Tuesday, June 14, 2011

Labia v. Foreskin


18 U.S.C. §116 - Female Genital Mutilation

(a) Except as provided in subsection (b), whoever knowingly circumcises, excises, or infibulates the whole or any part of the labia majora or labia minora or clitoris of another person who has not attained the age of 18 years shall be fined under this title or imprisoned not more than 5 years, or both.

(b) A surgical operation is not a violation of this section if the operation is -

(1) necessary to the health of the person on whom it is performed, and is performed by a person licensed in the place of its performance as a medical practitioner; or

(2) performed on a person in labor or who has just given birth and is performed for medical purposes connected with that labor or birth by a person licensed in the place it is performed as a medical practitioner, midwife, or person in training to become such a practitioner or midwife.

(c) In applying subsection (b)(1), no account shall be taken of the effect on the person on whom the operation is to be performed of any belief on the part of that person, or any other person, that the operation is required as a matter of custom or ritual.

Mutilating the genitals of an infant girl is absolutely prohibited, a felony punishable by five years in prison, with no religious exception whatsoever.

Mutilating the genitals of an infant boy is more common than tonsillectomy.

This is despite the fact that many adult women voluntarily choose elective surgery to have their genitals mutilated, while virtually no adult men do.

Really, what the fuck is going on here?


  1. "Mutilating the genitals of an infant boy is more common than tonsillectomy." And probably less harmful than tonsillectomy as well. I'm puzzled at your puzzlement. Is it your view that utilitarian concerns should be completely irrelevant? There is enough evidence to convince most people that female genital mutilation is harmful, and some see reason to believe it is extremely harmful. There is no convincing evidence that male genital mutilation (of the kind commonly practiced) is significantly harmful and really no evidence at all that it is extremely harmful. There are those who argue that it is harmful, but their case is no more convincing, and possibly less so, than those who argue that it is beneficial. And though I haven't seen any survey results, I'm guessing that the majority of circumcised men are happy with their parents' decision to have their genitals mutilated and would not prefer that they had waited until adulthood before making the decision. To a utilitarian, it is pretty much an open and shut case to allow genital mutilation for boys but not for girls.

  2. If it's so obviously not harmful, how come almost no men choose elective circumcision as adults, but lots of circumcised adults try to re-grow their foreskins?

    Circumcision is a loss of a sensitive, sexually responsive part of the body. It is irreversible.

    Also, note that some FGM is pretty minor - just a knick here, no loss of orgasm. But that's a felony.

  3. I didn't say that it's obviously not harmful; I said there is no convincing evidence that it is harmful. Lots of adults do all kinds of crazy things, but that doesn't constitute convincing evidence that there is good reason for them to do those crazy things.

    Those who argue that circumcision has benefits will say that some, perhaps most, of the benefits are realized before adulthood. It is an interesting question why more men don't choose adult circumcision, given that people choose to do a lot of silly things and there's no obvious reason that circumcision shouldn't be one of them. But I'm inclined to think that there is simply some greater irrationality that consistently outweighs the irrationality that would cause them to be circumcised.

    I should note that insufficient sexual sensitivity is rare in men (even in a culture like ours where circumcision is widespread) but common in women, and indeed excessive sexual sensitivity is more likely to be a problem for men (in part because the refractory period makes premature orgasm more problematic for men than for women). And in any case most medical authorities hold that the reduction in sensitivity due to male circumcision is quite minor (or nonexistent).

    There is perhaps a case to be made for more precise regulation of FGM, but as a first cut (no pun intended), we can at least say that common FGM practices include ones that are clearly harmful whereas common MGM practices do not. And as a general principle of governance, I'm inclined to think it better that laws should err on the side of too much generality rather than too much specificity.

  4. The burden of proof should be on those who wish to allow parents to amputate the foreskins of their minor sons for non-medical reasons. We don't allow parents to cut off their kids' ear lobes, or to give them tattoos. Why is foreskin amputation any different?

    It strikes me as bizarre to argue that non-consensual permanent body modification is OK as long as there isn't much evidence that it's physiologically harmful. To many men, it is manifestly psychologically harmful -- otherwise they wouldn't go through the trouble of trying to regrow their foreskin and the trouble of campaigning to prevent the harm they suffered from befalling others.

    My understanding of utilitarianism does not agree with the idea that it basically says that if you can't show that something is generally objectively harmful, then that something should be allowed. Subjective harms are real harms, even if they aren't medically detectable.

