Monthly Archives: June 2015

On the Chopping Block: Routine Male Infant Circumcision

chopping blockToday’s topic, by way of facebook discussion, is the matter of routine male infant circumcision. What started the discussion was an article about a movement to ban ear-piercing in infants because of “cruelty” — and it was an interesting conversation. As ought to be expected, male infant circumcision surfaced in the discussion, as did female genital mutilation — two topics I addressed previously . < — That link there is worth having a quick read-through before proceeding here, since it covers a few different things related to genital mutilation (and parental “choice” regarding the matter), but with respect to routine male infant circumcision (specifically newborn), this entry homes in on the history, the myths and the facts…the pseudo-justifications and the debunking of those things in particular.

Religious background

So, starting with the history…perhaps the oldest history is religious tradition. Specifically, the two major world religions that adhere to this practice are Judaism and Islam…and of course later into the American Christian tradition (but that is connected with American military history, which I will address next). Yes, the practice of male infant circumcision is arguably ancient. The justifications include a “covenant” with the appropriate deity, supposed hygiene arguments, and masturbation prevention (lest a man “waste his seed” — in the Bible, “Onanism,” from Genesis 38:9; and in the Quran, “Ḥarām,” Chapter 23: Al-Mu’minun – Verse: 5-7). Of course, there is the counter-argument that these verses (respectively) weren’t really about sin…they were about “hygiene” — and there may well be some truth to that argument, even while that argument ignores a couple of extremely important points. During the (stated) era of the Bible, and of the Quran, hygiene was…well, “primitive” is a harsh word to use (because I’m not keen on falsely anachronizing history), but comparative to modern hygienic practices, “primitive” is used in the technical sense (and not in a demeaning way) – meaning: “relating to, denoting, or preserving the character of an early stage in the evolutionary or historical development of something.” Parallel discussion exist, for example, about why pork is off-limits to both Judaism and Islam (and technically Christianity). Rationales and justification provided include cloven hooves, doesn’t chew its own cud, garbage disposal, et cetera…and really, adherents of the food proscription frequently don’t ask whether there may be an actual, logical reason for the proscription (and yes, logical reasons exist! really!). Again, we’re talking about ancient times. Large animals fit for eating generally couldn’t be eaten all in one sitting (compared with, say, chicken or other small fowl that can be cooked and eaten within a day). Larger livestock animals like beef could be preserved more safely if salted…or if cooked very well-done, dried out & jerkied, even…without much risk of later consumption. Pork, however, doesn’t keep in the same way…and consumption of old pork products can and does lead to *big time* sickness, and death even. So, yeah, it makes sense that pork would be placed on a food proscription list, given the hygienic factors of the era. When viewed through a long lens of history, circumcision as a practice then, would make a type of sense, given the lens of available and comparably primitive hygiene access at the time. Also, sexually transmitted infections existed during the Biblical era (which is older than Islam), and is documented fully. So definitely, it would seem that lopping off a piece of skin that might house all sorts of infectious material would make sense. Then. Not now. Today, it’s simply a matter of tradition…with no logical basis for continuation beyond tradition.

Military background -particular to the United States- and into the current debates

Moving past the ancient history of the practice, and moving westward (to the United States specifically), let’s have a look at the practice of circumcision in the United States, and why that came to be the norm (surprise — circumcision in the U.S. is not ancient, but only about a century or so old). Within the History of Circumcision website, which has numerous embedded citation links (feel free to peruse them), there is a link within the United States’ subheading about the military history in the U.S. about the practice of male circumcision. The linked entry on this is short by comparison — and worth reading in its entirety — but here I’ll copy/paste a couple of pertinent quotes from it.

“For the past 130 years the American medical industry has been involved in the business of removing part or all of the external sexual organs of male and female children. While the origins of sexual mutilations among prehistoric and primitive peoples is a matter for theory and speculation, the origin and spread of sexual mutilation in American medical practice can be precisely documented. Seen in the proper context of the entire scope of western history, the modern American enigma of institutionalized sexual mutilation is an historic aberration of profound significance and degree, one that could never have been predicted, and one that perhaps could not have been avoided.”

[…]

“The early promoters of circumcision fully acknowledged  the sexual functions of the foreskin and advocated circumcision as the intentional destruction of those functions. One of many such acknowledgements was published in an issue of the Medical News in November 1900:

Finally, circumcision probably tends to increase the power of sexual control. The only physiological advantage which the prepuce can be supposed to confer is that of maintaining the penis in a condition susceptible of more acute sensation than would otherwise exist. It may be supposed to increase the pleasure of the act and the impulse to it. These are advantages, however, which in the present state of society can well be spared, and if in their loss some degree of increased sexual control should result, one should be thankful. [42]

In 1902 an editorial in the American Practitioner and News made clear the anti-sexual motivation behind the doctrine of circumcision as a hygienic measure:

Another advantage of circumcision is … the lessened liability to masturbation. A long foreskin is irritating per se, as it necessitates more manipulation of the parts in bathing. … This leads the child to handle the parts, and as a rule pleasurable sensations are elicited from the extremely sensitive mucous membrane, with resultant manipulation and masturbation. The exposure of the glans penis following circumcision … lessens the sensitiveness of the organ. It therefore lies with the physicians, the family adviser in affairs hygienic and medical, to urge its acceptance. [43]”

[…]

…and then read the entirety of part 5 (World War II), click through to Part 2 , and read through the remaining section, which explains a LOT of why there is so much “justification” for circumcision (it shouldn’t surprise you to know that money is directly involved).

