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Correspondent:

ATTORNEY GENERAL OF CANADA


 
April 16, 1998

The Honourable Anne McLellan
Minister of Justice
Attorney General of Canada

Dear Minister:
 
RE:    Chapter C-48 — An Act respecting the Criminal Law, Section 268 (Criminal Code) as related to the Constitution Acts 1867 to 1982, Constitution Act, 1982, Schedule B Constitution Act, 1982(79), Part I Canadian Charter of Rights and Freedoms.


I am writing to you in the hope of obtaining a better understanding of Section 268 of the Criminal Code of Canada and its application to genital mutilation. Specifically, I am interested in learning about the applicability of this section as it pertains to the Canadian Charter of Rights and Freedoms.

I understand that Canada is a signatory to many treaties and conventions dealing with fundamental human rights. The topic of genital mutilation (GM) has been addressed as a fundamental human rights issue within some of the treaties and conventions. In response to these treaties and immigrant movements to Canada from countries where female genital mutilation (FGM) is commonly practised, Canada has adopted into its laws criminal charges for individuals participating in FGM as defined under Section 268 of the Criminal Code.

The practice of genital mutilation is certainly an abhorrent one and Canada has taken the first steps to eliminating this transgression against mankind in an affirmative manner. Without doubt, both male and female genital mutilations are a violation of the most basic of human rights.

My concern however, is that Section 268, as written, contravenes the Canadian Charter of Rights and Freedoms. Specifically, Section 268(3) of the Criminal Code contravenes Section 15(1) and—it is highly probable—Section 7 of the Canadian Charter of Rights and Freedoms.

In reviewing this section of the Criminal Code it is of note that females are specifically referred to through the use of gender specific terms such as labia majora, labia minora, and clitoris. Unfortunately the use of such specific anatomical terms indicates that males, who also widely suffer from the practice of genital mutilation (including circumcision), do not benefit equally from the law. This is an obvious violation under Section 15(1) of the Charter. While Canada has made a strong and admirable statement about genital mutilation, we appear to have formulated a law, perhaps unwittingly, that specifically violates the Section 15(1) Charter rights of men by not providing equal protection and equal benefit of the law to them.

Furthermore, it is apparent that by failing to address the Charter rights of men with respect to genital mutilation, yet clearly protecting the Charter rights of women, Section 268(3) fails to offer adequate security to the male gender thereby also contravening Section 7 of the Charter. Specifically, the law fails to provide for the “security of the person and the right not to be deprived thereof...” with respect to males.

This oversight must be rectified, and quickly so. To accept such an ongoing blatant violation of human and Charter rights diminishes everything Canadians believe in.

Furthermore, through minor alterations the law can provide substantial guidance and act as a strong deterrent to the practice of genital mutilation regardless of gender. The existing inequity within the law can best be remedied through introducing anatomical terminology into Section 268(3) that identifies male sexual and reproductive organs, and parts thereof, in a manner similar to that currently provided for females. Elimination of Section 268(3), as a remedy to the inequity, would result in the loss of specific protection for women resulting in the maintenance of an undesirable situation. Alternatively, the remedy of introducing simple gender neutralization within the clause lacks the specificity to offer the protection intended within the section. Therefore, the optimal remedy would incorporate the use of gender specific anatomical terms for both genders.

To further facilitate my understanding of the law and its current interpretation, a response to the following questions, regarding genital mutilation, the Criminal Code, and the Charter, is requested:

  1. Does the Minister believe that Section 268 violates the Canadian Charter of Rights and Freedoms as identified above? If not, please explain why.
     
  2. If female genital mutilation is a violation of human rights it logically follows that male genital mutilation is also a human rights violation. Does the Minister believe that male genital mutilation is a violation of basic human rights and should have equal standing under the law? If not, please explain why.
     
  3. Why does Section 268 only identify the female gender through the listing of gender specific anatomy with respect to the act of genital mutilation? Have gender specific male anatomical definitions been purposely excluded within the section?
     
  4. Is the Minister prepared to submit amendments to Section 268 in order to eliminate the gender inequity within Section 268 of the Criminal Code to the House of Commons within this sitting of Parliament? If not, when can remedies to Section 268, eliminating the gender inequality, and restoring the Charter rights of about half of all Canadians b presented to the House of Commons?

