Saturday, February 27, 2010

IMHO: Cut the Hysteria over Circumcision

My weekend morning routine includes turning on the computer, and checking links to comments and news items emailed overnight. Lo and behold, I read that a fellow here in Massachusetts has (yet again) filed a bill trying to restrict circumcision.

First, an explanation. Yes, anyone in Massachusetts can file a bill through their legislator, under a provision called “right of free petition.” Whenever a legislator files such a bill “upon request” (meaning: “I’m only doing this because my constituent asked me to”) it’s usually considered the kiss of death.

Still, it bothers me. The author of this bill, and those who share his views, don’t just regard circumcision as unnecessary; they equate it with clitoridectomy and other forms of female genital mutilation.

Before I state my own position on the matter, a bit of disclosure. Yes, I was circumcised in infancy. I’ve never felt traumatized or damaged because of it. But I’ve endeavored to base my own views on research, not just personal experience.

The problem with equating circumcision with clitoridectomy is anatomy. The foreskin of the penis is not analogous to the external part of the clitoris. It’s more accurate to equate the foreskin to the clitoral hood (the flap of skin that partially covers the clit) and the clit with the glans (the head of the penis).

One can certainly argue that removing an infant boy’s foreskin is rarely necessary – but to equate it with removing a grown girl’s clitoris is both inaccurate and insulting, both to the women who have been actually traumatized, and to the millions of Jews and Moslems who consider circumcision an important rite of passage for their infant sons.

Does this mean that, were I to have a son, I’d insist on having him circumcised? No. Unless a doctor showed there was a medical need or benefit, I’d rather not. But I would also not impose such a decision on any other parent. In my eyes, an alternative to the draconian proposal cited above would be to give every parent considering circumcision all of the facts, so that they could make an informed decision.

Expressing concern – sure. Offering facts and choices – absolutely. But histrionic distortion – count me out.


  1. My impression is that it makes the kid less likely to get an STD (and thus less likely to spread it to a partner) makes the decision a straightforward one for me, but those who disagree can comfort themselves that it is a decision I will likely never make.

  2. The fact you can't compare the foreskin with the clitoris doesn't negate the fact circumcision is a violent procedure that removes with no rationale behind it. The foreskin is a very valuable tissue with 20,000 nerve endings.

  3. @Anonymous:

    My argument is not whether the foreskin is necessary, but whether removing it is as traumatic as removing a clitoris. Yes, the foreskin has nerve endings; so does the glans of the penis. That's why millions of circumcised men have perfectly satisfactory sex lives.

    There's a big difference between giving parents the facts to make an informed decision, and using exaggeration and distortion to justify taking away their choice -- whether it is to effectively ban elective circumcision, or to mandate it as many Victorian doctors did.

  4. That bill doesn't make a comparison between male circumcision and clitoridectomy. It seeks to prohibit any form of genital cutting on minors that isn't medically indicated. That includes male circumcision and clitoridectomy. But it's basis is the principle that non-therapeutic genital cutting on a non-consenting individual is wrong. That's not histrionic distortion.

    It requires only similar logic to suggest that parents be given facts so they can make an informed decision for equivalent genital cutting on their daughters. But we've already decided - correctly - that such logic is not logical, that it's inappropriate. The issue before us is whether or not male minors deserve the same protection within the law that female minors already have. It's about rights, not whether or not unnecessary surgery A is comparable to unnecessary surgery B.

  5. Ear piercing is totally unnecessary. Would you ban ear piercing for anyone under eighteen, even if they wanted it and their parents consented? Similarly, if a sixteen year old wanted either circumcision or hymenotomy (the most comparable procedure for females) and their parents discussed it with them and consented, would you now deprive them of that choice?

    That's problem with this bill: It lumps all forms of "genital cutting" under the same draconian restrictions, regardless of relative risk and/or benefit. Given the facts I've researched, I don't see where such a blanket ban is warranted. Give families the facts about circumcision, and let them decide. That's the position of the American Academy of Pediatrics, among others.

  6. I'm happy to agree that the bill should include a provision for voluntary circumcision by a minor deemed competent to grant his consent.

    Removal of the clitoral hood (i.e. prepuce) is the comparable procedure for females, not hymenotomy. That's already illegal at the federal level. That law has the same restrictions on parents included in this bill, since the MA bill is obviously based on the language of the federal anti-FGM law. We don't get lost in relative risk and/or benefit for equivalent and lesser female genital cutting because we recognize it as a moral wrong.

