|Circumcision and genital mutilation|
Is circumcision male genital mutilation?
This is a controversial question on which there is much disagreement. Many men are quite happy with their circumcised condition and would not for one moment consider that they had been mutilated. Others are sorry that they had been circumcised without having a say in the matter and would prefer to have been left alone and entire; while they would not regard themselves as mutilated they do have sense of being incomplete. Others still are angry and resentful at what was done to them and do have a strong sense of having been deprived of an important part of their body, certainly amounting to mutilation. A smaller number who have suffered additional injury or complications carry such badly disfigured penises that even doctors have to concede that they have been mutilated. Some men have themselves circumcised in adulthood and are pleased with the result, though others regret it as a terrible mistake. No male wishes to admit that he has been wounded, much less impaired, in his most vital bits, so there is a natural tendency for circumcised men to deny (often angrily) any suggestion that their package is inferior or that their sexuality is impaired in any way. Many try to shift the focus of the discussion to the safely uncontroversial horrors of female circumcision.
Further information from Australia here and the USA here.
It is a striking fact that many men who do not accept that male circumcision is mutilation are vehemently opposed to any form of female circumcision because they believe that it is mutilation. Although Amnesty International has never said a word against male circumcision, it has taken a strong stand against female genital mutilation (FGM), which it defines as the removal of any part of the female genitalia; by this definition the removal of any part of the male genitalia must similarly be defined as male genital mutilation. Most of the tribal cultures which practise FGM also practise male circumcision, and they obviously see the operations as similar in nature, and the clitoris especially as the female equivalent of the foreskin. In the nineteenth century, when doctors were going all out to stop masturbation, the “heroic” remedy and preventive they recommended was clitoridectomy in girls and circumcision in boys; in each case they denied it was mutilation because the reproductive function was not damaged. Whether male circumcision is a mutilation or not, there is a striking visual difference between cut and uncut men.
Unlike the circumcision of boys, comparable procedures on women did not take off in English-speaking countries, with the result that people in the western world have been culturally conditioned to regard the first as an acceptable option and the latter as an unspeakable barbarity. Among the Islamic cultures which which do practise various forms of FGM, the operations are also considered normal and proper, and they are now justified with the same sort of medical rationalisations with which supporters of male circumcision defend their own surgical rituals. A cool look at the two operations, and the arguments used to justify them, will show that they have more in common than many people assume.
Further discussion on this site.
A recent United Nations report on the implementation of the Convention on the Rights of the Child in Guinea-Bissau states: “Traditional practices and customs are causing serious problems for children and women. The circumcision of boys aged 9 to 13 years and female genital mutilation in girls aged between 7 and 12 years among the Fula and Mandinga ethnic groups are the most cruel and harmful practices. There are no effective measures at the national level to eliminate them.” (United Nations press release, 22 May 2002)
Some people object to the description of circumcision as male genital mutilation because they believe that a procedure performed with therapeutic, disease-prevention or even just benevolent intent cannot be a mutilation, or that the injury is too minor to qualify as a mutilation. But this opinion rests on a misunderstanding of the plain meaning of English words, as shown in current dictionary definitions:
Shorter Oxford English Dictionary
Mutilate. 1. Deprive (a person or animal) of a limb or bodily organ; cut off, severely wound (a limb or organ); maim, mangle. 2. Make … imperfect by removing or severely damaging a part.
Maim. Orig., disable, wound, cause bodily harm or disfigurement to. Now, deprive of (the use of) a limb etc; mutilate, cripple; fig. render powerless or essentially incomplete.
Disfigure. 1. Spoil the appearance or beauty of; deform, deface. 2. Alter the figure or appearance of, disguise.
Mutilate. To deprive (a person, animal, the body etc) of a limb or other important part or parts. 2. Castrate. 3. To injure, disfigure or make imperfect by removing or irreparably damaging parts.
MUTILATION is an act or injury that degrades the appearance or function of the (human) body, usually without causing death. The term is usually used to describe the victims of accidents, torture, physical assault, or certain premodern forms of punishment. Acts of mutilation may include amputation, burning, flagellation, circumcision, female genital cutting, or wheeling. In some cases, the term may apply to treatment of dead bodies, such as soldiers mutilated after they have been killed by an enemy.
Some tribes practice ritual mutilation as part of an initiation ritual, such as circumcision.
“Benefit” not the issueBut even if circumcision did confer benefits, there is no contradiction between something being both of therapeutic value and a mutilation. If you are unlucky enough to need your arm or leg amputated because of incurable injury or disease, the operation is therapeutic (saves your life), but the result is still a mutilation: you lack the normal number of legs or arms, and you thus become a maimed and imperfect person. If you are circumcised, your penis lacks the normal suite of penile features: something is missing, and to that extent it is a maimed, imperfect and (unarguably) incomplete organ. It may still work, but not in the same way. Circumcision is thus always a mutilation: the argument is over whether it is a justifiable or unjustifiable mutilation. If the dangers of the foreskin and the benefits of circumcision were as great as its champions claimed, destruction of your foreskin might be considered a worthwhile sacrifice; but if the dangers of retention and the benefits of amputation are not as great as claimed, it would be a pointless sacrifice.
