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Circumcision

By:
Zaynab El Bernoussi, Baudouin Dupret
Source:
The Encyclopedia of Islamic Bioethics What is This? A comprehensive reference work covering the major issues in Islamic bioethics, including medicine, clinical practice, genetics, theology, and Islamic law.

Circumcision

Definition

There are two types of circumcision practiced in the Muslim world: khitān, the male circumcision and khifāḍ, the female circumcision. Ṭahārah, a term meaning purification, refers to both male and female circumcision. Though male circumcision is almost universal in Muslim societies, female circumcision is not.

Male circumcision consists in the surgical procedure of removing the penis’s foreskin, or prepuce. In the case of female circumcision, the procedure can consist of either cliderolectomy or the removal of the prepuce covering the clitoris. In some cases of female circumcision called excision, parts or all of the labia minora are removed. In extreme instances, infibulation is performed, which removes the clitoris, all of the labia minora, and the adjacent parts of the labia majora, and then stitches together the two sides of the vulva so that only a small opening for urination and menstruation remains (Giorgis, 1981, p. 25). The vaginal duct might be reopened just prior to or after marriage by surgical means or by coitus, a process known as defibulation.

Male circumcision can be performed at home, in barbershops, or, more often, at hospitals and clinics. Female circumcision, typically performed at home, presents higher risks of infection due to the lack of proper surgical equipment and on the severity of the procedure. In rural and traditional communities, circumcisions are mostly performed without anesthesia in nonmedical settings and can present a psychological trauma for children and adults. Despite the fact that circumcisers may be skilled in traditional medicine, their lack of medical training in surgery and poor equipment can present serious health risks for the circumcised.

The age of circumcision has varied from a few days after birth—typically the seventh day—or the sixth or seventh year, to sometimes as late as adolescence or even just before marriage. Though male circumcision in urban areas is often carried out in hospitals where the boy is brought two or three days after birth, in villages and rural areas there is a greater variation in the time of the operation.

The ritual of male circumcision often includes ceremonies and festivities. Female circumcision, on the other hand, does not often receive the same celebratory magnitude. In Malaysia, for example, female circumcision is performed on baby girls from six months to three years of age (Joseph and Naǧmābādī, 2006, p. 69), without any formal celebration. The ritual of circumcision, for both genders in Malaysia, can be carried out during wedding celebrations to limit costs and to symbolize a milestone in the road to married life. In Iran, the local Persian population adopted the ritual of circumcision at the time of Islam; however, it was practiced in Arab communities before Islam and stayed as an accepted practice.

The religious rationale behind circumcision is bodily purification for worship, though many medical professionals also make the case for male circumcision as a way of maintaining bodily hygiene. The ritual is not mentioned in the Qurʾān, which makes its status as an obligation disputable. As mentioned above, circumcision is often associated with pre-Islamic tribal societies, where it is administered as a ritual passage to adulthood or coming of age (Joseph and Naǧmābādī, 2006, p. 68). On the other hand, circumcision is mentioned in the ḥadīth as one of the five rituals for which humans have a natural predisposition or fiṭrah. The other four rituals are trimming a mustache, shaving pubic hair, clipping fingernails, and plucking hair from armpits. All of these rituals are based on the same rationale for purification. However, in the case of female circumcision, the rationale behind the different surgical procedures is to limit excess pleasure, which is also a form of bodily purification for worship (Campo, 2009, p. 149). Muslim jurists have reported that for both female and male circumcisions, the ritual is a farḍ (absolute requirement), a wājib (requirement), or a Sunnah (recommended) practice that purifies the body (ṭahārah) for a proper worship. Therefore, depending on the particular school of Islamic jurisprudence followed in different Muslim communities, circumcision may be seen as either an obligation or as a recommended practice and in general it is seen as an obligation for males and either a recommended practice or even anti-Islamic in the case of female circumcision.

