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The religious tradition of male circumcision has come increasingly under attack across a number of European states. While critics of the practice argue that the problem is about children’s rights and the proper relationship between secular and religious traditions, Jews tend to see these attacks within the longer history of attempts to assimilate and remake them according to the norms of the majority. Using the 2012 German legal controversy concerning the issue as my vantage point, I explore how contemporary criticism of male circumcision remains entangled with ambivalence toward Judaism and the Jews as the “other.” Through a close reading of the arguments, I show how opponents use the seemingly neutral language of universal human rights to (re)make Jewish difference according to the norms of the majority. I conclude by arguing that such an approach to this issue runs the risk of turning Jews once again into strangers at a time when cultural anxieties are troubling European societies.

Purpose – This chapter sketches the major historical shifts in American circumcision discourse and examines the sociopolitics of those shifts.

Methodology/approach – The chapter centers on a critical analysis of competing narratives and knowledge claims about circumcision. It re-examines these narratives and claims, most of which are packaged in a rhetoric of health, specifically for their political valence.

Findings – The medical necessity of circumcision in the United States cannot be ascertained without attending to the disciplinary systems designed to produce and maintain religious, sexual and other cultural norms.

Contribution to the field – The chapter provides a clear and focused synthesis of many different literatures and contentions about circumcision that have yet to be brought together into a single narrative accessible for students and scholars of the medical humanities and medical politics.

Complex inequalities have shaped the trajectory of the HIV epidemic in South Africa. These include factors related to gender disempowerment, poverty, family disruption and violence – all of which have intensified the risk of HIV infection among the majority of South Africans, contributing to one of the most severe country-level HIV epidemics globally. Neo-liberal economic policies adopted in the post-apartheid period failed to address poverty and burgeoning urban migration – both of which were key factors exacerbating vulnerability to HIV. While there was, ostensibly, a strong commitment to addressing the HIV epidemic by the post-apartheid government, HIV prevalence among pregnant women quadrupled from 7.6% in 1994 to 30.2% in 2005. Contributing to this rise, was a series of missteps by the national Department of Health in the late 1990s, which constrained HIV prevention efforts and stifled HIV treatment. The mid-2000s saw a reprioritisation of the response to the epidemic, with international guidelines supported by biomedical and social research underpinning a rights- and evidence-based response. Multisectoral HIV prevention activities were complemented by high levels of investment in implementing prevention of mother to child HIV transmission and expanding access to antiretroviral therapy (ART) for HIV through the public sector. While these efforts contributed to stabilising the epidemic, stark inequalities in vulnerability and susceptibility to HIV infection continued – in particular, among youth. In this chapter, we draw on a review of the research literature to describe concerns and explore opportunities for a response.

The question of ethics has accompanied all discussion of male circumcision and HIV: How can trials be run ethically? How could circumcision be promoted and provided ethically? Is it ethical to provide medical circumcision and payment to under-resourced test subjects? Would it be ethical to not do so? Two comprehensive and widely read papers (“Circumcision and HIV prevention research: An ethical analysis,” Lancet, 2006, and “The first randomised trial of male circumcision for preventing HIV: What were the ethical issues?,” PLoS Medicine, 2005) addressed the ethical issues of these investigations from the perspective of scientific liability, and many of the opponents of male circumcision, for this or other reasons, call their viewpoint a human rights matter. In this paper, I draw from social science and from the harm reduction movement to propose an ethic of wellness, built on causing the least harm and contributing to the most knowledge. This approach to the ethical question is linked to, but distinct from and sometimes at odds with, the traditional canon of medical ethics or bioethics.

Ritual female genital practices, widespread throughout Africa, are essential to gender identification and often are a pre-requisite for marriage. More severe forms of the practice, which are common in parts of Northeastern Africa, are also believed to enhance a woman’s childbearing capacity. Here, we critically review the gender- and class-based theories that explain the origins and persistence of female genital practices and the factors that precipitate social change. We also critically review evidence of the association of certain forms of the practice with various health, demographic, and social consequences. Our review exposes several methodological limitations of existing research that preclude population-based inferences about the medical and social implications of these practices and suggest that existing policies targeting such practices draw more on concerns over human rights than on scientific evidence about their sequelae. This review nevertheless exposes a potential contradiction between local justifications for and consequences of certain forms of the practice. Namely, despite an intended function of female genital practices to enhance a woman’s marital capital, certain forms may ironically lead to marital instability and dissolution through their negative effects on the health and reproductive capacity of women. We conclude with recommendations for research to examine the salience and implications of this potential paradox for women in Northeastern Africa.

For decades, researchers studying female genital cutting have sought to understand why the practice continues amidst abundant evidence indicating that serious health consequences can result from the more aggressive forms of cutting. Behavioral ecology theory is applied to data collected among Ghana’s Kassena-Nankana to highlight the gendered cultural forces that keep FGC practice in place through successful reproductive outcomes. With its strong association to marriageability, and thus women’s status and access to resources through marriage, circumcision has long been obligatory. However, the social transformation that is currently underway in this rural population is bringing a new perspective to the value of education, which is replacing circumcision as the resource access currency.

The medical suppression of female sexuality in Victorian society has long been the subject of historical and cultural scholarship, with documentation not only of textual threats by religious and medical “experts,” but also of surgical assaults on female reproductive systems (Longo, 1979, 1986; Scull & Favreau, 1986; Sheehan, 1997). Less well known is the apparent obverse: the use of medical techniques to stimulate the female genitalia as a means of treating hysteria and other mental disorders (Maines, 1999; Schleiner, 1995). In this paper, I trace the cultural history (mainly Anglo-American) of the psychiatric enhancement, as well as repression, of female sexual pleasure, through various genital treatments, including the surgical and the electrical.¹ I then make the case that these “opposite” treatments are, in the context of Victorian society, two sides of the same coin of the patriarchal, medical control of female sexuality.²

Because discussions of bioethical decision making often take place around specific cases that highlight the individual, the ethical issues these instances bring to the fore are often framed as problems of a deeply personal – and hence individual – nature. While the decisions of ethical bodies located at the intersection of the individual and the biomedical establishment have ramifications at the level of the individual, often constructed as a patient, discussions of bioethics directly inform policy in ways that affect large numbers of people – both as participants in the discussions around issues defined as bioethical in nature and as recipients of policies meant to reflect prevailing bioethical norms.

Support for child rights is widespread, and the 1989 Convention on the Rights of the Child is the most widely ratified treaty ever. Surprisingly, however, we find that child rights discourse is not integrated as a core element of mobilization around either the eradication of female genital cutting practices or the provision of free primary education. Analyzing history and the content of child rights claims related to these issues, we unpack this puzzle. In the process, we illuminate the constraints on mobilizing strategies in general and some difficulties inherent in using child rights discourse in particular.