Children's Rights - Human Rights Joint Committee Contents

Memorandum submitted by NORM UK

  I am a trustee for the registered charity NORM-UK, number 1072831, and would wish to draw the committee's attention to the following infringements of the human rights of young males.

The NHS discriminates against the male children of religious minorities by carrying out traditional practices prejudicial to the health of such children, thereby subjecting them to inappropriate medical intervention. The European Charter for Children in Hospital, to which Great Britain is a signatory, states at: 5) "Every child shall be protected from unnecessary medical treatment and investigation". We would argue that removal of a normal un-diseased part from a normal un-consenting child is a breach of the child's absolute right to freedom from cruel, inhuman or degrading treatment or punishment, (ECHR 3). Neonatal circumcision is a painful operation; the release of stress hormones indicates "pain consistent with torture".[419] We further argue that it is a breach of child's right to liberty and security of person, (ECHR 5). We note that these rights, ECHR 3 and 5, are in conflict with the qualified right to manifest religious belief conferred by ECHR 9 (2). However, it is moreover a breach of the child's right to autonomy: the freedom to make informed choices about his own life.

  In the light of modern evidence it is no longer acceptable to maintain that male circumcision is a trivial operation. Circumcision removes important erogenous tissue, which always includes the ridged band[420] which is now known to be the most sensitive area on the penis.[421] Circumcision is an irreversible act, which has life-long consequences. It is a fact that no man circumcised as a child will ever know what the sex act is supposed to feel like, he quite simply will not be equipped to do so. There are research studies of men circumcised as adults, for a variety of reasons and these studies show that there is a statistically significant decrease in penile sensation—research has also shown that circumcision may be associated with a risk of premature ejaculation and erectile difficulties. Fink et al in their 2002 study discussing the retrospective nature of their research made the point that: "if circumcision was supposed to correct the problem then we would have expected entirely favourable outcomes. Instead we found worsened erectile function and decreased penile sensitivity".[422] In 2005 the study by Masood et al noted that "the poor outcome of circumcision considered by overall satisfaction rates suggests that when we circumcise men, these outcome data should be discussed during the informed consent process".[423] There are more studies of a similar nature and we would draw the committee's attention to the following examples: Solinis, A Yiannaki. Does circumcision improve couple's sexual life?;[424] Pang MG, Kim DS Extraordinarily high rates of male circumcision in South Korea: history and underlying causes[425] and Coursey JW, Morey AF, McAninch JW, Summerton DJ, Secrest C, White P, Miller K, Pieczonka C, Hochberg D, Armenakas N Erectile function after anterior urethroplasty.[426]

  There is not one national medical organisation that recommends non-therapeutic male circumcision, there being no compelling medical reason to routinely amputate this normal tissue. The lawfulness of non-therapeutic male circumcision has never been tested in the criminal courts and the only legal authorities on non-therapeutic male circumcision are in family cases and are obiter dicta, being a judge's opinion on an inessential issue and therefore without binding authority. It is strongly arguable that as non-therapeutic male circumcision cuts through the full thickness of the skin it is a "wounding" under the Offences Against the Person Act 1861. It is at the very least an assault occasioning actual bodily harm. The Children and Young Persons Act 1933 specifically prohibits, as cruelty, assaults on those under 16 by a person with responsibility for that child.

  Any defence that non-therapeutic male circumcision is valid or necessary surgery implies that there is disease present and that the surgery is an effective, appropriate and proportionate treatment for the disease. This is clearly not the case for non-therapeutic male circumcision. An adult can make an informed choice about elective surgery but no one would for a moment argue that one adult should be able to opt for elective surgery on another's behalf, so we should extend the same protection to children, who cannot make an informed choice. To carry out non-therapeutic male circumcision on un-consenting children in a safe medical setting thus avoiding the risks involved of the practice being carried out by lay practitioners and in un-sterile conditions is really a sad admission that we cannot protect children in our society and that the best we can offer is to abuse the child in question as safely as possible. Even this carries risks. In infancy the foreskin is naturally fused to the glans, the mean age for the natural separation of foreskin from the glans is 10.4 years, this means that the removal of tissue from an undeveloped organ is at the very best only guesswork. Non-therapeutic male circumcision carries it's own risks—one of the most comprehensive reviews of the studies of circumcision complications put the risk of significant complications in the range of 2% to 10%.[427] This does not include the child's experience of pain—for example The British Association of Paediatric Surgeons latest circumcision advice (2007) states that discomfort lasting longer than seven days occurs in more than one in four circumcision subjects.

  The mental health charity Mind recognises circumcision as a physical cause of mental illness in males "The physical and sexual loss resulting from circumcision is gaining recognition, and some men have strong feelings of dissatisfaction about being circumcised. Studies of the practice of circumcision often describe it as `traumatic'. Research suggests that some boys, and some men, may experience PTSD as a result of circumcision".[428] Our charity, NORM-UK, has received more than a thousand un-solicited letters from men psychologically damaged by non-therapeutic male circumcision.