    It's no more valid that society focuses on relative risks and/or benefits with male circumcision. Relative risk ignores absolute risk. It obviously ignores medical need, which should be the only valid criterion for proxy consent when the child is healthy and normal. It ignores the child's rights. All individual tastes and preferences are subjective. Your conclusion on the net effect of the mix of potential benefits and risks is correct for you. Mine is correct for me. But none of that is allegedly relevant for us. The absence of equal protection for males indicates that we're supposed to accept the subjective circumcision preferences of a male child's parents' as a valid substitute for his preferences, forever. That's incorrect, which is what this law seeks to rectify.

    As a society we ignore the fact that healthy children don't need surgery. That's evidence-based medicine, properly understood. For example, we'd reject the fallacy of removing breast buds from infant girls to reduce their risk of breast cancer, if anyone seriously proposed it. Yet we could just as easily apply a "give parents the facts and let them decide" policy. What's special about male circumcision that it should get an exemption we would never give to something else that uses the same logic?

  7. Again: Millions of circumcised men have lived happy productive lives without their foreskins, including fulfilling sex lives. Compare that to how clitoridectomy traumatizes young women and deprives them of sexual pleasure. Lumping them together is like equating seasonal flu with Ebola; both are contagious viral infections, but you don't treat them the same.

    The question is which is the greater harm -- allowing some parents to choose circumcision for their sons, who can still lead normal lives afterwards, or imposing a ban because of a minority's absolutist position against it.

    Yes, I call your position absolutist. You posit that because you see circumcision as wrong based on a simplistic black-and-white logic, then you have the right to impose a virtual ban on the practice. You look only at circumcision, only at the simplistic description as "genital cutting", only at it being lumped in with much worse procedures, and declare: "It is wrong, so we're going to prevent parents from doing it, period." I say the imposition of such a ban is the greater harm, and an insult to the intelligence of parents. Not to mention an insult to me and other men circumcised as infants whom you would so quickly label as victims.

    As for cutting a clitoral hood versus cutting a hymen ... strictly on anatomy, you may be correct, but taking psychological and other factors into account, I stand by my comparison. Hymenotomy is much more common in Western medical practice, and the arguments around its need and/or benefits similarly debatable. So, for the same reasons, I would leave the decision to the patient and her family -- not to paternalistic busybodies who thing a girl's "genetic integrity" trumps all.

  8. I haven't said men haven't or can't live happy, productive lives without their foreskins. Prohibiting parents from imposing circumcision on their healthy children is about the child's choice, not his foreskin. As I wrote, all individual tastes and preferences are subjective. Inherent in that is my recognition that there are men who value circumcision and they're correct in reaching their conclusion. Nor have I lumped circumcision with clitoridectomy in a direct comparison. I'm not going to get very far if I have to defend words I didn't write.

    If I intentionally infect you with seasonal flu or Ebola, haven't I committed a harmful act against you? The difference in outcome to you for each would be significant. I concede this readily. However, the immediate question in this debate is not which is the greater harm. The question is whether or not I should be blameless for intentionally infecting (i.e. harming) you with seasonal flu because infecting you with Ebola would be worse. To answer 'no' would be ridiculous.

    Your question of greater harm is phrased incorrectly because you add subjective terms beneficial to you for each. The accurate way to state your question is: allowing parents to impose non-therapeutic circumcision on their sons or imposing a ban on parents choosing non-therapeutic circumcision for their sons. Basically, it's the harm to children from allowing non-therapeutic circumcision versus the harm to parents from prohibiting it.

    Non-therapeutic circumcision is objective harm. That doesn't have to label you as a victim. I don't, because I'm not making claims about how you must respond to that fact. But there is objective harm independent of your eventual determination on the benefits versus drawbacks for yourself. Circumcision removes healthy tissue and nerve endings. It leaves a scar. Parents making their son's choice impose those harms in every case.

    Now, maybe you don't mind that, and even prefer the changes after circumcision. I don't have an opinion on your conclusion for yourself because I'm not you. As I wrote, all individual tastes and preferences are subjective. But you're not me, either. You allege that I label you a 'victim' when you don't think you are, although I think I've clearly implied that I don't make that judgment. But you're apparently as quick to sweep away my opinion about my body based on your conclusions about circumcision, validating my parents' opinion over mine because they agree with you rather than me. The inherent problem is that parents can't know in advance how their sons will respond. When they're acting as a proxy for their children - particularly when their actions are a permanent proxy, as is the case with circumcision - that power can't be plenary. To state that is not a de facto insult to the intelligence of parents, although I can point you to examples of parents exhibiting no intelligence on this topic. It's a declaration that parents can't know what their healthy children will want, so they shouldn't guess with the most invasive response to non-existent problems. Acting in that situation is irresponsible. Since they're clearly willing and determined to guess, they should be prohibited from doing so because their guess imposes objective harms and subjective benefits on their sons.

