The RACP has updated its position on circumcision
Spoiler alert: It isn’t good
Twelve years after its last position on male circumcision, the Royal Australasian College of Physicians (RACP) has quietly released an update over the summer holidays.
The new position statement comes one year after the death of a young boy in Perth following circumcision complications. His younger brother, cut at the same time, was also left in a critical condition but thankfully survived.
Like the old position, the new one states that the RACP “believes that the frequency of diseases modifiable by circumcision, the level of protection offered by circumcision and the complication rates of circumcision do not warrant routine infant circumcision in Australia or Aotearoa New Zealand.”
Unfortunately that is where the good news ends.
Misplaced respect for parental choice
The RACP states, without adequate explanation, that parental choice to circumcise should be respected. But why? There are many decisions parents rightly get to make for their children. Deciding how much of their bodies they get to keep should not be one of them.
The fact is there are already limits to parents’ ability to make medical decisions for their children. The wishes of parents who seek to deny children life-saving medical treatment (which occurs sometimes based on their religious views) are disregarded. And special medical procedures like sterilisation require court approval to be performed on children because they are “invasive, irreversible and major surgery”. This legal precedent was set by Marion’s case in the High Court of Australia in 1992.
The case related to the sterilisation of an intellectually disabled young girl, with the Court also noting that there is a significant risk of making a “wrong decision” about both the child’s present or future capacity to consent. But when it comes to the non-consensual circumcision of children there is no such risk unless they are also intellectually disabled — most will grow up with the capacity to make the circumcision decision. The problem is many are simply not given the chance to grow up and decide for themselves whether or not they want their foreskin amputated.
No respect for individual autonomy
We know that when given the choice most opt not to circumcise. What’s more, we know many men are unhappy with the fact they were circumcised when they were too young to consent to it. They report feelings of violation, anger, distrust of medical professionals, and even envy of intact men.
The RACP might not want to acknowledge it, but the fact is amputating the foreskin is invasive, irreversible, and in the absence of medical necessity it is a major cosmetic surgery by definition under the Medical Board of Australia’s Guidelines for Registered Medical Practitioners who Perform Cosmetic Medical and Surgical Procedures. The Guidelines assume individuals provide their own informed consent for cosmetic procedures — clearly this isn’t occurring in the case of children who are circumcised.
Children are people, not property. How is it okay for parents to subject their children to unnecessary, harmful cosmetic surgery, and why would any medical doctor perform it?
If parents were asking doctors to amputate their young boys’ earlobes, would the RACP also tell us to respect that? Earlobes actually are useless flaps of skin, but despite the common misconception the foreskin is not — it is highly specialised tissue with a range of protective and sexual functions that the RACP statement fails to mention.
No understanding of basic anatomy
Perhaps the functions of the foreskin are not mentioned by the authors of the RACP’s position on circumcision because they don’t understand penile anatomy.
They define the head of the penis (or glans) as “the sensitive tip of the penis”. Wrong. The glans is one of the least sensitive parts of the male body. That is why the threshold for touch in the glans is actually the pain threshold.
The foreskin is the most sensitive part of the penis, and indeed the most sensitive part of the male body. It contains an abundance of corpuscular receptors that make it highly sensitive to fine touch, like the fingertips.
The foreskin is also also much more than the “thin layer of skin that covers the end of the penis” the RACP defines it as. While the outer foreskin is skin, the inner foreskin is a mucous membrane like the inside of the mouth. The foreskin also contains muscle, connective tissue, and blood vessels. And the foreskin doesn’t “cover” the end of the penis — it is the end of the penis.
Children deserve better than this
The RACP has had 12 years to put together an updated position on male circumcision — two more years than it took me to write The Final Cut: The truth about circumcision — and yet their updated position appears rushed, providing only a cursory and selective review of medical evidence.
Overall, the new RACP position on male circumcision downplays the complications, fails to understand basic anatomy, neglects to mention the functions of the foreskin, and displays a concerning lack of understanding about medical ethics and consent for medically unnecessary cosmetic procedures. It is also clear that no survivors of male genital cutting were consulted in its development, which is totally unacceptable.
It’s time for the RACP to take a stand against the non-consensual, medically unnecessary genital cutting of any child, regardless of their sex or gender. Anything less simply isn’t going to cut it.
Jonathan Meddings is the Chair of The Darbon Institute and author of The Final Cut: The truth about circumcision (Get your copy: Affiliate link)
