Guest Blogger

The Anteater & the Mushroom: Debating Circumcision

Filed By Guest Blogger | June 15, 2011 3:00 PM | comments

Filed in: Living, Politics
Tags: Alaric DeArment, circumcised penis, genital mutilation, Jewish rituals, uncircumcised

Editors' Note: Guest blogger Alaric DeArment grew up in Washington and Oregon, spent three years in China and went to college in Indiana. He now works as a journalist in New York.

On Memorial Day, I went to get lunch at one of the only places that stayed open in the predominantly Orthodox Jewish neighborhood in Brooklyn where I live: a kosher fast food restaurant. While waiting for my fish and chips, I noticed a sign on the wall above the counter: "Planning a bris? We can help with all your needs -- except for the mohel." Taco Bell, this was not.

But it also served as a reminder of the importance of ritual circumcision in the Jewish religion, such that while a gentile atheist like me with a penchant for Freudian slips would struggle to avoid asking the clerk about the status of my bris and chips, an Orthodox Jewish customer would likely not find its placement at all unusual. I'm the son of an anthropologist, and I grew up in a multiracial and multicultural household, so I learned from an early age to reserve judgment with regard to other cultures and avoid imposing my own cultural sense of propriety.

circumcised-or-uncircumcised.jpg

Thus, the blatant insensitivity displayed by Matthew Hess, the sponsor of a ballot initiative in San Francisco that would ban circumcision of males under 18 -- including ritual circumcision practiced by Jews and Muslims -- was already palpable when he released an online comic in which a blond-haired Übermensch of a superhero named Foreskin Man battles Monster Mohel as the latter tries to circumcise a newborn. Needless to say, Hess has faced numerous accusations of anti-Semitic sentiments over the comic, which is replete with crude stereotypes about Jews.

Because of the initiative's deliberate disregard for religious practices protected under the First Amendment and its trampling of the rights of two minority groups in the name of turning some people's values into law -- something that we as GLBT people should find repugnant, given our ample experience with referendums on our rights sold under the guise of "protecting" values and institutions -- it's unlikely that the initiative will ever make it past a judge's scrutiny, assuming it wins in the first place. A similar initiative, in Santa Monica, Calif., has been withdrawn.

Unfortunately, Hess' apparent mission to discredit himself and cast himself as just another one of those "intactivist" weirdos who hang around outside hospitals has resulted in most of the debate focusing on how the initiative would violate religious freedom. As a result, it's ruined an opportunity to have a real debate about the American tradition of routine circumcision. I use the term "tradition" because, while routine circumcision is considered a medical procedure and often promoted as a protective measure against urinary tract infections, penile cancer and sexually transmitted infections, it really has more to do with entrenched cultural values that ultimately stem from the misguided medical thinking of the late 19th and early 20th centuries.

I'm one of those rare American guys who was spared the scalpel. And like most uncut guys in this country, I was sometimes made fun of as a kid for having an anteater because, for my mushroom-bearing tormentors, it was just dirty, gross and abnormal. It's not because I had bad hygiene, but because Americans have formed an emotional association between circumcision and cleanliness despite the lack of any intrinsic relationship between the two. This emotional association often causes negative reactions to the very term "uncircumcised penis," thus making routine circumcision a cultural tradition rather than a tenable medical practice.

As such, I've approached with skepticism recent studies showing that circumcision can reduce the risk of STIs, including HIV. When news of HIV and circumcision studies in sub-Saharan Africa emerged, newspapers and magazines around the country made a big deal of them, and the San Francisco Chronicle even published an editorial recommending routine circumcision. Now, whenever the U.S. media cover the initiative in San Francisco, they include a little blurb about studies that have shown circumcision can cut the risk of STIs, including HIV. But they never bother mentioning that condoms can prevent the spread of most STIs by almost 100%, or the obvious fact that an uncut guy with a condom has a lower risk of getting infected with something than a cut guy without one.

Circumcision has also long been touted as a preventive measure against urinary tract infections and penile cancer. But the American Cancer Association no longer recommends circumcision as a prevention for penile cancer: Studies showing it offered protection were flawed because after they were controlled for men with poor hygiene and phimosis, a condition in which the foreskin can't be retracted, the benefit was no longer seen. And according to the American Urological Association, urinary tract infections occur in 12 percent of men and 2 percent of boys -- compared with 40 percent of women and 6 percent of girls -- and, as long as they're not allowed to go untreated for too long, they're curable with a oral antibiotics.

