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Male Genital Mutilation
A Feminist Study of a Muted Gender Issue
Seham Abd el Salam
Cairo, June 1999
B.Sc in Medicine, Graduate Diploma in Medicine, Graduate Diploma in Art Criticism,
Post masters Fellowship Research - Supervisor: Professor
American University in Cairo, School of Humanities,
Sociology, Anthropology, Psychology and Egyptology Department
English Version translated by: Azza Ali (Ph. D) and Seham Abd el Salam
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Chapter II: What women know about men and what men know about themselves: Respondents’ Knowledge and Beliefs about MGM: The two perspectives
I will start by describing the respondents’ knowledge and beliefs about MGM before they get updated information on the subject. These respondents are intellectuals from both sexes (see Annex 1), who represent an important social group who affects and is affected by social biases. They are an elite group, who are preoccupied with attaining knowledge, analyzing it and matching it against the inherited cultural traditions. Thus, they may create new social conceptualizations that may or may not be accepted by the common public, but are always considered as worthy of thinking and group interaction about them. Medical doctors are a category of intellectuals with specific significance to this study of MGM because of its relation to the body. Doctors' attitudes towards such an issue are of crucial importance because they are formed by their biases that are created by their inherited social beliefs, personal experiences, and acquired knowledge. Byron Good (1994) explained that medical discourse is a combination of knowledge and beliefs. The experience of family planning in Egypt is a good example, since it shows how doctors performed their profession with their own personal beliefs and religious and social convictions in mind, side by side with their medical knowledge (El-Mehiary, 1984).
I asked the respondents an open question: "What do you know about male circumcision?" to know from which perspective they see male circumcision. Then, I discussed in detail their expressed beliefs. The respondents had two basic perspectives on MGM: Socio-cultural and medical/health perspectives.
A - The Socio-Cultural Perspective
The respondents who considered circumcision as rooted in social traditions that have cultural significance mentioned several beliefs forming this perspective; the most important of which is that male circumcision is a rite of initiation of the male into manhood. According to this view, the non-circumcised male’s appearance is unacceptable, that is why the procedure is a condition for social acceptance. The other key cultural belief of the respondents is that circumcision is grounded on ancient Egyptian religions, Judaism, Christianity and Islam.
Some of them expressed their
astonishment when they saw pictures
of non-circumcised men because they did not seem repulsive.
The respondents did not find some of these common beliefs valid, but all of them were aware of their widespread prevalence among the common public. The respondents were especially aware of the belief that circumcision is a rite of passage or initiation. Some of them expressed their astonishment when they saw pictures of non-circumcised men because they did not seem repulsive. On the other hand, one of the women respondents expressed her opinion that a circumcised man is more sexually potent, that is why Western women are attracted to Egyptian men. Few respondents believed that circumcision is a religious obligation whether for Muslims or Christians. Whereas others believed that circumcision does have a religious background but it is not a religious obligation. Most of them stated that the relation between circumcision and religion is part of their information of people’s common knowledge. But some said that circumcision is not mentioned in the Qur’an or the agreed upon Sunna. Other respondents associated male and female circumcision because of the similarity of the rituals in both cases, for example, throwing away of the amputated part in the Nile, and this implies that it is a sacrifice to the river in order to make it flood. And this denies its relation to monotheism.
As the interviews developed, I discovered more about the details of the respondents’ background beliefs that were expressed during our conversation about the differences between male and female circumcision, the differences between the circumcised and non-circumcised males, the relationships between circumcision, masculinity and male sexual behavior, the social reasons that made Egyptians continue to keep this tradition, and how far they themselves believed in these justifications, their awareness of the attitudes of other communities all over the world towards circumcision and how they feel towards such people that do not practice male circumcision, and about their knowledge and beliefs of religion’s attitude towards male circumcision. Following is a detailed description of the results I got about the respondents’ social and cultural beliefs.
I) Backgrounds of the socio-cultural perspective
A) The Respondents’ perceptions of the differences between MGM and FGM
Expressing their beliefs, the respondents mentioned that male and female circumcisions are two different issues. Some of the differences that were mentioned to support this belief represent the respondents’ knowledge of the inherited Egyptian social and cultural traditions, e.g., age differences in male and female circumcision. Other differences represent beliefs, not knowledge. An example is the respondents’ beliefs about male and female infants’ psychological and physical set up. Respondent medical doctors mentioned differences that represent their professional interest to feel at ease when performing male circumcision, or at least to perform it without experiencing a sense of guilt. Such rationales reveal the biases that facilitate people’s acceptance of or tolerance of MGM.
a) The age differences on the time of circumcision
Most of the respondents realized that there is an age difference between MGM and FGM, since the male children are usually circumcised in early infancy, while female children are usually circumcised in childhood or early adolescence. But some said that circumcision of the male child when he is only a few days old, is a new trend, since originally according to Egyptian tradition, the male was circumcised between the age of 3-6. Dr. Yara and Seif associated this new trend with the transfer from the traditional local barber (hallaa’ issiha) - who used to be the one to do this procedure - to the medical profession. Dina said: "This trend is becoming a new fashion." Dr. Yara added, moreover, "in the old days, they used to let the boy grow up a bit so that they could celebrate by riding him around on a horse, and also because the hallaa’ issiha could deal with an older boy easier than a younger one."
Most of the respondents did not have any definite documented information of the reasons of the age difference between male and female circumcisions. Some of them just recounted what they knew from the common beliefs, and others expressed their own personal beliefs about such age differences. All of the expressed interpretations of the age differences on circumcision could be sorted out into two categories. One category includes knowledge and beliefs about the development of the male and female genitalia, and the second includes the beliefs concerning infants’ psychological and physical set up.
"It is easy to find
something to amputate from the bodies of little boys,
but little girls do not have it yet, her genitalia are not yet enticing
to cut something off it."
All of the respondents had broad social interaction with various sectors of Egyptians from different social classes because of their activities or upbringing. Thus, they are aware of the common beliefs about the differences of the male and female genitals. Most respondents considered these beliefs as the background to the delay of FGM and the early performance of MGM. The most common beliefs are that the clitoris is not completely developed before the age in which the female is circumcised, whereas the male prepuce is already developed when the male is born. Some respondents stated that they heard about this belief from the common public. Whereas, others (Salah – Fathy – Seif – Nehal – Dr. Mona – Dr. Khadiga – Dina) said that this was their own personal belief. For example, Dina said:
"It is easy to find something to amputate from the bodies of little boys, but little girls do not have it yet, her genitalia are not yet enticing to cut something off it. That is my interpretation but I don’t know why."
Dr. Khadiga, on the other hand, said:
"Little boys are circumcised at a very early age, whereas girls are circumcised at the age of 9-10 because their clitoris development is completed at this age."
There is another common belief that states that the male prepuce does not grow once it is amputated whereas, the clitoris and labia minora will grow again if they are amputated at a very early age. Dr. Nader said that he was aware of the existence of this belief but he did not believe in it.
Most of the respondents (from the medical profession and others) shared, as do common people, their conceptualization of the infants’ psychological and physical characteristics that enable them to tolerate trauma, pain and injuries more than older children, since they tend to forget about it as time passes. The respondents, who believed in MGM, confirmed that the child’s crying during the procedure is nothing but an expression of discomfort because his movements are being restricted. The male respondents – as other males who I talked to in other meetings - also denied that the memory of the MGM trauma persists over time. They justified this belief by stating that they do not remember their own experience with circumcision because it was done when they were infants. Dr. Nader, Dr. Afkar, and Nehal, who was not a medical doctor, shared the belief that the earlier boys get circumcised, the quicker they heal and the less sharp they feel pain. But some medical doctor respondents who believed in the advantages of early male infant circumcision, because infants do not feel pain, were aware that such belief is contradictory to the basic medical knowledge that affirm that male circumcision at an early age is very dangerous to the child. One of them is Dr. Afkar who said that boys should be circumcised when they are babies so that they won’t feel pain but not before 40 days so that they don’t have a hemorrhage; for the clotting process is not well developed before that. Dr. Yara also expressed her confusion because of the contradiction between her personal belief – which was a common one - and her medical knowledge. She said:
"Medically speaking, the nerve supply of the prepuce is less developed in infants. So, baby boys do not feel pain so sharply; also, at this age, the healing process is quicker. But there is another problem, which is that, the younger the boy is, the more the prepuce is attached to the tip of the penis; this is very painful because the doctor has to draw the skin back and pull it forwards to tear this attachment before he cuts the prepuce off. This is very painful at such an early age because sometimes the prepuce is completely and firmly attached to the head of the penis".
Whereas Dr. Nazmi did not deny the fact that the infant does feel pain, and disagrees with people who say the opposite. But in his opinion, we can accept the child’s exposure to such pain because it doesn’t last except for a few seconds. He refused to avoid the pain by anesthesia because it is hazardous. He said, "It’s very dangerous to give anesthesia in an operation which takes only seconds … Of course, after a few seconds, the child stops crying and that is it."
Some doctors, however, explained that male circumcision is done at an early age to facilitate the surgeon’s task and save him difficulties. Dr. Nader said that the younger the boy is, the easier it is for the surgeon because he can easily manipulate him, even without anesthesia. Whereas, the older the boy is, the stronger his muscles are and one cannot control him. That is why it is commonly done by dissection of the prepuce and under anesthesia if the boy is older.
Dr. Fahmi added:
"In my opinion, the inherited experience tells doctors that it is much easier to do this procedure to a boy at an early age. Healing is quicker then, the amputated part from the infant’s body is small and therefore, the injured surface is small. So, it is not a major operation, but rather a minor one with removal of a less amount of tissues. When we were house officers, as you remember, we used to do this procedure in the outpatient clinic. Many mothers came with their children, who were one week to two months of age; we used to consider it part of our training on surgery. As for females, they are rarely brought to doctors to be circumcised, as if it was a secret cult. A midwife or even an elderly woman who did not necessarily have to be a midwife but has some experience in FGM should do it. That is why they don’t take females to a hospital or clinic in the same simple way as they do with males. That may be the reason why boys are circumcised at a very early age, whereas girls are circumcised later on."
There is, however, another explanation to the age difference that was mentioned by other respondents. This explanation is based on social discrimination against females. According to social custom, male circumcision is done at an early age, to make it less painful and less shameful to the boy because it is believed that he soon forgets about it. But females are not treated with such sensitivity or given the same attention, as is the case with males. That is why these respondents considered the age factor of this procedure as being less stressful to males than to females. That explains partially why they did not consider MGM a priority in their struggle for bodily integrity as one of the most important human and gender rights, as is the case with FGM.
b) The differences of motives behind male and female circumcision
One of the differences by which the respondents justified that MGM is not to be considered a gender issue is that MGM is not part of the social politics that control sexual behavior. Some respondents noticed, through their fieldwork, that the majority of people intend to remind females of the pain that goes with circumcision as one of the tools of social control. Whereas males do not have to remember such a traumatic experience because it is not meant to impose such control on them. That is why FGM is delayed to a later age. MGM is not meant to intimidate boys of sex or guarantee their chastity, as is the case with females. That is why a girl is not circumcised when she is an infant because this would not teach her virtue, which means virginity. And in their opinion, also, this aspect of circumcision conveys a painful social message to females: "When a female is hurt in this place and is conscious of it, she will be afraid; but, if this happens when she is an infant, she will not associate this painful experience with any disciplining lesson." The respondents considered that this message does not apply to males, even if they are circumcised between the ages of 7-12, since their circumcision is accompanied with celebration, and they are taught that this procedure is beautification procedure that prepares them for masculinity, reinforces their sexual potency, and keeps them healthy. This is different from the situation in female circumcision that is followed by restriction of the girl’s mobility in the public space, prevention from mixing with the other sex, affirmation of sexual taboos and prohibitions and stressing that circumcision is done to her to preserve the family honor.
Some respondents, though, considered that there is a difference in the cultural motives behind FGM and MGM. Most of them believed that FGM is not mentioned in any of the three monotheistic holy texts. They considered that MGM is a Jewish religious ritual, but they have different opinions as its validity in Christianity and Islam. However, they believed that most of the common people who reject FGM accept MGM and justify it by their belief that it is one of the religious requirements. Nevertheless, respondents are aware that common people also believe that FGM is a religious requirement.
c) Differences concerning the nature and consequences of the procedure
The respondents believed that there is a difference in the nature of the surgical procedure in males and females because of the variation in anatomical structure and function between the prepuce and the clitoris. They believed that MGM is a form of beautifying since an extra piece of skin, that has no sensation or function, is cut off. On the contrary, in FGM, it is the sensitive part of the body that is cut off, which is responsible for sexual pleasure. Even to those who have previous knowledge as to the sensitivity of the prepuce and its physiological and psychological significance and its protective function for the tip of the penis, such as Dr. Laila, the procedure is considered different in either sex. The respondents also believed that male circumcision has only one degree, which is the cutting off of the "extra" piece of skin, whereas FGM has various degrees and forms.
...he got his impression of
the insensitivity of the prepuce as a result
of the fact that anatomy books illustrated the penis without the prepuce
and; therefore, did not mention any information about its sensitivity.
Abu el Fotuh had read a great deal of modern medical literature concerning this matter and thought that pre-mature ejaculation is a potential negative consequence of MGM because it is the cover at the tip of the penis that prevents it. He said, though, that he got his impression of the insensitivity of the prepuce as a result of the fact that anatomy books illustrated the penis without the prepuce and; therefore, did not mention any information about its sensitivity.
Most of the differences considered by the respondents, though, between MGM and FGM are limited to the psychological consequences of the procedure. They considered the psychological consequences in males to be very rare and trivial or even absent as a result of the procedure being done at a very early age. Also, some respondents believed that sexual pleasure in females is a psychological element and not a biological one. That is why they considered FGM as harmful and a violation; whereas, MGM does not have any effect on men’s sexual pleasure.
Other differences considered by respondents were related to the complications of FGM and MGM. They believed that MGM is not a dangerous procedure if done by a doctor in a clinic; contrary, to FGM in which many complications can occur if done by a person who is not from the medical profession and even if a doctor does this surgery, things would not be much different. The only difference would be that the wound would not be easily contaminated.
Some respondents believed that there are other differences in the consequences of male and female circumcision as to sex and health, the most important of which is that MGM is beneficial to both sexes because it makes the male more sensitive and cleaner.
d) Differences concerning medical literature
Some medical doctors respondents mentioned this kind of difference. Dr. Nader, for example, said:
"There are two aspects that doctors take into consideration. The first is that the benefits of male circumcision are documented in medical literature, whereas, there is no medical documentation stating the benefits of female circumcision. The second is that male circumcision was taught to us by our professors and consequently, we taught it to our students, but we did not study female circumcision as a subject, neither did we practice it in our early years as house officers."
B) The Respondents’ perception of the difference between the circumcised and the non-circumcised male
Some respondents believed that there are no differences between the circumcised and the non-circumcised males. From their point of view, in Western culture people are not circumcised but still are healthy and sexually potent. In societies where people are circumcised, such as the Egyptian society, the only difference is that a circumcised male is more socially accepted.
Other respondents expressed their perception of sexual differences between the circumcised and the non-circumcised males. These differences are related to the extent of sexual sensitivity, since some respondents thought that exposure of the head of the penis decreases its sensitivity because it is rendered more rough by the loss of it’s protective cover. Also, the respondents said that there were other differences such as the extent of potency. Some respondents thought that FGM has a negative effect on female sexual ability; whereas, this is not the case in males. Therefore, to them, there is no difference between the potency of circumcised and non-circumcised males. Sexuality, to them, is manifested in erection and sexual intercourse. Sa‘eed, moreover, said:
"The appearance of the organ is the same in a state of erection, irrespective of the male’s circumcision status, because the prepuce retracts on erection anyhow. But FGM is a different matter. They remove the essential part that is responsible for sexual pleasure."
As for Nehal, who is one of the respondents who believed that there is a difference between the circumcised and the non-circumcised men as to their sexual potency, she interpreted it in favor of the circumcised male:
"They say that foreigners are sexually cool because they are not circumcised. Here, men are hot because they are circumcised because the cut off part makes them more potent."
This is not only Nehal’s opinion. I have heard similar statements from some audiences of seminars on reproductive health. Once a man asked me: "How can a man perform sex with a woman if he has a prepuce? Wouldn’t it be a barrier?" Another man said that humanity would end if males were not circumcised because he believed that the prepuce prevents sexual intercourse.
"I believe that a woman enjoys sex more with a non-circumcised man."
