BILL ANALYSIS                                                                                                                                                                                                    �






                             SENATE JUDICIARY COMMITTEE
                             Senator Noreen Evans, Chair
                              2011-2012 Regular Session


          AB 768 (Gatto and Ma)
          As Amended August 15, 2011
          Hearing Date: August 23, 2011
          Fiscal: No
          Urgency: Yes
          RD   
                    

                                        SUBJECT
                                           
                                  Male Circumcision

                                     DESCRIPTION  

          This urgency bill would bar any city, county, or city and county 
          from prohibiting or restricting the practice of male 
          circumcision, or the exercise of parental authority to have a 
          child circumcised.  This bill would also make legislative 
          findings. 

                                      BACKGROUND  

          While male circumcision is considered a commandment from God in 
          Judaism, and is also routinely practiced by Muslims, male 
          circumcision is now also widely practiced by many others in the 
          United States for social reasons, as well as hygiene or other 
          health-related reasons.  Though now in the minority worldwide, 
          circumcised men remain the vast majority in the United States. 
          (Ogilvie, The Debate over Circumcising Baby Boys, L.A. Times 
           July 11, 2011 �as of August 17, 2011].)  

          To date, many major medical associations have not yet taken a 
          position on routine male circumcision.  The American Academy of 
          Pediatrics (AAP) states that circumcision has both risks and 
          benefits and further states that parents should be given all the 
          information available to make an informed decision as to whether 
          to circumcise their children or not.  (AAP website, 
           �as of August 17, 2011].) 
           (Note: the Center for Disease Control and Prevention (CDC) is 
                                                                (more)



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          currently working on a recommendation on the practice of 
          circumcision, but no such recommendation has been released as of 
          the writing of this analysis.)  

          In 2004, a coalition of individuals opposed to the practice of 
          male circumcision sought to introduce a bill in Congress called 
          the "Male Genital Mutilation Bill."  (MGM Bill, Press Release 
          February 23, 2004, available at 
           �as of August 17, 2011].) 
           Since that time, similar measures have been proposed in various 
          localities, including a recent initiative proposed in San 
          Francisco, as further discussed below.  
            
          In 2011, sufficient signatures were gathered to qualify the 
          placement of an initiative on the November ballot in San 
          Francisco to ban the practice of male circumcision, also coined 
          as "Male Genital Mutilation" by proponents of the ban, comparing 
          the practice of male circumcision with female genital mutilation 
          (FGM), which is prohibited by state and federal statute.  (Pen. 
          Code Sec. 273.4; 18 U.S.C. Sec. 116; See Comment 3b for a 
          discussion of the practice of FGM.)  Specifically, the proposed 
          San Francisco measure would have made the practice of 
          circumcision a misdemeanor offense punishable by a fine of up to 
          $1,000 or up to one year in jail.  The measure did not provide 
          for religious exemptions.  (SF MGM Bill, available at 
           �as of August 17, 
          2011].)  In Santa Monica, sufficient signatures were also 
          obtained to place a similar measure on the ballot, but the 
          measure was later removed voluntarily.  Together, these 
          initiatives represent part of a greater movement to ban male 
          circumcision.  

          Separate from this bill, opponents of the San Francisco male 
          circumcision ban filed suit in Superior Court, seeking the 
          removal of the measure from the November ballot.  The American 
          Civil Liberties Union (ACLU) and the San Francisco City 
          Attorney's Office both filed amicus briefs in favor of removing 
          the measure from the ballot.  On July 28, 2011, several weeks 
          after the introduction of this bill, a San Francisco Superior 
          Court judge ruled in favor of the male circumcision ban's 
          opponents, removing the measure from the November ballot.  The 
          judge's ruling states that "the proposed ballot Initiative is 
          expressly preempted by California Business and Professions 
          �Code] �460(b).  The evidence presented is overwhelmingly 
          persuasive that circumcision is a widely practiced medical 
          procedure.  California Business and Professions Code �460(b) 
                                                                      



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          applies to medical services provided by a wide range of health 
          care professionals.  The statute speaks directly to the issue of 
          local regulation of medical procedures and leaves no room for 
          localities to regulate in this area.  In fact, the legislative 
          history of �460(b) confirms that the legislature intended to 
          prevent cities and counties from regulating medical services 
          which is a matter �of] statewide concern.  Because the proposed 
          ballot initiative attempts to regulate a medical procedure, the 
          proposed ordinance is expressly preempted."  (Jewish Community 
          Relations Council of San Francisco, et al v. John Arntz, in his 
          official capacity as Director of Elections, et al, available at 
           �as of August 17, 
          2011].)

