You’ve just had a baby boy! You’ve brought him home from the hospital, you’re getting into that routine of late night feedings and too frequent diaper changes, and you think, “Hmmm. What this situation really needs is for someone to take a pair of scissors to this little rascal’s penis.” I don’t get it. But apparently, home circumcisions are a thing, and there are “professionals” (using the term loosely) who are so committed to their hobby of chopping up baby penises that they’ll resign from regular work to commit to the practice.
As part of the BBC investigation, an actor phoned up Dr Siddiqui and asked him to conduct a home circumcision on their baby. He agreed, in direct contravention of his GMC ban. Since then, and after discovering he had been exposed by the BBC, Dr Siddiqui has resigned from his NHS job. The astonishing consequence of that resignation is that it now allows him to resume conducting circumcisions, which it appears he fully intends to do.
Yes, you did read that correctly. Circumcisions are completely unregulated in the UK, and anyone – you, me or the local barber – can set up a business cutting off baby boy’s foreskins at a hundred quid a pop. Any doctor under the employ of the NHS, however, is bound to the regulation of the GMC and the Quality and Care Commission. A circumcision conducted in a hospital, with anaesthetic and surgical implements is carefully controlled and subject to monitoring and audit. A circumcision conducted on a kitchen table or in a community centre is completely unregulated. There are more regulations surrounding the piercing of an ear than the surgical amputation of a foreskin.
Weird. You know, if a guy made a habit of going around kissing baby penises, he’d be locked up on the spot, but add some sharp knives and olive oil to the process, and suddenly it becomes an honored and respected traditional folk practice that must be allowed to continue without interference.
During my nursing school labor and delivery rotation I witnessed several circumcisions. The infants screamed in obvious pain and while it wasn’t very bloody, it was pretty damn barbaric.
Largely OT (although circumcision is in there), but too good to pass up: Costco apologizes for labeling bibles as fiction.
No apology necessary, of course.
Somehow I’m not surprised.
cervantes, #2: Quite right. The book should be moved to the Horror section immediately.
Unlike in the US, non-medical circumcision in the UK is practised almost only by religious groups. One story I saw about it had a quote from a rabbi (I think) saying the group should be entitled to preserve their “self-determination”. Because nothing says self-determination like cutting part of someone’s body off when they can’t give consent.
We were still fairly young (21 and 22) when we had our second child. The first had been a girl, and I’m sure that we would have gone along with circumcision if we had had a boy.
When the second was on the way we found a wonderful doctor. He did not approve of circumcision, but would do it if the parents insisted. He insisted that both parents must be present for the procedure.
He also had a short film that he insisted that ALL of his expectant parents must view before the baby was born. That was the beginning of our education about it. After viewing that film and doing some research of our own, we were both totally against circumcision.
That second baby was another girl, so it was a moot point. When our third child was a boy, there was no question.
Our oldest grandson wasn’t circumcised either, and his Mom is well-versed on why.
I don’t think that the youngest is either, since his Mommy is from Mexico and I don’t think that it is part of their culture. My son has never brought it up, so I’m not sure.
However, two of our grandsons have been circumcised, mostly because they both have arrogant redneck fathers. Both have had some problems because of it.
Like breastfeeding (discretely) in public, I thought that this had been settled years ago, and that most hospitals and doctors were beginning to advise against circumcision, but now it seems that young parents are fighting these fights all over again.
As usual, follow the money. Doctors and hospitals make more money from doing unnecessary procedures. The formula companies can make more money when young mothers are shamed into not breastfeeding, so our culture is encouraged to be intolerant of breastfeeding.
I hope that our younger generation learns and ends the barbarism and stupidity.
Apparently PZ has not been reading some of the posts on FTB about Hassidic rabbis doing exactly that.
@6 Trebuchet: I read it as PZ has indeed been reading those posts and is referring to them pretty directly.
If he *just* did the kissing, he’s a nonce, obviously. But since he first does oils and knives and talking to the beardy sky man, THEN does the winky-kissing, well he’s not a paedo, he’s a respected pillar of the community and how dare you question his right to do this stuff what are you a racist or something?
@7: Oh, OK. That makes sense.
@4 robinjohnson is right, re: UK. This is part of the reason why I think this subject is tricky to discuss here – circumcision is, as far as most people in the UK are concerned, a Jewish thing*. So any condemnation of this barbarism, no matter how carefully phrased, no matter how rational, runs the risk of being perceived (and loudly condemned) as anti-Semitic.
*Yes, Muslims do it, and yes, there are ten times as many of them as there are Jews in the UK (there are more Muslims in the UK than there are in the US…). But knowledge of Jewish tradition is more widespread than knowledge of Muslim tradition. There’s no Muslim ‘Fiddler on the Roof’, no Muslim ‘Schindler’s List’, no Muslim equivalent of the Chief Rabbi, and we’ve never had a Muslim Prime Minister, whereas we had a Jewish PM in 1868 and the current leader of the Opposition is Jewish.
There’s a similar mindset going on in both. I saw a very young girl having her ears pierced in a shop some time back. Unlike circumcision, the girl was dead keen. That is, until the first ear was dome. After that, she was screaming with pain, and trying to run away. . The adults, however, insisted on continuing, and got their way. I’d consider that as simple criminal assault. There are regulations? What on Earth do they specify? That while assaulting a small child, you must use sterilised instruments? No mention that they’re committing actual bodily harm., and that this is normally illegal?
Circumcision of an infant is beyond the pale. But the adults seem to think it’s OK. Why can’t they see the assault for what it is?
Ugh, that is horrifying. Scissor and olive oil, they are butchers. My parents decided against circumcision when I was a baby, even though it was still fairly common then, and I am glad they did so. Later in life I had it done as an adult for phimosis that did not respond to other treatment, but I am very happy I was able to make that choice for myself when the time came.
Dave,
With four daughters, we had to address the question of ear piercing. My mother had never allowed me to get my ears pierced, and she would beat me if I begged, so I stayed quiet about it.
Soon after I got married, I got my ears pierced.
We decided that we would give our girls the option to get this done when they were old enough to decide for themselves.