Only one respondent (Salah) believed that the non-circumcised male is able to give more pleasure to his partner. He knew this from his interaction with people from other cultures that do not practice circumcision. He said: "I believe that a woman enjoys sex more with a non-circumcised man. I don’t know why but when I was in Europe, a woman told me so."
Other respondents expressed their belief in the differences in health conditions between the circumcised and non-circumcised males. Many respondents varied in their belief that circumcision tends to make the penis easier to clean. Some of them doubted this belief because they were aware of the fact that there are many non-circumcised men in the world who do not have any health problem nor are they considered unclean. Whereas, other respondents were doubtful because they read that the prepuce can easily be drawn back and cleaned. Those who believed so, thought that circumcision could in fact make the male cleaner. Dr. Yara; moreover, said:
"Non-circumcised men get secretions that are not present in the circumcised men, and if they are careful about their personal cleanliness, there is no problem. I cannot imagine the amount of the secretion nor its consequences. I would not know if both did not have a bath for two days, which one would have a smell."
Dr. Afkar added:
"I imagined that it would be cleaner not to have a prepuce, I thought it was a useless piece of skin, a dangling piece of skin that each one had to cope with according to the situation. For example, if he passes urine, he has to clean it. I imagine that it is like a tube around the penis that is difficult to clean if it is dirty. I imagine that when he has intercourse with his wife, he must pull it up or I do not know what exactly he does with it. I cannot imagine the situation … because I have never seen it."
It is strange, however, that Sa‘eed himself suffered from infections in the urinary tract that remained for months after circumcision. But he believed that the non-circumcised male is more exposed to urinary tract infection.
"Lower class women used
to say that a circumcised penis looks good.
I wonder, how does it look good?"
Other respondents believed that the main difference between the circumcised and the non-circumcised is in the appearance of the organ. They did not think that such difference has any functional or hygienic implications. Their attitudes towards this difference ranged between neutrality to disapproval. One of those who were neutral was Salah. He based his opinion on the fact that the difference in appearance of the penis disappears in erection. Thus, he concluded that there is no difference between the circumcised and non-circumcised males. He said:
"Lower class women used to say that a circumcised penis looks good. I wonder, how does it look good? I do not understand that? Haven’t you spoken with a woman from the lower class and been told the same thing? When it is erected, it looks the same. It looks good in both cases."
As for Dr. Salma, who saw a son of one of her friends - who was not circumcised and was of school age - said that his appearance did not seem repulsive but only astonishing.
Those who disapproved of the appearance of the intact male justified their views saying that they are accustomed to seeing the penis circumcised. But they add that the prepuce is a dangling piece of useless skin. Dr. Afkar asserted:
"Of course, there is a difference in appearance. I imagine that there is a piece of skin dangling from the penis. I imagine that if someone had not been circumcised, he would have a soft piece of extra skin dangling and I cannot imagine when he grows up, how big it will be. Also, we are used to seeing the circumcised penis; so, we consider that is the way it should be. Once, I saw a Western movie, the actor in it was nude and not circumcised. I was astonished and said, that guy has something strange. I felt that the circumcised man is better, perhaps because I’m used to seeing him that way."
Dina said with an expression of disgust on her face:
"The only difference between a circumcised and non-circumcised male is in the appearance of the organ. Nothing else. One of our friends’ son is not circumcised and the only difference in him is that he has an extra piece of skin hanging a little, but no other differences."
C) The Respondents’ Perception of the Relation of Circumcision to Masculinity and Male Sexual Behavior
When I asked the respondents about the relation between circumcision and masculinity, they equated masculinity with virility, which meant to them sexual potency, except Samia who said that in her opinion, masculinity is not represented by only the penis and Dr. Fahmi who said that masculinity is a complex concept. All respondents agreed also on their belief of the fact that there was no relation between MGM and restriction of their sexual behaviors. Some of them believed that MGM has no effect on sexual functions. But others believed that it did have an effect. Some said that it is a negative and some said that it is a positive effect.
However, most of the respondents believed that there is neither a positive nor a negative relation between MGM and masculinity. For, a non-circumcised male can get married and have children without any problem. Evidently, men from all over the world are married and have children whether they are circumcised or not. The respondents did not voice their own opinions only, but some expressed their knowledge of the common culture that was popular about the relation between circumcision and masculinity. For example, Aisha believed for a long time that circumcision was necessary for the male’s sexual ability until she recently read some books that convinced her that she was wrong.
Seif did not find any relation between circumcision and masculinity. He said, though, "If we considered the prevalent social belief that the circumcised male gets harder erection, then there is a relation, but personally I do not believe there is."
Salah added that the popular ideas among common folk concerning the relation between MGM and FGM and both masculinity and femininity are a patriarchal fallacy. According to that belief, it is thought that FGM ensures women’s chastity and fidelity; and MGM makes men more sexually appealing.
Moreover, those who believed that MGM does not affect sexual functions based their belief on the fact that erection is the most important sexual function, and the prepuce has nothing to do with that, and therefore, MGM has no sexual consequences. Moreover, they believed that as long as men do not remember their circumcision, this has nothing to do with their sexual behavior, which is not the case with FGM. But all of the respondents agreed that circumcision does not affect sexual desire, or the mechanism of sexual intercourse. But they differed in their knowledge and beliefs of its effect on sensitivity and consequently sexual pleasure.
Some respondents, though, had read about the functions of the intact male sexual organ before I interviewed them. These people thought that circumcision has a negative effect on sexual sensitivity, which limits the male’s sexual pleasure. On the other hand, other respondents considered that if males were not circumcised, it might have a negative effect on them. According to social norms, a non-circumcised man is considered abnormal, and in turn, this might have a negative effect on his self-image. As a result, circumcision does have a positive effect on masculinity. Sa‘eed said:
"In Upper Egypt, circumcision is considered a representation and reinforcement of masculinity. When a man is circumcised, he is in his full state of masculinity. For example, he does not have an extra piece of skin. People say that the presence of this extra piece of skin is against masculinity due to its appearance. When we are young, the male organ is small and weak. So, when the piece of skin is on it, the whole organ really looks like a piece of skin because of its skin cover. And when it is circumcised, it all takes the form of a fully developed masculine organ. So, a circumcised man appears more masculine because the head of the penis becomes exposed. It is, therefore, well shaped. However, a non-circumcised man can get married and have children. Everybody does this, or how do you think the nations that do not circumcise males survive?"
Dr. Fahmi though said:
"There is no relation between masculinity and sex. Masculinity is a complex concept. However, there is a relation between circumcision and masculinity. To build the child’s masculine image he should identify with his father and other male relatives and friends and look like them. At school, he compares himself to other children older than himself, and he wonders whether he has the same male characteristics as them or not, because sexual attributes are only a part of masculinity. Masculinity is a group of characteristics; such as chivalrous behavior, in the medieval sense, the brave man who protects others and the man who endures hardships … etc."
Dr. Salma added:
"There is no relation … but socially, circumcision is the shaping of a future man because it is taken for granted that men are circumcised. So, when a boy is born, he is shaped according to social norms."
Some respondents – all of whom are from the medical profession – considered that circumcision has a positive effect on sexual satisfaction. They based their belief on an ancient concept that stated that by exposing the head of the penis, it is made more sensitive. As for the respondents who gave a social interpretation of the belief that circumcision has a positive effect on sexual functions, they said that if the boy is circumcised at a later age, when he is more aware of what is happening, he would be more interested and conscious of his sexual organ, especially if he is told that this is a preparation for the new stage in his life and his role in it. This would have a greater impact on him if it happens right before the age of puberty, especially if the procedure is accompanied by the rituals that make him feel that he has become a grown up. He hears them saying that circumcision has an effect on erection and they congratulate him by calling him ‘a groom’ "‘arees".
D) The Respondents’ perception of the Egyptian’s social justifications for MGM
A lot of respondents stated that they believed in circumcision because it is a common social norm in Egypt. That’s why I inquired into the reasons for which Egyptians circumcise their children. The most important of these justifications is the respondents’ belief that it is a religious ritual. Most of the respondents (Muslims and Christians) agreed that religion is the most important factor that makes Egyptians circumcise their sons. However, some respondents doubted this justification because circumcision is not related to a certain religion to be considered one of its rituals. For example, both Muslims and Christians, in Egypt, circumcise their children. Most of them expressed their belief in the fact that circumcision is part of the ‘Sunna.’ Moreover, some said there is no doubt that male circumcision is a definite Sunna, contrary to the case of female circumcision. Although some of the Christian respondents said that it was not an obligatory procedure according to the New Testament, yet Hureya stated that most Christians still adopt the Old Testament. Moreover, Nehal said that circumcision was transferred to the Egyptians from Judaism. She also believed that Abraham lived in an earlier period than the ancient Egyptians.
Traditions were among the strong justifications that the respondents were aware of, for the continuity of male circumcision in Egypt. Moreover, it was the strongest one because both Muslims and Christians follow it. Sa‘eed continued that circumcision is an experience that was transferred to us by the Pharos and our ancestors. Its being practiced by one generation to the other without questioning reinforced the continuation of circumcision. Society doesn’t even doubt it. That’s why people do not stop to ask themselves why this procedure is being done. Dr. Mona, however, had an experience with people who defend MGM against any doubt. She raised the subject of MGM in meetings she had with some non-governmental organizations in various governorates. People got shocked because she dared to challenge an ancient tradition. They defended male circumcision as being one of the religious necessities. But Dr.Mona though, thought that people are attached to a religious justification because they are indulged in their old habits and do not wish to change.
Most respondents believed that the health justification is stronger than any other held by the intellectuals. Although all Egyptians call this custom "Taharah", i.e. purification, in the sense that it is a materialistic and moral cleanliness, the majority of common folk still practice it as part of tradition; whereas the intellectuals attain the information on the health benefits of MGM by their interaction with medical doctors and through reading books and other sources.
Although the respondents themselves doubted what is said about the necessity of circumcision to facilitate sexual intercourse and reproduction, some of them were aware of the common public belief in such "benefits." Seif heard that circumcision helps in sexual intercourse. He heard that if a male is not circumcised in childhood he cannot be erected when he becomes an adult. Moreover, Dr.Yara recounted that one of her relatives had not been circumcised as a child because his parents died, so when he was 22 and wanted to marry, he had to take the initiative himself. He went to the local barber "Halaq al Sihha," who used to perform first aid and some minor surgical procedures, and got circumcised because he believed that he would not be able to get married unless the procedure was done.
E) The Respondents’ perception of the validity of the social justifications for circumcision
What would happen if a boy
were not circumcised?
They all agreed on the fact that there would be no harm,
and most of them answered my question briefly saying, "Nothing."
As seen above, the respondents were aware of the common justifications that are prevalent in the Egyptian society on the subject of MGM. That is why they followed the tradition and circumcised their children. Many doctors agreed to do this procedure to clients who bring their children to them (as will be explained in the following chapter), but did they really believe in what they were doing. In exploring the respondents’ awareness of the truth of the social justification of circumcision, I asked them: What would happen if a boy were not circumcised? They all agreed on the fact that there would be no harm, and most of them answered my question briefly saying, "Nothing." Others explained their points of view. Fathi, for example, said, "The development of the child would not be affected." And Aisha said, " He won’t die if he is not circumcised." Dr. Mona, moreover, added that she thought that it would be better for the child if he remained without circumcision. More than one respondent backed up their opinion by explaining that Europeans do not practice male circumcision and still have a normal life.
F) The Respondents’ perception of the world prevalence of MGM
Some respondents thought that most of the men in the world are not circumcised. They believed so because of their experience and interaction with other nations or from what they read. Other respondents believed that most men are circumcised as they assumed from what they know about the extent circumcision is practiced among Muslims and Jews, for they believe that most of the world’s inhabitants adopt either of these religions.
Those who believed that most males in the world are not circumcised knew that Europeans do not circumcise males. Some of them believed that Americans also do not practice male circumcision and were surprised when I told them of the spread of male circumcision in North America. Others, though, knew that Americans practice male circumcision under the effect of the Jewish lobby. Most of the respondents who believed that most human males are intact based their assumptions on the fact that it was only Jews, Muslims and Christians who interacted with them, who insisted on practicing male circumcision. Therefore, they considered them a minority especially when adding the population of non-circumcised males in Asia.
Strangely enough, during our discussion, Dr. Salma laughed ironically. Suddenly she discovered the contradiction between her familiar information about the relation between lack of male circumcision and poor hygiene, and her certainty that European males were not circumcised, but still they did not suffer from cancer of the penis or cause cancer cervix to their partners, because they were concerned with their personal hygiene. Moreover, Nussa was surprised because European men are not circumcised and at the same time are Christians, although she knew an Egyptian Christian friend whose brother is circumcised. She said: " I don’t know why Western people do not practice male circumcision although they are Christian and why we do it here! "
Those who believed that most men in the world are circumcised mentioned various beliefs all of which are not supported by either experience or theoretical study but are merely inferences. There were opinions as to whether some or all of the Europeans and the Americans were circumcised. Some of the respondents said that they were 90% of the world’s male population, such as, for example, Abu el Fotuh who got his information from the films from various countries in which he had seen nude circumcised actors. So he concluded that all Western men were circumcised and took for granted that circumcision was practiced and accepted by the medical profession all over the world.
Samia believed that there were only the Australian aborigines and some Africans tribes who did not practice this custom.
Hureya, though, believed that all the countries that had the influence of Christianity or Islam circumcised their male children. She was aware of the movement against MGM in the West. She thought that this movement takes place in Europe, and that it is not successful because Europeans believe in the procedure. Moreover, in spite of the fact that Mostafa has been living in Germany and France and knew that their men are not circumcised, yet he still believed that the majority of the world’s male population are circumcised because this custom is related to Islam and Judaism and he thought that Muslims and Jews form 50% of the world population.
G) What the respondents thought about nations that do not practice MGM
"Maybe the higher
social class is more concerned about children’s rights
and so they leave the choice to them when they grow up."
If the respondents were aware of the fact that there is a percentage of the world’s population that do not practice MGM, how do they imagine the social and health status of people who are not circumcised? Some respondents thought that where MGM is not a tradition, men from all classes or ethnic groups are intact. Most of these respondents thought positively about non-circumcising groups and communities. They stated that this custom is not practiced in upper classes that are more liberal and well to do. Dr. Nader, moreover, said: "maybe the higher social class is more concerned about children’s rights and so they leave the choice to them when they grow up."
...these are the nations
that enjoy a more comfortable life,
such as the Scandinavian countries, that consider assault
on the human body as an unacceptable act.
Dr. Hazem, further more, said: " They are the ones who accept change and do not comply with social norms and have a more liberal attitude."
Americans do not have a
specific national culture based on
longstanding civilization, and that’s why they practice customs
taken from other cultures such as MGM.
Abu el Fotuh, though, thought that these are the nations that enjoy a more comfortable life, such as the Scandinavian countries, that consider assault on the human body as an unacceptable act. He justified the spread of MGM in North America by the fact that people there come from different nations and that’s why the Americans do not have a specific national culture based on longstanding civilization, and that’s why they practice customs taken from other cultures such as MGM.
The more civilized the
the more culturally and intellectually developed they are;
and therefore refuse to believe in the assaults on the human body.
Dr. Yara said that the more civilized the society becomes, the more culturally and intellectually developed they are; and therefore refuse to believe in the assaults on the human body. It is then that they open up and start to discuss issues to find solutions to the problems they face. By getting to the depth of their problems, they realize the truth and accordingly decide whether to give up their traditions or insist on practicing them.
What made Aisha think positively of the groups that do not practice MGM was the fact that she compared them with what she thought about FGM in Egypt. FGM is practiced less among the intellectuals and the more educated people who read and therefore are more understanding. As for the health conditions of those who are not circumcised, some respondents thought that they are more aware of what is considered healthy and hygienic. They justified this belief by saying that the nations that have a higher level of health care do not practice MGM. Other respondents thought that nations that do not circumcise males like to adventure and take risks. Thus, they accept the risk consequences of non-circumcision.
Hureya was the only respondent who thought that those who do not circumcise their children were the more illiterate and came from a lower cultural standard. Therefore, she believed that the intellectuals of the nations that do not practice this custom might perform circumcision as a kind of health awareness; where as the non-educated do not care to practice circumcision because they are not aware of its health advantages.
...they have European
friends who are not circumcised
and who are still both physically and sexually healthy.
