Conversation with Dr. Genevieve Johnson Stuber, DO, of Clinton Family Health Center, 293 Upper Falls Blvd, Rochester, NY 14605

Would those advocates of male circumcision for reduction in infection rates be open to studying female genital cutting for reduction in infection rates, especially considering that the female genitalia are in general more prone to infection? That was the question I posed to Dr. Genevieve Stuber of Rochestern, NY, who couldn’t seem to bring herself to think critically on the subject of a gender-neutral approach to researching cutting children’s genitals for “health benefits.”  Pretty sad that this is the state of intellectual openness exhibited by medical professionals in the United States today.

Everything in this post is public information.

Genevieve Stuber According to this article, penile cancer is 50 times more prevalent in uncircumcised men. That is no a small increase. Furthermore, the relationship between circumcision and hiv transmission is well established.

Not Yours to Cut Should we research cutting baby girls at birth too? I mean, their uncircumcised genitalia are more prone to infection, disease, and cancer than uncircumcised male genitalia.

Genevieve Stuber however, women who have not had genital mutilation are no more prone to infections than women who have. The comparison is inappropriate, inflammatory, and mysogonistic. It is similar to comparing rape to a prostate exam. Prostate exams are performed more frequently than science says is warranted but that does not make them rape.

Not Yours to Cut Gevevieve, as mentioned in the article I posted above, I am not referring to the grotesque mutilations performed with rusty razor blades on young girls in various African and island tribes, which are really the only forms of female genital cutting that we have researched with respect to health, concluding with the notable exceptions of Stallings 2005 and Kinuthia 2010 that there are no benefits, just as I am not referring to penile subincision performed on young boys in Aboriginal Australia or more severe forms of male genital mutilation.

Let’s compare apples to apples, if you please.

What I *am* referring to are forms of female genital cutting that merely excise folds of skin, leaving the glans clitoris and vaginal opening intact, performed in the same sanitary conditions in which we perform male circumcision. Comparing a surgery that removes folds of skin from a female child’s genitalia to a surgery that removes a fold of skin from a male child’s genitalia is in no way inappropriate, inflammatory, or misogynistic. However, claiming that *any* form of genital cutting performed on a child of Gender X is mutilation while not maintaining the same standard for Gender Y is indeed sexist against Gender Y.

The fact of the matter is that we have never studied the health effects of forms of female genital cutting more akin to male circumcision, such as excision of the clitoral hood and/or inner labia, under the same sanitary Western conditions in which we study male circumcision (if I am mistaken, kindly link to the studies). This is quite bizarre as the uncircumcised female genitalia have more folds of skin, more exposed mucosal tissue, and the same Langerhans cells found in the inner foreskin that many scientists posit as an entry point for HIV, and are more prone to most of the maladies that circumcision supposedly protects against than the uncircumcised male genitalia. Quite frankly, from an epidemiological perspective, if one had to choose to research the health benefits of altering only one gender’s genitalia, the female genitalia, not the male, should take priority. But that obviously has not been the case as far as American medicine has been concerned.

Knowing all this, would you be opposed to researching the health benefits of forms of female genital cutting more akin to male circumcision when performed in sanitary settings? If cutting a male’s genital folds provides such benefits, isn’t it at least reasonable to research the potential health benefits of cutting the female genital folds? Quite frankly, that we have not done so seems terribly neglectful of women’s genital health and hygiene, considering that we invest so much in researching altering the male genitalia at birth to support male health and hygiene. Why should only males enjoy research concerning altering their genitalia for improved health when in fact females are generally more prone to genital health issues? It simply doesn’t seem fair. Women deserve the right to know if having their genital folds altered or excised in sanitary Western conditions, which we have in fact never studied as we have male circumcision, could offer them health benefits such as reduced infection risk, for instance.

But why stop at the genitalia? What other tissues should we research excising from children’s bodies at birth for health and hygiene’s sake? A male actually has a greater chance of dying from breast cancer than penis cancer, you know. Cut all the baby boy boobies! I am of course being mildly facetious, but I hope you see my point: why should the prepuce, and even then only in males, out of all the non-essential bodily tissues that are potential infection and disease sites, be the only tissue that the American medical establishment weighs the pros and cons of excising in infancy and therefore the sole exception to the general rule of respect afforded to the human body in its naturally-occurring state?

