Although I know that comments are for the comment section, I wonder if we can’t already tell that this rule will remain, at least for now, broken. I couldn’t help but bring attention to Tony’s fantastic response to my articles on circumcision:
It’s clear that we all engage in rituals and imagine some significance to those rituals, whether we God to them or not. No problems there. It’s just in the application of our ritual onto another person’s body that it becomes unacceptable. Circumcision for cultural and/or religious reasons certainly falls squarely into that. It’s probably example #1.
If I followed my own intellectual interest, I’d get stuck in the semantic use of the word “rights”. I won’t, other than to say that it’s still a choice. The decision to remove healthy portions of a child’s body can never be a right, and shouldn’t be legal. But we haven’t gone that far, yet, for boys. (We have for girls.) We deem ritual meaning to the parents sufficient to grant consent-by-proxy power to cut a child’s genitals. It’s stupid.
I’d outlaw infant circumcision for religious reasons as quickly as I’d outlaw it for cultural nonsense or the chasing of potential minor benefits. There are negative consequences to circumcision, as you mention, and these don’t occur only if parental decision is ill-intentioned.
But I have no qualms with circumcision as a ritual of meaning. I fully expect that, if we outlawed infant circumcision, a significant portion of males whose religion calls for circumcision would choose it for themselves upon reaching the age of maturity. And I suspect it would have a much greater meaning to the male than having his foreskin cut away as an infant. Choice is quite powerful. Still, only he should determine if there’s meaning.
[editor’s note: Tony’s full comment, (formalities included), can be found here.]
I wholeheartedly agree with all save the fact that I find the ritual itself to be based, entirely, in deity-worship. When there is no deity, then why is the foreskin coming off? Well I would point others back to my earlier posts regarding circumcision for that argument (Links: Pt. 1 and Pt. 2). In the meantime, let me direct you to Rolling Doughnut. Tony’s article on circumcision is, without doubt, a more secular angle, and human rights play an important part. Finally, there is a good analysis of the various data concerning the speculative Junk Science (that’s right, it’s time we use this term for some good), coming out of these doctor’s mouths in Africa. An excerpt:
While it’s clear that public health officials are looking for the cumulative effect of mass circumcision, I challenge anyone to argue that the decision to undergo genital cutting shouldn’t be on an individual basis. If we dismiss the notion of the individual, we eventually end at mandatory circumcision. That is simply unacceptable. (Read the full article here.)
I have to agree that, when it all boils down, this is about our negligence of human choice. Men should make this decision with due diligence (and vigilance, frankly), when it is their decision to make, not any sooner (i.e. When they are still nearly blind, fresh out of the womb, and completely defenseless.) I appreciate the article’s many links to sound evidence that circumcision is by far less effective than other, “less invasive methods”, such as education and prophylaxis. I again thank Tony for this fresh slant.
More on circumcision:
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24 Comments
June 9, 2007 at 6:48 am
Bravo! Well stated.
I am in agreement with all points made and believe infant circumcision should not be a parental “right”. I also believe that Africa is in for a rude awakening when all of their newly circumcised countrymen still wind up with HIV/AIDS.
But something tells me they won’t see the error in all of this until it’s too late.
June 9, 2007 at 4:59 pm
I am very interested why routine infant immunization is largely accepted and uncontested. Surely the principles are similar. Human rights, individual choice etc etc. So the question must be asked why the spirited defense of the foreskin? Touching a psychosexual nerve perhaps?
June 9, 2007 at 5:15 pm
A psychosexual nerve? Fine, I accept that. It unnerves me to see the tips of penises cut off. And it weirds me out that the tip of my penis was cut off. Is that so odd? I would venture to say that it be natural to guard against the mutilation of our genitals. I’m sure it touches (if not slaughters) a psychosexual nerve when a woman’s labia is removed, too. Is that so very odd?
Immunization versus circumcision: I would go on espousing the utter disparities between the two, but it would take far too long, and bore people who see the obvious differences. Here’s one for you, Mr. Amos. Circumcision is a violent, invasive procedure that does no good whatever, save its ritual significance, of which I find none, barring, of course, the offering of flesh for a god non-existent.
Injections, which certainly protect the child from many diseases which can (and do, in countries where such vaccinations and immunizations are not as frequent) kill said child in infancy, are harmless (relative to genital mutilation), and perhaps the most necessary of postnatal procedures. I’m sure this won’t slake your thirst for the obvious, but I’ve done my best.
June 10, 2007 at 11:31 am
Alex,
Thanks for the kind words. Regarding the deity-worship, I disagree that everyone does it to please God specifically. However, you bring up on an interesting point. If we expand “deity-worship” outward beyond God and encompass authority-worship, I’m all in on your assessment. Whether it’s the perceived wisdom of doctors or the legitimacy of cultural trends, many people do find it hard to buck the accepted and go with the logical. Even when the accepted is so extreme that it involves genital cutting.
So, yeah, there’s definitely something to your idea.
Joshua,
As for immunizations, the distinction is quite clear. The diseases we immunize against are real, dangerous, and easily communicable without action. The last is the key, for only when there’s an obvious, identifiable public good can we justify violating rights to any extent. There must also be a cost-benefit analysis, done as objectively as possible, before proceeding.
Preventing the spread of polio is a public good. Without vaccination, acquiring polio requires no identifiable action on my part. And if I get it, I can spread it to others without any identifiable action. It affects public health.
Removing the foreskin must overcome that same burden. Nothing it supposedly prevents is communicable without identifiable, intentional actions.
HIV? In the way that the foreskin would affect it, the action is identifiable and intentional. You won’t catch HIV being in the same room. STDs? Same logic. Penile cancer? The rates are quite similar between the US and Europe, despite European refusal to cut their children. Other factors are at work, so genital cutting isn’t useful. UTIs? Here you have a case where it generally isn’t the person’s “fault”. But, girls get three times as many as circumcised and intact males combined. We treat girls with less invasive measures because they exist. And the risk to intact boys is around 1%. Radical surgery to prevent something that can be treated easily in the few cases where it occurs is irrational, passing no cost-benefit analysis. Note that UTIs aren’t prevented by circumcision.
