bodily mutilation

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bodily mutilation

Postby doug » Thu Nov 13, 2003 1:36 pm

These men want their foreskins back

Activists decry circumcision and offer 'restoration' process
By Jon Bonné
MSNBC
Oct. 1 — "I am covered and have overhang." R. Wayne Griffiths, 70 and a grandfather, is speaking frankly about his foreskin — which really is the only way one can speak on that topic. More to the point, he is gleefully describing the sensation of having his foreskin back after decades of living with a circumcised penis. "It's delightful," he says.
       AS HEAD OF the National Organization for Restoring Men, Griffiths spends his days advocating that circumcised men reclaim what he suggests is their birthright: a penis unmolded by the will of others.
       Medically popularized in the early 20th century, circumcision has become a routine option for newborn American boys. But a backlash has surfaced in recent years, often bolstered by conflicting medical data about the procedure's benefits. Out of that debate has emerged a tiny but growing movement of men who not only oppose circumcision, but want back what they consider taken from them. They want to regrow their foreskin.
       The notion doesn't pass many peoples' laugh test. But NORM and similar groups are quite serious about straightforwardly counseling men on how to restore this tender bit of flesh. As they portray it, circumcision comprises an insidious conspiracy; in performing an unnecessary procedure, doctors are either ignorant or greedy; hospitals simply look the other way; parents don't know any better and are hounded into consent.
       
'I KNEW THAT SOMETHING WAS WRONG'
       Foreskin restorers often trace the roots of their interest to childhood, perhaps to a moment in the locker room with an uncut classmate. "From the first time I noticed that a little boy was different than me, I knew that something was wrong with one of us ... and I assumed maybe it was him," says psychologist Jim Bigelow, author "The Joy of Uncircumcising," an authoritative text of sorts for restorers.
       That, in turn, could lead to shame. Born into an evangelical Christian family in 1933, Bigelow spent years as a boy trying to understand why he was circumcised — in part because he says the procedure left him with scars. "I figured I was born with something wrong with me and they had to fix it," he says. "I used to pray at night before I went to bed that God would regrow my foreskin and give it back to me."
       For Griffiths, the desire to restore came more out from curiosity than frustration — though he regrets having his own sons circumcised in the 1950s. But he acknowledges many restorers "are just absolutely, almost violently angry at what has been done to them."
       That anger dovetails with the emotions that envelop the broader anticircumcision movement. Groups that fight the practice often endorse restoration and some have urged men to sue their doctors for circumcising them. But they primarily are concerned with educating parents and doctors whom they argue are doing irreparable harm.
       "You cannot cut off normal, healthy sexually functioning tissue without cutting off normal, healthy sexual functioning," says Marilyn Milos, a registered nurse and director of NOCIRC, the National Organization of Circumcision Information Resource Centers. "It's a sexual issue, and it's a human rights issue."
       
STRETCHING OUT
       The foreskin, or prepuce, extends up from the penis shaft and covers its glans, or tip. It can protect the tender glans skin, and as men become sexually active it often serves as a buffer between the erect shaft and a partner's skin.
       Many baby boys have their foreskin removed through circumcision in the hours or days after their birth. Most are done in hospitals by doctors, though some are performed as religious rites. (Ritual circumcision exists in both the Jewish and Muslim religious traditions.) Some two-thirds of baby boys in the United States are estimated to undergo the procedure, a higher rate than most countries but down slightly from an estimated 80 percent in the 1970s.
       Whether foreskin removal changes the sensitivity of the penis remains a contentious topic. Those opposed to circumcision insist the extra skin makes a big difference, but a recent study by urologists found little difference in sensitivity in the penises of circumcised and uncircumcised men.
       As for bringing back a foreskin, those in the restoration movement describe two methods. They rarely discuss the first, perhaps because many harbor a deep distrust of doctors: skin tissue, usually from the scrotum, is surgically grafted to the penis shaft in a way that replicates the foreskin's shape and function.
       The other method essentially requires a man to stretch himself a new foreskin from his existing penis tissue. A variety of methods and devices help accomplish this — elastic bands, weighted metal containers, even special tape. Some are commercial products with names like P.U.D. (Penile Uncircumcision Device) and Tug Ahoy. Others are homemade with anything from silicon caulk to brass instrument mouthpieces. Several ounces of weights are sometimes added to speed the process.
       "Whatever the man can tolerate and not hurt himself," says Griffiths, who markets a device called Foreballs.
       All of these products basically distend the skin forward toward the glans and hold it in place to induce new cell growth, essentially forcing new skin to be created. Regrowth often takes years, with devices worn for 10 to 12 hours each day. Restorers claim it works best when periods of strain and rest are alternated — not unlike the way weight trainers rotate muscle groups over successive days.
       "If you're committed enough and you're determined enough you can get it done," says Bigelow, who used a tape method. "But it can be, for some men, a 5- or 6-year procedure."
       
SEEKING PLEASURE
       Of course, it's impossible to truly restore foreskin and restorers admit results are partial at best. Certain specialized nerve endings simply won't return. For example, researchers have described a "ridged band" just inside a natural foreskin's tip of specialized nerve endings known as Meissner's corpuscles, which help detect light touch.
       Instead, restorers focus on what they can bring back: revived friction on the penis shaft and what some claim is the "dekeratinization" of the glans: thicker skin peels off and leaves a tender layer beneath.
       Nonetheless, restorers speak with quiet joy about their new foreskins. They describe heightened sexual sensation — increased sensitivity for a man, less friction for his partner. They insist that the newly covered glans can become more sensitive.
       Before he was restored, Griffiths says, those qualities made him envious. "I had to just absolutely beat myself to death, so to speak, to get feeling, to get some pleasure," says Griffiths. "The intact man just goes on forever. He enjoys the trip."
       But the real value, restorers insist, is a new sense of dignity. Language used by restorers and other anticircumcision activists at times resembles that used to describe the healing process for female rape victims or women whose clitorises were cut off in "female circumcision" procedures.
       The rhetorical similarities are clearly intentional. Milos starkly describes male circumcision as "the torture and mutilation of infants."
       As such, advocates of foreskin restoration like to frame the subject as primal empowerment, mirrored in flesh.
       Exact numbers are a mystery, but NORM holds regular meetings around the San Francisco Bay area — part how-to sessions and part support group.
       Says Griffiths: "There's emotional healing that goes on for many, many men that says, 'I'm finally taking charge of my body ... I'm finally taking back what was taken from me without my consent.'"
       
'DON'T GO NEAR THEM'
       If restorers urge men to share the experience with loved ones, they are equally fervent when they argue it be done without a doctor's help. Most insist the medical community will be dismissive, if not outright hostile. On this point in particular, restorers reinforce the views of the broader anticircumcision movement.
       "Patients do call me and they want a doctor and I say: Don't go near them," says Dr. George Denniston, president of Doctors Opposing Circumcision. "They'll tell you you're crazy and you need psychiatric evaluation."
       Denniston and Milos both decry their experiences with medical circumcision, the training for which they describe as little more than an afterthought in obstetrics. The procedure, they argue, amounts to a violation of the "first, do no harm" precepts of modern medicine; its popularity in the medical community means parents can't possibly make informed decisions.
       
A MEDICAL PUZZLE
       Data on the medical value of circumcision largely remains inconclusive. Some studies suggest it improves hygiene and reduces incidence of STDs; other studies have found health problems associated with the procedure.

       In the past several years, medical groups have equivocated. Notably, the American Academy of Pediatrics reevaluated the practice in 1998 and essentially refused to endorse it. The American Medical Association came to the same conclusion a year later, noting circumcision was a choice often made "on social and cultural rather than medical concerns."
       Both groups underscored ethical precepts surrounding circumcision: anesthesia is essential, parents should take an active role in deciding whether to have it done and doctors need to accurately state the medical logic on either side.
       Circumcision has its own fervent advocates. Dr. Edgar Schoen, a longtime pediatrician and researcher in Oakland, Calif., not only remains unswayed about the procedure's benefits but also serves as a foil of sorts to the anticircumcisers. As author of the AAP's previous position on circumcision in 1989, which largely praised its benefits, he remains what could charitably be called dismissive of restoration.
       "It's not a serious medical procedure," he says. "The people who are involved in this have a lot of problems that are not related to the foreskin."
       As for the stretching process, few medical concerns are raised since it mimics well-tested methods to grow skin. "But you've got to spend a lot of time on stretching," says Dr. Ira Sharlip, a San Francisco urologist and spokesman for the American Urological Association. "It's not a very practical thing to do."
       Sharlip says a patient may occasionally inquire about surgical restoration — which really amounts to cosmetic surgery — but few urologists have regularly dealt with the issue. "The great majority of men have no problems with having been circumcised," he says, even if fewer parents are now choosing it for their children.
       Foreskin restorers see it differently. They believe most men are simply too afraid to address an unquestionably awkward topic.
       "Most men who do suffer, who are troubled by what was done to them, suffer in silence," says Bigelow. "If we didn't have what is this foolish tradition in our culture, we wouldn't have to do this."

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Postby doug » Tue Jan 24, 2006 11:18 pm

Should I have my baby boy circumcised?
Dr. Judith Reichman looks at the pros and cons of the procedure and offers recommendations to expecting moms
By Judith Reichman, M.D.
Dr. Judith Reichman'Today' show contributor
Q: I'm pregnant and expecting a boy. I'm still undecided as to whether I should have him circumcised. What can you tell me?
A: Ultimately, it's a personal decision, but the majority of parents do decide to have it done. Between 1997 and 2000, 61 percent of all newborn males in the U.S. were circumcised. Numerous studies have shown that circumcision can reduce the risk of urinary tract infections in male infants, and in later life can decrease the risk of penile cancer, penile inflammation and transmission of some STDs.
One study of 58,000 infants showed that the rate of hospitalization for bladder infections among circumcised males was 1.9 versus 7.0 for uncircumcised males.
Another recent study out of South Africa involving 3,000 men demonstrated that circumcision of adult men (ouch!) resulted in a decreased risk of infection with HIV after the men had intercourse with infected women. Other studies have looked at HIV risk in men who were circumcised as infants, and a review of 30 such studies found that uncircumcised men were 1.5 to 8.5 times more likely to contract HIV than those who had been circumcised.
Because I'm a gynecologist, I am also inclined to consider the effect of circumcision on the future health of women. Female partners of circumcised men have been shown to have a decreased incidence of cervical cancer. This may be due to reduction in risk of persistent human papillomavirus (HPV) among circumcised men.
Having said all this, I also want to mention the possible side effects of circumcision. The chief one is pain, followed by bleeding and infection. Some vocal anti-circumcision groups are highly incensed by the fact that a little baby cannot consent to the procedure. However, most children don't consent to any of their healthcare; instead, they "rely" on their parents.

The official word of the American College of Pediatrics is that "existing scientific evidence demonstrates potential medical benefits to newborn circumcision, but the data are not sufficient to recommend routine neonatal circumcision."
The American College of Gynecologists states the same, but adds that analgesia (usually with an anesthetic that is injected into the nerve supplying the penis) should be used routinely during the procedure.
Dr. Reichman's Bottom Line: Religion and "what daddy looks like down there" greatly influence parents' decisions about circumcision. But health concerns should also play a role: you have to consider the baby's current and long-term health, plus the health of his potential future partner. I personally would go for it. Then again, I don't have a penis.

Dr. Judith Reichman, the "Today" show's medical contributor on women's health, has practiced obstetrics and gynecology for more than 20 years. You will find many answers to your questions in her latest book, "Slow Your Clock Down: The Complete Guide to a Healthy, Younger You," which is now available in paperback. It is published by William Morrow, a division of HarperCollins.
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Postby doug » Wed Dec 13, 2006 9:50 am

Health officials back circumcision in AIDS fight

NBC: Top U.S. agency says procedure most effective way to stop HIV

NBC News
Robert Bazell
Chief science and health correspondent
Circumcising adult men is an effective way to stop transmission of the virus that causes AIDS. NBC News has learned that the National Institutes of Health will announce at Noon ET Wednesday that two clinical trials in Africa have been stopped because an independent monitoring board determined the treatment was so effective that it would be unethical to continue the experiment.

The NIH has been sponsoring two trials - one with 5,000 men ages 18 to 49 in Uganda and a second with 2,784 men of the same age in Kenya. Half the men voluntarily underwent circumcision. The men were then monitored for about two years. Far more of the uncircumcised men became infected with HIV.

This finding appears to apply only to heterosexual transmission which is the main mode of spread in Africa. Officials estimate that at least 25 million people in Africa are currently infected with the AIDS virus.

These findings present enormous ethical and policy decisions which have yet to be addressed. But scientists say the reduction of infection is so much that the findings cannot be ignored.

© 2006 MSNBC Interactive
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Postby doug » Tue Jun 19, 2007 1:12 am

Circumcision’s decline pinned on immigration

Changing attitudes about the body also play a role in the trend, experts say

Ruth Katz, 38, holds her sons Julian Rapaport, 2 (left), and 3-month-old Emanuel Rapaport. She and her husband, Michael Rapaport, were astonished when the teacher in their birthing class described circumcision as "immoral" and "not consensual." Both boys are circumcised. "
SAN FRANCISCO - On the eighth day of her son’s life, Julia Query welcomed friends and family to celebrate his birth and honor their Jewish heritage.

But there was no crying, no scalpel, no blood, no “mohel” — the person who traditionally performs ritual circumcisions in the Jewish faith. In fact, Elijah Rose’s “bris” differed markedly from the ceremony long used to initiate Jewish boys into a covenant with God: There was no circumcision.

“I knew before I was even pregnant that I would not circumcise,” said Query, 39, a San Francisco filmmaker whose son was born in 2002. “It’s not like you’re just cutting a piece of paper off a pad — there’s no ‘cut here’ line. It’s not made to be cut off, and I would never, ever do that to my baby.”

Query is among a growing number of American parents refusing circumcision, in which the foreskin is removed from the penis.

According to a study by the National Health and Social Life Survey, the U.S. circumcision rate peaked at nearly 90 percent in the early 1960s but began dropping in the ‘70s. By 2004, the most recent year for which government figures are available, about 57 percent of all male newborns delivered in hospitals were circumcised. In some states, the rate is well below 50 percent.

A heated issue
Experts say immigration patterns play the biggest role in the decline, which is steepest in Western states with big populations from Asian and Latin American countries where circumcision is uncommon. The trend has also accompanied a change in Americans’ attitudes toward medicine and their bodies.

“The rates of drug-free labor and breast-feeding all rose during the 1980s, while the initial declines in male circumcision rates began during the 1980s as well,” said Katharine Barrett, an anthropology lecturer at Stanford University. “It may have been part and parcel of the wider effort to reclaim bodies — adult female and infant male — from unnecessary and potentially harmful medical interventions.”

Circumcision remains the nation’s most common surgery, and the United States is still one of the few developed countries where a majority of baby boys are circumcised. But circumcision is a heated issue and the subject of vehemently pro and anti Web sites.

“We were all circumcised when I was born,” said R. Louis Schultz, a 79-year-old New Yorker and author of “Out in the Open: The Complete Male Pelvis.” “People thought it could ward off masturbation or disease, and those funny attitudes have really changed. Now people are saying, ‘Why do it?”’

Many doctors still recommend circumcision because of some evidence that it reduces the risk of penile cancer, urinary tract infections, HIV and perhaps other sexual transmitted diseases. Many major insurance companies still cover it, and many hospitals offer it free for newborns.

CONTINUED: Varying circumcision rates


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Postby doug » Tue Jun 19, 2007 1:18 am

Circumcision’s decline pinned on immigration

Rates vary
But circumcision opponents say the medical benefits are dubious. Penile cancer, for example, is extremely rare. Since 1999, the American Academy of Pediatrics has not endorsed routine circumcision.

The debate escalated in February, when studies found that heterosexual men in Africa who were circumcised had HIV infection rates up to 60 percent lower than uncircumcised men. Because of those studies, the American Academy of Pediatrics is taking another look at its policy.

About one in three males worldwide is circumcised. In the United States, the rates vary widely by region.

