While looking for something else, I ran into Why can’t the United States stop circumcising boys?, an interesting essay by Robert Darby. Widespread male circumcision is a phenomenon that, in wealthy countries, has happened almost exclusively ((I say “almost exclusively” because I suspect circumcision of boys is widespread in Israel.)) in English-speaking countries, and that has faded in every English-speaking country but the USA, where the majority of boys are still circumcised.
So why the American exceptionalism? Despite the title of Darby’s essay, he doesn’t provide a convincing answer, and some of the possibilities brought up seem unlikely to explain the distinction. (For example, I’m sure that the profit motive is important to circumcision — did you know that hospitals make huge profits selling cut-off foreskins? ((From Darby’s essay: “In the age of biotechnology and tissue engineering, human body parts have a high market value, and baby foreskins are especially prized as the raw material for many biomedical products, from skin grafts to anti-wrinkle cream. The strongest pressure for the continuation of circumcision may not be from doctors at all, but from the hospitals which harvest the foreskins and sell them to commercial partners. This would explain why so many mothers are still pressured to sign consent forms when they arrive for their delivery.”)) — but I don’t see any reason to expect that to be more the case in the US than in other countries).
Darby does suggest a legislative approach to reducing male circumcision, short of an outright ban, which is to stop having the government pay for it. In California, the circumcision rate plummeted once Medicaid coverage ended.
Two things annoyed me about Darby’s essay. First off, the seemingly obligatory passage ((Although Amanda points out an exception to this rule.)) , in any essay objecting to male circumcision, comparing the practice to female circumcision:
The claims of culture are taken very seriously in this age of globalization, but the problem with this particular claim is that it is applied inconsistently. First, there is discrimination based on gender. No matter how important circumcision of girls may be to the cultural/ethnic/religious groups that practise it, American opinion has determined that girls’ bodies are more important than tradition, and that any cutting of the female genitals is Female Genital Mutilation, now banned by law. Secondly, the cultural argument seems to be a one-way street. When faced by parents from circumcising cultures, doctors say they must respect their traditions and accede to their wishes, at least in relation to boys. But when it comes to non-circumcising cultures (the great majority) the argument is suddenly reversed: instead of enjoying automatic respect for their traditions, parents from non-circumcising cultures are pressured to conform to the American norm and to consent to have their sons circumcised, so that they will be “like other boys”.
A more likely explanation than gender-based discrimination is discrimination based on culture (otherwise known as xenophobia); of course we venerate our own cultural acts of child abuse even while correctly disliking the child abuse practiced by other cultures. It’s also the case that, bad as male circumcision is, FGM is in many ways worse; the implicit assumption that the two circumcisions are equivalent (and therefore there is no reason other than sexism that anyone might find FGM more objectionable) doesn’t hold water.
That said, regardless of what US circumcision practice is based on, the effect is a form of child abuse practiced nearly exclusively on boys, and that’s objectionable from a feminist point of view.
Darby also writes:
No matter how many statistics-laden articles get published in medical journals, circumcision cannot shake off the traces of its Victorian origins. It remains the last surviving example of a once respectable proposition that disease could be prevented by the pre-emptive removal of normal body parts which, though healthy, were thought to be a weak link in the body’s defences. In its heyday this medical breakthrough, described by Ann Dally as “fantasy surgery”, enjoyed wide esteem and included excisions of other supposed foci or portals of infection, such as the adenoids, tonsils, teeth, appendix and large intestine.
But circumcision is not “the last surviving” example of such a widespread practice in the US; weight loss surgery is skyrocketing in popularity, justified by unproven long-term preventative effects.
P.S. Also interesting: Darby’s review of the book Madhouse — about Henry Cotton, administrator of a New Jersey asylum, who for decades forcibly removed teeth and other body parts from unwilling patients “for their own good,” and was much admired for this practice.
Cotton was not just a fanatic applying the physicalist procedures of mainstream medicine to the new field of psychiatry, but the embodiment of a deep-seated trend in the medical profession itself: the assumption that if these wise experts think some sort of treatment or procedure is good for you, it is your duty to submit to it, and even that they are entitled–by virtue of their scientific understanding and promise of benefit–to force it on you, with or without informed consent. Throughout his career, Cotton insisted that he was at the forefront of scientific rationality and that his therapies must be enforced because they flowed inexorably, as a matter of mere logic, from the facts of disease as established by the science of which he was the anointed interpreter. He claimed that his approach was based on “scientific medicine,” the germ theory of disease, and “scientific evidence and proof.” His published articles are peppered with terms like “progressive medical men,” “indisputable facts,” “modern medical knowledge”; it hardly needs to be said that they were totally innocent of any ethical awareness.
Oh, well fine. Write this post while I have one in the works called “Male Circumcision is a Bad Idea.” ;)
It’s also funny that he discusses tonsillectomies as “fantasy surgery,” when in fact they can be medically necessary (infection can settle in them and be difficult or impossible to eradicate with antibiotics; plus, if someone is allergic to antibiotics, there may be no other choice). I have never, ever heard of a medically necessary circumcision.
As to the comparisons to FGM, I definitely think lots of people make these comparisons without completely thinking through the disparities between the two and of course to equate complete removal of the clitoris or infibulation with the removal of the foreskin is just a completely ludicrous comparison.
At the same time, I do think there might be an instructive comparison between one (probably rare )type of fgm in which just the clitoral hood is removed. As far as I can tell most definitions of “FGM” or “female circumcision” include this type of cutting, as do various international organizations like WHO which condemn FGM. It seems this kind of FGM–removing just the clitoral hood–is analogous to male circumcision, and in fact it seems some of the same arguments in favor of male circumcision can be used in favor of removing the clitoral hood. (For instance, I’m always hearing about smegma in males as a justification for circumcision. But females also have smegma that can accumulate under the clitoral hood; it seems if the hood is very tight or the smegma isn’t washed away, it can harden and cause irritation and pain just like in men.)
I’m actually not sure how most Americans would feel about a practice of removing the clitoral hood, but I’m guessing not good; and perhaps recognizing that might give male circumcision supporters some pause given that the procedures seem to be analogous.
“the procedures seem to be analogous.”
I totally agree that they’re more analogous than any of the other procedures that have been discussed.
But I have a ghost of a memory of reading about American contexts in which this surgery was done against women’s wills, and it having really bad results. I can’t find them, though, after brief googling. (I’m not sure where I first read it.) Do you have any information?
I have never, ever heard of a medically necessary circumcision.
I actually know several people who were circumcized as teenagers or adults for strictly medical reasons. I don’t know the details, but it has something to do with how the foreskin is attached in some men creating problems for them.
I have never, ever heard of a medically necessary circumcision.
It can happen. Like any other body part, the foreskin can get chronically infected and sometimes removing it is the only practical way to get rid of the infection. It can also occasionally develop cancerous growth, though I’ve never heard of anyone dying of cancer of the foreskin, perhaps because any abnormal growths are easy to spot before they get out of control. However, just as most tonsillectomies are unnecessary, most circumcisions are unnecessary and, at best, unhelpful.
Conversations I’ve had about circumcision have involved a fair number of anecdotes about boys uncircumsized as babies who end up getting circumcized during childhood on medical advice. Now, for at least one of those stories, the medical advice appeared to be “Because it might cause problems later”, which sounds like nonsense to me, but there are certainly doctors out there who look at uncircumcized boys and recommend circumcision.
When male circumcision involves using a piece of glass to scrape off their penises, then a comparison to FGM is valid, otherwise, no. (Yes, that happens.) We need to be absolutely clear that FGM can cause infection and death, that it makes it impossible for (many) women to enjoy sex and it can make it impossible for them to even have sex without further surgery. It’s often done in unsanitary conditions and CAN CAUSE INFECTIONS AND DEATH.
Did I mention that it can cause infections and death?
Amp, I love you, but you’ve got to come out stronger on this one. I’m not a fan of male circumcision, but it’s been shown in studies to reduce HIV transmission in some circumstances, which points to medically valid reason to keep it around in some places. This is in opposition to FGM which greatly, greatly increses the probability of HIV transmission. Because FGM leaves a mess of scar tissue which can bleed during sex. Not like a hyman breaking, but like ripping and tearing. Which can cause infections and death.
So the reasons not to do MC is that it’s probably not medically necessary in most cases in the US and it’s painful for male infants and can reduce sensation in adulthood. The reason not to FGM is because it’s medically dangerous, unsanitary, can lead to infections and death, removes sensation in adulthood and can be painful for the person’s entire life and may require many repeat surgeries: to allow the woman to have sex, to allow her to give birth and to re-stich up after she gives birth.
Frankly, ANY comparison between the two hurts a case against male circumscision. Because in comparison, who the heck cares about MC? It’s nothing.
Great post, Amp.
I guess one of the things that bugs me the most about this is when there are men who have been circumcised who make a point of talking about how great it is, the sensation is just as good, etc.
This bothers me because it makes the focus of the conversation sexual pleasure rather than child abuse, which is what circumcision is, pretty much.
By way of comparison, I know women personally who have had their inner labia and clitoral hood removed for purposes of sexual pleasure, and they rave about it . . . this DOES NOT make performing the same procedure on an infant an okay thing. Personal bodily autonomy is the key. Do whatever the hell you want to your own body, but lopping off bits of someone else’s should really give all decent people pause.
—Myca
Well I have read a few interesting articles lately indicating that circumcision in the US is falling, and circumcision in parts of Africa is increasing.
It’s increasing in parts of Africa because it is being touted as an HIV prevention technique, and studies have noted lower rates of HIV in regions where circumcision is more prevalent. (I’m not supporting this view; I’m just noting that this is the argument some public health people are using these days.)
The article on the US can be found here. In the article, the drop in circumcision in the US is attributed to immigration and changing attitudes toward the body. The drop in the US has been fairly large.
Here is the data source for the US article. What is most striking is the differences between Latinos and Asians (much lower) and the strong state variation, which is correlated with racial/ethnic make-up of a state, but even whites and blacks in those states have lower circumcision rates.
