assembly of the United Nations on December 10, 1948 adopted and proclaimed the
WHEREAS, said Declaration affirmed to "strive by teaching and education to promote respect for these rights and freedoms
and by progressive measures, national and international, to secure their universal and effective recognition and observance ... ;"
WHEREAS, Article 2 of said Declaration affirms that "Everyone is entitled to all the rights and freedoms set forth in this
Declaration without distinction of any kind, such as race, colour, sex, language, religion, politicaJ or other opinion, national or
social origin, property, birth or other status;" and
WHEREAS, Article 5 of said Declaration affirms that: "NO ONE SHALL BE SUBJECTED TO TORTURE OR TO
WHEREAS, the practice of medically unnecessary surgical circumcisions, excisions and incisions on male and female
genitalia that are conducted:
a) without anesthesia, inflicts incalculable pain and human suffering, constitutes an act of TOR TU R E within the terms of
Article 5 of the Universal Declaration of Human Rights; and
b) with anesthesia, constitutes an "act of cruel, inhuman and degrading treatment" within the terms of Article 5 of the
Universal Declaration of Human Rights; and
WHEREAS, other forms of male and female genital mutilation that are conducted as a matter of social and religious custom,
e.g. as in "ritual rites of passage," constitute acts of "TORTURE (A D) CRUEL, I HU MAN OR DEGRADI G TREAT-
MENT OR PUNISHMENT" within the language and intent of Article5 of the United Nations Universal Dec/aration of Human
Rights; and
WHEREAS, the above violations of Articles 2 and 5 of the Universal Dec/aration of Human Rightsfrequel1l/l' involves
helpless newborns and adolescents - religious and social customs notwithstanding;


a) Calls upon all persons and institutions to engage in "progressive measures" to end the practice of torture, cruelty,
inhuman and degrading treatment that is inherent in circumcisions and other forms of male and female genital mutilation
that are conducted as a matter of social-cultural and religious custom and which are defacto violations of Articles 2 and 5 of
the United Nations Universal Dec/oration of Human Rights; and
b) Calls upon all humane nations to pass legislation prohibiting the practice of torture, cruelty, inhuman and degrading
treatment that is inherent in circumcisions and other forms of male and female genital mutilation that are conducted as a
matter of social-cultural and religious custom which are de facto violations of Articles 2 and 5 of the United Nations
Universal Dec/oration of Human Rights; and
c) Calls upon all humane nations to petition the INTERNATIONAL COURT OF THE HAGUE to formally render an
advisory opinion and judgment that the practice of medically unnecessary surgical circumcisions, with or without anesthesia;
and other forms of male and female genital mutilation that are conducted as a matter of social-cultural and religious custom,
e.g. in "ritual rites of passage" constitute defacto acts of violation of Article 5 of the United Nations Universal Declaration of
Human Rights which specifically states:



Submitted to the General Assembly, The First International Symposium on Circumcision, March 1-3, 1989,
Anaheim, California by James W. Prescott, Ph.D. which was passed unanimously.
The substance of the above resolution was also passed unanimously at the 1988 Annual Meeting of The Humanist
Fellowhsip of San Diego.

I, (name) support the Universal Declaration on Circumcision, Excision and Incision.

Signature _ Date _


ft AN ACT To PRoltibiT GENiTAl MUTilATioNS ~

The Legislature of the State of , having reviewed the expert evidence on the
medical and nonmedical claims for justifications of male and female genital mutilations of infants and children;
and recognizing that genital mutilation of female children is being increasingly practiced in this country by
certain religious and ethnic groups; and noting the extraordinary pain and suffering inflicted upon these infants
and children who are subjected to ritualistic genital mutilations (circumcision, excision, incision, and infibula-
tion) which produce long-term psychological and psychosexual trauma and dysfunction; and recognizing that
genital mutilations of male and female children constitute a defacto violation of Article Vofthe United Nations
Universal Declaration of Human Rights which states:



Hereby enacts the following legislation:

''A II genital mutilations of male andfemale infants and children are expressly prohibited except for medical
necessity that involves clearly demonstratedpathology which requires surgery for correction and unanimously
affirmed, as such, by a committee ofthree physicians who shall represent expertise in the medical disciplines of
urology, gynecology, and pediatrics.