    And in any event, being deprived of the choice to amputate one's foreskin is a harm, arguably for everyone so deprived even if they don't opt to amputate, and unarguably for everyone who would choose to keep their foreskin.[1] The irrevocability of foreskin amputation surely weighs significantly, no?

    [1]. I'm assuming a bit of revealed preference here, but I find it hard to see evidence of a false consciousness. Societal "circumcision is normal" forces are stronger than "circumcision should be banned" forces, and yet circumcised men seek to undo their amputation (and many more silently lament their parents' decision) at far greater rates than uncircumcised men seek to have their foreskin amputated.

  5. []Circumcision is a loss of a sensitive, sexually responsive part of the body. It is irreversible.

    I just got depressed again. :-[

  6. @JasonSL

    "My understanding of utilitarianism does not agree with the idea that it basically says that if you can't show that something is generally objectively harmful, then that something should be allowed."

    Neither does mine, but I also believe that "subjective harms are real harms, even if they aren't medically detectable," and it seems obvious to me that prohibiting a widely-practiced religious ritual does tremendous subjective harm. If you can show that the ritual itself does considerable harm, there is a strong case for instituting the prohibition anyhow. You may believe that the subjective harm done by MGM exceeds the subjective harm that is done by prohibiting it, but you'll have to cite a huge amount of evidence on that point before you come close to convincing me. (I also believe there should be a strong presumption for the status quo, particularly where new legal restrictions are concerned. I find the case for FGM prohibition easily strong enough to overcome that presumption, but the case for MGM prohibition not even close.)

    Now if you want to argue about who has the right to do something potentially harmful to someone else, we are out of the province of utilitarianism. But I will argue it anyhow. I think prohibiting an important childhood religious ritual would do tremendous subjective harm to the children who would experience it and to their adult selves, not just to their parents. Of course the reason uncircumcised men seldom seek to have that ritual done on them as adults is that they are precisely the ones for whom it would not have a subjective benefit -- unless of course they are seeking to convert to a religion that requires circumcision, and among such men, the rate is much higher. As Sister Y said in the title of another recent blog post, "social belonging trumps everything." Circumcision is a ritual of social belonging. To prohibit it is to inflict tremendous harm. It's a bitter, almost envious attack by lonely moderns on the happiness of more primitive social organizations. Being a modern myself, I find that the case for that attack is strong enough in the case of FGM, given the medical evidence, but not in the case of MGM.

  7. Andy,

    Your first paragraph is somewhat persuasive, and it forces me to clear up my thoughts a bit, but I must admit discomfort with the idea that something bad can be made good by giving people an attachment to it. See Sister Y's post on the pathetic golem.

    I think it depends on the time horizon. People of various religions have an attachment to foreskin amputation. The world would be better off if they didn't have such an attachment. As it stands today, we have to choose between causing subjective harm to adherents of these religious from banning a practice to which they're attached and causing subjective and perhaps objective harm to foreskin amputees. So, from a purely utilitarian point of view, the time-integrated harm done by banning the practice and preventing future generations from being attached to it may be less than the harm done to the existing generations by banning it.

    You say that your second paragraph is outside of the province of utilitarianism, but it seems to me that you're still talking about persons enjoying benefits and suffering harms, rather than anything to do with rights or duties or the like. Utilitarianism does not observe distinctions between persons, and your arguments in (the first half of) your second paragraph in no way rely on distinctions between persons.

    In any event, I don't think you need to be so ungenerous to proponents of foreskin-amputation bans as to call them "bitter", "almost envious...of [others'] happiness", and "lonely".

    I think you misinterpret Sister Y's statement that "social belonging trumps everything". My understanding of what she said was that it was to some extent rhetorical, and in any event applied to people's (revealed) preferences, not to what is moral. And if the entire community is banned from amputating their sons' foreskins, then generations henceforth will be characterized by intact foreskins, and so, at least, intragenerationally, uncircumcised boys will still socially belong.

    I think I recognize your name from Yglesias's blog. Good to see familiar handles about the 'webs.

  8. It is an absurdly irrational practice period. The same people who go overboard to protect the rights of "unborn" don't let those who are born not even have their own bodies, complete and whole. It is an act of *violation*, if anything is.

    Besides, there is considerable physical pain in the process, even if it's done with anesthesia. And you talk of "subjective", "psychological" pain.

  9. "then generations henceforth will be characterized by intact foreskins, and so, at least, intragenerationally, uncircumcised boys will still socially belong."

    And if they don't, they can choose circumcision. =)

  10. "People of various religions have an attachment to foreskin amputation. The world would be better off if they didn't have such an attachment."