Whether anybody has the right to force a child to make such a sacrifice, even if it did offer benefits, before he is capable of giving informed consent is a separate and much debated question.
The force of customAs George Bernard Shaw remarked, custom will reconcile people to any atrocity. Because circumcision has been around in English-speaking countries for about a century, most people have grown accustomed to seeing men with circumcised penises and regard them as a perfectly normal option (“Cavalier or roundhead?” as schoolboys use to ask). It was not so before the 1860s, when Richard Burton (the famous explorer) could write that “Christendom practically holds circumcision in horror, and the biblical scholar George Rose described it as “a rite to which mankind must be naturally repugnant”, incomprehensible except as a divine command: “As this peculiar rite is painful and humiliating … it is difficult to conceive that the first people or family who received it could have do so otherwise than … as a heavenly injunction”. 
In the eighteenth century the average fellow regarded his foreskin as “the best of your property” , and Edward Gibbon referred to circumcision as a “painful and even dangerous rite” (Chap. 15, Vol. I, p. 449), and the result as “a peculiar mark” (Chap. 16, Vol. I, p. 525). He did not actually use the word “mutilation”, but that he regarded the operation as harmful and disfiguring is shown by his favourable reference to the replacement of circumcision with baptism by the Christians: “to the initiation of blood, was substituted a more harmless initiation of water.” (Chap. 15, Vol. I, p. 451) 
Not so mealy-mouthedBefore circumcision became common or routine, and doctors who wanted to do it were obliged to reassure parents that it was just a harmless little snip, with negligible impact on the appearance, feel and function of the penis, it was normal among almost anybody who discussed the subject to refer to circumcision as a mutilation. A striking instance of this willingness to call a spade a spade is provided by the American Jewish surgeon Abraham Arnold (1820-1904), who had “performed the operation of circumcision, as practised among the Israelites, not less than 800 times”, yet had no hesitation in calling the procedure a “mutilation”.  Arnold was the author of several articles on circumcision in which he argued vigorously against the idea, then being put forward by British and American medical men (all gentiles) in the late nineteenth century, that circumcision among primitive peoples, including the ancient Hebrews, originated as a hygienic or sanitary measure:
Probably, in latitudes where the laws of personal cleanliness are little respected, the external genital organs will fare as badly as the rest of the body. However much has been said in favour of indiscriminate circumcision on the score of its hygienic advantages, I doubt whether a bloody operation will ever become the fashion for the prevention of a possible trivial affection. It is to me extremely questionable if circumcision originated from considerations of bodily cleanliness, for people who are indifferent to filth will hardly resort to a mutilation to keep it off from one part of the body. If it had been intended to pay particular regard to the sexual organs, one would suppose the female pudenda would have received the first consideration.
Circumcision should be placed among “those aberrations that are intended to surpass nature. Thus, the women of China cripple their feet; the Hottentot female elongates her nymphae; some savage tribes compress the skulls of their children etc.” 
Arnold never wavered from this view, returning to the subject, with even greater vehemence, in the early twentieth century:
Like similar customs among barbarous people, it [circumcision] was invested in the course of time by a religious sanction. In fact, circumcision is a marked illustration of the pertinacity of religious customs, even at the cost of a bodily mutilation. Apologists will have us to believe that this practice has a moral aspect, but we are yet to hear that the Turks and Persians are noted for their continence.
The plea that circumcision is a sanitary measure is indefensible. No unbiased physician would recommend an uncalled-for, risky surgical interference for preventing an exceedingly rare and trivial disorder, for which ordinary cleanliness suffices. If there be malformation in exceptional cases, then the surgeon is the only person to be consulted. One may just as well advise the excision of earlaps, for they may possibly get sore. 
Scientists and anthropologistsScientists and anthropologists have been equally straightforward in their use of the term. Far from regarding mutilation as an emotional catchcry, they have seen it as a an entirely neutral descriptor of the action and result to which it refers. The great German biologist August Weisman had no doubt that any distortion or removal of any body part was mutilation, no matter what the rationale:
Cases of habitual mutilation which have been continuously repeated for numerous generations … have not produced any hereditary consequences. … The mutilation of certain parts of the human body, as practised by different nations … have not led to malformation or reduction of the parts in question. Such hereditary effects have been produced neither by circumcision, nor the removal of the front teeth, nor the boring of holes in the lips or nose, nor the … crippling of the feet of Chinese women. 