Most respondents had positive imaginations of the health conditions of non-circumcised males. They believed that they do not have any problems related to the fact that they are not circumcised. Some of them are sure because they have European friends who are not circumcised and who are still both physically and sexually healthy. These respondents denied the idea of the spread of cancer in nations that do not practice MGM as well as denying that they were the nations who were affected by urinary tract and reproductive system infections. Moreover, Dr. Nazmi described what is said of the filth of the men who are not circumcised and their exposure to infections as " Nonsense!" "kalaam faregh." He added that it would not be the case if these men were not keen on personal cleanliness. Seif stated that even if they do get infections they have good medical services to help them, although, personally he did not think that would happen.
...(he) commented on people
who do not practice MGM saying,
"Good for them."
...(he) expressed his
positive ideas towards people who are not circumcised,
describing them as, "the best."
Nussa commented on people who do not practice MGM saying, "Good for them." "‘amalu kheir." Dr. Fahmi furthermore, expressed his positive ideas towards people who are not circumcised, describing them as, "the best." "agda‘ naass."
Abu el Fotuh thought that the nations that do not practice MGM, especially the Europeans, do not tolerate dirt. He clarified his notion by giving an example of their idea of a bathroom; they consider it a nice clean place where as we have thought of it, till very recently, as unclean and dirty.
As for the two respondents Dr. Yara and Dr. Khadiga, who were gynecologists, they both attained their knowledge from updated scientific resources. Dr. Yara, thus, realized that in the last 15 years the medical concepts had changed; she found from what she read that the smegma was no longer considered one of the causes of cancer of the uterus. Both doctors moreover, did not believe that non-circumcised males suffered any harm. Dr. Yara added that whether circumcised or not, there are some males that are considered risky and may transmit diseases to their female partners. She acquired these new ideas from reading recent studies especially after her painful experience with her son’s circumcision.
Dr. Khadiga agreed with this opinion, she thought that people who claim that the non-circumcised male causes cancer of the uterus cervix to his wife gain their conviction from social biases and not from medical scientific knowledge. She supported her point of view by saying that this kind of cancer is more common among the Egyptians than the Europeans, in spite of the fact that Europeans do not practice MGM, whereas Egyptians do. In Europe, she explains, technology is more developed making early intervention easier. Finally, she concluded that European men and women are healthier.
While most of the respondents commented on the general health of the non-circumcised males, some of them commented on their sexual health. Sa‘eed considered that there is no relation between MGM and sexual health, if there was, all nations would have been keen on practicing this procedure since all the developed countries are keen about sexual health while most of them do not practice MGM.
Accordingly, Salah believed that a European man can enjoy sex up to age of 60, and said comparing the case with Egyptians " I do not think that an Egyptian man can reach that age and still be that sexually fit, just to age of 40 and then he quits."
Two of the respondents who were doctors, Dr. Afkar and Dr. Nader, expressed negative thoughts concerning the health of men who were not circumcised. The former based her beliefs on what she studied in medical school 25 years ago, when the common idea was that cancer of the uterus cervix was more widely spread in Europe because they do not practice male circumcision there, that was what she was expected to write in answering exams. As for Dr. Nader, who had been graduated about 10 years ago, he was not so sure. He doubted what he had studied and yet could not resolve the contradiction between what he had read in medical school and the more updated information he gained after his graduation.
H) The respondents’ perception of the attitude of religions towards MGM
The respondents’ perceptions of the relationship between religion and MGM ranged between certainty to doubt; some thought that it is a religious requirement, whereas, others thought that there is no relation between it and religion at all. The majority doubted such relation.
Dr. Hazem was among those who thought that circumcision is a religious requirement. He believed that circumcision is an Islamic religious ritual whether it is clearly stated in Qur'an or not. He thought that religion is a complete cultural system in which circumcision forms a part, and submission and obedience is the essence of this system. However, he believed that such a submission decreases among Muslims with the rise of rationalism and individuality. Moreover he believed that Judaism also commands people to perform circumcision, and although he did not know the actual verses, he believed that there is a story in the Old Testament on Abraham’s circumcision. He certified that in Christianity and Islam Allah’s power is ultimate. He thought that the Jewish concept of God is not that exalted. Jewish deity is almost conceptualized as the most mighty human, like Hercules for example. He also thought that the rituals are most significant in closed religions, and that Judaism is one of them. This gives the rituals their significance to become a symbol of the Jewish identity. As for Christianity and Islam, Dr. Hazem considered them more open religions, but he believed that Islam is turning now to be more closed. Accordingly, Muslims are more keen to highlight the difference between them and other non-Muslims. This is a new trend that did not prevail in the early days of Islam. Judaism however has been a closed religion all the time. Dr. Hazem combined the concepts of the perfection of Allah’s creation on one hand, and the evolution theory on the other to justify human interference in the male body by performing circumcision. He said that if God had made things perfect through His absolute will alone, neither religion nor moral instructions would be necessary. It is by religion and moral instructions that humans can interfere to complete the creation according to Allah’s pattern. If God had interfered physically there would not have been a religion. He added that the deity uses both His willpower and the submission of humans to complete His intended creation. The prepuce had a function in a certain stage of man’s development when he lived in wild nature without clothes. In another stage, it had to be reformed and trimmed because it is considered filthy from the religious point of view. It is worth paying for such a reform since there are clothes. This does not mean that the prepuce in itself is a defect, it is like the wild instinct that in itself is not something wrong but needs to be tamed. When man is committed to such taming he complies with social norms. When I asked him whether circumcision is done according to God’s will or the will of the father of the child, he answered saying, that on the philosophical level, it was God’s will; but on the procedural level, it was the father’s will.
Nehal justified her opinion that circumcision is a requirement in Christianity saying that Jesus Christ had been circumcised and there was a feast for that occasion. But when I asked whether all Christians should be crucified because Jesus was crucified, she laughed and said that there was in fact a symbolic crucifixion in Christianity; it was unnecessary to use nails and wood, but it was done by tolerating painful experiences and giving the other cheek to those who slap you. Then when I asked her why they insisted on performing circumcision, and why they did not have a symbolic form of this same procedure similar to the symbolic form of crucifixion, she answered that there was a symbolic circumcision which is represented in the experiences that men and women share. She said: "I think, but I am not sure… But there is a type of moral circumcision… Crucifixion is circumcision." Then, she stopped talking, thought for a moment about what she said, then she laughed and said: "What did I say!!… Oh my God!!!!" "ya lahwi!!!".
Abu el Fotuh, however, believed that there is a relation between circumcision and Judaism; moreover, he said that he had got his information from religious books and that it was stated clearly for the first time in the Old Testament. He referred to Sayyed Al Quimni, Mohamed Hussein Haykal, and Al Sheikh Al Ghazali to prove his point. He also said that he had heard in religious debates that the Prophet had adopted circumcision from Judaism; similarly, the Prophet had adopted fasting from dawn to sunset and the Forbidden Months "al ashhour al haraam". Therefore, he believed that Islam commanded Muslims to circumcise their males, although he was aware that it is not stated in the Qur'an. Neither could he remember what was said about circumcision in the Prophetic tradition. He admitted that circumcision was practiced in pre-Islamic times and also in the early days of Islam and that the Prophet went to such celebrations to which he approved. Abu el Fotuh said that although the Prophet did not circumcise his daughters, it was alleged that his grandsons, Al Hassan and Al Hussein, were circumcised. He added that circumcision was a private custom that the Prophet himself approved of, and yet if it was necessary to divert from this custom for any medical reasons, it is not considered religiously wrong. He gave more explanation of his point of view by saying:
"In the same manner, the Prophet used to have a beard and used to wear a gown; some people said that that was Sunna, but I think it was because that was the custom in those days. If the Prophet were still alive, he would have worn a suit like us. If he had followed a certain pattern of behavior that had been suitable for his time, it does not mean that I should behave accordingly."
As for Dr. Salma, she believed that MGM was a command stated in the Qur'an because she had heard clergy who preached against FGM saying so. She recalled hearing that FGM was not mentioned in the Qur'an, contrary to male circumcision which was. Therefore, she believed what she heard and was convinced in it.
Nussa also believed that Judaism and Islam proclaimed MGM. She got her information from what she heard people saying. Moreover, she assumed that she had heard or read a verse that said that God commanded Ibrahim to have it done.
Dr. Nazmi, however, justified his opinion saying that male circumcision was a religious matter as a part of the Sunna. Although he thought that Allah’s power is absolute and that there was a certain purpose for the presence of the prepuce, because Allah did not create anything haphazardly, and yet he thought that it should be cut off because men of religion say that it is part of the Sunna. He added:
"Why then, did God send the Prophet Mohamed if not to tell us Allah’s laws and explain certain things. For example, God did not tell us in Qur'an how to pray and what verses to read in prayers and yet prophet Mohamed explained all that."
Some respondents, though doubted that circumcision was referred to in religion. Salah, for example said that Judaism proclaims circumcision although he believed that it was an old cultural tradition among the ancient tribes who adopted Judaism. He added that he did not believe that any sacred book could have a command to amputate any of the genitalia. He denied any mention of such commandment in Qur'anic verses.
Fathi, however, thought that there is a prophetic tradition in which male circumcision is mentioned but he did not know the exact statement, neither did he know whether it was true or not. He had got his information from various discussions on the subject with his friends; but he himself did not believe it was a prerequisite for religion, but since it was stated in the prophetic tradition it must have a religious significance.
Dr. Nader also said that the three monotheistic religions, Christianity, Judaism and Islam proclaimed circumcision as far as he knew but he did not know exactly where to find the precise holy statements. He personally believed that God did not create anything haphazardly, but human beings could modify what He created. He believed also that religion was partially conditioned by people and circumcision belonged to the social conditioning of it. That is why people have the prepuce amputated or leave it as it is according to their acquired knowledge; each group of human beings is free to do what it believes in.
Nehal believed that true
religion is manifested in its spirit
and not in its text.
Nehal elaborately said that Paul the Apostle, the philosopher of Christianity, said that circumcision was a written law but not to be applied, and she believed that he did not consider it necessary, he only mentioned it as an example of the Jewish law. Nehal believed that true religion is manifested in its spirit and not in its text. She thought that circumcision as stated in the Old Testament, was a symbol of sacrifice that had no longer any significance. If Christ was circumcised, that was because he was an ordinary little boy at the time. Nehal believed in what she heard that the Prophet Mohamed had said: "Reduce but do not cut too much from it" and although some men of religion said that this was not true, she used it in her anti FGM campaign. She said that this statement reflects the Prophet’s wisdom because he did not totally oppose people and their customs so that they would not dislike him, but he did not have FGM done to his daughters. Finally, she said:
"We Christians, believe that Jesus lived till the age of thirty as an ordinary human being, but in the last three years of his life he appeared as Lord. That is why we say that the cross is for one person only who used to live before as an ordinary human being. That explains why he could not tell people that circumcision is not good like the Prophet who said reduce but do not violate."
Whereas, Aisha believed that there was a story of how the Prophet circumcised a boy and celebrated it but she did not know the text of this prophetic tradition. She said though, that her belief in it does not mean that she thinks that male circumcision is a religious matter; to her it is associated with the social but not a religious heritage.
Hureya thought that circumcision is a religious matter that was mentioned in the verse that tells about Ibrahim’s covenant with God. She also believed that it was mentioned in the three monotheistic religions. It passed through the Pharos to Judaism by Moses who was born in Egypt and lived with the Pharaoh, and that that is how he adopted many of the Pharonic rituals. She thought that the Old Testament is full of Pharonic rituals. Accordingly, she knew that circumcision was transferred from Judaism to Christianity and Islam. In her opinion, it is not explicitly a divine commandment but it is a matter that has come as a result of the interaction between the deity and mankind. She believed that man interacts with the devil too. Accordingly, the virtuous acts are a result of his interaction with the deity, and yet there is the evil side of man, which is part of the human diabolic nature. Accordingly, she saw circumcision not as part of some divine wisdom but as a practical prudence. So when medical scientific development considered it a beneficial procedure it was all right to do it but if this theory proves to be wrong people should stop to perform it. She gave an example comparing MGM with tonsillectomy that was common because people believed that it was healthy but later the medical sciences proved this wrong. So it is no longer done at the same rate. As for the Christian conceptualization of circumcision, she was aware that the apostles had various opinions on the subject. Some of them considered that it was a prerequisite in order to enter Christianity. Whereas Paul had a vision in which he saw himself being hungry and presented with a table full of different kinds of food; he was told to eat but answered that he could not because the food was of the polluted type. He was told that it is not the things that enter the mouth that pollute a man but what comes out of it. In the same way, circumcision is not a condition to make people Christians, what is more important is what’s in people’s hearts and their faith in Christian concepts. Hureya used Paul’s vision and its significance to prove that MGM is not a religious matter but it has to do with hygiene.
Dr. Afkar had believed til recently that male circumcision is definitely proclaimed in Islam. She based her information on what was being said by people that surrounded her, that was before she had read anything on the subject. She did not try to find the religious text concerning that matter. Moreover, she believed that although Islam was the religion that proclaimed this procedure, she was well aware of the fact that Christians in Egypt also have the custom of circumcising their boys. But she explained this phenomenon as a social custom that had become so deep rooted in the Egyptian community that everyone did it.
As for Dr. Khadiga, she also considered circumcision as a religious commandment but this does not mean that one can not debate it. In her opinion, since human beings have a mind they have to use it in finding out why things were proclaimed in religion. It is important to read the updated studies concerning circumcision to take into consideration whether to support it or give up the idea completely. She was aware, moreover, that what she had read about the relation between circumcision and cancer of the uterus cervix is no longer supported by recent scientific theories.
To Dr. Salma, God’s power and will in the Islamic concept is ultimate and people use this point of view to justify their inability to change their lives. In trying desperately to alter their life condition and fail, they say that this is God’s will. As to her experience in the matter of circumcision, she had heard someone say that it is stated in the Qur'an and believed him without doubting him or matching what he said with the concept of God’s ultimate power; since He delivered the Qur'an, Allah could also have created man without the prepuce since His power is ultimate.
Dr. Hussam said:
"Personally, I don’t believe that any religion proclaimed circumcision. As far as I know, it is a recommended Sunna and people had various interpretations to it. I do not know any text that states it and I don’t like to use religious justification in my personal affairs but, I do know that there are definite Prophetic traditions concerning circumcision. In my opinion, one should not use Sunna like the Qur'an."
Dr. Yara believed that MGM is an Islamic religious proclamation, and this in her opinion does not interfere with God’s power, which is absolute, and yet circumcision is not a divine proclamation since it was not stated in the Qur'an. Still circumcision should be considered by religion since it is part of the Prophetic tradition that was stated in the books of definite Sunna. That is why it is not a religious commitment.
Another group of respondents believed that there is no relation between religion and circumcision. Sa‘eed proved this point by saying that Christians, Muslims and Jews practice it. And although Seif knew a Prophetic tradition that proclaims circumcision, he did not know the exact text; he said that in such context, one should take matters as they are. He says:
"In my opinion, there are a lot of things in the texts that are either conditioned by the circumstances of that particular period or related to what people knew at the time or their culture. I think one should rationalize things according to scientific and medical facts. I don’t think, therefore, it is a religious matter."
Dina and Dr. Mona, moreover, probed into the matter and were convinced that there was no text in the Qur'an that mentioned MGM, which is why they strongly believed that there is no relation between it and religion. In Dr. Mona’s point of view, the assumptions about the relation of MGM to religion is similar to the same assumptions about FGM. She thought that both subjects have no relation with religion.
Although Samia knew the story from the Old Testament of Abraham’s circumcision, she is aware of the fact that it was not stated in the Qur'an. She concluded that religion did not proclaim circumcision because it never inflicts harm on mankind.
Dr. Fahmi, furthermore, who had studied jurisprudence in Islam, considered MGM similar to FGM, both of which were not one of Allah’s instructions in any of the three monotheistic religions. He believed that ancient Egyptians did not perform this procedure on their males, and that it was originally a Jewish custom to mark their individuals in order to show their identity during the exodus from Egypt, at the time the Pharaoh wanted to kill the Jewish male children. When I asked him about his interpretation of the pictures that illustrated male circumcision in ancient Egypt, he gave a different interpretation. He said that it might have been a ritual related to the ancient Egyptian religion. In that case, the source of male circumcision and female circumcision was the same; it was a sacrifice to the Nile to make it flood the land every year. That is how the Jews adopted this custom from the ancient Egyptians making it part of their religion. Since the Bedouins, who escaped to the Jewish territories, were not circumcised, the Jews used this procedure as a mark to show their identity. Dr. Fahmi, furthermore, knew that male circumcision was mentioned in the Old Testament and said:
"Personally, I think, like many others who studied Judaism and Christianity, that books of the Old Testament were written in various periods by different people and that is how it reflected the common cultures of those times. The problem is whether what is written in it are the actual words of Allah or are they the words of human beings; and here there is a big question mark. As a proof to what I say, is that the World Church Council has a meeting every 2-3 years to revise and reconsider some of the things stated in the Old Testament."
