Why can’t the United States stop circumcising boys?

While looking for something else, I ran into Why can’t the United States stop circumcising boys?, an interesting essay by Robert Darby. Widespread male circumcision is a phenomenon that, in wealthy countries, has happened almost exclusively1 in English-speaking countries, and that has faded in every English-speaking country but the USA, where the majority of boys are still circumcised.

So why the American exceptionalism? Despite the title of Darby’s essay, he doesn’t provide a convincing answer, and some of the possibilities brought up seem unlikely to explain the distinction. (For example, I’m sure that the profit motive is important to circumcision — did you know that hospitals make huge profits selling cut-off foreskins?2 — but I don’t see any reason to expect that to be more the case in the US than in other countries).

Darby does suggest a legislative approach to reducing male circumcision, short of an outright ban, which is to stop having the government pay for it. In California, the circumcision rate plummeted once Medicaid coverage ended.

Two things annoyed me about Darby’s essay. First off, the seemingly obligatory passage3 , in any essay objecting to male circumcision, comparing the practice to female circumcision:

The claims of culture are taken very seriously in this age of globalization, but the problem with this particular claim is that it is applied inconsistently. First, there is discrimination based on gender. No matter how important circumcision of girls may be to the cultural/ethnic/religious groups that practise it, American opinion has determined that girls’ bodies are more important than tradition, and that any cutting of the female genitals is Female Genital Mutilation, now banned by law. Secondly, the cultural argument seems to be a one-way street. When faced by parents from circumcising cultures, doctors say they must respect their traditions and accede to their wishes, at least in relation to boys. But when it comes to non-circumcising cultures (the great majority) the argument is suddenly reversed: instead of enjoying automatic respect for their traditions, parents from non-circumcising cultures are pressured to conform to the American norm and to consent to have their sons circumcised, so that they will be “like other boys”.

A more likely explanation than gender-based discrimination is discrimination based on culture (otherwise known as xenophobia); of course we venerate our own cultural acts of child abuse even while correctly disliking the child abuse practiced by other cultures. It’s also the case that, bad as male circumcision is, FGM is in many ways worse; the implicit assumption that the two circumcisions are equivalent (and therefore there is no reason other than sexism that anyone might find FGM more objectionable) doesn’t hold water.

That said, regardless of what US circumcision practice is based on, the effect is a form of child abuse practiced nearly exclusively on boys, and that’s objectionable from a feminist point of view.

Darby also writes:

No matter how many statistics-laden articles get published in medical journals, circumcision cannot shake off the traces of its Victorian origins. It remains the last surviving example of a once respectable proposition that disease could be prevented by the pre-emptive removal of normal body parts which, though healthy, were thought to be a weak link in the body’s defences. In its heyday this medical breakthrough, described by Ann Dally as “fantasy surgery”, enjoyed wide esteem and included excisions of other supposed foci or portals of infection, such as the adenoids, tonsils, teeth, appendix and large intestine.

But circumcision is not “the last surviving” example of such a widespread practice in the US; weight loss surgery is skyrocketing in popularity, justified by unproven long-term preventative effects.

P.S. Also interesting: Darby’s review of the book Madhouse – about Henry Cotton, administrator of a New Jersey asylum, who for decades forcibly removed teeth and other body parts from unwilling patients “for their own good,” and was much admired for this practice.

Cotton was not just a fanatic applying the physicalist procedures of mainstream medicine to the new field of psychiatry, but the embodiment of a deep-seated trend in the medical profession itself: the assumption that if these wise experts think some sort of treatment or procedure is good for you, it is your duty to submit to it, and even that they are entitled–by virtue of their scientific understanding and promise of benefit–to force it on you, with or without informed consent. Throughout his career, Cotton insisted that he was at the forefront of scientific rationality and that his therapies must be enforced because they flowed inexorably, as a matter of mere logic, from the facts of disease as established by the science of which he was the anointed interpreter. He claimed that his approach was based on “scientific medicine,” the germ theory of disease, and “scientific evidence and proof.” His published articles are peppered with terms like “progressive medical men,” “indisputable facts,” “modern medical knowledge”; it hardly needs to be said that they were totally innocent of any ethical awareness.

  1. I say “almost exclusively” because I suspect circumcision of boys is widespread in Israel. []
  2. From Darby’s essay: “In the age of biotechnology and tissue engineering, human body parts have a high market value, and baby foreskins are especially prized as the raw material for many biomedical products, from skin grafts to anti-wrinkle cream. The strongest pressure for the continuation of circumcision may not be from doctors at all, but from the hospitals which harvest the foreskins and sell them to commercial partners. This would explain why so many mothers are still pressured to sign consent forms when they arrive for their delivery.” []
  3. Although Amanda points out an exception to this rule. []
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214 Responses to Why can’t the United States stop circumcising boys?

  1. 201
    ballgame says:

    I checked out of this thread while it was still in progress because I wanted more solid evidence for my discussion about the implications of the gender ratio of autism in France. It turned out to be much more difficult to find than I imagined, but yesterday I was finally able to put my hands on it. I have a post up at Feminist Critics discussing what I found.

