Friday, April 22, 2016

Circumcision: Why I Mention It


Circumcision has been in the news recently, although you probably skim over it. The Huffington Post recently did an article about it, and the New York Post did an article awhile back. Male circumcision has been claimed to have health benefits and is said to reduce the risk of STD's/STI's. However, the science and ethics of circumcision make it perfect fodder for this blog.

My Story

Circumcision has always been an odd topic for me. Growing up, I always peppered my mother with questions like why my penis had a ring around it, and I was always baffled by her answer: "Because you were circumcised as a baby." So, I asked what that was, only to get, "They removed your foreskin." And I asked what that was, and I never really understood what it meant. All I really understood was that people were healthier without it, that it is easier to clean without it.

Hindsight is always 20/20, they say, and they are right. Finally, when I was in middle school, I saw a picture of an "uncut" male, and I understood what was missing. The part that stood out to me was that the foreskin had veins and seemed to be very much a part of the rest of the penis. That is when I first started feeling loss, and that the choice was not mine. My thought at the time was that my parents had a part of my penis cut off because a doctor said it was better for me. It seemed odd.

Fast forward into high school, and I still felt that same loss, and it was the same in college. As I started getting into learning about child sexual abuse and the issues surrounding it, I was getting into ways of improving myself. I was figuring out that there were things about me that I always saw as permanent that could change. Some of them were psychological- that I could change how I thought about myself. Others were more educational- that I could learn another language, as I had always wanted to do. But one of the tie-ins was physical: That I could restore my foreskin.

Foreskin... restoration?

Yes, foreskin restoration. The process works on the same principle as those that put guages in their ears, or plates, or neck stretching: You put skin or some other body part under a mild amount of stretching/stress, and the body can be molded as desired. There are devices sold that can help accomplish this. I thought it was a great idea because it is a long process that becomes habitual over time.

Ethical Issues

I see circumcision and intactivism (the advocacy for an intact penis and against male genital mutilation, as circumcision is sometimes called) as a basic human rights issue just like child sexual abuse is. In a case of child sexual abuse, the child is subjected to behavior they are not ready to handle and do not have any control over. In a case of circumcision, the child is subjected to a surgical procedure that is usually medically unnecessary and does not have any control over. Both are human rights violations.

While the harm between the two varies, the ethical issues are very similar. Circumcision has risk of complications that in some cases cause permanent damage to the penis. The damage is physical and only partially reversible. The nerves, the mechanism that holds the foreskin to cover the glans/head of the penis, the frenulum and the function and role it has to the function of the foreskin are still lost. While the functions can be partially restored, the skin will not stay on the glans the same as if the penis had never been circumcised.

To take that away from a child without their ability to choose it is barbaric, just as it is barbaric to take a child's innocence by sexually abusing them. The idea that circumcision is done for health reasons is just a distorted justification because of the poor science that is used to support that justification (there are many other articles on the subject), similar to the reasoning that a child molester uses to justify their abuse is just a justification.

A Child Has a Right To Their Body

The bottom line with both issues is the right of the child: In circumcision, the child has a right to an intact body and to make informed decisions about their body. In the absence of medical necessity, the child is being physically altered for no reason. In child sexual abuse, the child has a right to live a trauma-free life that does not involve people crossing their boundaries. That is why prevention advocates often talk about children having the ability to set boundaries and make their own decisions. The right of the child takes priority in both issues, and the concern in both is for the child.

That is why I occasionally tweet about circumcision, and that is why I am an intactivist. I do not see how anyone could be against child sexual abuse because of the rights of the child, but be pro-circumcision and ignore the rights of the child. It does not make sense and is hypocritical to be against one form of human rights violations, but in favor of another violation. My advocacy, if nothing else, is aimed at being consistent.

Saturday, April 2, 2016

Defining Child Sexual Abuse: A Therapeutic Approach

It is always helpful to define terms, particularly when terms can be as controversial as the subject matter is. Child sexual abuse is a controversial topic because it is a broad topic. Contained in that one subject are consent laws, mandatory reporting laws, civil laws aimed at improving public safety, SORNA, residency restrictions, sex offenders, law enforcement training, and a slew of other items. Many people love to debate controversial issues.

I used to be one of those people, but on this topic, I have a generally narrower focus. I specifically avoid the legal subjects involving age of consent and mandatory reporting because those issues are never-ending. I also avoid using a legal definition of child sexual abuse, because it is overly broad. It is possible for a legal act of child sexual abuse to occur, yet have the legal victim be an enthusiastic participant in the activity, particularly among older teenagers. It is also possible for teens to send explicit images of themselves to others, and have them be legally charged with child pornography, with themselves being both the legal victim and perpetrator.

That is why I avoid legal conversations. I avoid age of consent, because no matter what number is picked, there will always be someone below that number who is mature enough to consent, and someone above that number who is not mature enough to consent. I likewise try to avoid a legal definition of child sexual abuse: No matter how diligent or understanding the police are, there will always be someone arrested for something that was not harmful to the legal victim.


