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So welcome everyone to this Second St. Cross, special ethics seminar for the term.

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Today we have our very own I can say our very own.

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Brian now has recently joined the Uehiro Centre as a senior research fellow.

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He's also associate director of the Yale Hastings Programme and Ethics and Health Policy,

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which unsurprisingly is at Yale and the Hastings Centre and is the Associate Editor of and associate editor of the Journal of Medical Ethics.

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His first book was out, yeah, a couple of years ago now.

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Love drugs, the chemical future or relationships? That's what Julian said Liska.

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And he's got a new book on the way, or at least under contract, and I'm assuming they're seeing some of the work related to the book today.

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That book is sex and circumcision. And today he's going to present his paper against legalising female circumcision of minors and takes away, right?

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Well, thank you for the nice introduction and make sure my sides are working here.

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OK, so I'll just give an overview of what I hope to cover in the next 40 50 minutes or so.

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The main goal is that I want to inform you of some growing efforts amongst some legal scholars and bioethicists to advocate

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for the legalisation of what they regard as minor forms of ritual or otherwise medically unnecessary female genital cutting.

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In particular, they're advocating that particular practises should be legalised, such as nicking,

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pricking or partial removal of the clitoral prep, use or hood or parts of the labia menorah.

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And they tend to advocate that the practitioner should try to avoid cutting the clitoral glands.

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And so for that reason, they sometimes refer to this subset of practises as female circumcision.

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Given the anatomical analogy between the clitoral foreskin and the penile foreskin,

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where removal of the latter is called male circumcision in common parlance.

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So one important legal backdrop to this discussion is that just a handful of years ago,

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the U.S. federal law against what's legally defined as female genital mutilation and I'll talk about

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terminology in a moment was ruled unconstitutional by a federal judge and it was struck down.

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This was a very significant development, and I'll I'll return to this at the end of the talk.

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In particular, I'll tell you about the reinstatement of this law in 2021.

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This was the last one of the last laws signed by the Trump administration.

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But some scholars argue that this new law is also vulnerable to being struck down for various reasons.

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In the past five years, there's been a major shift in legal and bioethical scholarship,

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focussing on the ethics or legality of genital cutting based on the sex of the affected person is breaking down or being increasingly challenged,

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whereas you're starting to see these new battle lines, so to speak,

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drawn between advocates of children's rights who argued that children should be protected from medically unnecessary interference with their sexual

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anatomy versus those who advocate for placing greater weight on parental and religious rights to authorise genital modifications for their children.

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So long as by some threshold of harm, it's considered to be insufficiently harmful to warrant state interference.

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So it seems likely that legal protections for under-18 girls against medically

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unnecessary forms of genital cutting are at least at risk of continuing to be eroded.

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And this has potential UK implications because, along certain dimensions,

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the UK law regarding FGM as it's defined also in UK law and the U.S. law have some similarities.

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Interestingly, the UK law doesn't have an age criterion,

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so even over 18 year olds who undergo what the law defines as mutilation are considered to have been subjected to an illegal practise in the UK.

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So I want to help you understand these developments.

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The literature here has really stripped far ahead of most sort of common knowledge amongst the public,

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and even many scholars are not aware of these developments. So this is a seminar that's sharing with you really the latest work.

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I want to tell you a little bit about my perspective on these issues,

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just so you can tell what I'm what I'm trying to accomplish with this talk and when I'm speaking

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from my own perspective versus when I'm trying to clarify the perspective of others in general,

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my goal is going to be to steal the argument of advocates for legalisation.

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This is because these are very serious senior scholars who are making arguments that many will find compelling, and I argue against this view.

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The title of this talk originally is taken from a paper in which I argue against legalisation of so-called female circumcision of minors.

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Nevertheless, I think it's important to give the strongest showing of the of the opponents argument.

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My background academically, is in sort of two areas.

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At least one is philosophical ethics and one is in social psychology.

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I have a Ph.D. in philosophy and psychology, so I often evaluate complex practises from wearing two different hats.

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I from my ethical hat, where I make normative arguments. When I published in the Journal of Medical Ethics or comparable journals,

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I consistently argued that all medically unnecessary genital cutting of minors, including supposedly superficial forms, are wrong.

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I don't argue that they're wrong because they're harmful. Necessarily. I argue rather that they're wrong because they're disrespectful.

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They involve an unwarranted and unjustified intrusion into the private sexual anatomy of somebody who is vulnerable and cannot consent to that.

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So that's my ethical perspective that I've been pursuing now for something like 10 years.

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Recently, I had the privilege of working with about 90 colleagues in anthropology, medicine, philosophy, law,

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gender studies and so forth to put together a shared perspective where we argued that under most conditions,

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cutting any person's genitals without their own informed consent is a serious violation of their right to bodily integrity again,

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irrespective of how harmful some third party judges the cutting to be.

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As such, we argue it's morally impermissible unless the person is not autonomous,

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so they're incapable of consenting and the cutting is medically necessary and so

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cannot ethically be delayed until the person could consent on their own behalf.

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So that's my ethical standpoint.

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From a social psychology perspective, I have a different goal, which is to try to understand from the perspective of practising communities,

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why it is that they value certain genital modification rights.

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And so throughout this talk, when I try to present reasons for modifying the genitals of a child,

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it's not because I think that those reasons necessarily justify the practise,

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but rather it's because, again, I'm trying to help explain the practise from the perspective of those who value value these rituals.

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I think this is important even from a normal.

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Or public policy or advocacy perspective, because even if you're normative goal is to discourage genital cutting of girls,

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let's say it requires that you have an accurate understanding of the complex socio cultural backdrop of those practises.

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It's not enough to rely on stereotypes or bumper sticker slogans or the sorts of things that activists often

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appeal to in creating an oversimplified mental image of what people think female genital cutting involves.

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Because if you rely on those over simplifications, your your policy may misfire.

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You may come up with ineffective interventions interventions that have harmful side effects for the communities concerned,

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leading to stigmatisation of practising communities,

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often racially biased interpretations of the legality of genital cutting, unjust treatment of marginalised groups.

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And this can lead to loss of trust, cooperation and exacerbate us versus them kind of thinking.

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So just to clarify again in trying to understand practises, I'm not thereby assuming that they can be justified, morally speaking.

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I do think that morally decent,

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reasonable people who interact with particular social structures and incentives can engage in what others may see as clearly bad or immoral behaviour.

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Not just outsiders, of course, but also dissenting insiders.

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It's always important to remember that communities are not homogeneous, but rather they are heterogeneous.

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And within cultures where genital cutting is the dominant norm,

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there are often there is always some subset of people who object and are trying to advocate for cultural change.

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And again, from my own normative perspective, I support those dissenters.

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So some some of how I'm going to do this is to flip the lens, so to speak,

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and spend a portion of this talk looking at culturally familiar forms of genital modification that are associated with so-called

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Western culture and see if we can try to understand how those practises might look to outsiders who don't engage in the practises.

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So that again, we can try to avoid this othering tendency of viewing those who practise female genital

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cutting as somehow fundamentally different from us who don't practise female genital cutting.

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Now I need to talk about terminology. The set of practises in question go by many different names.

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Most scholars now prefer to say female genital cutting.

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The law in many countries following the terminology of the World Health Organisation and some advocacy groups is female genital mutilation.

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The subset of practises that I'll be talking about today are called by advocates of those practises of female circumcision.