          In making legislative findings in favor of the health benefits 
          of male circumcision and in order to clarify existing law's 
          prohibition against local authority to regulate medical 
          practices, this bill would expressly preclude any prohibition or 
          restriction of the practice of male circumcision or the exercise 
          of parental authority with respect to male circumcision through 
          any city, county, or city and county statute, ordinance, 
          regulation, or administrative action.  In order to ensure 
          uniform application of male circumcision laws throughout the 
          state, this bill expressly provides that it shall apply to 
          general law and charter cities, general law and charter 
          counties, and charter city and counties.  The bill also 
          reaffirms parental authority to make decisions as to male 
          circumcision.

          AB 768 includes an urgency clause and would take effect 
          immediately. 

                                CHANGES TO EXISTING LAW
           
           Existing law  , the U.S. Constitution, provides in part that 
          Congress shall make no law respecting an establishment of 
          religion, or prohibiting the free exercise thereof.  (U.S. 
          Const., 1st Amend, as applied to the states through the 14th 
          Amendment's Due Process Clause; See Cantwell v. Connecticut 
          (1940) 310 U.S. 296 and Everson v. Board of Education (1947) 
          U.S. 330 U.S. 1.)  

           Existing law  , the California Constitution, provides that free 
          exercise and enjoyment of religion without discrimination or 
          preference are guaranteed.  Existing law also specifies that 
                                                                      



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          this liberty of conscience does not excuse acts that are 
          licentious or inconsistent with the peace or safety of the 
          State.  Existing law also provides that the Legislature shall 
          make no law respecting an establishment of religion.  (Cal. 
          Const. Art. 1, sec. 4.)

           Existing law  , the U.S. Constitution, prohibits any state or 
          local government from depriving any person of life, liberty, or 
          property without due process of the law.  (U.S. Const., 14th 
          Amend., Sec. 1.)  Existing case law recognizes that the due 
          process clause protects "a realm of personal liberty which the 
          government may not enter," including the right of parents to 
          direct the upbringing of their children.  Planned Parenthood v. 
          Casey (1992) 505 U.S. 833, 847.  Existing case law also holds 
          that "the interest of parents in the care, custody, and control 
          of their children . . . is perhaps the oldest of the fundamental 
          liberty interests."  Troxel v. Granville (2000) 530 U.S. 57, 65.

           Existing law  provides that no city, county, or city and county 
          shall prohibit a healing arts professional licensed with the 
          state, as specified, from engaging in any act or performing any 
          procedure that falls within the professionally recognized scope 
          of practice of that licensee.  (Bus. & Prof. Code Sec. 460(b).)  
          
          
           Existing law  , criminalizes the practice of female genital 
          mutilation, as defined as the excision or infibulation of the 
          labia majora, labia minora, clitoris, or vulva, performed for 
          nonmedical purposes.  (Pen. Code Sec. 273.4.)   
           
          This bill  would provide that no city or county, or city and 
          county statute, ordinance, regulation or any administrative 
          action may prohibit or restrict the practice of male 
          circumcision, or the exercise of a parent's authority to have a 
          child circumcised.  

           This bill  would apply to general law and charter cities, general 
          law and charter counties, and charter city and counties as part 
          of a stated need to have uniform application of laws affecting 
          male circumcision throughout the state.  
           
          This bill  would make related legislative findings. 

           This bill  would go take effect immediately as an urgency 
          measure.   
                                          
                                                                      



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                                       COMMENT
           
          1.    Stated need for the bill  

          According to the author: 

            There have been recent efforts by some to enact local 
            ordinances banning this very personal parental choice.  A 
            local initiative in the City of San Francisco had qualified 
            for the ballot this November that would ban this otherwise 
            legal practice.  A court ruled the initiative unconstitutional 
            and removed it from the ballot in San Francisco. . . .  AB 768 
            seeks to nullify such a ban in the event the San Francisco 
            initiative passes this coming November, by occupying the field 
            at the state level as it pertains to male circumcision.  This 
            measure would further serve to prevent anyone from trying to 
            introduce a similar initiative either in San Francisco or 
            anywhere else in the State, and would save money in legal 
            costs by eliminating the need for lawsuits challenging the 
            constitutionality of such measures if they are brought up in 
            other localities.  Even if the courts keep the San Francisco 
            initiative off the ballot, AB 768 would effectively prevent 
            future attempts to qualify similar initiatives that might be 
            drafted to answer the courts' concerns, again saving money in 
            legal costs for the future court challenges that would come as 
            a result of such redrafted measures.