    Did you catch the part where ballgame suggested the evidence of a link is that France has lower rates of autism as well as circumcision?

    That’s a somewhat inaccurate rendering of what I said, mythago, but I guess it’s close. I’d be very interested to know why you think the male-to-female ratio of autism is 4 to 1 in the US, but only 2.3 to 1* in France, or at least why you think the circumcision connection is inherently ridiculous given the highly plausible mechanisms for such a connection outlined by mandolin above.

    (*That’s right, 2.3 to 1, not 3 to 1 as I suggested initially. Please read my FC post for an explanation.)

  2. 202
    mythago says:

    because I wanted more solid evidence for my discussion about the implications of the gender ratio of autism in France

    Dude. You never posted any “evidence”. You posted correlation-is-causation musing about how the French do X less than we do, and reported autism rates are lower, therefore clearly X is a factor that is causative of autism. To turn around and insist it’s my job to disprove a theory with no evidence is inherently ridiculous, even by Internet standards.

    Oh, and co-musing by Mandolin isn’t “evidence’. Neither is what you posted at FC: you cited a five-year-old American report and a 1996 French report as ‘evidence’. If you thought about autism much more than “ooo! can use in argument vs. circumciscion!”, the inherently ridiculous nature of waving this around as ‘evidence’ ought to be apparent to you. (For example, you might have a clue about how the understanding, and reporting, of autism-spectrum disorders has changed since 1996.)

    I’m opposed to routine infant circumcision, actually. But I don’t rest that opposition on scare-tactic stupidity.

  3. 203
    ballgame says:

    You posted correlation-is-causation musing about how the French do X less than we do, and reported autism rates are lower, therefore clearly X is a factor that is causative of autism.

    No, mythago, I said that X is a plausible causative factor in autism. With all the vehemence with which you deny saying that ‘circumcision couldn’t possibly be related to developmental disorders like autism’, you imply that you agree, but then you also claim that it’s inherently ridiculous, so I find your stance here to be a real puzzler.

    And yes, the differential gender ratios I point out ARE evidence for circumcision being a contributing factor … not conclusive evidence as other explanations are possible as well, but evidence nonetheless. The way to rebut the idea is to either produce better evidence or a better interpretation of the evidence at hand. Merely making dark allusions to arguments which might exist does not rebut my contention that circumcision is a plausible factor here.

    ‘The studies were done in different years.’ So? ‘We know so much more about autism now.’ What, exactly, and how does this new knowledge bear on the argument at hand? This Atlantic Monthly article from 2003 provides some indirect support to the idea that more sensitive infants may be prone to ‘shut down’ in response to powerful stimuli. Now, if you have more recent studies that compellingly demonstrate this is not the case, by all means, do share!

  4. 204
    mythago says:

    I said that X is a plausible causative factor in autism

    Yes, based on correlation. By your logic, lack of prenatal wine consumption and speaking English rather than French are equally plausible causative factors in autism.

    What, exactly, and how does this new knowledge bear on the argument at hand?

    Because there is an entire classification of autism-spectrum disorder that was not really known in the English-speaking world until 1995, and not really understood as it manifests in females until a few years ago. If you don’t see cases of autism, they don’t factor into your statistics, which are therefore not very helpful.

    The way to rebut the idea is to either produce better evidence or a better interpretation of the evidence at hand.

    Heh. We’ve been over this before. “I’m right unless you rebut me” is not a valid argument. You need to offer evidence other than “a correlation exists”.

  5. 205
    ballgame says:

    By your logic, lack of prenatal wine consumption and speaking English rather than French are equally plausible causative factors in autism.

    Not at all. It is your logic which is implying that the circumcision theory is just as implausible as the ‘speaking English’ or ‘not drinking wine’ theories. Mandolin’s quote helpfully explained why trauma may have a lasting impact on the brain. The last I checked, ‘speaking English’ and ‘having an alcohol-free fetal existence’ were not considered to be traumatic. But, perhaps, in mythago’s world…?

    [T]here is an entire classification of autism-spectrum disorder that was not really known in the English-speaking world until 1995, and not really understood as it manifests in females until a few years ago.

    Thanks for finally advancing a genuine counter argument here instead of rhetorical sneers. Now, I hate to be ungrateful, but sadly I have to punch a couple holes in it. You’re implying that the reason the French boy/girl autism ratio was 2.3 to 1 while the US ratio was 4 to 1 is because — up until “a few years ago” — US doctors were failing to diagnose an entire class of autism disorder that girls suffered from. Now that would only be relevant if the French doctors were aware of this feminine form of autism and diagnosing it … almost a decade and a half before those in the English-speaking world were.

    Unfortunately, this does not seem to be case. The French study I cite used two different criteria, a narrow one and a broader one. The narrow one used criteria most similar to DSM-III. That is the one that generated the 2.3 to 1 boy/girl ratio. (The broader criteria, which basically doubled the number of diagnoses of autism, generated a 2.1 to 1 boy/girl ratio.) For your rebuttal to hold water, the French would somehow have to be picking up on nearly twice as many cases of female autism using DSM-III-like criteria than Americans were detecting over a decade later using DSM-IV criteria. Or, the French would need to have missed nearly half the extant boy cases of autism using both the DSM-III criteria and a broader set of criteria which doubled the overall number of French autism cases discovered. I suppose that’s not impossible but it strains credulity. I certainly think the circumcision theory is a hell of a lot more plausible.

