Circumcision debate

UCLU ASHS 28/02/13

Antony Lempert (GP & Chair of the Secular Medical Forum)

vs.

Jonathan Arkush (Vice President, Board of Deputies of British Jews)

Here’s the full audio of the debate; it’s about 1hr 10mins but I’ve put highlights in my Pod Delusion report! I’ve also put timings on my notes below so that you can skip to the relevant bits if you like.

Antony had met Jonathan in July 2012 for Sunday Morning live, they had some email exchanges but they stopped because:

“he didn’t seem to like my Human Rights arguments and kept saying things like live and let live

- which I thought was funny, because that is pretty much the crux of the anti-circ position. And that boring old “human rights” argument people keep digging up, ugh!

Antony has tried in previous years to get routine infant circumcision debated at the BMA annual meeting; apparently, though, changing the wording of a proposal to remove “female” so that you’re discussing infant genital surgery generally is a no-no. Better luck this year, hopefully.

Debatable

It’s worth noting that some of the oft-discussed issues around MGM were irrelevant in this case. Arkush (I’ll refer to him as JA and to Antony as AL throughout) argues only from the perspective of a Jewish man upholding his faith; his interest is in the “religious rights” of individuals and families, so ignores arguments to do with necessity/benefit, health, female genital cutting and so forth. (For more on these, please see previous posts.)

I think an important take-home from this debate was something AL also pointed out: that there does seem to be a confusion in these of arguments. People cite “parental rights”, requesting tolerance, respect and permission to keep doing what they want to do. All well and good, until you harm other people.

The problem here seems to be that some parents do not believe their children are people in their own right. Interesting, as I wonder how many anti-abortion campaigners (especially in the USA) are pro-circumcision?? That’s a tangent though.

Without recognising that a child’s right to bodily integrity exists and you should really respect it, people end up thinking they can treat their child-property however they wish – sometimes culminating in something as disturbing as removing their most sensitive erogenous body part.

Obviously I am completely biased as a fully-fledged intactivist; there was no way JA would have convinced me of his position. He was at all times calm and polite, to his credit. However he also clearly holds some disturbing views about mental health (accusing all men who are unhappy about their circumcised status, who claim emotional trauma, to in fact have some other underlying condition) and the non-religious (with another worrying suggestion that lack of faith may lead to psychological issues, and people being devoid of values).

AL has kindly allowed me to use his slides to add information here, so you can find some interspersed with my notes below (part 2. AL 15 minutes).

Summary

JA considers it his right as a Jewish person to remove his sons’ foreskins in accordance with the traditions of his culture. He does not believe it is at all harmful. He argues against banning things we find distasteful, carrying this argument to an interesting and shocking conclusion when he disagrees with banning one of the most disturbing forms of male circumcision: the metzitzah b’peh, in which the Mohel sucks the blood off the child’s wound, thus exposing him to disease and an increased risk of death. Live and let live? The baby being worth little consideration here, apparently.

AL draws on strong arguments based in medical ethics to highlight that non-medically justified (it very rarely is) routine infant circumcision (RIC, or more accurately NTEF: non-therapeutic excision of the foreskin) is a permanently damaging procedure with complications that are often serious, and parents should not have the “right” to choose cosmetic surgery for minors, just because they are their parents. The child is not their property, and their responsibility is one of protection.

1. JA 15 minutes

00:00:00

Started with an appeal to tradition “Judaism is one of the world’s oldest faiths” (00:02:00)

The bible is clear that is matters “how we treat other people…” Indeed!

Rules, customs, values and ethical considerations

He follows Jewish traditions because he wants to

He would like family to inherit his tradition and values in turn

Judaism & Islam practise circumcision (asks us to note only boys at 8 days in Judaism) (00:02:45)

God commanded the practice from Abraham, with no reason given (00:02:55) “I wanted to keep that precept”

He “some Jews” pick and choose which parts of the tradition to keep, seemed to disapprove (00:03:30)

‘Brit’ (as in Brit milah, the circumcision ceremony) means covenant or promise (00:03:45)

It’s “more logical to keep all the rules I possibly can” (00:04:20)

Says circumcision is “safe and simple” (00:04:30)

Must be performed by specially trained and regulated individuals, “many are doctors” (00:04:45)

Initiation Society” set up in 1752 (00:05:05)

Cited example of royal family being circumcised and the same doctor cutting him as did Prince Charles ?! (00:05:45)

“In the Jewish community, complications are virtually unknown” – cited high standards (00:06:00)

Appreciates the arguments against and respects them (00:06:50). Guesses they consist of:

1) Wrong to impose on babies? “There are many things we decide for our children” (00:08:00) Waiting would be worse, it’s “safest and kindest … when the child is 8 days old” (00:08:50) and “more painful at 18″ (00:11:15)

2) Psychological issues? He dismisses these, calls it an “odd” claim, saying “some people believe they are… not in my experience” thinks any problems are down to something else and people blame circ only as displacement. (00:09:45)

Children have a right to be brought up in a faith we choose for them…” (00:10:20)

People are glad and relieved and grateful this was chosen (00:10:45)

I would not like to look different from them” ! (00:11:00)

To “we disapprove of this ritual/custom/value so we ought to ban it” he says the fact you disapprove is not a reason to ban; unless socially harmful (00:11:45)

We regulate rather than ban e.g. smoking (00:12:20)

Taking away “rights to believe” (00:12:45) – “It is not a fair way to run society… unless you can prove it is harmful to society as a whole” – 4000 years Jewish/muslim tradition… 60% American men cut (00:13:30)

Somehow tries to justify by quoting BHA (00:14:25) “Recognises the dignity of individuals… treats them with fairness and respect… respects and promotes freedom, democracy, human rights and the rule of law, and equal treatment of everyone regardless of religious belief” – “so please give me that equal treatment, let me circumcise my son” – from the perspective of a parent who wishes to cut children.

2. AL 15 minutes

00:15:50

Main points:

Function & sensitivity; autonomy; irreversibility; indoctrination; confusion in discussing parental rights

It is often argued by those in favour of ritual circumcision that parents have the right to procure circumcision in much the same way as they decide which school to send them to, whether to baptise them and the favourite comparator, whether or not to vaccinate their child. (00:17:45)

Childhood immunisation is an intervention that cannot wait until adulthood and one with overwhelming evidence of protection from serious childhood diseases such as measles and tetanus. It does not remove body parts.