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They're trying to draw a parallel with male male circumcision, which they assume is morally permissible.

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The recent legal developments that I'll be highlighting concern so-called ritual nicking of the vulva.

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This is a practise that's typical and indeed is the most common form of female genital cutting in some parts of South and Southeast Asia.

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So the World Health Organisation states that this form of cutting is rare, but it's not rare.

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It happens in the case of millions, and it's the most common form of cutting in some parts of the world.

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Now, in the cultures that practise what they would call female circumcision on an English translation of the local term,

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view it as a complement to penile circumcision. And it's important to stress that in every culture that practises what they call female circumcision,

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the same culture practises what they call male circumcision. There are no cultures that practise only female circumcision.

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And strikingly, in the case of the South and Southeast Asian cultures,

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the penile circumcision is a significantly more substantial than the form of circumcision that is carried out on girls.

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Moreover, it's seen as a gender inclusive, right.

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In other words, because male circumcision is a valued practise as intuitively might be seen by thinking of the case of Judaism in Judaism.

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Male circumcision is the central rite of the religion that's seen as the most important one.

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And yet, interestingly, girls are excluded from this valued social institution.

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There's no equivalent rate for girls,

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whereas some Muslim groups situated in this part of the world regard girls as being as it were deserving of inclusion in a central ritual practise.

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And they are therefore also circumcised on an equal basis as the boys.

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Now, in many cases, the female procedure does not involve or result in long term visible alteration to genital morphology.

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Often there is complete wound. Which makes it very hard to apply the term mutilation to this particular practise.

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So again, scholars tend to say genital cutting, which emphasises that this may nevertheless be a traumatic experience.

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It involves making, at the very least, an incision into highly sensitive genital tissue, depending on the age of the child.

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This may be something that they experience and remember as a sexual intrusion.

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The child will inevitably be held down by one or more adults.

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And so it should not be trivialised. And but nor does it make sense to say mutilation when there are no alterations

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in the long term to the genital morphology and the wound heals completely.

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So that's one reason for using the term genital cutting, which is typically what I'll use now.

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When I say female genital cutting,

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I'm really trying to refer to children who are born with what's called endo sex female traits in contrast to intersex female traits.

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So intersex just means in the way that, say, cisgender can be contrasted with transgender, and intersex can be contrasted with intersex.

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And it refers to children whose genitalia are easily and ambiguously categorised able as female,

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according to the classification classification classification criteria employed within medicine.

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These children may, of course, grow up to have some different gender identity than than a female, and so I'm not taking a stand on that.

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I'm just referring to to classification of sexual anatomy.

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Similarly, MGC, or male genital cutting is really meaning to refer to children who have intersex male traits,

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typically upon visibility of of an unambiguous penis, the child will be recorded as male.

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And so again, mostly I'll be talking about female circumcision in that in that context.

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And I don't tend to call it male circumcision because intersex males who have their penile foreskin removed may grow up to become transgender women.

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In fact, in the United States and in Israel,

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the vast majority of transgender women will have had part of their penile organ removed routinely when they were infants.

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Finally, intersex genital cutting refers to children who have variations in sex characteristics or differences of sex development or intersex traits.

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The language here is again contested. No, I'm not implying that intersex persons are necessarily some third separate sex category,

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some intersex people will append intersex to a binary sex term,

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so they may say I'm an intersex male or I'm an intersex female,

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or some intersex people identify simply as intersex and and may have a gender identification that falls outside of a gender binary.

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So I'm not I'm not trying to imply anything in particular about how these categorisation should go.

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And already you can see that trying to draw distinctions about the legality of and

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also the ethical permissibility of performing a medically unnecessary genital

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procedure on a child on the basis of how their genitalia are classified vis-a-vis

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dominant sex and gender categorisations is going to be hard to sustain.

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So here's the historical background that I mentioned earlier.

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In November of 2018, the US federal ban on female genital mutilation was ruled unconstitutional by a judge, and I'll explain why now?

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Strikingly, just a few months later. This is another article in the New York Times.

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You'll see that the practise is now called female circumcision in the headline,

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and the Justice Department declined to defend its own law against female circumcision.

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It was seen as fatally flawed, and so it took the passage of a subsequent heavily revised law to to replace it quite a bit later, as as I'll explain.

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So why did this happen? Why was this law struck down? What's the context and what's the future of law and policy on child genital cutting?

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I want to try to just present an overview, a high level overview of.

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The the broad structure of what's happening before I get into the details, so there's going to be a lot of points on this slide,

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but this is so you can kind of see how everything hangs together all in one go.

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Some scholars argue that in 1996, when the US federal law on medically unnecessary female genital cutting of minors was put into effect,

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this created a different legal standard for children who have either intersex female,

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intersex male or intersex genitalia with respect to genital cutting.

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And this different treatment of people on the basis of their sex traits is, of course,

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constitutionally prohibited in the United States and in many other Western legal regimes.

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And so a zero tolerance policy for female genital cutting of minors,

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including these so-called ritual nicking procedures that don't remove tissue where more over these laws do not have a religious exemption.

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In other words, it's legally prohibited to perform a ritual neck,

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even if it's believed to be religiously necessary by the parents puts considerable legal pressure

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on intersex and male forms of genital cutting that are currently considered to be permissible.

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And so prominent defenders of male genital cutting of minors, primarily ritual or religious newborn penile circumcision have expressed growing

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concern about the legal implications of zero tolerance for female genital cutting.

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Increasingly, then in the last five to 10 years,

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some of these scholars have been arguing in bioethics and law journals that female genital cutting of minors should actually be legalised.

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So rather than thinking of some restriction being placed on male genital cutting of minors, these scholars,

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in order to resolve the double standards and be intellectually and morally and legally consistent,

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have proposed that protections that are currently in place for girls should in fact be removed.

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Again, what they call female circumcision refers to a cluster of practises ranging from ritual nicking,

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pricking or partial removal of the clitoral prep use that falls under W.H.O. type for FGM or

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partial or total removal of the foreskin or hood is sometimes classified under FGM type one,

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a partial or total removal of the labia minora,

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which of course is referred to as labia plastic when it's performed on adults, is classified as W.H.O. FGM type 2A.

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In any event, these scholars argue that the clitoral glands the part of the clitoris that protrudes outside the body should should not be cut.

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So what does this mean for children of intersex traits?

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Some intersex females have clitoral surgeries in an attempt to mould their genitalia into a supposedly more feminine appearance.

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These surgeries are not medically necessary on any usual sense of that term and so on.

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Some views, these surgeries should simply be classified as FGM.

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So we need to think about how all this ties together. So, as I mentioned, sex based distinctions are breaking down.

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And you now see that there's this new set of lines being drawn between advocates of parental freedoms to modify children's genitals and those who

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advocate for children's rights when the when the child is insufficiently mature to consent on their own behalf to be protected from genital cutting.

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The Parental Rights Alliance, as I mentioned, is seeking to remove existing protections from girls.

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A counter movement has sprung up or gained in some prominence, arguing for a different type of solution to the problem of double standards.

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And I consider myself a part of this movement in that all of my academic articles advocate for this position.

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I and many others argue that all children who are insufficiently mature to consent on their own behalf,

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irrespective of their sex characteristics and irrespective of how harmful or harmless someone thinks it may be to cut their genitals,

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have, at the very least a strong moral interest in protection of their bodily integrity and their sexual anatomy from these intrusions.