So, nutshelled, as with the primitive practices…the rationale amounts to demonization of normal sexual behaviors like masturbation…along with supposed hygiene factors that are very easily destroyed on analysis.

Some of the various excuses given

What about appearance? An uncut penis looks “unnatural” and/or “gross”… I want my son’s penis to look like Daddy’s penis… et cetera ad nauseam/ad absurdum.

Rather than provide the numerous links available that refute these cosmetic claims, I’ll just point out the obvious retorts…

What *about* appearance?! What is the actual standard…and why? (This thought exercise is more in-depth than it sounds…)

Unnatural? A penis in its uncut and natural state is unnatural? How does that work?

Gross? Well, so are many things about the human body. Should we cut off our noses because we develop boogers? How about our ears because of earwax?

You want your son’s penis to look like his dad’s? Again, how about his nose? His ears? His eyes? If you don’t apply the same “justification” for other body parts, then why is his penis somehow different?

There are numerous logical retorts for the (many ridiculous) cosmetic justifications for circumcision, of course…but one must first actually ask the question of how they would deal with any other body part first.

Risk of UTI, STIs, and the *scary hashtag* #PENISCANCER !!!

Within this subheading, I’ll provide a few of the “justifying” links given to me during the aforementioned facebook discussion…starting with the Mayo Clinic’s recommendations on the topic.

Within that link, the justifications given are:

Hygiene, UTI prevention, STI prevention, prevention of “penile problems”, and decreased risk of penile cancer — WOW!! It must be really awesome to have such a strong recommendation from the Mayo Clinic, right? Well hold on there, partner…read the disclaimers in there VERY carefully. Each of the explanations are weaselly, with plenty of “howevers” and “mights” and “coulds” and such –and NO supporting citation…though surely the citations come from somewhere, right? Right…they come from…

…the American Academy of Pediatrics! Another well-known and well-trusted source (yes, I agree, they certainly are, actually) — complete with the noteworthy endorsement from ACoG and the American Cancer Society — so why on earth would I dare to challenge such well-respected sources? Well, part of the reason has to do with their own transparency. If you click through the link provided and scroll down below the abstract, you will find a huge list of articles that not only refute, but provide scientific explanation for refutation of the AAP statement. This is important, for many reasons, but I would argue that transparency within a scientific organization is necessary — and a perusal of the refutations is in order if you’re not familiar.

For example…the University of Oxford presents a full article with loads of embedded citations (back to MORE scientific sources) of why the AAP’s *new* policy statement on circumcision is embarrassingly out of date AND is in direct conflict with global medical opinion on the topic. Specifically, one of the criticisms actually noted IN the AAP files says THIS:

“The American Academy of Pediatrics recently released its new Technical Report and Policy Statement on male circumcision, concluding that current evidence indicates that the health benefits of newborn male circumcision outweigh the risks. The technical report is based on the scrutiny of a large number of complex scientific articles. Therefore, while striving for objectivity, the conclusions drawn by the 8 task force members reflect what these individual physicians perceived as trustworthy evidence. Seen from the outside, cultural bias reflecting the normality of nontherapeutic male circumcision in the United States seems obvious, and the report’s conclusions are different from those reached by physicians in other parts of the Western world, including Europe, Canada, and Australia. In this commentary, a different view is presented by non–US-based physicians and representatives of general medical associations and societies for pediatrics, pediatric surgery, and pediatric urology in Northern Europe. To these authors, only 1 of the arguments put forward by the American Academy of Pediatrics has some theoretical relevance in relation to infant male circumcision; namely, the possible protection against urinary tract infections in infant boys, which can easily be treated with antibiotics without tissue loss. The other claimed health benefits, including protection against HIV/AIDS, genital herpes, genital warts, and penile cancer, are 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.” (emphasis added)

So, the big “news flash” in the United States is that male infant circumcision should be routine (ask where the money is in that count), while ignoring that right in the *very same source* there is acknowledgment that ALL of the reasons provided are NOT equivalent in a American (Western) context as where the substantiating studies transpired…and for VERY similar reasons as provided in the religious history context above.

For further reading on the demolishing of the AAP’s updated stance on the subject of routine male infant circumcision, read here, here, and here.

For information about evolutionary thoughts on the human male foreskin, read here, here, and here. (I have more links to biological & evolutionary thoughts on this topic; if interested, email me.)

Closing thoughts

My stance is not actually opposed to male circumcision in general (if it is voluntary and consenting)…but I am opposed to routine male infant circumcision specifically. All of the claims made by variety sources justifying the practice are easily refuted (in many cases, outright debunked in terms of Western practice). In cases where circumcision IS actually medically indicated (where other, non-invasive measures do not resolve the issue in a child where the parents have to make a decision in their child’s best interest), then sure…no problem. Of course, medical indication makes sense. I also do not believe in demonizing parents for the decision to circumcise their sons. As I said in my original blog entry about this topic: “I don’t think that telling parents who made that choice for their sons that they “damaged” their sons is a good thing either. In fact, I think it’s cruel to do that, because chances are, they thought they were doing what was right for their child. Even if it meant permanent removal of something like foreskin.”

However, in the VAST majority of cases, I do not view routine male infant circumcision as anything other than cosmetic…and IF that male human DESIRES to be circumcised later in life, then he owns his own body, and has the right to that CHOICE. It should be his choice…in the end.

With that, Happy Fried Day!
~dw