    I'm not sure which psychological and other factors you're considering for comparing hymenotomy to male circumcision rather than the correct comparison of removing the clitoral hood. If you elaborate, I'll respond. If you don't, I'm not willing to add anything more to that because I'd have to guess at too much of your thinking.

  9. Again, again, again... You are preaching absolutism. You are saying that circumcision is bad, bad, bad and that you know better than any parent whether or not to do it.

    All you're thinking about is how bad and wrong you think circumcision is. Since you're so absolutely and totally convinced of this, you refuse to take into account how using government might to impose that decision on others will harm parents and children.

    And just as you lump circumcision in with even more harmful acts, you seem to be lumping me in with those who favor circumcision. I don't. I also do not favor using restrictive laws to make everyone's behavior conform to what I or you want, or else.

    We empower parents to make decisions on behalf of their children. We may not approve of every decision which every parent makes, but we also have to weigh whether prohibiting a given action is better or worse than bringing the force of law and government down on their heads.

    Would I rather my parents decide not to have me circumsized? Probably. But given all the facts at my disposal, I most certainly would not want politicians and other busybodies imposing that decision upon them.

  10. As a pediatric surgeon and a mother, I would like to add some perspective to this discussion. When parents have asked me about circumcision, I have always followed by my conscience and professional guidelines by providing as much information pro and con about the procedure. I have done circumcisions for over a dozen infant boys, but have always refused to do so for any child over six months.

    My husband and I have chosen not to circumcise our two sons. Does this make me a hypocrite? No, because our choice is ours, and the choice made by my patients is theirs. I have also observed these boys grow up and have not seen evidence that the procedure has made them any worse.

    Tony, I can understand that you want a simple and clear cut decision on this matter, but as a physician I can tell you that it is not always the case. I support laws which protect patients and their families. Unfortunately, taking away their right to choose regarding elective procedures does not do so. You may believe in the concept of "objective harm" but we in the healing professions know that it is much more complicated than that, and that doing the least harm often means empowering patients and their families. I certainly would not want the state second guessing every elective procedure.

  11. I didn't deny that my position is absolutist. But you treat that as if absolutism is automatically a bad thing. Can you think of any situations in which an absolutist position is reasonable? I can, beyond the circumcision debate. Being an absolutist is not enough to discredit a position. Anyway, you're position involves absolutism, when considered fully. Since your position requires that the healthy boy's opinion is secondary to his parents' opinion and is applicable only if his parents decide to leave him his choice, you're stating that his objective health isn't enough to demonstrate that he shouldn't have surgery.

    I'm not sure how many different ways I can say that I know circumcision is bad for me. I'm absolutely and totally convinced of this because I've weighed all of the factors according to my judgment for my body and my life. The emphasis I state is that circumcision is bad for me. I'm not sure why you expect me to defend the statement that circumcision is bad, full stop.

    I have said that circumcision is objective harm. It should be assumed that each person will agree until he can disagree. I've stated my case for objective harm. You haven't contested that. Instead I infer from your comments that I must embrace the subjectivity surrounding circumcision's benefits, in general, as a reason to permit parents to choose. I've said that each person's judgment of circumcision is individual to him and correct based on his personal criteria. It's about the individual, not the family. The flaw, the bad aspect, is imposing circumcision on someone who doesn't need it and might not want it. There is a valid reason to prohibit such imposition onto an individual.

    As a libertarian, I have considered how using government might to prohibit something works. (Here and here, for example.) We empower parents to make decisions on behalf of their children, but we restrict decisions that are objectively harmful. Hence, child abuse laws. And, no, I'm not comparing circumcision directly to child abuse here. I'm trying to show that there are limits to parental 'rights', and that my goal is to redraw those lines from where they are to where they should be.