But from my experience, most anteater-phobia in America stems from the misconception that uncut is unclean. Of course, nothing could be further from the truth, at least not from my experience. From 2001 to 2004, I lived in China, where most non-Muslim men are uncut. In fact, the Mandarin word for the head of the penis, "guitou," literally translates into "turtle head" because of the resemblance of the foreskin moving over the head to a turtle's neck skin moving over its head when it emerges from its shell, an indication that being uncut has historically been the norm there. Whenever I was in the public shower on my then-boyfriend's college campus in the coastal city of Lianyungang and observed the other bathers -- because if I'm in a room full of slender, naked college boys, I tend to do a lot of observing -- I noticed they were fairly meticulous about cleaning themselves down there, including washing under their foreskins.

One reason is because they're taught to clean themselves properly from an early age, usually by their fathers. But in the United States, many guys who are uncut -- including me -- are because of Baby Boomer and Generation X parents who rejected circumcision, but sometimes didn't know the fine art of pulling back the foreskin, applying soap and rinsing. I admit that while I knew how to clean myself before I went to China, I didn't quite master it until I saw the guys there doing it because I didn't have anyone to teach me when I was growing up.

When I came back to the United States to finish college, I ended up in Indiana, a state with such a high percentage of circumcised men that I'm surprised "foreskin" even appears in dictionaries there. Sampling the local menfolk, I often detected some rather funky smells emanating from my bedfellows' nether regions. When showering with them, I noticed they simply allowed the water to run over their private parts, but didn't do any real scrubbing. They apparently thought they didn't need to do much because they were circumcised. I also noticed they had difficulty masturbating, having to use spit, lubricant or even their underwear to provide traction. Not surprisingly, circumcision was originally promoted in English-speaking countries during the Victorian era as a way to prevent boys from masturbating, though the United States remains the only such country where it has remained common.

By contrast, I and most of the men I met in China needed nothing more than the parts we'd had since birth. Curiously, however, some men in China are getting circumcised today because they think it's "cleaner," so while we don't seem to have a lot of manufactured goods to export to China, we have plenty of silly ideas to send there. According to some literature I've read, similar thinking has taken hold in South Korea, where circumcised American servicemen have inspired many Korean parents to have their own sons circumcised.

If the goal is to call this misguided American tradition into question and eventually make it go out of fashion, then the San Francisco ballot initiative is the wrong way to go because it violates religious freedom and because if it passes and parents still want to have their sons circumcised, they can simply go to the next county. Making sure that parents are well-informed and teach their sons to bathe properly and not base their self-esteem on how identical their penises are to those of other guys in the locker room while eliminating routine circumcision from health insurance and Medicaid plans are much smarter ways to approach the issue.

But though Matthew Hess is at best culturally insensitive, at worst anti-Semitic and most definitely a loon, routine circumcision is a practice that should be questioned because it's a cosmetic surgery that permanently alters the body but offers no real medical benefit.


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You didn't return to your major premise—that the initiative counters religious freedom—until the very end of your post where you restate it. You didn't support it in the body of your post. Therefore, you didn't win me over.

You do not acknowledge the rights of a baby boy to his own foreskin. What if, in the name of religion, parents clipped off a baby's pinky finger? Would that be okay? Where are you going to draw the line?

Disclaimer: I resent having been circumcised as an infant. I resent the pain which thankfully I don't consciously remember. I resent the fact that my foreskin probably ended up in a landfill somewhere near the hospital. I resent the fact that a significant part of me that had aesthetic as well as functional merit was permanently altered/destroyed by a man with medical training but with dubious cosmetic credentials.

Let a religious man choose to be circumcised when he is old enough to make that decision for himself. We have many legal "ages of reason". One age let's you drive a car. One let's you enter a bar. One let's you vote. One let's you get a tattoo without parental approval. Etc. There should be an age set at which a man or a boy can choose circumcision. I suspect very few would do so.

Also, you entirely ignore the fact that one of the main reasons why circumcision persists is that many fathers, rightly proud of their infant sons, want the kid to "look like him". This unfortunate pressure could disappear rapidly if this practice were vacated.