As for Islam, Dr. Fahmi said that there is only one prophetic tradition on the subject of female circumcision and even that is not very strongly supported. It is known as Um Atteya’s tale which is single referenced (Hadith Ahaad ) and is of an uncertain validity ( Mogarah ). There is no mention, though, of male circumcision. As for texts that say "circumcision is Sunna," "Do not act like a disbeliever, and shave your pubic hair and get circumcised." Dr. Fahmi considered them anecdotes and not Prophetic traditions. Accordingly, he thought that male circumcision is not part of the Sunna although generation after generation it had been considered so. He said:
"To define what is from the exact Sunna is a big problem, since they began documenting the Sunna at the end of the first Hegira century till the middle of the second Hegira century. That means that there was a range of a hundred to a hundred and fifty years after the dawn of Islam when the Prophet was alive, and the time of documentation by oral tradition (‘An‘ana ). That is why El Bokhari and other scholars of the prophetic tradition started searching for a way to verify that Mr. So-and-So told Mr. So-and-So such a thing, and so forth, all of which was attributed to the Prophet. These scholars have what they considered ascriptions "Isnaad" and texts "Mutn"; first of all, ascription should be an unbroken link of speech, and the first one to tell the Prophetic saying should have lived with the Prophet himself and have heard directly from him whatever was said. Secondly, the text should confirm what is stated in the Qur'an and should be rational and not conflicting with the human mind. Therefore, El Bokhari gathered 140,000 Prophetic traditions and reduced them to not more than 6,000 or 7,000. Moreover, Muslim and Ibn Hanbel reduced them further, so that now the agreed upon prophetic traditions are 4,625. Other scholars say there are not more than 7 valid ones ( Ahaadith Sahiha ), and in conclusion the written documentation of what the prophet did or said as Sunna happened in a later period and by means of oral tradition (‘An‘ana). Scholars have tried hard to be sure of the truth of these Prophetic traditions. Al-Imam Al Ghazalli elaborated on this matter in his book Al Sunna Al Nabawaya Bayn Ahl Al Fikr Wa Ahl Al Hadith (Prophetic Sunna between men of thought and men of Prophetic tradition). We can depend on only seven of the Prophetic traditions in their constancy and all the rest are single referenced Prophetic traditions "ahadeeth ahaad" or fairly accepted ones "hadeeth hassan," and so forth."
Dr. Fahmi considered that customs like circumcision, putting coal in infant’s eyes, or putting drops of silver nitrate in their eyes are all not part of religion but are customs practiced at a certain period of social history and change from one period to the other. If these custom are considered part of religion they limit the progress of social development. Customs that were adequate for mankind who lived five centuries ago are not adequate now. Furthermore, he did not believe even that it is the concern of religion to probe into these matters. According to him, the essence of religion is to pave the path for mankind to worship God and on the other hand it gives instructions providing the laws that regulate the relations between people. Accordingly, this makes the fatal struggle of humans less, in order to enable them to establish a society which realizes Allah’s will to populate the earth.
II) The medical/health perspective
The most important feature of this perspective is the belief that MGM is part of the hygienic requirements in modern Western culture. Some respondents who began their rationalization from this point described the surgical procedure in which the prepuce is cut off as the main thing they knew about it. Some minimized this surgery describing it as "A simple minor operation" or "removal of a skin cover" "ta’sheer." Similarly they did not give much importance to the role of the prepuce saying: "It is only a piece of skin that covers the tip of the penis." Whereas others recounted some justifications that associates male circumcision to health conditions such as facilitating the cleanliness of genitals. They thought also that MGM prevents infant’s urine retention, cancer of the penis and protects the male’s partner from developing cancer of the uterus cervix. Most of the respondents who expressed their knowledge on this subject, bearing this viewpoint, believed in the common notion that MGM is actually related to health conditions. A few of them though, expressed their doubt in the validity of MGM because they disagreed with the manipulation of the child’s body, even without knowing the function of the prepuce. Some of the respondents who were medical doctors recently acknowledged that the preventive aspect of MGM is a fallacy, although they found it difficult to accept these new ideas that they acquired after their graduation from medical school. Those who could accept that MGM has nothing to do with cancer could not give up their belief in its relation to facilitating the male’s personal hygiene. On the other hand, some respondents who were not medical doctors, believed that MGM was introduced into medicine by Jews, and that it is a fallacy that unduly mixes Jewish religious beliefs with preventive medicine. Whereas, medical doctors who attended their own children’s circumcision said that it was a temporary traumatic experience but it would not persist in the child’s memory. Following is a detailed description of the background knowledge and beliefs of respondents who perceived MGM to be mainly a medical / health issue.
A) The respondents knowledge of the structure and function of the prepuce
Most of the respondents, even the doctors, said that the prepuce is merely a piece of skin covering the tip of penis. Some of them described it saying that "it is an extra and useless piece of skin" "zayda gildeyya" or "An insignificant piece of skin." "hetet gilda malhash aii ma‘na." Moreover, some did not know whether it had any nerve supply. As for those who had the opportunity to read more recent studies on the structure of the prepuce, they knew well that it is a fold of skin which is lined with a mucous membrane formed of cells that secret a sexual lubricant and that it is densely innervated. Furthermore, Dr. Yara knew that in infants the prepuce is closely connected to the tip of the penis, making it difficult to remove it without tearing it apart causing injury and bleeding.
Some male respondents who
believed that the prepuce did not have
a function justified their belief by that they themselves
did not miss anything.
Some respondents moreover, did not know anything about the function of the prepuce, and they could not even imagine what that function could be. Even the doctors, who had not had the chance to read articles that were not from their medical school curriculum, could not find any help in what they had studied. Some male respondents who believed that the prepuce did not have a function justified their belief by that they themselves did not miss anything. Some male and female respondents justified their belief that the prepuce has no function by that it is a common belief, and that doctors got used to removing it and that is what gave circumcision a scientific significance. These respondents appealed for proof by scientific experiments to show that the prepuce actually did have a function. They said: "Science has to convince us that our old scientific information were not correct and provide us with research results as a proof.." Whereas, others believed that the prepuce had a protective function in primitive man who was naked. So when he started to wear clothes, the prepuce no longer had a significance.
"Circumcised males must
be missing something.
...They say that circumcised women can compensate for their loss
and gain sexual pleasure through other areas of the body,
but still their sexual function lacks something."
Furthermore, some female respondents believed that every part of the human body has a function and a certain benefit, this applies to the prepuce even if we can not define its function. They are convinced that in spite of the fact that circumcised males can establish a normal sexual relationship, that does not prove that the prepuce has no function. As an example of such a belief, is what Dr. Mona said:
"Circumcised males must be missing something. I can not say that if I cut off a finger there will be a substitute for it because I have four others. Still it is a fact, I have lost a finger. OK; They say that circumcised women can compensate for their loss and gain sexual pleasure through other areas of the body, but still their sexual function lacks something."
"Of course it has a role in sexual intercourse."
The respondents from both sexes, however, believed that the only function of the prepuce is mechanical protection of the head of the penis. Only a few of them, as Dr. Laila, knew its other protective mechanisms. Dr. Laila said:
"It is the cover of the head of the penis. Its function is to protect and lubricate it. The prepuce serves as a protection because it secretes an anti-bacterial matter to prevent infection and also prevents premature ejaculation and exposes the head of the penis to stimuli, and a million other functions. Of course it has a role in sexual intercourse. If you take off the cover of the head of the penis, it is like removal of the scalp. Imagine your head without a scalp. It has no compensatory alternative. The prepuce protects the penis and when it is removed, the head of the penis becomes rough as a compensation. That is why circumcision is dangerous."
Most respondents, who mentioned the protective function of the prepuce, believed that it has no sexual function, except for Dr. Laila. As for Dr. Nazmi, he thought that the sexual function of the prepuce lies in it’s lubricant secretions that facilitates intercourse but he did not believe that it has a role in enhancing sexual sensitivity or pleasure. He based his opinion on the fact that the two sexologists Masters and Johnson proved by experimentation in 1966 that there is no difference in sexual sensitivity between the circumcised and non-circumcised males.
Some respondents, most of whom were doctors, believed that the prepuce has a harmful function, for they thought that it causes infections because of the urine drops and secretions that accumulate under it. Those who were not from the medical profession heard the same ideas from medical doctors or had read books on the subject that were written by doctors also, and accordingly believed them. Nehal, furthermore, had read and heard such information in seminars she had attended in which doctors had spoken against FGM but promoted MGM. This information made her think that it is better for males to be circumcised.
I set two questions to all the respondents who either believed that the prepuce did not have a function or had a negative function: Why are all infants born with it? Are there any other parts of the body that can be considered harmful? Most of them did not have answers to these questions. They could not guess why nature still continued to reproduce the prepuce as part of the human body. They gave various justifications for this phenomenon. Some believed that the prepuce is one of the remnants of evolution like for example, the appendix which is most commonly referred to by the respondents as a comparative example. In their opinion the appendix does not have a well-defined function, and therefore they compared it to the prepuce. They thought that if the appendix is a natural remnant of evolution, the prepuce is a remnant of culture. Abu el Fotouh for example, said: "I think that the prepuce was made to protect man in his wild natural environment." Since human beings had invented clothes ages ago, Dr. Hazem tried to justify the presence of the prepuce in spite of this cultural change, by saying:
"It has only been a short time since man has become a rational being. This period has not been long enough for the prepuce to disappear. To stand upright, it has taken man half a million years. Therefore, for a part of the body to disappear, it would take a longer time because cultural progress is much faster than biological evolution. That’s why although nature does not require it any longer, the prepuce has not disappeared yet."
Some respondents were surprised when they knew that the appendix is part of the immune system. Another explanation for the presence of the prepuce mentioned by the respondents, is its analogy to the cornified skin appendages like nails and hair that are both insensitive. For example, in Nehal’s opinion, cutting the hair and nails means that one is allowed to dispose of his body parts since this behavior does not harm the spirit. According to Nehal, circumcision is one type of this behavior because she thought that it is like the nails, a place under which dirt is accumulated. She only objected to the fact that circumcision is done to a male by another person. As for Dr. Salma, she compared the prepuce to the grease of the face, and if the face secretes this grease to protect it, that does not mean that one should not wash his face once every day or even three times a day if necessary. She said though, that she is not all for MGM but she is only giving a comparative example to explain the existence of the prepuce in all infants.
"What we say about girls should be applied to boys as well."
The respondents who could not find a biological explanation to the presence of the prepuce in all infants, said that it was God’s will, that is why they are all born with it. For example, Aisha said:
"When we say that God created girls like that, boys are also created like that. This is one of the things I’ve started to think about. What we say about girls should be applied to boys as well. We say God has created her like that and we should not change God’s creation. This also goes for boys."
Some respondents compared the prepuce to other parts of the body that they thought were unnecessary and might cause health problems or collect dirt, nevertheless, people were born with it. They were unable though, to provide objective justifications for keeping such "harmful" organs and removing the prepuce. Dr. Afkar said that toes were a representative of such harmful body parts. She said:
"We don’t think about everything that deeply. For example, why didn’t I think about the fact that I have five toes? Why aren’t my feet like a duck, which has three toes? Why five since I don’t use any of them. I could have had one small toe and one big toe even if I don’t have any toes at all, it would not mater because I feel that I don’t do anything with them. The leg could have been like a stump without any toes that are useless and I have to clean them all the time. The toes are really useless, in fact, they are insidious organs; they get contaminated and consequently are exposed to tinea. I don’t know what’s the use of having five toes. They are antique organs that have been descended to us over the ages from other species. They are useless although they have nerves. However, I never thought of getting rid of them because no one ever thought of doing so."
Moreover, Dr. Yara compared the prepuce to the uterus and ovaries since there is a trend to remove them after their reproductive function ends at menopause as a protection from cancer. Dr.Yara, though, disagreed with this trend. She thought that women need to feel that they possess all their organs even during menopause. Furthermore, Dr. Fahmi disagreed with Dr. Afkar’s opinion on the mater of toes. He compared the prepuce to the ears and tonsils; the ears secrete wax but no one ever thought of removing them to prevent this secretion. Moreover the tonsils were considered a potential septic focus, but later it was discovered that they are a part of the first line defense mechanism against microbes.
Dr. Nazmi considerd that the prepuce exists in all infants because it is a part of the natural development of the fetus. He said:
"It is a result of the natural development of the fetal genitalia. The male frenulum is analogous to the female frenulum. This means that the prepuce of the female clitoris is the same as the prepuce of the penis and is part of the sexual development of the fetus. Both of which appear in the sixth week of intrauterine life from a common fetal origin."
Although he was aware of this development and that each of the sexual organs in one sex has its equivalent in the opposite sex as to its structure and function, he excluded though, the male prepuce from this rule. Although, he thought that the female prepuce has an important function, he did not think that the male prepuce has the same function. He said:
"It has been proved that if the female prepuce is removed, it would mean the removal of the protective cover of the clitoris so that the erected clitoris would be exposed to friction during the second stage of sexual excitement which would be very painful."
B) The respondents’ perceptions of the significance and objective consequence of MGM
Some respondents said that they do not know any health benefits for MGM and do not even imagine that it has any. In their opinion MGM is not done with the purpose of gaining certain benefits. It is just a custom which is followed without much thinking, like giving the child a name. Dr. Salma said that it is difficult for anyone to gain a benefit by removing a part of his body. Some female respondents said that they never thought of asking men, even their husbands, whether they had gained anything by being circumcised. That’s why they knew nothing about this matter. Whereas, others imagined that there were, in fact, benefits to this procedure as a result of common beliefs they had heard either from their social surroundings or from medical doctors. The doctors had got their information from medical school as undergraduate medical students and had not become updated with most recent knowledge on the subject.
Other respondents perceived MGM as beneficial. The most common of these assumed benefits is to facilitate cleanliness; even those who did not believe in it considered it beneficial in social classes that did not reinforce teaching children personal hygiene. That is why they have justified the continuity of circumcision over thousands of years. Some associated it with certain contexts, for example, Dr. Laila considered that the rationale behind such bad customs, like circumcision, is that they helped to preserve the personal cleanliness of ancient people who lived in desert areas where there was very little water. Another benefit mentioned by the respondents is the prevention of certain diseases such as urine retention, cancer of the penis and cancer of the uterus cervix. The respondents who were medical doctors got their information from medical school; some said that they had not read anything different from what they had learned. Whereas, others got hold of more recent articles that proved the opposite. As for the lay men, they got their information on this subject from doctors. Two female doctors stated that MGM moreover, is beneficial to women and not to men themselves since it protects women from getting cancer of the uterus cervix.
Some of the respondents believed that MGM increases sexual sensitivity and said that by uncovering the head of the penis it is made more sensitive. Nehal tried to justify this benefit, that she had heard from some doctors, by saying that perhaps the uncovered head of the penis is more sensitive than the covered one. As for Dr.Yara, she said that the doctor who circumcised her son explained that after circumcision the head of the penis gets adapted to continuous rubbing against clothes and hence develops more sensitivity. Thinking about it for a moment, she said that this is contradictory statement and that she could not find a suitable justification to explain this belief.
Many respondents doubted the agreed upon "benefits" of MGM even after they had mentioned them. Then they stated the true one that they thought would be achieved: male circumcision was done to comply with traditional social norms that have been deep-rooted for thousands of years in a conservative society which does not easily accept different customs.
A few respondents however considered MGM harmful, whereas most of them considered the procedure, in itself, not dangerous. The only danger in their opinion could arise in a mistake in the surgical procedure especially if done by someone who is not a medical doctor. Such mistakes are for example, if part of the prepuce is not removed, if the head of the penis is injured or if it causes bleeding. Some males backed up the idea that MGM is not a dangerous procedure by saying that they themselves did not have any health or sexual problems. For example Dr. Fahmi said that he does not think that the risks of circumcision are more than risks taken when crossing a road or eating food that is not clean. He continued saying that if anything goes wrong it is just unexplainable fate "quadaa’ wa quadar" and not a result of the procedure itself. On the other hand, some respondents stated some physical and psychological damages.