I look forward to your response in this matter at your earliest convenience. Should you require further information or clarification, please contact me at the telephone numbers provided above and in the attached documents.

Very truly yours,
 
[signed]
 
Arif Bhimji
 


November 13, 1998

Dear Ms. McLellan:

I would like to raise questions in regard to a medical study undertaken last year by researchers at the University of Alberta. This study, designed to evaluate different methods of pain control for neonatal circumcision, was terminated early after two infants experienced severe vomiting and choking episodes that met the criteria for what are known in pediatric medicine as ALTEs, or "apparent life-threatening events." One of the infants stopped breathing for 25 seconds.

The reason I am concerned about this study is that it involved traumatizing vulnerable persons without apparent justification. Medical need cannot be invoked as a justification for neonatal circumcision, since neither the Canadian Pædiatric Society nor any other medical organization in the world recommends that this procedure be routinely performed. Nor would religious observance seem to be available as a justification for a scientific study.

It is my understanding that in the absence of justification, all wounding of one person by another person is criminal assault. If we are going to preach human rights around the world, should we not be prepared to address issues related to the human rights of children in our own country?

The current laissez-faire approach to infant male circumcision also raises the issue of discrimination based on sex. Though most forms of female circumcision are more harmful than male circumcision, some are less so. Since in the overwhelming majority of cases neither boys nor girls need to have their genitals surgically altered, why is protection from unnecessary genital surgery being extended only to girls? The effects of circumcision can be devastating for both sexes.

For your information I enclose the abstract of the study undertaken at the University of Alberta. I also enclose a recent media report entitled "Anesthesia Complications Killed Baby" as evidence of the fact that pain control does not render circumcision harmless, plus other material that may be of interest.

Sincerely,
 
[signed]
 
D ennis H arrison

Enclosures:

(1) Comparison of Ring Block, Dorsal Penile Nerve Block, and Topical Anesthesia for Neonatal Circumcision
 
(2) NewsNet5 report: Anesthesia Complications Killed Baby
 
(3) Circumcision in the physicians' own words
 


July 21, 1999

Dear Ms. McLellan,

I am writing with some questions that I have concerning the practice of male circumcision in Canada.

As far as I've been able to determine, there is no apparent law or guideline that restricts a parent or guardian from compelling circumcision upon their male child, from birth to 18 years. Most circumcisions of minors lack a specific medical indication.

While not all circumcisions are compelled on children for frivolous or punitive reasons, the possibility of that happening may also exist.

Here are my questions:

  1. Is there a policy to regulate genital cutting of male minors, or are there plans to enact such a policy? If not, why not?
     
  2. In terms of the right to security of the person as recognized in the Canadian Charter of Rights and Freedoms, is there any distinction that would make forcible circumcision of an infant constitutional, and forcible circumcision of a 17-year-old boy unconstitutional? If so, at what age is a distinction made?
     
  3. As far as I can tell, there is no legal distinction between genital cutting of male minors as performed by a licensed physician, an unlicensed third party (for example, a Jewish mohel or a Muslim cleric), or by an untrained individual. Is this interpretation correct?
The Federal government enacted a separate law to protect all minor females against genital cutting customs (mild to severe).

Thank you for your time and attention. I look forward to your response.

Sincerely yours,
 
[signed]
 
Geoffrey T. Falk, B.Sc., M.A.
 


December 3, 1999

Ms. Carole Morency
Counsel, Department of Justice
Family, Children and Youth Section

Dear Ms. Morency:

In the course of doing research on infant male circumcision, I came across an article on female genital mutilation (FGM) in a past issue of The Medical Post. The author of the article was Louise Gagnon. You were quoted by Ms. Gagnon as saying, “[t]here are quite a number of provisions, assault provisions and criminal negligence provisions, that would apply to anyone who performs FGM on a child.”

Would the same provisions not apply equally to anyone who performs male genital mutilation on a child? Males and females have an equal right to physical integrity under Sections 7 and 28 of the Charter of Rights and Freedoms. Stedman’s Medical Dictionary defines “mutilation” as “disfigurement or injury by removal or destruction of any conspicuous or essential part of the body,” and infant male circumcision certainly fits this definition. The prepuce is among the most conspicuous parts of the male anatomy, and it has been described in the medical literature as essential for normal sexual function.