Frankly, I really can’t get all het up about male circumcision. Particularly when foolish comparisons to FGM are made. Clearly , a lot of people are concerned though. I think Myca makes the most compelling argument. However, I’m not certain that it is wise to have the state superceding the authority of parents in this instance. Considering that any such law would have to have an exemption for religious reasons or run afoul of the establishment clause, it would be inherently discriminatory.
Of course, I’m probably biased by the fact that I feel no personal sense of injury or dimunition. In fact, if I were forced to express a sentiment one way or the other, I’d have to say that I’m rather glad I was circumcised. What little I know would seem to indicate that having a foreskin is a bit of a bother. It ‘s also likely that I’m biased by the fact that I first became aware of anti-circumcision activism in the days when I was researching and counter organizing against White supremacist and anti-Semitic groups. This kind of thing had an appeal among them for reasons that should be obvious.
The discussion here has made me curious. I wonder how many folks on the anti side of the debate have actually been circumcised? Obviously the pro side isn’t likely to have too many intact advocates, not for long anyway. What I’m getting at is how many people who oppose circumcision do so because they personally feel abused, injured or mutilated?
I’m circumcised, and although it’s never been much of a hassle for me, I still (golly) don’t think that it’s okay to slice hunks off of baby’s genitals for no medical reason.
Additionally, the sex-radical in me rebels at circumcision because the original reason for widespread US circumcision was to prevent masturbation, and I consider it part and parcel of the whole ‘sex is dirty and bad and wrong’ movement.
—Myca
Child abuse is a bit of a stretch. OK, a huge fucking stretch. That’s a big sledgehammer, you know.
It’s correct, BTW, that it’s being recommended as an AIDS prevention tactic. That’s because the “harm” of a physician-performed circumcision is so minimal, while the benefits of AIDS prevention (in countries where AIDS is rampant) are higher.
there are some fairly vocal anti-circumcision zealots out there. No surprise; there are ant-ANYTHING zealots out there. Of course, what has happened is that their view is often held to be “accurate” while the “it’s really not a big deal, and nowhere near child abuse” view is often referred to as “biased.
Alternatively, you can call it child abuse. But much like the expansion of other once-valid terms, this dilutes the term “child abuse” so much that it’s meaningless.
I am sympathetic to anti-circumcision position, but as others have said, the comparisons to FGM is ridiculous. It is also ridiculous that online feminist discussions of FGM are almost always derailed by discussions of male circumcision (sort of like every discussion of domestic violence, sexual assault, gender roles, etc). I wonder if individuals who are concerned with male circumcision will actually post on a thread devoted to the topic?
The language of “barbarity” when discussing male circumcision is also off-putting when discussing a Jewish and Muslim religious practice, as they are minority religious groups (in a North American context) who experience discrimination on the basis of their religious beliefs. For the record, I also find it unacceptable when talking about FGM because it has so many colonial connotations (connotations that are often specific to gender-related practices).
I was curious about the rates of infant male circumcision in Canada versus the US (apparently, less than 10% of infant males are being circumcized in Canadian hospitals – down from about 70% in the early 1970s). In the course of my googling, I found that Canadian medical ethicist Margaret Somerville has allowed an anti-circumcision group to post a chapter from her book (The Ethical Canary). I haven’t had a chance to read the chapter carefully, but a quick skim convinced me that it might be of interest to Alas readers despite it’s focus on the Canadian legal context. The chapter can be found here.
If you ever want to see a parenting site blow up, post the male circumcision debate.
Personally, I’m inclined to agree with Myca. Circumsizing male children is making unnecessary decisions about their bodies without their consent, and I’m not ok with that if it isn’t necessary.
As far as the AIDS thing goes. Well, I’m willing to bet that condom use is much better at AIDS prevention than circumcision and I’d really rather my child practice safe sex than assume that because he is circumsized he’s “safe” and doesn’t have to worry about condoms.
I know the child abuse language is strong… and I’m not certain I’m willing to go that far. I don’t think circumcision is right, but I’m not sure I feel a need to force a ban… but I can certainly understand why people feel it is abusive.
One thing I will say is that I find the arguments like: “well, I want him to look like his Daddy” or “Foreskin is gross” or “that’s what everyone else does” really really disturbing.
Ampersand writes: “… regardless of what US circumcision practice is based on, the effect is a form of child abuse …”
We should reserve phases like “child abuse” for cases where children are really suffering from mental and physical trauma. If you make a list of what would make the cut to be classified as child abuse, male circumcision just wouldn’t make it. Think of all the things that it must be compared against, like child rape, severe beatings, and severe neglect.
How many circumcised men complain about problems due to circumcision or feel that they were abused as a child? I would guess near zero. Certainly the views of people who have actually been circumcised should be considered before something is declared to be child abuse.
If earlobes were trimmed off at birth as a cultural custom, would that be child abuse? People could still hear fine, and some culture might consider this as beautiful. If no physical harm is done, I just don’t see a practice of trimming some skin on an infant’s body part as abuse.
“If no physical harm is done”
But that’s not the case, neh? There are studies that link male circumcision to some loss of sexual sensitivity, aren’t there? Or am I mistaken?
And there are also the botched circumcisions (a la the Money case) to consider, in terms of “no harm.”
I would never put male circumcision in the same category as female ‘circumcision’ . . . no way, no how. FGM is fucking barbaric, is designed to destroy female sexual pleasure, and should be rightly considered misogynistic torture.
That’s not to say that male circumcision is no big deal. It’s not FGM, thank god, but especially in the US, it’s incredibly widespread, almost 100% of the time medically unnecessary, and does, in fact, involve cutting a hunk off of an infant’s penis for no good reason.
Frankly, it’s creepy as fuck.
Like I said, I don’t think of it as equivalent to FGM in any way. If you like, we can analogize it to a piercing. As in . . . after your baby boy is born, you call someone in to pierce his penis, attaching a thick metal ring, and permanently soldering the ring in place. It will affect his sexuality for the rest of his life . . . maybe not in a bad way, but in a different way, and he’ll never be able to remove it.
That’s why I find circumcision creepy. Because it really is.
—Myca
I do have some sympathy for this point of view, but when bringing up the specter of religious discrimination, I think it’s important to note that the hugely overwhelming majority of circumcisions performed in the US are not done for religious reasons.
—Myca
Also . . . what’s the pro-circumcision argument?
I mean, the anti (for me, anyway) is that engaging in medically unnecessary genital surgery (which has many possible disadvantages and very very few possible benefits, especially in the USA) on infants is something we Should Not Do.
I hear a lot of complaints that anti-activists are sidetracking from FGM, or that their language is too strong, or that there’s not much loss of sensation, or that it’s sometimes a religious decision . . . but I don’t think I’ve ever heard a good affirmative argument as to why we should circumcise most male children in the US.
Is there one?
I don’t think there really is much of a pro-circumcision argument, beyond religious traditions. I keep seeing references to some studies around male circumcision and HIV transmission in sub-Saharan Africa. I’m not sure how relevant this is for prevention in the US, but it seems that comprehensive sex education, harm reduction (needle exchanges), and addressing HIV transmission in prison are more practical interventions.
Say Myca, can you provide a link on the connection between circumcision advocacy and masturbation? I’d be interested in that.
Sure, you can check it out here.
—Myca
Myca,
I don’t know about a specific pro-circumcision script, but the ones I hear are often as follows:
1) religious reasons (which makes sense to me).
2) It’s “cleaner”/ “more sanitary” despite the fact that this is no longer accepted in the medical community, it is a common argument. I also hear a lot of annecdotal, “My mom is a nurse in a nursing home and knows a lot of older men who have to be circumsized in their old age because they are unable to keep everything clean and it’s much more painful to do it then.” blah blah blah.
3) An uncircumcized penis is harder to “keep clean”
4) For aesthetic purposes (i.e. foreskin is “gross” “ugly” etc)
5) So that the kid will not be picked on/made fun of because he would “look different” in the locker room
6) Because that’s what my husband wanted – i.e. the boy should “look like daddy”
Those are the “pro” circumcision arguments I hear a lot.
Um, can we get another reference for the claim about selling foreskins, please? Sounds a whole lot like legend & hear say to me. (And, if CosmetiCo were to go to that much trouble to put something besides mineral oil and stearic acid in their wrinkle cream, wouldn’t they be advertising it as some sort of miracle ingredient, comparable to the “placenta” creams and other niceties?)
In other words, are we sure this guy isn’t nuts? (So to speak.)
Addendum: this site (http://www.museumofhoaxes.com/hoax/weblog/comments/1457/) claims that these folks (http://www.skinmedica.com/contact) use foreskins to make some high-falutin’ skin stuff. I sent them a message asking what’s up with all the foreskins (there’s no mention of them on their site.)
I’m still smelling a legend, here. (The supposed reselling of “baby parts” by abortion clinics is a hot topic among some especially gullible right-to-lifers right now, for one thing…)
“well, I want him to look like his Daddy”
There is a simple answer to that, which I gave to my ex husband when this topic came up – If you were missing an arm, would you want the doctors to remove one of the baby’s too?
My son is *not* circumcised as a result of that discussion – and since he’s about to turn 20, I am sure he’ll be glad I shared that with all of you ;-)
It’s interesting to me how much Kate’s reasons 2-4 are echoed in a lot of the misogynist rhetoric around female genitalia as well. “Vaginas are dirty and hard to keep clean and ugly and smelly, etc, etc.”
—Myca
PS. Not that these are actually Kate’s reasons. I just meant the ones she pointed out.
Actually, I think it’s less about the inherent dirtiness of penises (like female sexual organs) and more about our issues with bodily fluids in general.
That, and the whole “how could you possibly teach a boy/man to properly clean himself? we all know that boys are incapable of cleaning…” I actually hear that kind of crap a LOT. It’s the same kind of “men are incompetent” crap that is both patriarchal and incredibly demeaning to men.
