Sexual Mutilations: A Human Tragedy.

Sexual Mutilations: A Human Tragedy. Edited by George C. Denniston and Marilyn Fayre Milos. New York: Plenum Press, 1997, 237 pages. Cloth, $104.50.

The topic of female circumcision continues to elicit strong reactions throughout the world. Perhaps more accurately described as genital mutilation, the practice has been the subject of novels, nonfiction volumes (both academic and popular), and newspaper and magazine articles. Bestsellers such as Walker and Grose's (1992) Possessing the Secret of Joy and Kassindja and Bashir's (1998) Do They Hear You When You Cry, have served to inform the world's population that the practice has not ceased and that in some cases, such "gender-based persecution" has provided the justification for asylum in Western countries. Additional works regarding female genital mutilation (FGM) are released annually, and the year 2000 is no exception. New volumes will cover an array of related topics: international laws and policies (Rahman & Toubia, 2000), anthropological perspectives (Gruenbaum, 2000; Shell-Duncan & Hernlund, 2000), and a children's educational novel (Kessler, Gauch, & Colon, 2000), to name a few. In the first six months of 2000, The New York Times, The Washington Post, and the Christian Science Monitor published nearly 20 articles that referenced FGM, each of these educating the reader and keeping the issue in the public eye.

Although all of the recent publications contribute to an understanding of the practice of female circumcision, none has integrated material on the more widely practiced circumcision of males. Moreover, few of these efforts have incorporated descriptions of the actual physiological and biological changes that are associated with the alteration of one's genitalia. Finally, seldom does one see a volume that incorporates the cultural diversity associated with these proscribed genital alterations and the historical perspective that can be linked to these often painful and debilitating changes. Understanding the need for an all-encompassing volume, Denniston and Milos have edited presentations from the 1996 Fourth International Symposium on Sexual Mutilations within Sexual Mutilations: A Human Tragedy. The 23 resulting chapters cover the gamut of issues related to genital mutilation and a wide range of perspectives from many disciplines. In addition, the volume includes a much-needed FGM resource list as well as a chapter devoted to The Ashley Montagu Resolution To End the Genital Mutilation of Children Worldwide. The difficulties for the reader, however, are many. These include the need to wade through repetitive material; a lack of organization regarding the order and content of chapters; limited ethnographic material regarding circumcision of both males and females; a heavy emphasis on the white, Western, male experience; inclusion of papers as they might have been delivered at the conference rather than as book chapters; and a number of disconcerting cultural descriptions.

Sexual Mutilations: A Human Tragedy begins with a chapter on the geography of genital cutting, reviewing the regions of the world that have historically practiced circumcision on one or both sexes. The author, James DeMeo, also includes a very interesting distribution map illustrating the age at which males are circumcised throughout the world. A comparable map has not been constructed for females and the reader is not provided with information regarding the age of FGM among communities practicing female circumcision worldwide. Unfortunately, the remainder of DeMeo's contribution includes a psychoanalytic framework of those communities that perform circumcision on one or both sexes, reducing cultural diversity and history to a simple formulaic list. Moreover, general descriptions of circumcision are both Western and derogatory. For example, women within a "cultural unit" are said to "gather about the poor girl to chant and beat drums and tambourines" (p. 7). Clearly not all of the peoples that practice FGM have such a gathering, let alone chant or possess drums and tambourines. DeMeo suggests that "female mutilations exist within an hierarchical, sex-repressive and child repressive cultural complex" (p. 9), and although reference is made to cultural myths, citations are not provided. Finally, DeMeo compares genital mutilation to child abuse. This comparison cannot be a valid one given that FGM is a culturally-sanctioned behavior whereas child abuse, as uniquely defined by each culture, is both forbidden and taboo.