Dr. Afkar compared her
doubts of MGM hazards,
because she never heard a man complain of problems from his circumcision,
to rural women who defended FGM, because circumcised women do not complain.
As for the physical damages, Dr. Khadiga and Dr. Mona both recounted from their practical experience that they had seen excessive bleeding that was about to kill a boy. It was caused by the fact that the boy had a blood disease and the doctor had injured the head of the penis. Dr. Yara got her information about the hazards of MGM from both her readings and from her experience with her son. According to her, MGM hazards include mutilation, painful erection, infection, deformity and the possible development of neuroma that causes persistent pain in the scar.
Dr. Salma said that if we compare our excuses for not performing FGM, they apply also to MGM In both cases there is an unnecessary removal of part of the genitalia. Dr. Afkar compared her doubts of MGM hazards, because she never heard a man complain of problems from his circumcision, to rural women who defended FGM, because circumcised women do not complain.
On the other hand, Seif was the only respondent who said that the pain a child feels during and after circumcision is considered a problem in itself. All other respondents had controversial opinions on the psychological consequences of MGM. They did not deny that it is a painful experience but they thought that the child does not remember the pain if he is circumcised in infancy. They added that in this case, MGM does not have a negative effect on the boy. Many of the respondents believed that this experience could be traumatic if the child is circumcised at an older age when he is aware of what is going on. This belief, though, is opposite to what Sa‘eed said about his own experience with circumcision when he was eleven years old. As for Dr. Laila, who worked as a psychiatrist and who had received many men with psychological and sexual problems in her clinic that were a result of circumcision, she described these cases as having very serious problems.
After this review of the respondents’ knowledge and beliefs about MGM, we will go on to describe their actual experience with MGM.
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Chapter III: Cutting of live flesh: a closer look at circumcision: The respondents’ experiences with MGM and FGM
I) The respondents’ experiences with FGM
Some of the respondents assured that female circumcision is not practiced in their social class. Others, moreover, said that they had only heard of it recently. Sa‘eed said:
"FGM is not practiced in my family nor in my village; all my female relatives are not circumcised. I had never heard of FGM except when I came to Cairo."
Nousa said, "I heard about FGM recently and that was in 1994."
Moreover, Dr. Hazem said: " I didn’t know that FGM existed except when people started debating it. For, we did not study it in medical school neither had I seen it nor heard of it."
Dr. Nazmi said: " It is a well established fact that FGM is a sexual rubbish, of course, and that is how it is considered both scientifically and medically."
As for Dr. Khadiga, she said that her family has no idea of FGM. She furthermore, tried to convince her servant of the harm that could be made by this procedure but she would not listen and circumcised her daughter.
On the other hand, other respondents said that FGM is not practiced in the new generation although it was a custom in their grandparent’s days. For example, Dr. Nader said:
"In the social class from which I came in Upper Egypt, and in the popular area in Cairo where I was brought up as a child, FGM was done. But in the class I live in now, which is a high middle class, FGM has ceased ten years ago."
Moreover, Dr. Fahmi said:
"Females in this generation, my daughter and my nieces, all of them are not circumcised. Things are obviously changing in this generation. I think that 90% of the females from the age of 25 and less are not circumcised in Cairo. But in rural areas it is completely the opposite."
Furthermore, Nehal gave some explanations as to how her family recently stopped performing FGM; in general education and her mother’s increasing knowledge. She says:
"People from lower standards circumcise their girls, whereas the educated do not. For example, my mother was circumcised and experienced the pain of it, that is why she would not have her daughters circumcised. Even though she had not read anything about the subject."
Aisha added: "In my family, I was the last female to be circumcised."
Hureya certified: "FGM was practiced in the older generations but then it stopped."
Other respondents did not know whether FGM is practiced in their families or not because they were aware of the fact that the rate of FGM in Egypt is 97% according to 1995 demographic health survey. Even the respondents who came from the high class said that it could be possible that some of their neighbors still practice female circumcision. Mustafa said:
"The demographic health survey surprised me since I thought that FGM was not practiced in my family, among my friends, nor in the high class in which I live. But now I have to probe into the matter in detail. Although my mother and sisters are not circumcised, they have friends who are. Although the area in which I live is supposed to be a high-class area, it has apartments that belong to the old system of low rents. That means that you can find people from various social levels in one building; that is in one building you can find both ignorant tenants that have not exceeded primary school education on one hand, and elite businessmen on the other."
II) The respondents’ experiences with MGM
All of the respondents, whether Muslims or Christians, confirmed that MGM is a procedure done in their families, among friends and in their residential areas. As far as they knew, it was part of the birth rituals and part of the prevailing Egyptian culture that was done in hospitals even without taking the baby’s family permission. It is no longer considered an occasion to be celebrated.
MGM was a matter taken for granted among families of the respondents. It was out of the hands of young parents; those who hesitated to do this procedure on their children experienced a great deal of pressure from the older generation to circumcise their little boys. For example, Dina said:
"We never brought up the subject in front of anyone, although my mother and father always used to ask me: ‘Haven’t you circumcised your son yet? When he grows up he will have a very bad time.’ They were afraid that the boy would have a shock if he got circumcised at an older age. He will certainly be aware that something wrong is happening, especially that children don’t know why this is being done to them. I was afraid to have him circumcised when he grows a bit older because it might affect him psychologically. But really it made no difference to me if he remained without being circumcised."
Moreover, Dr. Hussam said about his experience with his son:
"When we said we did not want to circumcise him, no one took us seriously. They kept on asking, ‘when will you circumcise him?’ And we did not want to quarrel with our family because of this subject."
I was introduced to more than one category of the respondents’ experiences with MGM. All of the male respondents were circumcised and spoke with me about their personal experience although not with the same detail. Some of the respondents were parents to boys who had been circumcised and could speak more freely with me about their experiences. Moreover I was provided with statements that showed the differences between how men and women perceived the conditions of children who had been circumcised. I also asked the respondents who are medical doctors about their experiences with MGM in their professional practice, and from their statements it could be deduced the various elements that formed the bias of the medical institution on this subject. Moreover, I had a chance to get information concerning respondents’ observations of circumcision experiences of other boys rather than themselves, their sons, or their clients in case of medical doctors. Either they observed the circumcision experiences of sons of their relatives, friends, or neighbors. Because all the respondents belonged to the high middle class, their memories gave me a chance to explore the middle class practices and beliefs concerning MGM.
A) Male respondents’ personal experiences with MGM
Most of the male respondents did not remember anything about their personal experiences with circumcision. Neither did they question their families about the reason for doing this procedure to them nor did their families offer an explanation. They thought that it was a natural procedure that should be accepted without discussion and therefore, took it for granted. This meant that society considered this mater indisputable. Therefore, no one asked why circumcision was done nor did anyone explain the reason for it. Everyone dealt with it as an inevitable truism. The male respondents rarely asked even themselves about its significance. One of those was Dr. Hussam, who started considering the matter at the time of the circumcision of his son, when he began to think of the psychological impact of his own circumcision on himself when he realized that MGM was a traumatic experience to his little son. Dr. Hussam said:
"I was circumcised when I was very young and was not aware of the procedure at all. I could not associate the shock I had with anything else. I must have experienced a shock like my son and maybe it was kept in my sub-conscience. On the contrary, I think that I would look strange if I had not been circumcised because all my life I’ve perceived myself like that."
All of the respondents who were circumcised when they were infants had this procedure done in hospital by a doctor and they were not aware of who was the decision-maker. Although Mustafa believed that it was the doctor who suggested it, he could not prove it. Only three of the eleven males whom I met could clearly remember the experience of their circumcision. Two of them were circumcised when they were four; these were Dr. Nader and Seif. The third was Sa’eed and he was circumcised at the age of eleven. All of these three respondents remembered some ritual celebrations that had accompanied their circumcision. The experience of traditional circumcision that was most close to the traditional rite of passage from childhood to manhood is Sa’eed’s. He says:
"Personally, I was circumcised when I was eleven in Upper Egypt where it is done in a ritual similar to a wedding. It was a joyous occasion on which many boys were gathered to be circumcised. If someone decided to have his son circumcised, relatives and neighbors who had sons who had not already done this procedure brought them to share the experience, which turned it into a celebration. That is how the ritual is done. On that day my brother and I were circumcised in the midst of a group of no less that 30 or 35 boys. We were each given a sum of money (Noqut) as a gift to every newly circumcised boy to buy whatever he wants. I remember that I bought a goat. After the procedure was over drummers played and the celebration began."
Sa’eed recounted more details and continues saying that the decision of circumcising the boy is taken by the parents and the rest of the older members of the family. He was not taken by surprise but was fully aware of what was going to happen. He said:
"I don’t remember who told me but I knew what was going to happen and was prepared for it. I participated in the preparations; inviting the drummers, someone else inviting the flute players, and with us was an older cousin doing other preparations. Thus, we were not deceived or taken by surprise. It was an expected tradition that we all knew would happen and waited for because we would get money from it. It was going to be a celebration and visitors were going to come."
Sa’eed, moreover, considered circumcision at an older age to be an advantage because it makes the impact of the traumatic experience less. He said:
"I was not a small child then, and I knew what was going to happen because I had been to other similar celebrations. So it was no problem for me. On the contrary, I was looking for the day of my circumcision to come. In Upper Egypt, it is nice because they perform this ritual when the boy is totally aware of what is going on. That is nice because the pain is not too much and it occurs in the middle of the celebration as if the boy is going to be married and enter the world of men."
He said that he was not afraid in spite of the fact that he knew it would be painful; he added:
"I was not afraid because I had previously seen the circumcised boys cry a little then after half an hour, they would join us and have fun. It was only a temporary pain that lasted a short while. Personally, I was not afraid. I was keen on listening to the flute because I liked it a lot."
Sa’eed described the role of the ritual celebrations in making the male accept MGM and moreover reinforcing this acceptance in spite of the pain involved. He said:
"I only felt the pain for a short while then I got involved in the celebration and had fun. And after everything was over, my main concern was to see how much money I had got. Society creates a delightful story with a beginning and an end so the boy is always eager to complete it."
Sa’eed described the beginning of the story as follows:
"The women held us, either our maternal cousins, paternal cousins or aunts, with our hands behind our backs, and circumcision was performed by the local barber. The story is so simple, for the one who circumcised me is the same one who used to cut my hair so we are intimate."
I asked him whether the circumcision had an effect on this intimacy but he said, "No we remained friends." In spite of this friendship though, Sa’eed blamed the barber for being the cause of one of the most common complications of MGM which was urinary tract infection. He said:
"Something happened though, that lasted for many years and that was that I had a burning sensation whenever I went to the WC to pass urine. In my opinion the reason was because the barber had done something wrong."
Like the other two respondents, Sa’eed remembered that he wore a white gown (Galabaya) and that the women were singing wedding songs but he did not remember exactly which. He was the only respondent though, who remembered that circumcised boys were given certain types of food like chicken and boiled food.
"There was no choice. I
could not agree or disagree.
It is something done beyond one’s consent."
As for Seif, he said: "I remember my experience well. I was circumcised when I was four and I remember the horrible pain." Contrary to the intimacy between Sa’eed and the barber, Seif expressed his alien feelings towards the person who circumcised him; he said:
"Some one came in but he was not a doctor. He must have been a male nurse or a barber. He told me ‘I am going to have a look at you only.’ After that, I felt the horrible pain and then I fainted. It was early afternoon and when I regained consciousness it was very late at night. There were a lot of visitors coming to congratulate but still the pain was very sharp."
In spite of the pain that Seif described as horrible, he denied that the experience left a long term negative effect; he said: "I can not say it affected me although it was painful at the time but that was all." When I asked him if he had chosen to be circumcised, he said: "There was no choice. I could not agree or disagree. It is something done beyond one’s consent." Seif was unlike Sa’eed, no one took his opinion or told him what was going to happen. Unlike Sa’eed too, Seif was not happy about his circumcision. He expressed his feelings by saying: "Any painful experience of course will not be a happy one." The celebration, as he remembers it, was rather limited; he said: "People only came to pay congratulations and take sweets. This was because we used to live in the city and not in a rural area; consequently, the celebrations were different." When I asked him about the details of the celebrations, he said: "The boy wears a white gown and nothing underneath because of the wound. I don’t remember anything about the food. I only remember the white gown."
As for Dr. Nader he did not remember a lot of details of his circumcision and said that no one told him anything about it before hand. All he remembered was that the circumcision happened and he had worn a white gown.
B) The male and female respondents’ experiences with circumcision of their sons
Although most of the male respondents did not remember their personal experiences with circumcision, most of the respondents who had male children remembered it and expressed their feelings about this experience.
a) The male respondents’ experiences with circumcision of their sons
Dr. Nader was not present at the circumcision of both his two sons. He said:
"I did not attend either of my sons’ circumcisions because it was done to both of them in hospital. The youngest was circumcised directly after he was born. The oldest was a couple of months old when we took him to a doctor we trusted to be circumcised, but neither their mother nor me attended the procedures."
Moreover, Dr. Nader did not remember how the two boys were after they had done it. He thought that MGM is a medical procedure more than a social custom. He said: "It is a surgical procedure that is done in hospital like any operation we have like opening an abscess etc." That is why his family did not hold any rituals or celebrations as the more common classes used to do. As for the decision, it was made by both his wife and him because it was a procedure that "had to be done." That did not mean that medical doctors do not have a significant role in encouraging the families to circumcise their boys. Concerning this matter Dr. Nader said:
"When we had our youngest son, they asked us in the hospital ‘would you like him to be circumcised and take B C G?’ We wanted to get over with this procedure before leaving the hospital instead of coming back after a few months. The oldest though, was circumcised after a few months, not because we did not want to do it after he was born but simply because no one asked us at hospital whether we wanted to do it or not. Circumcision was not done in that hospital. After 6 years, when we had our second boy in the same hospital, we were asked if we wanted to do it. The nurse came in and asked us and we welcomed the idea because we wanted to get over with it just like a vaccination. As for our relatives’ situation, they were totally satisfied because what had been done was the expected procedure. ".
Dr. Nader explained that he did not celebrate his sons’ circumcision because it was just a surgery, as if they had tonsillectomy.
Abu el Fotuh recounted his experience with his son saying:
"They told me it should be done after one or two days after his birth in order not to cause any pain. But I do not remember why I left him till he was one or two years old, then I felt I was very late so I took him to one of my friends who was a doctor and did the operation. The doctor gave him local anesthesia that is why he did not scream when he was cut. But afterwards on our way back home, he started feeling the pain. I think he fell asleep from exhaustion. When we got home, his face was extremely flushed. It was actually quite an operation, whereas I had thought it was a simple procedure! I was really concerned. It took quite a while till he calmed down. He suffered for a long time from the pain. Since he had not yet been toilet trained he used to cry each time he passed urine. So I had to keep my eyes on him. I remember that we suffered two whole days with him for it was very painful and the doctor had not been very professional either. Until now my sons’ penis looks deformed because it was not clean cut."
"I think he asked once about the ugly scar around his penis..."
Abu el Fotuh said that the word ‘decision’ could not be applied to male circumcision because it is a natural procedure that is not to be discussed and therefore it is taken for granted. Both his wife and him agreed on the matter beforehand. The discussion though was about the timing of the procedure. When should it be done. He said that he did not tell his son why circumcision was done nor did the boy ask. "He also took it for granted and that he had to undergo the procedure. I’m sure that when he sees his friends, he thinks that that is the usual appearance." But the boy noticed that he was different from his peers and asked into the matter. Abu el Fotuh said: "I think he asked once about the ugly scar around his penis and I told him that the doctor was stupid and had done a stupid mistake. He had not made a clean cut." Other members of the family though, did not object. It was not a matter to be discussed. They had had a small celebration on the seventh day of the circumcision but it was different from the traditional ritual celebrations. The child was not offered any special kinds of food and although he was wearing a white dress it was just a coincidence. He said: "He was wearing a white gown, one of the many white gowns he had, in order not to irritate the wound. We did not buy him a special one."