    By the way, more evidence that trauma may contribute to autism can be found in a recent Danish study that linked autism with “breech births, premature births and problems immediately after delivery.”

  6. Pingback: Alas, a blog » Blog Archive » Woman recieves no punishment for nonconsensually piercing her 13-year-old daughter’s genitals

  7. 206
    Halfmad says:

    My brother-in-law had to hold down his infant’s son while they circumcised him. I’m sure it was awesome for both of them.

  8. 207
    Halfmad says:

    Sorry, his infant son, typo.

  9. 208
    mythago says:

    You’re implying that the reason the French boy/girl autism ratio was 2.3 to 1 while the US ratio was 4 to 1 is because — up until “a few years ago” — US doctors were failing to diagnose an entire class of autism disorder that girls suffered from.

    No, I’m pointing out that you are using two different data sets that do not compare well, and you are using them to pretend that correlation equals causation: The French have less disparity in autism rates; the French have a lower circumcision rate; therefore, circumcision causes autism.

    You also don’t seem to believe that Asperger’s as a disorder was diagnosed only recently in the US, or that it has been (and still is) underdiagnosed in girls. Is this because you have a reflexive aversion to anything that suggests girls might ever have a disadvantage, or are you really that uninformed?

    The last I checked, ’speaking English’ and ‘having an alcohol-free fetal existence’ were not considered to be traumatic.

    Really? Then you are deliberately overlooking all sorts of studies that show the beneficial effects of moderate amounts of alcohol, especially in the form of red wine. Perhaps all this Puritan absention is to blame?

    Setting your rhetorical sneering aside, again: it boils down to your advancing a correlation-equals-causation theory and declaring that anyone who disagrees with you is a Luddite who supports circumcision. You don’t give a rat’s ass about autism, or people with autism, except as talking points to go after your pet issue, and your utter ignorance on the subject of autism couldn’t be plainer.

  10. 209
    Mandolin says:

    “You don’t give a rat’s ass about autism, or people with autism, except as talking points to go after your pet issue, and your utter ignorance on the subject of autism couldn’t be plainer.”

    I agree with what you say about ASD. However, I have known people who are autistic or have autism in the family who don’t necessarily have a lot of knowledge about the theory of biology behind it. We don’t know Ballgame’s history, and it might be better to assume he does have a personal stake.

    I noted on another blog that someone was using my description of unremembered trauma to suggest that we should expect boys to manifest a number of problems we don’t see in girls because of infant circumcision. That’s not necessarily true, for a variety of reasons. First, you have to assume that there are no parallel disadvantages affecting female babies. Second, you have to remember that psychiatry functions from a male default, so those traits which occur more in women are more likely to be marked while those that occur in men are defaulted — potentially even if they are results of trauma.

    I admit that a lot of my knowledge of autism is based on the research of Sascha Baron Cohen, who is justly criticized by feminists. Nevertheless, last I was paying a great deal of attention, it seemed that autism was caused by certain atypical physiological brain formations (some symptoms of which could be mimicked in neurotypical individuals with specific brain injuries).

    I think Ballgame would have better luck tying male infant circumcision to other gendered psychological manifestations, although the problems with correlation and causation will remain.

  11. 210
    Cola Johnson says:

    Male circumcision is definitely something I’ve known little about, except that I had trouble with uncircumcised men before I grew up and started thinking about these things, largely because all of the men in my family are circumcised and I’ve been told my entire life that it’s gross and unclean not to be.

    I just thought I’d through a few of my cents so trolls on FGM threads would stop moaning that this discussion is dead. I’m open to responses.

  12. 211
    Mandolin says:

    “largely because all of the men in my family are circumcised and I’ve been told my entire life that it’s gross and unclean not to be. ”

    Yeah, I hear that. All my partners have been circumcised. My father is; my brothers are. It’s totally normalized in a lot of sectors of American society, I think.

    I absolutely didn’t start thinking about it until I took anthropology classes, and started to wonder, “Sup with that?” And then a friend of mine went to Australia and had a few partners with intact foreskins — something about an incident as pedestrian as that was frame-breaking for me, made me start to wonder why I viewed these altered bodies as so deeply normal.

  13. 212
    SarahMC says:

    “largely because all of the men in my family are circumcised and I’ve been told my entire life that it’s gross and unclean not to be.”

    And here is where FGM and IMC are similar. The above sounds like the rationale mutilated women give for promoting/perpetuating the practice. All the women in their families are cut, and they’ve internalized the message that cut = good while uncut = bad. Is that any reason to continue a practice that has no *real* benefit to boys’ bodies?

  14. 213
    Cola Johnson says:

    “Is that any reason to continue a practice that has no *real* benefit to boys’ bodies?”

    Not in the least. You make a great point.