Thanks for the edit :) They are definitely NOT my reasons. I find all but #1 to be completely idiotic and frightening. None of them are good enough reasons to me to lop off a perfectly working part of my child’s body.
The pro-circumcision argument of demonstrated lower incidence of HIV applies in high-prevalence, high-concurrent multiple regular sex partners, low-prevention measures, low-general health situation, ie, typical African high-incidence country. Circumcision has not been reliably shown to be a favorable HIV-reduction practice in the developed world where condoms are easily available and are often used. The US HIV prevalence rate is too low to detect small additional benefits (or detriments) readily in condom-using heterosexual men in the general population.
I have never gotten the impression that Jewish men are unsatisfied sexually due to lack of sensitivity. Surveys indicate that they are as happy or more happy in their sex lives as the general population. A large percentage of mohels (ritual circumcizers) in the US are physicians, and I don’t see any health issues – the main medical problems in (8 day old) infant circumcision are severe clotting deficiencies and infection, and the doc-mohels know about the first and use sterile technique to avoid the latter. So – butt out of the Jews’ business, I say. It’s their covenant, not ours.
Everyone else – why bother? A certain percentage of boys and men will get constriction and inflammation of the foreskin (phimosis), which can be painful. At that point they can be circumcised to deal with the anatomic problem.
Men do get cancer of the glans and foreskin, and they can die of it if it is neglected, but this disease, caused by the same virus that causes cervical cancer, is rare.
I’m shocked at how eager people are to maintain the status quo.
Foreskin absolutely IS SOLD:
http://www.sexuallymutilatedchild.org/f4sale.htm
(with no compensation or even notification to the victim or his family). TNS Recovery Complex face cream was discussed on Oprah Winfrey for crying out loud. This is not some phantom.
The US is the LAST country that still cuts most infants for non-religious reasons. NO MEDICAL SOCIETY on earth (not even the Israel Medical Association) recommends infant circumcision, so those professing “medical reasons” should post some credentials or shut it.
Circumcision IS NOT the appropriate treatment for phimosis:
http://www.norm-uk.org/circumcision_alternative_treatments.html
Female mutilation is now illegal in the US without religious exemption, but females have been cut in the US and Blue Cross paid for it:
http://www.amazon.com/exec/obidos/ASIN/1878411047/normuk-20
Religious exemption would not be needed to outlaw male circumcision, since the parent has no right to amputate valuable healthy normal tissue from a non-consenting infant for any reason.
Infants don’t have sex. HIV claims, while wildly overstated, are irrelevant.
Infants don’t get penile cancer. More men get breast cancer than get penile cancer.
More infants die from circumcision than you probably realize, between 1 in 5,000 and 1 in 10,000. The cause is often listed as bleeding, infection, or anesthesia complications, but the circumcision is at fault. http://www.circumstitions.com/death.html
Every circumcision removes over half the sensual nerve endings, denudes the glans, and eliminates the natural frictionless rolling/gliding action. About 20% have unintended results: tightness, asymmetry, skin bridges, bulgy veins, gouges to the glans, skin tags, jagged scars, etc.
http://www.noharmm.org/IDcirc.htm
It’s barbaric mutilation, child abuse, YES. 80% of the world does not circumcise.
HIS body, HIS decision.
It is just me, or is there a faint whiff of anti-semitism (not to mention anti Muslim racism) in all this anti circumcision propaganda?
In the real world, the foreskin is a vestigal organ, dating back to the ancient times when our primate ancestors hadn’t invented pants or underwear yet. In the modern world. we need a foreskin about as much as we do an appendix or tonsils.
For over 5,000 years, the Jews have been removing the foreskin – a tradition that the Muslims adopted 1,700 years ago.
It’s also a common cultural practice in America – most male American babies are circimcized at birth (I was one of those children – my foreskin was removed shortly after my birth 39 years ago).
I’ve never felt “mutilated” or “deformed” by this surgery – nor has the absence of a foreskin prevented me from having sex or masturbating.
I honestly don’t understand what all the frantic anti circimcusion hysteria is about!
Gregory A. Butler
New York, NY
Yes. It’s just you.
Proverbs 13:24 says “He who spareth the rod hateth his son,” and yet I oppose the beating of children. I bet I’m totally an anti-Christian bigot.
Well, as I asked earlier, is there an affirmative case to be made as to why we should circumcise most male children in the US? I’m open to hearing any arguments, it’s just that thus far I haven’t actually heard any.
—Myca
I so wish I had the time right now to comment here, since this is a topic I have written about and researched quite a lot. One article that people might find very interesting, given what has been said is David Gollaher’s From Ritual To Science: The Medical Transformation of Circumcision in America. His book Circumcision is also worth reading. Regarding Jewish circumcision, Howard Eilberg-Schwartz, in his book God’s Phallus devotes an entire section to examining the ways in which Jewish circumcision is understood in the Talmud (and maybe elsewhere) as feminizing of Jewish men so that they can be, collectively, as the people of Israel referred to constantly in the prophets (since only men were considered part of that “people’), God’s lover and bride—metaphors which recur consistently in the Bible when the relationship between God and the people of Israel is talked about.
Regarding male circumcision and male sexual sensitivity, here are two links:
http://www.noharmm.org/bjusuppl.htm
http://www.cirp.org/library/anatomy/sorrells_2007/
There are also plenty of articles, if you read through the literature, detailing research that demonstrates the effects of infant male circumcision on boys, everything from changes in sleep patterns to differences in pain threshholds between boys who were circumcised and those who were not. I don’t have time to dig the links out, though.
It’s worth thinking about how the medicalization of infant male circumcision, connected as it was to anti-masturbation theory and practice (and that whole notion is really connected to deep hostility in the 1800s to male sexual pleasure in general – read up on what Kellog and Graham–yes, the founders of the companies that give is breakfast cereal today–and other popular and medical authorities of the time–had to say about what would happen to men who had too much sex, even entirely “legitimate” married sex: it resembles to a striking degree the horrors that supposedly befell those who masturbated)–anyway, it’s worth thinking about how the connection between the medicalization of infant male circumcision in the 19th and early 20th centuries and its connection to anti-masturbation theory and practice is connected to people’s reluctance, until just recently, to acknowledge what should be an obvious fact: that if you amputate a nerve-filled piece of skin from a penis, the person that penis is attached to is not going to feel whatever those nerves were designed to feel. Once you acknowledge this fact, it seems to me, the question becomes not whether the sensation exists, not whether there is some competition between cut and uncut men in this regard— because, certainly, cut men are entirley capable of having entirely satisfactory sex lives—but, rather, what our cultural stance was and is towards that sensation in men and why?
And that is a much, much, much larger question that I don’t have the time right now to go into, though I should add I do not mean to imply that this is an entirely abstract and intellectual question. Obviously, we are talking about a practice that involves the real bodies of real boys and the men those boys grow up to be.
“but, rather, what our cultural stance was and is towards that sensation in men and why?”
Well, it’s certainly interesting in the context of mixed messages, in that we spend a lot of time talking about male sexual satisfaction while at teh same time giving the chop to nerve endings.
I’m not totally comfortable with the cultural phenomenon of male circumcision being framed around the idea of sensation though. There are cultural intentions, and cultural byproducts. And while male circ was popularized among gentiles as anti-masturbatory, I don’t think that the appeal was supposed to be reduced sensation so much as reduced need to handle the penis for hygeine, etc. I’m not sure there’s enough here to make the leap to assuming that sensation is the heart of (or even a primary factor in) the American obsession with (male) circumcision.
Dan Morgan:
If you saw a parent deliberately punch a small infant hard enough to give the infant a black eye — just the one punch, mind you — would you argue that it wasn’t an act of child abuse, because it’s not as bad as other acts are? (The pain of a black eye is almost certainly less than the pain of circumcision.)
I’d call it abuse. To say that no behavior towards children can be abusive unless it rises to the extremes of child rape et al is far too narrow.
In my opinion, yes. Especially if it were typically done without anesthesia.
Sailerman:
So do you agree with Dan, that to needlessly cut off a infant’s earlobe (presumably without anesthesia, to make the comparison valid) isn’t abusive? How about my example of deliberately giving an infant a black eye?
The only way to define child abuse that lets circumcision off the hook is if you define it based on the motivations of the adult who injures the child. It’s true that circumcision is not done maliciously in our culture, so perhaps from that perspective it’s not child abuse. But from the infant’s perspective, circumcision is identical to any other needless, painful, mutilating attack. I do think that’s a reasonable sense in which circumcision is indeed child abuse.
Nor am I convinced that including “needlessly cutting off body parts” in our understanding of what is abusive is going to dilute the term beyond all meaning. I think the opposite is true; if you refuse to admit that cutting off a body part for no good reason can be abuse, than your definition is far too narrow.
A couple of people have suggested that religiously-motivated circumcision is more acceptable.
I disagree. I don’t think that harmful acts are okay if they’re religiously motivated; for example, voting for laws banning abortion and homosexuality is morally wrong in my view even if the voter is motivated by their religious beliefs.
Religions can and do change to accommodate improved understandings of what is moral. Circumcision is, or should be, such a case.
Mandolin:
Except that when cricumcision was justified as an anti-masturbatory measure, it was justified largely–and I wish I could find the source for you, but I am not at home–on the basis of the pain it would cause (as an antidote to sexual pleasure) and the assumed reduced sensitivity that would result. I would agree with you that once other, more explicitly medical rationales were proposed–as in Gollaher’s article–reduced sensation sort of went underground as a rationale behind/motivating factor of the procedure (though it’s also true that if you read some of the debates on this that went on 20 or 30 years ago, there are people who actually applaud the reduced sensation since it ostensibly would help men not to ejaculate too quickly), but to me the question of sensation–though I would frame it much more broadly as the question of male physical pleasure in sex and what that pleasure means culturally; and I should add that I only came to this after doing quite a lot of reading; my initial impulse was the kind of framing you suggest–is the subtext running through the other rationales that are proposed.