At the age of 10, each of our girls happily marched off to the jewelry store to get their ears pierced and to get their first set of “real” earrings.
At the age of 12, each of the girls got her own make-up kit and a trip to the mall for the free make-over that went with it. This was a clever plan on my part – this way, the girls were learning about make-up from an “expert” and not being lectured at by Mom.
This worked well for us. I also hated seeing baby girls getting pierced ears at the same time as my 10 year-old girls.
I am thinking a bit about the last part of the quote paragraph talking about piercings. I am kind of curious what the regulations are about that in the UK. Yesterday I was reading a short letter in the British Dental Journal dealing with a tongue bifurcation gone wrong. In it they mention that the GMC said that it was not classed as surgery as it was cosmetic, and that they could do nothing as they have no jurisdiction over tattooists. I wonder how the people supporting child circumcision would feel if others decided their children had to have bifid tongues.
Any medically unnecessary modification of the body in a person too young to choose it for themselves (or in a child who “agrees” but is under great pressure to have it done, as is occasionally the case with circumcision AFAIK) should be classed as criminal assault.
I had my ears pierced twice, both times as an adult, and when my daughter was born, among the handful of cards and little gifts from relatives – toys, clothes and suchlike – there were a pair of ear piercing studs. I thought it was utterly shocking, really unexpected and does-not-compute, when I realised that they were expecting us to get her ears pierced as a baby. We promptly put the studs away and forgot about them forever; DaughterSpawn did eventually get her ears pierced when she was about 14, when we figured she was old enough to make up her own mind about it, and SonSpawn has so far eschewed piercings.
It is both horrible and insanely nonsensical that there should be more regulatory control of ear-piercing and tattoos than there is of home circumcision. This should be seen for what it is – criminal assault and GBH – regardless of the religious bullshit. (Though great care should be taken to prevent people from attaching any such laws to racist rhetoric, to antisemitism or islamophobia, here in the UK or anywhere else.) (I know non-religious circumcision is still common in the USA. Seems so strange – why would such modification be seen as the norm?!)
.
Magistramarla– Off topic, but I have to say it.
While it is true that some places have problems with public breastfeeding, my experience today is that formula companies in the US are no longer the ogres– the Breastfeeding Gestapo is. Breastfeeding was so heavily encouraged at the birth of my first daughter that they failed to notice that I didn’t produce any, and then called CPS on me because my nipples split and my daughter lost over 12% of her birth rate. For my second child, in a different location, they still doubted me and wouldn’t provide any formula in the hospital.
My experience is not unique– we have now flipped the other way in demonizing women who can’t or won’t breastfeed, telling them they’re bad mothers and that their children will be mentally impaired. Of course, this being America, you still can’t breastfeed in public either.
On one level, I’d be tempted to advocate regulation to increase safety.
On another level, I’d be worried that regulation legitimizes it when I’d rather abolish the practice on those too young to consent.
If someone plays the anti-Semitism card, I’d be tempted to bluntly state that we’re dealing with a painful, presumably irreversible procedure performed on helpless children for no overriding or necessary medical benefit. What I’m advocating is withdrawing an unjustified religious privilege that violates children’s rights, which is consistent with my attitude towards religious privilege in general.
http://uncutting.tumblr.com/ is a pretty neat intactivism blog I read. There are some NSFW posts(genitals of the day :D), but all in the spirit of body positivity.
Slightly OT, but what’s the consensus here on male infant circumcision from a medical standpoint, as part of standard preventative care? I ask because we’re expecting and want to have an informed decision.
18 comments into a discussion about male circumcision and no one has mentioned female genital mutilation, yet? Where is this vast gynocracy I’ve heard tell about?
/sarcasm, in case people didn’t know
opposeablethumbs:
Yeah… friends of mine got their infant daughter’s ears pierced when she was REALLY young. Like, a couple of months old. Their rational was because she’s a little girl, duh.
gillt:
There’s no reason to circumcise as “preventative care”. Most of the men in the world aren’t circumcised and it gained popularity in the US as an anti-masturbatory measure (which, shockingly, doesn’t work).
And if circumcision did work as an anti-masturbatory measure, I’d still be against it. Masturbation is a lovely thing.
Gillt
Preventing what, exactly?
Gillt, what are you trying to prevent? I can’t think of a valid medical reason for infant circumcision. No one has demonstrated that the very real risks from the procedure (pain, bleeding, infection, mutilation, death) outweigh the claimed risks from not doing it. I know two men who are serious masochists because their erections hurt because their circumcisions were botched. There are probably many, many more.
Billions of men around the world get along fine without circumcision. (Now count up all the male mammals born with foreskins.) Don’t do it.
@Alexandra:
I’ve always loved you, and frequently lately miss you, and then you go and give me #21 to make me love you more?
You sadist.
Wait, that makes me love you more…
Are you bringing this up because of the studies dealing with reduction in HIV infections, or something else like “cleanliness”? In the HIV case there is a lot of disagreement over it, and even if it can help, unless you are living somewhere with a large HIV+ population it is not likely to be of much use over other methods of prevention. I see the cleanliness argument come up a lot, which dumbfounds me. Anyway, unless you are more specific I don’t see how anyone can really comment on this.
Hi Alexandra,
Maybe I should start with what the pros of circumcision are according to some studies: reduces transmission of STDs, reduces UTIs and avoids issues with foreskin failing to detach, which can be apparently very painful. In other words, I thought the medical literature supports the practice, but it makes one suspect when there’s such a strong cultural pressure here in the US to do it.
They can deal with it later in life. That is what I did. It is quite normal for the foreskin to be non-retractable for some time, no need to jump the gun and do it at birth, it goes away in the vast majority of cases.
I don’t want derail this post, so if the moderates will step in and let me know, I’d appreciate it.
Timberwoof:
Circumcision related to urinary tract infections, sexually
transmitted infections, human immunodeficiency virus
infections, and penile and cervical cancer
http://onlinelibrary.wiley.com/store/10.1111/iju.12154/asset/iju12154.pdf?v=1&t=hoaitqnb&s=e93ec72cb2b41db352acc5f1ecfdad37a3ade6c0
If a boy (or man) has phimosis or other condition where there’s clearly something wrong with the foreskin/glans, then by all means circumcise. But outside of those situations, I really don’t see the point!