(00:18:15) Responsibilities of doctors

GMC guidance first words: “make the care of the patient your first concern”

Primum non nocere

(00:18:50) In September 2012 GMC issued a child safeguarding statement acknowledging possible damaging influence of religious and cultural beliefs:

In some cases, it may be difficult to identify where parents’ freedom to bring up their children in line with their religious and cultural practices or beliefs becomes a cause for concern about a child’s or young person’s physical or emotional well-being.

(00:19:20) Key principles of Medical Ethics:

1) Autonomy 2) Beneficence 3) Non-maleficance 4) Justice

People think “their rights are under threat when they can’t cut someone else’s body?!” (00:20:10)

constraints on personal autonomy should never be used by people claiming ‘cultural autonomy’ to justify the forced removal of healthy body parts from non-consenting people. (00:21:05)

It has been illegal to tattoo children from 1969 (00:21:50)

For those without the capacity to choose, questions must be asked about procedures: is it permanent or temporary? Is there clinical benefit? Any restriction of future decisions? (00:22:20)

Not only do medical associations not recommend it, many condemn (00:23:10):

The Royal Dutch Medical Association “…a violation of a boy’s rights to autonomy and physical integrity.”
The President of the British Association of Paediatric Surgeons, (BAPS) “…an irreversible mutilating procedure… rarely, if ever, an indication for male circumcision of boys aged less than 5 years old”
Chairman of the Swedish Paediatric Society “…an assault”
Australasian Association of Paediatric Surgeons “…does not support… routine circumcision”

Was promoted to limit masturbation (00:24:30)

1993 study in the Journal of Surgery, looked into complications (00:24:50):

- Meatal Stenosis (narrowed urethra opening)
- Scarring and sinuses
- Erectile dysfunction
- Denuding of penile skin
- Psychosexual problems
- Infection and bleeding
- Urinary difficulties
- Amputation of the Penis
- Death

Nigerian midwife manslaughter conviction 2013, baby Goodluck

Birmingham hospitals provide circumcisions on the NHS. FOI requests have revealed data showing that complications often cited as “tragic and unforeseen” “isolated incidents” are actually quite common (00:26:20)

Birmingham data

For an operation the British Association of Paediatric Surgeons say is rarely if ever needed.

Sorrells 2007 and Hoebeke 2013 on sensitivity and function; circumcision removes the most sensitive area of the penis. (00:27:10)

Frisch 2011 reported on circumcision harms to women: “Frequent Orgasm Difficulties in Danish men… and a range of frequent sexual difficulties in women” (00:28:15)

Men who speak out about circumcision damage are often isolated by circumcising communities, threatened and ignored. They are not well-supported to argue their case and are conveniently seen as non-existent, with advocates always saying they “haven’t heard” anyone complaining. It’s a sensitive issue anyway and being shunned for disagreeing makes it even less simple to do. (00:28:45)

November 2009 lawsuit between 20 y/o man and his GP over his meatal stenosis, dysuria, abrasive pain, tight circumcision, a sinus and asymmetric scarring leading to bent penis; was told he had “no case for medical negligence, because this level of damage is fairly routine” (00:29:20)

The UN convention on rights of the child 1989 – signed by all countries except Somalia and the USA
Article 14 (1) Respect the right of the child to freedom of thought, conscience and religion
Article 19 (1) Protect the child from all forms of… violence, injury or abuse… including sexual abuse whilst in the care of parent(s)…or any other person who has the care of the child
Article 24 (3) Take all effective and appropriate measures with a view to abolishing traditional practices prejudicial to the health of children. (00:30:10)

Blinded by religious privilege, we can lose sight of the child, and the adult the child will become

3. JA 5 minute retort

00:31:45

Emotive language!! Anti-semitic? (!)

40 million Jews, who collect data (really? Where is it?)

we don’t argue that it’s needed so that’s a moot point

WHO, AAP ‘pro’ stances

I don’t follow the practice because of health benefits “although HIV is drastically lower”

BMA and GMC have circ guidance! Ethical and religious values are important

These [negative comments] are minority views and not reflective of the whole practice

I want to make decisions for my children

in society we tolerate costly things e.g. drugs and smoking

4. AL 5 minute retort

00:36:35

We should aim for progress, not tradition

Actually the USA is the minority view.

legalizeforeskin.tumblr.com-image-44340298361

Obviously it’d be better to have some actual data on here!

In Jewish law: if 3 of your babies die, you don’t have to cut the 4th

Mohel reports are… where? Also easily dismissed

Milah UK Autumn 2012 set up to challenge German ruling

BMA is clear on circ, illegal under Human Rights act? BMA conference debates

5. Questions and discussion

00:41:00

1) Edward Presswood

You said your son was circumcised and didn’t even cry. Can you describe how it was done without making him cry?

JA: “I’m a bit squeamish but I wasn’t there. Local anaesthetic, quick, guard in place, wine in mouth to encourage child to sleep, feeding after, Mohel visits for following 2 days” (00:41:10)

Defends Jewish practices in comparison to ‘less well regulated’ procedures (00:42:05) such as baby Goodluck and another boy who died after a Rabbi cut him (00:42:40). Blamed the mother for ignoring instructions to call doctor/hospital/mohel if there was any bleeding. AL interjects with further information (00:43:25). “The issue is that taking a knife to a normal child’s body exposes them to risk that they don’t need to have”

JA: “complications in the Jewish community are extremely rare”

2) Jewish audience member: possible harm to welfare [when not cut]? Would boys have preferred “most likely” to have had it when they were younger? (00:45:20)

3) Difficulty with making things illegal; wouldn’t it still happen (00:46:25) – see FGM. No prosecutions. Doesn’t mean we shouldn’t make things illegal.

4) USA ‘looking normal’ concerns (00:47:55)

JA: Jewish community isn’t responsible for USA high circumcision rate; social reasons

AL: AAP is a trade organisation; it’s a cultural phenomenon and doctors profit from it (00:49:25).