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And what we call genital autonomy, which just means they will have preserved for them in the future.

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The ability to make a decision about whether they are comfortable having surgical risk concentrated on this particular sensitive part of their body.

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So the claim here is that medically unnecessary non-consensual genital cutting in children should be discouraged,

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regardless of the child sex by all appropriate means. Now I just need to emphasise that discouraging a practise does not necessarily mean it

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should be criminalised that criminal penalties should be applied to parents or doctors.

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Let's say who may perform these practises,

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particularly when general awareness of the potential illegality of the practise isn't, isn't, isn't widely there.

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There are many levers that people can pull in society to try to discourage problematic practises,

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including softer social change efforts like education and consciousness raising and building bridges with practise in communities and so forth.

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So I just want in our minds not to leap to the conclusion that if a practise is morally wrong, as I argued,

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these practises are that therefore they should be criminalised or be accompanied by criminal penalties.

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So this issue of double standards was raised in the early 2000s by Dena Davis, who's a prominent American bioethicist and legal scholar.

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And she says federal and state laws that criminalise genital alteration on female minors are so all encompassing in

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their language that they cover even procedures that are significantly less substantial than newborn male circumcision,

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which is widely considered to be legally acceptable in the United States and indeed in every contemporary country.

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Of course, these laws also cover procedures that are significantly more substantial than newborn male

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circumcision and these more substantial forms of female genital cutting that involve,

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for example, modification of the clitoral glands or the most extreme and invasive form so-called in tribulation.

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These are the practises that people tend to think about when they hear the term FGM and it's not an accident.

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It's because those who are advocating for laws to criminalise these practises strongly emphasise the most severe forms of them,

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and they tend to emphasise the forms of them that are done in septic unhygienic settings under the most coercive circumstances.

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And this has been helpful in that it raises attention to the problem and it gets people emotionally invested in trying to address it.

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However, it distracts attention away from the very wide range of practises affecting girls that are

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relatively similar to practises that Westerners quote unquote engage in that are considered legal.

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And so the sometimes racially discriminatory application of law is occluded by

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this tendency to emphasise only the most severe forms of female genital cutting.

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As Davis argues, a complete laissez faire attitude toward one practise, coupled with total criminalisation of the other,

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has troubling implications for the constitutional requirement of equal protection because the laws appear to protect little girls,

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but not little boys from religious and culturally motivated surgery.

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Again, you'll notice that this kind of language, even from Davis, who is a very forward thinking scholar,

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tends to exclude or erase the existence of children with intersex traits.

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So here is one representation of possible external genital formations of a child who may have androgen insensitivity.

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And on the left hand side, this is the so-called Quigley scale.

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It's controversial, but in any event, this is one way of categorising these different genital formations.

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The left hand side is is stereotypically or characteristically and no sex male traits.

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And the point here is that it is legal in every country of the world to perform a genital surgery on a child whose genitals have this

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external appearance with no medical indication and without any reason needing to be given simply upon the request of the parents.

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It's also mostly unregulated the surgeries that are performed on children whose genitalia have this appearance.

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You don't have to have a medical licence and so forth.

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Now, if you moved to the right hand side of the spectrum,

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if the child has what's called complete androgen insensitivity and has female genitalia that are

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characteristic or endo sex in the very same countries that legally permit the other kind of cutting,

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I just mentioned it's a serious criminal offence,

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often a federal offence to bring a sharp instrument into contact with genitals that have these characteristics to any extent.

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So again, it's not the case that the laws only prohibit what some may characterise as very harmful forms of female genital cutting.

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Rather, pricking nicking and partial removal of tissues, including labial tissues, are criminally forbidden in these same countries.

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The legal status of intersex genital cutting is contested,

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there have been some bills proposed to ban what are called medically unnecessary surgeries on intersex children.

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Obviously, we can talk about what medically unnecessary means if you like.

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But those proposed bills have been struck down by lobbying from medical professionals and in some parents groups.

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So obviously, there aren't just these two six types of genitalia.

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Intersex conditions fall along a spectrum in terms of the appearance of the genitalia.

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And this leads to a very troubling legal question that has not yet been resolved,

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which is at what point does a small penis, which is currently considered to be legal, to cut for any reason?

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Again, the parents don't have to explain their reasoning for why they're requesting it.

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At what point does that organ become a large clitoris,

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which is considered illegal to cut again for any reason other than medical necessity and to any extent?

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Now, of course, there aren't just intersex children that are growing in prominence in public discussions,

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but also people are, of course, now more aware of people with transgender identities.

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There's very many ways of thinking about and characterising what it means to be transgender,

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but basically a person's gendered sense of self or gender identity doesn't align with

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their birth sex categorisation in a way that's recognised by the dominant culture.

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So earlier, I raised the example of female circumcision and explain why I tend not to call it male circumcision.

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The reason is because modifications of the penis can affect people who grow up to

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have very different gender identities and social locations within gendered space.

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And so we shouldn't think of it as something that only affects so-called cis gender boys and men.

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People who have non-binary or genderqueer identities as well may be affected by penile circumcision.

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Interestingly, there's also very practical implications of removing the penile foreskin for people who adopt

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a female transgender identity and who may want to undergo a gender affirmation surgery.

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The most common surgery of this kind, leading to construction of the new vagina, involves use of the foreskin.

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And if that tissue has been removed, further full thickness skin grafts may have to be taken from the thigh or other parts of the body.

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OK. Now I'm going to get somewhat specific here in terms of what exactly is done in procedures that are considered legal in.

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Western countries, certainly, but also really other countries as well,

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so that you can get a better sense of why it is that advocates of what they call female circumcision think it

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should be permitted to perform the type of genital cutting that they endorse on religious or cultural grounds.

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Now, male genital cutting is often spoken about or penile circumcision in particular as just a snip.

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It's seen as something that is so minor that it shouldn't really come onto the scene in terms of legal prohibition, for example.

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Now, when people say this, this is more common in my home country of the United States,

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where newborn penile circumcision is a majority birth custom irrespective of, say, religious beliefs.

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It's just been a medicalized practise there, and there's an interesting history that maybe we can talk about.

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But penile circumcision is minimised and trivialised in the United States, often with this phrase, it's just a little snip.

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And I think when people say this, it's because they're imagining an infant's penis, which is very small.

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And so in absolute terms, not very much tissue is removed.

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But if the same surgery were performed on an adult,

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the amount of tissue would be about 200 percent greater and would amount to between 30 and 50 square centimetres of tissue,

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which works out to roughly a third of the penile skin system.

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So this, depending on your view, might be considered not a very trivial intervention into the body.

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The tissue that's removed is not just any tissue,

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it's a double layer tissue that has a soft mucous membrane on the inside and an outer protective layer on the outside.

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Like the eyelid itself lubricating it has sebaceous glands.

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It's hairless tissue, which is partly why it's so useful for skin grafts when it's used for that purpose.

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And it's directly anatomically analogous to the clitoral foreskin, which is an extension of the labia and has very similar properties to the labia.

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And so this analogy turns out to be crucial for understanding why some people think there's an existing double standard.

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So what is currently legally allowed not only in so-called Western countries,

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but in every country around the world on non consenting children who have been categorised as male at birth?

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This procedure is considered legal when there is no valid medical indication for performing it.

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It's widely considered ethical for doctors as part of their professional duties to perform this surgery when it's done for cultural,

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religious or any other reason. And again, it's simply upon parental request.

