Courts must not rule on circumcision, even in Israel

It is difficult to decide what is most shocking about the decisions made by Israeli Rabbinical courts last month. First there is the simple outrage that a mother could be fined for refusing to allow her son to be circumcised, with an additional 500 shekels (around £90) levied for every day she refuses to submit to the ruling. There is no secular law mandating circumcision in Israel, but the case arose as part of a divorce hearing, ruled upon by a religious tribunal, which also has the power to impose fines on plaintiffs.

The baby boy at the centre of the case did not have the traditional Jewish brit milah at eight days old, due to health concerns. By the time he was healthy, his mother had second thoughts. “I realized that I couldn’t do that to my son,” she was quoted as saying in Haaretz. “He’s perfect just as he is.”  Although the dispute between the issue of the circumcision is said not to be a factor in the divorce, establishing which parent has the authority to make such a decision has proved to be a point of bitter contention.

The district Rabbinical court of Sharon disagreed, ruling that “The Jewish people have always seen the circumcision as an act of repairing and completing the Creation.” Last week the High Rabbinical Court refused to overturn the original ruling. The woman now plans to appeal to the national supreme court.

Perhaps even more disturbing, the rabbis making the original judgement were quite clear that there was a political angle to their ruling. They noted a growing global trend against acceptance of infant circumcision, and were quite explicit that they were not going to tolerate a similar debate in Israel, stating:

“What will the world say if here too the matter of circumcision will be subject to the consideration of every person according to his perceptions? It is unthinkable that the matter of performing or failing to perform the circumcision will be taken away from Jewish scholars and be subject to the consideration of a civil court, when each one has his own opinions and worldview – this will not happen in Israel, God forbid.”

I hope what the world will say is that it unthinkable that such decisions might be ruled upon anywhere but in a civil court. In a state that so often proclaims its democratic credentials in contrast to its corrupt, totalitarian and theocratic neighbours, it is grotesque that theological interpretations should trump secular law.

Contrary to widespread perceptions, there is not uniform agreement on circumcision even among Jewish people. Both in Israel and around the world there is a small but growing movement of Jews who consider the practice anachronistic and barbaric.and who call for reform of the tradition. Without getting into Jewish theology, it is clearly essential to democracy and free civil society that people can explore and discuss such beliefs and live their lives in accordance with their own conscience, especially if their conscience is turning them away from harming others.

While the details of this case may be unique to Israel, in every country and culture where circumcision is practised, there will be families riven apart by the precise same argument – to cut or not to cut. Such disputes are likely to become more common as awareness grows of the risks of adverse consequences and complications, as religious devotion slides and appreciation of individual human rights to bodily integrity grows, and as claims for health benefits from routine ritual circumcision are increasingly shown to be arguable, if not downright spurious. Circumcision is a topic that divides opinions and divides communities so it is hardly surprising that it sometimes divides families.

Where such disputes arise, there can be only one humane judgement. When a child grows old enough to decide he would prefer to be circumcised – for whatever reason – he can make that choice. Once a foreskin is removed, it is gone forever.

Those who advocate the rights of parents to circumcise infants generally fall back on an argument of free choice and lifestyle. It is morally questionable, to say the least, that parents should have the right to irreparably mutilate a baby who is too young to dissent. The idea that a religious court should make such a decision, against the wishes of at least one parent, must be considered reprehensible.

The horrors of home circumcision and why intactivists share the blame

On Sunday BBC radio show 5Live Investigates carried an outstanding report on the issue of home circumcision, fronted by Adrian Goldberg with some brilliant journalism by Nicola Dowling.

Listen here.

The centrepiece of the show is a heartbreaking interview with the mother of Goodluck Caubergs, who died last year in Greater Manchester. The midwife who conducted the operation, on the family kitchen table with a pair of scissors and some olive oil, was later convicted of manslaughter. I wrote about the case here.

The real scandal revealed by Nicola Dowling was about a different case. Dr Muhamad Siddiqui, a hospital surgeon in Sussex, had been running his own little private sideline in home circumcisions. When 23 month-old Najem Braiha was left traumatised and infected after a home circumcision conducted, it is alleged, under unhygienic conditions, his parents complained to the General Medical Council. They imposed conditions on the surgeon’s GMC registration which barred him from conducting the procedure.

As part of the BBC investigation, an actor phoned up Dr Siddiqui and asked him to conduct a home circumcision on their baby. He agreed, in direct contravention of his GMC ban. Since then, and after discovering he had been exposed by the BBC,  Dr Siddiqui has resigned from his NHS job. The astonishing consequence of that resignation is that it now allows him to resume conducting circumcisions, which it appears he fully intends to do.

Yes, you did read that correctly. Circumcisions are completely unregulated in the UK, and anyone – you, me or the local barber – can set up a business cutting off baby boy’s foreskins at a hundred quid a pop.  Any doctor under the employ of the NHS, however, is bound to the regulation of the GMC and the Quality and Care Commission. A circumcision conducted in a hospital, with anaesthetic and surgical implements is carefully controlled and subject to monitoring and audit. A circumcision conducted on a kitchen table or in a community centre is completely unregulated. There are more regulations surrounding the piercing of an ear than the surgical amputation of a foreskin.

Nobody knows how many botched circumcisions happen in the UK each year. Paediatric urologists across the country report seeing cases as a regular part of their caseload. In my own experience as a journalist who covers the issue, virtually every case of a serious complications, infection or tragic fatality has resulted from a home circumcision conducted under non-clinical conditions.  The BBC documentary detailed many such cases, including the terrifying rates of complications found after a ‘circumcision camp’ in Oxford.