And so on. Removing the foreskin can’t pass the public health or the cost-benefit analysis. We protect girls because we know that their healthy genitals are important. Boys should have the same protection.
What’s most interesting to me, though, is your psychosexual nerve comment. Why are people who defend a human right considered strange because we believe in not cutting the healthy genitals of newborn males. How did genital mutilation (of one gender) get to be the sane position?
June 10, 2007 at 2:08 pm
Hi Alex, I used to the term “psychosexual nerve” because as the arguments against circumcision to not follow those used in the debate against routine child vaccinations there must be another ‘hidden’ factor driving the obvious emotion by anti-circumcision advocates. So the ‘nerve’ I mention is not an anatomical nerve but rather a figurative one driven by some or other psychosexual impulse. Why does it ‘werid’ you out that the tip of your mammalian penile sheath has been trimmed and not that your individual immune system has been irrevocably compromised by all the shots you have had, not merely by parental choice but by law in many places. Why no outrage at the human rights abuse here?
You talk of mutilation and use the work genitals as if the foreskin is anymore than a mammalian penile sheath. I assume this is an attempt to place some value on the foreskin to prevent this “this little piece of skin” from being routinely removed. You would of course not take the findings of a study funded and run by a Big Pharma company seriously just as the world will not take the findings of sensitivity in the human foreskin seriously in the study funded and run by the anti-circumcision organization NCIRC. So essentially you are on your own on the issue of a sexual function for the foreskin. As far as your use of the word mutilation is concerned it too does not do anything to sell your comments as being serious but enhances the emotional tone which in turn will cause people to think “what’s wrong with him” rather than what you are on about.
You avoid discussing the underlying principles between the enforced implementation of infant immunization and male circumcision I suggest because you have never thought there may well be common principles and public health issues at play here. Sadly this is a common problem with single issue advocates especially those driven by four parts emotion and two parts knowledge.
I thought a question was coming but you just made an emotional statement. There are many benefits that accrue through neonatal circumcision it is just that you refuse to acknowledge them, which is not very scientific. Where circumcision is carried out as part of religious observance the boy child ‘by accident’ receives the benefits which accrue through circumcision.
Right now as a result of three Randomized Controlled Trials and numerous other observational studies strong recommendations are being made for mass circumcision programmes in South Africa and other African countries among the uncircumcised sections of the populations indicating quite clearly that it is now beyond doubt that the foreskin is a public health risk. See here http://tinyurl.com/2cl4jo
Now do go and take a look at the arguments being made by the anti-immunization lobby and compare them to your unstructured emotional comment. You would serve your purpose of saving the foreskin at any cost better if you were to make fewer questionable statements and present references for what you claim as fact.
June 10, 2007 at 5:21 pm
Mr. Amos,
I want to thank you for clarifying your statement. I’d like to know more about the “anti-immunization movement.” You’ve piqued my interest. I invite you to e-mail me some book-links on the subject.
Your comment comes with its disciplined arguments and its vast array of attacks, some founded, some totally not so, and all abundantly barbed. Before I go on: You criticize me for employing a propagandic usage of the phrase “genital mutilation” to make a point. Guilty as charged. But in the same breath you attempt the same, branding the foreskin the “mammalian penile sheath,” which awes me. I suppose we will split the rowing work in the boat we seem to share. I, for one, will attempt to never hold myself above the rhetoric which I employ.
I won’t bother taking offense to your broad comments about my lack of research or knowledge. I should say that I have tried, in general, to provide reference for much of what I have written about. As I’m sure you’ve read my two initial articles, or at least hope you have, you will find that my links are, though not rife, at least sufficient for further reference to the interested mind, and certainly point to some compelling evidence for why the foreskin has been around for millions of years, why it is, in fact, useful, and why there are a lot of people who argue that it belongs where it is.
On your end, the single news story to which you refer is referring to a reference, nothing more. I needn’t suggest that you further educate yourself on these data. But I will say that we have news-machine reporting on these scant studies, and a bunch of zealous scientists running around with scalpels.
This news machine has spent some months now reporting data that was at first speculative. These scientists have done the same. We all love to get excited when a professor wearing a lab coat says “This seems very promising.” But should we not raise an eyebrow when a massive circumcision movement follows in the wake? Sure, these results have proved intriguing, and now there seems to be a bit of solidity to this data.
But Tony has said, as I have I, in my articles: It still seems as though the best protective measures against HIV and other sexually transmitted diseases are prophylaxis and some hygienic precaution. Tony goes further: analysis of these studies to which your news article refers, from the broadcast he references (This Week in Science), seems to show that education has also proven more effective than removal of the mammalian penile sheath. What a surprise: common sense prevails over the knife, as it so often does.
On to your criticism that I am too hot under the collar to have an opinion: You might see that this is very much a collection of articles relating strongly to common sense more than to scientific or academic rationalization. Still, I am a fan of these two things: However, I do not hold science and academia as tenets. A point I plan to make later in this collection of articles is that calling something “scientific” does not lay it forth as dogma. But I will err on the side of caution and say that I will make mistakes, because I am hot under the collar. Still, I feel as though I provided a sufficient amount of evidence to the contrary of the circumcision movement. I understood what you meant when you said “psychosexual nerve,” by the way, and I conceded to the fact that, yes, I have many nerves. I have a functioning brain which is aroused by the defeatist acceptance of the status quo.
Are we still ignoring the fact that I put forth but weeks ago? We have been benefiting from the protection of HIV for 20 years, give or take. But for some 2,000 years we have been benefiting from nothing save protection from a vengeful non-existent deity. You have indicted me as an amateur. I must humbly accept the rank. But two parts this and one part that: all of my parts cry for some common sense.
