Is Circumcision Right or Wrong?

[Meed]

I think one of the main reasons people circumcise in the United States is because they want their child to be "normal" within their society. What they probably don't realize is that despite the fact that circumcised adults are the norm here today, it won't be the case when your newborns are adults. The circumcision rate in the US in 2009 was only 32.5 percent (http://well.blogs.nytimes.com/2010/08/17/u-s-circumcision-rates-on-the-decline/).

 

[Meed]

I've seen conflicting reports on circumcision rates, but the highest I've seen for current US rates is still under 60%, which should not be abnormal to the point of concern.

 

[Ivor the Engineer]

<snip>

When you look at it purely in terms of the reduced HIV/herpes risk, of course it's going to seem great.

Those headline figures also don't take into account risk compensation, whereby people have more unprotected sex because they think they're protected by being circumcised.

Even if the risk reduction was maintained over time, it's red herring anyway. There are far less invasive and drastic ways to deal with or prevent problems that might arise more often when a child/man is not circumcised.

The bottom line is that people want to chop bits off their kids for emotional reasons (e.g., group membership, aesthetics, etc.) and then go looking for plausible rationalisations based on science.

Why physicians are still offering this service I have no idea. The excuse often offered up is that if they didn't provide the service for parents then more infants and children would have 'back-street' circumcisions, resulting in greater numbers of botched procedures and complications. Another is that the medical profession is there to serve the public and shouldn't be trying to direct public opinion on the issue one way or the other.

What few physicians seem to acknowledge is that their patient is the child and is both perfectly healthy and very unlikely to need a circumcision before he is able to decide for himself. That the parents wish the physician to physically assault their child should be irrelevant, as should any concern that they might take the child to someone less able if he or she does not oblige.

 

[brodski]

Why physicians are still offering this service I have no idea.

Market forces, coupled with the fact that like ritual slaughter without pre-stunning the protections of the religious freedoms of the Jewish and Muslim communities would make it effectively impossible to ban.

 

[zooterkin]

Market forces, coupled with the fact that like ritual slaughter without pre-stunning the protections of the religious freedoms of the Jewish and Muslim communities would make it effectively impossible to ban.

They managed to ban shechita in Sweden.

 

[jdp]

The links Professor Yaffle gave suggest that this case (I assume both links refer to the same case) was unusual in that the normal procedure was not followed, and there were complications.

Actually, there were two separate cases one involving a week old Jewish child who was circumcised by someone not certified in Finland and a Muslim child. I think in both cases the court dropped the ball, the conviction and fines should have stood. JJM is right though Finland is another example of a country that is out in front on this issue but even here we see that legal remedies aren't yet possible.

 

[jdp]

I think one of the main reasons people circumcise in the United States is because they want their child to be "normal" within their society. What they probably don't realize is that despite the fact that circumcised adults are the norm here today, it won't be the case when your newborns are adults. The circumcision rate in the US in 2009 was only 32.5 percent (http://well.blogs.nytimes.com/2010/08/17/u-s-circumcision-rates-on-the-decline/).

I don't believe those numbers for a second. The 60% you suggest in your next post is probably closer to the truth. Also in the US the figures are strongly regionally dependent. The West Coast has some of the lowest rates while the Mid-West has some of the highest rates. The trend is in decline though just not fast enough.

Market forces, coupled with the fact that like ritual slaughter without pre-stunning the protections of the religious freedoms of the Jewish and Muslim communities would make it effectively impossible to ban.

You're probably right on this. I think a good first step would be to abolish it from routine secular practice in places where it still exists. Doctors would simply not offer it for non-therapeutic reasons. In Finland, Norway, Sweden, the Netherlands, and the UK for example the doctors could just agree to no longer offer the procedure and it should be discouraged. Those performing it for religious reasons, such as the local Jewish populations, already have people available to perform it anyway.

