Letter from Duane Voskuil, PhD, to Alliance for Sexual Abuse Prevention and Treatment

August 23, 1998

Susan Cordes-Green, Director
Alliance for Sexual Abuse Prevention and Treatment
P O Box 9858
Fargo, ND 58106-9859

Dear Ms Cordes-Green and Members of the ASAPT:

After our all-too short conversation (8/ 21/98), I was pleased to find in you someone informed and sympathetic to the issues surrounding genital mutilation. However, I was left with the impression that one reason you and the Alliance are not even more aggressive in addressing the sexual abuse of non-medically indicated male prepuce amputations on nonconsenting individuals is that no official body has declared it to be sexual child abuse even though you and others feel it probably is (including Gladys Cairns, Director of Child Protective Services and Chair of ASAPT, who said as much to me in 1993). I ask you: Who is it that we expect to make such a declaration?

We certainly cannot be waiting for the perpetrators to do so. And the victims are dismissed when they speak out. Ridicule, social and economic ostracization meet them when they finally do become aware of the abuse.

We can't expect the medical profession to make this declaration: They include most of the perpetrators, or harbor the perpetrators; and many physicians correctly see, anyway, that this is cosmetic surgery and not a medical issue.

What about the watchdog agencies of the medical community? Specifically the North Dakota Board of Medical Examiners? This Board is charged with controlling medical fraud and unnecessary surgery according to its mandate in the ND Century Code. But here again, the Board is populated mainly by physicians and even when one or two recognize the inappropriateness or the amputation as did former Chair, Rhonda Ketterling, MD, the political pressure within the closed medical community is too much to overcome, so they fail to act. (See my letter, 3/3/95, to the Board, to which I've never received a response, even after several addition requests, posted at: http://www.datasync.com/SexuallyMutilatedChild/).

Then there are the State Health Officers who over the years have said it is a practice that should stop (Wentz); or begged off by saying the office was concerned only with medical issues (an incorrect assessment or the office), so elective prepuce amputation was not a medical issue (Rice); but they have done nothing further towards informing the public or physicians out of fear of inhibiting their career.

Since this surgery is a social custom in the United States (at least for the last couple of generations that have been birthed in hospitals), and a surgery better described as "moral surgery" (e.g., to stop masturbation) than as a medical procedure, and since it is an irreversible body modification having to do with social customs and religio-philosophical principles, perhaps we should be listening to what those say whose job it is to fret out the historical reasons for the operation and the ethical principles it follows or violates. One such, Margaret Somerville, medical ethicist at McGill University, after many years of struggling with this issue, has concluded it is "criminal assault" similar to female genital mutilation, since the Canadian Pediatrics Society among others has declared it a procedure with no medical benefit. I would put whatever prestige my doctorate in philosophy and a lifetime of research and teaching has, towards agreeing with this assessment.

Then there are the world's medical societies. They may not come right out and declare it to be sexual child abuse, but again they are not the moral or legal guardians of society. However, no medical association in the world considers amputation of healthy genital tissue to be a procedure done for medical reasons.

So while we wait for someone else to declare forced amputation of healthy genital tissue to be sexual child abuse, the abuse continues because of ignorance, malice, greed or fear. We are informed; we are those to whom historical circumstances has cast this lot, like it or not; We must declare to our corner of the world (that is so out of sync on this issue with most of the rest of the world), that this amputation, for whatever reasons it started and still continues, is no longer acceptable; It is morally reprehensible and illegal even though enforcement agencies so far have refused to prosecute, just as they refused to prosecute race discrimination and other such civil rights issues for many decades.

Permanently altering someone's body in such a significant way cannot be dismissed (as Dr. Somerville says) as de minimis (legally insignificant). It removes a valuable organ, that provides protection and stimulation. It violates one's basic human and civil rights to decide for himself whether he wants to live with a whole, intact body. Not only does it violate the laws already on the books to protect those too helpless to protect themselves, it also violates one's right to equal protection under the 14th Amendment of the US Constitution since the passage of the ND and federal FGM laws. It simply is a very unkind thing to do to another person; or as a Swedish nurse exclaimed when she surprisingly learned what we do this to our sons: "It's barbaric!" I got the same response when I was in China.

So what better organization can there be to declare this act inappropriate and abusive than the Alliance for Sexual Abuse PREVENTION and Treatment? The members of ASAPT are people in many walks of life who know about abuse and are charged with protecting the helpless. The time has come to stop waiting for someone else to step forward. Time has come to take a stand and tell parents that new information on the function of the foreskin and insights into the rights of all individuals, even babies, requires us now to see that the surgical amputation of this healthy genital tissue is sexual child abuse. Further, those physicians who claim to be absolved from complicity in the negative effects of this inappropriate surgery because they claim the "patient" requested it, must be educated and/or legally restrained from performing this amputation, first, because the parent is not the patient, and second, because removal of healthy flesh without a compelling medical reason violates the physician's own oath to First Do No Harm.

I would hope that the Alliance would (1) see to it that the medical community is appraised of the inappropriateness of the operation by helping educate physicians on the important functions of the prepuce and its anatomical development; * (2) get behind legislation to make third party payments for these contraindicated amputations illegal, and (3) support legislation to remove the sexism from the present law that only protects female minors; (4) encourage the appropriate government and professional agencies to disseminate information about the inappropriateness of continuing to perform medically unnecessary penile reduction surgery; (5) encourage educational institutions to talk about the issue in classes on ethics, sociology, health, psychology, etc., and especially in the appropriate classes in the University of North Dakota's School of Medicine's departments of pediatrics, obstetrics, gynecology and urology; and finally, (6) put together a taskforce of individuals responsible for recommending the simultaneous end of the abuse statewide so no one agency or individual has to go it alone thereby minimizing personal and economic hardships and the need for litigation.

Unless these measures are taken soon, the issue will become more and more the province of litigation wherein the only winners will be lawyers. Sooner or later the courts will have to see, as they finally did with other civil rights issues, that however sanctioned and comfortable people are with treating children like property, like a dog whose tail can be cropped at will, that our society, which claims to be based on maximum individual freedom, cannot allow someone the freedom to take away another's freedom to decide for himself whether he wants his penis docked. This amputation violates a person's freedom to have full sexual function and his freedom to chose which religion he wants to identify with, since some religions do not allow their adherents to worship with a mutilated body.

I have spoken before, in 1993, to the Alliance on this issue, and would be glad to do so again. I was excited to find the Alliance open to becoming informed then, and encouraged now to find how much more informed you are than people were five years ago. For those with internet access may I suggest that many excellent sites exist such as http://www.cirp.org/CIRP/. You might want to read my research on the possible ancient origin of male circumcision in the journal Circumcision at http://weber.u.washington.edu/~gcd/CIRCUMCISION/v2n1.html#reprint3.

Here's hoping we can stop this way of introducing our trusting babies into the world--

Sincerely yours,

Duane Voskuil, Ph.D.
Philosopher, Educator and now Violin Maker

1002 N. 8th St.
Bismarck, ND 58501

*Even the forced retraction of immature foreskins is abusive; the American Academy of Pediatrics' pamphlet on the care of the intact male infant says: "Foreskin retraction should never be forced. While the foreskin is still attached to the glans of the penis, do not try to pull it back, especially in an infant. Forcing the foreskin to retract before it is ready may harm the penis and cause pain, bleeding, and tears in the skin."

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