Also, an interesting conversation related to this on another blog: http://sexinthepublicsquare.wordpress.com/2007/04/06/the-foreskin-dialogues/
WB Reeves writes:
I don’t think anyone’s proposing legislation banning circumcision. Although I’m not against it.
No more than any other law with an exemption is discriminatory. This, in and of itself, seems like a very weak reason to oppose a law.
I don’t feel any personal sense of injury or dimunition, either. Nonetheless, unnecessary amputation of body parts without consent is simply wrong. Just because I myself wasn’t harmed by it is no excuse for continuing to perform it on a new generation of non-consenting boys.
“Except that when cricumcision was justified as an anti-masturbatory measure, it was justified largely–and I wish I could find the source for you, but I am not at home–on the basis of the pain it would cause (as an antidote to sexual pleasure) and the assumed reduced sensitivity that would result. ”
That makes sense in the context of the other kinds of anti-masturbatory procedures, like the application of blistering agents….
Hmm.
It’s not that I don’t trust your research. I’ve read about this stuff, but probably not as widely. But I don’t really know how to fit that into Western narratives about sex. I suppose it would slot in with the idea that men have to conserve their semen to avoid losing personal power.
It’s odd to see an emphasis on lessening male sexuality without stricture on female, but as I recall, the Victorians were pretty pleased with the idea of medical clitorodectomy. But also with the idea of therapeutic orgasm. Probably trying to look for a consistent narrative from them about sex would be over-simplifying deep neurosis. Must ponder.
I’ll take a look at the blog link! Thanks.
“A couple of people have suggested that religiously-motivated circumcision is more acceptable.
“I disagree. I don’t think that harmful acts are okay if they’re religiously motivated; for example, voting for laws banning abortion and homosexuality is morally wrong in my view even if the voter is motivated by their religious beliefs.
“Religions can and do change to accommodate improved understandings of what is moral. Circumcision is, or should be, such a case.”
My beef with this, Amp, is that circumcision isn’t “harmful.” Unnecessary in most cases? Yes. So is ear piercing, but many people do that to infants. Piercing the ear of an infant also makes a permanent change to an erogenous zone. But is it harmful? No. Would I do it to my kids? Never, but it’s not my business if other parents want to do it to theirs.
I would not counsel a non-Jewish friend to circumcise his or her son, because I don’t think it’s necessary if you don’t have a good reason for it. I do have a good reason to plan to do it to my sons – because (and this is goin to sound hokey) it’s a commandment from God. I would rethink that reason in a second if I believed that it would actually be harmful to my children, but until there’s actual proof that it’s actually harmful, I think it’s going way too far to call it child abuse, or to even suggest that we should be okay with banning it.
Parents are charged with their children’s well-being, and also with their raising. To that end, partents have the right to decide their children’s medical care, and also their religious indoctrination. Parents get to choose whether to vaccinate, parents choose whether to pierce, parenst choose how to educate, parents choose whether to baptize, and parents choose whether to circumcize. All of this is done without the consent of the children. It is in our best interests to leave the rights of the parents alone unless there is significant evidence that a practice is absolutely necessary, or unless there is significant evidence that a practice is extremely harmful. I think that sending Jewish girls to substandard religious schools where they are discouraged from studying much beyond the juior high school level is a bad idea, but that’s a parent’s choice, and as long as the schools are meeting the minimal state requirements, I don’t have a right to interfere in that choice. We get, and should get, wide berth in this country when it omes to our religious choices, and I don’t think that’s a bad thing.
Mandolin:
Another angle, this from Michael Kimmel’s book Manhood in America (or American Manhood? I can’t remember the title): In the 1800s, male sexual pleasure/indulgence was understood to run counter to the work of building the nation that men were supposed to be engaged in.
And you are, of course, absolutely right that the stance against masturbation in men accompanied an even stronger stance against masturbation in women, for which clitordectomy was one recommended “cure.” It is interesting, however, esecpailly since both practices were rationalized in the same way, that the routine circumcision of infant males lived, despite numerous instances in which the medical rationales for its practice were disproven, while clitoidectomy, though it did not entirely disappear as a practice in the States (and I guess I should make clear, if I haven’t, that I am talking about the US here), has certainly fallen over time very far from the favor in which it was once held.
“It is interesting, however, esecpailly since both practices were rationalized in the same way, that the routine circumcision of infant males lived, despite numerous instances in which the medical rationales for its practice were disproven, while clitoidectomy, though it did not entirely disappear as a practice in the States (and I guess I should make clear, if I haven’t, that I am talking about the US here), has certainly fallen over time very far from the favor in which it was once held.”
Oh, absolutely.
I actually think there’s a lot more productive discussion to be had talking about the parallel evolution of clitoridectomy and male circumcision in the west, then there is talking about FGS (female genital surgeries) and western male circumcision. Sex-phobic Victorians did seem to be viewing the procedures as cures for the same underlying problem, so that even though they aren’t physiologically similar, the ideology behind them is something that can be attacked at the same time.
While there are similarities between the western view of male circumcision and the non-western cultural roots of FGS (damn, I used to have a chart that had great quotes about hygeine, and the goodness of a “thorough” circumcision, and the medical ramifications of circumcision… can’t… find it…), there’s also a lot of unacknowledged difference that stems from ignorance about A) physiology, and B) the manifold variations of FGS and the cultures that surround and underlie it.
I’m actually surprised that western cultures aren’t more accepting of FGS. Why aren’t we seeing it sold in the mainstream as a cure for single motherhood? Of the top of my head, I’d wonder whether part of our self-definition is as the “civilized” half of a “civilized” versus “savages” dichotomy. Africans are “savage”; they practice FGS; we must not. Certainly, we see in Africa that there are places which have not traditionally practiced FGS which have taken up the practice as a way of defining themselves as “traditional” and “not westernized.”
I’m trying to come up with ways to slot male circumcision into any of those dichotomies and utterly failing. I hope I’m not thread drifting.
Quoting from the blog post that Richard listed in this thread:
This fascinates me, because there are places where the male foreskin is removed because it is the “female” part of the penis, considered analagous to the labia. (Likewise, the clitoris is removed as the “male” part of women because it is considered analogous to the penis.)
I believe that piercing an infant’s ear is wrong and immoral too, but let’s be clear.
It’s not permanent – When I take my earrings out, the piercings heal. Plus, I have the option of taking the piercings out.
It doesn’t involve permanent removal of tissue – It involves poking a hole (which, as I said, I consider immoral, since it’s an unnecessary violation of another person’s bodily autonomy), but that’s a far goddamn cry from permanent removal of a body part.
It’s not directly sexual – Yes, the earlobes can be erogenous zones, but come on, they’re not genitals. This is why no one has ever advocated mutilation of earlobes as a way to curb masturbation.
A reasonable biological analogy would be removal of the clitoral hood, but that’s problematic in discussion because it’s so often linked to clitorectomy (which is NOT analogous).
—Myca
But when it comes to non-circumcising cultures (the great majority) the argument is suddenly reversed: instead of enjoying automatic respect for their traditions, parents from non-circumcising cultures are pressured to conform to the American norm and to consent to have their sons circumcised, so that they will be “like other boys”.
I wonder what evidence he has that this actually occurs.
RonF–
This was clearly the case in the beginning of the 20th century, when people from non-circumcsing cultures were intensely pressured by the medical establishment and more to circumcise their newborn boys. Check out the article and book I referenced upthread by David Gollaher.
And again, while it is permanent, (just like the scars from a healed over piercings are permanent) I’m not getting the “harmful.” It’s different from the way we’re born, but it’s not damaging. It’s a permanent changing of a person’s body, but parents do that to their kids all the time. A vaccination, for example, is a permanent chnging of a kid’s immune system. Should circumcisions be required? No. Should they be encouraged? Again, no. But if you have a (minority) religious tradition of doing so, where’s the rationale for forcing a ban?
ADS:
How do you define “harm?” (Please forgive me if I missed something that you said earlier.)
It’s hard to define harm. Since I don’t beileve circumcisions are harmful, it’s hard to define it in this context (since it’s almost impossible to define a negative). I have not seen evidence that suggests that circumcision, especially infant circumcision, causes a decline in sexual function or sensitivity. A difference in sexual feeling/sensitivity/experience, probably, but a decline? I haven’t seen that shown. FGM produces clear damage to a woman’s sexual experience – male circumcision does not. Barring evidence of that, discussion of a ban is just more “let me force my choices on you because I know better than you do how to raise your children,” which I think we can all agree is wrong.
ADS:
Actually, the evidence is there, in many of the articles that have been linked to, and in extensive research on the physiology of the foreskin and of the glans penis pre and post circumcision. You may choose to see that evidence as pointing to difference rather than decline, but that is not the conclusion reached by the researchers themselves. The fact that a circumcised man can still feel sexual sensation and achieve orgasm and ejaculation does not, in and of itself, mean that those men do not experience a reduced sexual sensitivity as compared to men who are not circumcised.
“Needless?” Bit of an a priori there, mate.
But you’re digressing. The issue is whether circumcision is child abuse, not what “child abuse” is, generally speaking. All this is going to do is end up going down the road of debating whether circumcision is more similar to ___ than to ___; do we really have to go down the general-child-abuse-what-is-it road?
Bullshit. Here’s a few other ways:
You can:
1) decide that circumcision is simply not all that big a deal, irrespective of its motivations. If you believe that, it’s not child abuse. UNLESS, of course, you categorize “abuse” as including things that aren’t really a big deal.
2) decide that circumcision is more of a big deal, but that it’s justified. Similarly, this justification has nothing to do with parental motivation.
Those are only two examples.
Amp, I’m distressed by your arguments here. This is a blatant straw man (“can be” is quite different from “is always;” not to mention the obvious fact that “no good reason” is under debate.) You’re generally a trustworthy and logical debater, and I”m wondering why you are lowering your standards here.
But OK, OK, we’re going to have to go to generalities, i can see that now..