You were also quoted as saying that the Ministry of Justice has opted for an educational approach rather than a legislative one to stamp out the practice of female genital mutilation. Has the Ministry adopted an educational approach to stamp out corresponding practices on males?

For your information, I enclose copies of recent correspondence I have had on the subject of infant male circumcision with the Hon. Ujjal Dosanjh, Attorney General of British Columbia. Mr. Dosanjh says that infant male circumcision cannot be prosecuted because there is no intention on the part of the medical practitioner to cause harm. Is Mr. Dosanjh correct in his interpretation of the law?

Sincerely,
 
[signed]
 
D ennis H arrison
 


December 10, 1999

Dear Minister McLellan,

Thank you for introducing legislation to impose harsher penalties on those who abuse animals. Animal abuse is abhorrent, and must not be tolerated in a civilized society.

In addition to the questions I asked you in my letter of July 21, 1999, I would like to ask you one additional question:

Suppose someone were to take a newborn male puppy to the steps of the Parliament buildings in Ottawa; strap it down, force a blunt probe into the end of its penis, tear the adherent foreskin away from the glans, and amputate its foreskin. Could that person be charged with animal abuse for performing such an act? Would it make a difference whether or not the person used any kind of anaesthesia?
I look forward to reading your response to this question, in addition to my earlier questions. A copy of my prior letter is attached below, for your kind attention.

Sincerely yours,
 
[signed]
 
Geoffrey T. Falk
 


April 6, 2000

Dear Dr. Bhimji:

Thank you for your correspondence concerning section 286 [sic] of the Criminal Code. I apologize for the lengthy delay in responding. However, I understand that during this intervening period, you had an opportunity to discuss your concerns in detail about this matter with one of my officials.

You asked whether the provisions dealing with female genital mutilation (FGM) were unconstitutional because the equivalent protection for males is not specified in the Criminal Code. This question raised two equally important concerns: the equal protection of the Canadian Charter of Rights and Freedoms and the proper use of the criminal power.

Equality is a difficult concept, and much has been discussed in the courts and academia on the best approach to equality issues. These discussions and jurisprudence clearly show that not every problem will call for an identical solution for men and women because of important differences between the sexes. Furthermore, not every distinction in the law based on s. 15 of the Charter is discrimination. To determine whether discrimination is present, we need to understand the relevant facts and differences between the situation of any two groups. These facts can lead to an understanding of why it would be appropriate to take a different approach for women and men in any particular legislative context.

In my view, male circumcision cannot be compared to FGM. Clearly the practice of FGM raises unique consequences for females. FGM is a customary practice usually performed without anaesthetic by non-medical persons under unhygienic conditions. The procedure varies from one culture to another but generally involves the complete removal of the female genitalia. Regardless of the form of female genital mutilation practised it is the view of the government that there is never a medically accepted justification for it. The health risks and complications are serious and life-long, including death from shock and hemorrhaging, life-threatening childbirth and long-term psychological trauma. As a result, the Criminal Code provides for protection against FGM pursuant to section 286 [sic].

In contrast, male circumcisions are performed by qualified medical personnel under hygienic conditions and involve only the removal of the foreskin. Furthermore, the medical community, including the Canadian Paediatric Society, recognizes that male circumcision does have medical benefits, although it does not recommend the routine circumcision of newborn males. It recommends that parents decide in consultation with their doctor to determine the health benefits for each child.

Security of the person is also a difficult concept. The courts have considered that intrusions by the state into the physical and psychological integrity of individuals are breaches of security under s. 7 of the Charter. Here, of course, the decision of the parents in consultation with their doctor to seek circumcision for their newborn son is a private decision based on the health benefits for the child.

In relation to the second concern on the use of the criminal law power, it is important to recognize that the Criminal Code is a powerful instrument to be reserved for activities that Canadian society deems to be deserving of criminal sanction. We should not use the Criminal Code in situations where other solutions would be more effective, such as public education, promoting discussions with the health professions before decisions are made, and so on.