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There's no particular reason it has to be given for a doctor to comply with the parents request for a penile circumcision.

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I'm going to show some pictures now just to get really specific is are unpleasant,

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and some people have been affected by these procedures may find this distressing.

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So I want to let you know if you if you need to prepare yourself the first step of a

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newborn penile circumcision is to separate the foreskin from the head of the penis,

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to which it's adhered at birth by a membrane. In something like the way that your fingernail is, this is adhered to your finger.

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These structures will separate naturally over the years, and the foreskin will eventually become retractable.

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But at birth, it's it's stuck together.

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And so if you want to remove the foreskin at this age rather than in a adult consenting person where they will already have been separated,

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they have to be separated with a blunt probe, which is analogous to putting a blunt probe between your fingernail and the butt of your finger.

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What that means is that this can be excruciating to the infant, even when pain control is used and in the United States anyway.

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Until recently, pain control was not used. It was seen as too much of a hassle for the operator.

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Also, in many religious contexts, for example, in Orthodox Jewish circumcisions,

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the baby will not have any pain control, but will rather have a drop of wine applied to their tongue.

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The next step, depending on what implement you use, is to attach a clamp to cut off the blood supply and hopefully prevent too

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much bleeding and tightening it to apply quite a lot of force to the tissue.

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And then once haemostasia is achieved, then there's a excision of the tissue.

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And so as you can see here, proportionally,

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the amount of tissue removed from from this child's healthy genitals is about a third of the skin system of the penis.

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Now it's not just any tissue. This has been documented through a number of different studies as being the most sensitive

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tissue on the penis to light touch sensation and mild sensations of warmth as well.

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And it's not just physical effects. One thing about applying a sort of medical lens here, where we think of body parts and tissues and so forth,

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is we forget that a surgery is happening to a person.

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Now, the person in this case is probably not forming conscious memories of what's happening.

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It's very hard to know and to study what the effects are of this painful procedure affecting the

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genitalia of a child on their neurodevelopment because we can't just ask them what's going on.

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And and nor has there been a great effort to study brain development changes that may follow from this procedure.

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But there is some work suggesting that early, painful experiences can have long term consequences for neurodevelopment.

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Now, the manufacturers of this device, which is called a circum strange, have made the straps blue,

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which is probably playing on the gender stereotype that blue is for boys.

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But I want us to just imagine that instead the straps were pink and this was a

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child who was categorised as female at birth and was going to be raised as a girl.

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My strong intuition is that if she is healthy, if she has not facing any medical problem,

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it is morally impermissible for a doctor to bring surgical instruments anywhere near her genital anatomy.

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And I've made this argument in many papers, it's contrary to a doctor's professional duties, I suggest to perform a medically unnecessary surgery,

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no matter how slight on the healthy genitalia of someone who's in their most vulnerable possible state, namely a newborn.

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Now again, just imagine that instead of thinking of FGM or whatever stereotypes we may have about what that is,

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imagine we were instead speaking about cosmetic labia plastic cosmetic labia.

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Plastic is something that is common in Western culture. It's something that's widely performed typically on consenting adults.

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But of, of course, younger and younger girls are now undergoing maybe a plastic with a with a supposed proxy consent of their parents.

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With several hundred cases as young as 13 and 14 on the NHS in the last several years.

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Now, it's hard to make a direct comparison here, because if I told you that we were going to think about infant labia plastic,

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many people would would respond with incredulity.

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They would say, Well,

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maybe plastic is something that should be done only voluntarily when the person whose body will be permanently affected has asked for it.

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Indeed, according to the American College of Obstetrics and Gynaecology,

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and the British equivalent has the same policy maybe plastic in girls younger than 18 years old should be considered

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only for those with significant congenital malformations or persistent symptoms caused directly by labial anatomy.

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Surgery a surgical alteration of the labia that is not medically necessary in anyone

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under the age of 18 is a violation of federal criminal law in the United States,

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namely the 1996 FGM law. Now, strictly speaking in England,

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because there's no age criterion and the way that FGM is defined includes modifications of the labia that are medically unnecessary.

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The vast majority of so-called cosmetic or elective labia passes in the UK should be illegal.

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The reason why they're not treated as illegal is because they're primarily sought by people who are considered members of the dominant culture.

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If the very same surgeries were sought by people who claimed that they felt they were important for religious reasons or cultural reasons,

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they would on a on a racially discriminatory manner or religiously discriminatory manner or manner.

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It is discriminatory against immigrant groups be considered to be practising FGM again regardless of age,

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because the the UK law doesn't draw an age distinction.

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There's a very interesting discussion about how this law was passed and the really explicit racial motives and distinctions that were drawn,

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and we can talk about that during discussion. So I think there's some very important implications in thinking about this imagined

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procedure of instant labia plastic or just thinking of labia plastic in general.

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What it implies is that it's possible to cut or alter and even remove a substantial amount of

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genital tissue from a person in such a way that we don't tend to characterise it as mutilating.

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We don't think of it as net harmful to the person if they choose it for themselves because we recognise it by their lights, it's a bodily enhancement.

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And one person's enhancement, however, is another person's mutilation.

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And in particular, if your body has been altered in a way that you don't prefer,

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you may consider the very same alteration to your body to be a mutilation rather than an enhancement.

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So this highlights the significance of choice and agent relative preferences when people try to come up with medical cost benefit ratios,

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as though that should determine the permissibility of a non-consensual genital surgery.

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To my mind, they're really missing the point.

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The surgery is is not permissible or impermissible based on what the cost benefit ratio is as judged by some third party,

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but rather it's permissible or impermissible based on whether the person wants it.

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A final point here is you can remove quite a lot of genitals of tissue without causing sexual disability.

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A person whose penile foreskin has been removed can enjoy sex and ejaculate and so forth.

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And there's tends to be a kind of functional conception of what's characterised as sort of male sexuality that as long as an erection is possible,

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there's no problem here. But you might think that the tissue that's removed, which, as I've said,

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is analogous to the labia labia of the vulva by some people is valuable in its own right,

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and the ability to manipulate that tissue is seen as important for their sexual experience.

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And so although you can enjoy sex with this tissue removed,

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it doesn't mean that that that it's therefore ethically unimportant that the tissue has been removed.

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So if we think about what's wrong with infant labia plastic, which I stress is illegal, a doctor who performed an infant,

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maybe a plastic would lose their licence and be arrested for performing FGM is not that it's harmful.

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Many people undergo labia plastic, and they think it causes a net benefit.

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The reason it's wrong is because it's done without the consent of the affected person.

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It affects them for their whole life. The tissue can never be regrown,

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and it affects them in a part of the body that virtually every culture characterises as especially private

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and personal and intimate and related to the person's sense of self and sex and sexual identity and so forth.

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And so this isn't analogous to, for example, removing a mole or something in the way that some people may propose.

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Now, against this view, somebody might argue that actually there are medical reasons for performing labia plasticity in infancy so that it's not a

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direct comparison to say it should just be left to the the the the affected person to make in their in their older life.

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This argument is very commonly made in favour of why intersex genital surgeries supposedly should be performed before consent is possible.

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And it's certainly used in the case of intersex male surgeries as to why they should be performed before consent is possible.

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So here are some common arguments for why penile circumcision should be performed in infancy rather than leaving the decision to the affected person.