When I asked Dr. Nazmi about his experience with his son’s circumcision he disapproved answering, saying that: "It is not important. Why should it be?" But when I encouraged him to speak more about it he said briefly: "Of course, my son was circumcised like all of us." He said that the obstetrician who helped his wife in labor, was the same person who circumcised his son. Dr. Nazmi himself attended the procedure. He also disapproved of my question on how his son felt at the time. He said: "That is a strange question. A child of only three days old, and you are asking me how he felt?" But when I insisted he said: "He gave out a cry and then was quiet." He said that both he and his wife made the decision together to have the procedure done. Moreover, he did not have a celebration on that occasion. He said: "Circumcision is not a special occasion. It is done in all families. But in the common class they usually have a party. This though, is an old custom." When I asked Dr. Nazmi about his son’s feeding and sleeping pattern before and after circumcision he said: "Of course, there was no difference."
Dr. Fahmi furthermore, said: "My son was circumcised after the first week when he was still in hospital. They did not take our permission. It was part of the usual rituals." He gave the excuse for the procedure by saying: "It was done to his father, his father’s brother and mother’s brother. All the males born before him and that are still to be born are circumcised. It is the natural thing to be done."
b) Female respondents’ experience with their sons’ circumcision:
Dr. Salma said:
"My son was circumcised an hour after he was born. I do not know the details of what happened because I had had a Caesarean section and I was under anesthesia. I woke up and found my son dressed in bandages. Two days later, when I left hospital I could see nothing except some anti-septic solution on the penis. So I did not have to dress his wound and accordingly, I never heard him scream."
She said that it was the doctor who made the decision to do the procedure but she and her husband agreed to it. She recounted: "they waited till I awoke from anesthesia and fed him and then they told me, ‘we will take him for a moment.’ But they did not tell me why. My husband told me that they were going to circumcise him." She did not notice any change in her son’s feeding or sleeping patterns because he was circumcised after a couple of hours of his birth and had not yet developed any feeding pattern. As for the rest of the family, they had no reactions; they neither congratulated nor objected to the circumcision.
"I must tell you my
story because it shows how
the American society is bigoted. It is an awful society."
About her experience, Dr. Laila said:
"My son was borne in New York 34 years ago. I was studying for my masters’ degree at Columbia University. I must tell you my story because it shows how the American society is bigoted. It is an awful society. I should have sued them. I gave birth at hospital and on knowing that I am Muslim; they circumcised him without taking my permission. The fact that I was Egyptian and a Muslim made them think that all of us circumcise our boys but I think that they do it as a routine procedure."
Dr. Laila’s son was circumcised when he was a week old and she noticed changes in both his feeding and sleeping patterns. She said:
"The wound remained open for two or three weeks, because as you know, a child’s immunity system is still weak and its wounds don’t heal easily. All night he cried from the pain and I was a student at the time and was so tense and did not know how to cope."
I asked her whether she had thought, when she was pregnant, about what she would do if it is a boy, would she circumcise him? She said: "At the time, I did not think of the subject. But when they did circumcise him, I should have sued them." But in those days, she did not because she thought that circumcision was an ordinary routine procedure.
As for Dr. Mona, she said:
"I did not attend both my sons’ circumcision procedures. But it is really repulsive to cope with the baby after the procedure; the continuous screaming, and the feeling that you have to cope with a baby’s wounded penis that is bound in bandages makes you afraid to handle it. Every time he did pee-pee he screamed! It was repulsive really, until the healing was complete. You are afraid the wound might get contaminated."
About the feeding and sleeping patterns, she said:
"Of course they are affected. When the boy is circumcised he has a wound and naturally he cries a lot and every time he passes urine, he screams. Even if he is asleep, he screams because obviously it hurts."
"Is there any child who
does not feel pain? Of course not, because he screams.
Is not there a wound and something cut off?"
She circumcised her oldest son at the age of two weeks, whereas, she circumcised her youngest son when he was three days old. She justified the age difference between the two boys by saying:
"I had my youngest son circumcised earlier because the elder one suffered a lot after circumcision. I suppose it was because he had got older and could feel the pain. Doctors say that the younger a child is when he is circumcised, the better because he wont feel pain."
When I asked her what actually happened when her youngest boy was circumcised, she said: "Is there any child who does not feel pain? Of course not, because he screams. Is not there a wound and something cut off?" Dr. Mona though, did not remember the procedure’s effect on the baby’s feeding or sleeping patterns but she said: "Usually if the child is screaming for any reason, he stops crying when he is given the breast, then he starts screaming again." She said that both she and her husband took the decision of circumcision for both of their children. The doctor did not spontaneously offer to do it. She said:
"Their father and I made the decision. But the women of the family asked us when were we going to have them circumcised. The nurse, who was a woman, came in and said, ‘The doctor is here. Would you like to circumcise the little boy?’ I agreed without thinking."
Dr. Mona noticed that her two sons got different degrees of circumcision. She commented: "The two boys got two different types. The oldest still has an ample amount of foreskin. As for the youngest, the skin of his organ is tight, that is why I was worried." She described her feelings when the nurse took her sons saying: "I was tense and very worried. I was afraid and anxious for my sons." She said that these feelings were the reason that she had postponed the circumcision of her eldest son until he was two weeks old, after which she gave in. She said:
"The women of the family and the women nurses roused me saying, ‘Are you going to wait till he grows up to be a man? He will be traumatized then. The younger he is the easier the healing will be.’"
She described both her and her son’s conditions after the procedure saying: "After the operation he came out of the theatre crying and the nurse told me to take him to be fed. I took him and I was so sorry for him." Dr. Mona did not hold any celebrations for either of her sons’ circumcision. But her relatives congratulated her when they knew she had done it. She expressed her astonishment at the custom of being congratulated for her sons’ circumcisions saying:
"I do not know why people used to congratulate each other for circumcision! I felt it was absurd. My children were wounded and I wanted them to get well again. But we were told that it had to be done. It was a must that we had to get over with."
congratulated the baby by bending over him, kissing him
and saying, 'Never mind, this is the only time you will be hurt.
After that you will hurt others.'"
She said that the strangest comment that she heard and that really made her mad, was her cousin’s words. She said:
"My cousin congratulated the baby by bending over him, kissing him and saying, ‘Never mind, this is the only time you will be hurt. After that you will hurt others.’ "ma‘alihsh, el marra di inta ‘illi ha tti‘awwar, ba‘d kida inta ‘illi hat ‘awwar". I was surprised and said to her, ‘You wicked woman!! "ya mugrima!!", what are you implying now? Is this the right time to think about such things?’ This comment really surprised me. I felt that she was dealing with him as if he was a man although he was still a baby. It gave me the impression that he would have the upper hand and that he was going to be a man and injure women. Her comment gave me that feeling. It was an audacious statement. Why should he injure women? Of course she was implying something sexual but the statement did not give the impression that that was all to it. It made me feel that she wishes that he would have the upper hand in everything."
Hureya said that it was the doctor who made the decision to circumcise her sons. She said:
"I don’t know, there are some things in life that are deep rooted in society, but I did not take circumcision as a deep rooted custom. I was convinced with it as a principle when the doctor advised me to do it after I had told him that my son cried every time he passes urine. He was very young, only one week old. The doctor said ‘Because he must be circumcised.’ It was not the doctor though who did the procedure. At the time there were still rabbis in Egypt that were specialized in circumcising boys. So I got one of them who came to the house and circumcised my son. I can’t tell how much he cut off exactly but I think that he took off all of the foreskin. This is my personal experience but after that I did not think about it."
About the boy’s condition after the procedure she said:
"He screamed for a moment after that he was all right. I felt that after that, the boy was better. Maybe that was my imagination because of the ideas that the doctor had put into my mind and that was in the end of the 1950s."
c) Married couples’ experience with their sons’ circumcisions:
Among the respondents there were four couples; and below are the comparative statements and reactions of the mothers and fathers towards their sons’ circumcisions.
i) Sa’eed and Dina
Contrary to the positive memory Sa’eed had of his own circumcision, that was done in a traditional method in the middle of a ceremonious atmosphere, he had negative memories of the circumcision of his son. He said:
"When I circumcised my son in the modern way, he was still very young, and it was quite a problem. He was over one year old. The doctor gave him an injection of anesthesia. I was worried about him and told myself, ‘Why didn’t I circumcise him in the traditional way, waiting till he grows up and knows what is going on?’ We were worried about him because he remained a whole night completely doped."
Dina agreed with her husband about her being worried for her son, but they had different statements as to how the decision was made. Although Sa’eed confessed that Dina had hesitated at the moment of the procedure, he said that she shared him in making the decision. Dina said, though:
"It was the boy’s father who made the decision, but to tell the truth, it wasn’t only his father; a friend of ours thought he was doing us a favor, he said he had found a doctor who would do it without causing the baby any pain. We were cautious to make the operation with a minimum amount of pain. I didn’t object to it but I was simply worried."
She then recounted: "I have a daughter, but of course, I had not thought of circumcising her." Sa’eed remembered the disagreement he had with his wife concerning their son’s circumcision. He said:
"She asked why we had to circumcised him? I told her, ‘Because everybody has to be circumcised.’ It never occurred to me to ask that same question. I added, ‘He will be odd if he isn’t.’ She answered, ‘Of course not. Who told you everybody is circumcised?’ she was very nervous and anxious for her son. She used gender rights to support her argument. I told her that even all our Coptic friends were circumcised so why should we be odd?"
Sa’eed justified his determination to circumcise his son saying:
"I couldn’t say no to the procedure because I was convinced that it was healthy to do so. I don’t know till now if that’s true or not. I have no idea. But logically speaking, it seems to be healthy because there is no extra skin to keep the dirt underneath and consequently, cause infections. I couldn’t keep him uncircumcised in a society in which everybody is."
Dina then described the critical moments before the procedure was done. She said:
"I gave birth to my son prematurely, after seven months of pregnancy. He was born abroad. Usually boys in Egypt, according to how things are done now, are circumcised after a day or a week of their birth. My son though, remained without circumcision till he was about 12 months. It made no difference to me, I mean I wasn’t worried about it like his father who wanted him to be circumcised so that it wouldn’t affect him when he grows up. We ought to have done the procedure while he was still young so that he wouldn’t feel any pain. So when we went to the doctor, he insisted on giving him general anesthesia. Of course I was shocked because I hadn’t expected a child to take general anesthesia for circumcision. I thought that it might be bad for the boy’s heart. So I asked the doctor before doing anything, ‘Must boys be circumcised?’ I was serious because I had no pre-established ideas. I didn’t know why, but I found myself saying that there was no reason for male circumcision although I had no idea where I had got this information from. It just came to my mind by chance. Maybe because I was worried about my son. He said, ‘Some people say it’s not necessary.’ I was surprised because the doctor was a man who observed religious rituals, such as prayers. I told him, ‘Well, let’s not do it.’ I was about to take the boy and go home but his father insisted saying, ‘It is over. We are here now."
The doctor played a major role in motivating Sa’eed to insist on having the procedure done and in changing Dina’s mind. Sa’eed described the doctor’s role saying: "Actually, we were about to change our minds. There was a long discussion between my wife and me, and the doctor interfered and told us about the harm of the extra piece of skin." Sa’eed moreover, said that Dina was forced to comply with the doctor’s point of view and it was too late because the boy had already taken the anesthesia. But she was not really convinced. He said:
"The doctor did not convince her but the boy had already taken the injection and the doctor almost started to circumcise him. He was calming Dina down by telling her that it was more healthy to have it done."
Dina expressed the confusion that she experienced at that moment; although the doctor had told her that it was not necessary, the boy had already been given the anesthesia and he was telling her about the disadvantages of the prepuce. She said: "I wanted to withdraw but it was too late. On leaving the clinic, I was in a very bad state." Contrary to the elaborate celebration that was made on Sa’eed’s circumcision, his son’s experience was done in silence and surrounded by anxiety. Dina said:
"All the family was worried because he was prematurely born after seven months of pregnancy. They said, ‘Thank God it's over and done with.’ No one came to congratulate, there was no celebration or ceremony."
Feeling distressed on that occasion, which was opposite to his own happy experience, Sa’eed said:
"What I believe is that circumcision at an early age is not good. If I ever have another boy, and I still consider circumcision, I won’t circumcise him till he is 10 or 12 years old according to the Upper Egyptian traditions."
Sa’eed and Dina differed in their estimation of the amount of pain involved during the procedure. Sa’eed said: "The pain was very mild but it was the fright "khadda" that made him cry." Dina said however, "It hurts of course, isn’t it a wound it should hurt."
ii) Dr. Hazem and Dr. Afkar
Dr. Hazem was one of the respondents who did not remember his personal circumcision, because he was circumcised when he was very young. He attended his son’s circumcision, which was done when the boy was an infant, and he was moved by it. He said:
"We spent three miserable days. He cried such a lot. It wasn’t a pleasant experience at all. Imagine a father watching his son being circumcised and the poor boy is screaming! To me it was a horrible experience."
Because he had said that it is better and less painful to circumcise boys when they are infants, I asked him if he knew the extent of pain felt by his son. He said: "To my surprise, the boy suffered a great deal of pain." He tried to reconcile between the pain his son had felt and his belief that infants do not feel pain as much as adults. He said:
"Being his father, I perceived the slightest pain he feels as an exaggerated agony. I had imagined though, that because he was so young, he would not be aware of the pain. But of course it was painful."
He tried to console himself for causing so much pain to his son and said: "The most important thing is that the shock would not affect him psychologically." I tried to test Dr. Hazem’s objective perception of children’s sense of pain - especially that he justified his son’s pain by his paternal emotions – by asking him about the children he had circumcised when he was still under training. Dr. Hazem said:
"Of course, when I was a house officer I took it as part of my professional practice and I was happy because I knew how to do it. But although I saw a child in pain, the mother was happy and that used to encourage me."
As for Dr. Afkar, she realized the extent of her son’s pain. She also recounted that he had been exposed to one of the complications of circumcision and that was bleeding. She continued by giving the example of her nephew who had similar problems that were quite serious. She said:
"My son was two months old when he was circumcised. A friend of ours who was a doctor did it, and I was afraid he might have some complications. After the procedure was done, I was worried he might bleed and that I would not be able to get to the doctor in time. This reoccurred with my nephew two years later. He was about four months old; I refused to let my sister take him home. I insisted on making her spend the night at hospital, so that we would be there if anything happened. After the procedure, my son was so pale and I was worried about him, but still he bled. I remember that my nephew was also pale and bled too and I had been very anxious."
She found solace in another way by saying: "It seems that it is natural that boys bleed when passing urine for the first time after they are circumcised." In the same manner she justified circumcised children’s sense of pain. She said:
"They felt the pain and were crying and screaming but I thought that that was normal. The whole experience was normal and all little boys have to go through it. It is just one of those painful experience in life that makes them like everybody else, like for example, piercing the ears of little girls."
Dr. Hazem and Dr. Afkar agreed in that they both made the decision to have the procedure done. Dr. Afkar said:
"That was the way it had to be. Both his father and I decided to have it done. Although we were worried that something might go wrong, we wanted to have it done. We felt that it was a must. It was better to get over with it while the boy was still young than have him grow up and do it then; it would be more painful for him then."
Dr. Hazem, furthermore, said: "The discussion was about when it should be done. The boy’s mother suggested that we have it done after a month of his birth so that he would not bleed. I personally, felt sorry for him." When I tried to deduce the implications of the father’s pity, he denied that it had anything to do with his objecting to the procedure itself. He said:
"No it was not an objection. In general I don’t like surgical procedures. I have my own escape mechanisms. When the time comes for anything to be done, I always wish that something happens to stop it."
I asked him how he had overcome his fear at the time? He said: "I knew it had to be done so that the boy would not have further problems." Dr. Afkar’s mother told them that they should observe the traditional precautions that are known as (Moshahara) . She said: "I think it was my mother who said that no one who has just been shaved should see the boy. We always used to do what she said just to satisfy her."
iii) Dr. Hussam and Dr. Yara
"I discussed the matter
with my wife and we were convinced
that it was unnecessary; but we took the decision under social pressure."
Dr. Hussam and Dr. Yara are close friends of mine, they hesitated a while until they made the decision to circumcise their son. Dr. Hussam had read some articles that were against male circumcision before his son was born. When I congratulated him on having a baby boy, we had a long discussion on the subject. He told me about his state of confusion and anxiety and about the stress he experienced on knowing he had got a boy till finally he had him circumcised. He said:
"The issue was: should we circumcise him or not. I was aware of the scholars who thought that it was not necessary and I could not make up my mind whether to do it or not. If I were living in another society, I would not have done it. It really would not have been necessary, why should I? I discussed the matter with my wife and we were convinced that it was unnecessary; but we took the decision under social pressure. Family members and friends used to ask us, ‘Isn’t the boy going to be circumcised! Isn’t the boy going to be circumcised!’ We postponed it till we made up our mind; it might have been better though if we had circumcised him three or four days after his birth. People told us it would be better but we said we would wait and circumcise him after a month of serious thinking. Finally we decided to have him circumcised like all other little boys. Why should he be different? I don’t have the right to take the decision to make him different. I don’t know what would happen if a child like him went to the club and other children ridicule him because he would not be like them. He would even get psychologically upset for, how would I know that things would change in his generation? So we decided to have him circumcised. We were worried though, as to who should do it so that there would not be any complications. Hoping that there would not be any psychological problems, we had the procedure done."