I realize there will always be strongly held views, like yours, that the criminal law power should be invoked to ban male circumcision just as it has been used to specifically prohibit female genital mutilation. However, and for the reasons stated above, it is my belief that female genital mutilation and male circumcision are simply not comparable practices. Accordingly, in my respectful view, they ought not to be treated as such by the criminal law.

Again, thank you for writing and expressing your views.

Yours sincerely,
 
[signed]
 
A. Anne McLellan
 


June 13, 2000

Dear Mr. Falk:

Thank you for your correspondence concerning the practice of male circumcision in Canada and cruelty to animals legislation. I apologize for the lengthy delay in responding.

As you may know, section 268 of the Criminal Code was amended in May 1997 to specifically prohibit female genital mutilation (FGM). However, these amendments do not apply to male circumcision.

In my view, male circumcision cannot be compared to FGM. Clearly the practice of FGM raises unique consequences for females. FGM is a customary practice usually performed without anaesthetic by non-medical persons under unhygienic conditions. The procedure varies from one culture to another but generally involves the complete removal of the female genitalia. Regardless of the form of female genital mutilation practised, the Government believes that its justification is never medically accepted. The health risks and complications are serious and lifelong, including death from shock and hemorrhaging, life-threatening childbirth and long-term psychological trauma. As a result, the Criminal Code provides for protection against FGM pursuant to section 286.

In contrast, male circumcisions are performed by qualified medical personnel under hygienic conditions and involve only the removal of the foreskin. Furthermore, the medical community, including the Canadian Paediatric Society, recognizes that male circumcision does have medical benefits, although it does not recommend the routine circumcision of new-born males. It recommends that parents decide in consultation with their doctor to determine the health benefits for each child. As such, the age at which circumcision is performed would be decided by the parents and their doctor.

You ask whether the provisions dealing with female genital mutilation (FGM) were unconstitutional because the equivalent protection for males is not specified in the Criminal Code. This question raised two equally important concerns: the equal protection of the Canadian Charter of Rights and Freedoms; and, in the proper use of the criminal law power.

Equality is a difficult concept, and much has been discussed in the courts and academia on the best approach to equality issues. These discussions and jurisprudence clearly show that not every problem will call for an identical solution for men and women because of important differences between the sexes. Furthermore, not every distinction in the law based on the grounds listed in section 15 of the Charter is discrimination. To determine whether discrimination is present, we need to understand the relevant facts and differences between the situation of any two groups. These facts can lead to an understanding of why it might be appropriate to take a different approach for women and men in any particular legislative context.

Security of the person is also a difficult concept. The courts have considered thta intrusions by the state into the physical and psychological integrity of individuals are breaches of security of the person under section 7 of the Charter. Here, of course, the decision of the parents in consultation with the doctor to seek circumcision for their new-born son is a private decision based on the health benefits for the child.

The Criminal Code is a powerful instrument to be reserved for activities that Canadian society deems to be deserving of criminal sanction. We should not use the Criminal Code in situations where other solutions would be more effective, such as public education, promoting discussions with the health professions before decisions are made, and so on.

I realize that some people will believe that the criminal law power should be invoked to ban male circumcision just as it has been to specifically prohibit female genital mutilation. However, and for the reasons stated above, it is my belief that female genital mutilation and male circumcision are simply not comparable practices. Accordingly, in my respectful view, they ought not to be treated as such by the criminal law.

In your letter, you also mention cruelty to animals. As you are aware, I introduced amendments to the Criminal Code on December 1, 1999, which will improve the law in this area. Bill C-17, An Act to amend the Criminal Code (cruelty to animals, disarming a peace officer and other amendments), proposes to increase maximum penalties for animal cruelty from the current six months to five years in prison. Another aspect of the Bill will allow for courts to prohibit convicted offenders from owning or possessing an animal for any period of time the court considers appropriate. Courts will also have the power, for the first time, to order that a convicted offender repay the reasonable costs that were borne by a humane agency in caring for the animal.