His comments were made in reply to those reviving the ideas of the eighteenth century biologist Jean Baptiste Lamarck (1744-1829), who famously accounted for evolutionary change with the suggestion that an organism’s acquired characteristics were inherited by its descendants: by stretching to reach the leaves of trees, the neck of the giraffe gradually got longer and longer. This explanation was rejected by Charles Darwin, but until the mechanism of genetic inheritance (the genes) was discovered, it was difficult to explain evolutionary change, and even Darwin drifted towards a moderate Lamarckianism in later editions of The Origin of Species.  Weisman firmly rejected this tendency. The controversy led to many articles in medical journals, with titles such as “Are Mutilations Inherited”:
Are mutilations inherited? The Lancet, in a recent issue discusses this subject, and refers to some recent studies by Professor Weisman on the subject. The distinguished professor cut off the tails of 901 white mice of successive generations, but in no case was a white mouse born without a full-size tail. It as always been something of a puzzle that Jews should, after thousands of years of circumcision, still bear infants with long prepuces. Darwin refers to the fact, as noted by Gordon, that different races of men have from time immemorial knocked out their upper incisors, cut off joints of their fingers, made holes of immense size through the lobes of their ears or their nostrils, tattooed themselves, made deep gashes in various parts of their bodies, and yet there is no reason to suppose that these mutilations have ever been inherited. 
The pioneer sociologist Herbert Spencer described circumcision as “one of various mutilations imposed as marks on subject persons by terrestrial superiors”. He discussed its origins and prevalence in a chapter called “Mutilations” along with scalping, cutting off fingers, cutting the hair, piercing, taking trophies from the bodies of defeated enemies. Spencer’s sociological principles do not carry much weight these days, but what is relevant here is his use of the word, and his point that the less serious a mutilation is regarded, the more common it will be, seems to be broadly correct. 
The nineteenth century French surgeon and anthropologist Paul Broca likewise wrote:
The influences of climatic and hygienic conditions, of sexual selections and the social state, are no the only ones which may exercise a more or less durable action on the organization of man. Peculiar practices, at times very grotesque, much spread among a great number of peoples, subject certain parts of the body to more or less serious deformations or mutilations. Some, such as tattooing, are quite superficial, forming, so to speak, the national costume. Others, such as circumcision, piercing the ears, lips or nose, the extraction or filing of the teeth, the amputation of a phalanx or of a whole finger, the constriction of the chest, the compression of the feet, the flattening of the nose, the ablation of a testicle etc, alter the form and the functions of the respective organs and constitute real mutilations. Others, finally, the most serious and strangest of all, affect the conformation of the cranium and the development of the brain. 
A similar perspective may be found in Ernest Crawley’s rambling survey of marriage customs, The Mystic Rose (1906), which includes a discussion of circumcision among other mutilations, such as piercing the nose or other organs, filing or knocking out the teeth and perforating the hymen.  Like Spencer’s sociology, Crawley’s anthropology is now hopelessly out of date, but the point is to notice the unselfconscious word usage at that period. An even more striking instance of this is the ambitious Encyclopaedia of Religion and Ethics (1917), which not only included an entry on “Mutilations”, but referred without visible tremor to the mutilation of Abraham himself:
In the religions of antiquity and the practices of modern savagery there is complete evidence of mutilation of the human body as a definite part of the ritual, the ceremony or the action in which it takes place …. Examples of both rite and practice must be the starting point, and it will be found that there is no clear line of separation by peoples, race, or in stages of civilization between religious rite and savage practice. Thus in Hebrew history the mutilation of Abraham is the beginning of a religious rite which has continued through all subsequent periods.
The Encyclopaedia concluded its discussion with a list of examples: “A list of the several kinds of mutilations adopted is not a cheerful contribution to the subject …. It includes tails of hair, scalps, eyes, fingers, hands, thumbs, castration, circumcision, blood, cuts and lacerations.”
Encyclopaedia of Religion and Ethics, ed. James Hastings (Edinburgh: T.&T. Clark, 1917), Vol. IX, p. 63
Changing words, changing valuesBut usage was about to change. As circumcision as a hygienic precaution in the infant was popularised in Britain and the USA it became difficult to refer to the procedure as a mutilation – for what doctor or parent could admit to mutilating a helpless child? Thus the 1929 edition of the Encyclopaedia Britannica described circumcision as “a preventive measure in the infant … performed chiefly or purposes of cleanliness”; readers were then referred to the entries for “Mutilation” and “Deformation” for a discussion of circumcision in its religious context. By the 1920s medically rationalised circumcision was no longer regarded as a mutilation, but religiously motivated circumcision evidently still was.