          The ACLU writes that it supports AB 768 "because it clarifies 
          that existing law preempts local ordinances banning or 
          restricting circumcision and it is important because of the 
          fundamental rights at stake. . . .  A local ban or 
          criminalization of male circumcision interferes with the 
          parents' right to direct the medical treatment and religious 
          upbringing of their children." 

          The California Medical Association (CMA) writes: 

            �T]he CMA has long endorsed the concept of newborn 
            circumcision as an effective public health measure.  Numerous 
            studies and clinical trials have associated male circumcision 
            with a lower risk for HIV and HPV infection and, to some 
            extent, transmission.  While, like many medical procedures, 
            there are some risks, serious complications are rare.  Despite 
            the varying opinions on the benefits and risks of the 
            procedure, the CMA is generally concerned �with] any local 
            jurisdictions passing an ordinance that will interfere with 
                                                                      



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            the practice of medicine.  The decision to perform such a 
            medical procedure should be left up to the parents in 
            consultation with their physician. 

          2.    Freedom of religion  

          This bill would prohibit local governments from banning the 
          practice of male circumcision in an effort to ensure uniform 
          laws with respect to medical procedures throughout the state.  
          The bill also would have the effect of prohibiting interference 
          in the practice of religion insofar as male circumcision is a 
          tenet of that religion.  As a result, it could be argued that 
          this bill potentially raises issues as to the constitutional 
          guarantees of freedom of religion.  

          The United States Constitution's First Amendment provides for 
          freedom of religion in that it states: "Congress shall make no 
          law respecting an establishment of religion, or prohibiting the 
          free exercise thereof."  Thus, the right to believe in and to 
          practice one's religion is encompassed in two parts reflected in 
          the language of the First Amendment: the establishment clause 
          and the free exercise clause.  

          Similarly, the California Constitution provides that "�t]he free 
          exercise and enjoyment of religion without discrimination or 
          preference are guaranteed.  This liberty of conscience does not 
          excuse acts that are licentious or inconsistent with the peace 
          or safety of the State.  The Legislature shall make no law 
          respecting an establishment of religion."  (Cal. Const. Art. 1, 
          sec. 4.)

          Although the constitutionality of a statute is an issue for the 
          courts, for the reasons discussed below, it does not appear that 
          this bill would raise free exercise clause issues.

            a.    Free exercise clause
             
            The free exercise clause, first applied to the states through 
            the due process clause of the 14th Amendment in Cantwell v. 
            Connecticut (1940) 310 U.S. 296, is directed at individual 
            liberty and interpreted to provide that the government may not 
            compel or punish religious beliefs; all persons have the 
            individual liberty to think and believe in whatever they want. 
             (Erwin Chemerinksy, Constitutional Law Principles and 
            Policies (2006) 3rd Edition, pg. 1182; 1246.)  
             
                                                                      



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            By expressly precluding local governments from prohibiting or 
            restricting the practice of male circumcision, this bill does 
            not compel religious beliefs or practices, but instead 
            prohibits local governments from interfering with the free 
            exercise of religion by enacting ordinances or measures that 
            punish religious beliefs and practices that involve the 
            practice of male circumcision.  As such, this bill arguably 
            does not directly raise issues with respect to the free 
            exercise clause.  



            b.    Establishment clause
            
            The establishment clause, first applied to the states through 
            the due process clause of the 14th Amendment in Everson v. 
            Board of Education (1947) U.S. 330 U.S. 1, "?appears more 
            directed at the government.  The Supreme Court, however, has 
            explained that the establishment clause, too, protects 
            liberty."  (Erwin Chemerinksy, Constitutional Law Principles 
            and Policies (2006) 3rd Edition, pg. 1182.)  The clause 
            prohibits not just the establishment of an official state 
            religion, but also prevents the establishment of a preference 
            for one (or more) religion(s) over any others by the 
            government, or a preference for all religions over no 
            religion, the effect of which is to prevent not just the 
            creation of a state religion, but also to allow individuals 
            the utmost freedom to exercise the religion of their choice or 
            no religion at all.     