I agree. The issue of "hygiene" is both outdated and also a last minute argument that I find very convenient for many whose sole reason for circumcision seems to be "I want my kid to look like me" and "I don't want my kid to be made fun of". If anyone uses the "It's not hygenic" argument, then it's a failing on our part as educated individuals to dispel outdated health information and misinformation.

And in the interest of full disclosure, I am an uncircumcised man who is perfectly happy with his penis being uncircumcised. I am also friends with men who enjoy their circumcised penises and men who are resentful of the decision their parents made about their bodies. One even confronted his parents and was angry that their response was that indeed, they did it only because they wanted him to look like everyone else.

It's not broken, so don't try to fix it and in the meantime put it at risk of being damaged. If you want to modify someone else's body, at least wait until they're aware enough to consider your reasoning and free to agree or disagree.

Exactly.
On another note, I recall my first encounter with a man who had voluminous foreskin. He was able to insert my dick into his foreskin and manipulate it in a way that let me know what sex would have felt like if I had not been mutilated. It was quite a different sensation, and this made me resent circumcision even more.

I believe that's known as "docking" ;)

There is foreskin restoration. It doesn't restore everything, but it provides a similar effect.

I've heard of docking, but never engaged in it. Hmm.

And foreskin restoration is something I have also heard of, but never delved deep into. I wonder if it works for cut men?

Docking unfortunately only works if one has a "voluminous" foreskin...

As for foreskin restoration, it depends on how much skin was left over after circumcision. But as long as there's enough (and there usually is), a restored foreskin is almost indistinguishable from one that was never cut off to begin with.

We seem to tread sensitive ground by viewing this as religious freedom vs. abstract values. How much better would this debate be if it was framed as religious freedom vs. body rights?

And while it is uncomfortable to confront religious values, I suspect that it is only such an issue here because these religious values only incidentally happen to be in line with an American social norm of circumcising baby males.

How much is female circumcision defended on the basis of its heady cultural and religious tradition?

Let's be real here. If America didn't have a normative background of being pro-circumcision, it wouldn't matter if Jews and Muslims religiously believed in circumcision.

So let's confront this for what it is: A cultural norm, even if a religious ceremony, that intrudes inherently on body rights. Given that it is NOT a medically necessary procedure (barring phimosis), it is essentially cosmetic, and just happens to be both heavily normative and religious in this country.

I seem to recall the general discussion of rights to be "Your rights end where my body begins".

Also, please don't forget that these studies that showed protection for sub-Saharan African men were SPECIFICALLY found only for heterosexual activity. A similar study for men who have sex with men was conducted and had to be ended prematurely because of the overwhelming evidence that it did NOT have a protected effect against HIV.

And so far, those studies have not been replicated with the same results in the US, and I would never take a study conducted on sexually active men with different socio-cultural practices with regard to sex, safety, and resources and apply it with a full recommendation (as many scientific and medical agencies seem shockingly willing to do) to babies and infants in a completely different country and context.

My major premise was that the lack of an exemption for Jews and Muslims means that A) If the initiative passes, it'll likely be overturned in the courts on First Amendment grounds; and B) It's caused the whole debate to focus on religious freedom rather than the tenability of routine circumcision (i.e. circumcision not performed for religious purposes or medical necessity), which I show to be an untenable cultural tradition in America using personal experience and facts. Sorry if it was a bit unclear or buried, but that's what I was getting at.

This was meant as a reply to Father Tony's comment above...

I guess the question is should there even BE exemptions? Why is it we are against female circumcision as a freedom of religious action and ceremony, but fine with male circumcision?

Both violate body rights and both are unnecessary, regardless of their motivations. A myth is that FC is perpetrated largely by men to oppress the sexuality of women, when in fact it is a procedure largely promoted by women onto their daughters out of old beliefs that it will ensure their daughter's desirability and therefore lead to their happiness. It is actually an act of love and concern, and one that increasing numbers of young men in the Middle East do not desire or agree with themselves.

But I suspect that at the end of the day, MC gets a pass because it is so normative for where we are. At the end of the day, though, normative or not, it is not different than FC and I question if we should entertain the idea of religious exemptions to begin with. This isn't an issue of an individual's freedom to practice their own religion with regard to themselves. It is an issue of an individual practicing their religion ON someone else. And no matter how close you are to a baby--even being its parent--they are not the same being. A baby is a separate being, and one who will grow into an individual with the capacity to make cosmetic body modification and religious decisions themselves at some point.