The transition whereby ritual circumcision remained an incomprehensible mutilation while medical circumcision became a hygienic necessity, dictated by the march of scientific knowledge, was neatly registered by the American surgeon J. Henry Simes. In the 1890s he could simultaneously describe “the mutilation of the genitals among the various savage tribes of the world” as a “strange and unaccountable practice of human ideas, which one is not able to reconcile with any reasoning power”. Modern, medically-mandated circumcision, on the other hand, he praised as an operation “which may be performed for moral reasons; which is demanded for hygienic purposes; which is frequently necessary for pathological conditions; and, finally, which is of unquestionable prophylactic importance.” Apparently, the motive of the circumciser made all the difference to the result.
J. Henry Simes, “Circumcision”, Annals of Gynaecology and Paediatrics (Philadelphia), Vol. 4, 1890-91, pp. 374-83, cited in David Gollaher, Circumcision: A History of the World’s Most Controversial Surgery (New York: Basic Books, 2000), pp. 53 and 73.
Cultural relativismWith the decline of confidence in the superiority of western civilization and the rise of cultural relativism, however, this usage also began to disappear, and anthropologists became reluctant to use such a judgmental and value-laden term. Nineteenth century anthropologists had shown no reluctance to criticise savage customs as barbarous, stupid or harmful, and although such a smug attitude obstructed their attempts to understand different societies, they were not always far from the mark. Sir John Lubbock, in his Prehistoric Times (1865) described mutilations as “horrible rites”, and one of the most influential of all the Victorian scholars, Edward Tylor (1832-1917), went further. In his Primitive Culture (1871) he seems to have taken a grim pleasure in ridiculing irrational customs: explaining why he had devoted so much of his book to traits that are “worn out, worthless or … harmful folly”, he replied that “in such inquiries we have continual reason to be thankful to fools”. Ethnographers could take “a certain grim satisfaction” when they find “means to make stupid and evil superstitions bear witness against themselves” by revealing their origins in barbaric stages of culture. “It is quite wonderful … to see how large a share stupidity, unpractical conservatism and dogged superstition have had in preserving … traces of the history of our race, which practical utilitarianism would have remorselessly swept away”.
As Marvin Harris points out, this level of self-confidence did not last:
Under the combined influence of cultural relativism, historical particularism and synchronic functionalism it has become bad form for anthropologists to make public judgements concerning the relative “stupidity” of various primitive and civilized customs. Once we take care to amend Tylor’s maxim to embrace traits which he ascribed to “practical utilitarianism”, however, there is no reason why future generations of anthropologists should deny themselves that grim satisfaction with which the history of human folly has always repaid its serious students. When Tylor’s “practical utilitarianism” gave birth to a war in which practical machines enabled 30 million people to be killed, it seems that many anthropologists suffered a loss of critical nerve. Instead of declaring these machines, and the social arrangements that dictated their use, stupid, they went about adding witchcraft and circumcision to the list of man’s great achievements. It has yet to be demonstrated, however, that our understanding of cultural evolution is enhanced by an attitude of equal respect for all of its products.
Marvin Harris, The Rise of Anthropological Theory (New York: Thomas Crowell, 1968), pp. 168-9
The cultural arrogance of Tylor and his contemporaries blinded them to both the faults of their own societies and the virtues of the Other, but in the justified reaction against this sense of superiority later thinkers went too far in the opposite direction, arriving at the position that everything in somebody else’s culture was good or, if not good, at the very least beyond criticism. In post-modern times this has led to the syndrome in which all societies are good, except western civilization, which gets lambasted at every opportunity – a form of self-hatred now vigorously deplored by Roger Sandall and Keith Windschuttle.
In this context, one of the last anthropologists to refer to circumcision as a mutilation was George Murdock. In his Ethnographic Atlas (1967), he used the term “male genital mutilation” to cover any surgical cutting or alteration of the penis, ranging from slight nicks through slitting of the foreskin to full circumcision and subincision. 
Today, however, dictionaries and encyclopaedias of anthropology jump from “Music” to “Mythology” and rarely include the M word in the index. Even much recent anthropological discussion of surgical procedures on females prefers now prefers the more neutral-sounding “female genital cutting” in place of the old battle-cry, FGM. As Barnard and Spencer remark in their Encylopedia of Social and Cultural Anthropology:
Current arguments among anthropologists about power, human rights, and ritual genital mutilation reveal an old tension between the cosmopolitan tolerance of ethical relativism, with its corollary suspicion of the motives of those wishing to find or impose “universal values”, and an activist intolerance of repressive or violent conditions, with its equally apposite distrust of those who would allow such conditions to continue in the name of cultural autonomy.
Alan Barnard and Jonathan Spencer (eds), Encylopedia of Social and Cultural Anthropology (London and NY: Routledge, 1996), p. 480
Opponents and supportersUse of the term mutilation was not confined to anthropologists or uncommitted observers; discussing the most effective way of dealing with “sex perverts” such as “Negro rapists”, such an enthusiastic promoter of circumcision as Dr G. Frank Lydston advocated both castration and “penile mutilation according to the Oriental method”. 