            Under current U.S. Supreme Court case law, if government 
            discriminates among religious groups, it violates the 
            establishment clause unless it meets the strict scrutiny test 
            (i.e. it must be justified by a compelling government interest 
            and the law must be narrowly tailored to achieving that goal 
            or interest).  If there is no discrimination, the Supreme 
            Court has applied a three-part test first articulated in Lemon 
            v. Kurtzman (1971) instead of the strict scrutiny test.  (403 
            U.S. 602.)  Under the Lemon test, government violates the 
            establishment clause unless it meets the following: "First, 
            the statute must have a secular legislative purpose; second, 
            its principal or primary effect must be one that neither 
            advances nor inhibits religion; finally, the statute must not 
            foster an excessive government entanglement with religion."  
            (Id. at 612-3.)

                                                                      



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            In other words, a statute fails the Lemon test if its primary 
            purpose is to advance religion, or if the principal effect is 
            to aid or inhibit religion, or if there is excessive 
            government entanglement with religion.  With respect to the 
            California Constitution's guarantee against the establishment 
            of religion, California courts have likewise applied the Lemon 
            test (see e.g. California Educational Authority v. Priest 
            (1974) 12 Cal.3d 593; East Bay Asian Local Development Corp. 
            v. State of California (2000) 102 Cal.Rptr.2d 280).
             
            Because AB 768 would generally recognize that male 
            circumcision has benefits and would protect the practice of 
            male circumcision from local government prohibition or 
            restrictions, and because this particular procedure is closely 
            tied to the practices and beliefs of both the Jewish and 
            Muslim religions, the issue may arise as to whether the 
            proposed statute would violate the establishment clause of the 
            First Amendment.  Since the law is neither exclusive to those 
            religions nor facially lends preference to either of those 
            denominations over others, the relevant test to determine 
            whether there is any violation of the establishment clause is 
            the Lemon Test; strict scrutiny does not appear to apply 
            because the bill is arguably a neutral law of general 
            applicability.


               i.    Whether the bill has a secular legislative purpose 

                Here, with respect to the first prong of the Lemon test, AB 
               768 arguably has a secular legislative purpose: as 
               reflected in the language of the bill itself, AB 768 seeks 
               to advance uniform laws regulating medical procedures 
               throughout the state.  The reason male circumcision has 
               been specifically highlighted is to ensure clarity that 
               current law, Section 460(b) of the Business and Professions 
               Code applies to this procedure as well as any other medical 
               procedure within the scope of the profession, in light of 
               local efforts to circumvent the state legislative process 
               and prohibit that particular procedure.  The author further 
               asserts that "the statute has a purely secular purpose in 
               that it (a) addresses a medical procedure and (b) makes no 
               reference to religion."
                
               ii.     Whether the primary effect of the bill is to advance 
               or inhibit religion  

                                                                      



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               With respect to the second prong of the Lemon test, the 
               primary effect of this bill is neither to aid nor inhibit 
               religion as it leaves the status quo in place and has the 
               primary effect of prohibiting inconsistent laws about a 
               particular medical procedure throughout the state.  As 
               stated by the author, this bill merely "occupies the field 
               to regulate a medical practice, something �the state] has 
               done on countless other medical practices."  Moreover, 
               Committee staff notes that the proposed statute would 
               arguably aid persons of non-Jewish or non-Muslim faith who 
               wish to circumcise their sons just as much as it would aid 
               persons of those faiths.  Circumcision is a decision made 
               by many families for reasons wholly unrelated to religion, 
               but instead having to do with social concerns (for example, 
               wanting their sons to look like their friends in locker 
               rooms), hygiene benefits or other medical-related reasons. 

               iii.    Whether the bill fosters an excessive government 
               entanglement with religion  

               Finally, with respect to the third prong of the Lemon test, 
               this bill does not appear to cause excessive government 
               entanglement with religion given the secular nature of the 
               bill.  In making such a determination, the Supreme Court 
               has stated that "we must examine the character and purposes 
               of the institutions that are benefited, the nature of the 
               aid that the state provides, and the resulting relationship 
               between the government and the religious authority."  
               (Lemon, 403 U.S at 615.)  Thus, the nature of the improper 
               aid does not have to be in the form of monetary funds; the 
               Court pointed to Justice Harlan's dissent in Walz v. Tax 
               Commission (1970) 397 U.S. 664, which "echoed the classic 
               warning as to 'programs, whose very nature is apt to 
               entangle the state in details of administration . . . . '"  
               (Id. (citation omitted).)  