But perhaps we can find a happy medium yet. Again, if you read my initial articles, I ask that you forgive me for the redundancy: I do not believe it is the right of the parent, (or science), to circumcise a child. I believe that when the child enters an age of reason, and wishes to undergo a circumcision, then it should be that child’s right. I also strongly suggest that if parents must circumcise their child, than they at least educate themselves on the topic. You seem well-versed in the topic, as does Tony, as does Hitchens, as do many of these scientists doing these studies, et cetera. But do all of the parents who chose to circumcise their child know the potential risks, the potential benefits, the history of this procedure? Or are they all like me, making emotional decisions without doing any research, resting on poorly structured arguments and a malignant acceptance of the status quo? I’m trying to free myself of the last.
Thanks again for the challenging words.
June 10, 2007 at 6:58 pm
Joshua,
I think my earlier comment here hit upon many of the criticisms you lob at Alex. But to go further, I want to address this directly:
“There are many benefits that accrue through neonatal circumcision it is just that you refuse to acknowledge them, which is not very scientific.”
Speaking only for myself, I don’t now, have never, and don’t intend to deny such benefits. They exist, although your use of the word “accrue” is a bit of hyperbole reminiscent of the excessive claims made by infant circumcision advocates such as Dr. Edgar Schoen. If you insist that such benefits “accrue”, I must insist that you acknowledge that negative consequences of circumcision accrue. (There are more than just the human rights violation.) Also, those accruing benefits are minor, achievable and/or the malady treatable with less invasive procedures, and predominantly subjective.
A couple of examples, with citations where necessary:
Penile cancer: Every year, many more women get breast cancer than men get penile cancer. By the reasoning that preventive medicine accrues benefits for a child where risk is involved, parents should have the choice to remove the breast buds of their infant daughters. Or, to stick with men, at least as many men develop breast cancer each year as develop penile cancer. The answer must be obvious: infant male mastectomy.
But to the issue… The incidence of penile cancer is so low as to be a laughable justification. Besides, if we’re also looking to other countries, Denmark has virtually the same incidence of penile cancer as the United States (n/100,000). The majority of Danish males are intact. The rate is between .9 and 1.0 per 100,000 in the U.S. and .82 per 100,000 in Denmark. (link) One per 100,000 means that approximately 1,500 men will get penile cancer each year in America. Something other than the foreskin alone must be at work. The primary risk factors are smoking, unsafe promiscuous sex, and poor hygiene. I’d say not letting children smoke, teaching them sexual responsibility, and bathing them regularly are simpler solutions. (Equivocal but undeniable acquittal of circumcision here.)
One interesting correlation to other evidence is how that data is interpreted. The reduction in penile cancer is a threefold decrease. But that means that 3 men in 100,000 will get penile cancer. We must look at absolute numbers rather than deciding based only on statistics. Should we circumcise more than 1,000,000 male infants this year to save 3,000 of them from a disease in the year 2067? A disease with behavioral risk factors? That’s silly. Might the other 995,500 men want their foreskin for the next 60 years? Might those 4,500 who will get penile cancer want their foreskin for the next 60 years? That’s a different analysis than a threefold decrease.
HPV/HIV: The arguments surrounding these are useful, because these infections don’t just happen to a male. These are diseases that individuals pick up as a result of something they do, not something they have. Perhaps the foreskin plays a role in increasing risk. That is not a justification for circumcision unless parents know in advance that their son will be promiscuous and unsafe. I assume parents don’t know that, and that they also intend to educate their son about safe, responsible sexual behavior. Surgical intervention 15-20 years in advance of his engaging in the behaviors that would put him at risk is extreme, especially considering that the surgery does not change his need to act responsibly.
To HIV specifically, America has the highest infection rate in the industrialized world, as well as the highest circumcision rate among adult males. Again, something else is at work, namely drug use and irresponsibility. Circumcision prevents infection from neither. Condoms work.
The three completed studies showing a link between HIV infection and the foreskin only studied female-to-male infection, which is the least prevalent among the three scenarios involving men. It also studied adults electing to have themselves circumcised, which is important for both choice and anatomical reality. (The foreskin is fused to the glans at birth with synechia – the same cells that hold your finger nails to your fingers. This bond must be broken by tearing the foreskin from the glans. Not so in the adult male.)
And what about this study indicating that female genital cutting appears to reduce the risk of HIV? If we’re just looking to accrue potential benefits, we must consider this. So, do we keep all legal protections for girls without studying the issue fully? Don’t you care about the long-term health of females?
How many more benefits shall I address?
Life is full of risk. If parents don’t want their children to face risk, they shouldn’t create those children. We can and should take measures to reduce those risks, but removing healthy body parts is not an acceptable method. There are human rights involved, as well as medical ethics which should prevent doctors from performing unnecessary surgical interventions on non-consenting, healthy patients. Even if you mistakenly believe that parents have a right to have their healthy sons cut, you can’t deny that the child is the patient. The doctor’s responsibility is to the boy, his patient, not his patient’s parents.
For every benefit you can name, there are less invasive solutions. For that alone, infant/child circumcision is unacceptable.
P.S. A qualification on benefits is also necessary. Said benefits are “potential”, the key word often forgotten. My circumcision allegedly protects me from HIV. That might be a benefit if I had unprotected sex with HIV women. I do not, and never have. That benefit is not accruing to me in any way. Nor will it accrue in most cases where the parents circumcise their sons.
P.P.S. Full disclosure: Yep, I’m unhappy about being circumcised. However, that only informs the frustrated, sometimes angry tone I take. That’s a communication issue for me, not an issue with the scientific facts. If a male wants to have himself circumcised to accrue those potential benefits, I have no interest in stopping him.
June 13, 2007 at 4:02 am
Tony said: “Preventing the spread of polio is a public good.” and I suggest so is preventing the spread of HIV. Tony states that any public health action must pass this test: “I can spread it to others without any identifiable action. I’m sorry Tony I think you have just plucked this ‘test’ out of the air. You will be required to narrow your definition of ‘action’ to exclude breathing, drinking water, shaking hands, sharing clothes, sharing cooking and eating utensils, touching animals and other people, kissing, incorrectly storing food stuffs etc etc etc. So lets get down to what you are really saying. It is all about sex.