As you might expect, however, as circumcision became more common it was the opponents of the practice who continued to use the M word, and the advocates who began to insist that it was not merely not a mutilation, but that it was some sort of beautification. One of the most eloquent opponents of circumcision in the 1890s was Dr Elizabeth Blackwell, who condemned the practice in terms that have not lost their relevance:
Warning against circumcision
A serious warning against the unnatural practice of circumcision must here be given. A book of “Advice to mothers” by a Philadelphia doctor was lately sent to me. This treatise began by informing the mother that her first duty to her infant boy was to cause it to be circumcised! Her fears were worked upon by an elaborate statement but false statement of the evils which would result to the child were this mutilation not performed. I should have considered this mischievous instruction unworthy of serious consideration, did I not observe that it has lately become common among certain short-sighted but reputable physicians to laud this unnatural practice, and endeavour to introduce it into a Christian nation.
Circumcision is based upon the erroneous principle that boys, i.e. one half of the human race, are so badly fashioned by Creative Power that they must be reformed by the surgeon; consequently that every male child must be mutilated by removing the natural covering with which nature has protected one of the most sensitive portions of the human body. …
The plea that this unnatural practice will lessen the risk of infection to the sensualist in promiscuous intercourse is not one that our honourable profession will support. Parents, therefore, should be warned that this ugly mutilation of their children involves serious danger, both to their physical and moral health. 
Also of note is the observation of Thomas Szasz that “mutilating surgical operations on the penis” were standard Victorian sanctions against masturbation, and identified a paradox in that surgical treatment of the habit become more frequent as belief in the theory of masturbatory insanity declined. He explains this by suggesting that the phenomenon was related to “the development of surgical skills and aseptic operating techniques which allowed safe surgical mutilations”, not to new medical indications.  The last point is not quite accurate: in fact, as is show in my book A Surgical Temptation, new medical indications or the revival of old ones were brought up constantly, and they continue to be cooked up or reheated by die-hard circumcision advocates even today.
On the side of the advocates was the American Joseph Kaufman MD, a professor of surgery at the University of California, who stated in 1967:
In regard to the esthetic aspects of circumcision, my associate Professor Willard E. Goodwin has commented that “circumcision is a beautification comparable to a rhinoplasty”, and that the circumcised penis “appears in its flaccid state as an erect uncircumcised organ – a beautiful instrument of precise intent”. 
Well, whatever turns you on. Beauty is in the eye of the beholder: no doubt at least some members of the societies which practice elongation of the earlobes, protrusion of the lips or deformation of the cranium regard the results as a beautification.
In countries where circumcision did not become customary, however, the traditional view of the procedure as a mutilation has remained. Writing in a recent issue of Oral Medicine, a group of Spanish doctors have reviewed “certain aspects of mutilation practices”, which they define as having “permanent or lasting sectioning or lesions of a part of the body, and comprise skeletal deforming, dental mutilations, circumcision, ablation of the clitoris, scarification, tattoos and perforations (particularly of the soft tissues).” 
Contemporary confusionThe problem for doctors and those who think about biomedical issues in Anglophone countries (which have past history of widespread circumcision, and thus a powerful constituency with sympathy, nostalgia or enthusiasm for the practice) may be expressed like this: while the contemporary technique of circumcision is based on modern surgery, the practice had its origin in the stone age, and the ethics applied to it are still those of the nineteenth century, when medical ethics meant professional etiquette and children were not considered to have any rights as individuals. The paradox was noticed by an American doctor as early as the 1920s, in an article seeking the origins of medicine in religious ritual:
So if we see surgery creeping out we very naturally look for the marks stamped on it by sacerdotalism and the rituals of magic. They are rather ghastly. Fingers short of their joints, arms stiff with pointing to heaven, cuts and gashes, scarifications, castrations, circumcision, things thrust through loops of skin, noses, lips and ears distorted. 
But if circumcision is a bodily mutilation dictated by custom, habit or fashion, and should be classed with such procedures as tongue piercing or tattooing, then of course modern doctors should not be performing the procedure on infants and other minors, and perhaps they should not be performing it at all. As Thomas Szasz provocatively remarked:
“Why is routine neonatal circumcision legal? Because it is defined as preventive medicine. Why is it defined as preventive medicine? To avoid having to ban it as male genital mutilation”. 
Modern medical practitioners do perform the operation, a fact which obviously embarrasses the more thoughtful of them.