History

The ancient Hamito-Semitic civilizations in the Middle East practiced circumcision before Islam; textual and folk traditions along with human mummified remains attest to the practice (Sandison, 1963, p. 422; La Barre, 1972, p. 561). In the fifth century BCE, Herodotus reported the practice in ancient Egypt, where circumcision was originally a preparatory ritual to marriage and it was only later in history that infants came to be circumcised (Smith, 1894, p. 328; Smith, 1914, p. 75; La Barre, 1972, p. 106). The Jews practiced circumcision following the teachings of Abraham and so did the Christians at first but they soon gave up the practice (Bagatti, 1971, p. 106).

According to the ninth-century scholar al-Jāḥiẓ, pre-Islamic Arabs practiced circumcision for both genders at the age of thirteen years, because that was the age at which their ancestor Ismael was circumcised; the Persians later adopted a similar rationale (Massé, 1938, p. 51). Although the Prophet Muhammad himself, like Seth, Noah, and Moses, is said to be born circumcised (aposthia), there is no mention of the circumcision of any one of his Companions who converted to Islam as adults (Massé, 1938, p. 51; Thompson, 1960). According to the tenth-century writer Abū Ḥayyān al-Tawḥīdī, the companions must have been circumcised because at their time the “uncircumcised” or aqlāf were clearly stigmatized in the new Muslim society (Hamdani, 1978).

Arab tribes that converted to Islam also preserved some elements of pre­Islamic circumcision rituals such as the wedding ritual. This ritual was performed on the male at the time of marriage and in the presence of the bride. The circumciser would remove not only the prepuce but also the skin of the phallus. The groom was expected to endure the pain with no expression of discomfort, or the bride could refuse to marry him on the grounds that he is not manly enough (Remondino, 1891, p. 55; Patai, 2002, p. 89). The accounts on this ritual come from ethnographic work and it is therefore probable that the descriptions of this circumcision ritual may be exaggerated, or even entirely fictional, as such an extensive removal of skin would most often lead to infection and death.

In the case of female circumcision, there are signs of clitoral excision from the sixteenth-century BCE. Female circumcision also predates Islam and is not performed in all Muslim-majority countries. The practice is mostly prevalent in the African equatorial band and few places in Southeast Asia. Excision, infibulation, and defibulation were also practiced in Iran in the past, but in only a few geographical areas. Infibulation, the most extreme case of female circumcision, is currently mostly prevalent in the horn of Africa.

The ceremonial rites associated with circumcision have also varied over time. In Java and Morocco, for example, it is still considered one of the most important celebrations in the life of a Muslim man. In Iran, male circumcision is also celebrated and a number of magical features are attributed to the foreskin. For instance, it is believed in Persian tradition that the foreskin should be worn around the ankle to heal the wounds from the circumcision operation. Also, the foreskin would be swallowed by pregnant women in Jewish and Arab communities throughout the Middle East and North Africa to enhance the chances of having a baby boy (Patai, 2002, p. 160; Westermark, p. 427, 2013; Legey, 1935). In Iran, a wife may also secretly dry and powder the foreskin of a circumcised boy to then put it in her husband’s food as a love charm (Massé, 1938, p. 53).

Circumcision in Bioethics

According to religious tradition, male circumcision is traced back to Abraham’s own circumcision, while female circumcision is traced to Sarah’s circumcision of Hagar. Both are regarded as acts of submission to God. Hygienic reasons also explain circumcision, including reduction of the risk of cancer of the glans and venereal diseases (Remondino, 1891). Male circumcision is also believed to lower the risk of acquired immune deficiency syndrome (AIDS) (Cameron et al., 1989; Marx, 1989; Spicer, 1990; Wiswell, 1990, p. 862).

In the late 1960s, the medical benefits of circumcision came under attack, particularly in Western countries and especially when the Committee on the Fetus and Newborn of the American Academy of Pediatrics (AAP) took a stand against routine circumcision of male newborns in the United States. In 1983, the American College of Obstetricians and Gynecologists joined the AAP in opposing routine circumcision, which led to a sharp fall in the rate of circumcisions in the 1990s in the United States. In the same years, in India, South Africa, Germany, and the United Kingdom, the majority of pediatric surgeons and pediatricians also opposed routine neonatal circumcision (Chatterjee, 1989, pp. 236–37; Cywes, 1989, p. 233; Coran, 1989, p. 229; Hofmann von Kap-herr, 1989, p. 227; Rickwood, 1999).

