|FGM and circumcision: Problems of definition|
Differences and similarities between male and female genital mutilationObjective discussion of both male and female circumcision is hindered by problems of definition, vividly expressed in the fact that forcible alterations to the genitals of girls or women are referred to as Female Genital Mutilation, while comparable alterations to the genitals of boys and men are designated circumcision - which sounds, and is meant to sound, much less serious. Many of those who deplore operations on women as FGM see no objection to similar surgery on boys.
In tribal societies which practise these forms of initiations, however, FGM has the same cultural significance as the circumcision of boys, and its advocates today justify it with similar medical rationales: according to Islamic doctors, the health benefits of female circumcision include reduced sexual desire, lower risk of vaginal cancer and AIDS, less nervous anxiety, fewer infections "from microbes gathering under the hood of the clitoris" and protection against herpes and genital ulcers.  More objective observers point out that proven sequelae include clitoral cysts, labial adhesions, urinary tract infections, kidney dysfunction, sterility and loss of sexual feeling, but the advocates are claiming no more than what supporters of the operation for boys have been asserting for decades. Given the similarity in anatomy between the structures in question, it is likely that what is true for one sex will be true for the other.
western agencies like the United Nations and the World Health Organisation have defined female
circumcision as an atrocity which must be stopped while ignoring the
comparable operation on boys is an interesting question. The answer lies mainly in the fact that
millennia of Semitic custom and a century of routine male circumcision
in English-speaking countries have desensitised us into seeing the
procedure as a mild adjustment and the result as acceptably normal; although doctors in the US
performed a variety of operations on female genitals to cure nervous
and other complaints until well into the 1950s, the practice never
became routine, as it did with boys, with the result that it now seems
outlandish and cruel. In the nineteenth century masturbation in girls
was condemned as vigorously as in boys, and various genital surgeries
were often recommended (and sometimes performed) as treatment; but by
the 1890s, as Dr Yellowlees reluctantly concluded, they had been found
"ineffectual and unsatisfactory". 
Supporters of female
circumcision in the cultures which still practise it are quick to
identify the double standard at work here, pointing out that "American
parents circumcise their newborns so that the sons will look like the
fathers …. What, they ask, gives Americans the right to apply a
different standard to African women"?  The stance of the
American Academy of Paediatrics on female circumcision -- a form of
genital mutilation which members should actively discourage --
contrasts with its equivocating disapproval of the equivalent procedure
on boys, even though it regards each as equally irrelevant to health. 
1. David Gollaher, Circumcison: A history of the world's most controversial surgery, pp. 193, 195, 199
2. D. Yellowlees, "Masturbation", in A dictionary of psychological medicine, ed. D. Hack Tuke (London: Churchill, 1892), pp. 784-6
3. Gollaher, p. 200
4. Gollaher, pp. 172-3, 200
What do you mean by ... ?
Another problem is that the term female circumcision is
vague, referring to any one or more of a number of surgical procedures.
These have been defined by the World Health Organisation as follows:
The severity of female circumcision depends on which of these operations are performed (as well as how roughly), and it is true that the most extreme forms (involving the amputation of the external genitalia, with or without infibulation) are significantly worse than even the most radical foreskin amputation.
But what about boys?If medical authorities had the will, it would be very easy to compile and apply a classification similar that prepared by the World Health Organisation to non-therapeutic surgery on the male genitals, and it is sad sign of both sexist and cultural bias that the WHO does not seem to care enough about the welfare of boys to be interested in doing this. Like FGM, the effects of male circumcision are highly variable, depending on the nature of the surgery and how much of the loose penile tissue (“the foreskin”) is excised.
A leading Swiss authority on circumcision, Dr Sami Aldeeb (a Palestinian Christian, by origin) has attempted to remedy in his study, Male and female circumcision:
There are mainly four forms of male circumcision:
Type 1: This type consists of cutting away in part or in totality the skin of the penis that extends beyond the glans. This skin is called foreskin or prepuce.