This is the fundamental reason for hesitation shown by a thoughtful and well-intentioned professor of surgery at the Royal Melbourne Hospital, and one generally opposed to circumcision of minors, when confronted with the question as to whether circumcision was a mutilation or an assault. Writing in the Journal of Medical Ethics, J.M. Hutson referred to the prospect of “adult males who were circumcised in childhood begin[ning] legal action against their parents or their doctors for so-called mutilation of their bodies without medical indication or permission”. What does he mean by “so called mutilation”? He continues:
I have seen a number of men who had significant surgical complications with circumcision in infancy, leading to subsequently inadequate sexual function. The most serious complication is accidental amputation of the end of the penis or excessive removal of penile shaft skin leading to secondary deformity. In addition, there are many reported cases in the literature of diathermy burn leading to complete necrosis of the penis, as well as accidental amputation. In many places, such children have had gender reassignment to female because of the loss of the penis. Every one of these complications is a catastrophe, which could have been avoided by abolition of mass routine circumcision in the neonatal period.
The implication is that circumcision is a mutilation only if it leads to unusually severe damage, such as damage to the glans or excessive removal of penile tissue. There is no suggestion that the foreskin itself, despite its visual prominence, its psychological and cultural significance, and its erotic potential, has value in its own right, or that it might be something a male is entitled to hang onto, or that its removal, by destroying an integral part of the penis, would in itself constitute a mutilation.
Professor Hutson is less hesitant when confronted with the question as to whether circumcision could be regarded as an assault, and even tends to the view that, without the consent of the person operated on, circumcision is indeed an assault, though he hides this rather radical thought in a tangle of irrelevant references to boys held down on kitchen tables and anaesthetics.
Is circumcision an assault? Surgery would be close to the legal definition of assault if no consent was given and no anaesthetic or analgesia was used. Circumcision done this way is still common place in many parts of the world where five to ten year old boys are held down on the kitchen table by their uncles while another male family member cuts off the foreskin. This is physically cruel and potentially dangerous and must leave major psychological scars. Neonatal circumcision, if done without an anaesthetic, is not far removed from this practice. 
It should be remembered, however, that no matter how effective the anaesthetic, the boy will never get his foreskin back.; the loss, if not the immediate surgical pain, is a lifelong sentence.
Hutson concludes that routine circumcision is not warranted, but stops short of characterising it as physical harmful or morally wrong. Writing in the same issue of the Journal of Medical Ethics, Sirkuu Hellsten found this position equivocal and contradictory, and called on both doctors and ethicists to take a firmer and more consistent stand against both male and female genital mutilations.  Further thoughts on the subject have been developed in important articles by Marie Fox and Michael Thomson. 
Anybody who agrees that knocking out teeth, piercing the septum (or anywhere else), scarifying the chest, or footbinding is mutilation must think very carefully before denying that circumcision is in the same category. Few people outside the Islamic or African cultures which practise various forms of female circumcision (female genital cutting or FGM) would hesitate to call any of those procedures female genital mutilation, irrespective of the calculus of damage. As Anika Rahman and Nahid Toubia write, “the act of cutting itself – the cutting of health genital organs for non-medical reasons – is in its essence a basic violation of girls’ and women’s rights to physical integrity. This is true regardless of the degree of cutting or of the extent of the complications that may or may not ensue.” 
Why is the case of boys any different?
References1. George Henry Rose, The Early Spread of Circumcision (London: Hatchard and Son, 1846), pp. 35 and 9
2. Roy S. Wolper, “Circumcision as polemic in the Jew Bill of 1753: The cutter cut?”, Eighteenth Century Life, Vol. VII, 1982, pp. 24-36
3. References are to Edward Gibbon, The history of the decline and fall of the Roman Empire, edited by David Womersley, 3 vols (London: Allen Lane, 1994)
4. A.B. Arnold, “Circumcision”, New York Medical Journal, Vol. IX, August 1869, p. 514
5. A.B. Arnold, “Circumcision”, New York Medical Journal, 13 February 1886, p. 174
6. A.B.A[rnold], “Milah”, The Reform Advocate (Chicago), 20 August 1892, pp. 4-5 There is a good discussion of Arnold in Leonard Glick's study, Marked in your Flesh.
7. (1869), quoted in Ernst Mayr, The growth of biological thought: Diversity, evolution and inheritance (Cambridge, Mass. 1982), p. 698
