Circumcision is not mutilation

December 2, 2023

This article was originally published on the CircFacts website. Reprinted with permission.

Intactivists love to call circumcision “mutilation." One might be forgiven for thinking that this is their favourite word, such is the frequency with which it is deployed in their polemics. It conjures up images of harm and disfigurement and makes it easier to make the false analogy with female genital mutilation. This may be a great debating ploy, but it is nothing but a cheap attempt to score emotional points.

In the broadest sense any permanent bodily alteration might be construed as “mutilation," in which case a vaccination that leaves a scar (as some do) would be a mutilation, albeit trivial. But in the usual sense, mutilation is taken to mean harm and disfigurement, as alluded to in the preceding paragraph. Or, to use a dictionary definition: “disfigurement or injury by removal or destruction of any conspicuous or essential part of the body.”

Lest anyone doubt this choice of definition, they should note it is the one chosen by leading intactivists Denniston, Hodges and Milos (1999) who derived it from Stedman’s Medical Dictionary. So, for the sake of argument, we will stick with it.

The problem with this argument is that it is based on two premises: that circumcision disfigures, and that circumcision injures. Both premises are false.

Does circumcision disfigure?

Dealing with the first premise first, does circumcision disfigure? Of course, if it is botched in some way, then indeed disfigurement may result. But the vast majority of circumcisions are not botched and when something does go wrong it is usually trivial, and easily and fully resolved. Serious mishaps, such as partial amputation of the glans, are, thankfully, vanishingly rare (El Bcheraoui, et al 2014). For the purposes of this discussion we refer to circumcisions done properly, by trained practitioners, and without mishap. That is practically all of them in developed countries, and increasingly so in developing ones too.

Like all aesthetic matters, what constitutes “disfigured” includes an element of subjectivity, but that does not mean it cannot be objectively studied. And it has been. There are a bunch of studies on the aesthetic preferences of men and women, gay and straight, when it comes to the male organ. Thus:

• In a survey of U.S. women, 90% thought the circumcised member “looks sexier”: Williamson & Williamson (1988).

• 77% of women and 80% of men considered the circumcised member to be better in appearance, in a study in Kenya: Young et al (2012).

• 83% of gay men thought the circumcised organ looks better, in a study from Columbia: Gonzales et al (2012).

• Health care workers and parents thought that the circumcised member was “aesthetically pleasing”, in a study in Zimbabwe: Mavhu et al (2016).

• “Participants consistently described MC as more sexually desirable to women because of increased virility and a more attractive penis”, in a study in Tanzania: Plotkin et al (2013).

• 94.8% of men were “very satisfied with post-circumcision appearance of the penis”, in a study in Kenya & Zambia: Sokal et al (2014).

• Participants in a study in Botswana reported better self-esteem about the appearance of their penis after circumcision: Wirth et al (2016).

• Improved penile appearance was cited as a (minor) reason to get circumcised by Chinese men: Yang et al (2012).

• 99% of men circumcised in the course of a study in Kenya were “satisfied with the appearance of their penis”: Feldblum et al (2014).

• In a survey in Canada, "women with circumcised partners were significantly more satisfied with their partner’s circumcision status when flaccid compared to women with [uncircumcised] partners." No difference in satisfaction level was detected when the partner was erect. (Bossio 2015)

And this list is not exhaustive. In their extensive review of women’s preferences, Morris et al (2019) found four more studies (in U.S., Canada, Australia and Zambia) in which women preferred the appearance of the circumcised member. And in nearly all studies (29 of them) women, often quite strongly, preferred the circumcised member for cleanliness, health and sexual pleasure. This was true irrespective of the prevalence of circumcision in their societies, and the studies were often of women who had experience of both types of organ.

So, consistently, across continents and cultures (often non-circumcising ones) majorities of both genders say that the circumcised organ looks better. And many think it has other advantages too. Circumcision is not disfiguring; it is an improvement!

Does circumcision injure?

There is a temporary injury when the operation is performed, but that heals in weeks (faster for infants). What matters is permanent harm, and intactivists expend great amounts of time and energy peddling arguments, and cherry-picking studies, claiming that it does cause permanent damage. Which is why there is a whole section of this website devoted to showing that these arguments are bogus.

As explained in the Introduction to that section, a large body of good quality evidence demonstrates that circumcision has no adverse effect on sexual function, pleasure or satisfaction. In short, regardless of the speculations and pseudoscience of the intactivists, circumcision, done properly, does no permanent harm and does not constitute lasting “injury."

As circumcision neither disfigures, nor permanently injures, it is not mutilation.

Bad logic

The problems with the “mutilation” claim do not end there. As explained in the Sloppy Logic section, the argument is also an example of the Appeal to Emotion fallacy, and the Equivocation fallacy. When compared to female genital mutilation (which often deserves the epithet) it becomes a fallacy of False Equivalence. If that is not enough, “mutilation” is a very value-loaded word. It carries an implication of being ethically wrong, thus presupposing the very thing the intactivists are trying to prove, thus introducing circularity into the argument. But logic never has been intactivists’ strong point.

And still there are problems. As pointed out by Benatar & Benatar (2003a), even disfiguring (hence “mutilating”) medical procedures can have net benefit, citing as an example, the amputation of a gangrenous leg. They write:

“Where a mutilation is, all things considered, a benefit, it can be morally justifiable. Thus, even if circumcision is a mutilation, it does not inevitably follow that it is morally unacceptable. Further argument would be required to establish that conclusion. Although nobody would suggest that circumcision can save a life as directly as can amputation of a gangrenous leg, it is also the case that circumcision, if a disfigurement at all, is a much less radical disfigurement than a limb amputation. The benefit it would have to produce in order to be justified would thus need to be much smaller.”