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This comes from this article. These authors argue that infinity is an optimal time for clinical circumcision because infants low mobility,

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as you saw they can be strapped into a circum strain facilitates the use of local anaesthesia.

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Sutures are not required. Healing is quick. The cosmetic outcome, as judged by the surgeon or the parents, perhaps is usually excellent.

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We don't know how the child will view that cosmetic outcome. Costs are minimal and complications are uncommon.

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Whereas if you wait until adolescence or adulthood, the person may have a fear of pain.

388
00:43:02,860 --> 00:43:07,150
Time off work or school will be needed. Healing is slower and so forth.

389
00:43:07,150 --> 00:43:11,030
So let's just use these arguments and apply them to the case of infant may be a plus.

390
00:43:11,030 --> 00:43:14,110
Again, this is FGM type two A.

391
00:43:14,110 --> 00:43:20,320
Imagine that we said, well, it's easier to make sure she keeps still, because as an infant, she'll have lower morbidity.

392
00:43:20,320 --> 00:43:29,820
She won't remember it. That's a common claim that's cited as an advantage of performing neonatal penile circumcision.

393
00:43:29,820 --> 00:43:34,170
It'll heal faster. That's probably true. It's cheaper and less risky at this age.

394
00:43:34,170 --> 00:43:41,740
That may be true. Sometimes you'll see the claim that future sexual partners may prefer someone who has a genital

395
00:43:41,740 --> 00:43:47,620
modification and that therefore it's permissible or prudent to perform the surgery in infancy when,

396
00:43:47,620 --> 00:43:50,740
quote unquote, they won't remember it.

397
00:43:50,740 --> 00:43:57,730
Obviously, people have different attitudes toward what their preferences are for whether their partner should have modified or unmodified genitalia.

398
00:43:57,730 --> 00:44:03,760
So even if it's a dominant custom, you can't predict any particular sexual partners preferences.

399
00:44:03,760 --> 00:44:06,970
It might even be claimed that removing the labia has health benefits.

400
00:44:06,970 --> 00:44:12,010
It's easier to keep the vulva clean because there's less moist tissue to trap bacteria.

401
00:44:12,010 --> 00:44:15,340
This is again a common refrain in the United States regarding penile circumcision.

402
00:44:15,340 --> 00:44:21,640
It's less common in the UK, where it's understood that the health benefits are mostly trivial.

403
00:44:21,640 --> 00:44:27,760
Fewer labial injuries during sex. Lower risk of labial cancer.

404
00:44:27,760 --> 00:44:33,680
She won't have to take time off work or school, as we just saw in the previous slide.

405
00:44:33,680 --> 00:44:35,420
So all those arguments might be true.

406
00:44:35,420 --> 00:44:44,240
It might be medically better to perform a labia plastic in infancy rather than in adulthood, and so you can't make a direct comparison.

407
00:44:44,240 --> 00:44:50,840
But what I would argue is that all of those considerations are morally irrelevant because the baseline presumption should

408
00:44:50,840 --> 00:44:57,740
be that you must not interfere with the sexual anatomy of a non consenting person unless there is a medical emergency.

409
00:44:57,740 --> 00:45:04,490
And the reason for that is that it's her body and it's a special part of her body, and therefore it should be her choice,

410
00:45:04,490 --> 00:45:09,500
irrespective of relative risk profiles that could be documented for infancy versus later in life.

411
00:45:09,500 --> 00:45:15,650
That's my view. So I just want to wrap up here by drawing a distinction between harmfulness and wrongfulness.

412
00:45:15,650 --> 00:45:18,770
I think you can wrong a person without necessarily harming them,

413
00:45:18,770 --> 00:45:24,140
and you can harm someone without running them if you accidentally bump into them on the street or something like that.

414
00:45:24,140 --> 00:45:26,390
So I'm going to come back to the legal questions.

415
00:45:26,390 --> 00:45:34,820
But Labia Plast is morally impermissible in young girls, not because of any empirical facts having to do with the risk of surgical complications.

416
00:45:34,820 --> 00:45:42,740
You don't have to look up any medical studies to find out what the risk of complications is to make an ethical judgement about infant labia.

417
00:45:42,740 --> 00:45:46,700
Plastic doesn't doesn't rest on the predicted effects on sexual pleasure.

418
00:45:46,700 --> 00:45:51,440
You don't have to play up these ideas that somehow the genital cutting well will disable a person sexually.

419
00:45:51,440 --> 00:45:57,890
Even if it doesn't disable a person sexually. It's still wrong on my view, even if there are health benefits to it.

420
00:45:57,890 --> 00:46:02,930
Given that these health benefits could be achieved in non-surgical ways or in ways that are consensual,

421
00:46:02,930 --> 00:46:09,350
such arguments are, in my view, ethically irrelevant. It doesn't have to do with how much tissue is removed.

422
00:46:09,350 --> 00:46:17,090
Again, in my view, it's a non-consensual cutting of an intimate part of a vulnerable person's body without urgent medical need.

423
00:46:17,090 --> 00:46:24,690
And this, of course, applies to children, regardless of their sex characteristics. Now we have to ask what's so special about medical necessity.

424
00:46:24,690 --> 00:46:29,810
Some people might think that surgery is culturally necessary, or they might think it's religiously necessary.

425
00:46:29,810 --> 00:46:39,080
So why? Why should medical necessity, as it were, have a privilege over these other perceived necessities in creating an exception to the

426
00:46:39,080 --> 00:46:44,690
general strong moral presumption against interfering with another's sexual anatomy?

427
00:46:44,690 --> 00:46:48,530
Well, I think that they are not arbitrarily different from each other.

428
00:46:48,530 --> 00:46:55,970
Medical necessity is based on values that are universally shared across cultures and metaphysical belief systems,

429
00:46:55,970 --> 00:47:01,790
so almost everybody puts a very high value. You are not dying prematurely. Preserving core bodily functions,

430
00:47:01,790 --> 00:47:10,160
avoiding serious disability and alleviating other direct threats to well-being that are that are recognised as such robustly across time,

431
00:47:10,160 --> 00:47:17,390
culture and circumstance. And what that means is if somebody underwent a medically necessary alteration to their genitalia,

432
00:47:17,390 --> 00:47:25,220
it's unlikely that they will ever come to a view according to which they even could conceive of that as a moral wrong done to them.

433
00:47:25,220 --> 00:47:29,660
Whereas that is not true for surgeries that are performed on the basis of beliefs,

434
00:47:29,660 --> 00:47:35,480
norms and values that are in fact highly variable and contested and different between communities,

435
00:47:35,480 --> 00:47:39,440
and are the sorts of views that people often change their minds about in modern,

436
00:47:39,440 --> 00:47:45,770
multicultural societies where people have access to the internet and their future values cannot be controlled.

437
00:47:45,770 --> 00:47:55,580
And so imagine that if female genital cutting, even a supposedly minor form is done on the basis of the parents religious beliefs,

438
00:47:55,580 --> 00:48:02,390
those who advocate for female circumcision think it is a form of discrimination against them that they are not allowed to perform female

439
00:48:02,390 --> 00:48:12,590
circumcision for sincerely held religious reasons when other groups are able to perform male circumcision for deeply held religious reasons.

440
00:48:12,590 --> 00:48:20,510
And and I'll explain why that argument is correct in the sense that they are being discriminated against.

