The Sensitive Issue of Circumcision

[Loss Leader]

There's a report in The Economist this week...

http://www.economist.com/science/displaystory.cfm?story_id=11579114

...that explains how circumcision enables older males in societies to keep younger ones under control.

So the obvious answer is: of course you circumcise your child, but bear in mind that you are doing so for purely selfish reasons.

The research described in this article appears to be insane. From the article's explanation of Wilson's theories:

But there are several ways [circumcision] may affect fertility: most obviously, the lack of a foreskin could make insertion, ejaculation or both take longer. Perhaps long enough that an illicit quickie will not always reach fruition.

Fine, but the researcher doesn't actually test this theory. It's certainly easy enough to do so - Offer a bunch of college kids $10.00 to masturbate as fast as they can and have them report their times. Don't ask them if they're cut or uncut before they report their times so as not to "prime" them for any particular stereotype that might be floating out there.

The writer of the paper fails to do this. Instead, he engages in a bizarre anthropological game:

Dr Wilson made several predictions. Among them, he suggested that mutilation is more likely to be practised in polygynous societies ... and is especially likely in those polygynous societies where a man’s co-wives live in separate households from their husband.... To test his predictions, Dr Wilson looked at a database of 186 pre-industrial societies. Some 48% of the highly polygynous ones practised a form of male-genital mutilation, and the number rose to 63% when co-wives kept separate households.

That's great, except Wilson didn't make any predictions at all, did he? The man is studying Neurobiology and Behavior at Cornell. He already knew what types of societies were in the history books. He had already studied them.

By the way, the article wrongly calls Wilson a dictor, He's still a student.

 

[ponderingturtle]

But how often does that happen in, say, Europe?

I don't know, you would need to poll people about why they are circumcising their child.

Given the percentage of people who have this happen to them it would not be expected to have a high percentage of the population to be circumcised.

 

[Fiona]

http://www.who.int/hiv/topics/malecircumcision/JC1320_MaleCircumcision_Final_UNAIDS.pdf

There is a map on page14 of this link which shows world wide incidence of circumcision. The body of the report is quite interesting too

ETA the map is a little misleading since canada falls in the same group as the USA though the incidence appears to be far lower there - but you have to draw the lines between groups somewhere I suppose

 

[EeneyMinnieMoe]

@EeneyMinneyMoe. I don't think I follow. The argument from choice surely arises naturally, if it is conceded that circumcision has no significant health or medical benefits for the patient? The fact that the procedure is more difficult and more dangerous in adulthood does not change that, does it?

I think it does. The argument from choice doesn't really fly in practise. I don't think adult circumcision is a good option; you should either be cut as an infant or not at all.

I am afraid it is bogus to claim that adult informed circumcision is not viable in practice. The fundamental difference is that an adult can be properly informed of what the procedure entails and can take an informed decision on inflicting the associated pain on his own body for no good reason. A defenceless infant cannot.

Being a woman and having no children, I probably shouldn't be talking but I'd much rather be circumcised as an infant than as an adult for many reasons. An infant can't remember the pain; an adult is not that lucky.

 

[kellyb]

Does anyone have a link to stats of the prevalence of circumcision? I have to be honest and say that this thread is the first time I've heard that it isn't a common procedure. I live in the US, and a quick (and I assure you unintentional :d) poll of the high school showers showed me that circumcision seemed pretty universal, with one or two people without it.

It is common among men over 18, but for infants born now, it's more like 50/50.
It's very rare elsewhere in the developed world.

http://adc.bmj.com/cgi/eletters/90/8/772

The Association for Genital Integrity reports that only 13.9 percent of male infants in Canada were circumcised in 2003.18 Data provided by the National Hospital Discharge Survey indicates that the percentage of male infants circumcised in the United States declined to 55.1 percent in 2003.19 One expects to see further declines in the popularity of circumcision as newer data are reported. Many health maintenance organizations in the USA and most Canadian health insurance plans no longer pay for non-therapeutic circumcision of infant boys.

 

[kellyb]

Being a woman and having no children, I probably shouldn't be talking but I'd much rather be circumcised as an infant than as an adult for many reasons. An infant can't remember the pain; an adult is not that lucky.