I could argue a parallel with religious exemptions for vaccinations, but I think we've pretty well established that in societies where bathing is regular, there is no practical medical need for a circumcision. Thus the comparison would be invalid.

I also wonder, as progressive individuals with religious faiths steeped with shed traditions, why are we so hesitant to look at this one practice of our faith, see it for what it is, and let it go? Jews don't all observe kosher foods, nor do they all cover their hair, or go off to cleanse themselves for 23 days following a menstrual period. Not all Muslims observe hajib or pray regular each day.

We make exceptions for the practices we either no longer find practical, ethical, or warranted in modern society all the time. It is a serious question to me why circumcisions, of all the other practices to be held in reverence and eventually abandoned in the modern era, persists as an absurdly sacred religious custom.

I think there should be an exemption. For one thing, Jewish and Muslim circumcision have long been protected under the First Amendment, just like kosher and halal slaughter (which have also been prohibited in many Western countries throughout history on the grounds of preventing cruelty to animals, though the intention was to restrict Jewish religious practice).

Despite its practice in many Muslim countries, female genital cutting is actually NOT a Muslim religious practice, but a custom that evolved separately in certain parts of the world, and the rate of complications from it is much higher than from male circumcision.

Regarding Jews who have chosen not to practice circumcision, it's important to remember that they tend to be of the very liberal sort, but most Jews continue to practice it. That's especially true of the Orthodox Jews in my neighborhood, who are very strongly religious. According to Jewish law, a boy is supposed to have his bris a little more than a week after birth, so making Jewish parents wait until their children were 18 would be a major blow to them.

But a major component of my support for a religious exemption is pragmatic. If Hess had included one, the initiative would be much easier to pass, much harder to strike down in the courts and, most importantly, it would actually get people to think critically about routine circumcision. It's perfectly valid to argue that whether a boy's foreskin should be cut off when there's no real medical benefit should be up to the boy himself and not his parents or doctor when he's not able to give informed consent.

I haven't been following the discussion around this initiative very much, and I really appreciate your analysis. You make several fine points about how this initiative is an ineffective strategic option for challenging routine circumcision. However, I feel I must offer some pushback at the suggestion that LGBT people should identify this as people putting their values into the law.

As a trans person with intersex friends, I can't help but see this as an issue of surgical alteration of genitalia without consent. And I can't help but notice the inconsistency of a medical system that advocates surgery on those incapable of consent when a bar of soap can accomplish the same goal, but engages in endless handwringing, stalling, and outright refusal to perform a life saving surgery on teenagers who not only consent but seek the surgery with parental support. Such refusal is based on the presumption that they "might" change their mind, however, there are many more folks who later regret being circumcised than there are folks who regret getting SRS.

Perhaps an initiative like this does not actually address the problem in an effective manner. But when it comes to the religious freedom argument, can that really apply if the people this surgery is being performed on are incapable of consenting to anything and have given no indications that they are choosing to engage in this religious practice? It seems like it only applies if you recognize children as the property of their parents instead of individuals with their own rights - which I don't. It's the same concept used by parents who insist on their religious freedom to force their religion on unwilling children, or in an extreme, who employee physical force to take their teenagers to ex-gay camps.

I don't think either waiting until 18 or being performed soon after birth are good options, but whatever the options are, I would really like to see some consistency in medical practices around informed consent.

Wolfgang E. B. Wolfgang E. B. | June 16, 2011 1:29 AM

I completely agree, and to me it's all about informed consent and an individual's right to absolute sovereignty over his or her own body. Even if circumcision does, in some cases, protect against STIs, it is still ethically wrong to permanently alter a non-consenting person's body through a medically unnecessary--and arguably damaging--procedure.

On another note, I recall seeing a study that found that in developed nations where condoms are readily available, intact men are more likely to use them than circumcised men.

"I can't help but see this as an issue of surgical alteration of genitalia without consent"

That's the core of it. And as a Jewish woman I'm 100% against forced circumcision of anyone without consent.