It is most prevalent in the upper Midwest. In 2004, according to data compiled by the federal Agency for Healthcare Research and Quality, more than 79 percent of newborn boys in the Midwest were circumcised before leaving the hospital. Michigan and Kentucky had the highest rates, at 85 percent.

In the fast-growing West, the rate declined dramatically — from 64 percent in 1979 to just under 32 percent in 2004.


In California, the rate of hospital circumcisions among newborns was 21 percent. California — which has more immigrants than any other state — had the lowest circumcision rate in the study, which had comprehensive data on only 27 states.

The decline coincides with rising immigration from Asia and Latin America.

“If you have a solid Victorian, American background, routine circumcision is not unusual,” said Carol A. Miller, clinical professor of pediatrics at University of California at San Francisco.

Arguing for tradition
Circumcision was uncommon in 35-year-old Usha Toland’s family, which has roots in India, Sri Lanka and Malaysia. When her son, Reynick, was born in 2005 in San Francisco, her husband, Chris, a white man from Southern California, assumed his son would be circumcised. But after the couple read Web sites and medical literature, they decided against the surgery.

“Usha probably would have understood if I really wanted to have Reynick circumcised,” said Chris, a 42-year-old advertising executive. “But ultimately I didn’t want to bring pain to the child unnecessarily. We wanted to do things the way God or the universe meant them to be.”

Many parents fear their boys would feel awkward in the locker room if they were not circumcised.

“I like the idea of him looking like his dad — that’s the most important thing for me,” said Denise Milito Stockwell, 40, an artist in Chicago who had her 15-month-old son, Harlan, circumcised. “It wasn’t traumatic for him in any way. He came back from the event sleeping.”

Circumcision is still common in many Jewish and Muslim communities.

Ruth Katz, 38, of San Francisco had both her sons circumcised at brises. She and her husband, Michael Rapaport, were astonished when the teacher in their birthing class described circumcision as “immoral” and “not consensual.”

“The edict to have your son circumcised was the first covenant with God — the first challenge to being Jewish,” said Katz, pursuing a master’s degree in business administration. “I am a progressive person and think a lot about human rights issues, but I have never questioned this.”

FACT FILE Should your son be circumcised?

• Reasons for circumcision
• Reasons against circumcision

Though studies have shown some medical benefits to circumcision, the American Academy of Pediatrics says these benefits are not sufficient to recommend routine circumcision for all infant boys. When considering whether circumcision is right for your son, the AAP urges parents to consider the benefits and risks of the procedure.



Source: American Academy of Pediatrics



© 2007 The Associated Press. All rights reserved.
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Postby doug » Tue Jun 19, 2007 1:22 am

Live Vote

Do you think newborn boys should be circumcised? * 7889 responses

Yes
54%

No
46%

If yes, why? * 4433 responses

Religious beliefs.
5.7%

Conformity. You wouldn't want a boy to look different from his father or other kids in the locker room.
5.6%

Health reasons. It prevents diseases and it's cleaner.
49%

All of the above.
35%

Other.
5.1%

If no, why? * 3764 responses

The medical reasons aren't compelling. And even if they were, doctors don't normally cut off human tissue from infants to prevent potential health issues years later.
16%

It's unethical. Circumcision is a medical procedure performed on a non-consenting human. Boys should be able to decide for themselves when they grow up.
8.6%

It's cruel. Why are we putting babies through this?
4.3%

All of the above.
65%

Other.
5.9%

Not a scientific survey. Results may not total 100% due to rounding.

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Postby doug » Tue Jun 19, 2007 1:24 am

• Reasons for circumcision

A lower risk of urinary tract infections (UTIs). A circumcised infant boy has about a 1 in 1,000 chance of developing a UTI in the first year of life, compared with a 1 in 100 chance for an uncircumcised boy.

A lower risk of developing penile cancer. However, this type of cancer is very rare in both circumcised and uncircumcised males.

A lower risk of contracting sexually transmitted diseases (STDs), including HIV, the AIDS virus.

Prevention of foreskin infections.

Prevention of phimosis, a condition in uncircumcised males that makes foreskin retraction impossible.

Easier genital hygiene.


Source: American Academy of Pediatrics

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Postby doug » Tue Jun 19, 2007 1:26 am

• Reasons against circumcision

As with any operation, circumcision has some surgical risks. Complications from circumcision are rare and usually minor. They may include bleeding, infection, cutting the foreskin too short or too long, and improper healing.

When the foreskin is removed, the tip of the penis may become irritated and cause the opening of the penis to become too small. This can cause urination problems that may need to be surgically corrected.

Circumcision may make the tip of the penis less sensitive, causing a decrease in sexual pleasure later in life.

While uncircumcised boys may have a higher risk of urinary tract infections, STDs and penile cancer, they can be taught proper hygiene to decrease these risks.


Source: American Academy of Pediatrics • Print this

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Postby doug » Tue Jul 03, 2007 3:21 am

Death spurs Egypt to ban female circumcision

12-year-old died of anesthesia overdose during $9 procedure at illegal clinic
By CAIRO, Egypt
The death of a 12-year-old Egyptian girl at the hands of a doctor performing female circumcision has sparked a public outcry and prompted health and religious authorities to ban the practice.

The girl, Badour Shaker, died this month while undergoing the procedure in an illegal clinic in the southern town of Maghagh. Her mother, Zeniab Abdel Ghani, told the Al-Masry Al-Youm newspaper that she paid about $9 to a female physician to perform the procedure.

The mother also told the paper the doctor tried to bribe her to withdraw a lawsuit accusing the physician of murdering her daughter, in return for $3,000, but she refused.

A forensic inquiry into the case showed the girl’s death was caused by an anesthesia overdose.

The case sparked widespread condemnation of female circumcision, or genital mutilation, and was closely followed in Egyptian newspapers, which also reported the girl had passed out sweets to pupils in her class earlier on the day of her death, to celebrate her good grades.

It also evoked memories of a 1995 CNN television documentary depicting a barber circumcising a 10-year-old girl in a Cairo slum.

No penalty specified
On Thursday, the Egyptian Health Ministry issued a decree stating that it is “prohibited for any doctors, nurses, or any other person to carry out any cut of, flattening or modification of any natural part of the female reproductive system, either in government hospitals, nongovernment hospitals or any other places.”

It warned that violators would be punished, but did not specify the penalty. The ban is not as enforceable as a law, which requires passage in the national legislature.

Female genital mutilation usually involves the removal of the clitoris and other parts of female genitalia. Those who practice it say it tames a girl’s sexual desire and maintains her honor.

It is practiced by Muslims and Christians alike, deeply rooted in the Nile Valley region and parts of sub-Saharan African, and is also done in Yemen and Oman.

The ban by the Health Ministry marks a return to a 1950s government order prohibiting hospitals and doctors from carrying out the procedure.

After that order, the practice continued in Egypt, mostly carried out by barbers, midwives and other amateurs. The order was reversed in 1995, shortly after the CNN documentary, with only medical staff permitted to perform the procedure.

Although the documentary embarrassed Cairo internationally, it failed to propel the parliament to pass legislation penalizing female circumcision.

Many have had procedure
A 2003 survey by UNICEF said that 97 percent of married women in Egypt have undergone genital mutilation.

A recent study by Egypt’s Ministry of Health and Population found that 50.3 percent of girls between the age of 10-18 years have been circumcised.

After the girl’s death, the country’s supreme religious authorities stressed that Islam is against female circumcision.

“Its prohibited, prohibited, prohibited,” Grand Mufti Ali Gomaa said on the privately owned al-Mahwar network.

While top clerics insist the practice has nothing to do with Islam, parents, especially in villages and Cairo slums, believe they are helping their daughters. They think circumcision is necessary for cleanliness and to protect a girl’s virginity before marriage.

Opponents say girls can bleed to death, suffer chronic urinary infections and have life-threatening complications in childbirth as a result of the procedure.

The Al-Masry Al-Youm daily reported the doctor in Shaker’s case denied allegations of malpractice and said the girl was in a “bad condition” to start with, and was immediately transferred to a regular hospital where she died. The doctor was not identified.

Egypt’s renowned feminist activist, Nawal el-Saadawi, 76, who has published a biography on her own experience with circumcision, wrote: “Badour, did you have to die for some light to shine in the dark minds? Did you have to pay with your dear life a price ... for doctors and clerics to learn that the right religion doesn’t cut children’s organs.”

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Postby doug » Sat Dec 01, 2007 9:05 pm

Reporter gets circumcised to fight AIDS

Radio program strikes chord in Zambia, where frank talk about HIV is rare

In this image provided by the British Broadcasting Corp., Kennedy Gondwe, a southern African radio correspondent, is circumcised at a health center in Zambia's capital Lusaka.
LUSAKA, Zambia - A southern African radio correspondent has been receiving a flood of text messages and cell phone calls — some from offended listeners and readers.

All because Kennedy Gondwe chose to get circumcised to protect himself from AIDS, and took the British Broadcasting Corp.'s radio and Web audience through the procedure with him Friday.

A study published in the Lancet medical journal in February concluded that the findings of three major trials — in Kenya, South Africa and Uganda — show that circumcision can significantly reduce men's chances of contracting the virus that causes AIDS. U.N. health agencies followed up with an endorsement, but stressed that the procedure offers only partial protection and that abstinence, condom use, having few partners and delaying the first sexual experience are all among the steps that need to be encouraged.

Frank talk about AIDS and prevention methods, is still rare in Gondwe's Zambia, where HIV prevalence is 16 percent. That's what made Gondwe's public testimony Friday, the eve of World AIDS Day, even more striking.

A prominent Zambian journalist, Mildred Mpundu, died in November after going public with her HIV-positive status earlier this year and urging her fellow journalists to get tested.

Gondwe, who says he undergoes an AIDS test several times a year, said in an interview Friday he finds it "sad" that more people don't talk about circumcision as a prevention method.

"We as journalists also have a role to play in the fight against the disease," he said.

Gondwe, on the radio piece and in an online diary Friday, recounts his Nov. 22 procedure. Listeners can hear him gasp as a doctor injects him with a local anesthetic, but he assures them the procedure is otherwise painless. He was up, walking to his car and driving himself home soon afterward.

Dr. Jan van den Ende, a microbiologist at Toga Laboratory, which provides AIDS testing and counseling in neighboring South Africa, the country hardest hit by AIDS, said it was not entirely clear why circumcision provides the protection it does. He described it as a relatively simple and painless procedure, something Gondwe's story demonstrated.

While one admiring Web reader from Zambia told Gondwe he would soon follow his example, the reporter said others told him they were offended. Gondwe's Tumbuka people of Zambia's Northern Province do not embrace circumcision, he said.

David Alnwick, a senior AIDS adviser to UNICEF based in Nairobi, said UNICEF supports educating people that "circumcised men are relatively well protected against HIV." But he said there was a danger of creating demand that the world's poorest continent is not now prepared to meet.

Alnwick said Zambia has a long waiting list of men who want to be circumcised and only a few centers providing the service. But he says he expects governments to come aboard across the continent and international donors to provide funding.

© 2007 The Associated Press. All rights reserved.
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Postby doug » Fri Mar 07, 2008 11:13 am

Ex-model missing in Brussels
She hasn't been seen since early Wednesday morning, her manager says

UN special envoy and ex-model Waris Dirie arrives on the red carpet at the charity gala "Cinema for Peace" in Berlin, Germany, in early February.
The Associated Press
BRUSSELS, Belgium - Waris Dirie, a former model turned women's rights campaigner, has gone missing in Brussels, her manager said.

She has not been seen since the early hours of Wednesday morning when police saw her getting into a taxi after a mix-up over a hotel room, Walter Lutschinger said in a telephone interview.

"I'm really very scared," he said.

Somali-born Dirie gained international fame as a model posing in Chanel ads and acting in a James Bond film before launching her campaign against female genital mutilation 1996.

News of Dirie's disappearance comes a week after French police said they had found the body of another former model of African origin who had campaigned against female genital mutilation. Guinean-born Katoucha Niane was discovered floating in the River Seine in Paris.

The French police said an autopsy showed no signs of foul play, raising the possibility that she may have fallen accidentally into the river.

Altercation at hotel
Belgian police launched an official missing persons appeal for Dirie, asking the public for information.

The police, who gave her name as Waris Dahir Jones, said the 43-year-old was last seen outside a luxury hotel in downtown Brussels. They said she was wearing brown pants, a violet hat and a black-and-white poncho-style jacket. They said they were also looking for the taxi driver who took her from the area between 3 a.m. and 4 a.m.

Dirie, who now lives in Vienna, was due to speak to two conferences on women's rights organized by the European Union in Brussels this week, including one Thursday attended by U.S. Secretary of State Condoleezza Rice.

Lutschinger said Dirie had been involved in an altercation in a hotel reception area after a taxi driver took her to the wrong branch of the Sofitel hotel chain after a visit to a night club. The police were called and drove Dirie around Brussels looking for the correct hotel because she had she apparently forgotten where she was staying.

At one hotel, while staff and police were checking for her name on a computer, Lutschinger said police told him Dirie walked out and climbed into a taxi that drove away. He said hotel staff told him Dirie had said she was going to buy cigarettes.

Lutschinger said he thought she was carrying little money and no identification documents or cell phone when she vanished. As far as he knows she has no friends in Brussels, a city Lutschinger said she had only visited once before.

"No telephone calls, nothing; she disappeared and we have no idea what happened to her," he told The Associated Press. "We don't know if she had money because actually she doesn't take money or little money with her because we are always traveling with her."

EU officials said they had expressed concern when she did not show up Thursday at the conference and had been in touch with the police, but had not had any news of Dirie's whereabouts.

Shocked the world
Dirie is an Austrian citizen. "Our embassy in Brussels is in close cooperation with the Brussels police and state prosecutor ... they are trying to clarify the situation," said Peter Launsky-Tieffenthal, a spokesman for the Austrian Foreign Ministry in Vienna.

The U.N. office in Brussels said they had no information about where she might be.

Dirie was due to travel to the Netherlands to receive an award for her campaigning Friday in the town of Kerkrade.

Dirie's description of how she had to endure having her genitals sliced off with a dirty razor blade without anesthesia, and then stitched together, shocked a world that knew her from glossy fashion magazine covers, Chanel perfume ads and her role in "The Living Daylights," a 1987 James Bond film.

She chronicled her own experience in "Desert Flower" and three sequels, "Desert Dawn," "Desert Children" and "Nomad's Daughter." She served as a U.N. goodwill ambassador to fight the practice.

"There are millions of children — young, hopeless, desperate — who need help, a voice, somebody, somewhere," she told The Associated Press in a 2005 interview.



Copyright 2008 The Associated Press. All rights reserved.
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FGM

Postby doug » Sat Aug 16, 2008 10:48 am

Female genital cutting
From Wikipedia, the free encyclopedia

Female genital cutting (FGC), also known as female genital mutilation (FGM), female circumcision or female genital mutilation/cutting (FGM/C), refers to "all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs whether for cultural, religious or other non-therapeutic reasons."[1] The term is almost exclusively used to describe traditional, cultural, and religious procedures where parents must give consent, due to the minor age of the subject, rather than to procedures generally done with self-consent (such as labiaplasty and vaginoplasty).[2][3][4] It also generally does not refer to procedures used in gender reassignment surgery, and the genital modification of intersexuals.[5][6][7]

FGC is practiced throughout the world, with the practice concentrated most heavily in Africa. Its practice is extremely controversial. Opposition is motivated by concerns regarding the consent (or lack thereof, in most cases) of the patient, and subsequently the safety and long-term consequences of the procedures. In the past several decades, there have been many concentrated efforts by the World Health Organization (WHO) to end the practice of FGC. The WHO separates FGC procedures into four categories (see World Health Organization categorization below).

