Against Circumcision, pt. 1 (by David Simpson)

This is the first of two posts where I have teamed up with a friend and colleague, David Simpson, to address our problems with circumcision. If you’re interested in contacting David, reach out to him via email at dsimpson17@student.gsu.edu.

A child has their arms and legs strapped down. Their pants are taken off, and an adult uses a sharp metal instrument to cut healthy, nerve-covered tissue and remove it from the child’s exposed genitals. 

Is this immoral? 

Many readers will have the following answer: “It depends. Was the child a boy or a girl?” In this post, we will argue that this is the wrong response, and that the nonconsensual removal of healthy genital tissue is impermissible regardless of gender.

Before we make our argument, here are some facts to keep in mind:

These facts are worth keeping in mind, but we will not explore them further. They are not crucial to our argument.

Let us also review some important (and mildly amusing for the perpetually immature) facts about sexual anatomy. The foreskin is skin that covers the head (or glans) of the penis in biological males. In biological females, there is a similar structure called the clitoral hood that covers the head (or glans) of the clitoris. The foreskin and clitoral hood are so similar that they actually have the same scientific name (prepuce). Everyone has a prepuce. When a fetus has XY chromosomes, the prepuce grows in response to testosterone. The foreskin is essentially just a large clitoral hood. Both structures cover the glans, provide lubrication, and have sensitive nerve endings.

Our argument against circumcision is very simple. Circumcision is immoral because a) cutting the clitoral hood is immoral, and b) there is no morally relevant difference between the clitoral hood and the foreskin. We will respond to the two primary justifications for circumcision: a) religion and b) medical benefits.

We are not going to compare circumcision to the extreme forms of female genital mutilation in some parts of Africa. These generally involve the removal of the entire clitoral glans. This would be akin to removing the head of the penis (ouch). This has more profound implications for sexual experience and bodily integrity than traditional circumcision does. 

However, in regions like Malaysia, little girls “only” have their clitoral hoods cut. This is anatomically similar to male circumcision, which is the removal of the foreskin. This “minor” version of female genital mutilation is required by the Shafi’i school in Islam. Should we respect the religious rights of Malaysian Muslims?

Most readers will likely have the following response to such a suggestion: “To hell with their religious rights! Religious beliefs do not entitle someone to cut a girl’s body without her consent.” 

Exactly. 

Well, remember, the clitoral hood is the same structure as the foreskin, only smaller. This allows us to make the following argument:

1) Religious injunction does not justify the nonconsensual cutting of the clitoral hood of a young girl.

2) There is no morally relevant difference between the clitoral hood and the foreskin.

C) Religious injunction does not justify the nonconsensual cutting of the foreskin.

Crucially, if you wish to deny the conclusion, you must deny one of the two premises. Denying the first premise would amount to saying that Malaysian Muslims should be allowed to cut the clitoral hoods of their daughters. If any readers want to take that route, we wish them all the best. The other option is to claim that there is a morally relevant difference between a foreskin and a clitoral hood (i.e. deny premise two). 

One way of arguing for a morally relevant difference is to appeal to the medical benefits of removing the foreskin. There is evidence that circumcision reduces the risk of sexually transmitted infections (STIs) and urinary tract infections (UTIs). 

However, these conditions are preventable or treatable with other means. In the case of STIs, condoms (and other safe sex practices) are much, much, much better than circumcision at preventing them. Condom use also has two upshots: 

  • It is done with the person’s consent (hopefully)

  • It does not result in any permanent genital alterations (again, hopefully) 

In the case of UTIs, they are rare (around 1% of male children get them) and easily treated by antibiotics. Girls actually get urinary tract infections more often than boys do. If people really care about UTIs, why don’t we do a randomized controlled trial to see whether removing the clitoral hood reduces girls’ risk of getting UTIs? If anyone suggested doing such a study, they would be met with the following response:

“Are you out of your mind? Even if there turned out to be some minor protective effects associated with clitoral hood cutting, that wouldn’t make it ok to hold baby girls down and cut off parts of their genitals without their consent!”

To make this point even more definitively, we can modify our previous argument to be about health benefits. 

1) Minor health benefits would not justify the nonconsensual cutting of the clitoral hood of a young girl.

2) There is no morally relevant difference between the clitoral hood and the foreskin.

C) Minor health benefits do not justify the nonconsensual cutting of the foreskin.

Someone could argue that we are overlooking a relevant dissimilarity between girls and boys: women and girls have historically been oppressed by men. Even today, women across the globe fight for reproductive rights and girls are disproportionately sex trafficked. Affronting the bodily integrity of girls by cutting their genitals reproduces and reinforces injustices that have historically affected girls. One could argue on this basis that female genital cutting should be taken more seriously than male genital cutting. 

In response to this, we ask you to consider the following. Imagine a world in which women and girls were not historically oppressed (a truly lovely world). In this possible world, would it be ok to cut the clitoral hoods of young girls? Obviously not. Similarly, imagine that one day in the future (perhaps the very distant future), we end the oppression of women and girls. Would clitoral hood cutting become ok? Again, obviously not. Clearly, there is something wrong with clitoral hood cutting other than its connection with historical oppression. The absence of oppression would not justify the practice.

We also frequently hear the following arguments for male circumcision:

  • “It looks better” 

  • “He should look like his dad” 

  • “He should look like his peers” 

  • “It will be more painful if he decides to get it when he’s older” 

  • “He won’t remember the procedure”

  • “It was done to me, and I don’t mind”

If you are still tempted by these arguments (or any other argument), you need to ask yourself a question: would these arguments be acceptable if used in defense of forced clitoral hood cutting? If you remember nothing else about this blog post, please remember that question.

To defend the permissibility of male circumcision, you must either a) accept that small medical benefits (or religious requirements, or the absence of oppression, or whatever) would justify the nonconsensual cutting of the clitoral hoods of young girls, or b) explain a morally relevant dissimilarity between the clitoral hood and the foreskin. Neither route seems promising.

One possible reaction is “well, maybe there’s nothing wrong with forcibly cutting the clitoral hood”. If you are tempted by this, stay tuned for part 2. We will argue, contra those sympathetic to allowing both female and male genital cutting, that medical interventions like circumcision must be medically necessary when performed on individuals who cannot consent because their bodily integrity is at stake.

For those interested in learning more about this topic, we recommend the work of the bioethicist Brian Earp. For videos aimed at a popular audience, we recommend Laci Green.

Connor Kianpour