DeMeo's work is followed by that of Frederick Hodges, an historical piece detailing the way in which genital mutilation was institutionalized in the United States. Well written and engaging, the reader learns that, in fact, genital mutilation became a rather common treatment for masturbation in the late nineteenth and early twentieth centuries in the U.S. Moreover, for most of the twentieth century, articles were published describing the health benefits of male circumcision, ending in 1986 with the notion that circumcision could prevent HIV transmission. Hodges also outlines the various industries that have grown out of the practice of male circumcision in the United States, such as the Gomco Clamp and the multimillion dollar business of supplying foreskin to research laboratories. One also discovers that the U.S. has the highest rate of circumcision as well as the highest rates of genital cancers and sexually transmitted diseases: Ergo, circumcision does not reduce the incidence rate for diseases previously linked to uncircumcised males. More recently, the American Academy of Pediatrics has revised its policy statement. Although they continue to claim that there are positive benefits that result from circumcision, routine circumcision is no longer recommended.

Denniston and Milos have included several chapters on religious issues as they apply to genital mutilation. One of these, authored by S. A. Aldeeb Abu-Sahlieh, highlights the fact that at present female sexual mutilation is practiced in 28 countries. Although Muslims are noted as the major religious group practicing genital mutilation for both sexes, there is great diversity in the type of mutilation practiced within each community. Abu-Sahlieh provides clear definitions of the kinds of female circumcisions employed in Africa, the Middle East, and parts of Asia, and understands that strategies for eliminating the practice cannot be the same given the diversity of its practitioners, communities, and individuals. Abu-Sahlieh incorporates his own notions as to why male circumcision persists in cultures and religious groups throughout the world, underscoring that the Bible is the "major basis" justifying male circumcision (p. 43), whereas the Koran does not mention circumcision of males or females. Finally, it is argued that the basic notion of the right to have physical integrity should encompass all people: If you are against the circumcision of females you should also be against that of males.

Toward the end of Sexual Mutilations: A Human Tragedy, Denniston and Milos have placed two selections on male circumcision from Jewish writers. The first of these, by Miriam Pollack, focuses on male genital mutilation and opposes the discussion of male and female genital mutilation in the same breath, due to the differences "in scope and in consequence" (p. 163). Although thorough and insightful, this selection reads as it must have been delivered at the 1996 symposium--as an oral presentation rather than as a written document. Yet Pollack incorporates thoughts and ideas unique to discussions of male circumcision. For example, the actual functions of the male fore-skin are reviewed and the reader becomes aware that, indeed, circumcision alters the male form such that an alteration in function is inevitable. Pollack also understands that culture teaches a way of life that is meant to enhance or improve the possibilities for children, that mothers and fathers sanction genital mutilation precisely because they have concern for their children and embrace tradition. Immediately following Pollack's presentation, Jenny Goodman has contributed a thought-provoking selection that is more editorial than scientific. This too appears as a piece created for an oral presentation.

Seven chapters, in various locations within the Denniston and Milos volume, focus on specific efforts to eradicate the practice of male and/or female genital mutilation within a single country (England, Germany, Italy, Australia, and the United States) or by a specific group of professionals (doctors and nurses). There are no such chapters devoted to non-Western efforts to halt the practice of genital mutilation, despite the fact that such groups exist.

Sexual Mutilations: A Human Tragedy incorporates four chapters that do not necessarily relate to the other contributions: Instead, they cover a hodge-podge of topical areas. One of these features the Skoptzy, a Russian cult-like sect that mandated castration and is now outlawed. Another, entitled The Human Prepuce, appears in outline form with photographs illustrating the male foreskin during various stages of penile erection. Learned helplessness and the infliction of circumcision on children provide the basis for an additional selection. Finally, the long-term consequences of neonatal circumcision on males and the subsequent perceptions of those that have been circumcised are discussed in a fourth piece.