Contents
1 History of terminology
1.1 Female circumcision
1.2 Female genital mutilation
1.3 Female genital cutting
2 FGC Procedures
3 World Health Organization categorization
3.1 Type I
3.2 Type II
3.3 Type III: Infibulation with excision
3.4 Type IV: Other types
4 Prevalence
5 Cultural and religious aspects
5.1 Islam
5.1.1 Sunni View
5.2 Judaism
5.3 Christianity
6 Medical consequences
7 Sexual consequences
8 Attempts to end the practice of FGC
9 Laws and prevalence
10 See also
11 References
12 Further reading
12.1 Bibliography
12.2 Print
13 External links



History of terminology
Different terms are used to describe female genital surgery and other such procedures. The procedures were once commonly referred to as female circumcision (FC), but the terms female genital mutilation (FGM) and female genital cutting (FGC) are now dominant throughout the international community. Opponents of the practice often use the term female genital mutilation, whereas groups that oppose the stigma of the word "mutilation" prefer to use the term female genital cutting. A few organizations have started using the combined term female genital mutilation/cutting (FGM/C). All three terms are currently still actively used.


Female circumcision
Several dictionaries, including medical dictionaries, define the word circumcision as applicable to some procedures performed on females.[8][9][10] Morison et al. uses the FGC term for these procedures.[11] Cook states that historically, the term female circumcision was used, but that "this procedure in whatever form it is practised is not at all analogous to male circumcision and so the term 'female circumcision' gave way to the term 'female genital mutilation'"[12] Shell-Duncan states that the term female circumcision is a euphemism for a variety of procedures for altering the female genitalia.[13] Toubia argues that the term female circumcision "implies a fallacious analogy to non-mutilating male circumcision".[14]


Female genital mutilation
The term female genital mutilation gained growing support in the late 1970s. The word "mutilation" not only established clear linguistic distinction from male circumcision, but it also emphasized the gravity of the act. In 1990, this term was adopted at the third conference of the Inter-African Committee on Traditional Practices Affecting the Health of Women and Children (IAC) in Addis Ababa. In 1991, the World Health Organization (WHO), a specialized agency of the United Nations (UN), recommended that the UN adopt this terminology; subsequently, it has been widely used in UN documents.[15]

In this context, the term female circumcision was thus predominantly replaced by the term female genital mutilation:

The extensive literature on the subject, the support of international organizations, and the emergence of local groups working against the continuation practices appear to suggest that an international consensus has been reached. The terminology used to refer to these surgeries has changed, and the clearly disapproving and powerfully evocative expression of "female genital mutilation" has now all but replaced the possibly inaccurate, but relatively less value laden-term of "female circumcision".[16]


Female genital cutting
Because the term female genital mutilation has been criticized for increasing the stigma associated with female genital surgery, some groups have proposed an alteration, substituting the word "cutting" for "mutilation." According to a joint WHO/UNICEF/UNFPA statement, the use of the word "mutilation" reinforces the idea that this practice is a violation of the human rights of girls and women, and thereby helps promote national and international advocacy towards its abandonment. They state that, at the community level, however, the term can be problematic; and that local languages generally use the less judgmental "cutting" to describe the practice. They also feel that parents resent the suggestion that they are "mutilating" their daughters. In this spirit, in 1999, the UN Special Rapporteur on Traditional Practices called for tact and patience regarding activities in this area and drew attention to the risk of "demonizing" certain cultures, religions, and communities. As a result, the term "cutting" has increasingly come to be used to avoid alienating communities.[17]

In 1996, the Uganda-based initiative REACH (Reproductive, Educative, And Community Health) began using the term "FGC", observing that "FGM" may "imply excessive judgment by outsiders as well as insensitivity toward individuals who have undergone some form of genital excision."[18] The UN uses "FGM" in official documents, while some of its agencies, such as the UN Population Fund, use both the terms "FGM" and "FGC".[19][20]


FGC Procedures
FGC consists of several distinct procedures. Their severity is often viewed as dependent on how much genital tissue is cut away.


World Health Organization categorization
The WHO uses the term Female Genital Mutilation, and classifies FGM into four major types[21] (see Diagram 1), although there is some debate as to whether all common forms of FGC fit into these four categories, as well as issues with the reliability of reported data.[22]


Diagram 1:This image shows the different types of FGC and how they differ to the normal female anatomy.
[edit] Type I
The WHO defines Type I FGM as the partial or total removal of the clitoris (clitoridectomy),and/or the prepuce removal clitoral hood, see Diagram 1B. When it is important to distinguish between the major variations of Type I mutilation, the following subdivisions are proposed: Type Ia, removal of the clitoral hood or prepuce only; Type Ib, removal of the clitoris with the prepuce.[21] In the context of women who seek out labiaplasty, Stern opposes removal of the clitoral hood and points to potential scarring and nerve damage.[23]


Type II
The WHO's definition of Type II FGM is "partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (excision). When it is important to distinguish between the major variations that have been documented, the following subdivisions are proposed: Type IIa, removal of the labia minora only; Type IIb, partial or total removal of the clitoris and the labia minora; Type IIc, partial or total removal of the clitoris, the labia minora and the labia majora. Note also that, in French, the term ‘excision’ is often used as a general term covering all types of female genital mutilation.[21]


Type III: Infibulation with excision
The WHO defines Type III FGC as narrowing of the vaginal orifice with creation of a covering seal by cutting and appositioning the labia minora and/or the labia majora, with or without excision of the clitoris (infibulation)."[1] It is the most extensive form of FGM, and accounts for about 10% of all FGC procedures described from Africa.[24] Infibulation is also known as "pharaonic circumcision."[25]

In a study of infibulation in the Horn of Africa, Pieters observed that the procedure involves extensive tissue removal of the external genitalia, including all of the labia minora and the inside of the labia majora. The labia majora are then held together using thorns or stitching. In some cases the girl's legs have been tied together for two to six weeks, to prevent her from moving and to allow the healing of the two sides of the vulva. Nothing remains but the walls of flesh from the pubis down to the anus, with the exception of an opening at the inferior portion of the vulva to allow urine and menstrual blood to pass through, see Diagram 1D. Generally, a practitioner deemed to have the necessary skill carries out this procedure, and a local anesthetic is used. However, when carried out "in the bush," infibulation is often performed by an elderly matron or midwife of the village, with no anesthesia used.[26]

A reverse infibulation can be performed to allow for sexual intercourse or when undergoing labor, or by female relatives, whose responsibility it is to inspect the wound every few weeks and open it some more if necessary. During childbirth, the enlargement is too small to allow vaginal delivery, and so the infibulation is opened completely and may be restored after delivery. Again, the legs are sometimes tied together to allow the wound to heal. When childbirth takes place in a hospital, the surgeons may preserve the infibulation by enlarging the vagina with deep episiotomies. Afterwards, the patient may insist that her vulva be closed again.[26]

This practice increases the occurrence of medical complications due to a lack of modern medicine and surgical practices.[citation needed]

A five-year study of 300 women and 100 men in Sudan found that "sexual desire, pleasure, and orgasm are experienced by the majority of women who have been subjected to this extreme sexual mutilation, in spite of their being culturally bound to hide these experiences."[27]

Most advocates of the practice continue to perform the procedure in adherence to standards of beauty that are very different from those in the west. Many infibulated women will contend that the pleasure their partners receive due to this procedure is a definitive part of a successful marriage and enjoyable sex life.[citation needed]


Type IV: Other types
There are other forms of FGM, collectively referred to as Type IV, that may not involve tissue removal. The WHO defines Type IV FGC as "all other harmful procedures to the female genitalia for non-medical purposes, for example, pricking, piercing, incising, scraping and cauterization."[21] This includes a diverse range of practices, such as pricking the clitoris with needles, burning or scarring the genitals as well as ripping or tearing of the vagina.[21] Type IV is found primarily among isolated ethnic groups as well as in combination with other types.[citation needed]


Prevalence
Amnesty International estimates that over 130 million women worldwide have been affected by some form of FGC, with over 2 million procedures being performed every year. FGC is mainly practiced in African countries. It is common in a band that stretches from Senegal in West Africa to Ethiopia on the East coast, as well as from Egypt in the north to Tanzania in the south; see Map. It is also practiced by some groups in the Arabian peninsula. The country where FGC is most prevalent is Egypt, followed by Sudan, Ethiopia, and Mali. Egypt recently passed a law banning FGC.[28]


Map: Estimated Prevalence of Female Genital Cutting (FGC) in Africa. Data based on uncertain estimates.Whilst FGC is widely practiced out in the open by Africans of varied faiths, it is practiced in secrecy in some parts of the Middle East. In the Arabian peninsula, Types I and II FGC is usually performed, often referred to as Sunna circumcision especially among Arabs (ethnic groups of African descent are more likely to prefer infibulation). The practice occurs particularly in northern Saudi Arabia, southern Jordan, and Iraq. In the Iraqi village of Hasira, a recent study found that 60 percent of the women and girls reported having undergone FGC. Prior to the study, there had been no solid proof of the prevalence of the practice. There is also circumstantial evidence to suggest that FGC is practiced in Syria, western Iran, and southern Turkey.[29] In Oman, a few communities still practice FGC; however, experts believe that the number of such cases is small and declining annually. In the United Arab Emirates and Saudi Arabia, it is practiced mainly among foreign workers from East Africa and the Nile Valley.

The practice can also be found among a few ethnic groups in South America and very rarely in India (Dawoodi Bohra community[30]). In Indonesia, the practice is not uncommon among the country's rural women; almost all are Type I or Type IV, the latter usually involving the pricking of blood release. Sometimes the procedures are merely symbolic, and no actual cutting is done.[31]

As a result of immigration, the practice has also spread to Europe, Australia and the United States. Some tradition-minded families have their daughters undergo FGC whilst on vacation in their home countries. As Western governments become more aware of FGC, legislation has come into effect in many countries to make the practice of FGC a criminal offense. In 2006, Khalid Adem became the first man in the United States to be prosecuted for mutilating his daughter.


Cultural and religious aspects

The traditional cultural practice of FGC predates both Islam and Christianity. A Greek papyrus from 163 B.C. mentions girls in Egypt undergoing circumcision and it is widely accepted to have originated in Egypt and the Nile valley at the time of the Pharaohs. Evidence from mummies have shown both Type I and Type III FGC present.[32] While the spread of the practice of FGC is unknown, the procedure is now practiced among Muslims, Christians, and Animists.[33]

Although FGC is practiced within particular religious sub-cultures, FGC transcends religion as it is primarily a cultural practice.[34][35][36] UNICEF stated that when "looking at religion independently, it is not possible to establish a general association with FGM/C status."[37] The arguments used to justify FGC vary; they range from health-related to social benefits:[38]

maintenance of cleanliness
maintenance of good health
preservation of virginity
enhancement of fertility
prevention of promiscuity
increase of matrimonial opportunities
pursuance of aesthetics
improvement of male sexual performance and pleasure
promotion of social and political cohesion
Medical justifications offered by cultural tradition are regarded by scientists and doctors as unsubstantiated. Some African societies consider FGC part of maintaining cleanliness as it removes secreting parts of the genitalia. Vaginal secretions, in reality, play a critical part in maintaining female health. The Mossi of Burkina Faso and the Ibos of Nigeria believe that babies die if they touch the clitoris during birth[citation needed]. In some areas of Africa, there exists the belief that a newborn child has elements of both sexes. In the male body the foreskin of the penis is considered to be the female element. In the female body the clitoris is considered to be the male element. Hence when the adolescent is reaching puberty, these elements are removed to make the indication of sex clearer.[39]

In years past, doctors advocating or performing these procedures sometimes claimed that girls of all ages would otherwise engage in excessive masturbation and be "polluted" by the activity, which was referred to as "self-abuse".[40]

C.F. McDonald wrote in a 1958 paper titled "Circumcision of the Female"[41] "If the male needs circumcision for cleanliness and hygiene, why not the female? I have operated on perhaps 40 patients who needed this attention." The author describes symptoms as "irritation, scratching, irritability, masturbation, frequency and urgency," and in adults, smegmaliths causing "dyspareunia and frigidity." The author then reported that a two-year old was no longer masturbating so frequently after the procedure. Of adult women, the author stated that "for the first time in their lives, sex ambition became normally satisfied." Justification of the procedure on hygienic grounds, or to reduce masturbation, has since declined. The view that masturbation is a cause of mental and physical illness has dissipated since the mid-20th century.[42]

Clitorecdomy in its less invasive form, removal of the prepuce alone, also called a hoodectomy. It is an elective surgery undertaken by mature consenting adults. Some doctors[43] and other advocators[44] believe that hoodectomy can help to increase and improve sexual sensitivity and sexual pleasure in cases where the hood of the clitoris is too tight.

There are websites promoting the practice like Circlist, BMEzine (Body Modification E-Zine), and the Clitoral Hood Removal Information Page contain testimonials and citations of medical studies, which support this claim (for example a study done in 1959 Rathmann et al claim that 87.5% of women saw an improvement in sexual pleasure following a hoodectomy,[45] with 75% in a study by Knowles et al).

Social justifications similarly lack scientific evidence. FGC advocates have claimed the practice cures females of a myriad of psychological diseases including depression, hysteria, insanity and kleptomania. FGC is often used as a means of control over female virtue. FGC is often used as a means of preservation and proof of virginity, and is regarded in many societies as a prerequisite for honorable marriage. Type III FGC is often used in these societies, and the husband will sometimes cut his bride's scar tissue open after marriage to allow for sexual intercourse. Heavy stigma lies on men who marry an uncircumcised woman. Women who have had genital surgeries are often considered to have higher status than those who have not and are entitled to positions of religious, political and cultural power.[38] Removal of the clitoris is often cited as a means of discouraging promiscuity, as it eliminates the motivating factor of sexual pleasure. Feminists and human rights activists disapprove of this practice because it presupposes that women lack the self control or the right to decide when and with whom they engage in sexual activity.

Aesthetic reasons are also cited. Some societies believe that FGC enhances beauty. This stems from their belief that male foreskin is removed for aesthetic reasons, and that the clitoris thus should be removed for the same reason since it is the counterpart to the penis. FGC is believed to prolong sexual pleasure of men, because it is believed that the clitoris increases sexual stimulation.[citation needed]

There are no scientific or medical studies that support any of these viewpoints. While there is a correlation between FGC prevalence and religions like Islam and Christianity, prevalence rates vary by culture. These variances preclude an unequivocal link between religion and FGC.[35] However there is debate as to whether or not FGC constitutes a religious practice in particular religious sub-cultures.


Islam
Female genital cutting predates Islam.[35]In Saudi Arabia, in the area known as the Hijaz, where Islam originated, FGC was already being practiced during the lifetime of Muhammad. To call a man a "circumciser of women" was an insult among the pagan Arabs at the time. Female genital cutting is not commanded by the Qur'an[46] and is not practiced by the majority of Muslims.[35] In Egypt, mufti Sheikh Ali Gomaa stated: "The traditional form of excision is a practice totally banned by Islam because of the compelling evidence of the extensive damage it causes to women's bodies and minds." [47]


Sunni View
There are differences of opinion among Sunni scholars in regards to female genital cutting. These differences of opinion range from forbidden to obligatory. The debate focuses around a hadith from the Sunni collections. One narration states that "a woman used to perform circumcision in Medina. Muhammad said to her, 'Do not cut severely as that is better for a woman and more desirable for a husband.'"[48]Abu Dawood, who relates the narration in his collection, states the hadith is poor in authenticity. [49] Ibn Hajar al-Asqalani describes this hadith as poor in authenticity, and quotes Imam Ahmad Bayhaqi’s point of view that it is "poor, with a broken chain of transmission" [50] Zein al-Din al-Iraqi points out in his commentary on Al-Ghazali’s Ihya ulum al-din (I:148) that the mentioned hadith has a weak chain of transmission."[51] Yusuf ibn Abd-al-Barr comments: "Those who consider (female) circumcision a sunna, use as evidence this hadith of Abu al-Malih, which is based solely on the evidence of Hajjaj ibn Artaa, who cannot be admitted as an authority when he is the sole transmitter. The consensus of Muslim scholars shows that circumcision is for men".[52]

Imam Shams-ul-haq Azeemabadi asserts that, "[t]he Hadith of female circumcision has been reported through so many ways all of which are weak, blemished and defective, and thus it is unacceptable to prove a legal ruling through such ways."[51] While some scholars reject ahadith that refer to FGC on grounds of inauthenticity, other scholars argue that authenticity alone does not confer legitimacy. One of the sayings used to support FGC practices is the hadith (349) in Sahih Muslim: Aishah narrated an authentic Hadith that the Prophet said:"When a man sits between the four parts (arms and legs of his wife) and the two circumcised parts meet, then ghusl is obligatory." Dr. Muhammad Salim al-Awwa, Secretary General of the World Union of the Muslim Ulemas states that while the hadith is authentic, it is not evidence of legitimacy. He states that the Arabic for "the two circumcision organs" is a single word used to connote two forms; however the plural term for one of the forms is used to denote not two of the same form, but two different forms characterized as a singular of the more prominent form. For eg. in Arabic, the word with the female gender can be chosen to make the dual form, such as in the expression "the two Marwas", referring to the two hills of As-Safa and Al-Marwa (not "two of the same hills, each called Al-Marwa") in Mecca][53] He goes on to state that, while the female form is used to denote both male and female genitalia, it is identified with the prominent aspect of the two forms, which, in this case, is only the male circumcised organ. He further states that the connotation of circumcision is not transitive. Dr. al-Awwa concludes that the hadith is specious because "such an argument can be refuted by the fact that in Arabic language, two things or persons may be given one quality or name that belongs only to one of them for an effective cause." [51] [e.g. the usage in "Qur'an in Surah Al-Furqan(25):53" "bahrayn" is the dual form of "bahr" (sea) meaning "sea (salty and bitter) and river (sweet and thirst-allaying) (not "two seas").

