Tech + Health

02.02.14

Do Circumcision Bans Protect Kids’ Rights, Or Infringe Upon Parents’?

Scandinavian doctors have endorsed banning circumcision, claiming baby boys aren’t old enough to consent to ‘mutilation.’ But how far can the state go to limit religious parents’ impact on their kids?

If major medical associations in Scandinavia get their way, it will soon be illegal to circumcise an infant boy in Denmark and Sweden, even for religious reasons, without a pressing medical cause. Circumcision is an ancient practice, decreed in the Book of Genesis, enshrined in Muslim tradition, and central to both Jewish and Muslim notions of religious identity. Jews circumcise their infant boys on the eighth day of life; Muslims generally do so before age 10. Neither age, according to the Scandinavian doctors, is old enough to give consent for a procedure that they see as a medically unnecessary violation of the boy’s sovereign self.

Last week the Swedish Medical Association, citing the risk of complications and the bodily rights of the child, urged religious circumcision to take place at age 12 or 13, with the boy’s informed consent. (Quite the Bar Mitzvah present, jokes the Jewish Press). The Danish Society of Family Physicians, representing some two-thirds of Denmark’s general practitioners, bandied about the term “mutilation,” in their statement, also released last week. In an editorial on Thursday, Jyllands-Posten, one of Denmark’s main daily papers, went right for it: “Circumcision of boys is mutilation.”

It’s easy to see these statements as decrees on public health, premised on the technical details of a medical procedure. Look more closely, though, and it becomes clear that a public health perspective misses the point completely. The Swedish and Danish doctors are talking about human rights, and they’re raising a much broader set of questions. How permanently can parents shape the lives of their children? To what extent can parents induct children into a religious tradition? This is a debate over how much personal autonomy we give to children—and the implications go beyond a single snip.

Because, let’s be clear: the objections to circumcision are never strictly medical. On its own, the medical case against circumcision isn’t strong enough to merit language like “mutilation.” There’s a reason that the American Academy of Pediatrics recently recommended circumcision for newborn boys. It’s a small procedure that may reduce rates of infection, and that may slow the transmission of STIs. Complications are rare, and they tend to be minor. The pain doesn’t last, and circumcision of boys doesn’t seem to impair function. (That’s not the case with female circumcision, which is why comparisons between the two are so tenuous).

Sure, a few European doctors have accused the AAP of cultural bias in its support for the practice. I have no doubt they have good intentions, but it seem possible that some degree of cultural bias could also be at play in Denmark and Sweden, both overwhelmingly homogenous, Christian-majority countries with growing Muslim populations.

Another line of objection argues that removing the foreskin dampens sexual pleasure. Many critics of circumcision—including Danish physician Morten Frisch, in a recent Copenhagen Post op-ed—note that medieval rabbis, including the great Moses Maimonides, explained circumcision as a way to help men curb their sexual appetites. These rabbis were impressive thinkers, but not exactly reliable sexologists. It’s not clear why we should trust medieval medicine on this one issue.

Ritual circumcision is a holdover from an era when religious identity was less of a choice or personal construction, and more of a socially sanctioned absolute.

Sexual enjoyment is very difficult to quantify, but, as Eliot Spitzer could probably attest, circumcised men certainly are capable of considerable sexual pleasure. It’s hard to argue that a largely unverified, and perhaps unverifiable, effect on sexual pleasure is reason enough to interfere with a foundational ritual act of two ancient world religions.

Which leaves us with the issue of consent. And it’s here that the Scandinavian doctors have a case—a case that we’ll be hearing more often as circumcision rates in the United States decline, and as notions of identity change.

Ritual circumcision is a holdover from an era when religious identity was less of a choice or personal construction, and more of a socially sanctioned absolute. There is something deeply old-fashioned about having some component of your identity marked into your flesh by another human being. As liberal societies offer more and more personal choice—over sexual preferences, over gender identification, over religious or non-religious affiliation—is that kind of physical marking something that we’ll be willing to tolerate?

The doctors of Sweden and Denmark say no. Like many opponents of circumcision, they speak in terms of personal sovereignty. People should have the right to do whatever they want with their bodies. That’s a thoroughly reasonable, thoroughly modern opinion.

Jews and Muslims, though, can be forgiven for feeling unjustly singled out. After all, circumcision is just one of the many, many ways in which parents dictate the lives, and the futures, of their children. An Amish parent who raises her child in an insular culture, exposes this child only to Amish influences, and pulls her child out of school after eighth grade, as is customary, certainly leaves just as indelible a mark as any physical alteration. Sure, that child is free to renounce Amishness at a certain age, but the influence of that upbringing (and the practical realities of having an eighth-grade education) won’t easily be erased. You might compare the difficulty and expense of doing so to the difficulty and expense of having a foreskin surgically restored—although a missing foreskin, unlike an insular religious upbringing, is deeply private, and shouldn’t affect your access to education or other resources.

There are those who will suggest that no religious group should have that much power over its children. But it’s not just religious groups. Any upbringing—any education—places significant, difficult-to-remove markers on a child. And why shouldn’t it? Most parents are subject to competing impulses—on the one hand, a desire to mold their children, and, on the other, a desire to see them develop into independent adults.

In that tension, the Swedish and Danish doctors are falling squarely on the side of enforcing independence, at the expense of allowing parents to mold their kids. In the absence of clear evidence that circumcision has lasting, traumatic effects, it’s hard to see that move as anything other than an imposition. It’s not only Jews and Muslims who might feel a pang of concern. All religious groups, to some extent, make demands on the free choice of their members, and all traditions, one imagines, must mold the children born into them. Circumcision is unusual only in that it leaves a physical mark.

If an ethnic tradition consistently produces healthy, well-adjusted adults who appreciate their upbringings, and if those adults are peaceful, tolerant participants in democratic society, then why should the government interfere? Why prevent children from entering into that tradition, irrational or old-fashioned as it may sometimes appear? So far, the governments of Sweden and Denmark seem unwilling to act on their medical associations’ recommendations. The backlash would be considerable.

Still, this particular conversation won’t be disappearing soon. Circumcision rates have declined dramatically in the United States, and plenty of American activists (some of them within the Jewish community) have taken aim at the practice. Perhaps Ikea, Saab, and Lego soon won’t be the only imports that Americans recognize as distinctly Scandinanvian. And while circumcision may not exactly be a topic for light conversation, this particular debate can be oddly engrossing, and not just because it addresses fundamental tensions between state and individual, tradition and modernity, and personal choice and community membership, but because it’s also about religion, sex, knives, and the First Amendment. What more could you ask for?