Type 2: This type is practiced mainly by the Jews. The circumciser takes firm grip of the foreskin with his left hand. Having determined the amount to be removed, he clamps a shield on it to protect the glans from injury. The knife is then taken in the right hand and the foreskin is amputated with one sweep along the shield. This part of the operation is called the milah. It reveals the mucous membrane (inner lining of the foreskin), the edge of which is then grasped firmly between the thumbnail and index finger of each hand and is torn down the centre as far as the corona. This second part of the operation is called periah. It is traditionally performed by the circumciser with his sharpened fingernails.
Type 3: This type involves completely peeling the skin of the penis and sometimes the skin of the scrotum and pubis. It existed (and probably continues to exist) among some tribes of South Arabia. Jacques Lantier describes a similar practice in black Africa, in the Namshi tribe.
Type 4: This type consists in a slitting open of the urinary tube from the scrotum to the glans, creating in this way an opening that looks like the female vagina. Called subincision, this type of circumcision is still performed by the Australian aborigines.
Sami A. Aldeeb Abu-Sahlieh, Male and Female Circumcision Among Jews, Christians and Muslims: The child's right of self-determination as to sexual integrity
This classification is useful as far as it goes, but it neglects the vital fact that there is no precise definition of the foreskin and thus no precise definition of what is removed by “circumcision”. The foreskin is not a discrete organ like a finger or the thymus gland, but an extension of the surface tissue of the penis; where the foreskin starts and the rest of the penis ends is anybody’s guess. On top of that, the length of the foreskin varies enormously from one individual to another. Since the severity and harm of the surgery depends primarily on how much of the loose penile tissue is removed, and whether it is mainly the outer (skin) layer or the inner (mucous membrane) layer, MGM Types 1 and 2 listed above can easily be broken down into an indefinite number of divisions (10, 20, 30 per cent … etc of the foreskin), with both the visible damage and the impact on sexual sensation and function increasing at each step.
Where the foreskin is still adherent, forcibly tearing it from the glans adds an additional dimension of both damage and pain - the former often extending to the parts of the penis the boy is allowed to keep, the second so severe that it has been compared to tearing off a baby’s fingernail or eyelid.
With respect to FGM, it is also possible to break the WHO’s definition down more precisely into at least seven procedures:
Effects on sexual functionThe effects of FGM and MGM on sexual function area also uncertain. It is commonly said by opponents of FGM that the operation, especially in its extreme forms, destroys all sexual sensation, and can even reduce or eliminate sexual desire. Conversely, advocates for male circumcision insist that it makes no difference to sexual sensation, or even that it improves a male’s sex life. Much of the latter argument is based on the anatomically erroneous assumption that the most intense innervation of the penis is concentrated in the glans (by simple analogy with the clitoris); but it is now known that the densest concentrations of blood vessels and nerves is in the foreskin, while the glans is relatively insensitive, and equipped mainly to detect discomfort and pain – as Henry Head and colleagues discovered nearly a century ago:
The glans penis is an organ endowed with protopathic and deep sensibility only. It is not sensitive to cutaneous tactile stimuli … Sensations of pain evoked by cutaneous stimulation are diffuse and more unpleasant than over normal parts.
They also found that the sensitivity of the glans was not significantly affected by circumcision – thus making all the many studies since the notorious farce by Masters and Johnson on this question redundant and irrelevant.
Henry Head et al, Studies in neurology (London: Oxford University Press, 1920), Vol. 1, pp. 274-7
This conclusion confirms the remarks of the Renaissance anatomist Berengario da Carpi and other pre-nineteenth century authorities.
As the collection of quotes on the sexual significance of the foreskin shows, however, the overwhelming consensus of opinion since ancient times has been that the foreskin makes a major contribution to sexual sensation and function – which is precisely why the nineteenth century doctors who wanted to stamp out masturbation and other forms of unauthorised sexual pleasure were so determined to remove it. Observing that boys masturbated by manipulating their foreskin and girls by stimulating their clitoris, they concluded that circumcision and clitoridectomy were the appropriate responses if the aim was to stop these behaviours. Sander Gilman has noted that the late nineteenth century German authority Hermann Rohleder advocated circumcision for male masturbators, and burning of the clitoris with acid for female, and comments that “circumcision and clitoridectomy were seen as analogous medical procedures”. (quoted in Sander L. Gilman, Freud, race and gender (Princeton University Press, 1993), p. 65)
The conclusion is that while the glans/clitoris and foreskin/clitoral prepuce may be anatomically analogous, the correct analogy in functional or physiological terms is foreskin/clitoris.