Gerard Zwang employs medical terminology to discuss some of the results of female circumcision. Although parts are difficult to read without medical training, this selection incorporates rare descriptions of the actual process of circumcision, the associated medical difficulties that result, and the little known impact on female sexuality. However, the author then employs his own view of culture that can be offensive to the reader: "Despite the obvious obstetrical complications caused by mutilation, the myth continues to be disseminated by tribal chiefs and practitioners of mutilation--those whom ignorant occidentals naively consider to be the "depositories of ancestral wisdom'." (p. 68). Like a number of other authors in the Denniston and Milos volume, Zwang suggests that it is hypocritical to insist that female circumcision be eradicated without advocating a ban on the circumcision of males.

Midway through Sexual Mutilations: A Human Tragedy, Hanny Lightfoot-Klein's chapter compares generic commentary between the United States and Africa. Lining up dialogue that is used to sanction male versus female circumcision within the U.S. and Africa respectively, Lightfoot-Klein argues that there is more similarity in the often-used justifications than anyone would like to admit. Lightfoot-Klein dispels the notion that health benefits accrue to men and women who have been circumcised. Moreover, it is emphasized that an individual often views the alteration as something done for rather than to them, hence Lightfoot-Klein's assertion that there is a great need for community education regarding genital anatomy, hygiene, and sex. Berhane Ras-Work follows with a selection emphasizing FGM. Ras-Work associates the practice with patriarchal systems and reviews the types of genital mutilation and their associated consequences. This author also stresses that parents, with the best intentions, insist on FGM for their children as a way of ensuring marriage and hence security. However, Ras-Work clearly understands the practice of FGM in international settings. It is suggested that part of any eradication program must also find alternative sources of income for those practitioners who depend on circumcisions for their livelihood.

The last few chapters in Denniston and Milos' volume contain material that has been included in many of the preceding chapters. The penultimate chapter exclusively focuses on the United States and the legal issues and cases associated with male circumcision. The author proposes that it is not appropriate to outlaw female circumcision and leave male circumcision as routine practice. Given that males in the United States are circumcised more than males from any other country, this chapter has its place. However, information about circumcision and its practice in non-Western settings is conspicuously absent. The final chapter in Sexual Mutilations: A Human Tragedy is a reprint of a conference presentation regarding a petition to be sent to the World Court, the Hague, to ban genital mutilation of children all over the world.

Although many previous shortcomings have been addressed in this single volume, Denniston and Milos have failed to capture and appropriately package the issues that might allow one to fully understand circumcision as it is now practiced throughout the world. The reader is left with a number of unanswered questions and a need for an organized overview of the cross-cultural research data for both males and females. Little is gained with an unbalanced look at male circumcision, particularly when that view is focused on the Western male experience. The goal must be to provide a synthesis of the various mutilations inflicted upon both sexes in all settings, by all cultures, and from the perspective of all disciplines. Although Sexual Mutilations: A Human Tragedy provides a new reference book for one's library, it cannot be the definitive work on sexual mutilations. A more complete and well-balanced volume might provide the data that will actually allow both legislation and community education to be enacted, eradicating the mutilation of a child's body forever.

REFERENCES

Gruenbaum, E. (2000). The Female circumcision controversy: An anthropological perspective. Philadelphia: University of Pennsylvania Press.

Kassindja, F., & Bashir, L. M. (1998). Do they hear you when you cry. New York: Delacorte Press.

Kessler, C., Gauch, P. L., & Colon, R. (20001). No condition is permanent. New York: Philomel Books.

Rahman, A., & Toubia, N. (2000) Female genital mutilation: A practical guide to worldwide laws and policies. London: Zed Books.

Shell-Duncan, B., & Hernlund, Y. (2000). Female circumcision in Africa: Culture, controversy, and change: Directions in applied anthropology. Boulder, CO: Lynne Rienner Publishers.

Walker, A., & Grose, B. (1992). Possessing the secret of joy. New York: Harcourt Brace.

Mary S. Willis, Ph.D., Assistant Professor, University of Nebraska, Lincoln. 130 Bessey Hall, Lincoln, NE 68588-0368.