Medically unnecessary genital cutting and the child’s right to bodily integrity: an international expert consensus statement

In American Journal of Bioethics Vol. 19 (2019).

Keeping our focus exclusively on a Western context for the purposes of this article, we argue as follows: Under most conditions, cutting any person’s genitals without their informed consent is a serious violation of their right to bodily integrity. As such, it is morally impermissible unless the person is nonautonomous (incapable of consent) and the cutting is medically necessary.

This paper is authored by the Brussels Collaboration on Bodily Integrity (2019).

This work grew out of informal discussions among participants in the G3 International Experts Meeting on FGM/C in Brussels, Belgium, May 20-22, 2019, along with other scholarly collaborators. We are physicians, ethicists, nurse-midwives, public health professionals, legal scholars, political scientists, anthropologists, psychologists, sociologists, philosophers, and feminists from Africa, Asia, Australasia, Europe, the Middle East, and the Americas with interdisciplinary expertise in child genital cutting practices across a wide range of cultural contexts. 

You can read the paper here.

Corresponding author: Brian D. Earp, Associate Director, Yale-Hastings Program in Ethics and Health Policy, Yale University and The Hastings Center, 2 Hillhouse Avenue, New Haven, CT, 06511, USA. E-mail: brian.earp@gmail.co

Blending in and standing out: comfort and visibility in beauty practices

“My thought is this: a significant aspect of beauty practices is comfort and visibility. Comfort relates to discipline: discipline makes some actions and inactions seem comfortable and others effortful. Visibility relates to surveillance: some beauty practices make us seem visible or hyper-visible, others make us feel invisible. Sometimes beauty practices aim at making the practitioner visible: she wants her appearance to be noticeable. But beauty practices can also aim at invisibility: at making a person blend in rather than stand out. Both make up and its absence can have this effect, depending on the person and context involved.”

This short piece is published on the Beauty Demands blog. You can read it here.

Reasonable Disagreement and the Neutralist Dilemma

Chambers, Clare, “Reasonable Disagreement and the Neutralist Dilemma: Abortion and circumcision in Matthew Kramer’s Liberalism with Excellence” in The American Journal of Jurisprudence (May 2018).

You can read the paper here.

Abstract: This paper starts by investigating the idea of reasonable disagreement. It then considers Matthew Kramer’s argument that there is no neutral solution available to the disagreement over abortion. The paper argues that Kramer’s account has wider application, and identifies a neutralist dilemma. The neutralist dilemma applies when, of two policy options available to the state, one is unreasonable. It follows that the state should enact only the reasonable policy. However, in a neutralist dilemma the fact of reasonable disagreement due to the burdens of judgment means that it is not possible for the state to act at all, whether legislating or not, without deviating from neutrality. The paper develops the concept of the neutralist dilemma and then applies it to another case discussed by Kramer: infant circumcision. The paper argues that the debate over infant circumcision can be framed as a neutralist dilemma, but that the most plausible resolution of the dilemma results in an argument in favor of the legal prohibition of the practice. This is a surprising result, since most liberal states do not restrict circumcision and since prohibition of circumcision might initially appear to be non-neutral or even illiberal; however it is consistent with the tenets of neutralist liberalism.

Cosmetic procedures: ethical issues

Nuffield Council on Bioethics, 2017

This report was written by the Working Party on Cosmetic Procedures, of which I am a member.

There has been increasing demand for invasive cosmetic procedures in the UK, prompting questions about potential risks to users and the lack of regulation and professional standards in this area. This report explores ethical issues in cosmetic procedures with a particular focus on the role and responsibilities of health and scientific professionals and others in responding to demand for invasive non-reconstructive procedures that aim to enhance or normalise appearance. It engages in detailed ethical analysis and makes recommendations affecting all parts of the sector.

You can read the report here.

 

INTACT: The Unmodified Body

I am currently writing a book titled Intact: The Unmodified Body, to be published by Allen Lane.

Intact will investigate the philosophical and political significance of leaving the body unmodified, in the context of ever-increasing practices of modification. Philosophically, it will investigate concepts such as the natural body, wholeness and purity, bodily integrity, and the body as canvas. Politically, it will engage with the political significance of modification and its refusal or prohibition, including whether there are grounds for proscribing or regulating some forms of modification in the name of protecting the unmodified body.

