In the hubbub surrounding the American Academy of Pediatrics' endorsement of circumcision this week, a single question remains unanswered: Does infant circumcision violate basic human rights?
Though opinions abound, it is largely a question without consensus, thanks to a complicated stew of medical, legal, religious and cultural beliefs surrounding the issue.
The academy's position that circumcision provides life-long health benefits is based on new evidence and differs significantly from its last public position, in 1999, which held that there was insufficient medical evidence to make a recommendation for or against the practice.
The academy's new direction will surely entrench beliefs and practices of those who support it and redouble the efforts of those who oppose it.
In the U.S., neonatal circumcision rates have dropped from a high of over 90 percent in the 1970s to about 33 percent today. In Europe, a 10 percent circumcision rate is high. Many nations have much lower rates, with England, Scotland and Wales the exceptions at 20 percent.
For both Jews and Muslims, circumcision is a religious and cultural practice. Within the last few weeks, Germany outlawed the practice of male circumcision for any but the strictest medical reasons. An atypical alliance of Jews and Muslims successfully challenged the German court's ruling and Chancellor Angela Merkel has promised to make religious circumcision practices (on males, but not females) legal once again.
Meanwhile, Austria, Switzerland, Denmark and some other European countries are considering whether circumcision should be outlawed, all at a time when the globalization of the European workforce has brought an influx of people whose cultural and religious backgrounds require it.
Back in the U.S., outspoken opposition groups have proposed bans in Massachusetts, San Francisco and nationally. The San Francisco Fringe Festival in September will include a show titled "The Revolution Will Not Be Circumcised." In neighboring Canada, a "Foreskin Pride" parade was held recently.
Some American men feel so strongly about the damage done to them that they are working to restore their foreskins by stretching the remaining tissue to create what are humorously termed faux skins. To these men, circumcision is an abomination. Many are activists who lobby legislators routinely demanding legal protections for male infants just as female infants are already protected by the law.
The U.S. position is somewhat contradictory. Although the Centers for Disease Control and Prevention has shied away from issuing a specific recommendation, U.S. foreign aid programs pay for adult men to be circumcised in several African countries where HIV/AIDS is rampant.
The U.S. military promotes and conducts circumcisions in many of these countries. This, too, is not without controversy. Although most African governments have supported these public health programs based on research findings that circumcision decreases the likelihood of HIV transmission by 60 percent, some Africans complain this is just another American effort to manage, control and even emasculate African men.
Thus, the new academy statement stirs the waters in which already swim a variety of cultural practices, personal beliefs and religious arguments for circumcision, as well as a large number of anti-circumcision groups advocating the opposite position. Add to the mix the occasional lawsuit against doctors, hospitals and/or parents who circumcised an infant believing it was in the best interest of the child. A lawyer in Atlanta specializes in malpractice cases involving botched circumcisions (including the Kentucky man who woke up finding his entire penis removed), and doctors in several cities specialize in cosmetic adult circumcisions and even re-circumcisions.
The human rights issue emerges out of the Universal Declaration of Human Rights adopted by the United Nations in 1948, which proclaims that everyone has certain basic rights that supersede local laws, religious practice and cultural traditions. These rights include the right to life, liberty and security of person.
This declaration raises the thorny question of whether the decision to permanently alter one's body belongs only to that individual. It is a question not likely to go away. An international symposium will debate the matter in Helsinki in September, and the debate elsewhere will surely continue.
William M. O'Barr is a professor of cultural anthropology, sociology and English at Duke University. He is completing a book titled An Anthropologist Looks at Circumcision in American Life.