    I'm not convinced of that. People need rituals of belonging. The rituals aren't powerful unless they have some appearance of being consequential. Circumcision fits the bill perfectly in that it has the appearance of being consequential but in fact has only minor consequences. The very fact that some people seem so eager to reverse the effect, despite the lack of medical evidence of significant harm, demonstrates that it is a powerful, and therefore effective, ritual.

  11. Andy, the social belonging justification is the most interesting I've heard so far. That's very similar to how one of my lovers feels about his circumcision - he's rather religious, and takes meaning from having had his foreskin removed. (Of course, no one I know who HAS a foreskin would trade it, but . . . )

    I think the social belonging justification applies exactly as much to FGM as to male circumcision, however.

    Perhaps a more general way of phrasing the question: to what extent may parents irreversibly reduce a child's sexual responsiveness in order to achieve other goals for the child?

    The harm of circumcision, as touched on above, is exactly the harm of FGM: reduced ability to orgasm. Yes, this may not be a problem for some men - they may even take Zoloft or other SSRIs to treat premature ejaculation. But on the other hand, plenty of depressed guys go OFF their SSRIs because the sexual side effects are too awful. That's the nice thing about SSRIs - they're not permanent.

    Bottom line: circumcision makes it harder to orgasm. Which is exactly the reason FGM is supposed to be wrong.

  12. One other issue - reduced sexual responsiveness is a particular problem if your baby boys are going to grow up to be responsible and use condoms.

  13. Is anyone aware of medical studies that assess the relative sensitivity of penises under a condom as a function of foreskin status? Assuming you care whether boys and men engage in protected rather than unprotected intercourse, this seems just as relevant if not more so than studies on bare penises.

    Sister Y: Perhaps a more general way of phrasing the question: to what extent may parents irreversibly reduce a child's sexual responsiveness in order to achieve other goals for the child?

    I think this is the crux of the problem. Andy admits that FGM lies beyond that extent, but thinks that the other goals outweigh the harm of foreskin amputation to the child. So it's a quantitative rather than qualitative question for him, as I think it is for you as well, assuming you're not in favor of banning vaccines, for example.

  14. Replying to my own question about sensitivity under a condom:

    It seems that studies have been done, and have found small differences that could not be statistically distinguished owing to the large variances in the two groups (foreskin-less men and foreskin-ful men): Waldinger et al. "A Five-nation Survey to Assess the Distribution of the Intravaginal Ejaculatory Latency Time among the General Male Population". Journal of Sexual Medicine, 6, 2888-95 (2009).

  15. I am extremely suspicious of giving parents ANY right to unilaterally limit a child's sexuality, as parents' and children's interests seem dangerously contrary to each other in that context.

    I suppose you're right that I see it as a quantitative question, in that I can imagine situations in which a parent might limit the sexual capacity of a child for his own good (e.g., surgery when a child has genital cancer). I wonder how closely this follows Seana Shiffrin's distinction (introduction here) between (a) causing someone harm to prevent greater harm, and (b) causing someone harm to provide a mere benefit. I think this solves the vaccination case and puts the circumcision case on very shaky ground, since any "harm" from having an intact foreskin can be "remedied" easily when the child reaches adulthood (e.g., alleged greater susceptibility to HIV, a big concern if you're having lots of unprotected sex with Liberian prostitutes).

  16. Other thing on harm to prevent harm/ harm to provide benefit distinction: Birth and Consent: An Alternate Philanthropic Route to Antinatalism

  17. Sister Y,

    I recall having read your post following Shiffrin, but I've never been satisfied with a way to distinguish a benefit from a prevention of a harm. Supposing that foreskin amputation is important for social belonging. Do parents who have their son's foreskin cut off confer a benefit (grant him social inclusion), or do they prevent a harm (forestall social exclusion)?

    Making a big deal out of such a distinction seems to imply too much status-quo bias for my comfort. If you think hard enough, you can find a way for almost anything you do to harm someone else in some minute way, and so a hard prohibition against harming someone to confer a great benefit either to them or to someone else would prohibit us from doing anything.

    At a minimum, it seems reasonable to operate assuming that by taking part in society, we grant prior general consent to be harmed at or below some baseline level without consenting specifically to those harms. That is, I implicitly consent to having a car drive by and splash dirty water on my pants when I choose to go walking in the rain.

    Your point about the mismatch between the child's interests and the parents' interests is an important one. The default way of operating conflates the two without thought.[1] I agree that it is wrong to harm one's child for the purpose of one's own personal expression (of a religion, of an aesthetic preference, etc.). It is in the interest of the parents rather than the child to raise their children in a particular culture or religion. The parents are the ones who, in this example, value their own and indeed their child's belonging in a particular religious community; the children don't until their parents take positive steps to create in them that desire. As children do not choose what religious community if any they wish to belong to, it is the parents who create a situation for the child in which the child is in the position of having either to suffer the harm of social exclusion or the harm of diminished sexual capacity.