It all sounds like the “they are getting what they deserve” from the homophobic early days of the AIDS pandemic when the ‘band played on”. I sorry that still after all the lessons of the past peoples lives are still valued less that accepting the option that offering voluntary male circumcision to men in high risk areas/regions/countries will reduce the infection rate across that population by 60%.
Being opposed to routine infant male circumcision is one thing but to oppose all male circumcision, especially voluntary adult circumision begs the question as to a motive, an agenda or worse.
Tony states (without any references or other substantiation): “Removing the foreskin can’t pass the public health or the cost-benefit analysis”
Actually it can Tony, but only if you are open to that horrible prospect. A quick search finds http://tinyurl.com/28zxnv and http://tinyurl.com/2dh4ug . Did you even go looking? Or was your mind already firmly made up on the matter?
The ‘psychosexual nerve’ cooment seems to have touch a (ahem) nerve with you. You respond with a doctrinaire anti-circumcision activist sound bite. While I am happy to accept any opinion about infant circumcision I can’t see how you can expand your opposition to voluntary adult male circumcision unless you have a particular agenda in this regard. You have no presented public health or cost benefit case on this matter so until you do it can be assumed you have another agenda.
So really the question that should be asked given the alternative of a cost of millions more lives and millions more dollars … what prices the foreskin?
June 13, 2007 at 5:00 am
Dear Alex: As you so clearly point out we have both employed questionable debating methods. I do however, draw your attention to the fact that whatever my many faults and flaws may be they do not in any way diminish from the flaws and deliberate spin of your various statements. So lets not attempt to excuse our personal excesses by pointing out flaws in each other.
I would be very interested to hear what information (and from where) you received which led to your “learning the difference between cut and uncut” and your subsequent Damascus Road Conversion on the issue.
Alex stated: “Besides a scant few studies showing that male circumcision may reduce the transfer of such diseases as HIV and HPV, there is not a deluge of conclusive evidence that supports this.” Well Alex there is a lot of data out there but the rub is whether or not you find it conclusive or not, obviously you don’t but you leave casual readers with the impression that there is no data out there (this as distinct from no data that you can bring yourself to find conclusive).
Then we had a full paragraph in praise of the supposed sexual function of the foreskin. Where did you get this stuff from? Did it pass the same test that you applied to the data supporting the health benefits accruing through male circumcision?
Then you say: “From my limited research…” Oh dear Alex! The question I ask was it limited or selective? How can you come out so strongly on an issue and talk with such authority when you admit to having conducted limited research?
You then say: “But allow me this proposal: we allow our sons to reach an age of reason, where they can consider these things for themselves” And I say that within the current circumcision/HIV context it is all about offering male circumcision to adult males in high risk areas. So why is the possibility of some adults availing themselves of the offer, as you personally recommended, so frightening to you?
June 13, 2007 at 12:25 pm
I posted a long response recently addressing many of Joshua’s comments, but it seems to have been lost in the ether. (It never appeared. I still have it if you want it, Alex.)
Joshua,
I think there’s one specific point in your last comment that clarifies a lot, from my perspective. You wrote:
“And I say that within the current circumcision/HIV context it is all about offering male circumcision to adult males in high risk areas. So why is the possibility of some adults availing themselves of the offer, as you personally recommended, so frightening to you?”
I have no problem with an adult male choosing circumcision for himself. I think it’s a silly extreme when condoms are much more effective, but to each his own. Where this breaks down is the undeniable push to circumcise children based on these recent findings.
Here’s the only example necessary to prove my point: ( Link )
“‘These (African) countries should now prepare how to introduce circumcision on a large scale,’ UNAIDS chief Dr. Peter Piot told Reuters. ‘The science is clear.’
Baby boys should be targeted first but then attention should switch to adolescent boys and adult men, said Piot, who is in New Delhi to meet Indian officials on how they plan to tackle the world’s largest HIV/AIDS caseload.”
What rational scientist would choose to focus limited resources on circumcising males who won’t be sexually active until nearly two decades from now? That isn’t voluntary, and it isn’t effective, unless your goal is to indoctrinate the next generation to perpetuate genital cutting.
Again, I don’t care if adult males make what I think is an idiotic decision. But that’s not where this debate is going for public health policy.
June 13, 2007 at 12:50 pm
My comments seem to be getting eaten. I posted once in response to Joshua’s second comment, and again this morning in response to Joshua’s comment to Alex. I suspect I’m formatting links incorrectly. I’ll post URLs without links, and see if that works. (I have my first lost comment from a few days ago.)
Joshua,
We have a misunderstanding. I do not oppose voluntary adult male circumcision. If an adult male wants to make that decision for himself, it doesn’t matter to me, no matter how idiotic I think it might be. I would rely on condoms if I’d been given the choice. But that’s me. The only issue at stake here is the circumcision of children.
Six days after researchers announced the last HIV study in December, UNAIDS recommended that circumcision efforts in Africa start with infants and move to adolescents and adults after that. http://www.washingtonpost.com/wp-dyn/content/article/2006/12/19/AR2006121900331.html
I’m going to ignore the implication that I have an agenda along the lines of “people get what they deserve”, since my opposition to infant/child circumcision only wasn’t clear. I will state that personal responsibility is a vital aspect of life and mitigating risk that is getting far too little attention. I’ve spoken with too many people who expect the future irresponsibility of males, whether to shun regular bathing or to not wear a condom, as a reason to circumcise infants now.
To the more substantive argument, infant circumcision might pass a utilitarian cost-benefit analysis, but only if it’s devoid of any consideration for human rights. The subjective valuation of health body parts matters. If we’re only going to rely on objective, quantifiable predictions (i.e. not necessarily realized outcomes), we could justify mandating almost every preventive surgery. That can’t be right.
I’ve read the comparisons you linked. I’m unimpressed, specifically because they offer only number crunching, without consideration for the human beings involved.
Now that my stance is a little clearer, do we have differences on infant circumcision?
June 13, 2007 at 1:00 pm
Please note that Tony’s comments have been restored.