Genevieve Stuber Before responding to the above, I would like to give you some background on my perspective. I am a physician who is cautiously pro-circumcision in the US and fully pro-circumcision in those parts of the world with high HIV rates. I base this on the balance of pros and cons. Rates of HIV are markedly lower in those countries in sub-Saharan Africa that circumcise, but this is a relatively small effect overall in the US. Most additional pro circumcision arguments have relatively minor medical effects. However, most anti-circumcision arguments are anecdotal or theoretical, which make poor evidence. Never the less, I find the idea of altering anatomy without a good reason distasteful at best and often unethical, sometimes to the point of malpractice.

I used to be marginally anti-circumcision in the US. This was based on the idea that there is always a reason for the way we are made. There is little or no solid evidence as to the purpose of a man’s foreskin. I did not feel that we could make an adequate pro/con analysis without understanding the purpose of the foreskin in the first place. Then my husband pointed out to me that it may serve as purely mechanical protection. Modern underwear makes this purpose unnecessary.

Clearly, I am on the fence. Therefore I always read articles that appear reasonable in order to educate myself and make the most informed decision. Significant medical decisions should not be based on tradition or anecdotal evidence.

That being said, any comparison of circumcision to female genital mutilation is ridiculous, inflammatory, and inappropriate. I don’t care what your article says. Female anatomy is dramatically different on both an microscopic and macroscopic scale and the removal of tissue is always a significantly larger and more dangerous procedure.

My presumption is that your goal is to decrease circumcision rates with the eventual hope of discontinuing it. I would like to suggest that such inappropriate comparisons only make you look like an extremist and turn off your audience. They do not further your goals.

I will not reply further to any of your posts.

Not Yours to Cut How much of a male child’s perfectly normal, healthy genitalia can you cut off before it’s genital mutilation? Now, how much of a female child’s perfectly normal, healthy genitalia can you cut off before it’s genital mutilation?

“I don’t care what your article says.”

As you are a physician, I would have hoped that you would have taken the time to read through my thought process and give a thoughtful response, but apparently not. It baffles me that American physicians can believe so strongly that cutting off the male genital fold offers such health benefits while refusing to even consider researching cutting off the female genital folds under the same sanitary conditions under which we examine male circumcision.

“There is little or no solid evidence as to the purpose of a man’s foreskin.”

The same could be said for the labia minora and clitoral hood, if you discount the protective function of the foreskin. Why then would you be so opposed to researching the alteration of these female folds of skin to look for “health benefits”? Why do you label such cutting “female genital mutilation” while accepting male circumcision as a valid surgical procedure?

“Then my husband pointed out to me that it may serve as purely mechanical protection. Modern underwear makes this purpose unnecessary.”

Google “circumcision ruins the glans”. Imagine if your clitoris were constantly exposed to rubbing against your underwear all day.

“Female anatomy is dramatically different on both an microscopic and macroscopic scale”

Yes, in fact, it is *more* prone to most of the maladies that circumcision supposedly reduces the risks of, so it’s bizarre that you do not see value in researching altering the female genitalia to look for health benefits.

“and the removal of tissue is always a significantly larger and more dangerous procedure.”

“Always”? Really now? This is, as you say, “anecdotal or theoretical.” We’ve never actually researched cutting the female genitalia for health benefits in the same way that we have researched cutting the male genitalia.

 

About notyourstocut

Genital Autonomy For All. Her Body, Her Choice. His Body, His Choice.

One comment

  1. Gosh! Is Dr. Struber aware that every mammal, male and female, is born with a foreskin (prepuce). Is the evolutionary process so far off with American men that surgery is immediately required at birth? Further, if the Dr. were to take a finger and gently stroke the palm or her hand and then the back of the same hand I am sure she would recognize the presence of Meisners corpuscles (fine touch receptors) present on the palms of hands, soles of feet, lips and the inner foreskin of both men and women. The foreskin of a man has a purpose. Circumcision is a cultural/religious practice not a health measure.

    Liked by 1 person

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