Many of the health benefits purported to come from circumcision are things like cleanliness and avoiding a buildup of crud underneath the foreskin. And yet, men in cultures that don’t traditionally circumcise just learn to clean themselves. They aren’t falling over dead or suffering in large numbers from dirty foreskins.
Now, I will acknowledge that people advocating against circumcision have grounds to be careful in how they approach the Jewish and Muslim communities, especially since anti-Semitism and anti-Muslim bigotry is in fact a thing that occurs. That said, accusations of the “intactivism is inherently anti-Jewish/Muslim” should be shot down.
gillt:
Travis addressed your concern about STIs (basically, there are other, better preventative measures that don’t include the unnecessary cutting of a child) and I suppose one would have to look up UTI rates of American vs European males to address your concerns. My guess is that what you’ve been told is wildly overblown. (Might circumcision help someone who is otherwise prone to UTIs? It’s not a stretch to believe that, HOWEVER most men don’t suffer from UTIs in the first place, so why would you worry about that before it happened?)
Shorter me: Do your own research or at the very least, think about these things critically.
Crip Dyke:
After the completely and utterly shitty week and a half that I’ve had, you have made me smile and maybe tear up a little bit. I miss you too.
gillt
The short answer is that the actual medical literature does no such thing, but the fact that it’s so widespread in the U.S. has led to endless pseudoscientific excuses for continuing the practice, and many medical professionals here continue to push such bullshit.
I’ve lost the bookmark, but I recall someone here, a while back, linking to a study showing that there are more health problems, statistically, associated with botched circumcisions than cases where circumcision would have prevented a disease. If I can find it I’ll post it, but maybe someone else bookmarked it…? (he said, hopefully.)
A lot of the pro-circumcision studies and rhetoric out there strikes me as being very heavily post hoc rationalization. “It happened to me, I did it to my own son(s), and my parents were good people, and I’m a good person, therefore it can’t be all bad!”
Dalillama, Alexandra, Esteleth…the pdf link I provided was a recent literature review of benefits of circumcision. I would be interested to hear your opinions on that. Does it make a case good case?
Daz: I haven’t come across that study either, but a simple PubMed search shows a large majority of papers in support of circumcision than against it.
While not really a good argument, I think that if there was a real health benefit people would use those arguments more often, but instead you commonly see people talk about how unclean foreskins are, or how horrible it is that they will not look like their father (because they don’t want to have to explain that difference to their kids), or that they might get made fun of in a locker room. I think, in the end, it is cloaking cultural biases in questionable science. Yes, the AAP recommends it, but this is pretty unusual compared to most western countries. In the US something like 61% of children are circumcised, but in Canada the rate is now somewhere around 32%. It is considered so normal, I think many people have a hard time accepting the idea that something so common might not be needed.
gillt:
Something worth doing: making sure your links work. (I get a “forbidden” message from your link in 28.)
Bear in mind: many countries with better medical care than the US don’t routinely circumcise. Don’t you think that if it was at all useful, the rest of the world would be doing it for the reasons you listed?
WHO supports circumcision as part of battling the HIV epidemic:
http://www.who.int/hiv/topics/malecircumcision/en/
That said, condoms are obviously a much better alternative and WHO admits as much. Also this strategy only makes sense in regions with extremely high HIV infections rate. Furthermore, WHO’s comprehensive study (I lost the link, sorry) on circumcision in Africa wasn’t finished – it was stopped when the initial results came in and the medical personal decided it would be immoral to prevent the control group from being circumcised.
On the other hand, there are reports like this one:
http://www.google.com/hostednews/afp/article/ALeqM5hic5yDmi_hrS4-Di-u5nU5lBk5mw
And I remember reading (again, sorry for not having a link) that circumcision in Africa may actually increase the risk for HIV because it isn’t being done in a controlled and professional environment that WHO has provided in its study.
Gillt, I got an error off that link, so I cannot review it. *shrug*
However, I have a general idea of the literature out there, and basically it says that if someone is otherwise healthy and well-formed (i.e. no phimosis, no deformities of the foreskin or glans, no tumors, etc), and otherwise not at high-risk for conditions that make having a foreskin bad (inability to clean under the foreskin and lack of a caregiver to do it, for example) than the benefits of circumcision, as compared to the (not nothing) risks of the procedure, are iffy at best.
I’ve read through some of that paper and it hardly seems to make a strong case for circumcision. Most of the sections I have seen so far have been highly conflicted with contradictory results being reported. For instance, in the case of penile cancer it indicates there does seem to be an effect, but then indicates that is it extremely rare in developed countries, and that the rate is going down in Denmark even though circumcision is rare, and attributes this to better hygiene.
If anyone does want to see the paper you can read it here: http://www.ncbi.nlm.nih.gov/pubmed/23573952
Then there are places like Israel, where the majority of circumcisions are performed at home (or at banquet halls), whether by practitioners with or without a medical degree in addition to traditional training. It is so common hardly anyone questions why a surgical procedure on a newborn is being performed outside of a medical setting. There are fathers who want to participate so much they hold the mohel’s hand as he works. And back in the 1990s there was a case where a father agreed to let the mohel’s teenage son do the procedure on said father’s baby after hearing that the teenager had been assisting his father for years. Said teenager was interviewed on the radio – until that day all he ever actually practiced on was objects such as gloves. Yikes!!!
Isn’t the connection between circumcision and HIV reduction about people who are sexually active?
@alexanderz:
Thank you for providing that second link.
There was a systematic problem with some of the studies claiming that circumcision reduced HIV transmission. For example: one study was to take two randomly-selected and cohort-matched groups of uncircumcised adults; circumcise one of the groups; and then compare the relative rates of new HIV infections in the two groups over a certain interval of time. The circumcised group had fewer new infections. Hype: “circumcision decreases HIV transmission by X%”. But, in addition to not holding true for all people who were circumcised, the difference in transmission rates is likely to have been systematically overestimated because the study were short and because the the circumcised group had statistically fewer sexual encounters during the study period (understandable given that they had had surgery on their penises). Thus, the data do not justify the conclusions people have been drawing from them ( e.g. http://download.journals.elsevierhealth.com/pdfs/journals/0968-808/PIIS0968808007293024.pdf ).