An infant might not remember, but an adult can be sedated and given good pain relievers afterwards. Plus, an adult doesn't have pee on the wound like an infant in a diaper does.

Also, the actual procedure is more physiological trauma for an infant penis, because the foreskin has to be ripped off the glans (like ripping a fingernail off a finger) before the prepuce can be removed. It's totally seperated "naturally" by adulthood. If you watch a video of one, it really looks like separating the foreskin from the glans is by far the worst part.

 

[Fiona]

I think it does. The argument from choice doesn't really fly in practise. I don't think adult circumcision is a good option; you should either be cut as an infant or not at all.

But that is not the point, is it? And adult can make a choice for himself unless there are genuine ethical reasons to deny it. The pain and complications and all of that are of course to be made explicit, so that the choice is informed. Are you really arguing that a grown man cannot decide, for religious or any other reasons. that he wishes to be circumcised? I can understand that if you are committed to the idea that it is harmful, and therefore violates some version of the hypocratic oath. But I had not understood that was your position.

If it is your position then it seems to me to follow that it cannot be done to an infant. We have seen it argued that this is a matter of parental choice and so long as the procedure itself is at least neutral then that is fine. However the right of a parent to decide for a child is predicated on the idea that that right will be exercised in the interest of that child: parents cannot just do what they like. They get special status because it is presumed they are best placed to decide what is in the child's interest usually. Where there is evidence they do not follow that precept, then the right can be overridden by the court.

It seems to be inherent in your stance that you believe it is harmless for infants but not for adults. Well all surgical procedures carry some risk: and some procedures are more risky for adults than children. Yet I am uncomfortable with the idea that you would prohibit an informed adult from accepting those risks no matter how small: and yet allow that same adult to accept it on behalf of a child (again no matter how small)

Being a woman and having no children, I probably shouldn't be talking but I'd much rather be circumcised as an infant than as an adult for many reasons. An infant can't remember the pain; an adult is not that lucky.

I don't accept you have no right to an opinion on the basis of gender. But I do question your assertion that adults remember pain in any meaningful sense. Women who have babies tell me they do not shortly after the birth. My own experience with other kinds of pain tells me that I do not remember it much after the event. Pain which is chosen is perhaps different from accidental pain and different again from enforced pain: I have no way of knowing but it seems counter intuitive. Is your experience different?

 

[thesyntaxera]

My two measly cents...

When I worked on an inpatient medical floor I remember several instances of teens and young adults not maintaining their foreskin. Some had contracted some sort of UTI that eventually spread to the base of their spine and temporarily paralyzed them from the waste down. During this time I began to wonder why they didn't just keep it clean in the first place.

So you have to ask, how much cleaning can you expect a child, teen or young adult to actually do? It's great to say "All you need to do is keep it clean!", but in reality, how often do you think this advice will actually be taken?

I had another friend who had a son, and he had to have him circumcised at the age of 4 because the head of his penis was larger than the foreskin containing it. In this case leaving it intact would have caused more harm than good.

Personally, I am in favor of circumcising, but I understand why some object, and thats their prerogative. As a preventative health measure the pros out weigh the cons in my opinion, and not doing it means to me that one is going to have to rely on the "All you need to do is keep it clean!" argument...which as sound as that may be, has not been evidenced much for me in my personal experience.

 

[JoeEllison]

The Masturbation Defense! This is the first reasonable argument I've heard in opposition to circumcision. The frantic cries of "you're mutilating babies!" are just silly.

Not just silly, but also a little bit nutty.

 

[thesyntaxera]

Not just silly, but also a little bit nutty.

Agreed. Have you seen those restoration devices they came out with?

 

[Praktik]

Earlier this week my wife and I found out that we are going to have a boy this October. As we shared the good news, we unknowingly ran smack dab into a debate with very passionate advocates on either side: Were we going to circumcise our son?

My wife and I had half-discussed it in the past, but it was still sort of a maybe-we-don't-have-to-deal-with-it issue so we didn't really invest any energy into it. My wife is taking the cowards way out* by saying that it has to do with penises, so it's my responsibility to decide.

So, I'm bringing the question to the board. I'm starting from a default position that the kid should not be circumcised. Does anyone have medical reasons why this is a good idea? Can anyone persuade me that this would be a mistake based on medical reasons?

