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Des Spence’s article “Bad Medicine: Men matter too” is a courageous and necessary intervention in a long-overdue conversation. As a public health professional and someone who was subjected to non-consensual circumcision in infancy, I want to voice my full support for his clear-eyed critique of this medically unnecessary and ethically problematic practice.
Spence is right to highlight the inconsistency in how we treat male and female genital cutting. While female genital mutilation is universally condemned and illegal in many jurisdictions, male circumcision—though also performed without medical need or consent—is still widely tolerated, even normalized. This double standard is not grounded in medical evidence but in longstanding cultural taboos and institutional reluctance to challenge religious practices.
I echo the article’s call for ethical consistency. In public health, we emphasize bodily autonomy, informed consent, and the principle of “do no harm.” Routine infant circumcision violates all three. Medical professionals who perform irreversible surgery on healthy children without therapeutic justification are breaching the child’s fundamental right to bodily integrity.
Critically, Spence points to the need for change from within religious and cultural communities. As someone raised in a Muslim context, I know firsthand the power of internal voices. Questioning practices rooted in tradition ca...
Critically, Spence points to the need for change from within religious and cultural communities. As someone raised in a Muslim context, I know firsthand the power of internal voices. Questioning practices rooted in tradition can be difficult, but faith must evolve alongside ethical understanding. It is not anti-religious to protect children—it is profoundly moral.
The silence around male circumcision is not passive—it is complicit. It enables a practice that causes lasting physical and psychological harm while suppressing the voices of those affected. This silence shields institutions from accountability and leaves children unprotected. Spence has broken that silence with courage, confronting an issue many have avoided out of fear or convenience. I commend him for this bold stance, and I urge medical professionals, community leaders, and policymakers not just to reflect, but to act. The continued inaction around this subject is indefensible. It is time to prioritize children’s rights over social discomfort and question practices long considered untouchable.
Whilst gender discrimination has been reduced in many areas of medicine and society, it remains true that a UK child's protection from medically unnecessary irreversible surgical procedures on his healthy genitals still depends on perceived gender.
In 2013, the UNCRC categorised ritual circumcision as 'Violence against Children'1 and the Parliamentary Assembly of the Council of Europe expressed concerns2 about "a category of violation of the physical integrity of children, which supporters of the procedures tend to present as beneficial... despite clear evidence to the contrary...
In 2013, the UNCRC categorised ritual circumcision as 'Violence against Children'1 and the Parliamentary Assembly of the Council of Europe expressed concerns2 about "a category of violation of the physical integrity of children, which supporters of the procedures tend to present as beneficial... despite clear evidence to the contrary”, naming "the circumcision of young boys for religious reasons" as one such violation. In 2015, Sir James Munby, then President of the Family Division of the High Court noted3 that some forms of FGM were less severe than the usual form of male circumcision, describing all as constituting "significant harm" as defined by the Children Act.
GMC4 and more recent BMA guidance5 endorses the double standard. Regardless of the actual harm caused, no-one should cut a girl's genitals they say. For boys the emphasis shifts to his 'best interests'. And here's the rub. Unlike girls, boys' best interests may apparently include acquiescing to parental wishes to imprint their own strong religio-cultural beliefs onto his genitals before he can form his own beliefs, experience sex with intact genitals or withhold consent. Both organisations have been informed that many men feel harmed, and some boys have suffered irreparable penile damage, even death. They know that there are growing movements from within the cutting communities advocating peaceful alternatives.6
Regrettably, neither organisation has followed the lead of the Danish Medical Association,7 the combined Dutch medical community,8 and all the Scandinavian ombudsmen9 in declaring ritual male circumcision a fundamental breach of medical ethics that should be deferred until the person himself has the capacity to give or withhold consent. Non-therapeutic genital cutting of non-consenting children should all be treated as a significant breach of good medical practice when performed by doctors and as a serious safeguarding concern when performed by lay people regardless of gender.