There is also a danger if people think that circumcision is more effective at reducing STI transmission than it actually is (if it is at all): They are more likely to engage in higher-risk sex, e.g. not use barriers, which could increase the STI rates.
The link works fine for me but maybe that has to do with my access.
Try this:
http://www.ncbi.nlm.nih.gov/pubmed/23573952
Some of the highlights, but also some of the results were inconclusive or merely suggestive.
Epidemiological studies at army hospitals have shown 10 to 20 fold increased incidence of UTI in uncircumcised infants.
….52% possessed uropathogenic organisms before they were circumcised, whereas none of them did after the procedure.
….male circumcision reduces the rate of female to male HIV transmission by 55-76%.”
….evidence for an increased incidence for gonorrheal in uncircumcised men but no difference with respect to chlamydia infection.
Circumcision being protective against HIV could be specific to male/female transmission as one study suggests. But even if we take HIV off the table of concerns, there still seems to be more evidence in support of circumcision than against, especially if carried out under sterile conditions by a professional, which of course isn’t a reality for most of the world’s population, which may explain why most men aren’t circumcised.
Gillt:
Okay, you’re just getting annoying. We’ve answered your questions. There is not more evidence supporting circumcision and you’re still ignoring the fact that most of the industrialized world doesn’t circumcise and has comperable or lower STI transmission rates than the US.
Here. have a chart of HIV rates in 2011.
You don’t want your kid to get an STI? Vaccinate (for applicable diseases) and teach them to wrap it up instead of raw doggin’ it with strangers.
What is your stake in this game?
@43 michaelbusch
I can’t open the link. Is there another link?
@gillt
If we tentatively grant that circumcision provides a small reduction in disease transmission, it would seem that this would only be worthwhile in areas where major STIs like AIDS are endemic i.e. Poor Countries/Africa and there, the scarcity of medical facilities and expertise concomitantly increases the risks of the procedure as well. It’s an open question but I have a hunch that the risk/benefit ratio wouldn’t work out in circumcision’s favor except in the most dire of circumstances.
gillt @ 45
Are you suggesting all of Latin America and Europe have a lack of sterile conditions and professionals? The frequency of circumcision in the USA a matter of culture, not better access.
And the percentage of the USA’s adult population that has been diagnosed with HIV or AIDS is six times greater than in Germany, three times greater than in the Netherlands, and one-and-a-half times greater than in France. Source. All three of those European nations have a circumcision rate below 20 percent, which is far lower than the USA. They do not, as near as I can tell, have rampant problems with UTIs in men either.
gillt
Your very first comment on this thread:
Might I say, for someone who claimed to be looking for advice, you’re doing a helluva lot of arguing, and seem to have a helluva lot of exclusively pro-circumcision material to hand.
Pardon me for being somewhat cynical…
If you’re expecting, I think it would be likely a lot better to expect to teach your kid about hygiene and safer sex (when age-appropriate). Oh, and also about bodily autonomy.
Pre-emptively removing all teeth would have a great effect of reducing the rates of cavities, which can have very serious consequences if untreated too.
@alexanderz @47: Weird. That’s a PDF. Here’s an HTML version of the same article: http://www.rhm-elsevier.com/article/S0968-8080%2807%2929302-4/fulltext
In the event that that doesn’t work either, here’s the citation, for Googling:
Dowsett, G.W.; M. Couch (May 2007). “Male circumcision and HIV prevention: is there really enough of the right kind of evidence?” (PDF). Reproductive Health Matters 15 (29): 33–44. doi:10.1016/S0968-8080(07)29302-4. PMID 17512372
And here’s the one-sentence summary of the conclusions:
That is from 2007, but I was having trouble finding anything more recent that was based on actual new data .
Also: a simple cost-benefit analysis, ignoring all other factors, says that circumcision is not an effective way of decreasing STI transmission. Cost of (safe) circumcision: few hundred $. Number of circumcisions necessary to prevent one new STI case: greater than 60, even in high-incidence areas, and taking the known over-estimates as if they were actually correct. So cost-per-prevented-infection is something far upwards of $10,000. Those same $10,000 could provide a lifetime supply of barriers to far more than 60 people, and prevent far more than one STI case.
If an adult wants to get circumcised, then they can choose to do so. But there is not a public-health argument for people being circumcised.
Daz:
I can’t help you’re too cynical to tell the difference between someone trying to have a discussion and arguing, which apparently is offensive to you. I just wanted to see what the consensus was around here since I think of this place pro science and research. So thanks for the advice and opinions.
Of course circumcision is only one of many factors in sexually transmitted disease rates, so I think a more direct comparison can be had contrasting disease rates to circumcised versus uncircumcised, NOT comparing of disease rates by country and then noting their circumcision rates.
Mellow Monkey
Not what I’m saying. I’m saying most of the WORLD’S population doesn’t have access to sterile conditions and professionals because most people don’t live in first and second world countries.
@michaelbusch: thanks for the links
My stated concern was personal preventative care. I’m not arguing, as you are, for public health one way or another, but it is an interesting dynamic I hadn’t considered.
This might be an extraordinarily stupid question, I don’t know. I read threads about circumcision with a lot of interest, but being a non-Muslim and non-Jewish European I’m somewhat ignorant.
I’ve always thought that if somebody gets circumcised as an adult, for whichever reason, the portion of foreskin removed must be much less than in a newborn or a young child, when doctors use clamps that are very big in proportion to the tiny penis (argh) and probably don’t measure too carefully. But I’ve never read this as an argument in favour of waiting until adulthood, and I’ve read quite a few, so I suspect there’s something wrong with it. Can someone enlighten me, please?
@gillt: Public health is simply “personal preventative care” done massively parallel.