Ok - so here's the deal. I'm cut, my bro aint. I always wondered why. But then my sister visited our family friends out in England, my first friend ever is their son and he was born a few days after me.... At the dinner table, the father blurts out something about his son's "accident" during circumcision.

I dont know the details, but its a risk. And I assume that having a deformed penis represents a significant psychological stumbling block.

So you have to worry about that.

Being circumcised myself, I can say that when it comes to masturbation, the trial and error I went through as a teenager was difficult at times. For guys that are uncut, they can pretty much go to town because the hood and its inner lubricant make it nice and easy.

For me it took me a while to discover I needed an external lubricant, and a 13 year old isn't going to know this right away or have the stones to buy some lube at the pharmacy.

There's also the matter of sensitivity, and while people seem to be under the impression that men are easily pleased - with some credence I'll grant - the fact is that you will be denying your child their possible maximum pleasure. Sensitivity is reduced, by how much its hard to guage, but it is. And i've wondered what I'm missing out on...

Aside from that, there's the cultural issues. Your son will find porn, its a given. And almost every male porn star is cut. Girls often state their preference for cut men (though there are those that prefer uncut its true) but I'm sure uncut men do have to wrestle with this and may end up under some psychological duress in their first sexual encounters, second guessing the attractiveness of their unit, or maybe even being rejected in part because of it.

So its a thorny issue, but if I had my druthers I'd like to have my hat back please. I had no input into the decision at all - and that kind of rubs me the wrong way.

If I had a son I wouldn't do it.

THey also use the hats for cosmetics - do you want part of your son's penis applied to a stranger's face?

 

[Southwind17]

Earlier this week my wife and I found out that we are going to have a boy this October. As we shared the good news ...

I'm assuming you already knew your wife was pregnant, and that you've just identified the gender(?). But then I'm a little puzzled. What revelation(s) might have led you to share bad news?!

 

[Imrational]

I'm an ER Nurse.

Circumcision is not a medically necessary procedure. Insurance companies will pay for the procedure and represents a source of profit for hospitals and doctors. In other words, there is an economic incentive for the medical establishment to perform the procedure.

Current standard of care has that infants are given a topical analgesic prior to the procedure and that the procedure is held approximately 12 minutes to give the analgesic time to work.

In my brief experience on the floor (via nursing school), many doctors did not give the analgesic. Those that did, did not wait the 12 minutes even when parents witnessed the procedure. Again, this was only my brief experience.

If I ever have kids, they will not be circumcised.

 

[JoeEllison]

I'm an ER Nurse.

Circumcision is not a medically necessary procedure. Insurance companies will pay for the procedure and represents a source of profit for hospitals and doctors. In other words, there is an economic incentive for the medical establishment to perform the procedure.

Current standard of care has that infants are given a topical analgesic prior to the procedure and that the procedure is held approximately 12 minutes to give the analgesic time to work.

In my brief experience on the floor (via nursing school), many doctors did not give the analgesic. Those that did, did not wait the 12 minutes even when parents witnessed the procedure. Again, this was only my brief experience.

If I ever have kids, they will not be circumcised.

Everything that costs money makes someone money. Every professional field has good and bad practitioners. Neither point really makes a difference to this discussion pro OR con.

 

[JoeEllison]

Agreed. Have you seen those restoration devices they came out with?

Yeah, I have... funny stuff there! Of course, the guys using them sound sad and pathetic, from what I've heard in a couple of different interviews. Usually, it seems like people who feel generally insecure about their manhood have an overwhelming focus on their junk. Those are the same guys who blame their general insecurity on penis size as well. They seem to think that changing their genitals will make their whole life better.

The reality is that for most people, circumcised or not makes little or no difference.

 

[NewtonTrino]

See what Praktik is talking about with regards to external lube has always been my main argument. It sounds like some circumcisions are less complete but I do think that a lot of penises are being made less useful here. The entire concept of using lube for masturbation seems completely ludicrous to me. I don't see why anyone would ever need to do that. Well I think a good chunk of men that are cut do need this because their penis has been messed up. I've come to believe there are bigger evils in the world than this and I'm not cut so it's not really my fight. However, I would be pissed if someone had made this decision for me.