Violation of this provision is a felony punishable by imprisonment not to exceed three years and a fine of
$100,000 that will be placed in trust for the benefit of the mutilated infant or child

In addition, the infant/child who is violatedunder this statute will have the right ofrecovery of civil damages
for tort until the age of majority plus the statute of limitations. "

I, , petition the Legislature of the

State of _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ , to enact the above human rights legislation.

Signature _



This petition is sponsored by the National League for Separation of Church and State, P.O. Box 2832, San
Diego, CA 92122-2832, and by the National Organization of Circumcision Information Resource Centers
(NOCIRC), P.O. Box 2512, San Anselmo, CA 94960.

Please send signed petition to NOCIRC for forwarding to the appropriate state legislature.

Your support of this project is requested through your membership in the National League for Separation of
Church and State. Annual dues are $25 which includes a subscription to The Truth Seeker.


Contin ued from last issue.
Serialization of Superior Men
Book of Reason For the Man of Vision

Superior Men
by James Hervey Johnson

Publish ed By James Hervey Johnson , San Diego 1949

Chapter III (Continued) vivid nightma res of near death and attempt s to escape from
The Probable Origin of Religious Festivals wild and horrid animals . Probabl y he saw lizards and reptiles
which impress ed and greatly scared him. Probabl y real
There is little doubt that the origin of the folk stories of escapes in daytime were horribly exagger ated and repeated at
spirits and fairies develop ed from the phospho rescent lights
night in his dreams.
of the swamps and fens, from the lightnin g bugs, fireflies, the
It is natural for primitiv e man to believe that the souls or
phospho rescent minute sea life, and. from the pho~phorescent
spirits of the animals were after him. Hence the efforts of
fungus in the forest. The strange lIghts, the ongIn of which
was unknow n to man for centurie s must have filled him with primitiv e man to appease the spirits of reptiles and other
a feeling of fear and forbodin g. Some of the Irish, and animals .
Scandin avian stories of fairies and spirits can be traced to The Hindus fear to kill the monkey s, the cobras and
such origin. Thus, it is understa ndable how religion evolved tigers for fear the spirits of these offensive, destruct ive and
and develop ed from these simple but mysteno us natural dangero us beasts will cause them death and injury. Hence the
phenom ena, and, as is explaine d in another c?apter, these depreda tions of the vast multitud e of animals which are not
imagina tions and ideas, once started, were dIfficult to stop. extermi nated in India grows to great heights.
Primitiv e man feared to express any doubt as to the power of Witch doctors were swift to prey upon the imagina tion of
any of these spirits or gods or devils. At times beinginv isible, their weaker minded fellow men. They talked of their own gods,
they might know what he was thinking about or talkIng about manufac tured from their own dreams, nightma res and visions.
and might harm him. It was only a step to the manufa cture of horrible looking
Today the more primitiv e tribes of the South Seas, devils and gods, often half men and half beast. Even the
Africa North and South America , and India, carry a great Christia n devil has horns and tail.
many kinds of amulets , tokens, stones, chains, ~eads, and a~l The primitiv e races in China, Tibet, Japan, I ndia and the
manner of such things to protect them from the ImagIned evIl savages of Africa, the South Seas and the Indians of the
influenc e of the spirits of the stones and trees, animals and America s and totems, tiger and animal gods, devIls, are
even other human beings. Many soldiers, fliers, and others probabl y outgrow th of nightma res, visions, dreams and
also carry these tokens of good luck as a protecti on against imagina tion.
possible evil happeni ngs. And many of them belIeve. In It. One The savage primitiv e and medieva l rites of many reli-
craftily devout compan y went so far as to advertis e a steel gions practice d today, accentu ate the worship of all of these
covered Bible to be worn over the heart, probabl y recogmzIng fetishes, gods, devils and images. The dancing around them,
that the bullet-p roof steel would offer more protecti on than the sacrifice, the night rituals, the music, the tomtom 's repeti-
the Holy Word. tions all served to impress the images of the spirit - devil