As has been explained, whatever small health benefits circumcision may or may not have are more than offset by the costs and risks associated with the procedure and by the inability of an infant to consent. No one here is disputing that an adult can get circumcised if they want to.
gillt #54
You haven’t been discussing. You’ve been rebutting. You fit a certain… pattern, is all.
Most (all?) first-world countries have much lower incidences of child-circumcision than the US. Given that levels of health-care are at least roughly the same in the US as other first-world counties, the usefulness of such comparisons should be obvious. If circumcision has any appreciable benefit, then for whatever disease you check (STDs, penile cancer, etc), you should find a much lower incidence of that disease in the US.
I’ve always thought the only good use of piercing an infant’s ears is if you have identical twins and are not able to tell them apart easily. And even then, a sharpie would work just as well if reapplied regularly. Interestingly, that was the comparison my pediatrician made when we were discussing the circumcision question. I was just in the beginnings of learning how bad it was, and he described it as being on par with ear/body piercing in terms of being unnecessary but common and with about the same level of complications. I ended up letting Spouse make the decision since it was a guy thing. We… had not had much experience thinking about it in terms of bodily autonomy even for tiny people at the time.
I disagree. Sure, there’s overlap but it’s completely equal as you imply, especially in this context. As a soon-to-be parent I have control over my child’s wellbeing, of course taken in context of preserving his autonomy. That logic doesn’t map to public health at all.
Wrong again Daz. I noted that circumcision as protective against HIV may be dependent on sex thanks to michaelbusch and, again thanks to michaelbusch, the interesting public health angle I hadn’t considered. You’re so quick to bin me as a certain “type” it’s likely you’re looking to pick a fight or shame me into shutting up. Which is it? Do you want to trade insults or do you want me to go away?
gillt
Gah. Probably my bad. Offline-shit’s messing with my head, and I’m seeing bad everywhere. I should shut up. Sorry.
Dang Daz, it takes a lot to even suggest you’re in the wrong on the internet. I’ve been reading Pharyngula for 10 years, but I rarely post in the comments so I’m an outsider even after all this time and don’t know all the regulars yet, but if you’re one of them, hope to see you around.
Listen, gillt. It’s pretty simple. As I said from the get-go, circumcision was popularized in the US as an anti-masturbatory measure. Ever since then, doctors and parents have been trying to justify cutting their children after the fact.
If you can point to countries with comparable (or better) access to healthcare where penile cancer, UTIs, and/or STIs are higher than the US’s, then you might have a point. As I understand it, there is no such evidence out there.
Also consider that the reasons for cutting infants’ foreskin off keep changing. First, it was done to prevent boys from lingering on their penises. Then there was the “cleanliness” argument*, then the “he needs to look like Daddy”/”other boys will pick on him” whine, and now the claim is that circumcision might lower HIV transmission (but even the supporters admit that barrier methods are FAR better). One has to wonder what circumcision advocates will be lying to us about next.
*Seriously, am I the only one who cleans out her crevasses?
Some large crevices you have there, Alexandra!
HEYO!
This is hitting a bit close to home for me today. I was at the hospital just this Tuesday to correct a complication from my circumcision as an infant – so I’m wrapped in gauze as I read this, and the feeling is not a safely-distant memory.
As far as I know, my circumcision was not done for any medical reason (I was born in North America), and it’s maddening to me that not only was this unnecessary procedure done, without my consent, but also botched, and then left that way until I was old enough to seek medical treatment for it on my own. Now I have to live with the scars of both the original circumcision and the subsequent correction, for the rest of my life.
Against this experience, I confess that the promises that circumcision nudges risk factor percentages for this or that rare disease sound fairly uncompelling. I’d take that risk to be whole and unmarred, and voluntarily take other (non-amputative) precautions as appropriate, if anyone had given me that choice.
Ooops. Hope that wasn’t out of bounds, Alexandra.
I was just commenting (I thought amusingly) on your accidental use of crevasses where most people would use crevices.
Apologies if that was over a line.
I’ve read something recently on one of the atheist/freethinker sites about a Jewish circumcision practise of the rabbi/doctor/janitor/trolley collector sucking the blood out of the infant’s penis after chopping the evil unwanted bit off! That practise makes the regular Christian chop the bit off process a little bit less whacky but only in direct comparison. I’ve been accused of intolerance when questioning the circumcision thing with friends tainted with the Christian flavour of absurd religious belief.
To those referencing the American AAP’s report/statement recommending the use of circumcision, take a look at this response posted in ‘Pediatrics’ – the AAP’s own journal – shortly after that report came out:
Cultural Bias in the AAP’s 2012 Technical Report and Policy Statement on Male Circumcision
“Only 1 of the aforementioned arguments has some theoretical relevance in relation to infant male circumcision; namely, the questionable argument of UTI prevention in infant boys. The other claimed health benefits are also questionable, weak, and likely to have little public health relevance in a Western context, and they do not represent compelling reasons for surgery before boys are old enough to decide for themselves … The cardinal medical question should not be whether circumcision can prevent disease, but how disease can best be prevented.”
“There is growing consensus among physicians, including those in the United States, that physicians should discourage parents from circumcising their healthy infant boys because non-therapeutic circumcision of underage boys in Western societies has no compelling health benefits, causes postoperative pain, can have serious long-term consequences, constitutes a violation of the United Nations’ Declaration of the Rights of the Child, and conflicts with the Hippocratic oath: primum non nocere: First, do no harm.”
Far, far more women will die from breast cancer than men will die from HIV, penile cancer, or other illnesses that maybe, possibly, might have been prevented by circumcision, but we don’t lop off the breasts of pre-pubescent girls as a precaution. More women get uterine cancer than men will get penile cancer, but again, baby girls aren’t losing their uterus as a prevention. In fact, in the US, one is far more likely to die from a car accident than anything a circumcision might prevent. How about we just ban cars if one is so determined to save lives at the cost of personal freedom? And YES, ones child IS a person, in their own right, separate from the parent. The whole concept is inhumane and that it is allowed under “religious freedom” is reprehensible. What if a religion were to decide that everyone is healthier without a pinky?
a) The claimed reduction in STD transmission is contested.
b) Even if true, the benefit is so small it is vastly outweighed by other prophylactics such as a condom, which has the added benefit of not requiring surgery.
c) Even if true, and setting aside the fact that other methods are much better, STDs aren’t exactly a problem that an infant need worry about. You can safely ignore it until sexuality actually becomes a relevant topic for the boy.
