CIRCUMCISION

CIRCUMCISION

            Etymologically, circumcision is from the Latin word ‘circumcedere’ which means ‘to cut around.’ In a more technical sense, it is the surgical removal of the foreskin from the genitals. The origin of circumcision is not known with certainty, but, the oldest documented evidence so far, comes from ancient Egypt. Various theories have been proposed about how circumcision began such as; religious sacrifice and as a rite of passage into adulthood.

            According to David Brain, circumcision is the cutting of the foreskin of the penis of a male or the clitoris of females as a religious rite or on medical grounds. It was an indication for priestly status. The jews hold that Abraham introduced the rite among them, and it appears throughout the old testament for it signifies the covenant between God and the jewish people.

ARGUMENTS FOR MALE CIRCUMCISION

            Arguments today in favour of circumcision are supposedly based on scientific research. Recent health studies in Africa suggest that circumcised heterosexual men are less likely to get HIV as compared to non-circumcised men if they choose not to wear a condom during sexual intercourse. Proponents of this position also argue that urinary track infections are less likely for circumcised men and that circumcision is necessary for cleanliness.

            To establish a causal relationship between lack of circumcision and HIV, three randomized controlled test were commissioned. The result showed that circumcision reduced vaginal to penis transmission of HIV by 60%, 53%, and 31% respectively. As a result of these findings, the WHO and UWAIDS stated that male circumcision is an efficacious intervention for HIV protection but stressed that it should be carried out by well-trained medical professionals and under conditions of informed consent.

            Another proposition in support of circumcision is that it prevents boys from masturbation. John Harvey avers that a remedy for masturbation which is almost always successful in small boys is circumcision. He went further to opine that the operation should be performed by surgeon without administering any anesthetics. For him, the pain attained during the operation will have a salutary effect upon the mind.

            There are also arguments from the religious and cultural milieu. Proponents argue that in some cultures, male must be circumcised shortly after birth, during childhood or around puberty as a rite of passage. Also, circumcision is commonly practiced in the jewish and Islamic faiths. Jewish religious law states that circumcision is a commandment and is obligatory for jewish born males and for non-circumcised jewish male converts. In Islam, it is usually performed on the eighth day. Islamic scholars agree that circumcision is recommended in the Sunnah and is obligatory. While endorsing circumcision for males, it is not a requirement for converts. The Roman Catholic Church maintains a neutral standard on circumcision as a medical practice.

ARGUMENTS AGAINST MALE CIRCUMCISION

            Ethical issues have been raised over removing healthy functioning genital tissue from a minor. Opponents of male circumcision aver that infant circumcision infringes upon individual autonomy and represents a human right violation. Also, that using circumcision as a way of preventing HIV is highly rife in low income countries or underdeveloped countries in sub-Sahara Africa.

            New Zealand’s college of physicians believe that, the frequency of disease modifiable by circumcision, the level of protection offered and the complication rates of circumcision does not warrant routine infant circumcision in New Zealand. However, it is reasonable for parents to weigh the benefits and risks of circumcision and to make the decision whether or not to circumcise their children.

            The Canadian paediatric society strengthened this view by stating that infant circumcision is not medically necessary and thus, parents should first speak with their son’s paediatrician to learn about the risks and benefits of the procedure. The Finnish medical association follows these thoughts by opposing the circumcision of infants for non-medical reasons, arguing that circumcision does not bring about any medical benefit, and may risk the health of the infant as well as his right to physical integrity because he is not able to make the decision himself.

            Finally, some medical association take the position that the parents should determine what is in the best interest of the infant. They maintain that parents should determine how best to maintain the child’s interest.

FEMALE CIRCUMCISION

            The debate about the nature of female genital mutilation, female circumcision or female genital cutting has been a serious one in history, because, it discusses what some see as part of development into womanhood while others consider it a victimization of women. The WHO defines female genital mutilation as a procedure that involves partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons. It is carried out on girls from a few day old to puberty. The term cutting is considered by some as being less judgmental, thus many women health organizations and WHO use the word ‘mutilation’ not only to describe the practice, but also to point out the violation of women’s human rights.

TYPES OF FEMALE CIRCUMCISION

A) Type Ia: Circumcision which is the removal of the clitoral gland only.

      Type Ib: Clitoridectomy which is the complete or persistent removal of the clitoral glands.

     Type IIa: Excision which is the complete or partial removal of the inner labia with or without the removal of the clitoral glands.

     Type IIb: The removal of the clitoral gland and inner and outer labia.

B) Infibulation: This is racial circumcision (excision) followed by suturing, leaving the introitus open for urination and menstrual flow.

C) Defibulation: This is the tearing open or cutting of the sewed vaginal tissue as a consequence of sexual intercourse and menstrual flow.

D) Re-infibulation: This is the re-suturing of the introitus after childbirth.

            The proponents of female circumcision argue that the practice is carried out to reduce a woman’s libido. Opponents of female genital mutilation focus on human right violation, lack of informed consent and health reasons; which include fatal haemorrhage, recurrent urinary and vaginal infections, chronic pains and obstetrical complications. Thus, concerted efforts have been made to end the practice. They term FGM as barbaric. Similarly they claim FGM has no health benefits but harms women in many ways since, it involves removing and damaging healthy and normal female genital tissue and interferes with natural functioning of the girl’s body. This invasive nature of FGM and the unsanitary conditions under which it is usually performed can have severe consequences and create long term complications such as: infertility and prolonged labour during childbirth.

            Another controversy surrounding FGM is whether it is consistent with custom or religion. FGM is not a religious practice required by the Islamic faith. It has however become a law by custom. It has become important for islam because it is associated with female sexual purity. FGM is intended by its practitioners to control female sexual drive and also to cleanse women’s genitalia by removing the clitoris which is seen as masculine, ‘a female penis.’ Its association with purity has disallowed some young women who have not been circumcised from getting married in countries where FGM is practiced.

            More so, as a human right issue, FGM is recognized internationally as a violation of the rights of girls and women and it constitutes and extreme form of discrimination against women. It is mostly carried on minors, and it is a violation of the rights of children. It also violates a person’s right to health, physical integrity, the right to be ‘free from torture, cruel and inhumane’ treatment. When the practice results in death, it violates the right to life, thus, the WHO and UN have called for an end to the practice. Some medical associations and experts have called for severe penalties on those who practice it.

            There is also a serious disagreement as to whether the practice of FGM is culturally relative, or as issue of human right. Proponents of FGM argue that FGM is comparable to western practices such as breast enlargement, and other plastic surgeries. Practitioners thus consider western attack on FGM as ethnocentric.

            A three-fold critique was given to the above position, namely that, (a) a subject making the decision in the west is by law an adult and not the case for FGM whose subjects are mostly minors (b) neither the breast enlargement nor tattooing impedes natural body functioning as FGM can (c) It is an excuse for committing violence against women.

            Ashley Mantasu argues that FGM is a violence against women which is not any different from rape, murder, trafficking, forced prostitution and sexual harassment. Thus, opponents have called for its immediate eradication. The argument has also been that FGM is analogous to male circumcision and that both procedures are cultural traditions that have no real health benefits. But however, there are major differences between the two. The most striking difference is that FGM functions the natural functioning of the female body in the way that male circumcision does not.