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How to live ethically

San Francisco to Decide on Male Circumcision

Voters set to vote on banning male circumcision

When, in the 1930s, Scottish missionaries encouraged the British colonial government of Kenya to ban female circumcision, the mother of a friend of ours, along with hundreds of African women, took to the streets in protest. Whites had stolen their land, but they weren't going to steal their identity, they declared.

Jomo Kenyatta, who later to become the first president of an independent Kenya, famously defended female circumcision as a central Kikuyu cultural practice in his book Facing Mount Kenya. This protest against cultural imperialism was one the critical steps in the formation of sustained opposition to British rule.

After independence, female circumcision again became a source of protest, this time the opposition being led by African women, my friend included, who defined the practice as part of male dominance. Now these Kenyan women accused Kenyan men of sexual imperialism, one that put girls at much risk and sexual disadvantage.

My friend and her women activists in Kenya won their case. The practice is now outlawed for about a decade. The picture, though, is complex, for the practice is still widely practiced in parts of the country and in Kenya today it is frequently women who are its champions, just as it was in the thirties, claiming that to deny them the ritual cutting is to diminish their standing in society, relegating them to the status of, if not children, at least that of non-adults and outcasts within their own cultures.

International public opinion has lined up against the practice, relabeling it female genital mutilation (FGM). In many cultures, the practice is nothing less than mutilation. It often leads to uncontrollable bleeding, infection, complications in childbirth and diminished or absence of sexual pleasure. The World Health Organization opposes "all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons" that are performed on children.

The US agrees with WHO's stance. Since 1996, it has been illegal here, the issuing coming to the fore because of immigrants from parts of the world where it is part of the cultural norms. Americans find the practice so abhorrent that there has been virtually no opposition to the ban of cutting girls' genitals.

The political decisions about circumcision highlight the physical and psychological damage done to females in the name of tradition. Male circumcision has been exempt from the public discussion. The case for banning male circumcision has been around for years, circulating in small circles and largely relegated to the fringes. This is about to change.

Residents of San Francisco collected more than 7,000 signatures that will place on the November ballot a proposition to prohibit circumcision of male infants unless it is "necessary to the physical health of the [child] because of a clear, compelling, and immediate medical need with no less-destructive alternative treatment available, and is performed by a . . . licensed . . . medical practitioner."

This prohibition would go further than laws regulating the practice in other countries. Sweden, for example, requires that a physician or an anesthesia nurse accompany a ritual circumciser and that anesthesia be used during the operation. Several Australian states outlaw the practice in public hospitals, except for therapeutic purposes. These bans don't outlaw circumcision for religious or cultural reasons. The San Francisco ballot proposition would prohibit male circumcision before 18 years old, with no religious exemptions.

The arguments line up this way: the reason to ban the procedure is that non-therapeutic circumcision is genital mutilation, painful and dangerous and should not be performed on someone who hasn't reached the legal age of consent; the reason to continue to allow male circumcision is banning what is a minor procedure violates the rights of parents to practice their religion.

Is male circumcision a minor procedure? It clearly alters the look of a flaccid penis, but medical evidence is mixed regarding its benefits and harms. Unlike female circumcision, where most forms in which it is practiced are physically harmful to females throughout their lives, this isn't so for the male counterpart. The claim that male circumcision reduces sensitivity for the male seems a dubious proposition. If this were so, you would expect many Jewish and Muslim men leading the fight against the procedure. I've not known this to be the case.

As for the health risks, while there may be some, there also seem to be some benefits. In Kenya, for example, there is now a movement to encourage men from tribes that traditionally don't practice circumcision, such as the Luo, to get circumcised (even as adults) because there is strong reason to believe that male circumcision is an inhibitor of the AIDS virus and that circumcision may reduce the rate amongst them by 50%.

The argument that a prohibition would violate religious freedom isn't completely compelling. The state rightly trumps religious claims that present serious harm to children or to society as a whole. This is why it would be right to ban female circumcision, even if parents made the claim that it was fundamental to their religion (or tradition). The concern for the welfare of the child and society goes both ways-forcing parents to do something contrary to their religious beliefs and stopping them from doing something to the child that is harmful. Parents can't withhold life-saving procedures, such as a needed operation, or perform life-threatening procedures, such as child sacrifice.

Parents' right to raise their children the way they see fit is an important right. But it isn't inviolate. I can and should be overruled in compelling situations. Male circumcision isn't one. When and if medical evidence demonstrates the contrary, then there should be a sustained and open discussion about it. Certainly that won't happen before November. At this point, the San Francisco initiative strikes me as morally mistaken.

Arthur Dobrin, D.S.W., teaches applied ethics at Hofstra University. He is the author, coauthor, and editor of more than twenty books.

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