-June 10th, 2007 at 6:58 pm e
-June 13th, 2007 at 12:25 pm e
June 13, 2007 at 4:34 pm
Hey Joshua,
You casually remark that my “argument” that the foreskin has utility is unfounded. No:
The sphincter action of the preputial orifice functions like a one way valve, blocking the entry of contaminants while allowing the passage of urine. Ectopic sebaceous glands…produce smegma…It protects and lubricates the glans and inner lamella of the prepuce [foreskin], facilitating erection, preputial eversion, and penetration during sexual intercourse.
The prepuce is a specific erogenous zone. It contains a rich, complex network of nerves and an abundance of mucocutaneous end organs sensitive to motion, touch, temperature, and erogenous stimulation. Both the inner and outer folds of the prepuce have denser distribution of nerve networks than the rest of the penile skin. The rich innervation of the inner prepuce contrasts sharply with the limited sensory investment of the glans penis, which is characterized primarily by free nerve endings, which feel only deep pressure and pain.
Fleiss, Hodges, Van Howe (from “Immunological functions of the human prepuce”)
Here are seven more:
Circumcision: A History of the World’s Most Controversial Surgery
Circumcision, The Hidden Trauma : How an American Cultural Practice Affects Infants and Ultimately Us All
“ Recent Medical Studies on Circumcision”
“Circumcision and HIV: Harm Outweighs ‘Benefit’”
“Circumcision policy: A psychosocial perspective”
“Male Circumcision: A gender perspective”
“Answers To Your Questions About Your Young Son’s Intact Penis”
A majority of these are written by medical doctors, scientists, and psychologists. Others are more meta, but contain solid bibliographies. Suddenly two or three studies (that are questionably accurate, as some of the above references also speak to), do seem scant, do they not? In fact they are scant, though highly publicized.
The “limited research” angle: I will ignore, as I have so far, your condescending tone regarding my arguments, but I cannot help but address this: You mistake humility for oversight, the willingness to accept the possibility for a more enlightened argument as opposed to sheer ignorance and fallaciousness. I consider myself well aware of the potential costs and benefits of having a cut or uncut penis.
I would never claim to be an authority on such a topic unless I was in the research facility myself. And even then I would offer my findings to a peer-edited journal (if such things still truly exist). And even then those findings may, in fact, never be buttressed by other supportive findings but, rather discarded as insufficient and flawed.
I never, ever said that circumcision didn’t have possible preventative measures against HIV. I did explicitly say, as Tony has, that there are far less invasive and painful measures. I also said that the studies were scant, that many of them were spoken of before they had been published, thus bonded to speculation. I went on to say that infants shouldn’t need this procedure. That is, they shouldn’t need it unless they plan to begin having unprotected sex at the age of six months.
Of course I’m not an authority on such a matter of the evidence that circumcisionis the only way to go. If I said I were than I would surely be laughed off of the soapbox- Nonetheless here is a statement that is held by far more than a few (the above 8 links are a good place to start): Circumcision is not the only way to go. It is the most invasive, most idiotic way to go (save, perhaps, total abstention), but it is not, by any means, the only way to prevent HIV/AIDS.
I don’t care if an adult male chooses to undergo the procedure, and I am certainly not psychosexually frightened by the possibility. Just not kids, finally, and just not uninformed parents doing it to their kids.
You accuse me of avoiding gorillas. I hope I have now definitively made it clear that I do not ignore a potential preventative effect to genital mutilation, but I find it similar to killing a fly with grenade. But what about your gorilla? What do you say for the effectiveness, the more effective measures of prophylaxis and hygiene? You tell me that my argument is flawed, that my research is selective, so on. Why won’t you address condoms and soap?
Finally you criticize both Tony and me, claiming our arguments are flawed, and that we are negligent and ignorant. You repeat ad nauseum that you find my arguments to be flawed, that you find I have no authority and yet claim authority, that I have no evidence, no reference, and that this all stems from some base Freudian impulse; Why, then, do you keep coming back to this debate? If my references, opinions, evidence, and so forth are merely straw man arguments to you, why not move your debate elsewhere, where you actually respect your opponent as an authority? With so little respect for my argument, I find it difficult to understand why I, or you, should go on with it. In other words, spare me your trite “ Damascus Road”-style sarcasm and help me understand your point of view. If that doesn’t interest you, I would encourage you to go elsewhere for your fix of knocking down so-called single issue advocates.
June 13, 2007 at 5:43 pm
Wow, what a debate going on here.
I, like Tony, am a man who wishes he was not circumcised at birth.
Joshua, I don’t care how many benefits accrue resulting from circumcision. There are a great number of body parts we could cut off of infants, and then scientifically prove the benefits of not having those body parts, but would it be ethical? Irreversible body modification is generally legally limited to adults choosing it for themselves. What makes circumcision different? Why do you refuse to admit that Tony and Alex aren’t looking to stop circumcision altogether? They want to eliminate infant circumcision, letting the boys choose what body parts they want to keep or discard after reaching adulthood.
The only person who can truly measure the value of a body part is the person who owns that body part.
June 15, 2007 at 2:57 am
Tony stated (and then restated): “We have a misunderstanding. I do not oppose voluntary adult male circumcision.” And I reply that if you were it would be akin to howling at the moon. I note your fall back position is “The only issue at stake here is the circumcision of children.” And I note from a previous post of yours that you seem to lean on anti-circumcision rhetoric to make your case against infant male circumcision. This is a pity as with any single issue group their propaganda is always biased, always shockingly biased. (Another time)
What I note is that you take each of the reported potential benefits accruing through male circumcision individually and claim that each individually do not justify infant male circumcision. Now why do you do that? Surely they must be considered together? Surely the combined potential benefit is what should be considered? But knowing that you are on shaky ground you finally concede: “…infant circumcision might pass a utilitarian cost-benefit analysis but only if it’s devoid of any consideration for human rights.”
So finally we get to the point where we are supposedly aced with a human rights dilemma.
It is around the fact the presence of the male foreskin increases the morbidity and mortality rates among human males (and probably their sexual partners).