5) EP: Orthodox Judaism Mohels – what about tolerating/banning the sucking [metzitzah b'peh] practice? (00:50:15) – JA wouldn’t ban it!! “I’m just very chairy about going for bans” (00:52:25 – sorry about my phone buzzing there!)

00:52:50: AL on deaths from circumcision being excluded from studies’ data analysis (approx. 200/year)

6) 00:54:30 – asks AL for opinion on HIV/circumcision research. NB/ 57:30:00 a member of WHO circ “expert” board invented circumcision devices?

7) My question (00:58:15): would you really consider opposition to genital mutilation (as it is generally universal where it occurs; regarding male or female, hospital or elsewhere, religious or cultural etc.) to be anti-semitic?

I won the debate with this, because JA fell for Godwin’s law, and compared us all to Nazis and communists (00:58:45-01:00:40):

“the chancellor Angela Merkel was acutely concerned about a country where circumcision was last banned – incidentally 2 world rulers in modern times who sought to ban circumcision were Hitler and Stalin – so that’s the company you’re in”

At that point I did a \o/

8) How can you agree with criminalisation of theft and not with thieving a part of someone’s body? (01:02:10)

JA: parental decision because child is too young, a parent is entitled to that – compares to ear piercing or tattoos. Defends his right to remove healthy body parts from an incapacitated child. Cites “everyone I know in the Jewish community feels the same way”

AL: reiterates that those who speak out are ostracised by “the community” (01:04:30) and JA confirms that one woman on the Board of Deputies was removed because of her synagogue was ‘upset’ by her dissenting opinions (01:05:15). Insists someone would not be ignored if they said they were “born with” a circumcision that harmed them, but is picked up on this because he already dismissed them in his speech.

9) How would you feel if your son had to be castrated (?), how would you explain that to him? (01:07:00)

JA doesn’t seem to accept that risk of serious injury or death is a good reason to avoid this unnecessary surgery, saying hewould feel “desperately guilty and sorrowful” – he would say “I consciously exposed you to such risk as there was … but I probably would make the same choice again”

EP: asks if he does recognise there is a risk (yes) (01:08:45)

He also let slip that he believes those who lack faith also lack any values (01:09:15). Nice.

Cuts, labels and preferences

Last night I stumbled upon (via a friend) what is probably one of the best posts I’ve read in a long time about male circumcision – it’s got just about everything there. The religious angle, of course, since the article is written by Jewish Nobel prize winner, George Wald.

But more than that, it highlights what a complex issue genital cutting is and expands upon the probable motivations that drive people to it. Where angry victims tend to place the blame (squarely upon mothers, except in Judaism); FGM; issues of gender and misogyny; the less reported forms of MGM outside of the USA and Europe; basic embryology; health myths (for the skeptical readers!); and personal perspectives from those involved.

My one problem with article is minor but it started me thinking, so here it is. His use of the term “bisexual“. I think in the article’s context he means something more along the lines of intersex/hermaphroditic. He’s talking about the first people in creation myths being of both genders, parallel with the contested view of a god who is “both male and female”. That’s not what bisexual means, at least now – what it actually means is being attracted both to people who identify as the same gender as you do, and to those whose gender identity is different from yours.

To improve understanding, a common point is that you wouldn’t be surprised by someone who likes people whatever their hair/skin colour, height, or weight. For many bisexual people, gender is also no bar to attraction or, indeed, love. Through ignorance and misunderstanding, there are so many misconceptions and insults thrown at those who self-identify as bi, and in recent years I have become more aware of it and more annoyed by it. Bisexuality does not imply greed or promiscuity, it is not a product of indecisiveness, immature experimentation or a phase. Assumptions along these lines are offensive.

http://en.wikipedia.org/wiki/Bisexual_pride_flag

Bisexual pride colours

Biphobia, including the assumptions listed above, may not be a concept everyone is familiar with. Sometimes people argue bisexuality doesn’t even exist, but I disagree very strongly for many reasons. Bi-invisibility is part of biphobia; people often (consciously or otherwise) try to erase bisexual identity when they find it. Settling down with a partner of the opposite or same sex does not then magically make you straight or gay! Just as a prolonged involuntary dry spell does not make anyone who would rather be sexually active in fact asexual. Bisexual individuals who have only had sexual experiences with the opposite sex do not have to identify as “curious” – would you question someone’s professed heterosexuality at age 21 just because they happen to have remained a virgin?

Not everyone chooses a label for themselves. Some do not find it necessary, some find it restricting – people who have absolutely no boundaries with respect to gender (or anything else) and their relationships may, for example, prefer pansexual. However, there are good arguments against using semantics and etymology as reasons to shun labels – but especially, against criticising other people’s self-identification with them.

Many labels are reductive, they kind of have to be by their very nature. But people often like to be part of a group, it helps us to feel we belong and are accepted. Most of us crave that; we seek out communities that value similar ideas and this helps us value ourselves. It can be integral to our happiness, though may not be essential for everyone. Uniting under a banner – literally or figuratively – can also help push forward the drive for equality and fair treatment. It is important to bear in mind that identification with labels is (or should be) a choice that people make and when minority groups attack each other for it (bisexuals are somewhat famously persecuted by both gay and straight communities) it is so self-defeating.

Coming to grips with these ideas in theory is one thing. Living them in practice is another. For example, having seen otherwise sensible and lovely people come out with some nasty transphobia (something I have shamefully done in the past myself), I still consider direct experience – meeting people and getting to know them – to be one of the best ways of overcoming irrational prejudices. Once you meet people and see that your assumptions were total crap, it’s much easier to move on and make positive changes to opinions and behaviours. This, for me, is also one of the strongest arguments against segregated education, particularly on religious grounds.

I did go to a single-sex school, but that didn’t preclude my having male friends. It did mean I encountered a lot of homophobia (obviously going to school with pupils of one gender automatically makes you gay!) and, indeed, biphobia (well if you fancy any of the girls, you must fancy all of them! Another stupid biphobic idea that’s so obviously ridiculous if you apply it to straight or gay people) – but ultimately I feel positive about my education at least in academic terms. That’s a whole other post, though. Feel free to leave your views, teachers and single-sex/co-education fans!

