Dear Science,

The Economist recently ran an article about female circumcision. What are your thoughts on this, especially in comparison with male circumcision? Personally, I feel they are both brutal acts. I understand that male circumcision may reduce the HIV rate in Africa, but I still feel that in the long run, circumcision as a practice is best lost to history.


Female circumcision encompasses a broad spectrum of practices worldwide. Diligent anthropologists have cataloged them. Female genital cutting (FGC) comes in four broad forms: Type I involves cutting off the clitoral hood (prepuce); type II removes the entire clitoris (and typically a part of the labia minora); type III removes all of the external genitalia, leaving only a small slit; type IV is basically everything else (piercing, stretching, burning). Of this list, the closest approximation to male circumcision is type I; the female prepuce is derived from the same primitive tissues in the embryo as the male foreskin. The procedure is almost never done by a physician and typically done without anesthesia, sometime between the ages of 5 and 12.

As you might expect, type II and III female genital cuttings have the most severe potential long-term consequences, including pain during menstruation and sex. The urethra can be damaged—causing problems with urination and increasing the risk of infection. Scars and abscesses can form. New tunnels between the cut and the urinary and reproductive systems can form, causing all manner of problems. Monitoring childbirth can be next to impossible after a type III procedure, and delivery of a baby can be more painful and dangerous.

You want an opinion of this practice. Science would look to the women who have undergone FGC. A few scientifically rigorous surveys exist, asking if the women who have had one of these procedures would want it for themselves in retrospect (or for their children). One study of Egyptian women (97 percent of whom have undergone female genital cutting) demonstrated that 89 percent of women who had FGC would have their female children cut. Education, urban rather than rural life, and a lack of religious belief in the practice all put women into the 11 percent who did not wish to continue the practice. The health and medical consequences seem extreme, and there is a paucity of demonstrated benefits to the practice. From a scientific perspective (avoiding all cultural considerations), female genital cutting is difficult to justify.

In contrast, male circumcision has a lengthy list of demonstrated health benefits—lower HIV infection rates, lower penile cancer rates, lower urinary-tract infection rates, less cervical cancer in the sex partners of circumcised men, less infections of the penis head (balanitis), and lower rates of sexually transmitted infections. The biggest risks are cosmetic changes, with perhaps some reduction in sensitivity of the head of the penis. In comparison to female genital cutting, male circumcision is vastly safer and has far more demonstrated benefit.

Circumspectively Yours,


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