How International organisations turned a genital ritual into a global health policy: the resemantisation of male circumcision as a practice of world politics

Male circumcision is a practice of genital cutting used for millennia to structure social organisation and produce social norms. In 2007, the World Health Organisation (WHO) and the Joint United Nations Programme on HIV and AIDS (UNAIDS) established this ancestral practice as the 1st surgery ever used as a preventive health policy. In the initial stage of its implementation (2008-2017), the programme circumcised 18.6 millions boys and men as part of their Voluntary Medical Male Circumcision (VMMC) anti-HIV policy. Based on this case study, I develop resemantisation as a theoretical and methodological framework to empirically account for the discursive strategies through which organizational discourse attaches new meanings to practices and, doing so, legitimize their policies and naturalise norms and socio-political orders associated with such practices. First, we introduce the theoretical and methodological rationale behind resemantisation and draw guidelines for the empirical implementation of the approach, which we demonstrate in the following sections. Against political discourses that distinguish medicalized and non-medicalised genital cutting as inherently different, we show how the different globalization stages of male circumcision have led to different waves of resemantisation leading to the current medicalization of the practice that emerged in the in the XIX century British empire as a cure to masturbation. Second, we map the historical and contemporary domestic and inter-national uses of the practice, emphasizing the cultural specificity of the United-States, a main founder of global health organisations whose medical community is the only one to believe male circumcision has prophylactic and curative properties. Third, we explore the representations of VMMC in UNAIDS and WHO discourses through a computer-assisted discourse analysis of 396 documents curated by these agencies (2007-2017). We identify three main representations – as a service and commodity, as a modern act of expertise and as a sexual and masculine enhancer – that produce social norms contravening the explicit distinction between traditional and medical circumcision also explicitly defended by IOs as part of their legitimitation strategy. Overall, this paper contributes to build a bridge between the literature focusing on IOs and discourse and the practice turn in IR, and offers a template for theory-making regarding the role discourse in world politics.