Teaching hygeine is a part of being a parent, and as a foreskin-haver, I can tell you that cleanliness is pretty damn easy. So easy in fact, that I even managed to learn it for my self despite lacking a foreskin-haver to teach me.
Also, are you aware of the fact that you’ll be wiping much nastier places than under the foreskin yourself for the first few years? Every single shit your kid takes for the first X years will need to be wiped off by hand; the forskin is nothing next to that. Not liking the icky smells is not sufficient to justify for surgery. Cleaning your child is a part of taking care of your child – of being a parent.
This can be treated with surgery if it happens, which is uncommon. Why perform the surgery unless it becomes medically indicated?
Even trivial surgery has risk, meaning you are substituting one chance of misfortune for another.
For some reason (ineptitude!), I could find the incidence of HIV in North America (the geographic region) but not the USA. Anyway. North America has a population of about 529,000,000 and sees 70,000 new HIV cases per yer. That gives an incidence of 0.013% of the population.
Even if I take the upper bound of your figure (76%), this simply changes the incidence to… 0.01%. This shows us that the HIV figure is irrelevant as an argument, because although 76% looks pretty nice, it is rendered superfluous by the tiny initial risk.
I suspect that the risk is already so low due mainly to the prevalence of other, much-more-useful-and-also-less-invasive prophylactics. Such as condoms.
If you are merely interested in finding out the consensus here, why do you keep disputing people’s statements with tiresome cicumcision apologetics? Rather than coming here to ask a sincere question, your mind appears to be made up.
Also, ‘you’re too cynical to tell the difference’ is some irritating passive aggressive bullshit. If people doubt your sincerity already, this will only prove them right.
But since America has a high incidence of circumcision, and every other first world nation except Israel has less, it is exactly the type of comparison you are looking for: high circumcision vs low.
You missed an option:
Reasons To Bin You As A Certain ‘Type’:
1) Looking to pick a fight,
2) Shame you into shutting up,
3) Because you greatly resemble that type.
It’s even worse down here in South Africa. Circumcision is part of an initiation rite for some tribes where teenagers are taken into the bush for a week. There circumcisions are performed outside (at least a home is reasonably clean), with no medical care, no sterilisation and by untrained practitioners. Some of the initiation schools aren’t even proper traditional schools. Boys here die from neglect and abuse at the schools, from infections and some others survive but lose their penis.
Speaking of piercing, do you think parents could get away with piercing their male child’s penis (say, Prince Albert or apadravya) by using the excuse of religious practice or wanting their baby boy to ‘look like his father’*? It might actually be less horrible to alter a child’s penis in that way (although the infection rate would likely be astronomical) than to do foreskin amputation.
Never ceases to hurt my heart. Dear Parents, your baby’s body is yours to protect and care for, not yours to do with as you please (other than dressing them up in whatever style you deem fit and adorable).
*No little boy looks like his father, because little boys have little boy bodies and fathers have adult man bodies. Should we shave little boys’ heads when their fathers are bald, or give toddlers merkins so they can have pubic hair like mommy and daddy? Other than in locker rooms and showers, how often does a male child actually find himself in the unpleasant situation of viewing his father’s penis? Chances are that any child/pre-teen/teen with internet access has seen far more penises that don’t look like his own than he’s spent time comparing dicks with daddy.
I thought that “man” was made in “God’s” image. Who are these religious people to think that they can improve on “God’s” handiwork? If “God” ordered his people to cut it off, then is “God” admitting he made a mistake the first time around? Furthermore, are women made in “God’s” image too? Then he/she is a hermaphrodite.
In the real world, what happens to the foreskins? It turns out that they are an expensive product that is used in medical research and cosmetics, among other things. Just search “commercial uses of foreskin”. Here is one link among dozens: http://www.norm-uk.org/where_do_foreskins_go.html
So there are purely business reasons for promoting circumcision which may be more important than others. Parents are charged for the act and then the practitioner or hospital sells the skin for a double profit. If parents allow the surgery–and they shouldn’t–then they should at least get the profit from it.
To everyone comparing US HIV rates with those of other countries:
Your sentiment is correct, but your reasoning it totally wrong! Even proponents of circumcision don’t claim it to be the only possible solution. Sex rate, type of sex, use of condoms, use of narcotics and other factors all contribute to HIV rates. Merely comparing HIV and circumcision rates is silly.
You’re arguing with a straw man.
gillt:
Just as they can’t compare cross country circumcision rates with HIV rates, so you too can’t argue that a method that recommended for Africa (and only Africa!) as a desperate attempt to curve the spread of HIV there would be equally useful in the developed world where the factors are completely different.
There is nothing to suggest that in the developed world the benefits associated with circumcision would out-weight the dangers.
@52 michaelbusch:
Thanks for the link. Strangely I can open the pdf from the html article, but not directly. Weird indeed.
But, but, but…circumcised penises are just so handsome.
gillt, the comparison you should be making isn’t circumcision vs. non-circumcision, it’s circumcision of an infant vs. waiting until he’s old enough to make an informed choice or a circumcision becomes medically necessary.
Most foreskins are still attached to the glans for a good couple of years, so circumcising an infant is more traumatic than waiting for the foreskin to detach – and in cases where it doesn’t, you’re in a situation where circumcision is medically necessary. Having a medical procedure that you are old enough to understand and consent to is far less stressful than having such a procedure performed when you’re too young to understand what is happening and why people are hurting you. Furthermore, analgaesia can be used more effectively on a patient who can communicate when it has been sufficiently applied. So, even when there are no complications, the procedure itself is less traumatic if done when the patient is old enought to consent.