The AAP revised its unfavorable opinion on circumcision in 1989, citing some potential benefits for the procedure such as lower rates of urinary tract infections as well as sexually transmitted diseases. The AAP advised parents to make the decision on circumcision based on their cultural or religious beliefs.

With regard to female circumcision, the operation is also called Female Genital Cutting (FGC) and Female Genital Mutilation (FGM); the latter term refers to the trauma that the operation carries, particularly in the most extreme cases of infibulation. The term, however, is disputed for not representing the experience of certain circumcised women who consent to the operation and find use in it. In the horn of Africa, where infibulation is most prevalent, female circumcision is seen as desirable in society in order to ensure an honorable status for young women and increase their chances of getting married (El Dareer, 1983; Sami, 1986). These circumcised women are referred to as “closed” to assure that they cannot engage in promiscuous sexual behavior prior to marriage.

Malaysia is one of the non-African countries where female circumcision is still performed on baby girls in a few communities; however, infant circumcision is no longer compulsory for women (Joseph and Naǧmābādī, 2006, p. 69).

One of the main rationales for female circumcision is to discourage sexual intercourse prior to marriage by toning down young girls’ sexual drive (Joseph and Naǧmābādī, 2006, p. 70). Currently, female circumcision is illegal in several African and European countries and in Canada. In the United States it is illegal to circumcise females under the age of eighteen (Federal Prohibition of Female Genital Mutilation Act of 1995. House of Representatives 941, 14 February 1995) and the US Congress mandated the Department of Health and Human Services to educate communities on the health risks of the practice. A Togolese woman was even granted political asylum in the United States on the grounds that circumcision constituted a bona fide fear of persecution (Dugger, 1996). There are now public health campaigns in many African countries that educate communities about the harm of circumcision with the goal of eradicating the practice (Gruenbaum, 1991).

Currently, female circumcision is still embraced in Egypt, Ethiopia, Somalia, the Sudan, several parts of West Africa, and in some Shāfiʿī communities in Southeast Asia, mainly in Indonesia and Malaysia. Many Muslims and non-Muslims who reside outside these areas condemn this practice mostly for humanitarian and health reasons.

Circumcision and Pre-modern Islamic Normative Tradition

In order to understand pre-modern normative traditions of circumcision in Islam it is important to look first at historical aspects of circumcision and then the legal discussions within the different schools of Islamic jurisprudence.

In both Jewish and Christian historical accounts, the circumcision of Abraham at age eighty is perceived as one of the earliest descriptions of the operation as an act of submission to God. In terms of female circumcision, neither the Jewish nor the Christian traditions mention female circumcision. Also, there is no clear reference for the practice of female circumcision in the Islamic tradition and it is less widespread geographically in the Muslim world than male circumcision (Octavia, 2014).

In Genesis 17:7, God orders Abraham to perform circumcision. In this text, God says to Abraham:

"As for you, you shall keep my covenant, you, and your offspring after you throughout their generations. This is my covenant, which you shall keep between me and you and your offspring after you: Every male among you shall be circumcised. You shall circumcise the flesh of your foreskin; and it shall be a sign of the covenant between me and you. Throughout your generations every male among you shall be circumcised when he is eight days old, including the slave born in your house and the one bought with your money from any foreigner who is not of your offspring. Both the slave born in your house and the one bought with your money must be circumcised. So shall my covenant be in your flesh an everlasting covenant. Any uncircumcised male who is not circumcised in the flesh of his foreskin shall be cut off from his people; he has broken my covenant."