[I had asked whether one could be prosecuted, were one to circumcise a newborn puppy on the steps of Parliament, without using an anaesthetic. I guess this would be in Ontario, not Alberta (see below) —gtf]

In your correspondence you ask whether a person would be charged in a particular circumstance. It may be helpful for you to know that, while the Parliament of Canada is responsible for enacting the criminal law, the administration of justice in a province, including the prosecution of Criminal Code offences, is the responsibility of the provincial government. Therefore, if you have not already done so, you may wish to write to the Attorney General of Alberta, who is responsible for the administration of justice in Alberta. The office is located at Legislature Building, Room 320, 10800 - 97th Avenue N.W., Edmonton, Alberta, T5K 2B6.

Again, thank you for taking the time to write to me.

Sincerely,
 
[signed]
 
A. Anne McLellan
 


March 9, 2001

Ms. Carole Morency
Senior Counsel
Department of Justice
Family, Children and Youth Section

Dear Ms. Morency:

You were quoted in a recent Reuters news report as saying that male circumcision cannot be compared to FGM. If that is true, then why does the Criminal Code draw distinctions between these procedures on the basis of sex, which is a prohibited ground of discrimination? Why is a more appropriate basis not used? It seems odd that a prohibited ground is being used to distinguish between surgical operations which are supposed to differ fundamentally from one another in many important respects.

You also stated that FGM, in contrast to male circumcision, “was never medically accepted.” Sadly, I must inform you that this statement is not correct. Female circumcision was, and in some quarters continues to be, an accepted medical practice. The procedure was covered by the Blue Shield insurance company in the United States until 1977.

For your information, I enclose a small sample of pro-FGM articles written by licensed physicians. The articles were published in mainstream journals in 1915, 1958, 1959, and 2001.

The most recent article is by Dr. Nowa Omoigui, an American physician of Nigerian origin who holds a master’s degree in public health. According to Dr. Omoigui, female circumcision as performed in Nigeria removes only a small piece of skin that has no sexual function and no reproductive significance.

Dr. C. F. McDonald of Milwaukee, Wisconsin noted in the September, 1958 issue of the journal GP: “The same reasons that apply for the circumcision of males are generally valid when considered for the female.” Dr. W. G. Rathmann of Inglewood, California, writing in GP in 1959, stated that the value of female circumcision in improving sexual function has been accepted by various cultures for the past 3,500 years.

Your statement to the press implies that male circumcision, unlike FGM, is an accepted medical practice. However, circumcision of a male infant involves the removal of specialized sexual tissue from a non-consenting person who has no medical need for surgery. It's difficult to see how such an intervention can be regarded as acceptable, particularly since any operation on the genitals of a female person who has no medical need for surgery is expressly prohibited by the Criminal Code.

You were also quoted as saying that male circumcision does have recognized medical benefits. You seemed to be implying that infant male circumcision can be justified as preventive health care. Again, this is not correct. To be justified as preventive health care, a paediatric procedure must confer a net medical benefit. Moreover, this benefit must be necessary for the child’s well-being, and the procedure must be the only reasonable way to obtain the required benefit. None of these conditions are fulfilled for newborn circumcision. The Canadian Paediatric Society, like virtually every other medical society in the world, states that the potential medical benefits from infant male circumcision have not been clearly shown to outweigh the risks and costs. Consequently infant male circumcision cannot be ethically or legally justified as preventive health care.

The World Health Organization indicates in its classification of FGM that some forms of this procedure are trivial compared with male circumcision. Yet even these forms of FGM are prohibited under the Criminal Code.

Would you be kind enough to clarify whether or not male circumcision, when performed on an individual who has not given informed consent and who has no medical need for surgery, is prohibited under section 268 of the Criminal Code?

Sincerely,
 
[signed]
 
D ennis H arrison

cc: Hon. Anne McLellan, Minister of Justice and Attorney General
 


May 2, 2001

Dear Sir:

Thank you for your correspondence dated March 9,2001 regarding female genital mutilation ("FGM") and male circumcision. I have attempted to address your inquiries concerning the difference between the treatment accorded to the two practices by the Criminal Code of Canada.

As you know, the Criminal Code was amended in 1997 to specifically address the practice of FGM. Although FGM has always been prohibited in Canada, the 1997 amendment amended the aggravated assault provision (section 268) of the Criminal Code for greater certainty. Section 268 now reads:

(1) Every one commits an aggravated assault who wounds, maims, disfigures or endangers the life of the complainant.