The average man has never made a scientific study of the gods in the minds of the people and as they had little else to
success of those who wore the charms and amulets as com- think about they would dream and have VISIOns of these
pared to those who did not. things and that would serve to make them believe still more
As a matter of fact, for the most part natural things, such the claims of the priests and witch doctors.
as the trees and stones and rivers and seas and strange lights The great ritual and impress ive ceremon ies of the
never injured the average man and so it was easy for him to Catholic Church cannot help but impress childish minds and
believe, especially when he was so told, that these charms weak minds. Hence it is very reasona ble to attribut e the
protecte d him. Even lightnin g struck only occaSIOnally a~d visions of Saints, the Virgin Mary, and Christ to the dreams
struck a person very rarely, and thus it was easy to explaIn and nightma res of those who have been subjecte d to the
that that individu al had done somethi ng wrong. Most eve- influence of these rituals and ceremon ies. This probabl y
rybody has commit ted a sin of some kind and so disease and explains the many so-calle d visitatio ns whic~ appear from
acciden tal natural disaster s could be explaine d by the pnml- time to time in the press where chIldren or pnests or Simple
tive witch-d octor, the priest or the religious leader as the minded people are visited by saints and gods with messages
result of some transgre ssion by the individu al. which are claimed to verge on the miraculo us.
So by these simple steps evident and obvious ~o the From time to time I dream of my father, who was my part-
simple minds of early and uncultur ed men, more comphc ated ner and close associat e all my life until his death. Sometim es
customs , practice s, and religious systems graduall y grew the dreams are very vivid and I dream that I am discussi ng
through the ages to those of the present day. various matters with him as I did when he was alive.
The dreams of ignoran t people may seem to them to be
meeting s with those in the spirit world. Knowin g that their
Chapter IV
friends and relatives are dead, it is easy for ignoran t or insane
Dreams, Nightmares, VISIO NS or eccentri c (off-cen ter emotion ally or mentally ) people to
believe that they are talking to the souls of the dead.
Once I dreamed of elephan ts fighting over me. Primitiv e
man, living in the midst of wild animals , probabl y had very (This serialicalion olthe Superior Men
\I'ill he cul1linued in our next issue.)
-55- JULY/A UGUST 1989
BOOKS: HumanisticJudaism, Becoming Parents. Society for Huma-
Anne Briggs (1985), Circumcision: What Every Parent Should nistic Judaism, Michigan, Summer 1988.
Know. Virginia, Birth & Parenting Publications.
Lightfoot-Klein, Hanny (1989), Prisoners of Ritual, An
Odyssey Into Female Genital Mutilation In Africa, The A Matter ofChoice. Orion Express, 39 Marie Street, Sausa-
Haworth Press, Inc., New York. lito, CA 94965, 415/332-8489.
Paige, K.E. and Paige, J.M. (1981), The Politics of Repro- Newborn Circumcision. Foresight Productions, 1302 Oak-
ductive Ritual. University of California Press, Berkeley. land Avenue, Durham, NC 27705, 919/286-2793.
Romberg, Rosemary (1985), Circumcision: The Painful Di- NOCIRC Conference Tape. P.O. Box 2512, San Anselmo,
lemma, Bergin & Garvey Publishers, Inc., Massachu- CA 94960, 415/488-9883.
setts, (out of print). The Circumcision Questions. Perennial Education, Inc. 930
Wallerstein, Edward (1980),Circumcision: An American Pitner, Evanston, IL 60202, 1-800-323-9084.
Health Fallacy, Springer Publishing Co., New York. The First International Symposium on Circumcision. Promo
Video, 2240 Morely Street, #7, San Diego 92111.
Paige, K. E. (1978), The Ritual of Circumcision, Human
Nature May 1987,40-48. The First International Symposium on Circumcision, Master
Wallerstein, Edward (1986), Circumcision: Information, Misin- Duplicators, 11042 Bettes Place, Garden Grove, CA
formation, Disinformation, NOC/RC, 1986, California. 92640, 714/530-1838.
Wallerstein, Edward (1985), Circumcision: The Uniquely
American Medical Enigma, The Pennypress, Washington. NEWSLETTERS:
Wallerstein, Edward (1980), The Circumcision Decision, The NOCIRC Newsletter, P.O. Box 2512, San Anselmo, CA
Pennypress, Washington. 94960.
Wallerstein, Edward (1982), When Your Baby Boy is Not WIN Women's International Network News, Fran Hosken,
Circumcised. The Pennypress, Washington. Editor, 187 Grant Street, Lexington, MA 02173.
Circumcision. Mothering Special Edition. Mothering 1988,
New Mexico.
Circumcision Why? NOC/RC 1986, California. (Available in