The answer at first seems quite simple. But then advocating male circumcision at any age seems to touch a nerve, maybe a psychosexual nerve with some. Can’t do that they wail as if the foreskin has some intrinsic value which hitherto only a select few among anti-circumcision have knowledge. Unlike the human immune system they demand that it remain ‘intact’ regardless of the risk and the millions of deaths that will arise (through AIDS).
So what is it about the foreskin that has this small single issue group so worked up?
June 15, 2007 at 11:42 pm
Joshua,
First, let me point out something I ignored in my last response. To question whether or not I would prevent voluntary adult circumcision requires a stretch on your part to ignore the comment that Alex excerpted to start his post. To read any other idea into my original comment is simply not possible. I’m normally willing to assume oversight and give the benefit of the doubt, but I don’t know this time. I think you might be reading what you want me to say to represent my side, the anti-circumcision talking points.
Regarding bias, I don’t have much to say. You’re as biased as I am. Why is it bad for me but okay for you? At least I’ve considered all relevant issues, not just potential medical benefits.
Which gets us to the individual potential benefits. I did not consider them separately to avoid the cumulative, utilitarian argument. Yes, I said that infant circumcision fails a utilitarian cost-benefit simply because it violates human rights. When considering that it is medically unnecessary surgery at the time it’s usually performed, rights matter. That is a complete consideration of the issue, and it trumps all other considerations given that the foreskin at birth is almost always healthy tissue.
Instead, you focus only on what might go wrong, thinking that there are so many things, something is going to get the boy if he keeps his foreskin. Forget him, think of society! Even considering every individual argument together as one lump indictment of the foreskin, without ethics, less invasive treatments and preventions are available for everything. That’s what we apply to every other potential malady for children, particularly the genitals of girls. But if preventive medicine is the key, should we allow parents to remove the undeveloped breast buds from their infant girls? The presence of breast tissue increases the morbidity and mortality rates among human females. And that’s all there is, right? Something might go wrong.
(I see you didn’t respond to the link I provided to the study that suggested female genital cutting reduced the risk of HIV for women.)
Bottom line: I do not ignore inconvenient facts. I’ve responded to several of them, clearly explaining why they’re not adequate to advocate the extreme action of infant circumcision. If there is an issue that you think warrants circumcision that I haven’t addressed, challenge me on it. I’ll explain my position.
I don’t think you’ll do that because it’s easier to smear my approach than it is to tackle the topic. You ignore the facts you don’t like, so I have no reason to believe you’re interested in facts to any real extent. Hence, your repeated dismissal of the idea that the foreskin – an evolutionary development in every male mammal – has any purpose or benefit. You want justification for what you want to do, what is culturally acceptable to fight “risk”. That’s backwards from an analytical approach. You think we should cut the foreskin off, but you started where you are now. I started with the question “should we do this?” and determined that we shouldn’t. Huge difference.
I’ll ask you a question, to see if we can actually debate. What benefits can not be achieved through less invasive means, including treatment when something occurs, than pre-emptive surgical intervention on the healthy genitals of infant males?
June 16, 2007 at 8:45 pm
Alex I am disappointed that you have resorted to citing stuff from exclusively anti-circumcision activists. Would you take the opinions of Right-to-Life activists as being accurate and unbiased about abortion? Yes there are doctors involved with this single issue group as there no doubt are with just about every lunatic fringe organization, so why the need for the appeal to authority? Its a pity you don’t have a fall back position that you can argue from without pulling out stuff of dubious scientific value.
June 16, 2007 at 9:05 pm
Tony said: “To question whether or not I would prevent voluntary adult circumcision requires a stretch on your part…” That was not my question, so let me try it this way. Do you really think that you and the other anti-circumcision activists stand a snowballs chance in hell of preventing circumcision at any age? It is not going to happen.
That you believe there is a human rights issue relating to infant circumcision, that trumps the benefits accruing through circumcision, is merely an opinion shared with a minority of people, to which you are entitled. My best advice would be not to keep your hopes up on the matter.
You say: “think of society!” And I say that the call for mass circumcision is exactly that. People are thinking of society. People are thinking of ways to prevent millions of deaths from AIDS. Realizing the foreskin has become a public health hazard in this regard it seems logical to promote the wholesale removal of foreskins for the good of ’society’.
I now know where you are coming from and that is from the point of departure where you would rather see millions more unnecessary deaths from AIDS than support the prophylactic use of circumcision at any age. This attitude is clearly in conflict with your stated concern for human rights.
Where am I coming from on this issue?
I believe that male circumcision is a perfectly acceptable parental decision as a result of religious, cultural or medical considerations.
I see no sane reason why any person or group of persons would spend so much time collectively trying to stop circumcision when there is no medical reason or even a compelling human rights argument to be made.
That is why I come back to my use of the phrase “touching a psychosexual nerve”. What else can it be?
June 20, 2007 at 8:26 pm
Joshua,
Do you really think that you and the other anti-circumcision activists stand a snowballs chance in hell of preventing circumcision at any age?
I don’t base my sense of right and wrong on what will gain acceptance. Truth is independent of the unconsidered opinion of a majority. I could’ve said the same thing about slavery in 1787. Slavery was still wrong. I will work to end medically unnecessary infant circumcision until it’s achieved or I die because I am right.
And I say that the call for mass circumcision is exactly that. People are thinking of society. People are thinking of ways to prevent millions of deaths from AIDS.
Condoms. Abstinence. Education. Better drug therapies. Potential vaccines. A potential cure.
A “public health hazard” is polio, smallpox, measles, influenza, and so on. HIV is not a public health hazard in the same context. It is simply not communicable in the same unintentional way.
Also, modern medicine marches on. Look at the difference in treating HIV in 1987 and 2007. It’s improved, no? You offer a solution that suggests medical advancements will not occur in the time between a boy’s birth and his first sexual activity. For boys born today, we’re talking well over a decade before the decision needs to be made. At that point, he can also provide input.