For child abuse to have any meaningful definition, it has to reflect some objective measure of the actual harm to the child, right? There’s also a motive factor–a big one. Abuse is a subset of “bad;” not all things that are bad, or unpleasant, are abusive.
You know, and I know, that there are about 100,000 things that parents can do to affect the lives of their children. Many of them are legal; many of them are bad; none of them are currently considered child abuse. You can marry the wrong person; spend too much money on booze; start smoking; let your kids smoke as soon as they’re legally allowed to do so; let them get C and D grades in public school, thus probably cutting them out of higher education; give them bad advice on the job hunt; be a “bad parent;” have another sibling you can’t afford; raise them as white supremacists; etc.
Most of the things in that list will have much more of a lasting effect on a child than whether or not he has a foreskin.
Why are they NOT abusive?
I submit it’s because the “abuse” standard is pretty high. It actually is based significantly on intent to hurt someone. So locking my 2 year old in her room because I like to hear her cry is abusive; doing it because she just whacked her brother with a stick is not.
You already seem to think circumcision lacks the intent to harm. How, then do you classify it as child abuse, in comparison to the world of non-abusive greater harms?
Sailorman,
Are you reading Richard Jeffrey Newman’s comments? Because he’s pointed to some objective harms.
It’s a bit off-putting to read you insulting Ampersand’s arguments at the same time as you don’t seem to be responding to the material in the thread. In this instance, you’re the one pulling out the stops like calling his arguments “bullshit.”
The routine medical circumcision of infant boys is a medically unnecessary procedure. There are arguments out there that it has prophylactic value–against cancer of the penis; against HIV infection; against what will happen if a boy is not taught to keep himself clear–but there are plenty of other surgeries that we might perform that would save far more lives than circumcision. We could, for example, remove the breasts of infant girls, just to make sure there is no chance they will develop breast cancer, and far more women die of breast cancer each year than do men from cancer of the penis. Edited to add: Yet I doubt anyone would seriously suggest we ought to institute such surgery, despite the fact that girls whose breasts were removed could, except that they would be unable to breast feed their children, live perfectly normal lives (and there are substitutes for breastfeeding, and if all girls had their breasts removed when they were infants, a generation of girls would eventually be born for whom breastfeeding was nothing by myth); nor would they miss, because they would never have known, the erotic potential of the breasts they did not have. (And I feel I need to say this: I am not suggesting the removing the breasts from infant girls is analogous in its effect to those of the circumcision of infant boys; I am trying to point to the nature of the reasoning by which the routine medical circumcision of infant boys is justified.)
So what do you call it when the medical profession promulgates–as it still does in many places in the US, despite a growing trend to the contrary–a procedure that is not only medically unnecessary, but is also deeply and profoundly painful for the person on whom the procedure is performed. I think, in other words, when deciding whether the routine medical circumcision of infant males (I am, for the moment, not talking about religious circumcision) is or is not abuse, that it’s important to remember how deeply institutionalized the practice has been in the United States. Individual parents who chose or will choose to follow what has been until recently the overwhelming medical position in favor of circumcision are certainly not guilty of child abuse as individuals, but, if we call it abusive when a doctor performs unnecessary surgery….no, more to the point, if we can call it abusive that doctors used to perform unnecessary hysterectomies on women, why can we not call it abusive when they perform unnecessary circumcisions. Please note: I am not comparing the nature or severity of hysterectomy and cricumcision as medical procedures. I am talking about the wilfull way in which the medical profession endorsed and promoted the procedures despite the fact that they were unnecessary.
There’s also a motive factor–a big one.
I have to strongly disagree that motive is a factor in whether or not an action is child abuse. I see this as self evident, but I can expand on it if you need me to do so.
I have to strongly disagree that motive is a factor in whether or not an action is child abuse.
Denying a child food is considered abuse.
Scenario A: I come home from work and see my 12-year old son about to sit down to the dinner he made for himself. I knock it to the floor and say “the hell you’re getting food, you little shit” and send him to bed. Child abuse? Obviously.
Scenario B: I come home from work and see my 12-year old son has taken all the food from the cabinets and refrigerator, made an enormous pile of it in the backyard, and set it on fire, destroying $1000 worth of groceries. I tell him “since your behavior has resulted in all of us going hungry, it’s going to start with you. You go to bed now, and you’re not getting any supper.” Child abuse? Obviously not.
Same action, different motivation. One is abuse, the other is discipline or natural consequences or whatever you’d like to call it; “parenting” would be my word. Can parenting cross a line into abuse? Certainly – but for many, many actions, the fact that you’re doing it for the child’s own good is paramount.
Richard,
Quite a lot of the examples I saw in your links were about what can happen when circumcisions go wrong. I think this is a very good reason to not encourage routine medical circumcision (which, again, I am against) because in those cases, there’s no good reason to circumcize an infant. When the circumcision is being done as part of a religious ritual, there is a good reason, and the equation changes. We stopped giving smallpox vaccines routinely after smallpox was eradicated, because there’s no good reason to expose people to the risk the vaccine poses. If and when smallpox makes a reappearance, that equation will change. (In addition, while I cannot point to a reference right now, I have seen numbers that show that circumcisions performed by mohels – ritual circumcisers in Judaism – are far less likely to be botched than those performed by doctors, for the simple reason that mohels do circumcisions on boys the exact same age all the time, day in and day out, while urologists and plastic surgeons only do them occasionally.)
Small dimishments in fine-touch sensitivity in the glans, that do not prevent sensation, orgasm and ejaculation, seem to be to fall more in line with “difference” in sexual feeling than “decline” in sexual feeling, especially when balanced with needing to have a circumcision performed in adulthood, which, if you’re being raised as Jewish, will be required when you turn 13 if it wasn’t done in infancy.
ADS:
Unfortunately, I do not have the time to link you to all the studies that have been done relating to circumcision, but I assure you that the ones I am thinking of, and that you could find pretty easily yourself if you wanted to, are not about botched circumcisions, but are, rather about the effects of routine and successful operations.
As to whether circumcision results in a “small” diminishment of sensation: not only is “small” a profoundly subjective measure, but research I have read indicates that the diminishment of sensation can be as much as 30%, using the measure established by the researchers, and it was a fairly objective measure–if I remember correctly–having to do with a correlation between how much tissue, and therefore how much of the nerve network in the foreskin was removed (glans sensitivity is diminished; foreskin sensitivity is removed completely), and circumcised vs. uncircumcised men’s response to stimulii. Again, I don’t have the time to find the link, and I will not swear by my summary here–I will only say for sure that I know there is research that seems to show the difference in sensation between cut and uncut men is anything but uniformly small.
That being said, I do agree that we need to talk about medical and religious circumcision in very different ways, not in terms of the effect it has on the boys who are circumcised, but in terms of the cultural and other assumptions that frame the procedure.
Sure.
I come home. I’m drunk and surly, and my child is crying. I run to his room and punch him full in the face, bloodying his nose and splitting his lip. Abuse? Obviously!
I come home. I’m stone sober, but my child has made a mess of the house in my absence. I run to his room and punch him full in the face, bloodying his nose and splitting his lip. Abuse? Heck no, it was for his own good! That’ll learn ‘im.
—Myca
Surely, Myca, you can do better than that. The argument was that there is no difference in defining abuse based on intent of the parent. Several examples were provided showing examples in which the posters argued that the difference in intent was the difference between abuse and not. You countering with an example in which intent does not matter does not advance the argument, it’s just a strawman. Try again.
No, my argument is that (as Amp pointed out) circumcision is more severe than punching a child in the face, blackening his eye, bloodying his nose, and splitting his lip.
If intent isn’t exculpatory in the case of a punch to the face as a punishment, surely intent is much less exculpatory in the case of circumcision, which is much more permanent and is not intended as a punishment.
I’m not arguing that intent never matters, merely that in this case it doesn’t.
—Myca
Yes, and, once again, since the intent is not punishment, they’re nothing at all alike. Just because one is more severe does not automatically make that the winning argument.
Amputating a child’s leg, for example, is even more severe than blackening an eye. Doing it because you’re pissed at a kid and hit them with an ax is abusive. Doing it because they’ve got gangrene and will otherwise die is not.
When infant circumcision is performed within a religious context, the choice is not “perform this circumcision now without the child’s consent or nothing will happen later,” it is “perform this circumcision now while the child will have fewer lasting effects, when the danger is least, when it can be done without general anaesthesia,” or “wait until the child is a teenager, and then if they wish to remain within the religion in which they were brought up, they will have to choose to undergo a far more serious procedure that will be far more damaging to their sexual function and that carries far higher risks, including that of general anaesthesia.” Making that decision is parenting, not abuse. Might the child decide to leave Judaism rather than become circumcised? Sure. But I know far more adult male Jews who are stuck because their parents didn’t or couldn’t circumcize them in infancy who are furious at their parents for that then I know adult male Jews who feel like thir parents abused them by making that choice.
ADS wrote:
I don’t think anyone here is advocating a ban. In fact, the only people here who have brought up the subject are people advocating against a ban.
Just because people criticize circumcision doen’t mean they’re calling for a ban.
I’m talking specifically about where you said, Amp, that you wouldn’t be against a ban, and I don’t see a difference between not being against a ban and being for a ban.
Oh, and I would argue that calling male circumcision child abuse is basically the same as saying it should be illegal.
ADS, it’s simply not true that you have to be circumsized to remain within the Jewish religion. That’s the case in some extremely frum communities, but the vast majority of Jews in the US are not that strictly observant; to talk about the practices of a small minority of Jews as interchangable with “Judaism” as a whole is inaccurate.
It’s fine with me, of course, if an adult man has his foreskin removed for religious reasons. That’s his choice. But it’s something he does because he wants to, or because he believes that it will make him a more observant Jew, not because he will cease to be Jewish if he doesn’t.
My impression is many mohels these days are doctors. My nephew was circumcized by a mohel who is also an anesthegiolist, which was good because it meant that my nephew, unlike the majority of circumcized infants, was numbed for the procedure. My cousin Rachel is not a mohel, but she is a doctor, and she performed her son’s circumcision herself.
