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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 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.
a) 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."
b) 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."
c) 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.
d) 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.
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Last updated: 28 February, 2012
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