The actual facts do not support your premises at all (except about hostility to religion motivating those opposing circumcision). Here is the truth: 1) The many studies proving that circumcision reduces the transmission of HIV by over 60% are considered by the CDC and WHO to be 'definitive' and 'irrefutable'. 2) Circumcision virtually eliminates urinary tract infections. 3) Circumcision virtually eliminates fatal penile cancer. 4) Circumcision reduces fatal cervical and anal cancer in the partners of circumcised men. 5) Circumcision eliminates the risk of phimosis, paraphimosis, and other sexual and physical problems. 6) Studies have consistently shown absolutely no reduction in sexual function or pleasure - this has been repeatedly proven through studies of men who have been circumcised as adults (anecdotally, I have five friends who have done so and two say sex is improved while three say it is the same). This is the truth; it is not a matter of opinion. Please donate to www.stopcircban.com and, if you are having a son, please circumcise him as an infant.

In response to your claims:

1) The many studies proving that circumcision reduces the transmission of HIV by over 60% ...
I never addressed specifically the results of the studies on circumcision and HIV. However, even if circumcision cuts HIV transmission by 60%, condoms cut it by about 100%. Also, those studies were conducted on heterosexual men in sub-Saharan Africa and were not followed up by studies here. Obviously, circumcision would do nothing to cut the risk of transmission from an HIV+ top to an HIV- bottom. It's also worth noting that men in Japan and Western Europe are mostly uncircumcised, but their HIV infection rates are much lower than in the United States, showing that proper sex education has a much greater effect than circumcision.

2Circumcision virtually eliminates urinary tract infections.
So does a three-day course of oral antibiotics. And again, UTIs are rare in boys and men anyway.

3)Circumcision virtually eliminates fatal penile cancer
Not according to the American Cancer Society. Please see above...

4)Circumcision reduces fatal cervical and anal cancer in the partners of circumcised men
Cervical and anal cancer result from human papillomavirus (HPV, a.k.a. genital warts). As you probably know, there are vaccines available for that now.

5)Circumcision eliminates the risk of phimosis, paraphimosis, and other sexual and physical problems
These are easily treated with steroid creams or, in my case, simple stretching exercises.

6)Studies have consistently shown absolutely no reduction in sexual function or pleasure ...
I had a circumcised boyfriend who, when hard, had to literally put on his underwear and rub it up and down against his penis in order to masturbate because the skin was too tight to move, and I couldn't masturbate him the way I did myself because it actually hurt him. With another circumcised guy, I went through half a bottle of AstroGlide just to masturbate him, and it took him forever and a day to ejaculate. Please explain how that's "no reduction in sexual function or pleasure."

Alaric, regarding each point:
1) Of course condoms are critical and are much more effective than circumcision at stopping the spread of HIV and other STD's. However, as HIV infection rates in America and abroad show, not all at-risk men will use condoms consistently. We should be doing everything we can to save lives and end the pandemic.
2) It is better to prevent a disease rather than become infected and treat it later. Overuse of antibiotics is a major problem causing bacteria to mutate into more virulent forms.
3) The ACS does not deny that circumcision greatly reduces the risk of penile cancer (these data are also 'definitive'). It just does not say that this reduction alone necessarily mandates circumcision for everyone.
4) Unfortunately, the HPV vaccine is quite expensive and is not available to everyone. The same right-wingers who are trying to ban circumcision are also trying to ban vaccinating girls (and boys).
5) Again, you could eliminate having to apply creams and exercises by prevention (i.e. circumcision). Often these conditions can be quite severe.
6) While these two anecdotes are interesting, I am talking about statistically valid surveys with large representative samples. I have never heard of circumcised men having the problems you describe; these may not have anything to do with being circumcised. On the other hand (to cite non-representative anecdotes myself), I have three friends who had to be circumcised as adults because of problems with their foreskins that eliminated sexual function and caused great pain. Believe me, they all wish they had been circumcised as infants. Please donate to stopcircban.com.

In my post, I mentioned "'intactivist' weirdos," but I neglected to mention that there are also fanatics on the "pro-circ" side...

1) First of all, most cases of HIV among men in the United States are among gay men who get it through unprotected anal sex. Circumcision won't prevent anything in this regard, let along among people abusing injected drugs. And you might not be aware of this, but circumcised men who have unprotected vaginal sex can -- and do -- still get STIs, including HIV. And frankly, do you think it's smart to give a bunch of guys, especially horny young guys, the idea that being circumcised is some kind of magic talisman against STIs?