The “gender binary” is a problematic idea for lots of people and even male/female labels can be oppressive. This fantastic article sparked a little debate recently. I have had abuse shouted at me when I’ve not been looking obviously female – which probably isn’t too often but still – and people are often shocked by this. I hate that women and men are expected to look certain ways, and if you look out for it I’m sure you’ll see that insults based on this are common.

For some reason, not being able to work out the contents of someone’s pants (or indeed their sex chromosomes) is a legitimate source of comedy or, worse, justification for derision or violence. “Justin Bieber looks like a girl in that photo! Hahaha!” “Is that person over there a boy or a girl? I don’t know! Let’s beat the shit out of them to teach them a lesson.” – what? Why are people required to be open books? Misogyny, homophobia, transphobia – people don’t realise it, and they continue it.

Yet this kind of restriction is something that the majority don’t think about – they probably don’t have to, if they’re lucky to fit within the “normal” boxes that the culture has predefined. That extends to many lifestyles, decisions and qualities – we are not all the same and society’s (as opposed to the individual’s) need to label is often so restrictive that it oppresses huge numbers of people. But something else that annoys me is hypocrisy around protecting people’s right to choose and the nature of preferences.

I believe people can do whatever they like, especially when it comes to sex, if all necessary consent is obtained and no one is being harmed. So, I get pretty angry when people start throwing around accusations of -isms and -phobias based on other people’s sexual preferences. Thankfully we do have the right to decide who we sleep with! We have no obligations to anyone in that regard, from asexuals to enthusiastic sex workers, our choices are (or should be) our own. Don’t talk about choice and how important it is and then dictate to people what they should and shouldn’t do with their sex lives.

Attraction (or lack thereof) is innate, not chosen, as pro-equality campaigners will tend to argue. If you’re not attracted to someone of the same sex, not sleeping with them does not make you a homophobe, obviously – similarly, not being attracted to people from a particular “race” – or to none except similar to yours – does not make you racist. As long as your only discrimination is not sleeping with them, I don’t see how you could possibly come to any other conclusion. You’re looking for things to be angry about, perhaps. I witnessed a bit of a Twitter argument about this recently, and it’s one I’ve had myself, so now is a good time to make the point.

There are also different kinds of attraction: including (but perhaps not restricted to) physical, emotional, intellectual – different people place different levels of importance on those things and choose their partners accordingly. I’m a fan of all three at once, which is reflected in my history (that’s my own business unless I choose to talk to people about it!) and preferences – some decide to call that “picky”. Those with broader tastes might say they don’t have “a type”, or disconnect their physical experiences from other aspects of their lives.

These are all choices we can make, yet often we find ourselves judged for them. The “less discerning” among us might be labelled sluts or studs (again, depending on your gender and the ridiculous expectations people hold based on it) and those who are very selective about who they sleep with or simply place little importance on the physical might be frigid or gay – that most pathetic of insults that I still struggle to banish from my vocabulary because of the university environment.

This destructive judgmental behaviour is a bit like feminists sneering at women who have chosen to be stay-at-home-mums when that’s what makes them and their family happy and works in their relationships. Or when polyamorous folk start calling their monoamorous friends “weird”. When people with a particular fetish put down those who happen not to share it. Acceptance has to be given as well as received, and if you are going around being very negative about groups you don’t identify with then I’m not sure you’re helping, however active you are in other progressive causes. Live and let live.

Choice is what it’s all about. You should be free to choose things for yourself, in your own life, especially when you are harming no one. However, the imagined “parental choice” to cut the genitals of their children needs to go. That dangerous decision takes away choice from the victim, who can never regain what is taken from them, who can never choose for themselves what was done to their body. Irreversible damage. Adults choosing body modification/cosmetic surgery/assignment surgery for themselves is clearly different and irrelevant to the GM debate.

I might write a post that’s actually about GM soon..!

Invisible Lives

It’s a skeptics in the pub write-up!

In case you missed it, I luckily made it to Westminster Skeptics to see Juliet Jacques give her talk,

Thinking critically about transgender issues

and you can listen to it on the Pod Delusion but I shall write up my notes for those who prefer to read!

Firstly Belinda Brooks-Gordon introduced the talk by saying that trans rights have not really moved forward along with women’s rights. To try to highlight this and educate people, Juliet has a Guardian blog where she posts regularly about trans issues.

Now we can hear what Juliet has to say – it’s a lot of stuff, hugely informative, and it was a great talk!

I’ve put in a few thoughts of my own with [Comment: ...] along the way.

Transgender” is almost deliberately a loose term. There is no commitment to a transsexual (TS)/transvestite (TV) distinction; the two not being the same thing, in case you’ve never thought about it before.

It turned up in late 1960s United States literature and became popular in the 1990s as an umbrella term for gender non-conformity and gender-variant identities.

Terms such as male/female (referring to bodies) were challenged by transgender communities.

A Whistle-Stop Tour of Trans History

Gay/lesbian histories and identities are far better explored (also bisexual but to a lesser extent) and it is much easier to define these terms.

In the Victorian era, modern industrial cities like London were giving people the chance to cut themselves off from their families and old friends, to reinvent themselves and be isolated from their past.

Thus, LGBT identities became possible.

However, men who dressed as women in public were arrested and sent to court. The Met, from 1829 onwards, accused the offenders of being ‘sodomites’; Victorian authorities associated cross-dressing or, officially, ‘men in female attire’, with homosexuality.

[Comment: at this point I'm reminded of one of my favourite comedians. Now, it might piss some people off that I bring it up, but having had close family dismiss him for his transvestism when I was quite a lot younger, since then I've felt uncomfortable when people poke fun.]

Men would often try to have the charges dropped using a defence of humour; “it was just a lark”. They dismissed their actions in this way to avoid prison.

In 1870 two men were often seen out and about as women. The mainstream press showed photos of them and they were well-known in London theatre. One was also associated with the aristocracy. They were charged with committing an “unnatural offence” and were subjected to examinations trying to prove they had engaged in anal sex. This (unsurprisingly?) failed and new charges were brought:

“Conspiring to incite others to commit an unnatural offence”

There was no frame of reference. Law and the media were reacting to events, creating legislation. The prosecution tried to prove cross-dressing was innate in order to suggest that sodomy had occurred.

There was the basic assumption that these people were deliberately trying to deceive men into having sex with them, by pretending to be women.