A recent study of FGM
While male circumcision must inevitably alter sexual functionality, sexual pleasure is a highly subjective response, and it is difficult, if not impossible, to arrive at quantitative data on this issue. While it usually reduces the pleasure of fine touch and gentle manipulation (by excising the relevant nerves, found only in the foreskin), circumcision does not completely eliminate the capacity for sexual pleasure, and certainly does not inhibit the final orgasm. These points are sometimes presented as a positive reason for circumcision, but the same is true of all but the most severe forms of FGM. A recent study by F.E. Okonofua and colleagues in Nigeria examined 1836 women who had been subjected to either FGM type 1 (71 per cent) or type 2 (24 per cent). They concluded:
"No significant differences between cut and uncut women were observed in the frequency of reports of sexual intercourse in the preceding week or month, the frequency of reports of early arousal during intercourse and the proportions reporting experience of orgasm during intercourse. There was also no difference between cut and uncut women in their reported ages of menarche, first intercourse or first marriage in the multivariate models controlling for the effects of socio-economic factors. In contrast, cut women were 1.25 times more likely to get pregnant at a given age than uncut women. Uncut women were significantly more likely to report that the clitoris is the most sexually sensitive part of their body, while cut women were more likely to report that their breasts are their most sexually sensitive body parts. Cut women were significantly more likely than uncut women to report having lower abdominal pain, yellow bad-smelling vaginal discharge, white vaginal discharge and genital ulcers.
"Conclusion: Female genital cutting in this group of women did not attenuate sexual feelings. However, female genital cutting may predispose women to adverse sexuality outcomes including early pregnancy and reproductive tract infections. Therefore, female genital cutting cannot be justified by arguments that suggest that it reduces sexual activity in women and prevents adverse outcomes of sexuality."
F.E. Okonofua et al, “The association between female genital cutting and correlates of sexual and gynaecological morbidity in Edo State, Nigeria”, BJOG: An International Journal of Obstetrics & Gynaecology, Vol. 109, October 2002, p. 1089
Abstract available here
The conclusion here seems odd to western readers: arguments in favour of female circumcision because it curtails sexual activity and inhibits the inclination to promiscuity are invalid because female circumcision does not have these effects. It must be assumed that Okonofu is addressing a Nigerian audience, which believes that female sexual activity should be restricted and that circumcision is an efficient means to this end. The contrast between this perspective and western discourse is striking: articles in American medical journals which find that circumcision makes little or no difference to male sexual activity always present this as a positive reason why circumcision of infants should be performed. One can well imagine how this study might have been reported in the American media had it involved males: “Circumcision boosts pregnancy chances” is one likely headline.
Quantity or quality?It will be noted that Okonofu based his study on the response of the women to a questionnaire. For many western medical researchers, this is the notorious sin of “anecdotal evidence”, to which dustbin of non-scientificity are consigned the many claims by men that circumcision has harmed their sexual enjoyment.
Yet anecdotal evidence is not necessarily any less reliable than quantifiable data, and in an area where we are trying to assess subjective feelings, it may indeed be the only evidence that really counts. Could there really be an objective measure of sexual pleasure? Anecdotal evidence here really means personal testimony, and that can be perfectly objective evidence If we have enough of it pointing in a certain direction, and if it significantly outweighs testimony in the other direction, we may feel we have proven a case beyond reasonable doubt; if that's good enough for a court of law, and capable of sending a person to gaol for life, or even to the death penalty, it ought to be good enough for a study of the effects of circumcision. The problem is that most scientists want something much harder than personal testimony, preferably quantified, before they will be convinced. What is even worse, most scientists will believe weak "hard" evidence in preference to strong "anecdotal" evidence, as shown by the American doctors who repeatedly assure the public that there is "no evidence" that circumcision reduces male sexual function or pleasure and keep publishing the results of pathetic little experiments intended to demonstrate just that, thereby justifying the continuation their lucrative practice of stealing foreskins from helpless babies.
Further information on MGM/FGM comparison
Further information on anatomy
Further information on sexual function of foreskin