441
00:48:20,510 --> 00:48:30,660
But morally speaking, I still think it's wrong to perform genital cutting on someone who can't consent for religious reasons, and I'll explain why.

442
00:48:30,660 --> 00:48:36,870
This is a quote from a survey of the WD Bora, which is a Shia Muslim sect that performs both male and female circumcision,

443
00:48:36,870 --> 00:48:44,190
as they say, in most instances, the process involves the removal of a pinch of skin from the clitoral hood.

444
00:48:44,190 --> 00:48:54,150
Between the ages of seven or between six and 12, they point out that the Holy Book the Quran does not mention female circumcision,

445
00:48:54,150 --> 00:48:57,480
but a secondary source of Islamic jurisprudence does. The same is true for male.

446
00:48:57,480 --> 00:49:01,260
Circumcision is not mentioned in the Quran, it's mentioned in secondary sources.

447
00:49:01,260 --> 00:49:10,740
I'm realising now that I'm probably going to be over my time, and so I have to skip through the next few slides in order to draw this to a close.

448
00:49:10,740 --> 00:49:17,520
Very briefly, the argument that because something isn't in the Quran, it therefore isn't religious is not a reasonable view.

449
00:49:17,520 --> 00:49:22,710
Many practises are not explicitly listed in the Quran, such as praying five times daily and so forth,

450
00:49:22,710 --> 00:49:30,840
but they're recognised to be religiously obligatory for devout Muslims.

451
00:49:30,840 --> 00:49:38,400
OK, so what happens is if your body has been permanently modified or somebody cut your clitoral foreskin on the basis of their religious beliefs,

452
00:49:38,400 --> 00:49:44,730
and then you grow up to not share those religious beliefs, it's reasonable for you to feel that you've been violated in some way.

453
00:49:44,730 --> 00:49:51,180
And I want to share some someone's story to that effect. This woman writes a member of the deity Bora.

454
00:49:51,180 --> 00:49:58,890
As the years ruled by attained puberty and after experiencing my first menstruation, I became aware of my sexuality at this point of time.

455
00:49:58,890 --> 00:50:04,780
My second eldest sister, in order to give me an understanding of sexual knowledge, gave me a book to read.

456
00:50:04,780 --> 00:50:10,090
After reading that book, the full impact and realisation of that awful, painful and life-changing procedure,

457
00:50:10,090 --> 00:50:14,590
which I was made to undergo at the innocent age of seven years dawned on me.

458
00:50:14,590 --> 00:50:22,060
I was privately distraught and enraged to learn that I had been robbed of my full feminine rights to sensuality and sexuality.

459
00:50:22,060 --> 00:50:32,150
This feeling disturbs and traumatises me, and feelings of inadequacy and incompleteness remain with me even till today at the age of sixty one.

460
00:50:32,150 --> 00:50:41,510
After making a private self-examination, I found that the prep use for foreskin of my clitoris had been cut off.

461
00:50:41,510 --> 00:50:48,680
What's striking about this example is I see dogs here, so OK, that's my movement, I got to finish up.

462
00:50:48,680 --> 00:50:52,510
The woman had a change in mind. Sorry, but it wasn't. I wasn't.

463
00:50:52,510 --> 00:50:57,540
I wasn't. I wasn't sure if you had lost your internet or had lost my internet, and I thought, Oh, come back into the room to check it out.

464
00:50:57,540 --> 00:51:02,070
So I think we're working that. I wasn't trying to rush it.

465
00:51:02,070 --> 00:51:06,260
No, that's OK. Thanks. Thanks for checking in. And yeah, I'm seeing that.

466
00:51:06,260 --> 00:51:10,580
I'm almost at an hour now, so I'll I'll wrap up the next few minutes.

467
00:51:10,580 --> 00:51:14,390
So this, you know, this person underwent a change in her mind or her perspective.

468
00:51:14,390 --> 00:51:18,260
It's not that she she her body went through some further change.

469
00:51:18,260 --> 00:51:24,980
You know, what happened to her happened her when she was a kid, but when she grew up and gained a different perspective,

470
00:51:24,980 --> 00:51:29,600
she saw that that modification is something that maybe as a child she learnt was beneficial.

471
00:51:29,600 --> 00:51:35,570
Or maybe that she learnt was something that drew her closer to God or made her more connected with her community or her ancestors.

472
00:51:35,570 --> 00:51:40,250
And maybe she believed all of that. But if she changes her mind,

473
00:51:40,250 --> 00:51:50,060
it's not hard to see why the very same body modification can be reframed or be characterised as something that a person is daily disturbed by

474
00:51:50,060 --> 00:51:58,700
because they now carry a scar on a part of their body that they have also been socialised to believe is private and they can never remove the scar,

475
00:51:58,700 --> 00:52:01,550
no matter how, how long they live.

476
00:52:01,550 --> 00:52:10,790
So even in cases with supposedly limited physical physical effects, these symbolic meanings can be disturbing for many people.

477
00:52:10,790 --> 00:52:12,560
For the reasons that I've just just mentioned,

478
00:52:12,560 --> 00:52:17,360
it involves interference with a person's sexual anatomy when they're in a particularly vulnerable state.

479
00:52:17,360 --> 00:52:21,380
It involves exposing them to risk, even if you mean to do only a minor incision.

480
00:52:21,380 --> 00:52:26,690
You may cause nerve damage or the knife may slip and cause more damage than is intended.

481
00:52:26,690 --> 00:52:34,730
And it's rational to prefer that no such risk is concentrated on this part of a person's body, especially when they're healthy.

482
00:52:34,730 --> 00:52:39,980
And again, these procedures are carried out on behalf of reasons which, unlike in the case of medical necessity,

483
00:52:39,980 --> 00:52:46,320
medical necessity, there's a significant chance of adult rejection upon reconsideration.

484
00:52:46,320 --> 00:52:55,840
OK, so I'm in the final stretch here. The first U.S. test case, the one that led to the striking down of the federal FGM law concern,

485
00:52:55,840 --> 00:53:01,290
primarily this woman, Dr. Jonathan Agarwala, who's a member of the be on the Shia Muslim sect.

486
00:53:01,290 --> 00:53:09,360
I just told you about the deputy Boro are mostly based in India and Pakistan,

487
00:53:09,360 --> 00:53:17,130
but there's a global community, including members in Detroit, Michigan, where this case took place.

488
00:53:17,130 --> 00:53:25,560
The alleged cutting here was not done in a manner that is consistent with the stereotype of FGM that is put on the front page of the Guardian.

489
00:53:25,560 --> 00:53:34,830
Rather, this was cutting that was done by a doctor trained in the United States in a clinical setting with pain control and sterile instruments.

490
00:53:34,830 --> 00:53:39,150
Now again, as I've argued, none of that changes the moral permissibility of the procedure because I don't

491
00:53:39,150 --> 00:53:43,290
think that the permissibility rests on the stability of the instruments.

492
00:53:43,290 --> 00:53:51,660
But nevertheless, this is done in a way that's very different from the way that most people imagine the poor a practise what they call Cotner,

493
00:53:51,660 --> 00:53:59,550
which is an Arabic word that means circumcision. It's a gender neutral word, and they practise that on both boys and girls for religious reasons.

494
00:53:59,550 --> 00:54:05,640
Now this next slide, I think I'm going to go through it.

495
00:54:05,640 --> 00:54:13,590
The typical male operation in this case is more invasive than the one for females, but only the female operation was regarded as criminal.