In March 2005, Dr Ahmed Talib, Dean of the Faculty of Sharia at the Al-Azhar University, stated: "All practices of female circumcision and mutilation are crimes and have no relationship with Islam. Whether it involves the removal of the skin or the cutting of the flesh of the female genital organs... it is not an obligation in Islam."[54] Both Christian and Muslim leaders have publicly denounced the practice of FGC since 1998.[55] A recent conference at the Al-Azhar University in Cairo (December, 2006) brought prominent Muslim clergy to denounce the practice as not being necessary under the umbrella of Islam.[56] Although there was some reluctance amongst some of the clergy, who preferred to hand the issue to doctors, making the FGC a medical decision, rather than a religious one, the Grand Mufti Ali Jumaa of Egypt, signed a resolution denouncing the practice.[57]

One of the four Sunni schools of religious law, the Shafi'i school, rules that clitoridectomy is mandatory.[58] Sheikh Faraz Rabbani states, "That which is wajib [obligatory] in the Shafi`i texts is merely slight 'trimming' of the tip of the clitoral hood - prepuce." Contrary to the WHO definition, he states that this practice is not "FGM, nor harmful to the woman or her ability to derive sexual pleasure." He states that "excision, FGM, or other harmful practices" are not permitted.[59] In 1994, Egyptian Mufti Sheikh Jad Al-Hâqq argued that the procedure may not be banned simply on grounds of improper use.[60] The Al-Azhar University in Cairo has issued several fatwas endorsing FGC, in 1949, 1951 and 1981.[61]


Judaism
The Oxford Dictionary of the Jewish Religion states that female circumcision was never allowed in Judaism.[62] Toubia (1995) states that female circumcision is not even mentioned in any religious text.[63] FGC is practiced by the minority Ethiopian Jewish community (Beta Israel), formerly known as Falasha, most of whom now live in Israel. The operation may only be performed by a Jewish female. Those Ethiopian Jews who have emigrated to Israel no longer practice FGC. [64] In general, traditional Judaism maintains that the body of a person belongs not to the person but to God.[65] Any permanent modification of the body which does not serve the purpose of correcting a deformity is considered to be a defacement of God's property; thus, tattoos and body modifications are forbidden, with the exception of male circumcision, which is mandated. The U.S. Department of Health and Human Services, however, states that the practice of FGC cuts across religions, and lists Jews along with Muslims, Christians, and followers of indigenous religions as being among people who practice it.[66]


Christianity
FGC has never been part of Christianity as a faith system. There are no scriptural or doctrinal documents existing within the larger Christian tradition that even address the issue. The only contemporary examples of Christians practicing FGC are in Africa. As FGC rituals predated the missionaries work in North Africa, many African tribes continue the practice as a matter of cultural tradition, unrelated to religious belief.

FGC advocation by Christians has been rare and isolated to extremist groups. In the United States, as recently as 1938, FGC was advocated by Reverend Oscar Lowry as a method of preventing masturbation: "While incest and illicit commerce of the sexes is abominable, there is another even more so—if that be possible—that is, the heinous sin of self-pollution or masturbation... In some cases where there may be impingement of the clitoris, a slight operation may be necessary to relieve the tension and irritation..."[67]


Medical consequences
Among practicing cultures, FGC is most commonly performed between the ages of four and eight, but can take place at any age from infancy to adolescence. Prohibition has led to FGC going underground, at times with people who have had no medical training performing the cutting without anesthetic, sterilization, or the use of proper medical instruments. The procedure, when performed without any anesthetic, can lead to death through shock from immense pain or excessive bleeding. The failure to use sterile medical instruments may lead to infections.

Other serious long term health effects are also common. These include urinary and reproductive tract infections, caused by obstructed flow of urine and menstrual blood, various forms of scarring and infertility. The first time having sexual intercourse will often be extremely painful, and infibulated women will need the labia majora to be opened, to allow their husband access to the vagina. This second cut, sometimes performed by the husband with a knife, can cause other complications to arise.

A June 2006 study by the WHO has cast doubt on the safety of genital cutting of any kind.[1] This study was conducted on a cohort of 28,393 women attending delivery wards at 28 obstetric centers in areas of Burkina Faso, Ghana, Nigeria, Kenya, Senegal and The Sudan. A high proportion of these mothers had undergone FGC. According to the WHO criteria, all types of FGC were found to pose an increased risk of death to the baby (15% for Type I, 32% for Type II, and 55% for Type III). Mothers with FGC Type III were also found to be 30% more at risk for cesarean sections and had a 70% increase in postpartum hemorrhage compared to women without FGC. Estimating from these results, and doing a rough population estimate of mothers in Africa with FGC, an additional 10 to 20 per thousand babies in Africa die during delivery as a result of the mothers having undergone genital cutting.

In cases of repairing the damage resulting from FGC, called de-infibulation when reversing Type III FGC, this is usually carried out by a gynecologist. See also Pierre Foldes, French surgeon, who developed modern surgical corrective techniques.

A 12 year-old Egyptian girl, Badour Shaker, died in June, 2007 during or soon after a circumcision, prompting the Egyptian Health Ministry to ban the practice. She died from an overdose of anesthesia. The girl's mother, Zeniab Abdel Ghani, paid $9.00 [or 5 Pounds Sterling] to a female doctor, in an illegal clinic in the southern town of Maghagh, for the operation. The mother stated that the doctor tried to give her $3,000 to withdraw a lawsuit, but she refused.[68]


Sexual consequences
The effect of FGC on a woman's sexual experience varies depending on many factors. FGC does not eliminate sexual pleasure for all women who undergo the procedure. Although sexual excitement and arousal for a woman during intercourse involves a complex series of nerve endings being activated and stimulated in and around her vagina, vulva (labia minora and majora), cervix, uterus and clitoris, psychological response and mind-set are also important.[69] [70]

Lightfoot-Klein (1989) studied circumcised and infibulated females in Sudan, stating, "Contrary to expectations, nearly 90% of all women interviewed said that they experienced orgasm (climax) or had at various periods of their marriage experienced it. Frequency ranged from always to rarely." Lightfoot-Klein stated that the quality of orgasm varied from intense and prolonged, to weak or difficult to achieve.[71]

A study in 2007 found that in some infibulated women, some erectile tissue fundamental to producing pleasure had not been completely excised.[72] Defibulation of subjects revealed that a part of or the whole of the clitoris was underneath the scar of infibulation. The study found that sexual pleasure and orgasm are still possible after infibulation, and that they rely heavily on cultural influences — when mutilation is lived as a positive experience, orgasm is more likely. When FGC is experienced as traumatic, its frequency drops. The study suggested that FGC women who did not suffer from long-term health consequences and are in a good and fulfilling relationship may enjoy sex, and women who suffered from sexual dysfunction as a result of FGC have a right to sex therapy.

A study by Anthropologist Rogaia M. Abusharaf, found that "circumcision is seen as 'the machinery which liberates the female body from its masculine properties'[73] and for the women she interviewed, it is a source of empowerment and strength". [74]


Attempts to end the practice of FGC
Despite laws forbidding the practice, FGC remains an enduring tradition in many societies and cultural groups. Political leaders have found FGC difficult to eliminate on the local level because of its cultural and sometimes political importance.[75] For instance, in Kenya, missionaries present in the 1920s and 1930s forbade their Christianised adherents to practice clitoridectomy. In response, FGC became instrumental to the ethnic independence movement among the Kikuyu, the most populous ethnic group of Kenya - indigenous people reacted against what they perceived as cultural imperialistic attacks by Europeans.[76] Likewise, prohibition by the British of the procedure among tribes in Kenya significantly strengthened the tribes' resistance to British colonial rule in the 1950s and increased support for the Mau Mau guerrilla movement.[77]

Because the practice holds much cultural and marital significance, FGC opponents recognize that in order to end the practice it is necessary to work closely with local communities. In order to leave no individuals handicapped, as what happened with the rapid abandonment of foot binding among the Chinese early in the 20th century,[78] members of a marriage network must all give up the practice simultaneously.

Despite the close tie between FGC and cultural and, sometimes, religious tradition, there are cases where attempts at ending FGC have been successful. One example is in Senegal, where initiative was taken by native women working at the local level in connection with the Tostan Project.[79] Since 1997, 1,271 villages (600,000 people), some 12% of the practicing population in Senegal, have voluntarily given up FGC and are also working to end early and forced marriage. This has come about through the voluntary efforts of locals carrying the message out to other villages within their marriage networks in a self-replicating process. By 2003, 563 villages had participated in public declarations, and the number continues to rise. By then, at least 23 villages in Burkina Faso had also held such community wide ceremonies, marking "the first public declaration to end FGC outside of Senegal and showing the replicability of the Tostan program for large-scale abandonment of this practice". Molly Melching of TOSTAN believes that in Senegal the practice of female genital mutilation could be ended within 2–5 years. She credits education, instead of cultural imperialism, for the rapid and significant changes which have occurred in Senegal.

Some countries which have prohibited FGC still experience the practice in secrecy. In many cases, the enforcement of this prohibition is a low priority for governments. Other countries have tried to educate practitioners in order to make it easier and safer, instead of outlawing the practice entirely. However, with pressure from the WHO and other groups, laws are being passed in regards to FGC. On June 28, 2007 Egypt banned female genital cutting after the death of 12-year old Badour Shaker during a genital circumcision. The Guardian of Britain reported that her death "sparked widespread condemnation" of the practice.[68] However, Britain has had its own problem confronting cases of FGC, as immigrants from Africa have been known to send their daughters to their home nations to undergo the procedure before returning to Britain.

The United Nations Population Fund (UNFPA) has declared February 6 as the International Day Against Female Genital Mutilation.[80] The UNFPA has stated that [the] practice violates the basic rights of women and girls, [...]" and "[...] female genital mutilation or cutting is not required by any religion."

FGC can now be partially reversed via a surgical technique, which gives back certain sensation to the genitalia. Clitoraid, a non-profit international organization, is in the process of building a hospital in Burkina Faso, West Africa, where women who have undergone FGC will be able to receive this procedure free of charge. The hospital will be staffed with volunteers, including surgeons who specialize in this area.


Laws and prevalence
The countries where FGC is commonly practiced were identified by the US State Department.[81] Other information in this section is from Skaine (2005), Appendix I.[32]

Burkina Faso (71.6% prevalence, Type II)
A law prohibiting FGC was enacted in 1996 and went into effect in February 1997. Even before this law, however, a presidential decree had set up the National Committee against excision and imposed fines on people guilty of excising girls and women. The new law includes stricter punishment. Several women excising girls have been handed prison sentences.[82]
Central African Republic (43.4% prevalence, Type I and II)
In 1996, the President issued an Ordinance prohibiting FGC throughout the country. It has the force of national law. Any violation of the Ordinance is punishable by imprisonment of from one month and one day to two years and a fine of 5,100 to 100,000 francs (approximately US$8-160). No arrests are known to have been made under the law.
Côte d'Ivoire ( 44.5% prevalence, Type II)
A December 18, 1998 law provides that harm to the integrity of the genital organ of a woman by complete or partial removal, excision, desensitization or by any other procedure will, if harmful to a women's health, be punishable by imprisonment of one to five years and a fine of 360,000 to two million CFA Francs (approximately US$576-3,200). The penalty is five to twenty years incarceration if a death occurs during the procedure and up to five years' prohibition of medical practice, if this procedure is carried out by a doctor.
Djibouti (90-98% prevalence, Type II)
FGC was outlawed in the country's revised Penal Code that went into effect in April 1995. Article 333 of the Penal Code provides that persons found guilty of this practice will face a five year prison term and a fine of one million Djibouti francs (approximately US$5,600).
Egypt (78-97% prevalence, Type I, II and III)
Egypt's Ministry of Health and Population has banned all forms of female genital cutting since 2007. The ministry's ban order declared it is 'prohibited for any doctors, nurses, or any other person to carry out any cut of, flattening or modification of any natural part of the female reproductive system'. Islamic authorities in the nation also stressed that Islam opposes female circumcision. The Grand Mufti of Egypt, Ali Gomaa, said that it is "Prohibited, prohibited, prohibited."[83] The June 2007 Ministry ban eliminated a loophole that allowed girls to undergo the procedure for health reasons. [84] There had previously been provisions under the Penal Code involving "wounding" and "intentional infliction of harm leading to death," as well as a ministerial decree prohibiting FGC. In December 1997, the Court of Cassation (Egypt's highest appeals court) upheld a government banning of the practice providing that those who did not comply would be subjected to criminal and administrative punishments. This law had proved ineffective and in a survey in 2000, a study found that 97% of the country's population still practiced FGC. In light of the widespread practice of FGC, even after the ban in 1997, some Egyptian villages decided to voluntarily give up the practice, as was the case with Abou Shawareb, which vowed in July of 2005 to end the practice.[citation needed] However, it remains a culturally accepted practice, and a 2005 study found that over 95% of Egyptian women have undergone some form of FGC.[85]
Many other Islamic Leaders in Egypt believe that Ali Gomaa had to say such fatwa due to some political reasons. The media trend in Egypt during the last 5 years is being affected by the governmental campaigns opposing FGC.