               In the case of AB 768, the proposed statute arguably would 
               not result in excessive entanglement with religion as it 
               does not solely benefit Jewish and Muslim institutions; 
               religious institutions benefit frequently from general 
               laws, as they would in this case.  The nature of the aid 
               that would be provided by the proposed statute appears to 
               be to both secular and non-secular groups, insofar as it 
               would prevent local government entanglement in the 
               restriction or prohibition of a medical procedure that is 
               currently being performed and available to the general 
                                                                      



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               public (i.e. including both religious and non-religious 
               persons who wish to have circumcision performed on their 
               sons), irrespective of their religion or lack thereof.  As 
               such, proponents of this bill argue that AB 768 would 
               affect both secular and religiously-motivated 
               circumcisions, and constitutes a permissible, though not 
               mandatory, accommodation of religion.  

               The author would further argue that "�t]he state has long 
               regulated medical practices, but it does not inquire into 
               the religion of the person engaging in the practice. This 
               is no more an endorsement of religion than is the state's 
                                                                                  tolerance and regulation of wine, which is used by many 
               Christians as a sacrament."  To this end, Committee staff 
               notes that the bill does not result in the state becoming 
               further involved with circumcision as a practice any more 
               than it has been before, as there would be no need for 
               state administration or oversight of the practice of 
               circumcision as a result of this bill.  Arguably, the bill 
               merely prohibits local government interference with the 
               performance of circumcision, which the court in San 
               Francisco has already indicted would violate the free 
               exercise clause of the First Amendment.  (See Jewish 
               Community Relations Council of San Francisco, et al v. John 
               Arntz, in his official capacity as Director of Elections, 
               et al, available at 
                �as of 
               August 17, 2011].)  
             
          3.    Parental rights  

          This bill would permit parents to continue to make decisions 
          about circumcision of their sons with their physician.  Frequent 
          arguments made against male circumcision include that parents 
          should not be able to make this decision for their children in 
          light of the health risks, that male circumcision is in fact 
          more aptly described as Male Genital Mutilation and is the 
          equivalent of allowing parents to amputate appendages of 
          children without medical necessity or is analogous to the 
          outlawed practice of FGM (see Comment 3b).  In support of male 
          circumcision, the argument is inversely made that parents have 
          the right to direct the upbringing of their children, including 
          not only making decisions based on religious beliefs, but also 
          making medical decisions for the child, and that the health 
          benefits of male circumcision are sufficient to allow parents to 
                                                                      



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          make this decision in consultation with their children's 
          doctors.    

             a.    Preserving the right of parents to direct the upbringing 
               and medical treatment of their children  

            By explicitly stating that local governments may not restrict 
            or prohibit the practice of male circumcision, or the exercise 
            of parental authority with respect to the same, this bill not 
            only clarifies and reinforces existing law as to the authority 
            of the state to regulate medical procedures (see Comment 4), 
            but it also protects the fundamental interest of parents to 
            direct both the upbringing and the medical treatment of their 
            children, reinforcing what is already a matter of existing 
            constitutional law.  

            While proponents of a male circumcision ban argue for the 
            bodily rights of children who are unable to make this decision 
            for themselves and equate the practice to FGM or amputation of 
            any other body part without medical necessity, numerous 
            sources recognize medical benefits as well and parents often 
            must make the decision of treatment for their children, 
            despite any bodily autonomy rights of children, and in face of 
            potential risks.  Moreover, doctors have an ethical obligation 
            to do no harm to their patients, and would not likely perform 
            a procedure on a child whose overall health would be clearly 
            harmed by the performance of the procedure.  Committee staff 
            also notes, in Comment 3c below, the significant difference 
            between FGM and male circumcision, as well as premature 
            amputation of appendages.  