Obviously everyone’s lives revolve around heterosexual male perceptions!!

Women were also not accorded sexual agency; feminine sexuality was also suppressed.

[Comment: it was in the Victorian era that genital mutilation really took hold culturally; sex was something to be ashamed of and dampened, for both men and women. Circumcision was touted as a cure for boys' masturbation 'problems' and female circumcision became popular to suppress female sexual desires and 'hysteria']

A new defence was then brought: that they’re actors! Actors continuing their roles outside of the workplace. Male-female cross-dressing was a long tradition particularly in English theatre so there was an assumption of performance associated with it, and that London was a City of vice.

The judge did not like the police; he felt they had violated the men’s human rights with their invasive ‘questioning’. Public support increased due to this mistreatment.

In 1885 an amendment to criminal law was made: 2 years in prison for male-on-male sexual acts (which ensnared Oscar Wilde and he was sent down under this law).

Germany’s Paragraph 175 outlawed homosexual behaviour. After this, sexology developed, in order to classify and understand human sexual behaviours.

The medicalisation and pathologising of ‘conditions’ such as homosexuality and transgender/gender-queer identities then began.

Medicine and Media

In 1909-1910 Havelock Ellis published a book called The Erotic Drive to Cross-Dress.

Language is always evolving but there was little to describe transgender behaviour. Transvestite was coined as a broad term then, but is obviously more specific now; referring only to the act of wearing clothes traditionally thought of as being suitable for the opposite sex.

During World War I, Edwardian British and German sexologists were less active. There was still no separation of maleness vs. masculinity or femaleness vs. femininity.

In 1928 The Well of Loneliness was published, one of the first accounts from female perspectives.

The Institute of Sexual Science was founded in 1919 and pioneered sex reassignment surgery. A Danish painter, Lili Elbe, died after attempted ovary and uterus transplantations (Niels Hoyer wrote an account of her life, Man Into Woman). In 1933, the National Socialist Party closed the Institute down and people photographed the book burnings that took place.

These events caused the study and understanding of gender issues to be significantly held back.

Gender verification in sport also became an issue, resulting from people’s suspicions and prejudices, particularly those of Avery Brundage. Examinations to determine (mainly female) competitors’ sex were introduced with the intention of identifying people with an ‘unfair advantage’ – i.e. those born physically male but living as women.

In 1945 the first female-male sex reassignment surgery was performed on Laurence Michael Dillon who later wrote his own book, partly inspired by The Well of Loneliness.

Male-to-female transitions drew attention. A TV/TS schism formed, and also between TS and Gay/lesbian – the latter emphatically not desiring of surgery.

Then the first male-female transsexual was a friend of Dillon, in the early 50s; Roberta Cowell, an ex-pilot and racing driver. Her transition was serialised by the then equivalent of OK/Hello! magazine.

The front page of the New York Times featured Christine Jorgensen, a former US army conscript, in 1952. Her doctor, the sexologist Harry Benjamin, emigrated to the States during WWI. He worked on medicine for TG people, and with those who believed in pathologisation of the ‘condition’. He was closely involved in the development of phychological assessment and requirements for patients to follow ‘paths‘ to get the treatments they wanted.

The medical establishment was in control; unreasonable demands of femininity were made of M-F trans people (F-M were somewhat invisible – people assumed that women did this for practical reasons, to assume more powerful and respected roles in society); antiquated ideas of femininity were forced on people.

In ’66 Benjamin’s book The Transsexual Phenomenon was published, which detailed types of TS e.g. ‘Type 4′ – those with no desire to undergo surgery. These were all ideas articulated by non-trans people.

TS people became aware of the book. People understood the boxes to tick to get what you want - answering the questions posed ‘correctly’!

In 1960, April Ashley had surgery in Morocco. She had been married to Lord Corbett. He took her to court for divorce and the ruling was that she should still be considered male, so the marriage was void and there was to be no settlement. This set a legal precedent in the UK – that TS people’s sex is defined by what is printed on their birth certificate.

In the 60s, transitions and who could afford them were strictly controlled. ‘Sects’ emerged, for example in San Francisco. Sex workers funded their surgery. Police often harassed and blackmailed them in Compton’s Cafeteria, eventually causing them to fight back and a documentary film was made covering it.  Later the New York Stonewall Inn bar, rented by the LGBT community, was scene to more famous riots, where Sylvia Rivera stood up to police oppression. This led to the modern movement of Stonewall as the gay liberation front (gay in this context being queer & non-conforming identities).

People became more vocal about trans not being equal to gay and vice versa. Many were trying to integrate with ‘respectable’ hetero society. It became a cliché in the press; “I was born into the wrong body” – people started to think it was a new idea.

Lesbian and feminist groups became prominent in the 1970s. These were women-only spaces; M-F transitionists, did they fit in at all? Sport was also a bi-gender separated space. Trans decisions (and often requirements) to conform to patriarchal ideas of femininity annoyed some feminists.

Janice Raymond wrote ‘The Transsexual Empire: the making of the modern she-male’ and other anti-trans feminist literature, very aggressive in its content.

She managed to suggest that TS women were worse than rapists, that the appropriation of female bodies “becomes a total rape” (!). [Comment: hovering dangerously close to a no true Scotsman, I feel that 'feminists' being so obviously prejudiced against gender non-conformity would run against the very core of feminism itself, but maybe that's just my view of it.]

She claimed [comment: epic invocation of Godwin's law here] that TS technology was perfected in concentration camps, but there is no evidence for this. She interviewed 12 TS women (TS men didn’t fit; they were mainly dismissed as butch lesbians). This was prominent in the media.

Carol Riddell addressed Raymond’s comments in 1980. Sandy Stone also responded with The empire strikes back: a post-transsexual manifesto.

The Victorian persecution of cross-dressers made trans people invisible. Clinicians were free to frame the experience in a light designed by them alone, to propagate stereotypes, create legislation and silence trans people.

The mainstream media/trans schism developed as trans people were not used in film, TV etc. – the experiences presented were not framed by trans people themselves.