Eritrea (90-95% prevalence, Type I, II and III)
Eritrea has outlawed all forms of female genital cutting since 2007.[86] There have been no arrests made yet under the new law.
Ghana (9-15% prevalence, Type I,II and III)
In 1989, the head of the government of Ghana, President Rawlings, issued a formal declaration against FGC. Article 39 of Ghana's Constitution also provides in part that traditional practices that are injurious to a person's health and well being are abolished.
Guinea (98.6% prevalence, Type I, II and III)
FGC is illegal in Guinea under Article 265 of the Penal Code. The punishment is hard labor for life and if death results within 40 days after the crime, the perpetrator will be sentenced to death. No cases regarding the practice under the law have ever been brought to trial. Article 6 of the Guinean Constitution, which outlaws cruel and inhumane treatment, could be interpreted to include these practices, should a case be brought to the Supreme Court.[citation needed] A member of the Guinean Supreme Court is working with a local NGO on inserting a clause into the Guinean Constitution specifically prohibiting these practices.[citation needed]
Indonesia (No national prevalence figures avail., Type I and IV)
Officials are preparing to release a decree banning doctors and paramedics from performing FGC. Azrul Azwar, The director general of community health, stated that, "All government health facilities will also be instructed to spread information about the decision as well as the redundancy of female circumcision."[87]
Nigeria (25.1% prevalence, Type I, II and III)
There is no federal law banning the practice of FGC in Nigeria. Opponents of these practices rely on Section 34(1)(a) of the 1999 Constitution of the Federal Republic of Nigeria that states "no person shall be subjected to torture or inhuman or degrading treatment" as the basis for banning the practice nationwide. A member of the House of Representatives has drafted a bill, not yet in committee, to outlaw this practice.
Senegal (5-20% prevalence, Type II and III)
A law that was passed in January 1999 makes FGC illegal in Senegal. President Diouf had appealed for an end to this practice and for legislation outlawing it. The law modifies the Penal Code to make this practice a criminal act, punishable by a sentence of one to five years in prison. A spokesperson for the human rights group RADDHO (The African Assembly for the Defense of Human Rights) noted in the local press that "Adopting the law is not the end, as it will still need to be effectively enforced for women to benefit from it.
Sudan (91% prevalence, Type I,II and III)
Currently there is no law forbidding FGC, although Sudan was the first country to outlaw it in 1946, under the British. Type III was prohibited under the 1925 Penal Code, with less severe forms allowed. Outreach groups have been trying to eradicate the practice for 50 years, working with NGO's, religious groups, the government, the media and medical practitioners. Arrests have been made but no further action seems to have taken place.
Tanzania (17.6% prevalence, Type II and III)
Section 169A of the Sexual Offences Special Provisions Act of 1998 prohibits FGC. Punishment is imprisonment of from five to fifteen years or a fine not exceeding 300,000 shillings (approximately US$380) or both. There have been some arrests under this legislation, but no reports of prosecutions yet.
Togo (12% prevalence, Type II)
On October 30, 1998, the National Assembly unanimously voted to outlaw the practice of FGC. Penalties under the law can include a prison term of two months to ten years and a fine of 100,000 francs to one million francs (approximately US$160 to 1,600). A person who had knowledge that the procedure was going to take place and failed to inform public authorities can be punished with one month to one year imprisonment or a fine of from 20,000 to 500,000 francs (approximately US$32 to 800).
Uganda (<5% prevalence, Type I and II)
There is no law against the practice of FGC in Uganda. In 1996, however, a court intervened to prevent the performance of this procedure under Section 8 of the Children Statute, enacted that year, that makes it unlawful to subject a child to social or customary practices that are harmful to the child's health.

See also
Breast ironing - a practice of flattening the breasts of girls
Foot binding - an old, primarily Chinese, practice of constricting feet
Labiaplasty - a recently developed cosmetic practice
Vulvectomy

References

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^ Cook, Rebecca J.; Bernard M. Dickens , Mahmoud F. Fathalla (2003). Reproductive Health and Human Rights: Integrating Medicine, Ethics, and law. Oxford University Press, 262. ISBN 0199241333. “The terminology used to describe this procedure varies. The term 'female circumcision' has been used historically. However, as the harm that such procedures caused to girls and women became increasingly recognized, and because this procedure in whatever form it is practiced is not at all analogous to male circumcision, the term 'female circumcision' gave way to the term 'female genital mutilation'. The term 'female genital mutilation' has been adopted by many women's health organizations, such as the Inter-African Committee on Traditional Practices Affecting the Health of Women and Children, and intergovernmental organizations, such as the World Health Organization. However, the use of the term may offend women who have undergone the procedure and do not consider themselves mutilated or their families as mutilators.”
^ Shell-Duncan, Bettina (April 2001). "The medicalization of female "circumcision":harm reduction or promotion of a dangerous practice?". Social Science & Medicine 52 (7): 1013–1028. doi:10.1016/S0277-9536(00)00208-2. “"The term "female circumcision" is a euphemistic description for what is really a variety of procedures for altering the female genitalia. While numerous terms have been used to describe the wide range of procedures, there are generally four commonly recognized forms of genital cutting."”
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Eliminating Female Genital Mutilation - An interagency statement OHCHR, UNAIDS, UNDP, UNECA, UNESCO, UNFPA, UNHCR, UNICEF, UNIFEM, WHO, Department of Reproductive Health and Research (RHR), World Health Organization, 2008., <http://www.who.int/reproductive-health/publications/fgm/fgm_statement_2008.pdf>
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^ (infibulation). When it is important to distinguish between variations in infibulations, the following subdivisions are proposed: Type IIIa, removal and apposition of the labia minora; Type IIIb, removal and apposition of the labia majora. "Female genital mutilation". World Health Organization (June 2000). Retrieved on 2008-01-23.
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^ a b c d Obermeyer, Carla Makhlouf (March 1999). "Female Genital Surgeries: The Known, the Unknown, and the Unknowable" 13 (1): 79–106. Retrieved on 2007-12-01. “Regarding religious differences, it is now generally recognized that even though a number of the countries where female genital surgeries are found are predominantly Muslim, the practices are not prescribed by Islam and are, in fact, found among non-Muslim groups such as Coptic Christians of Egypt, several Christian groups in Kenya, and the Falasha Jews of Ethiopia. In CDI, the prevelance is 80 percent among Muslims, 40 percent among those with no religion and 15 percent among Protestants, and in Sudan the prevalence is highest among Muslim women (DHS 1989-90). In Kenya, by contrast, prevalence is highest among Catholics and Protestants compared with other religious groups (MYWO 1991). Thus, there is no unequivocal link between religion and prevalence. p.88”
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^ a b c Dr. Muhammad Salim al-Awwa, Secretary General of the World Union of the Muslim Ulemas, "Female Circumcision Neither a Sunna, nor a Sign of Respect"(Al Alazhar, Cairo),[3]
^ Al-tamhid lima fil-muwatta min al-ma’ani wal-assanid, XXI, 59
^ Abbas Hassan, An-nahw al-wafi, I, 118–19
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^ (1997) "Circumcision", in R. J. Zwi Werblowsky & Geoffrey Wigoder: The Oxford Dictionary of the Jewish Religion. New York & Oxford: Oxford University Press. Retrieved on 2007-12-23. “Circumcision was widespread in many ancient cultures. Some of these also practiced female circumcision, which was never allowed in Judaism.”
^ Nahid, Toubia (Jan 1995). "Female Circumcision -- Dr. Toubia replies". New England Journal of Medicine 332: 188–90. doi:10.1056/NEJM199501193320313. Retrieved on 2007-12-23. “Male circumcision is an absolute requirement of Islam and Judaism, whereas female circumcision is not even mentioned in any religious text. However, scholars of African cultures would testify that on our continent traditional and tribal rituals commonly supersede religion.”
^ Female genital mutilation among Ethiopian Jews
^ How Jewish is Body Piercing? by Rabbi Chaim Steinmetz.
^ "Female Genital Cutting". “Some argue that FGC has religious significance, but the custom cuts across religions and is practiced by Muslims, Christians, Jews and followers of indigenous religions.”
^ Lowry, Reverend Oscar. A Virtuous Woman: Sex Life in Relation to the Christian Life. Zondervan Publishing House, 1815 Franklin Street, Grand Rapids, Michigan; November, 1938 (Fourth Edition); pp. 29 and 35.
^ a b "Death of 12-Year-Old Circumcised Girl Shocks Egypt, Prompts Ban on Rite", Associated Press (2007-06-27). Retrieved on 2008-01-11.
^ Komisaruk, B. et al.: The Science of Orgasm. JHU Press, 2006. For an interview with two of the researchers, see ”Exploring the Mind-Body Orgasm", http://www.wired.com/medtech/health/news/2007/01/72325
^ Mah, K., Binik & Y.M: ”Are orgasms in the mind of the body? Psychosocial versus physiological correlates of orgasmic pleasure and satisfaction”. Journal of Sex and Marital Therapy 31:187-200, 2005.
^ Lightfoot-Klein, Hanny: "The Sexual Experience and Marital Adjustment of Genitally Circumcised and Infibulated Females in The Sudan". The Journal of Sex Research Vol.26. No.3, pp.375-392, 1989. http://www.fgmnetwork.org/authors/Lightfoot-klein/sexualexperience.htm See also Prisoners of Ritual: An Odyssey into Female Genital Circumcision in Africa, by Hanny Lightfoot-Klein; Harrington Park Press, 1989, ISBN 0-918393-68-X
^ Catania, Lucrezia; Omar Abdulcadir, Vincenzo Puppo, Jole Baldaro Verde, Jasmine Abdulcadir, Dalmar Abdulcadir (November 2007). "Pleasure and Orgasm in Women with Female Genital Mutilation/Cutting (FGM/C)". The Journal of Sexual Medicine 4 (6): 1666–1678. doi:10.1111/j.1743-6109.2007.00620.x.
^ Abusharaf, Rogaia M. (2001). "Virtuous Cuts: Female Genital Circumcision in an African Ontology". Differences: A Journal of Feminist Cultural Studies 12: 112–140. doi:10.1215/10407391-12-1-112.
^ Female genital cutting: traditional practice or human rights violation?
^ Birch/Abril, Nicholas (2008-01-04). "An End to Female Genital Cutting?", Time Magazine. Retrieved on 2008-01-08.
^ Natsoulas, Theodore: “The Politicization of the Ban of Female Circumcision and the Rise of the Independent School Movement in Kenya. The KCA, the Missions and Government, 1929-1932”. Journal of African Studies 33(2):137-158, 1998.
^ Birch/Abril, Nicholas. "An End to Female Genital Cutting?", Time Magazine, 2008-01-04. Retrieved on 2008-01-08.
^ Vento, Mary (1998-03-07). "One Thousand Years of Chinese Footbinding: Its Origins, Popularity and Demise". Retrieved on 2008-01-08.
^ TOSTAN (Wednesday, May 18, 2005 11:22:52 PM). "Ending Female Genital Cutting In Dialacoto - A Celebration Of Life And Culture". Press release. Retrieved on 2006-10-02.
^ "Statement on the International Day Against Female Genital Mutilation, UNFPA". Retrieved on 2008-02-08.
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^ Stolz, Joëlle (septembre 1998). "Le Burkina Faso fait reculer l’excision" (in French), Le Monde diplomatique, pp. 18. Retrieved on 2006-10-02.
^ "Egypt outlaws circumcision after girl dies", Cairo: The Observer (2007-07-01).
^ "Egypt strengthens ban on female genital cutting", Reuters (2007-06-28). Retrieved on 2008-01-11.
^ "Circumcision Rites Gone Wrong". Reuters. Retrieved on 2007-08-20.
^ "Eritrea bans female circumcision". BBC. Retrieved on 2007-07-28.
^ "Indonesia to ban female circumcision" (in English), CBCnews (Thursday, June 2, 2005). Retrieved on 2006-10-02.

Further reading

Bibliography
Al-Qaradawi, Y. (2004, February 7). Islamic ruling on female circumcision. Retrieved March 29, 2006.
Al-Qaradawi, Y. (2004, December 13). Circumcision: Juristic, medical & social perspectives. Retrieved March 29, 2006.
Boyle, E. H. (2002). Female genital cutting: Cultural conflict in the global community. Baltimore: Johns Hopkins University Press. ISBN 978-0-8018-7063-7.
Dettwyler, Katherine A. (1994). Dancing skeletons: life and death in West Africa. Prospect Heights, Ill.: Waveland Press. ISBN 0-88133-748-X.
Ferguson, I and Ellis, P. (1995). Female Genital Mutilation: a Review of the Current Literature Department of Justice, Canada. Working document
Gruenbaum, E. (2001). The female circumcision controversy. Philadelphia: University of Pennsylvania Press. ISBN 978-0-8122-1746-9.
Hoffman, B. (2002). Womanhood and Circumcision: Three Maasai women have their say. Berkeley: Berkeley Media.
Johnson, Michelle C. (2000). Becoming a Muslim, Becoming a person: Female 'circumcision', religious identity, and personhood in Guinea-Bissau. In B. Shell-Duncan & Y. Herlund (Eds.), Female circumcision in Africa: Culture, controversy, and change. Boulder: Lynne Rienner Publishers.
Kandela, P. (1995, January). Egypt sees U turn on female circumcision. British Medical Journal, 310, 12.
Kassindja, F. (1998). Do they hear you when you cry. New York: Delacorte Press. ISBN 0-38531-832-4.
Obermeyer, Carla Makhlouf (2003). The health consequences of female circumcision: Science, advocacy, and standards of evidence. Medical Anthropology Quarterly, 17(3), 394-412. PMID 12974204. doi:10.1525/maq.2003.17.3.394
Pieters, G., & Lowenfels A. B. (1977). Infibulation in the horn of Africa. New York State Journal of Medicine, 77(5), 729-31. PMID 265433.
Research papers from medical gynecologists, judges, linguistics, and social scientists on the subject (1994). University of Khartoum, Sudan. Umm Atteya Organization website (Arabic). Retrieved March 29, 2006.
UNICEF (1999). Consultation on the elimination of female genital mutilation: 14 December-16 December 1998. New York: Author. 40 pp.
World Health Organization. (1996). Female genital mutilation: Report of a WHO Technical Working Group (unpublished document WHO/FRH/WHD/96.10). Geneva: World Health Organization. Retrieved 2007-02-21.

Print
Aldeeb, Sami (2000). Male and Female Circumcision in the Jewish, Christian and Muslim Communities, Religious debate. Beirut, ISBN 1855134063.
Daw, E. (1970). Female circumcision and infibulation complicating delivery. Practitioner, 204(222), 559-63. PubMed.
Dewhurst, C.J., & Michelson, A. (1964). Infibulation complicating pregnancy. British Medical Journal, 2(5422), 1442. PubMed.
Dirie, Waris (2001). Desert Flower. Autobiography of a Somali woman's journey from nomadic tribal life to a career as a fashion model in London and to the post of special ambassador at the United Nations. Dirie recounts her personal experience with female genital mutilation that began with circumcision at age five.
Leonard, Lori (2000). We did it for pleasure only: Hearing alternative tales of female circumcision. Qualitative Inquiry, 6(2), 212-228.
Mernissi, Fatima. Beyond the veil: Male-female dynamics in a modern Muslim society. Cambridge, MA: Schenkman Pub. Co. ISBN 0-470-59613-9.
Mustafa, Asim Zaki (1966). Female circumcision and infibulation in the Sudan. Journal of Obstetrics and Gynaecology of the British Commonwealth, 73(2), 302–306. doi:10.1111/j.1471-0528.1966.tb05163.x.
Robinett, Patricia (2006). The rape of innocence: One woman's story of female genital mutilation in the USA. N.p.: Aesculapius Press. ISBN 1-878411-04-7.

External links

Female genital cutting
Clitoraid: [4] Is building a hospital in Burkina Faso to offer reversal surgery to FGM victims free of charge
Amnesty International: Women's Human Rights
BBC: Female mutilation is 'birth risk'
BBC: Kenya shock at mutilation death
B
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Postby doug » Sat Aug 16, 2008 1:13 pm

Foot binding
From Wikipedia, the free encyclopedia

"Lotus Feet" redirects here. For the song, see Real Illusions: Reflections.

An X-ray of bound feet
A comparison between a woman with normal feet (left) and a woman with bound feet in 1902Foot binding (simplified Chinese: 缠足; traditional Chinese: 纏足; pinyin: chánzú, literally "bound feet") was a custom practiced on young girls or females for approximately one thousand years in China, beginning in the 10th century and ending in the early 20th century.

According to a study conducted by the University of California at San Francisco, "As the practice waned, some girls' feet were released after initial binding, leaving less severe deformities." Some effects of foot binding are permanent. In the 1990s and early 2000s, some elderly Chinese women still suffered from disabilities related to bound feet.[1]

The custom is commonly cited by sociologists and anthropologists as examples of how an extreme deformity by today's standards can be viewed as a source of beauty, and how immense human suffering can be inflicted in the pursuit of beauty.