As for Dr.Yara, she described the social pressure and said:
"I had never thought of it except when I gave birth to a boy. Then the subject was brought up. It wasn’t a pleasant experience. Apart from the convictions or beliefs, I could not accept the idea of my baby son’s being tied up to have the operation without any anesthesia or anything to soothe him. I could not accept the idea of him being exposed to so much pain for the purpose of cutting off a piece of his body! I just couldn’t accept it and why should I? What was the good of it?"
Although Dr. Yara wasn’t convinced of circumcision, she finally gave in to the social pressure. She said:
"People kept nagging me saying that he will be odd in our society because everybody does it. He might have psychological problems when he grows up and finds himself the only one who is different. His sexual satisfaction will be less because circumcised males are more satisfied sexually; when the head of the penis is exposed it is more sensitive. But I wasn’t keen on it. All I wanted was that the boy would not suffer pain. I didn’t want him to go through anything I didn’t really understand neither did I want him to be different from others."
She went on to mention who put pressure on her saying:
"My brothers and sisters, my mother and my husband’s relatives. You were the only one who told me not to do it. At the time I was reading a book by Dr. Spock, who was a Jewish pediatrician, he acknowledged circumcision. I read an Arabic translated edition of the 1980s in which he was neither against nor for it. He had written that circumcision was a procedure done and was describing how to cope with the child during and after it but I didn’t feel he had any objection to the procedure itself."
Dr. Hussam said that he and his wife played an equal role in deciding to circumcise their son. He said: "We discussed the subject and wanted to take your opinion but did not have time for at the time the boy was a month old. If we had waited any longer, it would have been more complicated." When I asked him about the signs that made him realize that his son needed to have the operation done urgently, he said: "There were not any symptoms or signs, the problem was that we had the idea that the longer we waited the more difficult it would be." Furthermore, Dr. Yara described her role in making the decision saying: "Although I did not refuse, it was his father who made the decision. But even his father, at a point, hesitated." Although this statement implied that her role was not as big as her husband’s, but she repeated that they were both equally responsible. Dr. Yara said:
"Both of us shared the initiative; he started looking for someone to do it but I said that I knew a doctor who could do it well. We all knew how to do it but I introduced him to this professor at the hospital. I could not attend the operation though, so I waited outside in the waiting room."
Dr. Hussam recounted that the doctor did not give the boy any anesthesia, in addition to other professional malpractices. He said:
"I was not pleased at all with this operation. My wife had chosen that doctor because she knew he was good at circumcising. He did it in the delivery room "kushk el wilada" and I went in with him. He went in without changing his regular cloths nor even wearing surgical gloves nor over shoes. I was not happy about what was going on. I did not like him going into the operation like that. He even let me enter the theater with my everyday cloths on. I did not care to put on a surgical gown, if the surgeon himself neglected it, why should I care? The boy’s prepuce was closely attached to the head of the penis so it bled when the surgeon separated it. The doctor said, ‘Usually, I don’t take any stitches but in this case I will have to.’ Till now, the appearance of my sons’ penis is strange because the scar edge is irregular. The head of the penis is surrounded by a scalloped scar."
Apart from the mistakes that Dr. Hussam mentioned about the surgeon who circumcised his son, he continued to describe his feelings and reaction to his son’s pain. He said:
"The situation was difficult it was not easy at all. I’ve seen circumcisions being done before and I know how painful it is to a baby. I felt its pain even more when it came to my son. I felt that it was a traumatic experience and I must say that circumcision is sure to have a psychological impact. However, I wonder how this traumatic experience would affect a boy of three days old?"
He explained his description of circumcision as a severely traumatic experience by saying: "There is a wound of course, because a doctor had to snip, press with the forceps and cut. The boy got disturbed and screamed. I don’t know what impact this will have on him." In spite of the fact that Dr. Yara was not present in the surgery theater, her state was not any better than her husband's. She said:
"I was in the waiting room and could not hear what was going on in the operation theatre but I knew the kind of operation and what was done in it. I’ve done it myself before. My friends were around me comforting me and saying, ‘Everybody has to go through it. It is a simple procedure.’ But in spite of all that I was in a very bad condition."
Dr. Hussam said that they were worried and tense for three weeks after the circumcision because the baby was having a lot of pain. Dr. Yara said though, that the difficult period was more than that. She said:
"He was in a very bad state for a month and half after the procedure, and I felt that he had changed a lot. I kept wishing I had done what you Seham had told me. The baby was sick and tired and so was I."
Moreover, Dr. Hussam described his son’s condition during that period. He said:
"He had become very nervous and cried a lot. He had a great deal of nervous movements. It was then that I felt that perhaps he had got a shock and I was worried and afraid. That is why, I tell you, I want to know more about the subject."
"What happened after
the circumcision was that he cried a lot,
as if he was afraid of the world."
As for Dr. Yara, she described the child’s condition as follows: "What happened after the circumcision was that he cried a lot, as if he was afraid of the world." When I asked her what were the signs of the fear she said:
"He cried about anything and was afraid of everything. He cried when he woke up and cried when left alone. If you try to do anything for him he would cry even if what you were doing does not hurt. He suffered for a long time during which his sleeping pattern was irregular; he used to sleep a short while and then wake up and so on. He used to have stomach ache or that was what I imagined."
Dr. Yara furthermore had read some material that increased her anxiety: she said:
"After I had circumcised my son, I read two whole pages on the complications of circumcision, some of which I thought had happened to my son. He had stitches that were inflamed for quite a while after the procedure. The scar had rather an irregular edge that formed scallops around the head of the penis. The author of the article I had read said that that was one of the complications that could happen and it would persist all over his life. Perhaps if I had read that article before circumcising him, I would have strongly objected to having the procedure done. Moreover, I was very disturbed after reading it and remained terrified for many days and felt a deep sense of guilt. I felt that my son had experienced more or less all the problems stated by the author. I also felt that he had been psychologically affected; before circumcision he used to be very quiet and did not cry much."
Dr. Hussam however, tried to find other excuses that deny the relation between these signs and circumcision. He said:
"He cried more than usual that is why his sleep was disturbed, I’m not sure though that circumcision is the cause. During that period I was really worried and experienced a sense of guilt. I asked myself, ‘Could it be that we had really done something wrong?’ But gradually, my sense of guilt diminished because I thought that his crying might not necessarily be related to circumcision. He went through different stages; sometimes he would be all right and sometimes he would be sick this was not related to anything except developmental stages."
When I asked him if nervousness is a sign of normal development, he said that these signs might not even be nervousness at all. He said:
"We interpreted them as signs of nervousness. Before, in the first month of age we used to wake him up to feed him. Then, in the second month, he used to wake up more and cry more so we would consider that a sign of the child’s being nervous. I don’t have much experience though, with children; but because I want the best for my son, every time something happened, I would get worried."
Dr. Yara agreed with him in his opinion. She said:
"I don’t know, but even in research when they say that these signs are related to circumcision, it is not correct. There are other factors that are to be taken into consideration. The child grows up and changes. Perhaps there are other factors that changed him."
In this state of anxiety, it was quite natural that Dr. Hussam and Dr. Yara did not have any celebrations. Although some relatives called them up to congratulate them on the circumcision.
iv) Seif and Aisha
Seif said that he remembered the experience he had in both of his sons’ circumcisions: "I was present at the time of both my sons’ circumcisions. They were very young. Although I did not go into the operation theatre, I was in the hospital." He expressed that the responsibility of making the decision lay on both parents and doctor. He said:
"Since it is a custom that we all went through, my wife and I made the decision to circumcise them. At the hospital, after our eldest boy was born, they asked us if we wanted to circumcise him. We answered, why not. As for the second son, we had him circumcised after 40 days."
Aisha described the role of the doctor in suggesting the circumcision of one of her sons saying:
"The youngest was circumcised at quite an early age because he had a problem in passing urine. So, instead of giving him medication, the doctor suggested to circumcise him because the prepuce was blocking the urethra. That is why the procedure was done after a month and a half of his birth."
She insisted that the doctor did not try to cure the boy with medicine but advised them directly to do the operation. About her experience with her two sons, Aisha said:
"It was a tragedy in both cases! No matter what I say, I can not describe it. The screaming!!! Oh my God!!!! I will never hear like it again! I left the clinic and went out and my husband was the one who stayed. After everything was over they called me to nurse the baby. On entering the room, I found my husband’s face as pale as a white sheet "bafta bida" and the blood vessels bulging out of my son’s face, just like the pictures you see of the African children in the famine. His face was so pale too "bafta bida." I could see an extraordinary expression of questioning on his facial expressions. I gave him my breast and all the time I was crying."
"With his eyes he was
‘What have you done to me? Didn’t you have mercy on me?’"
When I asked her about the expression on her son’s face, she said:
"With his eyes he was asking me, ‘What have you done to me? Didn’t you have mercy on me?’ I will never forget what happened to my two sons when they were circumcised. It was really terrible. When I was feeding him he stopped sucking every now and then from the pain and kept looking at me as if he wanted to tell me something. It was a real tragedy. I hated myself. The conclusion is that I hated myself for circumcising my two sons."
Seif too remembered the condition of his sons after circumcision. He said: "All I remember was that there was a lot of screaming and pain each time they passed urine for two or three days." Aisha added that her son was not sleeping well also. Although she realized the cruelty of the experience with her first son, she repeated it with the second. She justified this by saying that no one discussed the subject in front of her as an important issue. In her opinion, her feelings were not enough to stop her from doing it again.
Both Aisha and Seif agreed that male circumcision is a normal procedure. Neither should there be any celebrations nor should any one object to it. They said, accordingly: "We did not have any ceremony or celebration nor did we get presents. The same happened with all the other males in the family."
C) The respondents who recounted male circumcision experiences of other acquaintances
Some respondents could remember MGM experiences of other males rather than themselves and their children. Salah started by saying: "I do not care if I attend these ceremonies. I am not very interested in them." However, after much encouragement he said:
"Now I remembered. My nephew was a year old. They took him to a doctor to circumcise him. No one discussed the matter. They took him to the doctor as if it was a natural procedure. But no one suggested the circumcision of my niece."
He interpreted what happened to his nephew by saying that it was because they belong to middle class bourgeois and were not concerned with issues of human rights. They only had a small celebration like that of a birthday party.
Sa‘eed recounted experiences of some of his relatives saying that there were some interesting stories. On one hand, some of them gave in to the procedure like him, and others tried to run away. He said:
"Some children succumbed to the procedure and some ran away and were brought back crying. One cannot generalize. I remember that my uncle was a very strong boy. He used to be able to crush a coin in his hand. They circumcised him by three stages. Each time they would cut a piece and he used to run away and hide to be brought back after a day or two. It took them three or four days to complete the circumcision. He was 15 years old then and was as strong as a horse, but was afraid of the pain in spite of his strength. The funny story spread in the whole village about my uncle who was circumcised in four days."
Dr. Fahmi moreover, said that he came from one of the popular Cairene areas and was aware of how people considered it a happy occasion there. He said that he had seen processions like those described by Salah Jahin, a famous author, in the song "Sprinkle Salt 7 Times, Little Boy’s Mother" (Ya Um el Mittaher Rushy el Malh 7 Marrat). On such an occasion the child is usually dressed in a white gown and rides a chariot (Hantour) accompanied by drummers and flute players (Zaffa). Usually it is a group ceremony when three or four boys are circumcised together. He had not experienced such a ceremony because he was circumcised at the age of two weeks He remembered though, the circumcision of his youngest brother who was three years old at the time. The family had the doctor come in to do it at home. He said:
"He was given local anesthesia. At the time I was eleven and can remember. He screamed a lot of course. My father and uncle tied him down, and I remember that there was a male nurse as well. They did the procedure in the drawing room, lying him on a table in the middle of the room. The boy cried and fainted. Then my mother came and held him in her arms soothing him. The doctor prescribed a painkiller and told her he would be all right after he passes urine. For two or three days he walked with his legs far apart. The first two or three times he passed urine he screamed, but after that he was all right."
The family had told that child that he was going to be circumcised so, he was afraid and tried to run away. Dr. Fahmi added:
"We used to live in the ground floor, and had a garden. He hid in the garden when the doctor came. I remember we had a male servant who looked for him and finally got him. The boy was in tears."
But all the boy’s kicking and sobbing were not enough to make the family change their minds. Dr. Fahmi justified this by saying that that was a normal reaction. He explained: " It is just like when a woman screams during labor. It is normal that she screams and normal that her family accept it without being worried." The family did not explain why the child should be circumcised, nor did the child ask. Dr. Fahmi said about the decision: "Circumcision is usually taken for granted. Just like when a child turns six, he must go to school, no body necessarily makes the decision." After a week from his brother’s circumcision, the family celebrated. Dr. Fahmi described the celebration by saying:
"Mama brought a jug and put it in a big tray, similar to that we have in Soubou.‘ She bought it from Hussein area. At the time, my grandmother, God bless her soul, was still alive and she gave him sweets, nuts, and money. He was wearing a white gown and people who congratulated him told him, ‘Now you have become a man’ (Maborouk Ba’eit Ragel). Of course he did not understand. It was our custom on such occasions to have boiled meat with Fatta and rice pudding. We sent some to the neighbors. What I remember is that it was a sort of rite of passage into manhood."
Dr. Yara also remembered the circumcision of her younger brother, and said
"He really suffered! He was circumcised at a doctor’s clinic but he really suffered although he was given anesthesia. He was six years old. It was a torturing procedure. The wound was inflamed for a whole month. He knew he was going to be circumcised, and was prepared for it. They told him he would not feel anything because he was going to take anesthesia. Although he was afraid, the family did not change its mind. He was a quiet child and did not make a fuss, but suffered a lot after it."
Dr. Yara said that it was her father who took the initiative and her mother agreed to the procedure, so, the subject was not debated. She said that they did not have a celebration for the occasion, but some relatives came and gave him toys and chocolates and told him, ‘congratulations, now you have become a man’ (Mabrouk Ba’eit Ragel).
Nehal told about her personal experience with the circumcision of her nephews and friend’s son. She said:
"They were 40 days old, and did not stop crying. Their legs were apart. My friend’s son got a hernia from crying so much. My nephews cried constantly. One of them healed quickly, but the other did not. They could not pass urine easily and cried each time they tried to. That was all."
About the children’s feelings she said:
"It is known… it is said that children do not feel pain, and they cannot ask why you do it to them. I believe that if the fetus could feel anything, then, an infant would have a memory that records his experiences through his nervous system."
Nehal insisted that it was the family who made the decision not the doctor, but the latter was the one who made the procedure at hospital. Moreover, she said that the families usually decided to have it done a week after the baby’s birth because they believed that he would not feel pain. They said that he cried anyway, so, it made no difference whether he cried due to circumcision. Nehal’s family neither celebrated the occasion nor objected to the circumcision, but encouraged the mother to have the procedure done. Nehal said that she herself encouraged her sister to circumcise her baby boy. She justified that by saying:
"Because I know that the procedure will inevitably be done and I did not want him to suffer if he grows up and has it done then. When the baby is young, the wound will heal quicker."
Nousa, however, was a high school girl when she saw photographs of circumcision for the first time in her life. She said:
"My teacher brought photographs of her grandson’s circumcision to show them to us. It was really repulsive, all the blood and every thing. At the time, the photographs shocked me because they were so bloody and disgusting. But afterwards, I did not think about it."
In her family, it is taken for granted that the baby boys have to be circumcised at hospital by a doctor directly after their birth. She thought about the issue seriously though, when her best friend gave birth to a boy. Her friend told her that it was the doctor who took the initiative and circumcised the boy without taking the permission of the parents.
Dr. Salma also recounted her experience with the circumcision of her friend’s son, she said:
"He was 40 days old. I remember that he suffered a great deal of pain whenever he was changed. His mother suffered also while he was screaming all the time. He used to have her breast more than usual and did not sleep well at night."