In short, even if circumcision is mutilation the conclusion that it is therefore morally wrong still does not follow, it is a non-sequitur. The ability of intactivists to cram multiple logical fallacies into a single argument is impressive.

Predictably Benatar & Benatar’s discussion of “mutilation” elicited indignant objections from the anti-circumcision brigade but, as Benatar & Benatar showed in their detailed response (2003b), those objections were largely irrelevant or missed the point. Again, the intactivists’ poor grasp of logic showed.

Intactivists cannot let go of the “mutilation” claim. No amount of rational argumentation or scientific evidence will sway them. It is a central tenet of their faith. A dogma that is impervious to reason.

Just how silly the “mutilation” claim really is was neatly summed up by the Circumcision Choice team in the following meme.

References

Benatar, M. & Benatar, B. (2003) Between prophylaxis and child abuse: The ethics of neonatal male circumcision. American Journal of Bioethics, 3(2), 35-48. On-line abstract: https://www.ncbi.nlm.nih.gov/pubmed/12859815

Benatar, D. & Benatar, M. (2003b) How not to argue about circumcision. American Journal of Bioethics, 3(2). W1-W9. On-line: https://pdfs.semanticscholar.org/d669/3d16c041ddebeed469ea0a440614b5ed0cbc.pdf

Denniston, G.C., Hodges, F.M., Milos. M.F. (1999) Preface in, Male and female circumcision: Medical legal and ethical considerations in pediatric practice, ed. Denniston, G.C., Hodges, F.M., Milos, M.F., i–vii. New York: Kluwer.

El Bcheraoui, C., Zhang, X., Cooper, C.S., Rose, C.E., Kilmarx, P.H., Chen, R.T. (2014) Rates of adverse events associated with male circumcision in US medical settings, 2001 to 2010. JAMA Pediatr., E1-E10. On-line: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4578797/

Feldblum, P.J., Odoyo-June, E., Obiero, W., Bailey, R.C., Combes, S., Hart, C., Lai, J.J., Fischer, S., Cherutich, P. (2014) Safety, effectiveness and acceptability of the PrePex device for adult male circumcision in Kenya. PLoS One, 9(5), e95357. On-line: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006910/

Gonzales, F.A., Zea, M.C., Reisen, C.A., Bianchi, F.T., Betancourt Rodríguez, C.F., Aquilar Pardo, M., Poppen, P.J. (2012) Popular perceptions of circumcision among Colombian men who have sex with men. Culture Health & Sexuality, 14(9), 991-1005. On-line: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3463718/

Mavhu, W., Hatzold, K., Ncube, G., Fernando, S., Mangenah, C., Chatora, K., Mugurungi, O., Ticklay, I., Cowan, F.M. (2016) Perspectives of parents and health care workers on early infant male circumcision conducted using devices: Qualitative findings from Harare, Zimbabwe. Global Health: Science & Practice, 4, Supplement 1, S55-67: On-line: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4944580/

Morris, B.J., Hankins, C.A., Lumbers, E.R., Mindel, A., Klausner, J.D., Krieger, J.N., Cox, G. (2019) Sex and male circumcision: Women’s preferences across different cultures and countries: A systematic review. Sexual Medicine, 7(2), 145-61. On-line: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6523040/

Plotkin, M., Castor, D., Mziray, H., Küver, J., Mpuya, E., Luvanda, P.J., Hellar, A., Curran, K., Lukobo-Durell, M., Ashengo, T.A., Mahler, H. (2013) ‘‘Man, what took you so long?’’ Social and individual factors affecting adult attendance at voluntary medical male circumcision services in Tanzania. Glob. Health Sci. Pract., 1(1), 108-16. On-line: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4168557/

Sokal, D.C., Li, P.S., Zulu, R., Awori, Q.D., Agot, K., Simba, R.O., Combes, S., Lee, R.K., Hart, C., Lai, J.J., Zyambo, Z., Goldstein, M., Feldblum, P.J., Barone, M.A. (2014) Field study of adult male circumcision using the ShangRing in routine clinical settings in Kenya and Zambia. J. Acquired Immune Deficiency Syndrome, 67(4), 430-70. On-line abstract: https://www.ncbi.nlm.nih.gov/pubmed/25162816

Williamson, M.L. & Williamson, P.S. (1988) Women’s preferences for penile circumcision in sexual partners. J. Sex Education & Therapy, 14(2), 8-12. On-line abstract: https://www.tandfonline.com/doi/abs/10.1080/01614576.1988.11074930

Wirth, K.E., Semo, B.W., Ntsuape, C., Ramabu, N.M., Otlhomile, B., Plank, R.M., Barnhart, S., Ledikwe, J.H. (2016) Triggering the decision to undergo medical male circumcision: a qualitative study of adult men in Botswana. AIDS Care, 28(8), 1007-12. On-line abstract: https://www.ncbi.nlm.nih.gov/pubmed/26754167

Yang, X., Abdullah, A.S., Wei, B., Juang, J., Deng, W., Qin, B., Yan, W., Wang, Q., Zhong, C., Wang, Q., Ruan, Y., Zou, Y., Xie, P., Wei, F., Xu, N., Liang, H. (2012) Factors influencing Chinese male’s willingness to undergo circumcision: A cross-sectional study in Western China. PLoS One, 7(1): e30198. On-line: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257276/

Young, M.R., Odoyo-June, E., Nordstrom, S.K., Irwin, T.E., Ongong’a, D.O., Ochomo, B., Agot, K., Bailey, R.C. (2012) Factors associated with uptake of infant male circumcision for HIV prevention in western Kenya. Pediatrics, 130(1), e175-8. On-line: https://www.ncbi.nlm.nih.gov/pubmed/22711723