Mandolin:
Yes, I saw RJN’s posts. Are you aware of the sites on which they reside? They’re about as unbiased as reading about hospital birth on the “Homebirth Today!” website. See my comment below responding to one of his posts directly.
And as for Amp’s arguments: if he’s going to use a straw man, or claim “there’s only one way” to do something, or make constant a priori arguments, i’ll call him on it. It’s not his usual tactic, and I”m disappointed as hell.
That may seem like a logical conclusion, but it’s not. (Mandolin, is this the sort of thing you were talking about?)
What you are arguing here is stated as “this is medically unnecessary because there are other options that would save more lives than circumcision.”
But that isn’t the criteria for medical necessity. It’s not even close (and a good thing, too) On a pure cost/benefit basis that takes into account OTHER issues than the one at hand, there are a lot of things we shouldn’t be doing. And a lot of people we shouldn’t be helping. On a pure cost/benefit basis worldwide, we should probably all shoot our dogs and donate the money we save.
So. You list some positives. Would you mind explaining why they don’t exist? Cancer of the penis and HIV infection are not “nothing.”
Look, what gets so frustrating here is that the anti- crowd seems to be doing two things:
1) Constantly stating the “medically unnecessary” over and over, without really doing a lot to support it. The term properly takes into account BOTH costs and benefits. Here, the benefits are probably fairly small. But so are the costs.
2)Trying to formulate an ad hominem attack: people thought masturbation was bad; masturbation is good, therefore circumcision is bad. This makes no sense. Whether circing is good/bad is unrelated to what people thought then.
Myca: I pinned down my child while a third party stuck needles in her.
Abuse?
Or good parenting?
Your definition would make vaccination pretty difficult, you know.
Oh yeah, and on the Jewish thing: It’s the mark of the covenant with God; it’s an utter requirement for Judaism with some rare exceptions. You can’t (generally speaking) be an uncircumcised Jew any more than you can be an unbaptized Catholic, or a Christian who doesn’t believe in ‘that whole Christ thing.’
There’s no law preventing you from CALLING yourself whatever you want, of course. But that doesn’t make it so.
Sailorman,
What are the pro circumcision arguments then?
Let’s turn this around a bit. Baby boys are born with foreskin. If you want to remove an otherwise perfectly functioning body part, please tell me WHY.
Well, Sailorman, you are right that the articles I linked to are on anti-circumcision cites, but the articles were all originally published in refereed medical or academic journals, and I would urge you, if you are really interested, to go straight to the journals themselves and read the literature. It almost unanimously supports the contention that circumcision is not medically necessary.
And regarding this:
Which you wrote in response to this, from me:
You misread me: I am not suggesting that circumcision is medically unnecessary because there are other operations that would save more lives than circumcision. I start from the position that the routine medical circumcision of infant boys (and please note that phrase; I have chosen it very carefully) is medically unnecessary. I am arguing that the prophylactic argument in favor of circumcision could be made for other kinds of surgery as well, and my point is that if you make that argument for other kinds of surgery that no one would advocate despite the fact that they would prevent many more deaths than cricumcision, then the absurdity of making that argument for circumcision becomes clear.
I suppose we need to be clear about what we mean by medically necessary. When I say that the routine circumcision of infant males is medcially unnecessary, I am referring to the fact that–all else being equal–there is nothing wrong with a newborn boy’s body that requires circumcision to save or improve his life. And, in fact, all of the non-religious arguments in favor of circumcision are prophylactic ones; they are about what circucmcision will prevent. So let’s take cancer of the penis: if I remember correctly, 1 in 100,000 men will get cancer of the penis; not only does that statistic hold true whether the population of men is circumcised or not, but it has also been shown that cancer of the penis tends to occur, at least in the US, primarily among populations that are poor and are characterized by poor hygeine. Teaching a boy how to keep himself clean is at least as, if not more effective in preventing cancer of the penis as circumcision.
Regarding HIV infection; it may be true that circumcision, because it creates a callus on the glans, can hinder HIV infection, but no official that I know, medical or otherwise, has advocated it as a primary means of AIDS prevention. Might there be adult men for whom circumcision might be a kind of last resort preventive measure to protect themselves? Sure. But that is very different from advocating the routine medical circumcision of infant boys on the grounds that it helps prevent AIDS.
Regarding the history of circumcision and whether that has any bearing on what we do, think, etc. now: go read the history before you dismiss it. It matters a great deal.
One more thing: When you say that you think the costs of circumcision are probably small, how do you define small and what specifically do you understand the costs to be?
The reason nobody would advocate them is because (here we go again…) the positive–or negative–aspects are ONLY ONE SIDE of the equation.
You are being repeatedly and continually dishonest in presenting that fact. Your breast removal surgery example fails on that case. “Hey, I can avoid arm cancer by cutting off my arms. But I LIKE my arms… therefore circumcision is a bad idea!” Do you see how ridiculous the slippery slope argument gets here? That you can find surgeries which offer some putatively positive benefits, but whose negatives outweigh the benefits, says nothing about the positive/negative effects of THIS procedure.
This “nothing wrong with the body” is, just FYI, only sort of true. It’s a naturalist standpoint but it’s not really wrong. We have all sorts of things “wrong” with our bodies, insofar as we need to to intervene or change them. (there’s nothing “wrong” with women’s bodies, for example, but birth remains dangerous as all hell, to mother and infant.)
And “save or improve” his life… does that include life EXPECTANCY? There’s certainly little immediate benefit.
No disagreement here.
Sure. And that means?
I’m not sure why you’re suddenly a single-issue person. teaching boys to be clean is good. But (seeing as larger #s are dying, it doesn’t always work, so if circumcising them helps, it will prevent deaths, yes?)
Unless you’re deliberately planning to hide behind the “primary” qualifier: You’re dead wrong on this one.
See above.
Facts are history-proof. It’s the wonder of science.
Either the benefits exceed the risks, or they don’t. I don’t necessarily think that “what we do now” means it’s scientifically correct. But the history is 100%, completely, entirely irrelevant to the answer of whether circumcision is a good idea.
? I define “small” as “minimal” or perhaps “not large” or something equivalent. Don’t you?
The costs? Possibly a minor loss of sensation, though it’s not clear that it’s functionally apparent, since circed men have sex, procreate, masturbate, orgasm, etc, just fine. Some (small) risk of injury or infection. A bit of short term pain.
Sailorman,
Are you Jewish? Just wondering.
Circumcision is not “the” mark of the covenant with God. It’s one of many marks. For example, covering your head is a mark of the covenant with God, but it doesn’t follow that those who do not cover their heads cease to be Jewish. (Whether or not women cover their heads varies from congregation to congregation.)
By Jewish law (for most of Judaism, anyhow), what makes someone a Jew is if they have a Jewish mother; although of course, like everything in Judaism, opinions vary. A Jew who doesn’t follow the covenants isn’t fully observant, but he or she is still a Jew. It may be that some Jews think you can’t be Jewish if you’re male and uncircumcised, but that is not a universal opinion.
For example, this Rabbi writes:
Kate:
The costs seem to be pretty well known and quantified, since people have been circed for thousands of years.
The benefits so far appear to include reduced risk of certain diseases, and/or reduced transmissions of certain diseases. Unlike the costs, new benefits are quite possibly forthcoming (recent HPV discoveries as an example.)
The transmission/infection thing is a nifty one. For some small subset of diseases–HPV and AIDS so far, it seems–it makes a HUGE difference. There is little reason to believe that those will remain the only two illnesses which are, eventually, discovered to be subject to that effect. As a result it seems likely that the future known benefits of circing will increase, not decrease.
Amp:
yes, i was raised Jewish, went to temple thrice weekly, got barmitzvahed, the whole kebang. I’m firmly atheist now, though.
Circ isn’t the only mark of the covenant, but AFAIK it’s one of the required ones. Here’s a link to Genesis 17:11
http://bible.cc/genesis/17-11.htm
which may make my position more clear.
You realize that’s an interfaith site, dedicated to, um, “expansion” of the Jewish community, right? Positing that as a representation of Judaism is a bit like RJN’s links. Or to analogize from another thread, if that’s judaism then Ann Coulter’s a feminist.
If you’re a Jew, you know that Reform judaism is the most liberal of the three major categories. Here’s a few links from their site:
http://urj.org/Articles/index.cfm?id=8320&pge_prg_id=29839&pge_id=3450
http://rac.org/advocacy/irac/enewsletters/nonorthodox_circumcision/
http://clickonjudaism.org/pages/FAQ_brit.html
Sailorman:
I think we will need to agree to disagree. I have neither the time nor the energy to engage you right now. You want to think I am being dishonest and illogical (though I wish you would stop characterizing the articles I linked to by the site where I found them; they are, as I said, from refereed journals, and you can find them in more neutral places as well–the sites I link to happen to be the ones that were easiest to find and free). I think you are consistently and wilfully misreading and, frankly, anti-intellectual in your argument. Facts, for example, are most certainly not history-proof. All kinds of ostensible “facts” surrounding circumcision, not to mention a whole helluva lot of other things, have fallen by the wayside as history has progressed.
I do have to say, though, that you are correct, as far as I know, about circumcision: it is the one, biblically mandated mark of the covenant, and while–again, as far as I know–not being circumcised does not make one not-Jewish, if one’s mother is Jewish, for believers it excludes one from certain aspects of the convenant, though I don’t remember now what they are.
There’s a lot of good discussion here.
In my view, it comes down to this:
A physician has a duty to his patient. That includes not performing surgery except when there is (at least) a genuine medical indication. By definition, if the physician is not strongly recommending surgery for his neonatal patient, no such medical indication is present.
The neonate does not need a circumcision. Circumcision is not recommended by any medical association. There is no evidence that potential benefits of the surgery outweigh the risks. Prophylactic interventions in a child require an even higher standard than minimal efficacy. A physician offering to perform such surgery on a neonate violates numerous duties to his patient.