Uncircumcised people are also considered in many verses of the Bible as “impure” and were even forbidden from entering a sanctuary, or even Jerusalem. In the Qurʾān, on the other hand, there is no mention of circumcision and the uncircumcised are not banished from entering religious sites. According to al-Marṣafī, a contemporary Muslim author, circumcision was a practice deeply rooted among Arabs who inherited it from Abraham as well, similarly to Jews and Christians (1994). Even though the uncircumcised were not clearly condemned in Islamic religious texts, Muslims still regarded the uncircumcised negatively and considered them impure. Al-Marṣafī also added that Arabs were called “the nation of circumcision” and gave the following legend reported by al-Bukhārī:

While Heraclius was visiting Ilya (Jerusalem), he got up in the morning with a sad mood. Some of his priests asked him why he was in a sad mood. Heraclius was a foreteller and an astrologer. He replied: At night when I looked at the stars, I saw that the leader of those who practice circumcision had appeared. Who are they who practice circumcision? The people replied: Except the Jews, nobody practices circumcision, so you should not be afraid of them. Just issue orders to kill every Jew present in the country. While they were discussing it, a messenger sent by the king of Ghassan to convey the news of God’s Apostle to Heraclius was brought in. Having heard the news, Heraclius ordered the people to go and see whether the messenger of Ghassan was circumcised. The people, after seeing him, told Heraclius that he was circumcised. Heraclius then asked him about the Arabs. The messenger replied, Arabs also practice circumcision. After hearing that, Heraclius remarked that sovereignty of the Arabs had appeared.

For juristic discourses, the Ḥanafī tradition, for instance, presents male circumcision as Sunnah and fiṭrah. For women, on the other hand, circumcision is makrumah. The term makrumah refers to a noble deed, meaning that circumcision is a preferable ritual (shaʿīrah) but it is not obligatory from a religious point of view. The eighth-century jurist al-Shāfiʿī considered the practice of circumcision an equal duty for both sexes, while Mālik ibn Anas considered it Sunnah for males. For Ibn Ḥanbal, circumcision for men is more important than for women, as the foreskin represents a clear problem for hygiene. Ibn Ḥanbal also prescribed circumcision for converts who were old, saying that Abraham was circumcised when he was eighty years old.

Concerning female circumcision, a notable ḥadīth reads: “If the two circumcised membranes meet, complete body ablution (ghusl) is necessary.” This ḥadīth is interpreted as meaning that both male and female circumcisions were practiced in Islam. It is also reported that the Prophet Muḥammad said to the female circumciser to cut very slightly and not exaggerate, as it was preferable for the husband and better for the face (El Saadawi, 2007).

Circumcision and Modern Islamic Normative Tradition

One case against the practice of circumcision in the Islamic tradition is the argument present in many verses of the Qurʾān that the creation of God is perfect, and that God did not create things without a purpose (Abu-Sahlieh, 1999).

The Qurʾān Alone, or Qurʾānists (Qurʾaniyyun) movement, rejects making male circumcision a religious requirement due to the fact that it is not mentioned in any verse of the Qurʾān and that the Qurʾān stresses the perfection of God’s creation, such as in surah al-Sajdah:

"That is the Knower of the unseen and the witnessed, the Exalted in Might, the Merciful, Who perfected everything which He created and began the creation of man from clay."

(31:20)

Surah al-Nisāʾ also contains a warning to those who follow Satan’s commands to change God’s creation, which is forbidden. According to this argument, circumcision becomes contrary to the rules of the Qurʾān, and some Qurʾānists claim that circumcision is forbidden (ḥarām), such as Canadian Muslim activist Arif Bhimji, Libyan judge Muṣṭafā Kamāl al-Mahdāwī, and Egyptian feminist Nawal El Saadawi, who links it with her own struggle against FGM (Denniston, Mansfield Hodges, and Fayre Milos, 2007).