496
00:54:13,590 --> 00:54:24,900
Now, the fact that the practised circumcision on boys and girls alike is something that may seem unfamiliar or striking to many people,

497
00:54:24,900 --> 00:54:27,270
particularly because when people think of female genital cutting,

498
00:54:27,270 --> 00:54:34,440
they think of it as something that's targeted at girls in order to, as it were, control their sexuality or as a means of subordinating them.

499
00:54:34,440 --> 00:54:40,860
And therefore female genital cutting is strongly symbolically linked in the western imagination with patriarchy.

500
00:54:40,860 --> 00:54:49,620
And so this is an area where considerable scholarship over 40 years, but certainly in increasing volume in recent years,

501
00:54:49,620 --> 00:54:53,700
has tried to highlight that this view is at the very least,

502
00:54:53,700 --> 00:55:00,960
an oversimplification of the symbolic meanings and these social functions of female genital cutting where it occurs.

503
00:55:00,960 --> 00:55:05,610
So here are some complications that have been raised in the recent literature.

504
00:55:05,610 --> 00:55:10,440
According to the World Health Organisation, all non-Western associated female genital cutting.

505
00:55:10,440 --> 00:55:13,980
So they ignore things like labia, plastic and so forth.

506
00:55:13,980 --> 00:55:23,820
Is is a form of sex discrimination stemming from patriarchy from the unequal status of men and women in society.

507
00:55:23,820 --> 00:55:33,690
But it's hard to square that with some facts. One is that almost all FGC practising societies also practise MGC under the same conditions,

508
00:55:33,690 --> 00:55:38,400
and for largely similar socio cultural reasons, the inverse is not true.

509
00:55:38,400 --> 00:55:45,540
There are many societies that only cut the genitals of boys, but there are virtually no societies that only cut the genitals of girls.

510
00:55:45,540 --> 00:55:47,730
Now, the reasons for cutting are obviously multidimensional,

511
00:55:47,730 --> 00:55:54,570
but the idea that the point of female genital cutting is simply to suppress the sexuality of the girl.

512
00:55:54,570 --> 00:55:59,550
There's anthropological support for that in certain areas, in particular where infiltration is practised,

513
00:55:59,550 --> 00:56:03,330
which is explicitly about narrowing the vaginal opening to prevent premarital sex.

514
00:56:03,330 --> 00:56:11,400
So of course, it's strongly, physically and symbolically associated with this paradigmatic patriarchal control of women's sexuality.

515
00:56:11,400 --> 00:56:15,450
But that's the least common form of female genital cutting and where it's practised in other groups.

516
00:56:15,450 --> 00:56:19,890
For example, amongst the Cono of Sierra Leone or the Jola of Senegal,

517
00:56:19,890 --> 00:56:27,180
these groups have a relatively liberal sexual attitudes and are not primarily concerned with female chastity or virginity.

518
00:56:27,180 --> 00:56:35,550
For example, women will sometimes take lovers during their initiation ritual, and that's culturally tolerated.

519
00:56:35,550 --> 00:56:44,280
So depending on the group, either the male or the female version of the initiation rate may be more physically severe.

520
00:56:44,280 --> 00:56:50,470
Now, virtually all societies are. All societies are, to some extent, patriarchal and patriarchal to different degrees.

521
00:56:50,470 --> 00:56:59,460
In other words, virtually all societies have some means or another by which they tend to asymmetrically restrict female sexuality by various means.

522
00:56:59,460 --> 00:57:07,020
How is that related to practises of genital cutting? Well, most of those societies do not practise female genital cutting or male genital cutting,

523
00:57:07,020 --> 00:57:11,580
for that matter, or they practise only male genital cutting.

524
00:57:11,580 --> 00:57:19,290
But nowhere are girls selectively targeted, and therefore a empirical association between the degree of gender inequality in

525
00:57:19,290 --> 00:57:25,350
a society and the prevalence of female genital cutting is not well established.

526
00:57:25,350 --> 00:57:32,610
In fact, amongst the most strongly patriarchal societies, according to World Bank analysis and other sorts of indices of gender inequality,

527
00:57:32,610 --> 00:57:38,520
for example, Afghanistan is the most gender unequal society where women are the most strongly oppressed.

528
00:57:38,520 --> 00:57:41,370
These societies practise only male genital cutting.

529
00:57:41,370 --> 00:57:46,590
They do not practise a female genital cutting, and in the male ritual, it's really the male ritual.

530
00:57:46,590 --> 00:57:52,200
That reemphasize is the patriarchal norm because boys undergo a trial of violence in which they have to

531
00:57:52,200 --> 00:57:58,260
prove that their quote unquote real men and adhere therefore to the norms of masculinity in society.

532
00:57:58,260 --> 00:58:10,620
So if patriarchy is a concern, the male right where patriarchal masculinity is passed down each generation is one that should it should be contested.

533
00:58:10,620 --> 00:58:16,590
Now again, from the perspective of the practising communities, genital cutting is typically valued institution.

534
00:58:16,590 --> 00:58:22,710
You might think of it as something like the military. There are all sorts of critiques that could be raised about the military.

535
00:58:22,710 --> 00:58:26,340
For example, it fosters certain sorts of authoritarian hierarchies,

536
00:58:26,340 --> 00:58:31,150
and it's the sort of thing that maybe you would want to argue is a flawed institution.

537
00:58:31,150 --> 00:58:38,790
Nevertheless, from the perspective of the society, it's a highly valued institution and therefore the exclusion of girls and women from

538
00:58:38,790 --> 00:58:43,890
the military is seen as a way in which their lower status in society is reflected.

539
00:58:43,890 --> 00:58:51,240
Similarly, within Judaism, where the main genital cutting ritual is a central custom.

540
00:58:51,240 --> 00:58:57,640
The main right of the religion only boys are as it were entitled to.

541
00:58:57,640 --> 00:59:02,350
Because to participate in this ritual. Whereas girls are excluded.

542
00:59:02,350 --> 00:59:09,010
And so Shai Cohen has argued that it is the exclusion of girls from genital cutting in societies

543
00:59:09,010 --> 00:59:16,120
that practise circumcision of boys that most strongly reflects the lower status of the girls,

544
00:59:16,120 --> 00:59:24,140
not the genital cutting of girls where they are initiated on the same basis as their brothers.

545
00:59:24,140 --> 00:59:30,400
Now, the female genital cutting rituals are almost invariably led by women who are their strongest supporters

546
00:59:30,400 --> 00:59:36,310
and various accounts of false consciousness and brainwashing and so forth could be raised here.

547
00:59:36,310 --> 00:59:43,000
That's a long conversation. But in practical terms, even if you accept that these initiations are happening under non-ideal conditions

548
00:59:43,000 --> 00:59:47,920
where there is gender discrimination in the society as there is in every society,

549
00:59:47,920 --> 00:59:52,240
you have to recognise that the female genital cutting rituals led by women,

550
00:59:52,240 --> 01:00:00,580
the mothers in the grandmothers high status women are often the main site of bonding and the formation of communal networks

551
01:00:00,580 --> 01:00:07,390
that allow the women to therefore have some means of political resistance against male domination in the society.

552
01:00:07,390 --> 01:00:16,730
And so in practical terms, the female initiations that involve genital cutting are often anti patriarchal institutions under non ideal conditions.