(2) Everyone who commits an aggravated assault is guilty of an indictable offence and liable to imprisonment for a term not exceeding fourteen years.

(3) For greater certainty, in this section, "wounds" or "maims" includes to excise, infibulate or mutilate, in whole or in part, the labia majora, labia minora or clitoris of a person, except where
(a) a surgical procedure is performed, by a person duly qualified by provincial law to practise medicine, for the benefit of the physical health of the person or for the purpose of that person having normal reproductive functions or normal sexual appearance or function; or

(b) the person is at least eighteen years of age and there is no resulting bodily harm.
(4) For the purposes of this section and section 265, no consent to the excision, infibulation or mutilation, in whole or in part, of the labia majora, labia minora or clitoris of a person is valid, except in the cases described in paragraphs (3)(a) and (b).
As you will see from this provision, it does not prohibit a duly qualified medical practitioner from performing a surgical procedure on the labia minora/ majora or clitoris "for the benefit of the physical health of the person or for the purpose of that person having normal reproductive functions or normal sexual appearance or function."

You have compared FGM to male circumcision and indeed, you are of the view that the two practices are identical. In fact, the two practices are not comparable. Since the extent of female mutilation varies from one practising culture to another, experts have classified FGM into three broad categories: clitoridectomy (types I and II), infibulation (types III and IV) and introcision. Clitoridectomy (type I), also called 'Sunna', is accompanied by partial or total excision of the prepuce or hood of the clitoris, and sometimes excision of the tip of the clitoris. Excision (type II) is total excision of the hood or prepuce of the clitoris, and sometimes excision of the tip of the clitoris and partial or total excision of the labia minora. Modified infibulation (type III) involves clitoridectomy and an incision of the labia minora and the upper two-thirds of the labia majora, leaving a small posterior opening. Total infibulation (type IV), also called Pharaonic circumcision, involves the same operation as type III but with wider excision of the labia majora to create raw surfaces which are then stitched together to cover the urethra and the vagina, leaving a tiny opening for passage of urine and menstrual blood. Introcision is a rare form of FGM, which involves the incision and inward folding of the vaginal introitus.

FGM is usually performed by non-medical persons, under unhygienic conditions and without anaesthetics. Complications are common to all types of FGM, and may include: haemorrhaging, prolonged bleeding causing shock and death, local and systemic infection, abscess and ulcer formation, anaemia, tetanus, gangrene, cystitis, infertility and obstetrical complications. Consequently, in Canada, all provincial Colleges of Physicians and Surgeons ban the practice.

Male circumcision, on the other hand, is a recognized and accepted practice within the medical community. In the 1996 review of male circumcision by the Canadian Paediatric Society (CPS), which review was re-affirmed in 2000, the CPS recognized certain medical benefits of male circumcision (e.g. decreased urinary tract infections, reduced risk of penile cancer and sexually transmitted diseases). Although the CPS does not recommend routine circumcision of newborns, it acknowledges that it is a matter to be decided by parents in consultation with their family physicians. The American Academy of Paediatrics (AAP) takes a similar position on male circumcision.

The law treats FGM and male circumcision differently, due to the fundamentally different nature of these two practices, as described above. Not every problem will call for an identical solution for men and women because of important differences between the sexes. Furthermore, not every distinction in the law based on the grounds listed in s.15 of the Charter is discrimination. To determine whether discrimination is present, it is important to understand the relevant facts and differences between the situation of any two groups. These facts can lead to an understanding of why it might be appropriate to take a different approach for women and men in a particular legislative context. In the case of FGM, a medically accepted justification for the practice does not exist. Further, the health risks and complications are serious and lifelong, as listed above. In contrast, male circumcision is performed by qualified medical personnel under hygienic conditions and involves only the removal of the foreskin. Importantly, the CPS and the AAP recognize that male circumcision has medical benefits.

I appreciate being provided with your views as well as with the enclosed materials.

Sincerely,
 
[signed]
 
For Carole Morency
Senior Counsel
Family, Children and Youth Policy Section
Department of Justice
 


May 24, 2001

Ms. Carole Morency
Senior Counsel
Department of Justice
Family, Children and Youth Section

Dear Ms. Morency:

Thank you for your letter of May 2nd. I would like to respond to some of the points you have made.