The medical benefits of circumcision are marginal at best. Even if we were to concede that it gave a significant reduction in the transmission of STIs, there is no reason not to wait until this becomes relevant. The preventative effect on UTIs is also usually marginal, especially when the boy cleans himself properly. In any case, the vast majority of UTIs are easily treatable by non-invasive means. In a tiny minority of cases, a recurrent UTI might warrant a circumcision as a prophylactic against further re-infection, but again this is a “medically necessary” case. As has been mentioned, in the early years a good parent will handle the genital hygiene needs of the boy, and so circumcision for cleanliness and infection prevention can easily wait until the boy is old enough to decide whether he’d rather lop off his foreskin or spend two seconds washing under it when he takes a shower. The other proposed marginal benefits (such as reduction in penile cancer) are so tiny and rare that waiting a few years would have no perceptible effect on the already tiny risk reduction, so again it can wait until the boy is old enough to decide for himself.
The risks are also rare, but significant. Any surgery carries risks, and cutting off a bit of a squirming infant is no different.
The other arguments are purely cultural and aesthetic. There is no moral justification for making an irreversible decision about a person’s appearance without their informed consent. Again, if the boy really feels the need to be circumcised to conform to social norms or look like his dad, he can easily make the decision to do so for himself when he’s old enough to care.
Short version: circumcision may or may not have benefits, and every man is welcome to make his own judgement on whether he wishes to risk the drawbacks in order to get the benefits. There is, however, no good medical reason to circumcise a boy before he is old enough to make that decision for himself. You asked what the consensus here was, and I think I’ve seen this discussion come round often enough to be able to claim that this isn’t too far from being that consensus.
Thank you for putting it so well, Marcus #76 – that’s certainly a good expression of my view on the subject too (as parent of a penis-haver). The medical benefits would have to be both indisputable and significant before a parent (or anyone else!) should even consider irreversible modification of an infant’s body. And the fact is, any benefits there may be (if indeed there are any at all, particularly considering that we are looking at this as a blanket prophylactic measure, not even on a case-by-case basis!) are both highly disputable at best, and utterly insignificant (considering industrialised-nation access to soap and water and condoms).
Certainly nothing there to trump the bodily autonomy of a human being too young to give informed consent.
http://blog.practicalethics.ox.ac.uk/2012/05/when-bad-science-kills-or-how-to-spread-aids/
Re infant ear piercing – there are cultures where it’s the norm for women to have pierced ears, and so the rationale is that it’s better to do it when they’re babies, because they won’t remember the pain and it’s easier for the parents to take care of the cleaning/healing than to expect a young child to do it.
“Bodily autonomy” as an absolute principle is not really a good argument unless you’re also an anti-vaxxer, and it’s a particularly weak argument when applied to, say, earlobe piercing rather than circumcision. Arguing that the violation of the child’s autonomy is only OK when it’s outweighed by something more important – like protecting them from polio – is much better.
sonofrojblake @9, that’s because many of the anti-circumcision arguments are problematic; perhaps not strictly “anti-Semitic” in the sense of hating Jews, but coming from a culturally privileged stance of not understanding why “they” would engage in their weird practices instead of just doing what the majority does. Even atheist Jews feel very, very strongly about circumcision; it’s not simply God Says So. It’s because this has been an integral part of a culture that has been the minority pretty much everywhere and has been under assault by the Christian majority since pretty much there WAS a Christian majority. And it’s difficult to try and separate ‘you shouldn’t circumcise’ from all the other you-shouldn’t-do-this-or-that-you-Christ-killers, especially when it’s coming from a place of obvious ignorance, like sneering about ‘folk beliefs’.
Let me give you an analogy here. Say you’re stuck with a thesis advisor who’s kind of a bigoted Christian asshole and is always making remarks and exerting not-so-subtle pressure to get you to change your stupid atheist ways. You complain, but your advisor is super popular with the other students and the administration, so you’re not getting much traction. And then one day your advisor actually tells you that you shouldn’t be doing X because it offends God – but, objectively to an outside person, you really shouldn’t be doing X because it’s a bad idea. How willing would you be to listen to your advisor, as opposed to ignoring him, or deciding that doing X is just more God bullshit? Particularly if X was something you’d been doing all your life and that’s extremely important to you?
(Can’t edit, but I should emphasize, above, that I do not feel atheism is ‘stupid’; I was describing Professor Bigoted McJesuspants’ attitude.)
That is exactly what it comes down to for me, also.
neverjaunty, the point about vaccinations is that the benefits of doing them before the child is old enough to give consent really do, both on an individual and societal level, outweigh the risks of waiting until consent is feasible. Young kids die or are permanently harmed by vaccine preventable diseases all the time, the chance of death or serious injury from anything preventable by circumcision is zero (to a very close approximation). The wrong-headed idea of antivaxxers is actually to overinflate the potential risks of vaccination to the point where they outweigh the benefits of waiting.
The argument about “not remembering the pain” is plain vacuous. Is it OK to tattoo kids? They won’t remember it. How about anaesthesia? Why waste it on the very young, after all they won’t remember the pain. A child old enough to give informed consent understands, by the very definition of informed, that the procedure will cause a degree of temporary pain. Also, I had an ear pierced when I was 18, and I don’t remember the pain at all.
I probably expressed it poorly, but for me the whole point is that you only consider infringing upon someones bodily autonomy when there is overriding need. Whether that’s emergency surgery on an unconscious adult or the proven significant benefits of infant vaccination, etc.. Sorry if I wasn’t clear. Marcus has said it better! :-)
“Wrong again Daz. I noted that circumcision as protective against HIV may be dependent on sex thanks to michaelbusch and, again thanks to michaelbusch, the interesting public health angle I hadn’t considered. You’re so quick to bin me as a certain “type” it’s likely you’re looking to pick a fight or shame me into shutting up. Which is it? Do you want to trade insults or do you want me to go away?”
Castration prevents genital cancer so I guess we might as well do that too.
Why don’t we give all girls preventive double mastectomies? And oophorectomies to boot, as frequently ovarian cancer has progressed past the point of treatment by the time it’s detected? Why don’t we surgically resect the prostates of all men?
Wait, you say that the benefits of such are vastly outweighed by the costs?
Some inadequate proofreader @82:
IIIM “the benefits of not waiting”. FTFM.