References 1. United Nations. Convention on the Rights of the Child. Published July 2013. http://docstore.ohchr.org/SelfServices/FilesHandler.ashx?enc=6QkG1d%2FPPRiCAqhKb7yhsv1txuQys3LgW60cwoE2%2BBVbWayRn7lstRQMslo7IkA%2Bj8M11XqULQ1v73knmXrksz29yHCH3forzCeDQXkQCGOQp77xlMo8ssYBfGT5Rb9W. 2. Parliamentary Assembly of the Council of Europe. Resolution 1952. Children’s right to physical integrity. Published October 2013. http://assembly.coe.int/nw/xml/XRef/Xref-XML2HTML-en.asp?fileid=20174. 3. Munby J. Royal Courts of Justice. Published January 2015. www.judiciary.uk/wp-content/uploads/2015/01/BandG_2_.pdf. 4. GMC. Personal beliefs and medical practice. Published April 2013. www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/personal-beliefs-and-medical-practice/personal-beliefs-and-medical-practice 5. BMA. Non-therapeutic male circumcision of children toolkit. Published February 2019. www.bma.org.uk/advice/employment/ethics/children-and-young-people/non-therapeutic-male-circumcision-of-children-ethics-toolkit. 6. Facebook. Jews Against Circumcision. Accessed November 2019. www.facebook.com/pages/category/Education/Jews-Against-Circumcision-165424110207450. 7. Huffpost. Denmark Doctors Declare Circumcision Of Healthy Boys 'Ethically Unacceptable'. Published January 2017. www.huffpost.com/entry/denmarks-29000-doctors-declare-circumcision-of-healthy_b_58753ec1e4b08052400ee6b3. 8. KNMG viewpoint. Non-therapeutic circumcision of male minors. Published May 2010. www.knmg.nl/web/file?uuid=4f46a948-1a37-4ee4-95be-976b541ec6ee&owner=5c945405-d6ca-4deb-aa16-7af2088aa173&contentid=286&elementid=2360433. 9. Lapsi-asia. Joint statement from the Nordic Ombudsmen for Children and pediatric experts. Published date: September 2013. http://lapsiasia.fi/en/tata-mielta/aloitteet/aloitteet-2013/joint-statement-from-the-nordic-ombudsmen-for-children-and-pediatric-experts.
I thank Des Spence for having the courage to share his views on the circumcision of boys for non-medical reasons.
In recommending or agreeing to perform an operation, health professionals are expected to look at the risks and benefits of the procedure. In the case of these circumcisions there are no medical benefits, hence the risks however small they may be, cannot in my mind be justified.
Is this being looked at by the appraisal system?
Should this be looked at by the GMC?
Let's consider safeguarding.
We are agreed that all children are vulnerable and should be protected and their safety trumps all other considerations. This would appear to be the case, unless parents decide to have their young boy's foreskin cut off. He is too young to understand or voice an opinion, yet the surgeon and the law (or lack of law) collude in this act.
Many times, I have heard the argument that banning the practice would lead to unqualified people carrying out the procedure in unsafe circumstances and increase the risk to the child. This does need some consideration and thought. However, is this not similar to someone saying that we should not ban the importation of goods coming from factories shown to be exploiting child labour for fear that it will render the children unemployed and put them in greater danger. There needs to be an open debate that looks at the human rights of our young boys.
I open the BJGP hoping to improve my practice by evidence-based medicine. Male circumcision may tick many of the boxes of political incorrectness, but there is no evidence whatever to suggest that it is in any way comparable in terms of physical or emotional trauma to female circumcision. A more rational discussion would be to compare the benefits and harms of Des Spence’s proposed solution. He seems to be suggesting that doctors in this country should be banned from performing this procedure. This will not stop non-medical circumcision, but will ensure that it will...
I open the BJGP hoping to improve my practice by evidence-based medicine. Male circumcision may tick many of the boxes of political incorrectness, but there is no evidence whatever to suggest that it is in any way comparable in terms of physical or emotional trauma to female circumcision. A more rational discussion would be to compare the benefits and harms of Des Spence’s proposed solution. He seems to be suggesting that doctors in this country should be banned from performing this procedure. This will not stop non-medical circumcision, but will ensure that it will be largely carried out by non-medical practitioners, thereby increasing the risk of harm to the children. Des Spence’s polemic on male circumcision is bad medicine indeed.
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