DO YOU KNOW that in 1980 the United States ranked #6 in
infant mortality rate among the advanced industrialized
nations of the world; and this ranking deteriorated to #18 by
1988? In other words more infants under one year of age
DIED in the U.S. than in 17 other countries of the world!
DO YOU KNOW that since 1980 the leading cause of injury
death for American Infants under one year of age is
DO YOU KNOW that suicide among American Children ages
10-14 rose 112% from 1980 to 1985?
DO YOU KNOW that the National Institute of Child Health
and Human Development, NIH has abandoned its agency
responsibility to support studies on the causes and conse-
quences of violence against infants and children and has
supported no new research on child abuse and neglect and the
developmental origins of violence since 1980?
DO YOU KNOW that Surgeon General C. Everett Koop, M.D.
stated in his address on "Violence and Public Health" before
the A merican A cademy ofPediatrics (October 26, 1982) that:
"... violence... is one of the most extensive and chronic epi-
demics in the public health of this country"; and that the
Institutions closest to being able to provide a multi-disci-
plinary approach to research in the prevention of family
violence, for example, would be the National Institute of
Mental Health and the National Institute of Child Health
and Human Development?"
(Corrected Copy - The Truth Seeker - Vol. I, No.2) HELPl

An Odyssey Into Female Genital Circumcision in Africa

"Thi. i. an illuminative book ... It i" abo an illustriou.sly fair.

minded book. Among writing. on genital mutilalion., therefore,
it i, unique in giving the reader a 360 degree underaJanding of
the .ocial and peraonal.igni/icance of,uch prcretice•. It Jell,
the truth and the truth i. devastating. For .mall gir", it i.
catastrophically traumatizing. Yet, becau,e the book doe. not
.enllationalize, wrath doe. not override compollSion, and the
gateway to change i, unlocked and kepi open. In addition to
being a contribution to the .cholar.hip of anthropological
.exolog" Prisoners of Ritual i, an adventure .tory-
an extroordinory mid/ife odyney of a .010 woman', de,erl

.... ....
'walkaboul'through the spaces and the mind, of Nilotic Africa.
There', nothing el.e quite like itt" ~ An Odyssey
John Mlrley, PhD, Dore<:lOO' Psychohofmonal Resea.-cn UM. prores<OO' 01 Medoc.aI Psychology.
and proresso<01 PlKlIalflCS,Eme-<llUs. TneJonnsHopklnsUnvefSlrySchoololtAlKhClne, 2! into Female Genital Circumcision

• W\
c in Africa
Hanny ligntloot·Klein studied the tOPiC :II!
~ ~------- ~
ollemale genital circumcision during a six·
year trek through Sudan, Kenya, and Egypt,
during which time she lived with African 1:1
families. An educator and family counselor, ~
she is the author of numerous articles on
the subjec1 of temale genital circumcision lID
that have been published in scien:ilic and
popular publications in England,the United ':i
Slales, Germany, Denmark, Norway, and
Sweden. She is a member 01 the Sociely
for the Scientific Study 01 Sex and the
Association for Women in Psychology. Ms.
Lightfoot·Klein received her MA in social
psychology Irom the American University
in Washington, DC.

Harrington Park Press , ,

10 Alice Street. Binghamton, NY 13904·1580

ISBN 0-918393-68-X


National Organization WOMEN'S national League F01f
Of Circumcision I NTE RNATIONAL The Sepa1fation Of
Information Resource NETWORK NEWS (9hU1fch And State

ON CIRCUMCISION $25 Annuaf Memb~1iip

WORLDWIDE $30 Per Year: Individual
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P.O. Box 2512 187 Grant Street p.o. Bo~ 2832
San Anselmo, CA 94960 Lexington, MA 02173 San ~oJ CA 92112
put the matter ofabortion into clear
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perspective. "

Abortion Rights and

Fetal 'Personhood'
Edited by Edd Doerr & James W. Prescott

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perspective. In a series of essays the matter of abortion is gone into logically
and intelligently."
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anyone who wants to think and argue intelligently about this critical issue."
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