  To have a law that protects only one gender (Female Genital Mutilation Act 2003) is discriminatory. There are many varieties of female genital mutilation some of which are less harmful than male circumcision, even a tiny cut and no ablation of tissue is illegal on a female unless it is necessary for her physical or mental health. The Act makes it clear at s.1(5) that "for the purpose of determining whether the operation is necessary for the mental health of a girl it is immaterial whether she or any other person believes that the operation is required as a matter of custom or ritual". This is not an issue of competitive suffering; anyone who has anything amputated without their informed consent and for no good medical reason is arguably the victim of an assault. This is an issue of child protection, or rather, our collective failure to provide it. As long as we do not protect boys as well as girls from unnecessary genital surgery we are guilty of discriminating against boys and the men they will become.

  In UK domestic law the concept of "parental responsibility" for children has replaced the concept of "parental rights" (Children Act 1989). This change is compatible with the principles of the Human Rights Act 1998 and has been tested in Gillick vs Wibech which notes that parents have a duty to protect and nurture the child rather than having dominion over it. Parental responsibility means acting towards your child in a way which is consistent with the child's best interests. If a parent acts in a way which causes or is likely to cause the child significant harm the state has a right and duty to make arrangements to ensure that the child's welfare is protected (Children Act 1989 S31). Where there is conflict between the right of the child not to be harmed and the parental rights to respect for family life or religious freedom, for example, it is the child's rights which will, in law, prevail. The physical and psychological harm caused or likely to be caused by non-therapeutic male circumcision plainly falls into the category of significant harm. Male circumcision involves the removal of significant tissue from the male genitalia removing with it sensory, mechanical and immunological functions. The United Kingdom does not tolerate any other form of bodily modifications to children such as tattoos or facial scarring and it is surprising that child protection professionals, prosecuting authorities and the courts do not intervene to protect a male child from unnecessary genital surgery requested by carers or parents when they rightly intervene to protect a female child.

  The NHS is denying children their absolute ECHR rights and is discriminating against the children of religious minorities by providing a circumcision service to satisfy the wishes of parents. An inequality in the provision of health care is created by allowing children born into some communities to lose their bodily integrity while others can—and should—retain theirs. Children are not born for example as a "Christian child" they are born as a "child of Christian parents". This is an important distinction; adults are only too vociferous in articulating their rights to "freedom of thought conscience and religion" Article 9 (Human Rights Act 1998). Non- therapeutic male circumcision contravenes Article 3 "No one shall be subjected to torture or to inhuman or degrading treatment". Unnecessary genital surgery is at the very least degrading as it permanently alters the form and function of an important body part.

  To use an adult's qualified right (Article 9) to override a child's absolute right (Article 3) fails to honour or respect the child's rights.

  The state has a special duty of care towards children who cannot enforce their own rights. The UN Convention on the Rights of the Child provides in Article 2:

    1. States Parties shall respect and ensure the rights set forth in the present Convention to each child within their jurisdiction without discrimination of any kind, irrespective of the child's or his or her parent's or legal guardian's race, colour, sex, language, religion, political or other opinion, national, ethnic or social origin, property, disability, birth or other status.

    2. States Parties shall take all appropriate measures to ensure that the child is protected against all forms of discrimination or punishment on the basis of the status, activities, expressed opinions, or beliefs of the child's parents, legal guardians, or family members.

  Importantly, the Convention also provides that:

    "States Parties shall take all effective and appropriate measures with a view to abolishing traditional practices prejudicial to the health of children" (Article 24.3).

  All children are born with a full set of Human Rights and we will be harshly judged by future generations if we fail to protect our children whatever their sex, religion or creed.

February 2009

419   Ref: Fleiss P M, Warren J P, Circumcision (letters), The Lancet, 1995; 345:927. Back

420   Taylor J R, Lockwood A P, Taylor A J, The prepuce: specialized mucosa of the penis and its loss to circumcision. Br J Urol 1996; 77: 291-5. Back

421   Sorrells M L, Snyder J L, Reiss M D, et al, Fine-touch pressure thresholds in the adult penis. BJU Int 2007;99:864-9. Back

422   Fink K S, Carson C C, DeVellis R F, Adult Circumcision Outcomes Study: Effect on Erectile Function, Penile Sensitivity, Sexual Activity and Satisfaction, J Urol, 2002; 167(5):2113-6, Fink K S. Back

423   Penile Sensitivity and Sexual Satisfaction after Circumcision: Are We Informing Men Correctly? S Masood, H R H Patel, R C Himpson, J H Palmer, G R Mufti, M K M Sheriff. Back

424   I Solinis, A Yiannaki, Does circumcision improve couple's sexual life? J Mens Health Gend 2007; 4(3):361. Back

425   Pang M G, Kim D S, Extraordinarily high rates of male circumcision in South Korea: history and underlying causes, BJU Int. 2001; 89(1):48-54. Back

426   Coursey J W, Morey A F, McAninch J W, Summerton D J, Secrest C, White P, Miller K, Pieczonka C, Hochberg D, Armenakas N, Erectile function after anterior urethroplasty, J Urol 2001; 166(6):2273-6. Back

427   Williams and Kapila, 1993. Back

428 Back

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Prepared 20 November 2009