Ritual circumcision in the courts, the dock and the lab

21 Apr 2016

When covered by the mainstream press, the forced genital cutting of (male) children, aka ritual circumcision, is more often than not considered from the perspective of angst-ridden parents debating whether or not to continue the ritual. Not so this week.

On Monday 18th April it was widely reported that the High Court had refused permission to the Muslim father of two young boys aged 4 and 6 who had wanted to perform the ritual on his sons against the wishes of his estranged wife, the boys’ mother.

http://www.bbc.co.uk/news/uk-england-cornwall-36074482

The following day it was reported in the Mirror http://www.mirror.co.uk/news/uk-news/family-doctor-repeatedly-bungled-babys-7785711 that Dr Muhammad Chaudhary, a GP, was being investigated by the GMC after allegedly performing a botched circumcision on a child and bungling 2 or 3 further repair attempts. It is alleged that the GP even attempted to cover his tracks by offering the family bribes and by pretending to be the boy’s relative and his usual GP which he was not.

The same week, a press release from Queen’s University in Canada about recent research on adult penile sensitivity was widely reported as showing that infant circumcision does not reduce penile sensitivity. In fact, the research did not demonstrate this at all and even several of the authors’ own comments indicated quite the contrary conclusion.

Speaking about these three related stories, SMF chair, Dr Antony Lempert, made the following comments.
About the High Court judgment he said:
‘This judgement is a welcome small step towards safeguarding children from forced genital cutting. Ritual ‘circumcision is an irreversible surgical procedure’ as Mrs Justice Roberts so rightly said. More than that, it is a procedure that permanently removes healthy, erogenous and functional tissue from the most intimate part of a person’s body without that person’s consent and for no medical reason.

That it should take a parental disagreement in court for a child to be protected from forced genital cutting remains a serious concern from a child safeguarding perspective. When both parents are in complete agreement that they would like to surgically assign their child’s genitals with their own religious or cultural preferences a (male) child’s healthy intact genitals remain fair game in the UK.

Mrs Justice Roberts is absolutely right that children this young do not yet have the maturity and insight to make such a decision. This principle should not be a hostage to fortune based on the chosen religious beliefs of the child’s parents. It is therefore unfortunate that the judgement, in part, relied on the fact that early circumcision is not a requirement of Islam. The various so-called requirements and rituals of the different dogmas and creeds of the various subdivisions of the many religions should not be allowed to override a person’s most fundamental right to grow up with an intact body and to make their own choices about permanent bodily modifications.

All surgical interventions risks causing harm. The harms of childhood circumcision are increasingly well-documented and include haemorrhage, infection, severe scarring, erectile dysfunction, psychological problems and death. The common myth, repeated in the judgement, that infant circumcision is the least harmful of all circumcision types, is not supported by evidence. Many infants suffer serious life-threatening complications. And whilst infants are in no position to verbalise a complaint, many adult men who were forcibly cut as children are now verbalising their distress. Many of the men seek resolution, not through the courts or through further harm to others, but through taking action to prevent such serious harm being inflicted on the next generation.’

Dr Lempert said this about the case of the botched circumcision. He said:

‘This story is one that repeats itself with nauseating regularity. A healthy child is forced to have unnecessary surgery performed on his normal genitals and suffers significant harm over and above the removal of a sensitive, functional part of his penis. There are practically no restrictions on who can perform forced genital cutting on young (male) children in the UK. The procedure is almost wholly unregulated in the UK. The reality is that we simply don’t know the extent of harm caused to young children by ritual circumcision. We do know that many such children turn up in A&E and some need treatment in paediatric Intensive Care Units as a direct result of non-therapeutic circumcision.

Dr Chaudhary is being investigated because he is a doctor who is alleged to have behaved dishonestly. Ironically, should Dr Chaudhary be removed from the medical register, he would no longer be required to satisfy even the limited requirements of the GMC in this matter and would be free to continue cutting young boys’ genitals.’

In response to the Canadian research, Dr Lempert said:

‘The curiously misleading headline conclusion from this Canadian study into penile sensitivity would have you believe that neonatal circumcision (ie removal of the healthy foreskin from a baby for no medical reason) does not affect the sensitivity of the adult penis. But here are three direct quotes from the paper itself which appear to directly contradict the ‘conclusion': ‘Of all the genital sites tested, the foreskin was the most sensitive to tactile sensation stimuli…’, and this: ‘with respect to warmth sensation, the foreskin was more sensitive than the glans penis’ and this: ‘…the difference in warmth detection thresholds at the foreskin and glans penis indicates that the tissues may function differently…’.

The study had significant limitations, the conclusions even more. Only men under the age of 40 with a healthy, active sex life were studied, yet it is frequently older circumcised men who report gradually decreasing sensitivity from their exposed penis. Men unable to experience a healthy sex life as a direct result of their previous neonatal surgery were excluded from this research from the start. Being a part of the penis itself, removal of the foreskin necessarily removes that part of the penis that experiences foreskin sensitivity; this fundamental point seemed lost to the researchers. The most sensitive part of the foreskin, the inner mucosa, was not tested at all. And in statistical parlance, the researchers acknowledged that that the small size of the study didn’t have sufficient power to test most of the hypotheses it set out to examine.’

The medical ethicist Brian Earp has published an excellent critique of the study here: http://www.huffingtonpost.com/brian-earp/does-circumcision-reduce-_b_9743242.html

Overall, it is good news that two young boys have been given protection from forced genital cutting. It is good news that doctors who lie and perform botched surgery are investigated. But it is not good news that most boys born to religious parents in the UK remain wholly unprotected from forced genital cutting. It is not good news that there is no regulation of those who perform the cutting unless things go disastrously wrong. And it is not good news that uncritical media outlets, often fearful of upsetting powerful religious interests, regurgitate the same uncritical nonsense that forced genital cutting of (male) children doesn’t do them any harm- it does, frequently.

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