    The federal anti-FGM act, enacted in 1995, is an example of this in practice, and it's not because male circumcision is somehow the same in degree as clitoridectomy. It's not, never has been, never will be. The anti-FGM act prohibits non-therapeutic genital cutting on female minors, period. That's a standard of rights for the individual child, which I support for the reasons I've stated. By your logic, you should demand that the portions of the anti-FGM act that are equivalent or less harmful than male circumcision must be repealed to avoid harming parents. I don't assume you hold that position.

    But, for some reason, I'm not getting anywhere explaining circumcision relative to the individual being circumcised. You seem to think it's about the parents, somehow, even though it's the (healthy) boy's penis. How does it harm parents to prohibit them from circumcising their sons?

  12. Anonymous:

    You're not healing anything when you circumcise a healthy boy. That's why my focus is on non-therapeutic circumcision, not circumcision. The choice to circumcise healthy boys does not properly belong to his parents based on their subjective analysis because he is healthy and owns his body. Parents do not have a legitimate 'right' to choose, in this context.

    When you tell parents the pros and cons of circumcision, do you tell them that their son might grow up to resent their decision? That's not a rhetorical question. I'm curious.

  13. @Tony:

    So far you have been dominating this discussion with very long-winded repetitions of your rightness.

    My problem with moral absolutism -- especially when it involves calling on the government to impose it -- is that it is based on a very narrow conception of what you call "objective" facts or reality. As one acquaintance of mine has put it, absolutism may be logical but it is neither reasonable nor realistic.

    1) Jaywalking is a threat to road safety.
    2) Drunk driving is a threat to road safety.
    3) The government has a vested interest in enforcing road safety.
    4) Checkpoints and strict penalties have been proven to decrease the incidence of drunk driving, or at least their negative consequences by taking violators off our streets.
    5) Therefore we should consider taking similar measures against jaywalkers.

    The problem with such "logic" is that it does not compare the degree to which each violation is a threat. The question is not whether jaywalking is a threat, but how much of a threat, and hence the appropriate response.

    This is what you don't get. You repeatedly want to elevate circumcision to the same level of harm as clitoridectomy or castration. You repeatedly want to label every circumcised male as a victim. You want one draconian standard for every act fitting a sweepingly general category, and you want to give government the power to impose that standard and strict punishment regardless. You want to eforcee your will on everyone through government fiat. And yet you call yourself a libertarian???

    You've been taking up a great deal of space repeating yourself. Unless you have something new to say, I feel I'll have to put on the editor's hat and decline any further comments from you. Let's hear other comments from other readers.

  14. May I repeat my attempt to move the conversation forward into something new? How does it harm parents to prohibit them from circumcising their sons?

  15. @Tony - Very simply, you are keeping parents from being parents.

    We entrust parents with rights and responsibilites when raising children. We do not micromanage them. The more we allow government or other "powers that be" to meddle in parenting, the more we interfere in the relationship between parent and child.

    Does this mean government should never intervene or set standards? Of course not. When there are clear cases of abuse and neglect, or when the child is older and a dispute arises, then it makes sense for government to step in. But we should refrain from doing so when we have good reason to believe that such interference would lead to far worse consequences.

    This bill also came up for discussion on a social networking site I'm on. One of the members mentioned how a rigid ban on circumcision in the Ukraine actually made things worse. Instead of ending the practice, the law and police drove it underground -- and threw it into the hands of unsafe and unscrupulous practitioners, much as when abortion was outlawed.

    Now compare that to the efforts of an international women's organization to deal with clitoridectomy in Middle Eastern and African countries. Instead of focusing efforts on trying to get governments to pass legal prohibitions, knowing those countries would be either unwilling or unable to enforce them, they have been going into villages and urban neighborhoods to talk to the women there, educating them about the harm this practice actually does. And guess what? Village by village, block by block, they are succeeding. Not just in reducing the practice, but in encouraging women to create new ways to celebrate a young woman's coming of age.

    An author and philosopher once said: "Nature, to be commanded, must be obeyed." That includes the nature of humanity. Imposing one's will over another tends to create misery and resentment; persuading them of a better way yields better and more long-lasting results, even if it takes longer.

    So, unless you can produce clear evidence -- not just superficial logic -- to impose your will on others, let's first try the route of persuasion.

  16. Desmond said: "This is what you don't get. You repeatedly want to elevate circumcision to the same level of harm as clitoridectomy or castration. You repeatedly want to label every circumcised male as a victim. You want one draconian standard for every act fitting a sweepingly general category, and you want to give government the power to impose that standard and strict punishment regardless. You want to eforcee your will on everyone through government fiat. And yet you call yourself a libertarian???"