Authors stepped forward to promote the anti-transphobia cause, including: Jan Morris (Conundrum: An Extraordinary Narrative of Transsexualism, 1987); Kate Bornstein (Gender Outlaw: On Men, Women And The Rest Of Us, 1994); Leslie Feinberg (Transgender Liberation: A Movement Whose Time Has Come, 1992); and Viviane Namastie (Invisible Lives: The Erasure of Transsexual and Transgendered People, 2001).

The organisation Press for Change was established in 1992 and finally the UK government passed a bill to create the Gender Recognition Act in 2004.

Today

Trans identities have some constitution now. The meanings of words for ‘Gender-queer’ individuals (TS, TV, TG etc.) are still evolving. We are experimenting with the language. The challenge is tackling transphobia and in a sense this is following on from the gay liberation movement. Homophobic violence is still often based on gender expression and identity.

Fear of unknown and unusual drives people’s prejudices. This is often reinforced in the media, a prominent example being Psycho; in which Norman Bates fits the ‘all crossdressers are crazy!’ stereotype. [Comment: I'm reminded again of Mr. Izzard's distinction between TV people in general and the "fuckin' weirdo transvestite!"]

Work is ongoing to close the gap between the mainstream media, trans people and how articles are produced. Also questioning the usefulness of bracketing TG with mental illness; at the moment it is still in the DSM of mental disorders. Perhaps we can overturn the idea that TS is a mental health issue. TS people do have a fear of ‘coming out’ so to do so may help.

In tackling transphobia there is a need for good language use and critical thinking on these issues.

Questions

Q. The ‘Real life experience’ requirement – no scientific basis to it; just tradition?? Good reasons for it potentially being harmful. Barrier and ritual humiliation. People coming to harm via the ‘Hormonal black market’ – e.g. oestrogen without prescription.

A. Especially in Britain. The Trans pathway is structured by the NHS’ fear of being sued; transition and regret. Public money and anxiety over its use! People often suggest decommissioning of gender reassignment to save money (approx 70% comments on Guardian!).

Need for some gatekeeping. If there’s no test; it’s an irreversible surgery. Russell Reed: hormones as diagnostic tool (effects are reversible) – one can stop and revert.

Bit of an endurance test. Street hassle, everyday things become an ordeal. Some programmes do away with the psychiatry element. Difficult – more flexibility? Equality? They were allowed x time… cut-off points?

Increased acceptance – more people – pressure from the right to not spend money?

Q. Language. LGBT(Q) bit awkward? Internal disagreements – your view?

A. Ever-expanding acronyms. LGBTQQI (lesbian, gay, bi, trans, queer, questioning, intersex) – a way around?

Umbrella term. But PC & this are kind of concurrent. Press fatigue with ‘PC’. Introduction of new words isn’t really tolerated now cf. 70s/80s.

“PC” is now pejorative. Causes some friction? Sexuality =/= gender identity. The state didn’t separate these.

How do to this but keep an ‘alliance’? Tend to occupy the ‘same spaces’. Contesting rights (Belinda BG). Trans & bi rights trampled! Medicine/sci/law intersection and research is behind –> guesswork policies.

Q. Liz D. Popular culture e.g. Coronation St. (did it badly?) M-F trans people e.g. in Little Britain – offensive?

A. C St. Hayley. History of trans people not given a direct voice/part. Spurred dialogue and was sympathetic to the issue.

Dana international won eurovision; informing people that TG different from L/G etc. “City of Lost Souls” TS singer in lead roll. Autobiography “Man Enough to be a Woman”. Warhol, punk etc.

Tara O’Hara character. Argument on need for surgery and ‘womanhood’.

Little Britain:  trans women as comedy. Trans men ignored; men who want to be female/feminine are funny whereas if women want to be men it’s practical. Merton & co. should be more careful with jokes.

You don’t always know how your creation will be perceived eg.. Al Murray pub landlord! Taking the piss out of people but then they adopt it; uncritical identification and missing the point.

 

Stereotypes often have a basis. Not being critical of them, historical context needed. The LB catchphrase “I’m a lady!”  is now shouted at people; people aren’t aware of transphobia.

Q. Pronouns. He/she/it ?? Queer has pejorative connotations (depends on who it’s from) – are you happy with the bifurcation?

A. Personally, yes. Have there been attempts to create new terms for people who don’t fit M/F and or don’t want – outside the binary; se/hir.

If you’re not sure, ask! Give the right of ID to the person rather than imposing your definition, but if you can’t…

e.g. Sonia/David Burgess and tube incident. Press coverage was awful.

Transmedia watch. Work with media creators; gap in education. Social innovation camp; trans techies, media, journos/broadcasters – contact us @transmediaact @transmediawatch

Q. A utopia where law does not interfere with people and their gender? Legal M-F/F-M transitions.

A. There was; they just existed. Legislation and pathologisation led to project to re-normalise.

Q. Change of language ?? To reflect diversity of trans group?

A. Complicated! TG is useful for many. Weird stereotypes around TV e.g. otherwise successful men putting wife’s undies on at home.

Trans cf. privacy issues. Often that history is irrelevant and incidental.

Q.  Is the goal to erase negative or balance negative with positive?

A. Balance. People will share strong negative opinions inevitably.

Q. 1. is use of ‘proper’ pronouns a barometer for accpetance? 2. Maybe human minds are wired to categorise things. 3. Sexuality =/= gender… do you think it might be useful to dissociate completely from LG(B)?

A. 3. Trans people have sexuality; B or G or L… L&G esp have fixed gender associations and so are inadequate to deal with trans. Hence, LGBTQ(I) more relevant.

BBG: Stonewall etc. have resources and can often help.

1. Principle: right to self-determination. Choose your own pronouns (cf. ms?) Changing beauty standards related.

Q. Scientific studies e.g. on brains etc. If there is a ‘trans test’, is it good or potentially harmful?

A. It would change dealing with transsexuality.

Q. Ignorance. People are unaware of the issues; do trans people need to ‘get real’ and understand that people generally have no knowledge of these things?

A. Panic about making mistakes can increase their frequency; allay people’s fears – better for all – some trans responsibility here.

LGBTQQ… we’re all beaten up by the same people!

A call was made for a Corrie/LB blogpost.

Also: David Walliams played ‘Vulva’ in Spaced; when wearing some make-up after filming and walking through a park – he was verbally abused and stones thrown – he wrote about it and was apparently amused by this?!

