Saturday, December 6, 2008

Circumcision

I was circumcised as a baby because back when I was born, it was common practice. My mother admitted that she had given in to peer pressure and had me circumcised just because everyone else was doing it. I don't blame her, and in fact, she said if she knew then what she knows now, she wouldn't have done it. Hearing her say this, I naturally assumed that circumcision was a thing of the past, so I was shocked to find out that it's still common practice today.

Male circumcision consists of removing the foreskin from the penis, while female circumcision can take many forms from removal of the clitoral hood, removal of the clitoris, or removal of both along with the labia major and labia minor. Opponents of the practice on females call it female genital mutilation, since equating it with circumcision makes it seem not so bad. Of course, circumcision for males is also genital mutilation. However, it isn't often called male genital mutilation in the west where circumcising males is viewed as more acceptable than circumcising females.

As a religious practice, both male and female circumcision are common in the Muslim world, although the Koran does not mention it. Jews mainly practice male circumcision, believing it is part of their covenant with God, although female circumcision is also performed, especially in Africa. Among Christians, religious circumcision is rare outside of Africa. Nationally speaking, male circumcision is only common in the US, Australia, and Muslim countries, while female circumcision mainly takes place in Africa.

Both male and female circumcision apparently began in ancient Egypt during the time of the pharaohs and continued to be practiced among semitic peoples. The practice didn't catch on in English speaking countries until around 1900, when doctors began advocating that it was necessary for hygiene and claimed it would prevent masturbation, which was viewed as detrimental back then.

"A remedy for masturbation which is almost always successful in small boys is circumcision, especially when there is any degree of phimosis. The operation should be performed by a surgeon without administering an anesthetic, as the brief pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment, as it may well be in some cases." - John Harvey Kellogg (1888)

C.F. McDonald wrote in a 1958 paper titled "Circumcision of the Female" that "If the male needs circumcision for cleanliness and hygiene, why not the female? I have operated on perhaps 40 patients who needed this attention." However circumcision of females never caught in the English speaking world the same way male circumcision did.

Over the years, the reasons for circumcision changed. A 1987 study found that the most prominent reasons US parents choose circumcision were "concerns about the attitudes of peers and their sons' self concept," rather than medical concerns. Basically, they circumcised their children just because everybody else was doing it. They thought their son might be made fun of when he showered with other boys if his genitals hadn't been mutilated. Aesthetics is also a reason given to justify female circumcision. However, like foot binding in China and rings to elongate the neck among the Padaung, disfigurement for the sake of beauty hardly seems like a good justification for an ancient and barbaric practice.

Isn't there some kind of medical reason for circumcision?

The short answer is no, not really. Although, if there were, I think parents should at least be informed enough to know what the medical reason is before mutilating their infant's genitals. Most parents in the US don't even consider female circumcision even though some doctors used to think it was necessary for hygienic reasons. Most countries around the world don't think there's any medical reason for male circumcision either, but despite this, it's still common practice in the US.

The American Medical Association stated in 1999: "Virtually all current policy statements from specialty societies and medical organizations do not recommend routine neonatal circumcision."

The American Academy of Pediatrics (1999) stated: "Circumcision has been suggested as an effective method of maintaining penile hygiene since the time of the Egyptian dynasties, but there is little evidence to affirm the association between circumcision status and optimal penile hygiene."

The American Cancer Society (2006) stated, "The current consensus of most experts is that circumcision should not be recommended as a prevention strategy for penile cancer." Even if circumcision helped prevent cancer, it seems overboard. Kind of like removing part of a healthy person's liver because there's a remote possibility they might get liver cancer at some point in their lives.

There have been studies indicating that circumcision reduces the risk of HIV and other STDs, however other studies show that circumcision actually increases the likelihood of contracting these diseases, so the jury's still out on that one. However, everyone agrees that circumcision on its own is not a good way to prevent the spread of HIV, making it a moot point. Instead of circumcising your child, tell them about condoms instead.

Similarly, the jury still seems to be out on whether circumcision prevents or increases the risk of infections, with studies supporting both theories. However, since most infections are easily treated, using circumcision to prevent them seems overboard. It's true that uncircumcised boys are more likely to get a urinary tract infection, however, only 1% of boys will get one, while 2% of boys get an infection as a result of circumcision. In this case, the cure is worse than the disease.

Circumcisions can be extremely hazardous when not performed by a trained professional with side effects such as death and the need to remove the penis entirely. Even when performed by trained professionals, there's still a one in a million chance of death. Even though it's extremely rare, is it worth risking the life of your child for an unnecessary medical procedure?

Does getting a circumcision reduce sexual pleasure?

Depending on the type of circumcision, it can be quite the opposite. Recent studies have show that partial female circumcision (removing only the clitoral hood, but leaving the clitoris intact) increases sexual pleasure. (for example a study done in 1959 by Rathmann et al claim that 87.5% of women saw an improvement in sexual pleasure, with 75% in a study by Knowles et al). However, since sexual pleasure is often tied in with psychological reasons, this might be attributable to the placebo effect.

Even more extreme forms of female circumcision don't reduce sexual pleasure as much as one would expect. This is because sexual pleasure isn't purely physical, it is also psychological. Basically, in cultures where female circumcision is seen as desirable, women report being sexually satisfied, while in cultures where it is viewed as undesirable, it decreases sexual pleasure.

The same can be said of male circumcision. While it's true that circumcision removes part of the anatomy that is rich in nerve endings and thus necessarily decreases sensation, it's also true that sexual pleasure is partly psychological, so men who have been circumcised can still have a satisfying sex life. Men who were circumcised as adults report a loss in sensitivity, but no reduction in overall sexual satisfaction.

What about religious reasons?

Christians have no religious reason for circumcision. Christians in the US mainly do it simply because it's become a tradition in that country since 1900, but it's not common for Christians outside the US. Circumcision is common among Muslims, but it is not specified in the Koran. Some religious writings outside the Koran seem to indicate that it should be encouraged, but it's not an official part of the Muslim religion.

The Bible tells us God made us in his own image and that the body is a temple. Jewish law prohibits tattoos and considers body piercings to be a defilement of the body. The only form of bodily disfigurement allowed is male circumcision. For Jews, circumcision is part of their covenant with God, although archeologists tell us it wasn't practiced until the Babylonian captivity as a way for the Jews to maintain their cultural identity and avoid being assimilated into the larger culture.

In either case, I think the choice should be left up to the individual. A person's genitals shouldn't be mutilated without their consent. A baby isn't old enough to consent. Your child may decided not to practice Judaism when they grow up. They might choose a different religion. Even if they decide to be a Jew, they may not choose to observe every practice. The choice to be circumcised or not should be the child's choice, and not forced upon them by parents.

1 comment:

Anonymous said...

Absolutely. If we as a society repsect our children, we have to end infant circumcision. It is just plain wrong in so many ways. Thanks for speaking up.