    The mentally easy way out is to not create the situation in the first place (this reminds me of antinatalism). The best solution is to not have as a component of religious/cultural belonging the need for diminished sexual capacity. But that's not an option unless somehow a universal, all-at-once ban can be implemented *and* circumcision isn't driven underground.

    [1] This is related to the annoyance I share with Richard Dawkins about referring to infants and toddlers as "Muslim children" or "Christian children".

  18. It's a fairly minor point, but people have been known to have unprotected sex before reaching adulthood (not mostly with Liberian prostitutes, but still...).

    In general I think it has to be a quantitative question. If freedom of religion doesn't include the right to do extremely mild harm to your own children, then the concept is virtually worthless. If it includes the right to do severe harm, then it's a bad idea and certainly not what is intended by its advocates. Somewhere one has to make a judgment, whether as an interpretation of the principle or as an application of the utilitarian advantage (which I believe exists) for freedom of religion, about when the harm is sufficiently material to justify prohibiting a religious practice. In spite of qualitative similarities, I think there is a quantitative difference between MGM and FGM which places them on opposite sides of that threshold.

    I'm surprised, though, that nobody has pointed out that non-religious male circumcision is also quite common (a majority of circumcisions in the US, I believe) and that it would not be difficult to provide a religious exemption from a prohibition. The point rather weakens my "belonging" argument, because the general community of circumcised men is not really a club particularly worth belonging to.

    I nonetheless continue to favor allowing MGM (even in nonreligious cases) but disallowing FGM (even in religious cases). Parents, even in a nonreligious context, can reasonably believe that circumcision will have a net benefit to their male children (including the benefit of not having to make the decision themselves, which I bet the majority of circumcised men would regard as a benefit). Parents cannot reasonably believe that FGM has a net benefit for their children (though they can unreasonably believe it). I realize this argument is unlikely to convince anyone, but...whatever. Anyhow, I feel the need to reiterate that the quantitative difference, despite the existence of exceptions on both sides, is, on average, a large one: female orgasmic dysfunction is much more common than male orgasmic dysfunction, and the influence of genital mutilation is much better established.

  19. Andy,

    I agree that making decisions for someone that result in outcomes they prefer but that also are unpleasant or harmful to make can indeed be doing someone a favor. This reminds me of Velleman's argument and Sister Y's discussion thereof against euthanasia, as merely offering the choice can be harmful.

    I appreciate your honesty in bringing up non-religious circumcision. Circumcision rates in the U.S. are falling; they're already below 50% on the West Coast. So it doesn't seem to be important for social belonging outside of particular religious communities. And pretty much every other developed country doesn't routinely circumcise their boys -- French men do not opt for circumcision not because they don't want to have to make the decision and face the physical pain in adulthood, but rather because they see no benefit to it. As uncircumcised penises become increasingly less of a curiosity in the U.S., non-religiously-based subjective benefits will disappear.

    I'm also uncomfortable with the idea that something that would normally and rightly be banned (like cutting off your child's ear lobes) can be made wrong to ban because it's fairly popular.

  20. This comment has been removed by the author.

  21. *If freedom of religion doesn't include the right to do extremely mild harm to your own children, then the concept is virtually worthless.*

    I think it is worthless anyway! Even harmful. See http://randomthoughts-srikant.blogspot.com/2011/05/steven-weinberg-quote.html

    I am also reminded of this quote from vhemt.org

    "If an idea lacks enough merit to be passed on without being force-fed from an early age, it probably deserves to be forgotten."
    -- http://vhemt.org/death.htm#meme

  22. Before this discussion, I was positing more of a role for anti-Islamic bias in particular for the double standard, but the more I think about it, status quo bias seems to be the biggest factor (though I guess you could argue anti-Islamic bias is a form of status quo bias for folks in non-Muslim countries).

    A society will always condemn the barbaric practices of others while defending its own barbaric practices.

  23. I like the connection between the Shiffrin asymmetry and status quo bias. That's sweet.

  24. "As uncircumcised penises become increasingly less of a curiosity in the U.S., non-religiously-based subjective benefits will disappear."

    I'm not so sure about that (thought the benefits are small anyhow). I would guess that, among androsexuals, there are many that have preferences on one side or the other as to the circumcision status of their potential partners. A decrease in the relative supply of circumcised penises should raise the "price."