    I've read these replies several times and I don't see where Tony is doing much of the things you are accusing him of. He does not seek to elevate circumcision to the same level as clitoridectomy or castration. Rather he rightly points out that female circumcision is prohibit regardless of degree of harm and also without regard to any other issue that might be important to the practitioners. Would you propose loosening the restrictions on female circumcision to only prohibit those that are demonstratively and objectively harmful? He also has never labeled anyone, except perhaps himself, a victim. Do you challenge his estimation that circumcision for him was bad, that he may consider himself a victim?

    There are many men who, as you say, don't regret their circumcision or consider themselves victims. There are also men on the other side of that coin who do regret it to varying degrees and consider themselves victims. What do you say to them? Where is their justice? A guy who, for whatever reason, wants a circumcision can always get one but if he regrets what his parents imposed on him, and let's remember that there is no rational reason to impose it, there is really no recourse.

    I will add as an aside that by rational I mean medically therapeutic, necessary or important to the health of the child. I do recognize that sometimes it is necessary but this is rare.

  17. @Joe:

    It would be one thing to propose a two-tier approach to the issue, looking at the overall consequences of different procedures, and recommending different approaches based on harm.

    The problem with the bill proposed, and with the stance taken by those who want to outright ban circumcision, is to see all procedures as the same, with the same consequences, regardless of the evidence.

    You ask about "justice" for men who view their circumcisions negatively. What would you propose -- that they sue their parents, have courts order them to pay for therapy and/or foreskin restoration? If so, then what about those men who resent that their parents did not circuncise them (and they do exist)? Should they likewise be able to sue their parents for the cost of therapy and surgery?

    Now contrast them to the women who have had their clitorises removed, often in unsanitary conditions and with no anesthesia. Compare this traumatic experience against the circumcision of an eight day old boy who will never remember the experience (at that age, an infant cannot yet develop and retain memories).

    There's a reason why a police officer is more likely to overlook or warn a jaywalker than a drunk driver -- the latter poses a greater risk than the former. If we were to punish all jaywalkers the same way we punish drunk drivers (would that include confiscating their shoes?) then our courts and jails would be too bogged down to operate.

    The question is not whether we respond to circumcision, but how. Given all of the evidence, what is appropriate and proportional? That is measure not only of justice, but of effectiveness.

  18. The problem is that with the female circumcision law we don't do, as you suggest, look at the actual harm that may or may not be involved; there is a blanket prohibition. If we prohibit all forms of female circumcision, even those that are objectively less harmful than male circumcision, and do not in someway prohibit male circumcision then we have an equal protection violation.

    Which brings me to your jaywalking example. Both actions you described are illegal so in that sense they are treated the same. The penalties reflect our evaluation of the danger or harm.

    Perhaps the proposed bill should not be so coarse but we are in fact coarse on one issue but not another. I see no problem with having various levels of criminal or civil penalties assigned to the different types of circumcision (female or male). Would that make it a better bill? I suspect you might still disagree with it.

    I wouldn't advocate suing parents, I would have no problem with the men suing the doctors who circumcised them unless they could demonstrate there was a medically therapeutic reason for it. This has already occurred in the US BTW. I don't see how an intact man might sue his parents if there was no therapeutic reason to perform a circumcision, it would be like suing your parents for not getting you that tattoo. Perhaps you could elaborate on how you see that occurring.

    Finally, why do we discuss the environment? Would we permit female circumcision if it was done in a sterile surgical environment, on infant rather than prepubescent girls? That isn't the reason it's banned in the US. It's banned because it's not part of our culture and we therefore find it abhorrent.

  19. First off: Clitoridectomy is not circumcision. Those who mobilize against it are just as adamant as those who are neutral or supportive of circumcision.

    Second: Why is clitoridectomy outlawed? Precisely because of the detrimental effects. Contrast that to Muslim women wearing headscarves in the US; many may disapprove of it, and even consider it bad for women, but do we ban them? No, because we don't consider it a proportionate response.

    The title of this post included the provocative word "hysteria" -- and I stand by it. My view is not so much about circumcision as it is the overblown reaction of some to the issue. It's similar to how I view pornography -- I may not like the majority of stuff which is out there, but that doesn't mean I would ever join forces with anti-porn extremists like Andrea Dworkin or Judith Reisman.