            In support of this bill, the ACLU argues that "�t]he 
            circumcision of male infants is a fundamental religious ritual 
            of the Jewish and Islamic faiths.  Parents from these faiths 
            have a protected right to direct the 'religious upbringing and 
            education of their children in their early and formative 
            years.�'] Wisconsin v. Yoder, 406 U.S. 205, 213-214 (1972).  
            Banning circumcisions would deny parents this right.  A ban 
            would also interfere with parents' right to direct the medical 
            treatment of their children.  According to the World Health 
            Organization, 'there is compelling evidence that male 
            circumcision reduces the risk of heterosexually acquired HIV 
            infection in men by approximately 60%.' 
            http://www.who.int/hiv/topics/malecircumcision/en/index/html" 

            It is well established by U.S. Supreme Court precedent that 
                                                                      



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            the U.S. Constitution prohibits any state or local government 
            from "depriving any person of life, liberty, or property 
            without due process of the law."  (U.S. Const., 14th Amend., 
            sec. 1.)  The Supreme Court has interpreted the due process 
            clause as "a promise of the Constitution that there is a realm 
            of personal liberty which the government may not enter," 
            including the right of parents to direct the upbringing of 
            their children.  (Planned Parenthood v. Casey (1992) 505 U.S. 
            833, 847; see also Truxel v. Granville (2000) 530 U.S. 57, 65: 
            "We have long recognized that the Amendment's Due Process 
            Clause . . . 'guarantees more than fair process.'  �Citation 
            omitted.]  The Clause also includes a substantive component 
            that 'provides heightened protection against government 
            interference with certain fundamental rights and liberty 
            interests.'")  In Troxel, the Supreme Court noted that "the 
            interest of parents in the care, custody, and control of their 
            children . . . is perhaps the oldest of the fundamental 
            liberty interests."  (530 U.S. 57, 65.) 

            At the same time, under Prince v. Massachusetts (1944), if it 
            appears that parental decisions will jeopardize the health or 
            safety of the child, or have a potential for significant 
            burdens, there may be limitation to even the claim of a First 
            Amendment right to the free exercise of religion, which 
            includes directing the religious upbringing of one's child.  
            (321 U.S. 158.)  Likewise, while the state can clearly enter 
            the private "realm of personal liberty" guaranteed by the 
            Fourteenth Amendment in cases such as those involving child 
            abuse, neglect, or other dangers to the child's health or 
            safety, to equate male circumcision to such cases or to FGM or 
            unnecessary amputation of appendages arguably overlooks that 
            there are documented health benefits associated with male 
            circumcision that are recognized by many in the medical 
            profession, even if the medical community has not definitively 
            made a recommendation one way or another at this time.  

            The author's office notes that the comparison of male 
            circumcision to FGM is "an apples and watermelons comparison.  
            FGM involves the complete removal of female body parts, namely 
            the clitoris, or the sewing together of their vulva. 
            Circumcision, obviously, does not involve the complete removal 
            of the penis, or the sewing together of any part of the penis. 
             Unlike FGM, which is known to cause serious health issues in 
            women and endanger their lives, circumcision is known to have 
            health benefits.  From a sociological perspective, FGM is 
            essentially a means to subjugate women.  Circumcision is done 
                                                                      



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            by parents with no such societal intent. The intent is to 
            provide for the health of their male offspring."  

            This bill would allow doctors and parents to continue to 
            evaluate and make these decisions in private, for children who 
            are not of age to make this decision for themselves.  Parents 
            make similar decisions continually for their children until 
            they reach the age of maturity.  As a matter of public policy, 
            for local governments to insert themselves in this private 
            realm as parens patriae arguably appears premature, if not in 
            violation of the 14th Amendment, absent the finding among the 
            medical community that this is the equivalent of FGM or 
            harmful amputations.

