Not since 1980 and the publication of Ed Wallerstein's classic Circumcision: An American Health Fallacy has circumcision been addressed in such wide scope by an assembly of international authorities-historians, psychologists, anthropologists, lawyers, and physicians. The books 24 chapters constitute the Proceedings of the 4th Int. Symposium on Sexual Mutilations held in Lausanne, Switzerland in August 1996. Each of the contributions represents a stand alone statement yet provides a necessary contribution to the work as a whole.
The origins of circumcision are approached by studying the distribution of sexual mutilations on the map of continents and their severity among indigenous cultures. The analysis suggests that Africa is the epicenter for altering the genitalia of both males and females.
Frederick Hodges, now a medical history fellow at Oxford, supplies a fascinating history of how involuntary sexual mutilation was institutionalized in the United States. What began as a cure for masturbation, and all the illnesses thought to be caused by onanism, has been lauded and subsequently dismissed as the cure for epilepsy, immoral behavior, cancer, and sexually transmitted diseases. Hodges argues, quite convincingly, that the validity of the current medical justifications do not differ much from the original justifications. He notes, "Whatever incurable disease happens to be the focus of national attention in any given time period will be the disease that circumcision advocates will use as an excuse for circumcision."
Circumcision is part of mainstream American culture, and, despite having its medical credibility essentially decimated, it continues unabated. In my own article "Why does neonatal circumcision persist in the United States?" I suggest a combination of reasons: the paucity of rights of children, protection from criticism of the procedure by the American medical journals, and third-party reimbursement. Jeannine Parvati Baker shares her success in convincing Mormon parents of circumcision's inconsistency with their religion using citations from the book of Mormon and poignant, direct questioning. In Englishspeaking countries where circumcision has fallen out of favor, physicians still have trouble knowing how to regard the intact penis and how other countries have established such low circumcision rates.
A major portion of the book addresses the issue of female genital mutilation as currently practiced in parts of Africa. Berhane RasWork, the current president of the Inter-African Committee on Traditional Practices Affecting the Health of Women and Children, provides a history of the organizational attempts to end the practice of FGM in Africa. Efforts started with general statements from international organizations and are now being implemented by people in the community. Outside interference is shunned and only acts to galvanize opposition. While the prevalence of FGM in Europe is unknown, Italian investigators presented their estimates of the number of genitally mutilated women in their country. Likewise, a representative of Germany's organization (I)NTACT spoke to how her country is responding to this practice.
While some of the African women attending the symposium felt that Western men opposing male circumcision were usurping their issue, Hanny Lightfoot-Klein, the author of Prisoners of Ritual: An Odyssey into Female Genital Circumcision, points out the striking similarities between female and male genital mutilation. Sami Aldeeb Abu-Sahlieh argues that to differentiate between male and female mutilation practices, one has to argue convincingly that: your culture is better than others' cultures; your religion is better than other religions; your holy book is better than others' holy books; and girls have to be protected but not boys. He adds, "There is one principle that must be either accepted or totally rejected: the right to physical integrity. If you accept this principle, you must apply it to any person, regardless of his religion, race, color, gender, or culture."
Human rights and constitutional issues are addressed by a pair of American attorneys, J. Steven Svoboda and Zenas Baer. While the protection of bodily integrity is sacrosanct in the United States and all of the applicable precedents weigh in favor of leaving a minor's genitals alone, it is unwise to depend on the judiciary to alter an American "cultural" practice, says Svoboda. Baer lays out the basis of "equal protection" case against the North Dakota law banning FGM. According to Baer, the law is clearly unconstitutional because it does not afford the same protection to boys as is provided for girls.
Two powerful voices in the collection are those of two Jewish women, Jenny Goodman and Miriam Pollack. Goodman wrote her piece while 9 months pregnant, while Pollack reflects on the horror of having a mohel circumcise her sons over a decade earlier. Both women confront their religion's tradition by pointing out circumcision's inconsistencies with the basic teachings of Judaism that place infinite value on human life. Pollack sees circumcision as part of patriarchal control in an effort to sever the primordial bond between mother and son. She writes, "The subordination of the mother and the mother's deepest maternal instincts to protect her newborn are intrinsic elements of any circumcision tradition."
This book is appropriate for the person who has more than a cursory knowledge of the issues surrounding involuntary sexual alterations. For the novice Billy Boyd's book, Circumcision: What it Does (second edition in press) may be more appropriate. For those looking to resolve the dialectic of irreversible genital surgery and a religious requirement, the chapters by Pollack and Goodman are a must read and can be supplemented with Ron Goldman's Questioning Circumcision: A Jewish Perspective (Vanguard Publications, 1997). The psychological ramifications of circumcision, touched only lightly in this symposium, are well addressed by Ron Goldman's Circumcision: The Hidden Trauma (Vanguard Publications, 1997).
The book edited by Denniston and Milos is the scholar's choice for broad authoritative information. Chapters are complete, well written, and well-documented. Plenum will also publish the proceedings of the next International Symposium scheduled for August 5-7, 1998 in Oxford, England, building upon the firm foundation provided by Sexual Mutilations: A Human Tragedy.
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