I try my best to be clear that when I talk about child sexual abuse, I use a therapeutic approach. In my treatment/support group, they considered a sexual offense as an act that crossed someone's sexual boundary in a way that harmed or traumatized them. For me, the definition of child sexual abuse is tied with harm done to the victim: If there was no harm, there was no victim, if there was no victim, it was not abuse. The act is tied to sexual exploitation and the aftermath of the act: If the act was done by someone several years older than the victim, and the act was sexually exploitative, coercive, and resulted in harm, it was abusive.

So... what is a child?

In talking about perpetrators of abuse of said children, there is typically an age difference of at least a few years. For example, an 11-year-old touching the private parts of a 7-year-old would be considered child sexual abuse if the 7-year-old was harmed. Developmentally, such behavior is not expected or considered the norm. If a 7-year-old is touching the private parts of another 7-year-old, that behavior is considered normal curiosity and exploration. The key is an age difference. Many groups push for considering anyone under 18 a child, but I do not think the reality is that simple unless a therapeutic definition is used for abuse.

Practically speaking...

That is great, but how does that look practically? An adult who photographs a child when they are nude is sexually abusive if that child is harmed in the process, or afterwards by knowing the photograph is on the internet. They are not if the child is unharmed during or afterwards (still illegal). Someone several years older who touches a child's private parts are sexually abusive if the child is uncomfortable with it, and are harmed by it. They are not abusive if the child is unharmed and okay with it (still illegal). Someone who, as a 19-year-old, has sex with their 15-year-old lover, is sexually abusive if the 15-year-old was harmed and did not consent to the act. They are not abusive if the teen was unharmed and consented (still illegal in the US). A lewd conversation between an adult and a child, if the child was harmed, it was abusive (legal unless solicitation was involved).

Those are just a few out of many possible situations. You might ask me, "How can you describe a situation where a child goes through that and isn't harmed? That's impossible." However, those situations are real and documented. There are a number of studies that show that there are some children who are either unharmed, or move past the event enough that it ended up not being traumatic. Running With Scissors is a book where one such situation is detailed by the author. The book is an autobiography. As I have pointed out before, those situations do not justify or make legal the acts that do not result in harm, it means a therapeutic definition is important.

Researchers prefer to view those situations as examples of people overcoming potentially traumatic events. I have the perspective that these children are well-adjusted because they were able to accurately examine how they felt about the events, and decided for themselves that they were not harmed. You could say that these children are very robust and emotionally healthy, because they were able to look at an event and decide for themselves how they felt about it. Here is one great example of an act that was consensual, that the teenager did not report harm, but was still illegal and still overreacted to by the adults in their life. Bear in mind that this would have still been illegal if the man was not on probation for a different sex crime. Also, that case is a great example for groups that discuss age of consent laws. They would point out that in most parts of the world, including Europe, that act would not have been illegal. It perfectly illustrates why legal discussions on this subject are never-ending: What if the girl was 15? 14? 12? What if she still consented then? How does she know what consent is?

Primary prevention tie-in?

The presence of these situations is critical to the primary prevention of child sexual abuse, and here is why. The presence of these situations means that there are children who knew their own boundaries and feelings well enough to know when something did or did not cross those boundaries. It is a win for primary prevention, because these select few children were able to express themselves clearly. It serves as a model for what happens when children are able to create, set, and maintain their own boundaries. If they are able to look at something potentially traumatic as a neutral event, they will likewise be better able to determine when something crosses boundaries and causes them harm.

It is also a reminder that when approaching a child who was impacted by sexually exploitive behavior, we must let the child tell their own story. It is a reminder that overreacting can make a neutral situation traumatic for the child, and to respect the child enough to tell their own story.

Why the emphasis on children?

When it comes to detecting when abuse is occurring, preventing it from happening, and holding perpetrators accountable, the first priority must be the child. While the surrounding community does have feelings about abusive events, the primary impact is to the child. No one should ever presume to tell a child how to feel, only help the child work through how they feel and what they think. It is extremely common for children who have been abused to care for and trust their abuser. The child has a right to feel that way, just as they have a right to hate their abuser. Without that sort of emphasis on children, it is possible to dictate how the child feels and make the impact and effects of the abuse worse than they initially were. Magnifying the effects of child sexual abuse is obviously not something to be striving for, and that is why an emphasis on children must take priority. Without it, primary prevention cannot happen.

Final thoughts...

I know there are some people out there who might twist my argument here to mean that sexual acts with children are acceptable if the child is not harmed, and I must be clear that just because there are children who are not harmed does not make the behavior on the part of the older youth or adult acceptable or moral. The high potential for harm makes the act immoral and unacceptable, every time. Just because even 15/100 cases do not result in harm does not make the behavior itself okay. Another issue is that child sexual abuse does not always result in readily apparent harm. Sometimes, it can take years for someone to realize they were in fact traumatized.

My own abuse was exactly like that: It affected how I saw myself and the world around me. It was not until I began talking about my past that I came to a more realistic understanding of what happened to me, where previously I saw it as normal. I felt shamed for the normal experiences because I did not believe I had the right to enjoy them. But I felt that the abusive experiences were normal for no other reason than that they happened to me. And how I felt about everything was a garbled mess because I had no idea how to properly feel or identify my emotions.

While it is possible that children involved in sexual acts with older youth or adults will not be traumatized or harmed does not make the behavior acceptable. Just because a handful of alcoholics are able to recover to the point of being able to drink socially with no problems does not mean that all alcoholics will get to that point.