"Just a snip"?: A social history of male circumcision
"Just a snip"?: A social history of male circumcision
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DOI：
10.1016/s0968-8080(07)29303-6
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发表时间：
2007-05-01
影响因子：
--
通讯作者：
Aggleton, Peter
中科院分区：
文献类型：
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作者：
Aggleton, Peter
过去七年里，越来越多的人主张将男性包皮环切术作为预防艾滋病毒的一种手段，首先是在主要在美国工作的公共卫生专家中开始，然后是在国际组织中工作的一些专家，最近又被认可为世界卫生组织和联合国艾滋病规划署支持的一揽子综合措施的一部分。 1 对于是否实施这种形式的预防*或实施的速度，人们的意见仍然存在很大分歧，尽管似乎越来越多的共识认为，与所有与艾滋病毒相关的公共卫生干预措施一样，必须以文化上适当、基于权利和性别敏感的方式促进男性包皮环切术。 3 其他地方的论文和讨论涉及性别敏感性和权利问题。我想在这里探讨的是文化和政治问题。在世界各地，男性包皮环切术都深深扎根于社会结构中。即使在医疗环境中进行，它也远不是一种简单的技术行为，它是一种带有大量社会意义的实践。其中一些含义与作为一个男人的含义有关，在一些非洲和大洋洲社会，割礼是进入成年的仪式。在其他情况下，男性割礼具有宗教含义，在犹太人和穆斯林中广泛实行，但在基督徒中较少，在其他宗教中也很少见。然而，从19世纪末开始，男性包皮环切术也进入了公共卫生领域。尤其是在美国，历史上它被视为解决各种医学和社会问题的灵丹妙药——从瘫痪和髋关节疾病到紧张、反社会行为和低能。 4 然而，至关重要的是，男性割礼仍然是等级制度和社会差异的有力指标。在奥斯曼帝国和摩尔帝国时期，在纳粹德国，在分治时期的印度，以及最近在波斯尼亚和东帝汶发生的种族灭绝事件中，一个男人的割礼状况对其所受到的待遇产生了严重的后果：对于那些未达标的人来说，后果就是暴力、酷刑和死亡。在此背景下，本文旨在为当前有关男性包皮环切的争论增添平衡和背景。它质疑具有如此深刻的社会意义和如此丰富的意义的行为的价值中立性。它强调了男性割礼——就像其对应的女性生殖器切割一样——几乎总是一种强烈的政治行为，由权力者为了更广泛的公共利益而对他人实施，但也会产生深远的个人和社会后果。社会学家、人类学家、历史学家和精神分析学家等就这一主题撰写了大量文章，5 我仅在此提及，但在当前艾滋病毒预防的全球化身中，男性包皮环切术被视为最微不足道、最无关紧要的事情。最近世界卫生组织/联合国艾滋病规划署关于男性包皮环切的咨询会议的一位与会者如此描述“只是一个小插曲”。
THE last seven years have seen growing advocacy for male circumcision as a means of HIV prevention, commencing first among public health specialists working mainly in the USA, then among some of those working in international organisations, and more recently endorsed as part of a comprehensive package of measures supported by both the World Health Organization and UNAIDS. 1 Opinions continue to differ sharply as to whether or not to implement this form of prevention*–or how quickly to do so–although there appears to be growing consensus that, as with all HIV-related public health interventions, male circumcision must be promoted in a culturally appropriate, rights-based and gender sensitive way. 3 Papers and discussions elsewhere take up issues of gender sensitivity and rights. It is issues of culture and politics that I want to examine here. All over the world male circumcision has its roots deep in the structure of society. Far from being a simple technical act, even when performed in medical settings, it is a practice which carries with it a whole host of social meanings. Some of these meanings link to what it is to be a man, with circumcision taking place as a rite of passage into adulthood in several African and Oceanic societies. In other settings, male circumcision carries religious connotations, it being widely practised among Jews and Muslims, although less so among Christians and rarely among other religions. From the late 19th century onwards, however, male circumcision also entered into the field of public health. It has been viewed in the USA in particular as a panacea for a wide range of medical and social problems historically–from paralyisis and hip joint disease to nervousness, anti-social behaviour and imbecility. 4 Crucially, however, male circumcision remains a potent indicator of hierarchy and social difference. During the Ottoman and Moorish Empires, in Nazi Germany, in India at partition and in the recent genocides of Bosnia and East Timor, a man’s circumcision status had serious consequences for how he was treated: with violence, torture and death being the consequence for those who fell short of the mark. Against this background, this paper seeks to add balance and context to current debates concerning male circumcision. It questions the value neutrality of an act so profound in its social significance and so rich in meaning. It highlights how male circumcision–like its counterpart female genital mutilation–is nearly always a strongly political act, enacted upon others by those with power, in the broader interests of a public good but with profound individual and social consequences. A vast deal has been written on this subject by sociologists, anthropologists, historians and psychoanalysts, among others, 5 which I will only touch upon here, yet in its current global incarnation for HIV prevention, male circumcision is being talked of as if it were the most trivial and inconsequential of matters.‘‘Just a little snip’’was how one participant in one of the recent WHO/UNAIDS consultative meetings on male circumcision described it.