8. For the critique of this explanation, see any of the collections of Stephen Jay Gould's essays.
9. Editorial in New York Medical Journal, cited in E.R. Palmer, Circumcision, Medical News, Vol. 57, 2 August 1890, p. 99
10. Herbert Spencer, (1876-82), Principles of sociology (1876-82), Vols 1 and 2, (repr. Westport, Connecticut: Greenwood press, 1975), Vol. I, p. 408, Vol. II, Chap. 3, “Mutiltions”
11. Paul Broca, “On Anthropology”, Anthropological Review, Vol. 6, January 1868, p. 50
Paul Broca (1824-80) was a French surgeon an anthropologist specialising in bone disease, and with a particular interest in the skull. The Oxford Companion to Medicine refers genially to his pioneering efforts in orthopaedics and neurosurgery, as well as to his collection of skulls and contributions to “the science of craniometry”. Stephen Jay Gould takes a less favourable view, regarding much of his craniometry (skull and brain measuring) as pseudo-science, and especially criticising his contention that intelligence was directly related to brain size. Since women had smaller brains than men, Broca argued, they were necessarily less intelligent than men. This sort of measuring project was fairly typical of nineteenth century medical and anthropological research and would not be regarded as scientifically sound today, quite apart from the nasty political implications. My point in quoting the passage is merely to illustrate that nineteenth century thinkers, writing before circumcision became common or routine, took it for granted that the procedure was a mutilation, to be classed with piercing, extraction or filing of teeth, and amputation of fingers. References are to the Oxford Companion to Medicine (New York 1985), Vol. I, p. 156; Stephen Jay Gould, The Mismeasure of Man (Pelican Books, 1984), esp. pp. 92-107
12. Ernest Crawley, The Mystic Rose: A Study of Primitive Marriage, new edn, revise and enlarged by Theodore Besterman (New York: Boni and Liveright), 1927, 2 vols, Vol. I. p. 168
13. George Murdock, Ethnographic Atlas (University of Pittsburgh Press, 1967)
14. Hunter McGuire and G. Frank Lydston, “Sexual crimes among the southern Negroes – Scientifically considered – An open correspondence”, Virginia Medical Monthly, Vol. XX, May 1893, cited in Ronald Hamowy, “Medicine and the crimination of sin: ‘Self-abuse’ in nineteenth century America”, Journal of Libertarian Studies, Vol. 1, 1977, p. 245. Further information on the efforts of white American medical men to forcibly circumcise Negro Americans is available on this site.
15. Elizabeth Blackwell, The human element in sex: Being a medical enquiry into the relation of sexual physiology to Christian morality (1884; 2nd edition, London, 1894), pp. 35-6
Elizabeth Blackwell (1821-1910) was the first woman in the United States to take a medical degree. She later practised in both the USA and Britain, where she played a significant role in the feminist campaign to repeal the Contagious Diseases Act during the 1880s. She also denounced masturbation and fornication but believed they should be controlled by moral instruction and personal willpower, not disabling surgery. See American National Biography (1999), Vol. 2
16. Thomas Szasz, The Manufacture of Madness (Paladin edn), p. 221)
17. “Should circumcision be done routinely?”, Medical Aspects of Human Sexuality, December 1967, p. 30
18. E. Chimenos-Kustner et al, “Appearance and culture: oral pathology associated with certain fashions (tattoos, piercing etc)”, Oral Medicine, Vol. 8, May-July 2003, pp. 197-206
19. Jonathan Wright, “The dawn of surgery: The ritual mutilations of primitive magic and circumcision”, New York Medical Journal, Vol. 17, January 1923, p. 103
20. “Routine neonatal circumcision: Symbol of the birth of the therapeutic state”, Journal of Medicine and Philosophy, Vol. 21, 1996, p. 143.
21. J.M Hutson, “Circumcision: A surgeon’s perspective", Journal of Medical Ethics, Vol. 30, 2004, pp. 238-40
22. S.K. Hellsten, “Rationalising circumcision: From tradition to fashion, from public health to individual freedom – Critical notes on the cultural persistence of the practice of genital mutilation", Journal of Medical Ethics, Vol. 30, 2004, pp. 248-53
23. M. Fox and M. Thomson, “A covenant with the status quo Male circumcision and the new BMA guidance to doctors”, Journal of Medical Ethics, Vol. 31, 2005, 463-69, p. 464; M. Fox and M. Thomson, “Short changed? The law and ethics of male circumcision”, International Journal of Children’s Rights, Vol. 13, 2005, 161-81
24. Anika Rahman and Nahid Toubia, Female genital Mutilation: A Guide to Laws and Policies Worldwide (London: Zed Press, 2000), cited in Kirsten Bell, “Genital cutting and western discourses on sexuality”, Medical Anthropology Quarterly, Vol. 19, 2005, p. 130
More on mutilationsFrom Ernest Crawley, The Mystic Rose: A Study of Primitive Marriage
While it is the functions and external organs connected with nutrition and sex that are most guarded, and the senses of taste and touch that are here most sensitive, yet the instinct to preserve and insulate from danger all the channels of sense is seen in savage custom. The insulation is effected sometimes by wearing amulets upon the external organs, sometimes by means of the painful process of tattooing, boring and scarification. It is erroneous to attribute these practise to the desire for ornament. There is ample evidence that “savage mutilation” is never due to this desire; the savage does not hold with the maxim, Il faut souffrir etre belle; on the contrary, he is extremely averse to pain, except for the purpose of preserving his life, health and strength. Accordingly, when we find that the mouth and lips, the teeth, nose, eyes, ears and genital organs are subject to such processes, we may infer that the object is to secure the safety of these sense organs, by what is practically a permanent amulet or charm.