    If you want to justify the idea of virtually banning circumcision, or even suing every doctor who performed it, then I would ask that you point to clear scientific evidence to demonstrate that such a response is indeed a proportionate one. Otherwise, you and Tony are just rehashing the same tired simplistic argument.

  20. I am curious what does the author think aboutthe fact that parents are prohibited from performing other type of body modifications on their child that are / can be demonstrated to be of equal but likely much lesser harm. A tattoo comes to mind. Does preventing a tattoo unjustifiably curtail parents? Based on your discussion to date, and the insignificant risk of a tattoo, I have to assume you would believe that.

  21. The law in the United States varies across jurisdictions. Some states allow minors to get tattoos, with written parental consent; at the other end of the spectrum, other states prohibit anyone from getting a tattoo before the age of 21; until a few years ago, you could not even operate a tattoo business here in Massachusetts.

    A more realistic parallel: Some cultural groups have girls' ears pierced at a very young age. Again, while I would rather they not do so, I believe that using the law to prohibit the practice would only lead to parents going to underground practitioners, or even attempting to do the piercing themselves. Better to have availability to hygenic and skilled practitioners, but combined with educating people about the potential risks.

    Going back to tattoos... When legislators were debating legalizing tattoo artists here, I did some extensive research, including talking to professionals and aficionados. Tattoos do carry some level of health risks, which is why tattoo artists typically undergo several years of training in apprenticeship. And part of the process involves sitting and discussing these risks, and the desired results, with the client. As one acquaintance told me: "We collaborate with our canvas."

    Whether you're talking about tattooing, piercing or circumcision, I would prefer prior informed consent to extreme regulation. In the case of minors, getting parental consent makes sense. But telling the parent who is informed and does consent that their judgement cannot be trusted crosses the line.

  22. I picked tattoos for a reason so I'll stick with that. As far as I can tell, a tatto done in a properly established parlor carries little real risk. There are some cultures that practice tattooing. By my count, tattooing a minor is illegal in no less than 40 states. From how you responded can I assume you find that restriction unreasonable?

  23. Uh, read the last paragraph of my previous comment. Clear enough?

  24. Well at least you're consistent; at least 80% of states and I'd bet more parents would disagree with you.

  25. If a parent does not want to consent to their kid having a tattoo, then that's their choice. I'd like to see more parents actually sit down and talk with their kids about body issues in a sensible way, rather than just react.

    And just because a given point of view is "the law of the land" does not mean it's right. That's merely an appeal to authority.

  26. I think what you mean is that if a parent wants to tattoo their child nobody should stand in their way.

  27. Except the tattoo artist, and from the conversations I've had with a number of them, I'd say most would decline.

    For one thing, tattooing can cause a person to go into shock, especially when a large area of dermis is being covered in one sitting -- which is why artists recommend doing larger tattoos in stages.

    Given a young child's comparable size, and that they would be more likely to go into shock, most reputable artists I know of would decline to do so even at the parent's request. Some are even hesitant to do so for teens, and I've known one who says she would never tattoo an adult who was intoxicated.

  28. So if parents want to tattoo, say, the name of their favourite rock group across their daughter's forehead, that's OK by you - as long as the tattooist is willing to do it? They're being parents. Oh yes, and as long as they don't do it in one sitting.

    A man in Fresno is now serving 6 yeaars for having a friend tattoo a bear paw on his son's side. But I guess that's merely an appeal to authority.

    (Oh and boys often go into shock when they're circumcised. Unfortunately doctors, commonly OBGYNs who have no special training in male anatomy, seem to have less of a conscience than tattoo artists.)

  29. @Hugh7: Once again, showing why I've chosen to label so many "anti-circumcision" rhetoric as hysteria.

    Rather than weighing all of the factors involved, just present an extreme appeal to emotion. Circumcision must be horrible, and therefore must be banned, because you see it as no different from the extreme example you choose to provide. Doesn't matter that most people don't see whether a man has been circumcised or not; go ahead and compare it to the extreme example of tattooing someone's face, and forget what your opponent actually said in the previous discussion.

    More important, you only see "permit or prohibit" -- nothing else. Read again, my position has been to educate parents about the facts, which show no significant benefit to circumcision. And by the way, one of the most successful efforts against clitoridectomy has been to go into villages and ... educate women there about the risks involved.

    It's very easy to cry out with indignation: "There ought to be a law against this!" But aside from the fact that laws don't change things by themselves, there's also the question of the precedent being set by so quickly appealing to -- and relying upon -- the force of goverment power to make more and more ethical decisions for us.