Contents
1 History
2 Reception and appeal
3 Process
4 Foot binding in literature and film
5 See also
6 Notes
7 References
8 Fictional accounts
9 Further reading
10 External links



History

A bound footThe origin of the practice is uncertain. Multiple accounts attempting to explain its beginning exist, each advancing a different theory: from the desire to emulate the naturally tiny feet of a favoured concubine of a prince, to a story of an empress who had club-like feet, which became viewed as a desirable fashion. However, there is little strong textual evidence for the custom prior to the court of the Southern Tang dynasty in Nanjing, which celebrates the fame of its dancing girls renowned for their tiny feet and beautiful bow shoes. Foot binding was first present in the elite, and was initially a common practice only in the wealthiest parts of China, particularly the north. However, by the time of the late Qing Dynasty, foot binding had become popular among people of all social classes except among the poorest - who needed to be able-bodied to work the fields - as well as among Hakka women. In the early twenty-first century, there have remained cases of disability among elderly Chinese women on account of foot binding.[1]

In Chinese foot binding, young girls' feet were wrapped in tight bandages so that they could not grow and develop normally; they would, instead, break and become highly deformed, not growing past 4-6 inches (10-15 cm). As the girl reached adulthood, her feet would remain small and prone to infection, paralysis, and muscular atrophy. Though the process had made her completely incapable of any strenuous physical labour outside, or walking for great distances without aid, women with bound feet had no greater difficulty preparing meals or doing general household chores than women with unbound feet. If a girl's feet were bound in this manner, four toes on each foot would break within a year; the first ("big toe") remained intact. The arch had to be well-developed for the perfect "lotus foot" to be formed, so some women would bind their girls' feet at a later age; the ideal was a 3-in. foot (gold lotuses), and no longer than 4 in (10 cm), called silver lotuses. Bound feet would bend, becoming so concave they were sometimes described as "lotus hooks". The binding process resulted in intense pain and caused phalanges to fracture easily, and additionally resulted in an unsteady walk, referred to as the "lotus gait."

The earliest recorded opponent to footbinding was a writer from the Song Dynasty (960-1279) called Ch'e Jo-shui.

The Manchus, who conquered China in the 17th century, tried without success to abolish the practice. Manchu women were forbidden from binding their feet or the feet of their daughters. Instead they wore 'flower bowl' shoes which gave the illusion of tiny feet. Bound feet became an important differentiating marker between Manchu and Han. [1] One of the objectives of the Taiping Rebellion was to end footbinding in the name of gender equality.

The practice continued into the 20th century, when a combination of Chinese and Western missionaries called for reform and a true anti-footbinding movement emerged. Educated Chinese began to understand that it made them appear barbaric to foreigners, social Darwinists argued that it weakened the nation, for enfeebled women inevitably produced weak sons, and feminists attacked it because it caused women to suffer.[2]. At the turn of the 20th century, gentry women, such as Kwan Siew-Wah, a unique[citation needed] pioneer feminist, advocated for the end of female foot-binding. Kwan herself refused the foot-binding imposed on her since her youth so that she could grow normal feet.

In 1911, after the fall of the Qing Dynasty, the new Republic of China government banned foot binding; women were told to unwrap their feet lest they be killed. Some women's feet grew 1/2 - 1 inch after the unwrapping, though some found the new growth process extremely painful and emotionally and culturally devastating. Societies developed to support the abolition of footbinding, with contractual agreements between families promising their infant son in marriage to an infant daughter that would not have her feet bound. When the Communists took power in 1949, they maintained the strict prohibition on footbinding, which is still in effect today.


Reception and appeal

A Chinese woman with her feet unwrappedBound feet were considered intensely erotic. Qing Dynasty sex manuals listed 48 different ways of playing with women's bound feet. [3] Some men preferred never to see a woman's bound feet, so they were always concealed within tiny "lotus shoes". Feng Xun is recorded as stating, "If you remove the shoes and bindings, the aesthetic feeling will be destroyed forever." For them, the erotic effect was a function of the lotus gait, the tiny steps and swaying walk of a woman whose feet had been bound. The very fact that the bound foot was concealed from men's eyes was, in and of itself, sexually appealing. On the other hand, an uncovered foot would also give off a foul odor, as various fungi would colonise the unwashable folds. The other primary attribute of a woman having bound feet was to limit her mobility, altering the means by which females were allowed to be a part of the world at large. It also gave the woman an irreversible dependency on her family. Thus bound feet became an alluring symbol of chastity, as a bound foot woman was largely restricted to her home and could not venture far without an escort to help her, thus denying any advances upon her and ensuring her total devotion to her husband.


Process

A bandaged bound foot
Schema of an x-ray comparison between an unbound and bound footA mother or grandmother typically began binding her daughter's or granddaughter's feet when the child was between the ages of four and seven. The process was started before the arch of the foot had a chance to properly develop. Binding usually started during the winter months so that the feet were numb, meaning the pain would not be as extreme [4].

First, each foot would be soaked in a warm mixture of herbs and animal blood. This concoction caused any necrotised flesh to fall off [5]. Then her toenails were cut back as far as possible to prevent ingrowth and subsequent infections. To prepare her for what was to come next the girl's feet were delicately massaged. Silk or cotton bandages, ten feet long and two inches wide, were prepared by soaking them in the same blood and herb mix as before. Each of the toes were then broken and wrapped in the wet bandages, which would constrict when drying, and pulled tightly downwards toward the heel. There may have been deep cuts made in the sole to facilitate this [6].

This ritual would be repeated every two days, with fresh bindings. Every time the bandages were rebound they would be pulled tighter making this process continually painful. The most common ailment of bound feet was infection. Toenails would ingrow and could lead to flesh rotting, occasionally causing the toes to drop off. Disease inevitably followed infection meaning that death could result from foot binding. Occasionally, the ball of the foot would grow directly into the heel. As the girl grew older, she was more at risk from medical problems. Older women were more likely to break hips and other bones in falls and were less able to stand up from sitting. [7]


Foot binding in literature and film
The bound foot has played a prominent part in many works of literature, both Chinese and non-Chinese. These depictions are sometimes based on observation or research and sometimes on rumor or supposition. This is only to be expected when a practice is so emotionally charged. Sometimes, as in the case of Pearl Buck's The Good Earth, the accounts are relatively neutral.

Anchee Min describes a graphic depiction of a young girl's foot binding in her memoir Red Azalea, as well as another's refusal to have her feet bound in Becoming Madame Mao.

Lisa See has read widely and writes about foot binding in Snow Flower and the Secret Fan and Peony in Love.

Li Juzhen (1763-1830) wrote a satirical novel Jinghua yuan, translated as Flowers in the Mirror which includes a visit to the mythical Kingdom of Women. There it is the men who must bear children, menstruate, and bind their feet. The recent Chinese author Feng Jicai's (b. 1942) novel Three Inch Golden Lotus presents a satirical picture of the movement to abolish the practice.

In the novel and miniseries Broken Trail, by Alan Geoffrion, one of the young Chinese slaves has bound feet and relies heavily on others for support while walking.

Isabelle Allende's novel Daughter of Fortune includes a character whose feet have been bound, as well as a several passages about the aesthetics of foot-binding.

Diana Gabaldon's novel Voyager (the 4th installment of the Outlander series) includes a Chinese character who explains his foot binding and the sexual aspect of it.


See also

Foot binding
Attraction to disability
Artificial cranial deformation
Body modification
Corset
Sexual fetishism
Female genital cutting
Violence against women

Notes
^ a b Painful Memories for China's Footbinding Survivors, by Louisa Lim, Morning Edition, March 19, 2007. Accessed March 19, 2007.
^ Levy (1992), p. 322
^ Painful Memories for China's Footbinding Survivors, by Louisa Lim, Morning Edition, March 19, 2007. Accessed March 19, 2007.
^ Jackson, Beverly: Splendid Slippers. Berkley: Tenspeed Press. 1997
^ Levy, Howard S: The Lotus Lovers: The Complete History of the Curious Erotic Tradition of Foot Binding in China. New York:Prometheus Books 1991
^ Hwang, David Henry: The Golden Child. http://users.rcn.com/frances.interport/feetbinding.html
^ Cummings, S & Stone, K: Consequences of Foot Binding Among Older Women in Beijing China. American Journal of Public Health EBSCO Host. Oct 1997

References
Dorothy Ko, Cinderella’s Sisters: A Revisionist History of Footbinding. Los Angeles: University of California Press, 2005.
Dorothy Ko, Every Step a Lotus: Shoes for Bound Feet (Berkeley: University of California Press, 2001). Catalogue of a museum exhibit, with extensive comments.
Beverley Jackson Splendid Slippers - A Thousand Years of an Erotic Tradition: Ten Speed Press
Howard S. Levy, The Lotus Lovers: Prometheus Books, New York, 1992
Eugene E.Berg, , M.D. Chinese Footbinding. Radiology Review - Orthopaedic Nursing 24, no. 5 (September/October) 66-67
Marie Vento, [2]One Thousand Years of Chinese Footbinding: Its Origins, Popularity and Demise
The Virtual Museum of The City of San Francisco, [3]
Ping, Wang. Aching for Beauty: Footbinding in China. New York: Anchor Books, 2002.

Fictional accounts
Li Ju-chen [Li Ruzhen], Flowers in the Mirror translated, edited by Lin Tai-yi (Berkeley: University of California Press, 1965).
Lisa See, Snow Flower and the Secret Fan: A novel (New York: Random House, 2005)
Jicai Feng (translated from the Chinese by David Wakefield), The Three-Inch Golden Lotus (Honolulu: University of Hawaii Press, 1994).
Kathryn Harrison, The Binding Chair, or, a Visit from the Foot Emancipation Society: A Novel (New York: Random House, 2000).

Further reading
Fan Hong, Footbinding, Feminism and Freedom (Frank Cass, London, 1997)

External links
Information about Lotus shoes and foot binding from a footwear history site
"Chinese Girl with Bound Feet" Virtual Museum of the City of San Francisco.
Page about Chinese foot binding
Page from thinkquest
Another page on foot binding
A photograph

Retrieved from "http://en.wikipedia.org/wiki/Foot_binding"

Categories: Body modification | Chinese culture | Foot


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Postby doug » Sat Aug 16, 2008 4:10 pm

Breast ironing

Breast ironing is a form of body modification practiced in parts of Cameroon. A pubescent girl's breasts are flattened, usually by the girl's mother, in an attempt to make her less sexually attractive to men. This practice is believed to help prevent rape and early marriage. Grinding stones, pestles, belts, heated objects and breast bands are used to press or beat down the forming breasts. Local non-governmental organizations are trying to call attention to this practice and stop it.

Contents
1 Health consequences
2 Scope
3 See also
4 Notes
5 References
6 External links



Health consequences
While there is little research on the health effects of breast ironing, it is generally believed that the practice can cause tissue damage in addition to the pain of the ironing process. Other possible side-effects include breast infections, the formation of abscesses, breast cancer, malformed breasts and the possible complete eradication of one or both breasts.[1] In addition, the practice can inhibit or prevent successful breastfeeding.


Scope
A survey by the German development agency GTZ from June, 2006 of more than 5,000 girls and women between the ages of 10 and 82 from Cameroon, estimated that nearly one in four, or four million girls in Cameroon alone, had been subjected to the procedure.


See also
Body modification
Female genital cutting

Notes
^ Ruth Gidley and Megan Rowling (2006-07-07). "Millions of Cameroon girls suffer "breast ironing"", Reuters. Retrieved on 2008-01-02.

References
Randy Joe Sa'ah (2006-06-23). "Cameroon girls battle 'breast ironing'", BBC News. Retrieved on 2008-01-02.
"An Unwelcome "Gift of God"", IPS News (2006-06-13). Retrieved on 2008-01-02.
"Campaign launched to counter "breast ironing"", PLUSNEWS (2006-06-28). Retrieved on 2008-01-01.
Sabri Ben-Achour (Trans.) (2007-01-15), Ironed Maidens, Harper's Magazine, <http://harpers.org/IronedMaidens.html>. Retrieved on 31 January 2007 (subscription required)

External links
"Film about Breast Ironing".

Retrieved from "http://en.wikipedia.org/wiki/Breast_ironing"

Categories: Body modification | Breast | Cameroon stubs

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History of male circumcision

Postby doug » Sat Nov 29, 2008 7:31 pm

History of male circumcision
From Wikipedia, the free encyclopedia
Jump to: navigation, search
The examples and perspective in this article or section may not represent a worldwide view of the subject.

It has been variously proposed that male circumcision began as a religious sacrifice, as a rite of passage marking a boy's entrance into adulthood, as a form of sympathetic magic to ensure virility, as a means of suppressing (or enhancing) sexual pleasure, as an aid to hygiene where regular bathing was impractical, as a means of marking those of lower (or higher) social status, as a means of differentiating a circumcising group from their non-circumcising neighbors, as a means of discouraging masturbation or other socially proscribed sexual behaviors, to remove "excess" pleasure, to increase a man's attractiveness to women, as a symbolic castration, as a demonstration of one's ability to endure pain, or as a male counterpart to menstruation or the breaking of the hymen. It has been suggested that the custom of circumcision gave advantages to tribes that practiced it and thus led to its spread regardless of whether the people understood this.[1] It is possible that circumcision arose independently in different cultures for different reasons.


Circumcision in Ancient Egypt.

Contents
1 Circumcision in the Ancient world
2 Male circumcision in the Greco-Roman world
3 Male circumcision in the Renaissance
4 Male circumcision in East Africa
5 Male circumcision in the 18th century
6 Male circumcision in the 19th century and beyond
7 Male circumcision to prevent masturbation
8 Medical circumcision from 1870 to 1950 in English-speaking countries
9 Circumcision since 1950
10 Circumcision in the 21st century
11 External links
12 References
13 Bibliography



Circumcision in the Ancient world

Ancient Egyptian caved scene of circumcision, from the inner northern wall of the Temple of Khonspekhrod at the Precinct of Mut, Luxor, Egypt. Eighteenth dynasty, Amenhotep III, c. 1360 BC.Sixth Dynasty (2345 - 2181 BC) tomb artwork in Egypt is thought to be the oldest documentary evidence of circumcision. The most ancient depiction being a bas-relief from the necropolis at Saqqara (ca. 2400 B.C) with the inscription reading "Hold him and do not allow him to faint". The oldest written account, by an Egyptian named Uha, in the 23rd century B.C, sees him describe a mass circumcision and boast of his ability to stoically endure the pain: "When I was circumcised, together with one hundred and twenty men...there was none thereof who hit out, there was none thereof who was hit, and there was none thereof who scratched and there was none thereof who was scratched."[2]

Circumcision in ancient Egypt was thought to be a mark of passage from childhood to adulthood. The alteration of the body and ritual of circumcision was supposed to give access to ancient mysteries reserved solely for the initiated. The content of those mysteries are unclear but are likely to be myths, prayers, and incantations central to Egyptian religion. The Egyptian Book of the Dead, for example, tells of the sun god Ra performing a self-circumcision, whose blood created two minor guardian deities. Circumcisions were performed by priests in a public ceremony, using a stone blade. It is thought to have been more popular among the upper echelons of the society, although it was not universal and those lower down the social order are known to have had the procedure done.[3] The Egyptian hieroglyph for "penis" depicts either a circumcised or an erect organ.

Circumcision was later adopted by Semitic peoples living in or around Egypt. The Book of Jeremiah, written in the sixth century BC, lists Israelites, Edomites, Ammonites, and Moabites as circumcising cultures. Herodotus, writing in the fifth century BC, ascribed circumcision to the Colchians, Ethiopians, Phoenicians, and Syrians and Macrones, as well as to the Egyptian priestly caste. He also reports, however, that the salutary influence of Greek culture induced the Phoenicians to abandon circumcision.[4]

According to Genesis, God told Abraham to circumcise himself, his household and his slaves as an everlasting covenant in their flesh. Those who were not circumcised were to be 'cut off' from their people (Genesis 17:10-14). Moses and his sons were not circumcised and neither were his followers (Joshua 5: 4-7). However according to the Book of Joshua, his wife Zipporah circumcised their son when God threatened to kill Moses (Exodus 4: 24-26).


Male circumcision in the Greco-Roman world
According to Hodges, ancient Greek aesthetics of the human form considered circumcision a mutilation of a previously perfectly shaped organ. Greek artwork of the period portrayed penises as covered by the foreskin (sometimes in exquisite detail), except in the portrayal of satyrs, lechers, and barbarians.[4] This dislike of the appearance of the circumcised penis led to a decline in the incidence of circumcision among many peoples that had previously practiced it throughout Hellenistic times. In Egypt, only the priestly caste retained circumcision, and by the second century, the only circumcising groups in the Roman Empire were Jews and Proselytes and some Christians, Egyptian priests, and the Nabatean Arabs. Circumcision was sufficiently rare among non-Jews that being circumcised was considered conclusive evidence of Judaism (or Early Christianity and others derogatively called Judaizers) in Roman courts—Suetonius in Domitian 12.2 described a court proceeding in which a ninety-year-old man was stripped naked before the court to determine whether he was evading the head tax placed on Jews and Judaizers.[5] The first-century Alexandrian Apion denounced circumcision as a barbaric custom in his diatribe against the Jews, notwithstanding that it was still practised among the Egyptian priestly caste.[citation needed]

Cultural pressures to circumcise operated throughout the Hellenistic world: when the Judean king John Hyrcanus conquered the Idumeans, he forced them to become circumcised and convert to Judaism, but their ancestors the Edomites had practiced circumcision in pre-Hellenistic times.