 

[zooterkin]

Actually, there were two separate cases one involving a week old Jewish child who was circumcised by someone not certified in Finland and a Muslim child. I think in both cases the court dropped the ball, the conviction and fines should have stood. JJM is right though Finland is another example of a country that is out in front on this issue but even here we see that legal remedies aren't yet possible.

I was referring to the Jewish child mentioned in both the quotes; I assume that was the same case in both quotes.

 

[jdp]

I was referring to the Jewish child mentioned in both the quotes; I assume that was the same case in both quotes.

I see, sorry for the confusion.

 

[zooterkin]

You're probably right on this. I think a good first step would be to abolish it from routine secular practice in places where it still exists. Doctors would simply not offer it for non-therapeutic reasons. In Finland, Norway, Sweden, the Netherlands, and the UK for example the doctors could just agree to no longer offer the procedure and it should be discouraged. Those performing it for religious reasons, such as the local Jewish populations, already have people available to perform it anyway.

I'm not aware that the procedure is offered routinely, at least not in the UK. It certainly never arose when my son was born. I'm guessing you may be American. As far as I know, that's the only country where it's routine for boys to be circumcised for non-religious reasons.

 

[zooterkin]

I see, sorry for the confusion.

Well, maybe I wasn't clear; I was talking about that one since JJM 777 had referred to a case he remembered recently with a Jewish boy. As the Jewish populations in Europe are generally longer-established than Muslim ones, I was asking about that one because it seemed something out of the ordinary must have happened to bring it to court (as indeed seemed to be the case).

 

[brodski]

I'm not aware that the procedure is offered routinely, at least not in the UK. It certainly never arose when my son was born.

It's not paid for by the NHS unless there is a medical reason. This is why although circumcision was popular in the English middle classes from the Victorian era to the mid 20th century the practice has pretty much stopped.
People don't tend to want to splash out on painful cosmetic surgery for their kids.

 

[jdp]

I'm not aware that the procedure is offered routinely, at least not in the UK. It certainly never arose when my son was born. I'm guessing you may be American. As far as I know, that's the only country where it's routine for boys to be circumcised for non-religious reasons.

I guess what I meant to say is that for non-therapeutic reasons, you shouldn't be able to find a doctor to perform a circumcision on a child. I pretty much knew it wasn't done in the UK as a matter of routine but I think you could still find doctors to perform it if you ask around; stopping just that would be a good place to start. Those doing for religious reasons have people in their community for that.

I am American and yes it's offered so routinely here that even though the rates have come down, it's not unheard of to still be done without the parent's consent. There was a recent case about this that went to trial in Indiana. The doctor was ultimately found not liable. So those who don't want it done have to pay very close attention to their child after he is born in some places still. The interesting thing about this whole matter is that if you get into a private conversation with many US doctors more often then not, they'll admit that it's unnecessary. They'll also frequently admit that they don't like to do them and they didn't do it to their own children or wouldn't today. But they just still won't say no, the excuse being that either they want to make sure it's done "right" or they're concerned about their business interests.

 

[Meed]

I don't believe those numbers for a second.

I'm willing to entertain it's wrong, but can you at least give some supporting reasoning or evidence?

The 60% you suggest in your next post is probably closer to the truth.

I said less than 60% (mid 50s).

Also in the US the figures are strongly regionally dependent. The West Coast has some of the lowest rates while the Mid-West has some of the highest rates.

True.

 

[AmandaM]

I guess what I meant to say is that for non-therapeutic reasons, you shouldn't be able to find a doctor to perform a circumcision on a child.

Not sure I agree -- that would make it seem like a "conspiracy" of big Pediatrics to prevent your children from being healthy or whatever.

What I would much rather see is for pediatricians to simply be honest with new parents, as ours was, and just say "In 99% of children, there is no reason to recommend routine circumcision."

That pretty much clinched it for me. No reason to recommend elective surgery? Fine. We won't have it.

It also helped that our insurance would not pay for it, and the hospital quoted us between $400-$600 for it.

Those doing for religious reasons have people in their community for that.

This is true, and our Ped said as much.