Bottom line, there are no good studies on the damage caused. If I was a new parent I would be extra careful about this kind of woo based procedure.

Oh, and the keeping it clean.. come on seriously. If you take regular showers and just soap up, give it a couple of rubs and you're done. Really not a big deal.

 

[Fiona]

@ thesyntaxera. Nobody is disputing there can be problems from infection but honestly I do not think personal experience in a hospital is likely to give you a very realistic perception of how much of a problem that is. The evidence presented here does not support the idea that this is a common consequence of not being circumcised and I think if it were then circumcision would be common in this country. It is not.

You say children and young men cannot be expected to keep clean. I just do not accept that I am afraid. But if they cannot be persuaded to wash then I imagine they will die of tetanus or septicaemia or something long before they are paralysed by a UTI (perhaps I am wrong about this if I am I cannot see why)

Similarly there are medical conditions which require circumcision, such as you describe with the 4 year old: again those are not very common and such operations are done in this country when they are required.

I think there is little evidence for real health benefits and this has been agreed by many n both sides of this argument. I agree there is little evidence for harm either. The decision is much more to do with culture and identity I think, and those matters are very important. Bu in the absence of such considerations I suppose that I draw the line at procedures designed to prevent unlikely problems, if those procedures make you bleed. Bleeding is generally a sign that your body is not all that happy, IMO. A preventative procedure which causes bleeding needs to give a real and significant benefit in order to be justified. There is none here so far as I can see.

It is not so long ago that removing tonsils was done on the same rationale, but we do not routinely do that here now either. Is it done in the USA as a preventive measure?

I did ask before if the fact that physicians are paid to do this is relevant to the prevalence in the US as compared to europe. The article I linked above does mention money as a factor in the change in the UK but I do not know how it works in the US.

ETA. I see Imrational has addressed my final point. Thank you

 

[Praktik]

If you wanna see a horror story there's a Canadian kid who had his penis BURNED OFF in the late sixties/early seventies, when they used some kind of machine to "zap" off the hood... no idea how that worked in detail.

Anyway - it over-volted or something and completely burned off his penis. His parents were watching CBC and this psychologist was on talking about how all gender is learned behaviour, that a boy could be raised to be a girl and vice versa. THey decide to go to him for help...

So this guy didn't even know he was boy until he was a teenager. THere's tapes of him with this psychologist and he asked "what do boys have?" ""a penis", "and what do girls have?" "a flat"....

That part broke my heart, a "flat", I guess that's all he had....

ANyway - he ended up getting a reconstructed penis, he married, even had a kid...

but killed himself in his mid twenties, suffice to say his childhood was pretty traumatic.

Im pretty sure they dont use that method anymore, but a pretty sad story. It plays sometimes on CBC for my fellow Canukistani's - keep checking the Passionate Eye listings...

 

[JoeEllison]

It is not so long ago that removing tonsils was done on the same rationale, but we do not routinely do that here now either. Is it done in the USA as a preventive measure?

Slight derail... but I wish they did. I had my tonsils out last year, and I was sick for months before they were out, then I was out of work for 6 weeks, and I had to wait around to see whether or not I had cancer! I can see why they don't take them out automatically, but I can also see why they would.

 

[Southwind17]

As parents, we frequently must choose to cause our children short-term pain in pursuit of greater goals: in my case, permanent identification with my religious group.

You mean like some sort of secret "hand shake"(!!!), so to speak?! Shame Monty Python didn't do a skit on this one, or did they?! Would you not consider the old kippah might suffice, or is that not sufficiently permanent, you know, in case the little fella decides to renounce his religion in adulthood, you know, if he feels he wants to determine his identity for himself. Just asking.

Aside from that, there's the cultural issues. Your son will find porn, its a given. And almost every male porn star is cut.

I could be wrong here, but this makes me wonder whether you believe that just because the glans is fully exposed then it must be a circumcised penis, and whether your circumcision has led to such misunderstanding (I knew I'd find some valid anti-circumcision justification somewhere down the line!). To my mind, a penis with a fully retracted foreskin looks pretty much identical to a circumcised penis, unless, of course, it has a particularly ill-fitting foreskin!