Some Jews tried to hide their circumcision status, as told in 1 Maccabees. This was mainly for social and economic benefits and also so that they could exercise in gymnasiums and compete in sporting events. Techniques for restoring the appearance of an uncircumcised penis were known by the 2nd century B.C. In one such technique, a copper weight (called the Judeum pondum) was hung from the remnants of the circumcised foreskin until, in time, they became sufficiently stretched to cover the glans. The first-century writer Celsus described two surgical techniques for foreskin restoration in his medical treatise De Medicina.[6] In one of these, the skin of the penile shaft was loosened by cutting in around the base of the glans. The skin was then stretched over the glans and allowed to heal, giving the appearance of an uncircumcised penis. This was possible because the Abrahamic covenant of circumcision defined in the Bible was a relatively minor circumcision; named milah, this involved cutting off the foreskin that extended beyond the glans. Jewish religious writers denounced such practices as abrogating the covenant of Abraham in 1 Maccabees and the Talmud.[7] Because of these attempts, and for other reasons, a second more radical step was added to the circumcision procedure. This was added around 140 A.D., and was named Brit Peri'ah. In this step, the foreskin was cut further back, to the to the ridge behind the glans penis, called the coronal sulcus. The inner mucosal tissue was removed by use of a sharp finger nail or implement, including the excising and removal of the frenulum from the underside of the glans.[8] Later during the Talmudic period (500-625 A.D.) a third step began to be practiced by the more orthodox Jewish groups. This was known as Metzitzeh. In this step the mohel would suck the blood from the circumcision wound with his mouth. Although initially thought to reduce the infections by sucking out any bacteria, it was actually found to introduce infection such as tuberculosis and venereal diseases. More modern day mohels use a glass tube placed over the infant's penis for suction of the blood when performing metzitzah. In many Jewish ritual circumcisions this step of Metzitzah has been eliminated.[8]

First Maccabees tells us that the Seleucids forbade the practice of brit milah, and punished those who performed it–as well as the infants who underwent it–with death.

The 1st century Jewish author Philo Judaeus (20 BC-50 AD)[9] defended Jewish circumcision on several grounds, including health, cleanliness and fertility.[10] He also thought that circumcision should be done as early as possible as it would not be as likely to be done by someone's own free will. He claimed that the foreskin prevented semen from reaching the vagina and so should be done as a way to increase the nation's population. He also noted that circumcision should be performed as an effective means to reduce sexual pleasure: "The legislators thought good to dock the organ which ministers to such intercourse thus making circumcision the symbol of excision of excessive and superfluous pleasure."[11]

The Jewish philosopher Maimonides (1135-1204) insisted that faith should be the only reason for circumcision. He recognised that it was "a very hard thing" to have done to oneself but that it was done to "quell all the impulses of matter" and "perfect what is defective morally." Sages at the time had recognised that the foreskin heightened sexual pleasure. Maimonides reasoned that the bleeding and loss of protective covering rendered the penis weakened and in so doing had the effect of reducing a man's lustful thoughts and making sex less pleasurable. He also warned that it is "hard for a woman with whom an uncircumcised man has had sexual intercourse to separate from him."[12][13][14][15]

A thirteenth-century French Maimonides disciple, Isaac ben Yediah claimed that circumcision was an effective way of reducing a woman's sexual desire. With a non-circumcised man, he said, she always orgasms first and so her sexual appetite is never fulfilled, but with a circumcised man she receives no pleasure and hardly ever orgasms "because of the great heat and fire burning in her."[16][17]

Flavius Josephus in Jewish Antiquities book 20, chapter 2 records the story of King Izates who having been persuaded by a Jewish merchant named Ananias (claimed by Robert Eisenman in James the Brother of Jesus to be Paul of Tarsus) to embrace the Jewish religion, decided to get circumcised so as to follow Jewish law. Despite being reticent for fear of reprisals from his non-Jewish subjects he was eventually persuaded to do it by a Galileean Jew named Eleazar on the grounds that it was one thing to read the Law and another thing to practice it. Despite his mother Helen and Ananias's fear of the consequences, Josephus said that God looked after Izates and his reign was peaceful and blessed.[18]

There was also division in Pharisaic Judaism between Hillel the Elder and Shammai on the issue of circumcision of proselytes. See also Circumcision in the Bible#In rabbinic literature

The Council of Jerusalem in Acts of the Apostles 15 addressed the issue of whether circumcision was required of new converts to Christianity. Both Simon Peter and James the Just spoke against requiring circumcision in Gentile converts and the Council ruled that circumcision was not necessary. However, Acts 16 and many references in the Letters of Paul show that the practice was not immediately eliminated. Paul of Tarsus, who was said to be directly responsible for one man's circumcision in Acts 16:1-3 and who appeared to praise Jewish circumcision in Romans 3:2, said that circumcision didn't matter in 1 Corinthians 7:19 and then increasingly turned against the practice, accusing those who promoted circumcision of wanting to make a good showing in the flesh and boasting or glorying in the flesh in Galatians 6:11-13. In a later letter, Philippians 3:2, he is reported as warning Christians to beware the "mutilation" (Strong's G2699). Circumcision was so closely associated with Jewish men that Jewish Christians were referred to as "those of the circumcision" (e.g. Colossians 3:20) [3] or conversely Christians who were circumcised were referred to as Jewish Christians or Judaizers. These terms (circumcised/uncircumcised) are generally interpreted to mean Jews and Greeks, who were predominate, however it is an oversimplification as 1st century Iudaea Province also had some Jews who no longer circumcised, and some Greeks (called Proselytes or Judaizers) and others such as Egyptians, Ethiopians, and Arabs who did. According to the Gospel of Thomas saying 53, Jesus says:

"His disciples said to him, "is circumcision useful or not?" He said to them, "If it were useful, their father would produce children already circumcised from their mother. Rather, the true circumcision in spirit has become profitable in every respect."" SV [4]
Parallels to Thomas 53 are found in Paul's Romans 2:29, Philippians 3:3, 1 Corinthians 7:19, Galatians 6:15, Colossians 2:11-12.

In John's Gospel 7:23 Jesus is reported as giving this response to those who criticized him for healing on the Sabbath:

Now if a man can be circumcised on the sabbath so that the Law of Moses is not broken, why are you angry with me for making a man whole and complete on a sabbath? ( Jerusalem Bible)
This passage has been seen as a comment on the Rabbinic belief that circumcision heals the penis (Jerusalem Bible, note to John 7:23) or as a criticism of circumcision [5].


Male circumcision in the Renaissance
Europeans, with the exception of the Jews, did not practice male circumcision.

The Church issued a papal bull in 1442 that prohibited the practice of circumcision for all Christians [6].


Male circumcision in East Africa
Male circumcision in East Africa is a rite of passage from childhood to adulthood, but is only practiced in some nations (tribes). Some peoples in East Africa do not practice male circumcision (for example the Luo of western Kenya).

Amongst the Gikuyu (Kikuyu) people of Kenya and the Maasai people of Kenya and Tanzania, male circumcision has historically been the graduation element of an educational program which taught tribal beliefs, practices, culture, religion and history to youth who were on the verge of becoming full fledged members of society. The circumcision ceremony was very public, and required a display of courage under the knife in order to maintain the honor and prestige of the young man and his family. The only form of anesthetia was a bath in the cold morning waters of a river, which tended to numb the senses to a minor degree. The youths being circumcised were required to maintain a stoic expression and not to flinch from the pain.

After circumcision, young men became members of the warrior class, and were free to date and marry. The graduants became a fraternity which served together, and continued to have mutual obligation to each other for life.

In the modern context in East Africa, the physical element of male circumcision remains (in the societies that have historically practiced it) but without most of the other accompanying rites, context and programs. For many, the operation is now performed in private on one individual, in a hospital or doctor's office. Anesthesia is often used in such settings. There are tribes however, that do not accept this modernized practice. They insist on circumcision in a group ceremony, and a test of courage at the banks of a river. This more traditional approach is common amongst the Meru and the Kisii tribes of Kenya.

Despite the loss of the rites and ceremonies that accompanied male circumcision in the past, the physical operation remains crucial to personal identity and pride, and acceptance in society. Uncircumcised men in these communities risk being "outed", and subjected to ridicule as "boys". There have been many cases of forced circumcision of men from such communities who are discovered to have escaped the ritual.


Male circumcision in the 18th century
Circumcision was not practiced amongst Christians in Europe in the 18th Century. It was regarded with repulsion.

Edward Gibbon had referred to it as a "singular mutilation" practised only by Jews and Turks and as "a painful and often dangerous rite" ... (R. Darby)[19]
In 1753 in London there was a proposal for Jewish emancipation. It was furiously opposed by the pamphleteers of the time, who spread the fear that Jewish emancipation meant universal circumcision. Men were urged to protect:

"the best of Your property" and guard their threatened foreskins. It was an extraordinary outpouring of popular beliefs about sex, fears about masculinity and misconceptions about Jews, but also a striking indication of how central to their sexual identity men considered their foreskins at that time. (R.Darby)[19]

[edit] Male circumcision in the 19th century and beyond
Until well into the Nineteenth Century, the same sentiments prevailed.

The English explorer Sir Richard Burton observed that "Christendom practically holds circumcision in horror". This attitude is reflected in the ninth edition of the Encyclopaedia Britannica (1876) which discusses the practice as a religious rite among Jews, Moslems, the ancient Egyptians and tribal peoples in various parts of the world. The author of the entry rejected sanitary explanations of the procedure in favour of a religious one: "like other body mutilations ... [it is] of the nature of a representative sacrifice". (R. Darby)[19]
Then, a change of attitude began, something that was reflected in successive editions of the Encyclopaedia Britannica:

By 1910 the entry had been turned on its head: "This surgical operation, which is commonly prescribed for purely medical reasons, is also an initiation or religious ceremony among Jews and Muslims": now it was primarily a medical procedure and only after that a religious ritual. The entry explained that "in recent years the medical profession has been responsible for its considerable extension among other than Jewish children ... for reasons of health" (11th edition, Vol. 6). By 1929 the entry is much reduced in size and consists merely of a brief description of the operation, which is "done as a preventive measure in the infant" and "performed chiefly for purposes of cleanliness". Ironically, readers are then referred to the entries for "Mutilation" and "Deformation" for a discussion of circumcision in its religious context (14th edition, 1929, Vol. 5). (R. Darby)[19]
Historically, routine neonatal circumcision was promoted during late Victorian times in the English-speaking parts of Canada, Australia, New Zealand, the United States and the United Kingdom and was widely practiced during the first part of the 20th century in these countries. However, the practice declined sharply in the United Kingdom after the Second World War, and somewhat later in Canada, Australia and New Zealand. It has been argued (e.g., Goldman 1997) that the practice did not spread to other European countries because others considered the arguments for it fallacious. In South Korea, circumcision was largely unknown before the establishment of the United States trusteeship in 1945. More than 90% of South Korean high school boys are now circumcised, but the average age of circumcision is 12 years, which makes South Korea a unique case.[20]

Routine infant circumcision has been abandoned in New Zealand and Britain, and is now much less common in Australia and in Canada (see table 1). The decline in circumcision in the United Kingdom followed the decision by the National Health Service (NHS) in 1948 not to cover the procedure following an influential article by Douglas Gairdner which claimed that circumcision resulted in the deaths of about 16 children under 5 each year in the United Kingdom.[21][22]


Male circumcision to prevent masturbation
Non-religious circumcision in English-speaking countries arose in a climate of negative attitudes towards sex, especially concerning masturbation. In her 1978 article The Ritual of Circumcision,[7] Karen Erickson Paige writes: "In the United States, the current medical rationale for circumcision developed after the operation was in wide practice. The original reason for the surgical removal of the foreskin, or prepuce, was to control 'masturbatory insanity' - the range of mental disorders that people believed were caused by the 'polluting' practice of 'self-abuse.'"

"Self-abuse" was a term commonly used to describe masturbation in the 19th century. According to Paige, "treatments ranged from diet, moral exhortations, hydrotherapy, and marriage, to such drastic measures as surgery, physical restraints, frights, and punishment. Some doctors recommended covering the penis with plaster of Paris, leather, or rubber; cauterization; making boys wear chastity belts or spiked rings; and in extreme cases, castration." Paige details how circumcision became popular as a masturbation remedy:

"In the 1890s, it became a popular technique to prevent, or cure, masturbatory insanity. In 1891 the president of the Royal College of Surgeons of England published On Circumcision as Preventive of Masturbation, and two years later another British doctor wrote Circumcision: Its Advantages and How to Perform It, which listed the reasons for removing the 'vestigial' prepuce. Evidently the foreskin could cause 'nocturnal incontinence,' hysteria, epilepsy, and irritation that might 'give rise to erotic stimulation and, consequently, masturbation.' Another physician, P.C. Remondino, added that 'circumcision is like a substantial and well-secured life annuity...it insures better health, greater capacity for labor, longer life, less nervousness, sickness, loss of time, and less doctor bills.' No wonder it became a popular remedy." [8]
At the same time circumcisions were advocated on men, clitoridectomies (removal of the clitoris) were also performed for the same reason (to treat female masturbators). The US "Orificial Surgery Society" for female "circumcision" operated until 1925, and clitoridectomies and infibulations would continue to be advocated by some through the 1930s.

One of the leading advocates of circumcision was John Harvey Kellogg, who is well known for his pseudoscientific views on human sexuality. He advocated the consumption of Kellogg's corn flakes to prevent masturbation, and he believed that circumcision would be an effective way to eliminate masturbation in males.

"Covering the organs with a cage has been practiced with entire success. A remedy which is almost always successful in small boys is circumcision, especially when there is any degree of phimosis. The operation should be performed by a surgeon without administering an anesthetic, as the brief pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment, as it may well be in some cases. The soreness which continues for several weeks interrupts the practice, and if it had not previously become too firmly fixed, it may be forgotten and not resumed. If any attempt is made to watch the child, he should be so carefully surrounded by vigilance that he cannot possibly transgress without detection. If he is only partially watched, he soon learns to elude observation, and thus the effect is only to make him cunning in his vice."
Robert Darby, writing in the Australian Medical Journal, noted that some 19th Century circumcision advocates—and their opponents—believed that the foreskin was sexually sensitive:

In the 19th century the role of the foreskin in erotic sensation was well understood by physicians who wanted to cut it off precisely because they considered it the major factor leading boys to masturbation. The Victorian physician and venereologist William Acton (1814–1875) damned it as "a source of serious mischief", and most of his contemporaries concurred. Both opponents and supporters of circumcision agreed that the significant role the foreskin played in sexual response was the main reason why it should be either left in place or removed. William Hammond, a Professor of Mind in New York in the late 19th century, commented that "circumcision, when performed in early life, generally lessens the voluptuous sensations of sexual intercourse", and both he and Acton considered the foreskin necessary for optimal sexual function, especially in old age. Jonathan Hutchinson, English surgeon and pathologist (1828–1913), and many others, thought this was the main reason why it should be excised. [9]

Medical circumcision from 1870 to 1950 in English-speaking countries
Until 1870, medical circumcisions were performed to treat conditions local to the penis: phimosis, balanitis, and penile cancer. In that year, Lewis Sayre, a prominent New York orthopedic surgeon and vice president of the newly-formed American Medical Association, examined a five-year-old boy who was unable to straighten his legs, and whose condition had so far defied treatment. Upon noting that the boy's genitals were inflamed, Sayre hypothesized that chronic irritation of the boy's foreskin had paralyzed his knees via reflex neurosis. Sayre circumcised the boy, and within a few weeks, he recovered from his paralysis. After several additional incidents in which circumcision also appeared effective in treating paralyzed joints, Sayre began to promote circumcision as a powerful orthopedic remedy.