553
01:00:16,730 --> 01:00:23,180
And so this leads to is a situation where as the whole global policy stance has

554
01:00:23,180 --> 01:00:28,460
been to criminalise only the female half of what in every context where it occurs,

555
01:00:28,460 --> 01:00:30,270
is is part of a gender inclusive right.

556
01:00:30,270 --> 01:00:38,060
A rite of passage where the boys are also initiated means criminalising women who control and manage those rights.

557
01:00:38,060 --> 01:00:47,510
Meanwhile, men retain their bonding ritual, where norms of toxic masculinity are passed down and also escape criminalisation.

558
01:00:47,510 --> 01:00:51,260
So this is discriminatory and unjust on multiple different levels.

559
01:00:51,260 --> 01:00:57,380
And the point here is that it is not helpful to the women who are being criminalised for carrying

560
01:00:57,380 --> 01:01:04,850
on a tradition that they value in the same way that the men carry on a parallel tradition.

561
01:01:04,850 --> 01:01:15,010
OK. This site is just emphasise again that in the top 10, most gender asymmetrical countries,

562
01:01:15,010 --> 01:01:19,360
according to various metrics where women are the most seriously oppressed,

563
01:01:19,360 --> 01:01:24,280
as you see in the left hand column there, most of them have no form of female genital cutting.

564
01:01:24,280 --> 01:01:28,090
However, all of them have extremely high rates of male genital cutting.

565
01:01:28,090 --> 01:01:30,580
In other words, if there is a statistical association,

566
01:01:30,580 --> 01:01:36,070
it's likely between male genital cutting and patriarchy in terms of the degree of gender inequality,

567
01:01:36,070 --> 01:01:42,740
rather than between female genital cutting and degree of gender inequality.

568
01:01:42,740 --> 01:01:50,480
So here's how this plays out in the case of the Bora, according to Richard Schrader, amongst some Muslim groups,

569
01:01:50,480 --> 01:01:58,760
there is a gender inclusive version of the Jewish Abrahamic Covenant not only the boys, but also the girls are circumcised to use his term.

570
01:01:58,760 --> 01:02:05,720
The procedure for girls amounts to a neck, abrasion piercing or small cut restricted to the female foreskin or prep use.

571
01:02:05,720 --> 01:02:12,110
The custom is less invasive than a typical male circumcision, as routinely and legally performed by Jews and Muslims.

572
01:02:12,110 --> 01:02:15,110
So the same families that practise female circumcision,

573
01:02:15,110 --> 01:02:23,660
for which the Nikola was faced with federal criminal charges, also circumcised the boys more extensively.

574
01:02:23,660 --> 01:02:29,150
Now, recruiters view is if the practise is legal for the gander, why should it be banned for the goose?

575
01:02:29,150 --> 01:02:33,740
And so to follow his reasoning through female circumcision should be legalised.

576
01:02:33,740 --> 01:02:36,990
That's what that's what he argues.

577
01:02:36,990 --> 01:02:44,040
Now, Aaron Chavkin, I have said this sort of reasoning leads to a to a dilemma if male circumcision should be permitted generally and for any reason.

578
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Because in some groups it is regarded as an explicitly religious practise,

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then relatively mild forms of female genital cutting that are regarded by some groups as religiously required,

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should, by this logic, also be given equal consideration and should be tolerated for all groups,

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regardless of the reason so that parents who want to modify their daughter's genitalia without cutting

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the clitoral glands should be allowed simply upon parental request in order to achieve sex equality,

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according to this view. And this is precisely what defenders of male circumcision have now been arguing,

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so Aurora and Jacobs in the Journal of Medical Ethics argue that because male genital cutting is tolerated even when non-consensual.

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So too should female genital cutting, they argue. We argue that in a liberal society that tolerates expression of culture or religion in

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the manner of male circumcision should also permit what they regard as minor procedures.

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Again, the people who undergo these procedures do not always regard them as males.

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Making a judgement for someone else about how much harm they're going to experience from having a genital operation is a tricky proposition.

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In any event, their justification is this is appropriate because all Western nations, in fact, permit ritual circumcision of men.

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I don't know why they say men here. Men are not ritually circumcised.

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If you circumcised a man without his consent, it's understood to be a sexual assault and battery its infants who are circumcised,

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who are even less able to defend themselves than men. This is not an obscure academic debate, the economists picked up this line of reasoning.

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The editors wrote After 30 years of attempts to eradicate a barbaric practise, it continues, It's time to try a new approach.

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What they suggest the new approaches that should be tried is to tolerate a legally female circumcision.

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And so increasingly, what you're seeing is that the presumed moral and legal acceptability of medically unnecessary,

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non-consensual penile circumcision is now being used by prominent legal scholars,

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bioethicists, anthropologists and others to justify urgent arguments in favour of what they regard as minor non-consensual female genital cutting.

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As Davis concludes, as long as Western countries continue to countenance male genital cutting,

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the criminalisation of even the ritual neck cannot fail to dilute the persuasiveness of the official

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stance against FGC while carrying the unmistakeable taint of intolerance and double standards.

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And as I've been alluding to throughout the talk, it's not just sex based double standards, but race and religious based double standards in practise.

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So here's the federal ruling Judge Bernard Friedman struck down the FGM law, making a jurisdictional argument.

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He said that the federal government didn't have the authority to pass a law

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affecting all 50 states as it concerns what he calls local criminal activity.

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01:05:25,500 --> 01:05:33,570
And this is a very important point. The local criminal activity in question was this so-called ritual nicking or female circumcision.

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So something that's less severe than male circumcision. And he says it's already illegal in the United States because it's a physical assault.

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If there's not a valid medical indication and the person can't consent, cutting them is an assault.

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01:05:46,970 --> 01:05:49,040
And that's true in English law generally,

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and so the argument has been made that that applies here in England to circumcision of children of whatever sex.

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So the judge avoided confronting the collision at a federal level,

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but he passed it down to the states who know if they have a state level law, it will be enshrining different standards for males and females.

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The judge was nevertheless aware of the equal protection problem, he says.

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01:06:11,120 --> 01:06:15,170
As laudable as the prohibition of a particular type of abuse of girls may be.

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It does not logically further the goal of protecting children on a non-discriminatory basis.

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01:06:20,690 --> 01:06:25,670
So my last slide here is the FGM law was reinstated.

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It was reworded so that it could be consistent with the Interstate Commerce Clause of the Constitution.

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This is a cosmetic thing that was done. It's not really the underlying legal basis for for the law.

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The law now makes explicit that pricking the collateral prep use without any removal of

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tissue or long term functional damage is considered and defined legally as mutilation.

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01:06:48,800 --> 01:06:51,840
And it's explicit that there is no religious exception to this.

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Even if the parents are devout pricking and control prep use, they will face federal criminal penalties.

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So to summarise, I think the future of law and policy is going to really shift from the x axis here,

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which is making a judgement about how stereotypically male or female a child's genitals

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are in deciding whether it is permissible to modify those genitals medically,

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01:07:17,630 --> 01:07:22,550
unnecessarily and non consensually over to the y axis.

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01:07:22,550 --> 01:07:30,830
Where the overriding question should be, is the person sufficiently attired autonomous to choose to have their own sexual anatomy?

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That's healthy, modified for reasons that they themselves endorse in the fullness of their adult values and and chosen community and so forth.

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So that's why I think this conversation is heading.

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I wanted to give you a heads up and I really look forward to our discussion over the time that remains to be.