Dr. Salma said that one of her relatives did not circumcise his son, not because he did not want to, but because something happened every time they made an appointment to do the procedure. Once, the child was ill, another time the family had other commitments. Dr. Salma said that the mother of this child though was not keen on circumcising him but his father wanted to have it done, although he hesitated a bit because he had read some information on the harm of circumcision.
Dr. Mona remembered her neighbor’s circumcision, she said:
"When I was a child, the neighbors had a boy. I remember that he was almost a young man when he was circumcised. It was known in the whole neighborhood that that boy had been circumcised then."
As for Dr. Afkar, she told me about her younger brother’s experience. She recounted:
"He was 3 years old. All I remember is that he was wearing a white gown and a skullcap and was hiding behind the wardrobe. He used to sit there. It was his favorite place. He was scared stiff while they were trying to drag him out. He was screaming and tried to run away. When I grew up I always wondered why mama had left him till he was three without circumcising him? Usually people do this procedure when the baby is one or two months old."
D) Medical doctors’ experiences with male circumcision as part of their profession
Most of the medical doctors whom I met as respondents, performed circumcisions themselves or had seen it being done. Dr. Salma however, was the only one who had not circumcised a child nor had seen the procedure done, because she is afraid of surgery. Even during the two months in which she was forced to attend surgical operations, when she was a house officer, she always used to volunteer to go to the blood bank instead. That is why she has never held a surgical instrument in her life. As for the rest of the doctors whom I interviewed, they either circumcised children themselves or only attended circumcisions as part of their training.
a) Medical doctors who did not circumcise boys
Dr. Hosaam, who was specialized in internal medicine, justified his not having done circumcision as a practitioner, saying that he did not like surgery in general. All he knew about it was how to help a woman in labor. Although he had not done circumcisions, he saw it being practiced when he was a house officer. About his reaction to the procedure he said: "I have always thought of it as a traumatic experience. But I did not have a certain attitude towards it." His idea of the experience being a trauma was not the reason that prevented him from doing it to children. His excuse was that he disliked surgery, even those types of operation that he knew were not traumatic; but necessary to save the patient’s life. An example of such operations was the removal of the inflamed appendix that all newly graduated doctors did, but Dr. Hussam had not performed the operation.
Moreover, Dr. Laila had utterly refused to do circumcision to children during the period of her training in surgery. She said: "I couldn’t. Simply I could not." Remembering this period she said: "As you know, house officers do not get adequate training. I did not do it partly because I was not trained for it. How can I do an operation without being trained?" Nevertheless, she attended operations in which children were circumcised so she had seen it practically done. About it she said:
"It is terrible, terrible, terrible! Who are the ones who do circumcision? Some young doctors who do not really understand anything! I really don’t know why people allow this to happen. It surprises me."
She described the procedure she called ‘terrible’ as follows:
"The boys are a week or two old and a doctor with big fingers, who can’t even hold the scissors, cutting. I saw terrible things and I just couldn’t take it. I couldn’t. I never ever performed male nor female circumcisions, it was against my nature. As you know, when I graduated I didn’t know exactly what was going on. I was not completely aware but I refused because I felt how horrible the operation is. They are both terrible. I felt that male circumcision was horrible and painful."
She described the boy who was been circumcised and said:
"He screamed just like a rabbit who is being slaughtered, yes a slaughtered rabbit! ‘arnab beyndebeh dabh!!’ And the doctor was holding the scissors and didn’t know what he was doing exactly. Once I had a quarrel with one of my colleagues who was holding the scissors and circumcising a child. I told him: ‘It is not done like that.’ I found him making a hole in the head of the penis without giving the child anesthesia and the doctor was digging into the child’s flesh; and blood was everywhere. I almost fainted. It is terrible, terrible. It is a terrible operation and naturally I refused to do it. Female circumcision is also terrible. When I saw it done, I vomited."
When I asked her whether the boy who was circumcised and that she had described was like a slaughtered rabbit, was suffering in the same way as the girl or if his pain was less, she said: "There was no difference actually. The pain in both cases was the same. It was terrible." Then I asked her if circumcision would have been less terrifying if a senior doctor had done it, or if it was terrifying in any case? She answered: "No it would not be that bad. At least a senior doctor would know what he was cutting. But with junior doctors it was as if an idiot was cutting the boy’s flesh."
Dr. Mona moreover, had not circumcised children by herself at all. She had taken this attitude because of her general ideas that were against inflicting violence on children. She said: "I don’t know, but it is terrible to fix a child down and cut off a piece of his body. It is really terrible." Nevertheless, she had attended male circumcision as part of her training and still remembers this experience saying:
"The child was very young. He was only a week old. Very, very young. The doctor first drew the prepuce back then pulled it forward, then applied the forceps to it. Of course the baby screamed. I couldn’t take it. I never did it again."
Dr. Afkar also had never circumcised children herself. She said: "I never liked surgery and therefore was never interested to learn it. I had seen only a few surgical operations when I was forced to help the senior doctors."
b) Medical doctors who circumcised boys
Some respondents who were medical doctors had performed a small number of male circumcisions. Those were Dr. Hazem and Dr. Khadiga. Others performed circumcision on a large number of boys, these were Dr. Nader, Dr. Nazmi, Dr. Fahmi and Dr. Yara.
Dr. Hazem was not specialized in surgery but had performed circumcision on a boy once while he was a house officer. He recounted his experience saying:
"At the time I was a house officer and I was very happy that I was performing circumcision. I did it under the supervision of a senior doctor. The boy was a couple of days old as far as I remember."
When I asked him if the child’s parents had brought him to the clinic with certain symptoms or signs of diseases that required the procedure, he answered, ‘No.’
As for Dr. Khadiga, who is a gynecologist and an obstetrician, she said that she had performed circumcision on a small number of children because it was part of her training but she did not ever practice it after that. She also said that the children she had circumcised did not suffer from any symptoms nor did they have any pathological signs. According to Dr. Khadiga, it was their families, especially the mothers, who brought them to the clinic to be circumcised. She said:
"The woman would come and say ‘I want to have him circumcised.’ So we would examine him first but we did not ask for a blood picture before the procedure. When some boys bled severely, senior doctors said that we should have a blood picture first so that we wouldn’t have further problems. We used to do it under supervision and did not give anesthesia. The boy would be a couple of weeks old and he used to scream, scream, and scream all the time! He suffered a great deal of pain although he would not remember the experience afterwards."
Because Dr. Khadiga said that she was aware of the child’s pain, I asked her why she had agreed to perform this procedure and not stopped after her first experience? She said that although she did not like this procedure, she was forced to do it while she was being trained to do minor surgical procedures since she was still a house officer. When her training period was over she did not do it because of the pain she had seen suffered by the children.
Dr. Nader is not a surgeon but he had performed circumcision on many boys while he was still being trained. The children did not have anything wrong with them pathologically. He said: "They were newly born children and their family had brought them without any complaints to have them circumcised at the out patient clinic in the hospital." He could not remember the children’s reactions to the operation. He said:
"As a house officer, I saw many children, and usually three or four doctors were present and circumcised them, one after the other. The patient used to leave directly after the procedure. Of course the child would be crying, for after all it is an operation. But I did not have older children who could express their feelings. It was just a baby crying from a surgical procedure."
Dr. Nazmi moreover, delivered mothers and circumcised their boys without their having any pathological complaints. He said: "We circumcise boys 3 or 4 days after they are born. There is no problem."
He admitted that the local anesthesia he gave the children was not effective.
Dr. Fahmi circumcised a lot of children while he was being trained as a house officer. He said that it was a simple operation. And when I asked him simple for whom? He said: "For the young doctor who does it" As for the boy, it is not simple. He said:
"Of course a baby 3-6 months screams. We were not allowed to do it to a child older than 6 months because the penis would have grown and there would be the possibility of bleeding. We used to do it with the bone forceps. In some cases we had to take stitches to fix the remaining skin to the underlying connective tissue. In this case, circumcision is quite an operation!"
He admitted that the local anesthesia he gave the children was not effective. He described it as follows: "The stupid thing you know. It is stupid because it is not effective enough." He said that he knew that it was not effective because the child could feel the operation. Some doctors had to tie the child down so that the doctor could cut the prepuce off. Dr. Fahmi said about his reaction to the circumcised boy’s feelings:
"I don’t think I sympathized with him. I was happy because I was learning something new so I did not feel sorry for the child. We put an antiseptic on the wound and the mother took the child in her arms. He would be quiet then. I didn’t feel I was being a butcher, and we bragged about who had performed the largest number of circumcisions today! And who was the best in mastering the technique!"
Dr. Yara is a gynecologist and an obstetrician and said that she had done many male circumcisions especially on newborn infants and sometimes to babies of one or two months old. All of them did not have any pathological symptoms or signs. They all screamed which did not prevent her from doing this procedure nor did she give them anesthesia to protect them from the pain. She said:
"I did this procedure when I was young and had not yet specialized in gynecology. I was happy because I had learned how to do surgical operations and was convinced that the child must have this procedure done. I believed that it was better to cry a bit than give the child general anesthesia and that the nerve supply is not as strong in babies as it is in older children. They cry because they do not want to be tied down not because of the pain. These ideas made me set my mind on what my hands were doing so that I would not make mistakes and complete my job correctly according to standard measurements."
In spite of her belief that newly born children do not feel pain as much as older children, her practical experience proved otherwise. But she had a different interpretation for the child’s screams that she developed according to the theory she had learned concerning children’s sense of pain. She said: "Of course they cried but probably because they were tied down."
III) Degrees of MGM According to the respondents experiences
It is agreed that FGM could be classified into four degrees, according to the amount of cut tissues and the type of the procedure. This classification is not made according to academically determined quantitative surgical descriptions but is only a classification that was set by those who were against FGM to make the subject easier to describe. There is no parallel classification for MGM. From my personal experience with males that had come to see me in surgery and dermatology clinics during my practice because they had hernia or fungus infection, I found different degrees of the amputation of the prepuce. It varied from the cutting of the tip of the prepuce to the complete removal of the two layers of the prepuce, and sometimes it reached the skin of the shaft of the penis. Some of the respondents commented on the various degrees of MGM but most of them, even circumcised male respondents and female respondents who have circumcised sons, did not know exactly the amount of the removed part according to their personal experience. Most of the respondents who were doctors moreover, could not determine the degrees of MGM. Dr. Hussam said: "The doctor cuts as much as he can." Other doctors said that they don’t remove the entire prepuce. One of these is Dr. Nazmi who did not determine the degree of removal but said that he only used to cut the tip of the prepuce. As for Dr. Khadiga, she estimated that she used to remove as half a centimeter from the prepuce, so that an ample piece is left to cover the head of the penis. When I asked her why she did not cut it all? She said: "I did what the resident told me." But other doctors, as Dr. Nader, said that they cut the entire prepuce so that the head of the penis would be completely uncovered. Others described other degrees of circumcision that they had practiced personally or had seen done on their children. Dr. Mona said:
"It is evident that there are different degrees since there are some children who still have some loose skin whereas, in others the skin is tightly pulled over the penis so that it pulls the penis itself."
Samia said: "I think that doctors cut the entire prepuce."
Aisha said: "They cut the piece of skin that surrounds the head of the penis."
And Seif said:
"I think that the degree of circumcision differs according to the child’s age. A newly born child has less cut off than a child who is 6 years old because the size of the penis is different."
IV) Respondents who had non-circumcised male acquaintances:
She knew someone who is a
European Jew and his family had decided
not to circumcise him. She added that he is in good health
and his appearance is clean. He accepts himself as he is
and considers himself normal.
Some respondents have acquaintances who are not circumcised most of whom are Europeans. Samia said that she knew someone who is a European Jew and his family had decided not to circumcise him. She added that he is in good health and his appearance is clean. He accepts himself as he is and considers himself normal.
Dr. Khadiga knew European men who were not circumcised but still were in good health and she believed moreover that their sexual life was normal, because of the fact that they were married and had children. Fathi agreed with Dr. Khadiga’s opinion because he knew non-circumcised European men. He added that he did not discuss the matter with them because he considered that they were normal. The same applied to Sa’eed and Dr. Fahmi with their non-circumcised European acquaintances.
Dr. Hussam was the only one to say that he knew Egyptian friends who were non-circumcised and considered them normal from health, cleanliness and sexual perspectives. One of these friends was a Christian man who told him about his persecution at school by his peers. Dr. Hussam thought that this had been a traumatic experience because of his being different, not only because he was not circumcised but also because he was from a different religion. I asked Dr. Hussam why his friend had not got circumcised in order to escape this persecution? He answered explaining:
"probably because the boys did so because they did not accept the difference of religion. He could not stop being Christian nor could he have changed his name. Circumcision is part of all that."
During his medical practice, Dr. Nazmi circumcised many children. He thought that personal hygiene is difficult with the presence of the prepuce, circumcision makes things much easier. In his opinion, if the mother does not clean the child and teach him how to clean himself, and if men do not know how to keep themselves clean by washing and bathing, and if the prepuce is narrow, he will develop infections due to the accumulation of secretions. When I asked him if he knew any people who were not circumcised and who had such infections? He answered saying that he knew some Europeans who are not circumcised but as far as he knew had none of the above mentioned complications. He considered them as they considered themselves to be normal health-wise. When I asked him to explain the contradiction between what he had said and his practical experience as to his non-circumcised acquaintances, he refused to answer. He told me to go and do a research on all the non-circumcised males to make a survey calculating the number of those who suffered from infections and those who didn’t.
A) Simsim’s story
Simsim is a pseudonym of a boy in primary school. He is the son of one of my close friends. His father is a friend of many of the respondents. When I went to congratulate him for having a baby boy, I talked to him to persuade him against circumcising his child as I do with all my acquaintances and friends. He did as I advised him and did not perform this procedure on his son. But still he is worried and not quite sure whether he had done the right thing. Simsim is referred to by many respondents as an example of a non- circumcised Egyptian person whom they know.
Samia is one of those who knew Simsim and she said: "He might have some complexes when he grows up." Hureya also knew him and felt sorry for him because he was ashamed to pass urine in front of anyone. Moreover, Dr. Salma knew Simsim too. In her point of view, he had a problem because he was ashamed to undress in front of others because of the fact that he is not circumcised. She said that once when his mother was away the family had a difficult time with him because he wouldn’t let any body else take him to the W.C. His regression to the stage of wetting his pants was due to his feeling different from other children. Aisha knew the boy and considered him normal, healthy and clean. She described him saying: "He is a sweet boy; so cute!" From her quick and sharp observation, she believed that he did not suffer any stress because he was not circumcised. Although she did not discuss the subject with his father, she thought that the boy was not circumcised because his father believed that it is not necessary.
V) The respondents’ experience of seeing intact male genitalia
Most of the respondents had not seen intact males neither in pictures nor in reality. Even doctors who had examined many males said that all their male patients were circumcised. Dr. Yara noticed that the ancient Greek statues represented non-circumcised men, but she could not imagine a live male who had not been circumcised. She could not imagine how he could have sexual intercourse while he still had the prepuce.
Some respondents went abroad and saw the difference between circumcised and non-circumcised males in reality. Mostafa furthermore, lived his adolescence in a European country and said: "Of course, at first I was astonished because we were not all alike. I thought that our appearance was better than them."
He interpreted the absence
of the prepuce from the anatomy books
by the fact that medical books are influenced by cultural biases.
When Dr. Hazim went abroad on academic scholarship, he noticed that the men who appeared in sex advertisements promoted themselves by saying that they are ‘clean cut.’ For Dr. Hazem, this implied that male circumcision is a sign of being attractive and charming. He had not seen intact males before and commented that even in anatomy books males appeared without a prepuce. He interpreted the absence of the prepuce from the anatomy books by the fact that medical books are influenced by cultural biases. He said: "It is just like how medical texts promote the adult man image as a male who weighs 75 KG."
Dr. Hussam also had been abroad and commented:
"There are a lot of non-circumcised males abroad and their appearance is normal but different. I’m talking for myself. If I saw myself like that I would not accept myself. In the same way if I were blond, I most probably would be disgusted."
As mentioned above, Abu el Fotuh had saw Western films in which there were nude actors who were not circumcised. His reaction to them was similar to Dr. Hussam’s and Mostafa’s reactions who believed that the appearance of circumcised males is better. Dr. Afkar moreover, saw a similar film and the non-circumcised actor astonished her.
After review of the respondents’ experiences with MGM, I will move to probe into their present and future attitudes towards this subject.