Also listen to the Pod Delusion report by Liz in Episode 107! Transgender and the Media (41:00) ft. Nathalie McDermott

My no. 1 overlooked issue in skepticism

This week I submitted a guest report for the Strange Quarks podcast (you can also listen on the Guardian website, ooh!); you can follow them on Twitter.

Here’s what I said in text format with some links and a bit of stuff that had to be left on the cutting room floor; also see my earlier posts here and here for expansion. I hope to find time to do a proper post on the HIV/circ issue some time but my free time is practically non-existent right now!

I’m going to talk about my number 1 overlooked issue in skepticism, which is: circumcision. I think people should be talking about it more.

We’re quite rightly disgusted by and vehemently opposed to female genital mutilation or FGM.

All its various forms are reviled and usually illegal, from those as minimal as a pinprick to the most severe and life-threatening.

However, the developed world, including the UK, used to widely practice FGM alongside male circumcision or MGM both for similar reasons, including beliefs of hygiene benefits, curing disease or unwanted behaviour and aiming to reduce or remove sexual desire.

But girls now have their healthy, functional tissue – their bodily and genital integrity – protected by law; makes sense.

I’d argue all children should be protected from unnecessary, damaging, permanent genital surgery; routine infant circumcision is cosmetic surgery, encouraged by parents, religious traditions, or physicians who sometimes make a profit from it, in the case of the US.

No baby can consent to having a healthy part of his body removed or altered and this is surely a violation of his basic right to protection from abuse and, indeed, of a doctor’s oath to Do No Harm. Edit: it pays to think before it starts to matter more, because then it can be too late. Watch this medical student, and read his comment underneath his video.

There are a lot of lame excuses around.

People wrongly believe that “It’s harmless!” The deaths of over a hundred babies per year in the US alone suggests otherwise, not to mention non-fatal complications such as scarring, meatal stenosis, skin bridges, fistulas, cysts, impotence and the one-in-a-million chance of the loss of the penis altogether.

Edward Wallerstein said, “Circumcision is a solution in search of a problem.”

It’s been cited as a cure for all sorts of ridiculous things down the decades, from epilepsy and masturbation to bed-wetting and blindness. It offers no more hygiene benefit than 10 seconds in the shower with a bar of soap. I file it with alternative medicine-style quackery and the reasons for its persistence are strangely complex.

One problem now being recognised with the latest in a long line of dubious justifications is that suggesting “circumcision could prevent the spread of HIV!” to already poorly-educated populations causes a sort of invincibility complex to form, where people believe they are resistant and therefore end up spreading the virus even more.

Improving sanitation, education, barrier contraception availability, and reproductive autonomy for women are things we should be striving for anyway, not trying to shoe-horn in outdated surgical procedures.

Then there’s the “He won’t remember if we do it when he’s a baby!” line. People don’t really remember anything from their infant days but that doesn’t mean you can abuse them in any way you like.

“Oh, the foreskin is useless!” people proclaim light-heartedly. A false perception likely the product of depressingly insufficient sex education, including within medicine. It’s actually the most nerve-dense, sensitive part of the penis. Any volunteer test subjects for this assertion? I thought not.

Studies assessing whether circumcision affects sexual function and pleasure often make two critical mistakes in the groups they compare to intact men; 1. those circumcised at a young age (who therefore have no ‘natural’ sexual experiences to relate to) or 2. recently-cut adult men reporting increased pleasure, when it takes a few years for permanent glans exposure to have its desensitising effects. Men attempting foreskin restoration in later life should surely also be consulted – yes, there is such a thing, do check it out.

Some will make exceptions for “it’s a religious/family tradition” – or even “we want him to look like his dad!” The children of amputees surely feel relieved. These also reasons given for FGM that we reject.

It’s quite sickening to read women’s comments about their sexual preferences used as reasons to force it upon their children– “it looks better!” and “intact is ugly” are too frequently heard. If a man confessed to saving up for his daughter’s breast enlargement or labioplasty we’d be appalled, right? We don’t do this with any other body part.

There is also increasing evidence that permanent psychological damage can result from such a huge physical trauma in early life, including Post-Traumatic Stress Disorder. These effects are not only limited to recipients of the surgery; read experiences of women who deeply regret allowing it here (NB/ is quite upsetting). One man seeking compensation writes:

I was circumcised as an infant and my mother was not informed of the great injustice being performed on her only son. Not only has it caused great physical trauma but psychological and emotional as well. Damages are immeasurable. I want justice for what was done to me, and I never want another child to be sexually assaulted and butchered in their first moments of life. It has long lasting horrid affects. How can you ever trust when the first thing you know is pain and the most pleasurable part of your body is taken away?

There are other quote-unquote ‘reasons’ for the practice, which I’ve gone into more detail on in my blog and maybe could expand upon at a later date. No medical organisation recommends routine infant circumcision, yet thousands of boys are subjected to it every day.

Why?

Have you thought about it?

FGM and MGM; still a long way to go

For some time there has been an apparent hypocrisy, particularly in the United States, with regard to non-medically-necessary genital operations performed on infants and children, a subject I posted about previously.

This article is a reasonable summary for starters, apart from the perhaps over-emotive first paragraph, but to be honest I’m inclined to find it appropriate.

Girls have long been (at least officially) protected from damaging genital surgery, although along with MGM it used to be common in the developed world – for similar reasons (myths regarding hygiene benefits and the wish to reduce or destroy sexuality). Sadly, while there are laws against FGM (it is illegal in Egypt but the problem has certainly not disappeared), it is still practised not only in the developing world  but also in the UK and the US.

Boys have not been afforded the same protection, despite the fact that more than 100 boys die because of circumcision complications every year in the USA. That may not seem like a lot in terms of the population size but that’s 100 families whose lives have been shattered, 100 lives lost needlessly. One is too many.

There is an interesting Wiki article on circumcision-related law, past and present. ‘Cosmetic circumcision’ is banned in Australian public hospitals, it seems in Britain we cannot make a firm decision on the matter despite some encouraging analyses:

Fox and Thomson (2005) argue that consent cannot be given for non-therapeutic circumcision. They say there is “no compelling legal authority for the common view that circumcision is lawful.”