 

[slingblade]

The other thing is aside from forums like this, I don't ever see the media portray stories of men who fault their parents for circumcising them, but I have seen many in which uncircumcised men rail against their parents both for social consequences of not being cut (i.e. a girl is turned off by it, they are teased, etc) or because they had to have it later in life for medical reasons, and faulted their parents for not having it down in infancy when it was a simpler, less dangerous procedure (as the risk factor is higher when you do it at an older age), and also at an age where he wouldn't have been old enough to remember the pain and discomfort that follows a circumcision.

In fact, reading this reminded me of an episode of Nip/Tuck I watched in which the teenage son was rejected by a girl because he was uncut and he asked his parents for the surgery. Which was refused. So, he cut himself, bled copiously, and got the surgery anyway.

This is not a great endorsement for the uncut male. If I were an uncut teen watching that, well, it would make me worry a bit. It would make me worry more if that were the message I seemed to be getting in general from the media. And it generally does seem to be the message.

Americans are presented with a very one sided argument. I've tried to talk to my hubby about this but he's incredibly pro circumcision and there's just no convincing him otherwise. But as we don't plan to have our own kids, just maybe do foster care or adopt older children, it's not really worth arguing over.

My sons' father wanted them cut, as well. Given the nature of our relationship, it would have happened regardless of how I felt about it. Not offering that as any excuse, just pointing out that there are often two parents' desires in consideration, and when they conflict, one of them will likely be overruled.

 

[jdp]

I'm willing to entertain it's wrong, but can you at least give some supporting reasoning or evidence?

I admit that I don't have any that directly refute that study; call it more like well informed hunch. Just considering where the study took place (both the state and the specific area within the state) and their policy on Medicare among other things. I'll say though that I would like nothing more than to see information that confirms that result.

I said less than 60% (mid 50s).

Which is about where we were in my state when I asked for figures from the Medicaid office. About 53% and on a downward slide the last few years. This was 2008, I should probably try and get new figures to see if things are still improving.

Not sure I agree -- that would make it seem like a "conspiracy" of big Pediatrics to prevent your children from being healthy or whatever.

What I would much rather see is for pediatricians to simply be honest with new parents, as ours was, and just say "In 99% of children, there is no reason to recommend routine circumcision."

That pretty much clinched it for me. No reason to recommend elective surgery? Fine. We won't have it.

I think it's great that you approached it that way but I don't see why the doctor could add to that '... and because of that I don't perform them now go home and enjoy your healthy son."

It also helped that our insurance would not pay for it, and the hospital quoted us between $400-$600 for it.

This is helpful, as Medicaid has drop the procedure, private insurers have followed.

 

[JoeMorgue]

Those headline figures also don't take into account risk compensation, whereby people have more unprotected sex because they think they're protected by being circumcised.

It also doesn't take into account that we almost universally done to children, mostly infants.

If an adult weighs the pros and cons of it and wants to slice the end of their knob to prevent the spread of certain STDs... more power to them.

I fail to see the purpose of doing it to an infant that will not be sexually active for at least well over a decade and who is not able to be part of the decision.

That and really circumcisions has been practiced for tens of thousands of years. The link between it and STDs was discovered very recently. Let's not start pretending like that's why people do it.

 

[Ivor the Engineer]

Well ladies, looks like it might not be long before you'll be being asked by your gynaecologist if you'd like to have that unsightly bodge of evolution between your legs trimmed, tightened and generally made more "beautiful".

http://www.guardian.co.uk/lifeandstyle/2011/oct/14/designer-vagina-surgery

To (mis)quote my dentist: "On a scale of 1 to 10, how happy are you with your vagina?"

 

[AmandaM]

I think it's great that you approached it that way but I don't see why the doctor could add to that '... and because of that I don't perform them now go home and enjoy your healthy son."

We haven't had him yet -- he's due in a couple of weeks. The circumcision discussion was at our interview to determine if he would be our pediatrician. I don't know if we actually asked him if he did the procedure himself. ? Pregnant brain forgets.