The idea behind the mutilation of organs is complex. Let us take the common practice of piercing an organ, filing the teeth, knocking out the teeth, circumcision or perforation of the hymen. The fist part of the idea is to obviate possible difficulty of function, suggested by an apparent closure of the organ; this possibility of difficulty is to the savage a potentiality of evil, and is connected with the fear of doing a thing for the first time, a fear which creates a material dangerous substance attaching to the thing in question, and needing removal before contact can safely take place. Shortly after birth the Malays administer to the child “the mouth opener”: “first you take a green cocoa-nut, split it in halves, put a grain of salt inside one half of the shell, and give it to the child to drink, counting up to seven, and putting it up to the child’s mouth at the word seven”. This account is important as suggesting that the first taking of food, the first employment of the mouth, is a dangerous crisis. When we take into account the importance of food in savage life, and the care of the mouth and teeth resulting, also the fact that this knocking out of teeth, like the similar process of teeth-filing, is regularly performed at puberty, when as aarule there are certain food taboos removed, and a boy is initiated to “man’s food”, it is a fair conjecture that its object is to secure in some way the safety of that important function. Dr Skeat (W.W. Skeat, Malay Magic) was invariably told that the Malay practice of teeth-filing not only beautified, but preserved the teeth from decay. When a Dieri boy has had the teeth knocked out, he may not look at the men who performed the operation, or “his mouth would close up and he would be unable to eat”. (A.W. Howitt, “The Dieri and other kindred tribes of Central Australia, Journal of the Anthropological Institute, Vol. XX, 1891)
With the particular imaginary danger already mentioned, all danger of material contact of course combines, including that of disease in the wide range of reality and imagination with which early man regards disease. Amongst the Cadiacks a hole is bored through the septum of the child’s nose when it is washed after birth. These people also have the practice of piercing the septum in cases where venereal disease attacks the nose. The connection is obvious. The Yorubas call circumcision “the cutting that saves” (A.B. Ellis, The Yoruba-Speaking People of the Slave Coast of West Africa). Amongst the central Australians there is a causal connection between the practice of subincision and the common disease Erkincha. It is not, as has been proved, intended to prevent impregnation, nor does it have this result. The ceremony of head-biting performed on central Australian boys at puberty, is supposed to make the hair grow strong. Now, it is prevention of future harm, illness and weakness, and the transmission of strength and life that are one special object of ceremonies at puberty.
Again, it has been conclusively proved that circumcision does not prevent disease, (1) and it is probable that there was no sanitary intention in its origin, except such as forms part of the explanation here given. The ceremony amongst the Semites was originally “religious” in the primitive sense, but here, as elsewhere when the religious habit becomes rational, the fallacy of sanitary intention in circumcision became prominent, and may often have been the reason for the continuation of the practice.
The deleterious emanation from strange or new things is identical in theory with human emanations, not only from strange or handselled beings, but from characteristic parts of such and, in later thought, from such parts of one’s own personality. The dangerous emanation is any physical secretion religiously regarded, and its retention is prevented by cutting away separable parts which would easily harbour it, as the teeth retain morsels of food. This primitive notion is the same as with those of personal cleanliness and of the removal of separable parts of a tabooed person. Sir James Frazer points out the idea of destroying separable parts of tabooed persons; thus, in Rotti the first hair of a child is not his own, and unless cut off it will make him ill (2). When the part is cut off, there result the ideas, first of securing the safety of the rest by sacrificing a part, a practice well illustrated by the custom of cutting off a little finger; and secondly, of sacrificing such a part to a deity so as to compensate the ret by making it less “impure” or taboo. Thus, Sir A.B. Ellis infers that circumcision among the Yoruba and Ewe peoples is a sacrifice of a portion of the organ, which the god inspires, to ensure the well-being of the rest. The rite is there connected with the worship of Elegbra. And for the earlier notion, the Jews and Egyptians regarded circumcision as “cleansing”.
Circumcision and artificial hymen perforation thus originated in the intention both to obviate hylo-idealistic danger resulting from apparent closure, and to remove a separable part of a taboo organ, on the above-stated principles. This removal also explains the practice of excision. The other ideas follow later, and the safety of both the individual and of those who will have contact with him or her is the more necessary because the contact is with the other, the dangerous sex. As to the insertion of plugs and sticks and the like, in the nose, lips and ears, it is probable that the original object was to keep off evil from the organs by a mark, an idea connected with the widely spread belief that he attention of the evil influence is thus diverted from the organ as lightning is diverted from an object by the lightning rod.
from Chapter VI, Human Relations (Concluded)
1. J. Jacobs, “The racial characteristics of modern Jews”, Journal of the Anthropological Institute, Vol. XV, 1886
2. J.G. Frazer, The Golden Bough (1911-1915), Vol. III, p. 283