I wouldn’t suggest such a standard, because it would still assume an illegitimate parental choice. However, that you won’t make such a concession is instructive. Again, the studies looked at voluntary adult circumcision. We can still rely on that for HIV prevention. But you don’t seem to care for the voluntary part, opting instead for a belief that males won’t eventually decide to protect themselves, while speculating that infant and adult circumcision are the same. That is flawed.
This next part I’m going to quote, when you read my response, please insert the sufficient exasperation that I’m now feeling at the obviously ridiculous nonsense you attribute to me.
I now know where you are coming from and that is from the point of departure where you would rather see millions more unnecessary deaths from AIDS than support the prophylactic use of circumcision at any age.
That is not what I’m saying, have said, or will ever say. I know it. You know it. Yet, you rely on intellectually dishonest ad hominem rather than a legitimate argument. But since you want to host this straw man, I’ll smack him for kicks.
I have more faith in condoms, abstinence, education, and improving medicine than I do in a “cut first, think never” policy. I already pointed out how the recent studies demonstrated the unadvertised reality that education seemed to work significantly better at reducing the risk of HIV than circumcision. Still you offer “cut first, think never”.
But looking specifically at HIV prevention, will more people die from HIV without circumcision? Possibly. Those numbers are simply projections, but I can accept that they may be at least moderately accurate. They have flawed assumptions, but they could happen. Unfortunately, circumcision merely reduces the already slim chance of female-to-male HIV transmission by 50%. Without a complete combination of condoms, education, monogamy, and personal responsibility, we won’t prevent much. What I do know is that money that will now be spent on circumcision will not be spent on education and condoms, both of which work demonstrably better. You’d rather spend limited funds on cutting the genitals of innocent children.
Just to further highlight your intellectual dishonesty, I’ve made it abundantly clear that I have no problem with the prophylactic use of circumcision after the age of majority. Voluntary adult circumcision, no matter how inferior I think it is, should be allowed. Shout it out and encourage it all you want, and you want hear a word from me about it. You know this, but you’d rather smear. Flattering trait.
This attitude is clearly in conflict with your stated concern for human rights.
Rights do not have to out-compete each other. They are inherent, not mutually exclusive. But you are mistaken in your understanding of rights. You pit the right to bodily integrity (be free from harm) against a mythical “right” to not get HIV. There is no human right to be free from HIV through consensual conduct. Personal responsibility matters. Someone’s lack thereof is not my fault. I don’t wish HIV on anyone, but I will not excuse cutting every (male) child to protect a comparatively few adults. That may sound cold. Fine, but I am not to blame. Feel free to perpetuate that idea, though, because it makes you look so honest.
(For a counter-example, rape can cause HIV transmission. There is a right to not be raped, which falls under the right to bodily integrity. The state has a compelling, legitimate reason to stop that. The possibility of HIV is an unfortunate outcome, which is why it’s in the state’s interest to do everything it can to discourage rape and protect citizens. Everything short of violating the same right it’s trying to protect. You don’t preserve a right by violating it.)
Where am I coming from on this issue?
I draw the conclusion that you have a desire to cut children for their “benefit”. I think you believe that people either don’t have or don’t want to be concerned with taking responsibility for their own actions, so other, somehow responsible people must take action on their behalf. I think you believe that any action, as long it’s well-intentioned and garners popular acceptance, is justified.
I see you didn’t answer my question. I wonder why? Allow me to ask again: What benefits can not be achieved through less invasive means, including treatment when something occurs, than pre-emptive surgical intervention on the healthy genitals of infant males?
I believe that male circumcision is a perfectly acceptable parental decision as a result of religious, cultural or medical considerations.
You are wrong.
August 6, 2007 at 9:11 pm
I know what that psycho-sexual nerve is. It’s called the prepucial frenular delta nerves. It comes out of the glans of the male and the glans clitoris of the female. AKA the masculine “Gee String” and the feminine “G Spot, it relays sexual arousal back to the reproductive parts of the brain when stroked or pulled. Sometimes they sever these nerves during neonatal circumcision resulting in disuse atrophy after puberty’s brain chemistry sets in, this leading to psychological and neurological sexual nerve damage trauma. This in turn leads to various sexual dysfunctions, including erectile dysfunction, suicidal depression, and even paranoid schizophrenia. These weird side effects can reduce the risks of acquiring HIV from unprotected rough dry reproductive sex with infected prostitutes that causes rips in the male and female prepuce, from not being able to keep it up long enough to finish the job. Adult males who know of the function of the frenulum’s nerve bundle will not allow the anti intactivist’s to cut them, so they are trying to push neonatal circumcision to cause the infants to grow up sexually dysfunctional. They cut my frenulum off as an infant and I have a psycho-sexual nerve disorder causing me not to be able to keep it up around others, male and female. It appears to be some type of natural eugenics to diminish the men of masculine god worshipers. That is why the Jews have to trace their ancestors back by their mothers blood line as the males keep dying off from wars and disease, and suicide bombings in the Muslims case. It also engrams into our brains at the infancy time, a subconscious need to attack the enemy. Can you think of a better reason for why 9/11 happened? It’s all psychosexual nerve trauma related. The creator had nothing to do with it. Nature’s first commandment would be, if she could speak, would be “I am your child, put no god before me.”
August 16, 2007 at 10:26 pm
[...] a hot topic on this blog, and others. Last week, Mr. Fred Hodes wrote a comment on an older post (Tony Responds: Circumcision’s Encore), and given that the post is a bit buried, I thought I’d go ahead and post his comment in [...]
August 19, 2007 at 6:26 am
Tony Said: “You are wrong.”
I immediately though how apt this quote was when applied to Tony who believes that he has found the truth. Nobel Prize-winning French novelist Andre Gide had a point when he advised, “Believe those who are seeking the truth; doubt those who find it.”
It is not a question of “What benefits can not be achieved through less invasive means, including treatment when something occurs, than pre-emptive surgical intervention on the healthy genitals of infant males?” but more of how circumcision when added to the range of initiatives to prevent HIV infection can assist in reducing the infection rate. When did it ever become a question of either/or?