Egyptian Islamic scholar al-Qaraḍāwī leaves the choice of circumcision to parents according to their beliefs, in spite of the fact that he favors female circumcision on the grounds that it protects girls’ morality against Western influence in Muslim societies (1987). According to medical historian David Gollaher, there is also a correlation between female circumcision and the hashish plague in Egypt. He cites the work of Hamid al-Ghawabi, who claims that female circumcision reduces the sexual instinct in women, which is necessary to cope with the declining male sexual instinct with age. Therefore, a circumcised wife will then be at the same libido level as her aging husband and this will avoid him having to use drugs to satisfy her needs (2001).

Opponents of female circumcision use the reverse argument. For instance, El-Masry states that female circumcision distorts sexual relations between a husband and his wife because it will be harder for him to bring a circumcised woman to orgasm, as she can lose her capacity for pleasure, which can harm the marriage relationship (1962). The husband, then, may resort to the use of hashish and other narcotics to satisfy his wife sexually.

In 1996 in Egypt, a ministerial decree forbade female circumcision; however, a group of gynecologists successfully petitioned the administrative court of Cairo requesting that the minister’s decree be suspended and annulled based on three arguments: 1) the decree contradicted the principle that Shariʿah law is a main source of legislation in the Egyptian constitution; 2) the consensus among Muslim jurists supported the legitimacy of female circumcision; 3) the government does not have the power to modify a clause of the Qurʾān or a prophetic Sunnah (Dupret, 2013). The court’s decision to cancel the decree was based on evaluating the claimant’s right to act selflessly, the minister’s power to sanction customs that are justified with reference to Shariʿah law, and the right to physical integrity (Bälz, 1998). This legal case also showed that some social actors can use the judiciary and Islamic references in Egyptian law to enforce a constraining definition of Islam and of morality; this can allow the state, through government institutions, to further control and codify human bodies (Dupret, 2013). The Egyptian Supreme Administrative Court eventually overruled the first instance administrative ruling and declared the minister’s decree valid in 2008.

In Indonesia, there was a similar attempt to criminalize female circumcision; however, Indonesia’s Ulema Council (Majelis Ulama Indonesia - MUI) issued a fatwa in 2013 to reintroduce the practice as a fiṭrah in concordance with Islamic law (Octavia, 2014).

Conclusion

Currently, male circumcision is practiced almost universally in Muslim-majority countries and often in clinics or hospitals at the time of birth. Female circumcision, on the other hand, is less common and is still often practiced outside medical institutions. Although in the modern age circumcision is mostly practiced on newborns or young children, there are still significant variations with regard to the time of the circumcision depending on different local traditions. The ritual of circumcision may also come with a feast and celebrations that also depend on local traditions. In the case of male circumcision, the foreskin is considered in some Muslim communities to bring luck to the boy, his mother, and, in some cases, other expectant mothers.

Within Islamic tradition, female circumcision is not as clearly recommended as male circumcision, which raises a greater debate about its legitimacy as a religious practice. Moreover, several activists use the term FGM to condemn a practice contrary to human rights and a violation to the integrity of the human body, particularly due to its harming effects on the body. The rejection of male and female circumcision also represents a relatively new trend in Islamic society even if the practice of changing one’s body (through circumcision) seems incompatible with accepting the perfection of God’s creation present in the Qurʾān.

Contemporary Muslim scholars such as al-Zuḥaylī, a Syrian jurist, and al-Ḥāʾirī, an Iranian author, continue to consider female circumcision a makrumah, although their countries do not practice female circumcision. An important argument in favor of female circumcision is the chastity argument, which would increase a young girl’s chances of getting married.

Concerning male circumcision, it is often seen as a religious obligation and useful for health reasons to prevent numerous illnesses. Also, several texts in the Jewish and Islamic traditions emphasize male circumcision as an act of submission to God’s orders. On the other hand, several international organizations such as the United Nations and the World Health Organization (WHO) state that female circumcision is a violation of human rights (Octavia, 2014).

In both types of circumcision, the laws and regulations found in different Muslim-majority countries inform the rules of sexual morality in these societies. Whether it is defying rules or abiding by them, the choice is not an objective statement but a particular point of view often influenced by law and the judiciary (Dupret, 2002).

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