Sayre's prominence within the medical profession allowed him to reach a wide audience. He lectured widely in the United States and the United Kingdom, and his ideas influenced physicians throughout the English-speaking world. As more practitioners tried circumcision as a treatment for otherwise intractable medical conditions, sometimes achieving positive results, the list of ailments reputed to be treatable through circumcision grew. By the 1890s, hernia, bladder infections, kidney stones, insomnia, chronic indigestion, rheumatism, epilepsy, asthma, bedwetting, Bright's disease, erectile dysfunction, syphilis, insanity, and skin cancer had all been linked to the foreskin, and many physicians advocated universal circumcision as a preventive health measure. In 1855, the Quaker surgeon, Jonathan Hutchinson, observed that circumcision appeared to protect against syphilis.[23] Although this observation was challenged (the protection that Jews appear to have are more likely due to cultural factors[24]), a 2006 systematic review concluded that the evidence "strongly indicates that circumcised men are at lower risk ... syphilis."[25]

Specific medical arguments aside, several hypotheses have been raised in explaining the public's acceptance of infant circumcision as preventive medicine. The success of the germ theory of disease had not only enabled physicians to combat many of the postoperative complications of surgery, but had made the wider public deeply suspicious of dirt and bodily secretions. Accordingly, the smegma that collects under the foreskin was viewed as unhealthy, and circumcision readily accepted as good penile hygiene.[10] Secondly, moral sentiment of the day regarded masturbation as not only sinful, but also physically and mentally unhealthy, stimulating the foreskin to produce the host of maladies of which it was suspected. In this climate, circumcision could be employed as a means of discouraging masturbation.[11] All About the Baby, a popular parenting book of the 1890s, recommended infant circumcision for precisely this purpose. (However, a survey of 1410 men in the United States in 1992, Laumann found that circumcised men were more likely to report masturbating at least once a month.) As hospitals proliferated in urban areas, childbirth, at least among the upper and middle classes, was increasingly under the care of physicians in hospitals rather than with midwives in the home. It has been suggested that once a critical mass of infants were being circumcised in the hospital, circumcision became a class marker of those wealthy enough to afford a hospital birth.[26]

During the same time period, circumcision was becoming easier to perform. William Halstead's 1885 discovery of hypodermic cocaine as a local anaesthetic made it easier for doctors without expertise in the use of chloroform and other general anaesthetics to perform minor surgeries. Also, several mechanically-aided circumcision techniques, forerunners of modern clamp-based circumcision methods, were first published in the medical literature of the 1890s, allowing surgeons to perform circumcisions more safely and successfully.

By the 1920s, advances in the understanding of disease had undermined much of the original medical basis for preventive circumcision. Doctors continued to promote it, however, as good penile hygiene and as a preventive for a handful of conditions local to the penis: balanitis, phimosis, and penile cancer.[citation needed]

Infant circumcision was taken up in the United States, Australia and the English-speaking parts of Canada and to a lesser extent in the United Kingdom and New Zealand. The British Royal Family had a long tradition requiring that all male children be circumcised” (Alfred J. Kolatach’s The Jewish Book of Why, Middle Village, New York; Jonathan David, 1981). Although it is difficult to determine historical circumcision rates, one estimate[12] of infant circumcision rates in the United States holds that 30% of newborn American boys were being circumcised in 1900, 55% in 1925, and 72% in 1950.


Circumcision since 1950
In 1949, a lack of consensus in the medical community as to whether circumcision carried with it any notable health benefit motivated the United Kingdom's newly-formed National Health Service to remove routine infant circumcision from its list of covered services. One reason may have been Douglas Gairdner’s famous study, The fate of the foreskin, which revealed that for the years 1942–1947, about 16 children per year in England and Wales had died because of circumcision, a rate of about 1 per 6000 circumcisions. [21] Since then, circumcision has been an out-of-pocket cost to parents, and the proportion of newborns circumcised in the hospital has fallen to less than one percent.

Similar trends have operated in Canada, (where public medical insurance is universal, and where private insurance does not replicate services already paid from the public purse) Individual provincial heath insurance plans began delisting non-therapeutic circumcision in the 1980s. Manitoba was the final province to delist non-therapeutic circumcision which occurred in 2005 [27]. The infant circumcision rate in Canada has fallen from roughly half in the 1970s to its present value of 11%, albeit with strong regional variations.

In South Korea, circumcision was largely unknown before the establishment of the United States trusteeship in 1945 and the spread of American influence. More than 90% of South Korean high school boys are now circumcised, but the average age of circumcision is 12 years, which makes South Korea a unique case [13].

In some South African ethnic groups, circumcision has roots in several belief systems, and is performed most of the time on teenage boys:

"...The young men in the eastern Cape belong to the Xhosa ethnic group for whom circumcision is considered part of the passage into manhood... A law was recently introduced requiring initiation schools to be licensed and only allowing circumcisions to be performed on youths aged 18 and older. But Eastern Cape provincial Health Department spokesman Sizwe Kupelo told Reuters news agency that boys as young as 11 had died. Each year thousands of young men go into the bush alone, without water, to attend initiation schools. Many do not survive the ordeal..." [14].
Prior to 1989, the American Academy of Pediatrics had a long-standing opinion that medical indications for routine circumcision were lacking. This stance, according to the AMA, was reversed in 1989, following new evidence of reduction in risk of urinary tract infection. [28] A study in 1987 found that the prominent reasons for parents choosing circumcision were "concerns about the attitudes of peers and their sons' self concept in the future," rather than medical concerns.[15] A 1999 study reported that reasons for circumcision included "ease of hygiene (67 percent), ease of infant circumcision compared with adult circumcision (63 percent), medical benefit (41 percent), and father circumcised (37 percent)." The authors commented that "Medical benefits were cited more frequently in this study than in past studies, although medical issues remain secondary to hygience and convenience."[16] A 2001 study reported that "The most important reason to circumcise or not circumcise the child was health reasons."[29] A 2005 study speculated that increased recognition of the potential benefits may be responsible for an observed increase in the rate of neonatal circumcision in the USA between 1988 and 2000.[17] In a 2001 survey, 86.6% of parents felt respected by their medical provider, and parents who did not circumcise "felt less respected by their medical provider".[29]

In the United States, statistics (1999) collected by the National Center for Health Statistics show that the overall rate of neonatal circumcision had remained near 65% since data collection began in 1979 [18]. However, strong regional differences in the circumcision rates have developed during this time. While more than 80% of newborn boys are circumcised in the Midwest and South, circumcision rates have declined to about 37% in the West in 1999. [19]. This has been attributed in part to increasing births among Latin Americans, who usually do not circumcise [20].


Circumcision in the 21st century

Map published by the United Nations (WHO/UNAIDS) showing percentage of males who have been circumcised, at a country level. Data was provided by MEASURE DHS [1] and other sources. [2]The major medical societies in the USA[21], Britain[22], Canada[23], Australia and New Zealand[24] do not recommend routine non-therapeutic infant circumcision. Major medical organizations in the United States and Canada now say that parents should decide what is in their child's best interests, declining to make a recommendation one way or another. The AAP advises that "Physicians counseling families concerning this decision should assist the parents by explaining the potential benefits and risks and by ensuring that they understand that circumcision is an elective procedure."[25]

In recent years, some have voiced ethical concerns about the procedure. See Bioethics of neonatal circumcision for more information.

Neonatal circumcision nonetheless still remains the most common pediatric operation carried out in the U.S. today.

The South African Children's Act (No. 38 of 2005) has made the circumcision of male children unlawful except for medical or religious reasons [26].

For current circumcision rates, please see this table.

In 2005, a study suggested that male circumcision can reduce the chance of H.I.V. infection in men. The study was conducted on more than 3,000 HIV-negative South African men, ages 18 to 24. Half of the men were randomly selected to be circumcised while the other half remained uncircumcised.After following the men for a year, the researchers found that for every 10 uncircumcised men in the study who became infected with HIV, the virus that causes AIDS, only an estimated three circumcised men contracted the virus. [27]

The AMA remarked that, in one study, physicians in "nearly half" of neonatal circumcisions "did not discuss the potential medical risks and benefits of elective circumcision prior to delivery of the infant son. Deferral of discussion until after birth, combined with the fact that many parents' decisions about circumcision are preconceived, contribute to the high rate of elective circumcision."[28]

Table 1: International circumcision rates Country Year Neonatal circumcisions (%)
United States 2003 55.9%* [28]
Canada 2003 < 14% [29]
Australia 2004 10%-20% [30]
New Zealand 1995 0-5%** [31]
*The percentage refers to infants born in non-Federal hospitals; see p 52, Table 44 of the reference.
**Samoans, Tongans and Niueans in New Zealand continue to practice circumcision, but not in public hospitals, to which these data refer.


External links
VIDEO - Male Circumcision: History, Ethics and Surgical Considerations Dr. Benjamin Mandel speaks at the University of Wisconsin School of Medicine and Public Health, December 2007.
Peter Charles Remondino. History of Circumcision from the Earliest Times to the Present. Philadelphia and London; F. A. Davis; 1891.
Doyle, D: Ritual Male Circumcision: A Brief History (PDF), in: Journal of the Royal College of Physicians, Edinburgh 2005; Vol.35, 279–285
Hodges FM. The Ideal Prepuce in Ancient Greece and Rome: Male Genital Aesthetics and Their Relation to Lipodermos, Circumcision, Foreskin Restoration, and the Kynodesme., in: Bull. Hist. Med., 2001 Fall; 75(3): 375-405
John M. Ephron: In Praise of German Ritual: Modern Medicine and the Defense of Ancient Traditions, in: Medicine and the German Jews, New Haven: Yale University Press, 2001: 222-233, ISBN 0-300-08377-7
Dunsmuir WD, Gordon EM.: The history of circumcision., in: BJU Int, 1999;83 Suppl. 1:1-12
Gollaher DL.: From ritual to science: the medical transformation of circumcision in America., in: Journal of Social History, 1994;28(1):5-36.
Jewish Encyclopedia: Circumcision
The History of Circumcision website

References
^ Ronald Immerman and Wade Mackey (1997). "A Biocultural Analysis of Circumcision". Social Biology 44: 265–275. doi:10.1111/j.1467-9744.1976.tb00285.x, http://www.cirp.org/library/psych/immerman2/.
^ Gollaher, p. 2.
^ Gollaher, p. 3.
^ a b Hodges, F.M. (Fall 2001). "The ideal prepuce in ancient Greece and Rome: male genital aesthetics and their relation to lipodermos, circumcision, foreskin restoration, and the kynodesme". The Bulletin of the History of Medicine 75 (3): 375–405. doi:10.1353/bhm.2001.0119. PMID 11568485, http://www.cirp.org/library/history/hodges2/.
^ Suetonius (translated and annotated by J. C. Rolfe) (c. 110 C.E.). "De Vita Caesarum-Domitianus". Ancient History Sourcebook at fordham.edu. Retrieved on 2008-04-09.
^ Rubin, J.P. (July 1980). "Celsus' decircumcision operation: medical and historical implications". Urology 16 (1): 121–124. doi:10.1016/0090-4295(80)90354-4. PMID 6994325.
^ Hall, R.G. (August 1992). "Epispasm: circumcision in reverse". Bible Review: 52–57, http://www.cirp.org/library/restoration/hall1/.
^ a b Peron, James E. (Spring), "Circumcision: Then and Now", Many Blessings (volume III): 41-42, http://www.cirp.org/library/history/peron2/
^ Hillar, Marian. "Philo of Alexandria (20 B.C.E.-50 C.E.)". The Internet Encyclopedia of Philosophy. Retrieved on 2008-04-09.
^ Philo Judaeus. "A Treatise on Circumcision.". thriceholy.net. Retrieved on 2008-04-09.
^ Gollaher, p. 13.
^ Gollaher, p. 21.
^ Moses Maimonides (translated by Shlomo Pines) (1963). "Guide to the Perplexed by". University of Chicago. Retrieved on 2008-09-25.
^ Maimonides, Moses (translated by Michael Friedländer) (1885). The Guide of the Perplexed.. London: Trübner and co., pp. 267-269. ISBN 0524083037 No copyright in the United States.
^ Lisa Braver Moss. "Circumcision: A Jewish Inquiry". Beliefnet. Retrieved on 2008-04-09.
^ Davis, Dena S. (Summer 2001). "Male and female genital alteration: a collision course with the law". Journal of law-medicine 11: 487–570, http://www.cirp.org/library/legal/davis1/.
^ Gollaher, p. 22.
^ Josephus. "How Helene the Queen of Adiabene and her son Izates, embraced the Jewish religion; and how Helene supplied the poor with corn, when there was a great famine at Jerusalem.". Antiquities of the Jews - Book XX, Chapter 2, verse 4. Christian Classics Ethereal Library. Retrieved on 2008-09-29.
^ a b c d Robert Darby. ""Circumcision: A history of the world's most controversial surgery"". Book review. circinfo.org. Retrieved on 2008-10-07.
^ Pang, MG; Kim DS (2002). "Extraordinarily high rates of male circumcision in South Korea: history and underlying causes". BJU Int 89 (1): 48–54. doi:10.1046/j.1464-410X.2002.02545.x, http://www.cirp.org/library/cultural/pang1/.
^ a b Gairdner, Douglas (December 1949). "The Fate of the Foreskin". British Medical Journal 2 (4642): 1433–1437. PMID 15408299, http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=2051968&blobtype=pdf. Retrieved on 1 July 2006.
^ Gairdner, Douglas (February 1950). "The Fate of the Foreskin (letter of response)" (pdf). British Medical Journal 1 (4650): 439–440, http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=2036928&blobtype=pdf. Retrieved on 7 October 2008.
^ "On the influence of circumcision in preventing syphilis". Medical Times and Gazette NS Vol II: 542–3. 1855.
^ Epstein E (1874). "Have the Jews any Immunity from Certain Diseases?". Medical and Surgical Reporter (Philadelphia) XXX: 40–41.
^ Weiss, HA; Thomas, SL; Munabi SK; Hayes RJ (April 2006). "Male circumcision and risk of syphilis, chancroid, and genital herpes: a systematic review and meta-analysis". Sex Transm Infect 82 (2): 101–9. doi:10.1136/sti.2005.017442. PMID 16581731, http://sti.bmj.com/cgi/content/full/82/2/101.
^ Waldeck, S.E. (2003). "Using Male Circumcision to Understand Social Norms as Multipliers". University Of Cincinnati Law Review 72 (2): 455–526, http://www.cirp.org/library/legal/USA/waldeck1/.
^ Treasury Board of Canada secretariat. "Public Service Health Care Plan Bulletin Number 17". Retrieved on 2007-09-04.
^ a b "Report 10 of the Council on Scientific Affairs (I-99):Neonatal Circumcision". 1999 AMA Interim Meeting: Summaries and Recommendations of Council on Scientific Affairs Reports 17. American Medical Association (December 1999). Retrieved on 2006-06-13.
^ a b Adler, R; et al (2001). "Circumcision: we have heard from the experts; now let's hear from the parents". Pediatrics 107 (2): E20. doi:10.1542/peds.107.2.e20. PMID 11158494, http://pediatrics.aappublications.org/cgi/content/full/107/2/e20.

Bibliography
David L. Gollaher, Circumcision: A history of the world's most controversial surgery, New York, Basic Books, 2000, ISBN 0-465-04397-6, hardback
Paul M. Fleiss, M.D. and Frederick Hodges, D. Phil. What Your Doctor May Not Tell You About Circumcision. New York: Warner Books, 2002: pp. 118-146, paperback (ISBN 0-446-67880-5)
Leonard B. Glick. Marked in Your Flesh: Circumcision from Ancient Judea to Modern America. New York: Oxford University Press, 2005. (ISBN 0-19-517674-X)
Robert J. L. Darby. A surgical temptation: The demonization of the foreskin and the rise of circumcision in Britain. Chicago: University of Chicago Press, 2005. (ISBN 0-226-13645-0)

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Categories: Circumcision debate | Judeo-Christian topics | Cultural assimilation | History of medicine

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