Finland seems to be moving towards criminalisation (see the case of a mother being fined after her son developed complications, for example) and Denmark seems to be flirting with the idea.

The American Academy of Paediatrics (AAP) has recently revised its statement on female genital mutilation (FGM). To address the hypocrisy and sexism in the USA regarding genital mutilation of children (where it’s OK to remove healthy, sexual tissue  from the penis but not the vulva), instead of doing what would seem like the sensible thing – officially stating that neither FGM nor MGM is recommended – it has actually relaxed its position on FGM. Truly astonishing.

“Ritual cutting and alteration of the genitalia of female infants, children and adolescents, referred to as female genital cutting (FGC)*, has been a tradition in some countries since ancient times and continues today in parts of Africa, the Middle East and Asia.

According to a new policy statement from the American Academy of Pediatrics (AAP), “Ritual Genital Cutting of Female Minors,” in the May issue of Pediatrics (published online April 26), the AAP opposes all forms of female genital cutting that pose a risk of physical or psychological harm, and encourages its members not to perform such procedures.

In addition, the AAP urges pediatricians and pediatric surgical specialists to actively dissuade parents from carrying out ritual FGC and provide families with education about the lifelong physical harms and psychological suffering associated with the procedure.

Many parents who request FGC do so out of tradition**, and also out of concern for daughters’ marriage ability within their culture, so physicians need to remain sensitive while informing them of the harmful and potentially life-threatening consequences.”

Intact America has released this statement in response to the AAP and Forward rightly calls it “A step backwards for women’s rights”.

* The ridiculous decision to switch to a more PC-term, ‘genital cutting’, avoiding ‘mutilation’ is analysed well by Jezebel. Mutilation is an apt term for this practice, if one looks up its dictionary definition.

** The tradition argument should NOT be acceptable for this. It’s the 21st century and we’re still accepting the most basic, childish argument as justification for such an act. ‘Well, they did it, why can’t I?’

You’re only free to do whatever you want as long as you’re not harming anyone else. Your freedom to do what you like ends when you start infringing on the freedom of others. I cannot imagine many greater infringements of personal freedom than lopping off bits of a child’s genitals, because you want to or you have some half-baked reasoning behind it (see earlier post for a few of those).

For example, I was recently quite shocked by a girl stating (after someone brought up their reasons for not particularly wanting to convert to Judaism):

Well it can be good for women, so why not! … Makes them last longer

I cannot find this sentiment anything other than disgusting. Increased male pleasure is one of the many ‘reasons’ given for severe FGM. In fact, if you talk to enough women you are likely to find that this is not the consensus opinion (anyone who’s found themselves bored, staring at the ceiling after half a repetitive hour can partly appreciate why), if it even matters; advocating unnecessary and dangerous genital surgery on minors for your own sexual gratification… well, I don’t really have the words for it. Selfish wouldn’t suffice.

For anyone who is interested, http://www.norm.org/comes highly recommended by friends who are restoring; trying to recover something of what was taken from them without their consent. Let me know if you want me to put you in touch with them.

Here are a couple of good videos I saw today:

Dr John Geisheker speaking about American physicians escaping justice after babies die as a result of cirumcision.

Steven Svoboda on the currently popular myth that circumcision is a miracle strategy to prevent HIV spread.

This page has some very good educational videos on the functions of the foreskin and consequences of circumcision (not safe for work, obviously)

Finally, the following is from Guggie Daly; a fairly comprehensive run-down of foreskin functions (for all the ‘It’s just a useless bit of skin!’ people).

All of the following comprise the foreskin and are removed in the typical American circumcision:

(1) The Foreskin
comprises up to 50% (sometimes more) of the mobile skin system of the penis . If unfolded and spread out flat the average adult foreskin would measure about 15 square inches( the size of a 3×5 inch index card). This highly specialised tissue normally covers the glans and protects it from abrasion, drying, callousing (keratinisation), and contaminants of all kinds.The effect of glans keratinisation has never been studied.

(2) The Frenar Ridged Band
The primary erogenous zone of the male body. Loss of this delicate belt of densely innervated, sexually responsive tissue reduces the fullness and intensity of sexual response.

(3) The Foreskin’s ‘Gliding Action’
- the hallmark mechanical feature of the normal natural, intact penis. This non-abrasive gliding of the penis in and out of itself within the vagina facilitates smooth , comfortable, pleasurable intercourse for both partners. Without this gliding action, the corona of the circumcised penis can function as a one-way valve, scraping vaginal lubricants out into the drying air and making artificial lubricants essential for pleasurable intercourse.

(4) Nerve Endings
Nerve Endings transmit sensations to the brain – fewer Nerve Endings means fewer sensations; circumcision removes the most important sensory component of the foreskin – thousands of coiled fine-touch receptors called Meissner’s corpuscles. Also lost are branches of the dorsal nerve, and between 10,000 and 20,000 specialized erotogenic nerve endings of several types. Together these detect subtle changes in motion and temperature, as well as fine gradations in texture.

(5) The Frenulum
The highly erogenous V-shaped web-like tethering structure on the underside of the glans; frequently amputated along with the foreskin, or severed, either of which destroys its function and potential for pleasure.

(6) Muscle Sheath

Circumcision removes approximately half of the temperature-sensitive smooth muscle sheath which lies between the outer layer of skin and the corpus cavernosa. This is called the dartos fascia.

(7) The Immunological Defense System of the soft mucosa.

This produces both plasma cells that secrete immunoglobulin antibodies and antibacterial and antiviral proteins such as the pathogen-killing enzyme lysozyme.

(click ‘more’ below the links for references)

This page with illustrations demonstrates the functions of the male prepuce:
http://www.circumcision.org/foreskin.htm

Dr. Peter Ball on the function of the foreskin:
http://www.norm-uk.org/function.html

Video showing a computer generated model of the function of the foreskin during sexual activity.
http://www.youtube.com/watch?v=wj6UjduMTiU

Contrast and compare pictures of cut and intact penises:
http://www.circumstitions.com/Restric/comparison.html

What is lost due to circumcision?
http://www.norm.org/lost.html

The three zones of penile skin:
http://www.foreskin.org/3zones-c.htm

The functions of the foreskin:
http://research.cirp.org/func1.html

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