Intact will show that leaving one’s body unmodified is a politically significant act. The pressures to modify are so intense that having a completely unmodified body is virtually impossible. We face overwhelming pressure to change our bodies: to conceal the realities of ageing, to disguise the distinctive features of disability and disfigurement, to perfect our complexion or our waistline or our muscle tone. In this context, refusing even some practices of modification can be an act of rebellion.

At the same time, the concept of the unmodified body is extremely hard to grasp: so hard, in fact, that we might conclude that the unmodified body is a fiction. Does a defence of the unmodified body idealise the impossible? An attempt to give substance to the idea of the unmodified body produces a number of imperfect proxies. Intact discusses three such proxies: the natural body, the normal body, and the sexed body. Intact aims to find a way to defend the unmodified body without fetishizing it. Along the way, I investigate practices as diverse as reconstructive surgery, anti-ageing treatments, and bodybuilding.

Medicalised Genital Cutting and the Limits of Choice

in Female Genital Cosmetic Surgery: Interdisciplinary Analysis and Solution, edited by Sarah Creighton and Lih-Mei Lao (Cambridge University Press, 2019).

In this chapter I challenge the idea that an appeal to choice exonerates Female Genital Cosmetic Surgery (FGCS). My argument proceeds in five stages. First, I consider the normative role that choice plays in liberal society and philosophy. Second, I note that UK law does not treat choice as adequate for accessing FGCS. Third, I consider the relationship between choice and the concept of normality. Fourth, I consider choice in the context of cosmetic surgery generally, and analyse the distinctive features of FGCS. Fifth, I consider the policy implications of my analysis.

You can find the book here.

Judging Women: 25 Years Further Toward a Feminist Theory of the State

Feminist Political Quarterly (Vol. 3 No. 2, 2017).

The title of this paper is “Judging Women”, a phrase that can be understood in three senses. First, when is it acceptable or necessary to make judgements about what women do? Feminists may be wary of subjecting women’s choices and actions to criticism, but the paper argues that such criticism is implied by a feminist perspective on patriarchy, a perspective which is necessarily critical. Second, when can women engage in the act of judging? The paper argues that being judgmental is popularly considered a vice, but only when done by women. Feminism should insist on women’s right to judge. Third, how are we to judge who counts as a woman? The paper investigates the commonalities and contrasts between feminism and trans issues, and discusses the concepts of essentialism and transphobia. The focus throughout is on MacKinnon’s work, which offers profound, sustained, rich analysis of these questions but does not fully resolve them.

You can read the paper here.

Genital Autonomy Conference

cir_genitalintegrity_internlsymbolI had a profoundly moving and informative time listening and speaking at the Genital Autonomy 14th Annual Symposium on Changing Global Perceptions: Child Protection & Bodily Autonomy. The Symposium was at Keele University on 14-16 September 2016. You can find details of the Symposium here. My talk was titled “Cultural v. Cosmetic v. Clinical Surgery: Challenging the Distinction.”

There is a general consensus in liberal theory, practice, and law that female genital mutilation (FGM) is a violation of rights and justice that should be banned. However, there is no such consensus about male circumcision or cosmetic surgery, including labiaplasty. These practices are legal in most liberal states and there is no general critique of them in mainstream liberal theory. This talk will consider the philosophical reasons in favour of distinguishing FGM from male circumcision and labiaplasty, and find them wanting. Both cosmetic and clinical surgeries are fundamentally cultural. I argue that male circumcision and cosmetic surgery should be regulated in the same way as FGM – which means, among other things, much stricter regulations on when such surgeries can be performed on children.

Nuffield Council on Bioethics Working Party on Cosmetic Procedures

nuffieldI am a member of the Nuffield Council on Bioethics Working Party on Cosmetic Procedures. You can find more about the project, including the other members, here.

Invasive cosmetic procedures are becoming increasingly popular and accessible in the UK, prompting questions about potential risks to users and the lack of regulation and professional standards in this area.

This project will explore ethical issues in cosmetic procedures with a particular focus on the role and responsibilities of health and scientific professionals and others in responding to demand for invasive non-reconstructive procedures that aim to enhance or normalise appearance.

Autonomy and equality in cultural perspective: Response to Sawitri Saharso

home_cover-2Feminist Theory Vol. 5 No. 3 (December 2004).

This paper criticises Sawitri Saharso’s argument that hymen repair surgery and sex-selective abortion can be both multiculturalist and feminist policies.

You can read the paper here.