            Furthermore, if such a ban is to take place, because of 
            concerns for uniform laws for medical procedures, it is also 
            arguable that as a matter of public policy such a decision is 
            one that should be made at a statewide level, as recognized by 
            existing state law, Business and Professions Code Section 
            460(b).  (See Existing Law.) 

             b.    Female genital mutilation is distinct both in character 
               and consequences from male circumcision  

            In 1996, the California State Prohibition of Female Genital 
            Mutilation Act was enacted, making various legislative 
            findings about FGM and criminalizing the practice, which the 
            bill defined as the excision or infibulation of the labia 
            majora, labia minora, clitoris, or vulva, performed for 
            nonmedical purposes.  (AB 2125 (Figueroa, Ch. 790, Stats. 
            1996); Pen. Code Sec. 273.4.)  Among the findings made are 
            that FGM is a medically unnecessary modification of the female 
            genitalia which typically occurs at about seven years of age, 
            but is known to be practiced on girls any time between infancy 
            and puberty.  FGM involves the excision of a young girl's 
            clitoris and other parts of the external genitalia. The most 
            extreme form of this mutilation, known as infibulation, also 
            involves the sewing together of the two sides of the vulva, 
            leaving only a small opening for the passage of menstrual 
            blood and urine.  

            As stated in AB 2125, FGM constitutes a major health risk to 
            women, with lifelong physical, psychological, and human rights 
            consequences.  Complications due to FGM include, shock, 
            hemorrhage, infection, tetanus and septicemia from 
            unsterilized instruments, bladder infection, and even death.  
                                                                      



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            Long-term complications include chronic vaginal and uterine 
            infections, severe pain during urination, menstruation, and 
            sexual intercourse, and obstetric complications due to 
            obstruction of the birth canal by scar tissue.  For the 
            obstructed infant, labor can lead to brain damage or death.  

          4.    Arguments in opposition  

          In opposition to this bill, Jews for the Rights of the Child 
          writes: 

            Our group believes it is anachronistic for Jews and Muslims to 
            be allowed to commit a heinous crime on their boys, amounting 
            to ritual sexual abuse, in the name of religion. No other 
            religious or cultural groups are granted such license.  We 
            Jews are required to respect the Law of the Land.  We feel it 
            is high time for the Law of the Land to reflect current policy 
            and thinking about the personhood and rights of infant and 
            minor boys. If the US Government and the State of California 
            will not, our Cities must have the right to do so.  

            The claims to medical advantages for infant male circumcision 
            inserted into the bill are fraudulent.  Any amputation 
            (provided the victim survives) results in a lower infection 
            rate of the missing part (even with female genital cutting). 
            But in no other context does that slight benefit provide 
            sufficient justification to legally perform the amputation of 
            a healthy organ (such as the prepuce) from a protesting minor. 
            The short- and long-term neurological, psychological, sexual, 
            relationship, social, cosmetic, ethical, and financial -- as 
            well as medical (including death) -- harms from circumcision 
            (certain and potential) far outweigh any advantages.

          Also in opposition, Intact America argues that "�n]o medical 
          society in the world recommends circumcision as necessary 
          medical care.  Neonatal circumcision destroys erogenous tissue 
          and places newborns at immediate risk of infection, hemorrhage, 
          penile damage, and even death.  In 2010, a Georgia boy received 
          $2.3 million as compensation for a botched circumcision that 
          removed a large part of his penis.  Earlier this year, a South 
          Dakota family was awarded $230,000 for the loss of their son, 
          who bled to death following his circumcision."  �Emphasis in 
          original.]  Intact America further asserts that "�c]ircumcision 
          violates a child's basic human body right to bodily integrity.  
          All children must be protected from bodily harm.  In the United 
          States, federal and state laws prohibit any form of genital 
                                                                      



          AB 768 (Gatto and Ma)
          Page 15 of ?



          cutting on girls by health care professionals or laypersons, 
          while the genital cutting of boys is not only currently 
          tolerated but actually promoted in medical settings."  �Emphasis 
          in original.]  


           Support  :  American Civil Liberties Union (ACLU); California 
          Medical Association (CMA)

           Opposition  :  Alliance for Transforming the Lives of Children; 
          Bay Area Intactivists; Circumcision Resource Center; Colorado 
          Chapter, National Organization of Circumcision Information 
          Resource Centers; Doctors Opposing Circumcision (D.O.C.); Intact 
          America; Intact Sonoma; Jews for the Rights of the Child; 
          MGMbill.org; National Organization of Circumcision Information 
          Resource Centers (NOCIRC); Wellness Associates; seven 
          individuals

                                        HISTORY
           
           Source  :  Author

           Related Pending Legislation  :  None Known

           Prior Legislation :  AB 2125 (Figueroa, Ch. 790, Stats. 1996), 
          See Comment 3b.  

           Prior Vote  :  Not Relevant

                                   **************