Holy shit, an infant was able to tell you hir gender identity so soon after birth? It’s a developmental miracle!
Coercive gendering is a serious problem – one could arguably make a case for categorizing biological gender, but since the kid hasn’t had enough socialization to have a gender identity and since ze can’t exercise the requisite agency for any kind of gender expression, gendering infants with terms like “boy” and “girl” should always be avoided.
On to the substance. I agree entirely with Bronze Dog’s comment #16. Non-voluntary circumcision needs to be banned, but if we can’t have that (I’m not sure why – if I went around cutting the earlobes off of infants or branding them, I would hope I’d wind up in prison), it should at least require sterile conditions.
As for gillt’s questions, Dr Marcus Hill Ph.D. (arguing from his own authority) nails it in #76. Even if there are potential benefits to being circumcised, in no way shape or form do they justify non-consensual circumcision of an infant. Wait until your kid is capable of exercising bodily agency and let hir make the decision.
better known as ‘sex’
curiouser and curiouser.
A boy is a juvenile man (likewise a girl is a juvenile woman). “Man” and “woman” are not sexes, but genders.
A person who was born with a penis and an XY karyotype is male. Most (but not all) such persons grow up to be men.
And no, gender is not the same thing as sex.
@Rumtopf @78: Thanks for linking that one.
It reminded me of another serious flaw in at least one of the “circumcision decreases HIV transmission” studies from ’05 – ’07, in addition to the ones I mentioned before: the group of adults who were circumcised got additional counseling about safe sex practices as compared to the control group. That is such an obvious thing to provide to both study groups equally that I begin to have doubts about the ethical standards of the researchers concerned.
@randay @73: Any hospital or clinic that is operating at anything close to safe and ethical clinical standards is not “selling [foreskins] for a double profit”. Unless explicit permission has been given to take tissue samples for culture, the removed bits get burned sufficiently for safe disposal – just like any other medical waste.
Nobody seems to be bringing this up here but what about the benefits of NOT being circumcised?
When a man is not circumcised the glans remains protected, wetter and more sensitive (i.e. more enjoyable sex). Circumcised men also have more problems with erectile dysfunction later in life. There are many wonderful things you can do with an intact penis that you can’t do with a circumcised one.
*cough* *cough* docking *cough*
I hate to be the person to cough this here, but there was actually a circumcised fellow complaining about this on the Internet, a few months ago.
doki #92
Complaining that he couldn’t do those things or complaining that this was being said?
Michaelbusch @90, you are in fact incorrect there. Foreskins (and medical waste of other sorts) are in fact routinely sold to medical labs for various purposes. In graduate school I learned the fine art of pureeing human foreskins for the purposes of supporting embryonic stem cell cultures.
Generally, though, the fees involved are enough to cover the shipping charges and a small administrative overhead.
Bicarbonate #93
Complaining that he couldn’t do it. Sorry. My own failure to communicate properly never ceases to amaze me…
Crip Dyke (66):
Not at all. I caught my mistake before I hit “Submit” and got a chuckle out of it. So, I left it.
Now to catch up!
Can we phrase this differently? I have no doubt that covered glans generally react differently to attention than those that are bare all the time, but to suggest that the sex those with a foreskin have is better than those who don’t, well, that’s a stretch I would prefer be better supported or not included as an argument.
@Esteleth: Even if the relevant patients / proxies thereof haven’t signed a release for the tissue to be used for culture? My understanding was that that getting the relevant permissions was very important, to avoid another HeLa-cell case. But perhaps I was confusing one jurisdiction’s rules for a general requirement.
Dhorvath @97
If you want to know, you can just google it. I just did. There isn’t a plethora of studies and many are based on self-report (reliable?). After all, there are few things people lie more about than money and sex. Also, the authors, may have an investment for or against circumcision depending on their own status and what they might have done to their children. No one wants to learn that they have been robbed of pleasure by something done to them at birth.
There is activism around this issue and activists against circumcision are known as “intactivists”, Youtube also provides info, you can judge for yourself on its quality.
I have looked into this previously just because I’m very interested sex. My statements, however, were based on my personal observations and experience which I suppose remains anecdotal even if my sample population is several hundred men of whom the majority were uncut.
@michaelbusch
Honestly, I don’t know. I was always on the lab side, and a very strict wall separates donors from people doing the work. Most of this is for confidentiality reasons, I suppose.
I guess, though, that when new parents sign all the forms after the birth of a son, there’s a checkbox on the circumcision form about donating the tissue. There’s probably no more than that, unless they ask for more information.
I’d look at the objective evidence rationally.
Jews, including the atheist ones, (and Muslims) can do that.
If your culture involves cutting bits off defenseless babies, then excuse me, but fuck THAT part of your culture. Talk to the weather all you like, don’t eat pigs, light candles, grow a beard and wear a hat, but put down the fucking knife if you wish to be even considered a civilised human.
Germany recently had a debate on whether to ban circumcision. It ended in a consensus that it simply can’t be done because there’s no way it wouldn’t come across as a full frontal attack on Judaism.
Oh, I don’t think they’re lying. It looks more like clutching at straws.
There is no such thing.
Read the Book of Acts in the New Testament. Christians, by default, have not circumcised almost since the half-mythical beginning.
You’re talking about the regular American process.
First approximation (see comment 71): only Jews, Muslims, estadounidenses and a third of Canadians are circumcised. Almost nobody else is. I was very, very surprised to learn that most Americans are.
I’ve never actually heard of a case of a urinary-tract infection in a male-bodied person either. I know it’s not completely unknown, but, come on.
Depends on the father, obviously. Mine will readily undress in front of me if he’s, like, changing into pyjamas and I happen to be in the (large) bathroom. *shrug* And no, his has never looked like mine, and I never expected it to.
Obviously I’d appreciate input from trans* people, but as far as I can see using terms like “girl” or “he” won’t by itself do any damage. If the child disagrees, they’ll sooner or later say so. :-| What’s important is how the parents react to that; the traditional responses, which range from “lolno” to violence, have done much harm in the long run.
Nudity ≠ sexuality.