The only possible justification for ablative (tissue removing) surgery in the absence of immediate need is for prophylaxis. Circumcision is not even minimally efficacious (i.e. potential benefit in excess of risk), yet a far higher standard is required for prophylactic amputations such as circumcision.
Circumcision meets non of the standards for an invasive prophylactic intervention. A coherent set of standards can be found in this very thorough analysis:
Prophylactic interventions on children: balancing human rights with public health
That neonatal circumcision violates the physician-neonate relationship is good news to those who are uneasy about an outright ban to protect the genital integrity of males. All that is needed is for physicians to come back into line with the ethical standards of their profession.
Physicians today should understand that their neonatal patients will one day grow to be adults capable of holding them responsible for their actions. Additionally, any parent who signed away their baby’s foreskin but were not fully informed about Sorrells (which found the most sensitive parts are removed by circumcision), and upon reading it realizes they made the wrong decision, should have strong grounds for a lawsuit. May I respectfully recommend to those who do this, please aim for a judgment or settlement not for cash, but for a public promise to never be involved in a non-therapeutic circumcision ever again.
1) For me, the difference between not being against a ban and being for a ban is marked by neutrality. I’m not going to agitate for a legal ban on male circumcision. If one were put before me, I might vote for it.
(I also might not. Should such a ban be put before the public, I do suspect its motivations would be primarily anti-semetic [just because of where power lies in the US], and I’m sure the way the law was written would reflect that.)
2) Reduced nerve endings and loss of sensitivity don’t count as harm? Seriously?
3) I don’t recall the transmission issues actually being “huge.” My memory is that they were relatively small AND that the methodology for the AIDS study was pretty poor.
4) I suppose the question of male circumcision plus religion is a matter of whether male circumcision is more like putting on a headscarf (which one can take off!) or more like enforced seclusion. Something doesn’t become automatically good just because it is a religious practice, which surely we know from criticizing religions other than Judaism.
5) Why don’t babies require general anasthesia for circumcision? They DO feel pain. Circumcision is inflicting a great deal of pain on an unprepared infant who can’t interpret the source. I don’t put a lot of credence in the suggestion (advanced by some who oppose male circumcision) that this post-natal trauma is the cause of many male problems. But still — lots of pain on an infant is not my idea of a good time. We anesthetize adults because they can slap us. But let’s not pretend that giving the surgery to babies is a fantastic good time because they don’t need anasthesia. They still have pain, they just don’t get the painkillers.
6) I note the absence of Nick and Tamen, who wanted to talk about male circumcision when it was an INappropriate subject on my thread. I note, however, the presence of Myca, Ampersand, and Richard Jeffrey Newman, who are opposed to male circumcision but who respect the boundaries of conversation about female genital mutilation. This confirms my impression that the “what about the men!” discourse that shows up on FGM threads is about derailing feminism, NOT about helping men.
Why don’t babies require general anasthesia for circumcision? They DO feel pain.
General anesthesia carries with it a risk of death. That risk is higher for babies. The calculus is that the pain isn’t worth the death risk. As an adult the pain is far greater, and there also aren’t any ethical concerns about risking death on someone else’s behalf.
As an English woman with an American boyfriend, I am amazed that the US still circumcises as a matter of routine, or indeed at all. In the UK the practice is still widespread among Jewish and Muslim communities but only exists for medical reasons in the rest of the community. And people still have it done by non-professional medical staff, religious leaders, etc despite the risks (e.g. of death).
RJN:
I apologize for implying that your articles were themselves false. However, the reality is that the site on which they exist is a site with a ‘mission.’ As a matter of course, I strongly distrust sites which present science with a political bias. I apply this distrust evenly to sites whose conclusion I “like” and those I don’t. Perhaps we will have to, as you put it, agree to disagree.
Actual scientific facts are, in fact, history proof. They change, they evolve as we find out new things. But real, honest, scientific knowledge is… what it is. It is unquestionably true that science has been used to bad ends, but that says little about the worth of the underlying science itself. Things don’t fall by the wayside as HISTORY progresses, they fall by the wayside as SCIENCE progresses. there’s a huge difference. I’m happy to debate this with you in another thread if you wish.
Mandolin, apparently the U.N. disagrees with your interpretation of the AIDS study. Care to elaborate a little and/or support your assertion that it’s a bad study?
Robert, as per some L&D nurses I know, the infants get pain meds, simply not general. I don’t know any further details.
brick5, that ethics article takes an unusually extremist view that prophylactic action may only be taken when there is at least a 1:1 chance of actually contracting the disease.
the article also, IMO, presents an inaccurate model. It described breast cancer as carrying a risk of 1:8 in a woman’s life (correct) and then goes on to discuss prophylactic mastectomies as if they would be the logical conclusion to such a statistic.
That is hogwash. We DO, RIGHT NOW, perform all sorts of prophylactic actions on women to reduce their chances of dying from breast cancer. Mammograms are an excellent example: they are neither entirely risk-free, nor are they cost-free (especially when opportunity cost is considered.) Because cancer can (when caught early) be treated and eliminated, it is vastly more effective to catch it than to treat all women.
And then you get dreck like this:
Really? You think they’d coerce young girls to cut their breast off instead of, say, starting frequent mammograms, ultrasounds, or MRIs at a young age? I mean, does this actually make sense to anyone? It seems like pretty obvious scaremongering to me. (note the telltale “some____,” which gets used a lot here.)
This is, BTW, the sort of presentation bias I’m talking about. What sort of person could present that argument with a straight face?
Sailorman,
You are making the same point as the authors of the paper, which is that prophylactic mastectomy of children is not ethical, despite the potential for disease reduction. That’s precisely why it is an instructive example.
“Foreskin absolutely IS SOLD…(with no compensation or even notification to the victim or his family). TNS Recovery Complex face cream was discussed on Oprah Winfrey for crying out loud. This is not some phantom. ”
OPRAH GIVE-ME-AN-EVER-LOVIN’-BREAK WINFREY? That amoral, moronic, very-strange woman who thinks that diets work and will exploit whole towns just for a photo op and who thinks that Schwarzenegger never beat up anybody and who will say or do anything so long as it helps her ratings? PLEASE! You’ve just PROVED that this whole idea’s a joke! Next you’ll be expecting me to accept a Wikipedia reference as proof!
It’s a legend, folks. (The alligators in the sewers live on the leftover foreskins that nobody buys.) The site cited is also hysteria with no legitimate references. There’s talk of “neonatal growth factors,” as if foreskins were somehow the equivalent of stem cells, instead of just regular old skin. Once again, we see magical thinking associated with male naughty bits. If foreskins could be used for “therapy” or to grow “acres” of replacement skin, so could any skin cell from anyone’s body (even women’s!)
Show me the data, folks. And, by “data” I mean articles that are not from 1984, or which can be found readily without my having to go to a university library. (Just because a citation deals with skin grafts doesn’t mean the word “foreskin” even appears in it anywhere.)
Please resume your more important conversation.
Kell,
Would you be more convinced that infant foreskins are procured for use by biotechnology companies (do you think hospitals don’t get a cut, financially, that is?) when you read it in their annual reports?
Here’s one:
Has anyone ever heard of this potential use being disclosed to parents when they give consent to remove this part of their child’s body?
Let me just also point out, on a note related to the “business” of circumcision, that circumcision is big business in a whole variety of ways.
One of those is treatment of the pain and potential for infection after circumcision:
Painful infant circumcision wounds create business opportunity
Ouch.
Um, wouldn’t a much better way to handle the “overwhelming pain” and need for “Protecting Against Infection” be, oh, I don’t know, not genitally mutilating the boy’s penis???
.
Let me just also point out, on a note related to the “business” of circumcision, that circumcision is big business in a whole variety of ways.
One of those is treatment of the pain and potential for infection after circumcision:
Painful infant circumcision wounds create business opportunity
Ouch.
Um, wouldn’t a much better way to handle the “overwhelming pain” and need for “Protecting Against Infection” be, oh, I don’t know, not genitally mutilating the boy’s penis???
Mandolin:
Do they? Sure, they kick their legs and cry, but it’s not clear whether this reflects subjective experience of pain, or is simply reflex. I’m not convinced that infants subjectively experience pain (or anything else, for that matter). And even if they do, does pain matter if you can’t remember it? I can’t see how I’m any worse off for having been circumcised without general anesthesia.
Not absent, just hadn’t gotten around to this one yet.
On your post, I was not wanting to talk about it. I was pointing out that a term (circumcision) was being used for a practice (FGM) that does not adequately describe the horrors of FGM to most men. Its a euphemism.
Most men in America have been circumcised and most think nothing of it. It happened when they are young. It doesn’t seem to affect them much. Course they can’t compare to what it might be like with that bit of skin back because they have never known it.
As for me, I could sign up for the operation and give you a before and after view — but I am not. I have no plans on letting a doctor with a sharp knife getting close to me anytime in the immediate future. That is the next eighty or so years.
FGM is much more akin to the horrific castrations that used to be done to men by the slave trade. Although perhaps the castrations were worse because allegedly the death rates were close to 90%.
As in:
http://en.wikipedia.org/wiki/Arab_slave_trade
I fall into the ‘anti-circumcision’ camp. I had a daughter, not a son, but if I had had a son, he would not have been circumcised.
I have never heard of any good reason to get circumcised. Y’all hit all the high points. The ‘cleanliness’ issue was raised. The ‘look like the other boys’ is another. Other than those two absurd points, there are not any reasons to do it.
I think the practice is barbaric, but less so than some of the other issue that have higher priority. We can only tilt at one windmill at a time. I’ll let others wet their lances on this one.
[Extremely long, extremely off-topic discussion of a law relating to child abduction snipped by Amp.]
Re circumcision and pain:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9057731&dopt=Abstract
This is only an abstract, though. You can view the full article here:
http://www.cirp.org/library/pain/taddio2/
I am trying to make no particular point here except that the pain of circumcision is real and that there are studies indicating that it has, relatively speaking, long lasting and substantive effects.