  25. Andy,

    The preferences are likely induced by norms. I think the system has multiple stable attractors, along with some randomness / drift components. Almost-nobody-circumcised-except-for-medical-or-religious-reasons is a stable attractor in most of the developed world. Almost-everybody-circumcised has been a stable attractor in the U.S. for about a century. The price mechanism you suggest may make intermediate distributions also stable attractors, but empirical evidence shows that it doesn't prevent lopsided distributions.

  26. Andy, could you be more wrong? Not just wrong, but dangerously wrong. Your freedom of religion ends when it involves another person. Hence "freedom of religion" Laws should be general? Um, no, countless laws have been thrown out for being vague. Laws should protect the status quo? Um, no, then what is the point of having laws? Laws are made in response to activity that is already taking place not the other way around. That's why murder, theft, assault, etc are illegal. I hope you are never in any position of power if you don't understand these basic principles of law.

  27. Disclosure: I haven't read any of the comments yet.

    But why is it that posts about how bad teh menz supposedly have it compared to people with vaginas tend to generate wayyy more comments on this blog than anything suicide or antinatalism-related (this is in no way an endorsement of male circumcision, BTW)?

    If anyone is interested, here's what David Benatar and his brother (from the Harvard Medical School) had to say on the subject. I think they concluded male circumcision is sort of okay, but I can't be sure since I didn't finish the article due to the cringe-worthy subject matter. If anyone has a stronger stomach than me, it's probably worth a read.

  28. it's pretty fucked up what people do in the name of their religion, but if you DARE question them, you must be anti-semetic....

    just like those feminists who try to boss everyone around and if you don't unquestionably kowtow to their dogma--you must be a woman hating misogynist....

  29. Circumcision is a pet topic of mine because (a) it has perfect, uncomfortable, rare similarities with human reproduction, and (b) I am aesthetically and intellectually influenced by Beavis & Butt-Head more than I care to admit.

    Circumcision is:
    - inflicted upon a baby without its consent
    - subject to "privacy" claims (the idea that inquiry into a child's welfare isn't a proper subject for anyone but the parents)
    - widely practiced and felt by many to be innocent
    - bloody and barbaric in fact
    - often defended by its victims, for whom it is logically impossible to know the difference

  30. At a minimum, it seems reasonable to operate assuming that by taking part in society, we grant prior general consent to be harmed at or below some baseline level without consenting specifically to those harms.

    This baseline is defined by the whims of tort law. Are there cases of men suing their parents for diminished sexual experience?

  31. Paul,

    I'd say the baseline people operate under is one defined by the characteristics of a given society. I consent to thousands of people piloting deadly, faster-than- and more-massive-than-human-scale machines about my neighborhood and across my path to work by living in an automotive society. These harms would not be so readily consented to, say, two hundred years ago.

    Tort law and its jurisprudence follows these characteristics; it, except in maybe a few very specific cases, does not lead them.

    As for your question, I'm not sure whether it's rhetorical. I haven't heard of any such case. Men know that no court would impose damages for having been circumcised, so nobody bothers I'd imagine. This is a separate issue from how severe the harm to them has been.

    My post you quoted brings up problems with Shiffrin's absence-of-benefit/presence-of-harm distinction, and also argues that we should be talking not about whether circumcision is at all harmful but rather about whether it is *sufficiently harmful* to rise above the baseline of acceptable non-consensual harm.[1] I never endorse non-medical circumcision. I'm not sure what you're getting at in your reply to me.

    [1] One away of thinking about the baseline is that imposing occasional harms on someone that do not exceed it is not unethical. Another way is that they're still unethical, but not worthy of our serious attention on an individual basis. So even though driving cars is an antisocial activity -- it pollutes (particulants, smog, GHG, noise, heat (though black roads that decrease cities' albedo)), weakens social fabric, demands public resources, and is prone to cause injury and death -- one car driving past me on the way to work is not morally problematic in any meaningful way, but thousands of cars may be.

  32. Tort law and its jurisprudence follows these characteristics; it, except in maybe a few very specific cases, does not lead them.

    True. But theoretically, that should mean that harms above the baseline should be subject to legal action. I'm not so sure that no court would impose damages for circumcision. Also, even if the chances of legal success are slim, if some men regret their circumcision to the degree that they apparently do, it seems likely that at least some of them would seek legal action. I apologize if I came across as sarcastic - I really am curious to find out if there are any such cases.

    Robin Hanson has a proposal with regard to such minimal harms: http://hanson.gmu.edu/gamblesuits.html

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