But I guess when people approach this issue from the position of having placed the value of the human mammalian penile sheath (aka the foreskin) above the lives of millions of people and the enormous suffering of their dependents and families we have entered the realm of the truly bizarre. There is no hope.
November 28, 2007 at 4:29 pm
I have read this entire thread. I am eight months pregnant with our son. I wish he was a daughter. Then we could have a baby naming celebration and celebrate birth without bloodletting. I am the child’s mother, I am the only person who is supposed to experience pain associated with childbirth.
My husband wants to circumcise our son so he will “look the same.” He is a secular Jew and could care less about having a ceremonial bris. But it matters whether his son will feel alien among other Jewish boys. Or whether he as a father will feel alienated from an uncut son. I can’t even begin to understand this and it is clearly a deeper irrational need than my husband can articulate.
He hated Hebrew school, is perfectly willing to forgo any religious approach in his daily life, he doesn’t keep kosher, he regards Shabbat dinner with relatives as an annoyance rather than a pleasure. But the most violent vestigial blood sacrifice of Judaism is the one he can’t question and can’t reject.
As my girlfriend says, “you just can’t question men and their penises.”
I agree with Alex and Tony.
I think there is no rational justification for consenting to my son’s circumcision. The medical benefits are vastly overstated. I am not concerned so much about the infintesimal risks, and I think my son will more likely than not be as accepting as circumcision as his dad– but I am deeply concerned about inflicting pain on a defenseless baby for no good reason other than cosmetics. (And yes, I have put my daughter through routine vaccinations and significantly more painful lead blood tests because these are medically warranted, and because vaccines strengthen (rather than weaken) an immune system against deadly diseases in most cases).
Joshua’s arguments are weak and unconvincing. Sorry, Josh, you put up a good effort but I think that your defense of routine infant circumsion is essentially: “Everybody’s doing it, you can’t stop it, therefore, everybody should continue doing it.”
It’s stupid, circular and irrational and I think Joshua just wants to have his own sons circumcized and be able to rationalize it as “AIDS prevention” as opposed to unthinkingly, witlessly, unquestioningly perpetuating a collective and sanctioned pattern of child abuse.
My husband wishes I would stop thinking about this issue. It is easier to circumcise your child when you don’t think and don’t ask questions, and don’t admit to or examine your true reasons and motivations.
He just wants his son to “look like him” and avoid bucking the group (cattle) mindset that advocates circumcision.
If your first impulse as a parent is to protect your child, than you have to stop thinking or asking questions in order to consent to routine circumcision.
I will not be signing any consent forms. However, I will not stand in the way of my husband’s circumcising our son because on a deep visceral level, I think I will be putting my marriage at stake if I do and otherwise, my husband has proven himself with his daughter to be a deeply caring and loving father & person with whom I want to maintain a good relationship.
That being said, I hope that in the excitement & confusion of my son’s delivery and birth, my husband develops a case of amnesia and forgets to request a circumcision. I certainly won’t be reminding him.
December 29, 2007 at 8:15 am
Jen, your friend who counseled not to interfere with a man and his penis may be interested to hear from me, a cut man who, after learning what was taken, became endlessly sad – for about 8 years I hid the topic from myself. In other words, I repressed strong feelings of grief and loss. Maybe this, more than a simple bond between a man and his penis, could be involved with your husband’s strong devotion towards circumcision. I have read enormous amounts already on this topic, and have learned this – anatomical information clearly points to a highly errotogenic, protective and mutually (male and female) necessary structure for pleasurable sex, as is any man’s birthright. Bodily integrity is understood in the US, except where male genitals are concerned. This in my view and the view of others, including Ron Goldman, is due to deep cultural and personal repression and denial.
This is what may help to frame your husband’s behavior: If you could entertain the idea that circumcision represents one of the most serious traumatic experience in the neonatal period, that infants retain memories, that trauma has immediate and delayed-onset Post Traumatic Stress Disorder (PTSD) symptoms as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), it is possible, if not likely that your husband is experiencing denial as a way to protect himself from the experience of the overwhelming and unconscious pain of his circumcision. Some young boys have recalled their circumcision, and according to several counselors, thousands of men have relived their circumcisions in adulthood. Memories are rarely completely erased, rather they are lost or repressed.
I am so sad to have lost erogenous tissue I can never recover, and as an adult male, since learning about this issue, has left me feeling helpless, frustrated sexually, and deeply resentful, but of whom? My parents – the doctor? I don’t even know, except that I have deep rage over this issue that I am learning to tap in a safe environment. I plan on speaking publicly to expectant parents, but I’d rather not have been cut so I could be occupying my emotional landscape with other issues. It’s also humiliating, don’t you think, to send the message to the child that your genitals are not perfect as they are? Given the insanity, the social insanity as demonstrated by Joshua, who himself may be suffering from PTSD, I believe it essential to help our society advance forward on this topic, give it the air it needs to vent the stale, sick air, and hopefully we as a culture can recover and move forward towards a much more loving, trusting, nurturing birth experience as a way to welcome our children into the world. Out with the patriarchal medical model, with its insistence on episiotomies, forceps, and worse! In with the women-centric midwife wisdom again!
I completely understand your decision, while having some guilt about sharing this with you, thinking it may cause distress. I wonder if there is some way to approach your husband with information that’s close enough to his viewpoint to reach him, that will begin his thought process towards not circ’ing. If you are considering this issue any further, I wholeheartedly endorse a hero of mine, Ron Goldman, Ph.D, author of “Circumcision – The Hidden Trauma”. I’ve read it three times now; it will help inform me for my speaking. He also runs the Circumcision Resource Center in Boston – perhaps a phone call to them could help you in your dilemma as well. Also, I wonder if it’s not possible to ascertain your obstetrician’s stance on circ, let them know your thoughts, and even ask that them in advance to circ ‘loose’. By doing so, it could save more of the extremely sensitive frenulum, although any cut will necessarily amputate the erogenous ridged band area, unfortunately. I wish you the best for your son, and I apologize in advance if you read this and are disturbed by it. Talking to more people could help you, too.
Andre M.