1) Unlike some of the other “anti-circumcision” folks here, I think the evidence is strong (although not ironclad) that widespread circumcision in Africa would reduce transmission of AIDS. There have been three randomized clinical studies showing that men who get circumcised as adults are less likely to become HIV-positive. Although there are still some doubters, I think the evidence is strong enough — and the need desperate enough — so a reasonable case can be made for circumcision in the African context. (But a reasonable case can also be made against; see this article by Howe).
However, it doesn’t follow that widespread circumcision is the right idea for the U.S.. Widespread prophylactic surgery only makes sense if what you’re preventing is widespread and commonplace (such as AIDS in Africa); it doesn’t make sense if what you’re preventing is relatively rare (such as AIDS in the US). Quoting from Howe’s essay:
2) It’s also not clear to me that removal of the foreskin actually leads to a less satisfying sex life in any way (see this study, for example). It may be that the subjective amount of sensation and pleasure one feels is based more on responses that take place within our brains than on the particular nerve endings lost in circumcision.
* * *
Sailorman, if you respond to me as you’ve responded to Richard, you’ll probably point out that the link to Howe’s article is on the CIRP site. However, that doesn’t mean that you can logically dismiss the article. It was originally published in The International Journal of STD and AIDS, a legitimate peer-reviewed publication. It might make sense to dismiss an article because of where it was originally published (although even that is a bit dicey, except in extreme cases), but it’s irrational to dismiss an article because of which websites reprint it (most likely without permission).
Your wholesale dismissal of the other peer-reviewed articles Richard has linked to was also irrational, for exactly the same reason.
[Edited substantially by Amp at 9:20am.]
Sailorman:
Step one: Study is originally published in JAMA.
Given JAMA’s peer-review process and academic prominence, being published in JAMA lends the article some credibility. (Almost no one would say “well, if it’s been published in JAMA it must be junk.”)
Step two: Several years later, a biased advocacy website reprints the JAMA article word-for-word, probably without permission.
Suddenly, in the world according to Sailorman, the exact same article has lost all credibility and can be dismissed based only on where it was reprinted. On Monday, it’s a credible scientific article. On Tuesday, biasedwebsite.com reprints it, and suddenly it’s junk. Does that make any sense?
Sailorman, I agree that an article’s credibility can be reduced by the venue it was originally published in; knowing a news article was written for The Onion suggests that the article isn’t true, for example. But what you’re doing here is making ridiculous excuses for dismissing legitimate peer-reviewed articles. Are you really incapable of telling the difference between an article written for an advocacy website, and one written and published in a peer-reviewed journal but later reprinted on the web?
“On your post, I was not wanting to talk about it. I was pointing out that a term (circumcision) was being used for a practice (FGM) that does not adequately describe the horrors of FGM to most men. Its a euphemism. ”
You’re right, Nick. I realized this morning that you weren’t engaging in the behavior I was talking about. I apologize.
Sailor,
Amp’s provided links about the HIV studies which represent the anti-view. If you skim thorugh Pandagon threads on the subject, you can also find links provided by Ms. Kate, who I’m pretty sure is a sociologist.
There may be an argument for using male circumcision as a preventative measure in regions where condoms are difficult to come by. I just went and checked transmission rates among one of the cultures in Africa that routinely practices male circumcision, and it looks like there is data that the Kikuyu have a lower AIDS transmission rate than other groups that don’t practice male circumcision. I suppose circumcision could be a stop-gap in that situation. However, there are often factors that affect African contexts which westerners aren’t aware of, and I’m not comfortable making an assumption about what the effects would be of circumcizing groups that haven’t historically practiced circumcision.
“I don’t like the website that was published on, therefore I can dismiss it” is an ad hom argument (and one that you’re overly fond of).
I never claimed that the website I linked to was representative of Judaism, so your argument is a strawman; I said it was an example of a rabbi arguing that being uncircumcised doesn’t make a Jew suddenly non-Jewish. Which it is.
It’s true that in the US, most Jews agree that getting a circumcision is extremely important. It’s not true that there’s universal agreement that you can’t be Jewish if you’re male and uncircumcised. [*] (Not even the links you provided make that claim.) There are some rabbis who won’t allow a bar mitzvah ceremony for uncircumcised boys, but there are also some rabbis who will allow it.
In European Jewish communities, incidentally, this question is barely an issue at all; not being circumcised is generally considered the equivalent of eating ham, in terms of how “unjewish” it is. (Or so I’ve been told by a couple of European Jews). The belief that circumcision is an absolute requirement of Judaism is a belief held by many American Jews (and others), but it’s not one held universally by all Jews.
As for Genesis 17:11, surely you’re not claiming that we have to follow everything demanded of us in the Torah or else we’re no longer Jewish.
[*] I’m referring here to born Jews, not converts.
Thanks for the education on the issue Amp. Those are very interesting articles.
I AM OUTRAGED !!! I just read how they were doing those ‘studies’.
from New York times link
Talk about using live human guinea pigs. This is just sick. Instead of providing help for this community, they are conducting some bogus study to fit some sick doctors idea of a ‘fix’.
At least they stopped the trial on ethical grounds. Their excuse was that it was not ethical for the uncircumcised group to continue. Geez. 22 of the 1,393 circumcised men were infected. They should have stopped the test just on those grounds.
I really liked the discussion between Mandolin and Richard of the link between anti-sexuality (and anti-masturbation) ideology and male circumcision.
This is total speculation, but I wonder if the high prevalence of, well, prudishness in the USA could be a factor that explains our unusually strong devotion to circumcision?
Here’s one example of the links Ms. Kate recommended on Pandagon – http://www.cirp.org/library/disease/HIV/cochrane2003/
Nick, I’m not sure I understand what your objection to the study is. It’s not as if they deliberately infected the men with HIV; they just gave half of them a treatment, and the other half no treatment[*], in order to determine if the treatment worked. If they hadn’t run the study, then none of the men would have gotten the treatment at all.
What other means of testing if a treatment works is available, that’s as reliable as a random clinical study? None that I know of. And to recommend a treatment as extreme as universal male circumcision (not just of infants) without first doing very high-quality studies to test if the treatment works or not would be extremely irresponsible and could potentially harm millions of people.
[*]Edited to add: Actually, they gave all the men treatment, in the form of safe sex counseling, and they also gave all the men who wanted them circumcisions — but the control group was only given circumcisions after they decided to end the study.
“Talk about using live human guinea pigs. This is just sick…”
Yeah.
Heh, being in the unusual position of agreeing with Nick…
Among other things, if you look at the objections in both Cochrane and Howe, it appears that the researchers did a poor job of controling for their own cultural biases when they went in to do the research. They don’t seem to have understood the places or peoples they were investigating.
Howe: “Other cultural factors, such as age at first coitus, chastity and monogamy, that could otherwise explain the differences were not considered by the authors.”
Cochrane: “A potential confounder that has not been measured in any study to date, to our knowledge, is the use of vaginal drying agents in female partners of the men. This practice is reportedly common in parts of Africa (Brown 93; Runganga 95; Kun 98) and may result in increased vaginal abrasions and micro-lacerations, possibly facilitating HIV transmission to both men and women.”
There’s a paternalistic flavor here, and an ethnocentric flavor here, and a lot of other things that make me uncomfortable.
Mandolin, the Cochrane analysis (which is excellent, thank you for providing the link) and the Howe article were both written before the Random Clinical Trials that the Times article Nick linked to describes.
Because men are assigned at random into the control and treatment groups in an RCT, it’s unlikely that any of the confounding factors you mention would make a difference, because it’s unlikely that a random trial — let alone three separate random trials — would by random chance assign all the men who had (say) early first coitus to one group but not the other.
Edited to add: But I can think of other potential problems with the RCTs. For example, it’s possible that patients who have had surgery (even minor surgery, such as having their foreskins cut off) are more likely to take doctors’ instructions seriously than those who did not have surgery. If so, then perhaps the men who got circumcised were more likely to follow safe sex advice than those who were not circumcised.
Ampersand,
You’re exactly right, that the African RCTs introduced many uncontrolled confounds by not performing a maximally similar surgery on the control group. They could have done a surgery which didn’t remove any tissue, but they didn’t.
John Talbott actually himself makes this point in commentary on his recent research which found that female sex worker populations were able to explain the high rates of HIV found in some countries.
Amp:
I think it is crucially important to distinguish between having a satisfactory sex life, which is about far more than whether or not one possesses a foreskin, and the fact that circumcision removes sexual sensitivity from the penis (and when I say “removes,” I am talking about the foreskin, not the glans).
Regarding the abstract you linked to: I am stretching pretty far back into memory here, but if I remember correctly, the nerves in the glans penis resemble most strongly the kinds of nerve endings that you find, for example, in the heel, which respond mostly to pressure. The nerves that are removed when the foreskin is cut off are of a very different sort, and are quite a bit more sensitive. IN men who are circumcised, what remains of the foreskin is usually a little bit of the frenum (frenulum?), which is on the underside of the penis right beneath the glans. That is often, in circumcised men, the most sensitive part of their penis (as is, often, the circular area just beneath the glans). Part of what you have to imagine, if you want to imagine what is missing, is that kind of sensitivity spread out over the entire area of the foreskin and, as importantly, that kind of sensitivity spread out over skin that is similarly smooth and moist to, say, the inside of your mouth. I have read accounts from uncircumcised men who could make themselves come just by manipulating their frenum. In other words, assuming that the study you link to is authoritative, it may be that the sensitivity they are talking about is very different from what one would experience with a foreskin.
Again, though, and I can’t emphasize this enough: I am not arguing that possession of a foreskin is the determining factor in the degree of satisfaction one finds in one’s sex life. I am simply trying to point out that there is a very real loss, that men who were circumcised as infants can not know we suffered in anything other than a theoretical way. It would be interesting to hear from any men reading this blog who were circumcised as adults, say, or after puberty.