In my experience, people who are new to this issue are astonished to learn about the legal position of circumcision practice in the UK. How can it be that this is possible? Whatever one’s feelings on the rights and wrongs of circumcision as a whole, how can it be that nobody has ever got around to laying down some basic health and safety regulations and a requirement for anaesthesia and clinical conditions?

It pains me to say it, but I lay at least some of the blame squarely at the feet of anti-circumcision activists. Legislative progress rarely materialises from the ether or spring from the initiative of politicians’ imaginations. Changes occur through lobbying, campaigning, persuasion and demand. The simple truth is that nobody has been badgering politicians to introduce a law to provide the most basic protection for infant boys at risk.

After the death of Baby Goodluck, I tried taking some initiative myself, I tried to organise petitions, letter-writing campaigns, lobbying through official channels. I approached the UK’s leading anti-circumcision campaigns and they all refused to help, stating that they could not support any policy that could be seen to be endorsing circumcision at all.

When I wrote in the Guardian calling for regulation of circumcision rather than an immediate ban, I received several abusive emails and messages from intactivists calling me a sellout, a traitor, a disgrace and more.

This is infuriating to me.  I too would like to see an absolute end to circumcision but let us be clear – for the foreseeable future, the prospects of enforcing a legal ban without the active co-operation of Jewish and Muslim communities are literally zero. For all kinds of reasons, and whether we like it or not, it is Not. Going. To. Happen. Anyone with the faintest grasp of the realities of politics must recognise that.

If (or when) the day comes that circumcision can be criminalised, it will come at the end of a long process of awareness-raising, education, persuasion and the gradual marginalisation of the tradition within cultural communities. Not before.  A campaign to control and regulate the practice would and could be a significant first step along that route. Those who refuse to countenance regulation remind me of those extreme ultra-leftists who opposed progress on issues like gay rights as a bourgeois distraction that would delay the glorious revolution. It is self-indulgent, self-defeating Narnia politics.

All the while, day after day, real boys little boys with real names, real lives, real futures, continued to be subjected to needless suffering, illness, lifelong scarring and the risk of serious medical complications all the way up to death, because nobody is doing anything to help. That is unconscionable, and simply has to change.

This is what is crude about circumcision, Lynne Featherstone

When I write about the ritual infant circumcision of boys, I try to avoid lazy and crass comparisons to female genital mutilation. FGM, in the form of clitoridectomy (as commonly practised in countries like Somalia), is a horrific procedure that causes unfathomable pain and trauma at the time it is conducted, followed by lifelong sexual pain and dysfunction. There is no question that the physical impacts and health risks of FGM are genuinely incomparable to those of male circumcision, or to give it a less euphemistic description, ritual male genital mutilation.

So making trite comparisons between FGM and MGM is unhelpful and obscures differences. It is often unhelpful to even hint at comparisons. That is why I was appalled and repulsed by Lynne Featherstone MP, who at the Lib Dem Conference today used the exact inverse analogy to make a rhetorical point.:

“It’s a practice that has been going 4,000 years and, without wishing to be crude about this, quite frankly if it was boys’ willies that were being cut off without anaesthetic it wouldn’t have lasted four minutes, let alone 4,000 years.”

I’m guessing that Featherstone has never sat in a court and listened to testimony describing an untrained practitioner taking a pair of kitchen scissors to the penis of a four-week old boy, without anaesthetic, dabbing it with olive oil and then leaving him to bleed to death. I have. When I read her words, the first image that flooded my mind were those vivid descriptions of the death of Goodluck Caubergs in Manchester last year.

Perhaps Lynne Featherstone has never heard of Angelo Ofori-Mintah  who died in London, aged 28 days, after a Rabbi told his parents to daub his uncongealed wound with Vaseline. He lost three quarters of his blood before he died of cardiac arrest. Perhaps she hasn’t heard of the baby in Bristol who suffered a fractured skull after falling off a table during a home circumcision. She may not know that Manchester children’s hospital treats an average of three babies a month with botched circumcision wounds, she may not know that 45% of babies circumcised at an Islamic school in Oxford suffered medical complications. She may not know that well over 100 baby boys die from complications after circumcision every year in the USA alone. While her eyes are on Somalia, she may have missed the story from South Africa where 30 boys died in one province alone during the “circumcision season”, with another 300 hospitalised with dehydration, gangrene and septic wounds, at least ten of whom had to have their penises amputated.

The truth is that nobody has got a clue what the true global toll of death and injury from male circumcision might be, because global bodies such as the World Health Organisation make no efforts to find out.  With around 30% of the world’s baby boys being circumcised every year, many in countries with minimal medical care, it is likely to be in the tens of thousands at the least.

Yes, the probabilities of mortality or morbidity following female genital mutilation are certainly far higher. However the other side of that coin is that while FGM is prohibited and abhorred in all but a handful of cultures on earth, male circumcision is tolerated and encouraged. Around one in four baby boys born on the planet this year will be subjected to an unnecessary ritual mutilation, the overwhelming proportion of which will be carried out without anaesthetic and not under surgical conditions.

Featherstone said she didn’t want to be “crude” and in that, I suspect she meant by using the word “willies.” Her crudeness is not in her vocabulary, it is in the grossly tasteless indifference and ignorance she shows to the fact that for 4,000 years we have indeed been taking knives to baby boys’ willies, countless numbers have died as a result, innumerable more have suffered botched mutilations, sexual dysfunction, pain and suffering,  and rather than “putting a stop to it in four minutes” we have turned our backs, averted our eyes to the blood, closed our ears to the screams and let it happen.