First of all I wish to say that contrary to your letter, I do not consider male circumcision and female genital mutilation (FGM) to be "identical" procedures. I do, however, believe that every person has an identical right to physical integrity. In other words I believe that no child, regardless of sex or other personal characteristics, should undergo surgery that is not medically justified.

The FGM classification scheme used in your letter appears to be out of date. The rare form of FGM known as "introcision" was dropped from the World Health Organization's (WHO) classification in 1995. The current internationally accepted standard, which was adopted by WHO in July 1995, recognizes four types of FGM:

Type I: Excision of the prepuce with or without excision of part or all of the clitoris.

Type II: Excision of the prepuce and clitoris together with partial or total excision of the labia minora.

Type III: Excision of part or all of the external genitalia and stitching/narrowing of the vaginal opening (infibulation).

Type IV: Unclassified: includes pricking, piercing or incision of clitoris and/or labia; stretching of clitoris and/or labia; cauterization by burning of clitoris and surrounding tissues; scraping (angurya cuts) of the vaginal orifice or cutting (gishiri cuts) of the vagina; introduction of corrosive substances into the vagina to cause bleeding or herbs into the vagina with the aim of tightening or narrowing the vagina; any other procedure which falls under the definition of FGM given above.
[Ref: World Health Organization: Female Genital Mutilation Information Pack.]

As you can see, one form of FGM (namely, excision of the clitoral hood) is analogous to male circumcision, and other forms (such as nicking the clitoris and/or labia) are less severe than male circumcision.

You write that male circumcision, unlike FGM, has medical benefits. This argument is problematic for two reasons. In the first place, there are ostensible medical benefits to amputating virtually any normal part of the body, since a missing body part can never develop medical problems. Removing healthy breast tissue prevents breast cancer, amputating a toe prevents nail fungus, and so on. Even FGM can be said to have medical benefits, since anyone whose clitoris and labia have been removed will never suffer from lichen sclerosis, vulvar agglutination, or cancer of the labia. It makes no sense to argue that cutting off the foreskin confers medical benefits, while at the same time denying that there are medical benefits to cutting off other normal body parts.

In the second place, as I mentioned in my letter of March 9th, medical societies everywhere have concluded that the purported medical benefits from infant male circumcision are so slight that they do not clearly outweigh the risks and harms of the surgery itself. Consequently infant male circumcision cannot be ethically or legally justified on the basis of its medical benefits.

You contrast the high rate of complications from FGM with the relative safety and low risk that supposedly attend male circumcision. But comparisons between the risks of different operations are meaningless unless the same baseline is used in all cases. Any surgical procedure becomes high risk when performed by an untrained operator under unhygienic conditions. Male circumcision is no exception: in one region of South Africa alone, at least 18 circumcision-related deaths, 5 mutilations, and 42 hospitalizations were reported during the tribal initiation season that began last September (Source: U.S. State Department, Report on Human Rights Practices in South Africa, February, 2001.)

Conversely, the rate of complications from FGM would be much lower if the operation were performed under hygienic conditions. (I say this without in any way condoning the performance of FGM by medical professionals.) In short, it's inappropriate to measure FGM undertaken in remote African villages against male circumcision performed in modern Canadian hospitals.

In stating that "male circumcision ... involves only the removal of the foreskin" you seem to be implying that male circumcision does not amount to much. But circumcision permanently alters the most private part of the body, and the inviolability of the body is a cornerstone of our legal system. As Justice Cory of the Supreme Court noted in R. v. Stillman, [1997] 1 S.C.R. 607,

Any invasion of the body is an invasion of the particular person. Indeed, it is the ultimate invasion of personal dignity and privacy.
Moreover, the foreskin has been described in the medical literature as "an important component of the overall sensory mechanism of the human penis" (British Journal of Urology 1996, vol. 77, pp. 291-5). Thus the idea that male circumcision is a trivial intervention has no basis in science and is inconsistent with fundamental principles of law and ethics.

In your letter you do not address the important issue of consent. Merely because there is some evidence that a particular surgical operation may reduce the risk of contracting certain diseases later in life does not mean the operation can be legally performed on a person incapable of giving informed consent. In E. (Mrs.) v. Eve, [1986] 2 S.C.R. 388, the Supreme Court ruled that no parent and no court has the legal authority to consent to the performance of an irreversible, non-therapeutic surgical operation on an incompetent person.

The issue of consent for circumcision has been addressed by Dr. Margaret Somerville, Founding Director of McGill University's Centre for Medicine, Ethics and Law. In her recent book, The Ethical Canary, Dr. Somerville writes:

In general, parents cannot authorize non-therapeutic interventions—that is, routine circumcision—on their children. A competent adult man could consent to non-therapeutic circumcision on himself, but this does not mean he may consent to it on his son.

Finally, if FGM was always prohibited in Canada, I have some difficulty understanding why it was necessary to amend section 268 of the Criminal Code "for greater certainty." A need for greater certainty implies that something is in doubt. If the unlawfulness of FGM was not in doubt, then why was there a need for greater certainty? More importantly, why was there a need for greater certainty with respect to FGM, but not with respect to infant male circumcision? The legal status of infant male circumcision is, if anything, even more uncertain than that of FGM. Furthermore, as the Supreme Court noted in Eve,

barring emergency situations, a surgical procedure without consent constitutes battery.
It seems to me that under these circumstances, there is an immediate need to clarify the law in relation to infant male circumcision. Could the Department of Justice please explain whether or not the Criminal Code prohibits circumcision of a non-consenting minor who has no medical need for surgery?

To sum up:

  1. The FGM classification scheme used in your letter seems to be outdated.
     
  2. Your letter ignores the fact that one form of FGM is analogous to male circumcision, and other forms are less severe than male circumcision.
     
  3. The arguments relating to medical benefits are specious.
     
  4. You use an inappropriate basis for comparing the harms of FGM to the harms of male circumcision, effectively minimizing the latter.
     
  5. In characterizing circumcision as a relatively innocuous operation that removes "only the foreskin," your letter underplays the importance of the right to physical integrity.
     
  6. Your letter takes no account of the limits to parental consent.
     
  7. You have not explained why greater certainty was required with respect to the legal status of FGM but not with respect to the legal status of infant male circumcision.
     
  8. You have not clarified whether or not circumcision can be legally undertaken on a non-consenting minor who has no medical need for surgery.
I would appreciate a response to the above points. Thank you for considering the issues I have raised.

Sincerely,
 
[signed]
 
D ennis H arrison
 


July 23, 2001

Dear Ms. Morency:

I wrote to you on May 24th requesting clarification of some points you had made regarding female genital mutilation and male circumcision. To date I have received no reply.

For your ease of reference, I enclose a copy of my letter of May 24th. I would appreciate a response at your earliest convenience.

Sincerely,
 
[signed]
 
D ennis H arrison
 


December 11, 2002

The Hon. Martin Cauchon
Minister of Justice
Attorney General of Canada

Dear Minister:

Re: Section 268 of the Criminal Code of Canada

I'm writing to request your assistance in obtaining a better understanding of section 268 of the Criminal Code as it applies to genital mutilation. Specifically, I would like to know whether section 268 applies to what might be called "token interventions."

The Toronto Star recently published an article on female genital mutilation (FGM) in Singapore. According to this article, FGM as practised in Singapore involves making a "small nick" on the clitoris with stainless steel scissors. The operation is performed on babies or young girls by female physicians at Muslim clinics. Under the internationally accepted classification scheme for genital mutilation, piercings or incisions of the clitoris are categorized as "Type IV FGM."

Since I consider genital mutilation to be an important human rights issue, I would appreciate answers to the following questions:

  1. Does a symbolic incision on the clitoris, as described in the Toronto Star article, constitute a violation of the Criminal Code of Canada if performed on a person under 18 years of age?
     
  2. Does male circumcision, if performed without medical indication on a person under 18 years of age, constitute a violation of the Criminal Code of Canada?
I would appreciate answers to the above questions at your earliest convenience. I enclose a copy of the Toronto Star article on FGM and an article from The Province (Vancouver) describing the death of a baby boy following circumcision in Penticton, B.C. According to the College of Physicians & Surgeons of B.C., routine infant male circumcision has no medical indication.

Sincerely,
 
[signed]
 
D ennis H arrison

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