2) Again, UTIs are relatively rare and much more common among girls and women than boys and men, and they have not shown significant (if any) resistance to antibiotics; and besides, bacterial resistance to antibiotics has nothing to do with circumcision, and promoting circumcision to prevent them will have no effect on it. By your logic, we should also have routine pulling of toenails to prevent toenail fungus.

3) Again, penile cancer is very rare. Breast cancer is much more common, so do you recommend routine mastectomies for girls? And the ACS specifically said that once studies showing a reduction in penile cancer in circumcised men were controlled for men with (easily treated) phimosis and (easily addressed) problems with hygiene, the benefit of circumcision was no longer seen. As a result, the ACS no longer recommends circumcision to prevent penile cancer.

4) First of all, it's mostly left-wingers, not right-wingers who are trying to ban circumcision. Second, the fact that some people have financial difficulty gaining access to the HPV vaccine is an issue of healthcare access, not a justification for circumcision.

5) Are you actually suggesting that a painful surgery that permanently alters one's anatomy is simpler than applying creams and/or stretching? When I was 13, I was able to get rid of my phimosis in less than a week. Had I been circumcised, it would have lasted a lifetime. In general, you're really grasping at straws here, but this one takes the cake.

6) It's not just anecdotal. Most men who are circumcised have to use some kind of lubricant -- KY/AstroGlide, shampoo, vaseline, spit, etc. -- to masturbate. You think the issues with those two guys were because of some problem unrelated to their circumcisions? Don't insult my intelligence. When they were hard, the skin on their penises couldn't move -- it was like trying to jerk off a broomstick handle, and that's because when they were circumcised, the entire foreskin was removed. By contrast, all I need to masturbate is my hand -- no lube of any kind is required.
If the world's most common sexual activity (i.e. masturbation) requires use of some "third party" object or substance, that most definitely constitutes a reduction in sexual function. Duh.

Twice, you have requested donations to the campaign against the circumcision ban. Are you affiliated with it in any way?

What?! Most of those studies have been debunked, DB. Check with groups like the American Cancer Society on those claims. They're false and misleading. They're like claims from the religious right about gays - they're meant to continue a religious tradition (circumcision vs anti-gay positions) with no real basis in fact or need.

Alaric and Bil, on the contrary, these studies are considered 'definitive' and 'irrefutable'. Please read http://www.cdc.gov/hiv/resources/factsheets/circumcision.htm and listen to http://www.kqed.org/a/forum/R201106080900. Indeed, the findings from one study were so overwhelming that the study was stopped so that the uncircumcised subjects could be offered life-saving circumcisions and the data could be published immediately. Please donate to www.stopcircban.com.

Bil, on the contrary, check out summaries of some of the data at http://www.cdc.gov/hiv/resources/factsheets/circumcision.htm . The actual studies are also available through Pubmed (http://www.ncbi.nlm.nih.gov/pubmed/).

DB, following your strange logic, if I were to have my head cut off, I'd never go bald. Seriously, as Alaric points out, circumcision is a drastic solution given the other easier and less invasive options. It is clear to me that you have some other motivation fueling your trying to sell us on circumcision. The "between the lines" element of your comment glares. Wanna come clean?

Two points:
1) There is nothing 'drastic' about circumcision.
2) I am not trying to force people to be circumcised. The anti-circumcision folks such as Matt Hess are the one trying to control other people's behavior and take away the rights of parents to protect their kids. I believe it should be up to individual parents (in consultation with their doctors). As a scientist, I am just trying to point out the medical evidence as opposed to the inflammatory and false claims I have seen by some commenters here. I would no more force someone to have a circumcision than I would force him to marry someone of the same sex. I just want to A) dispel any myths based on misinformation and B) protect the freedom of parents to protect their children without government intrusion.

You're making a number of comments that call your impartiality as a scientist/doctor (assuming that's true) into question. First, you said a law mandating circumcision would be "less egregious" than one banning it; now, you're saying that removing a normal, natural and functional part of the male anatomy is "not drastic."

You claim that you're just a scientist offering information, but you've repeatedly endorsed the campaign opposing the San Francisco ban, which shows that you at least have a strong personal opinion about this, if not a substantial personal interest.

You say you would never force someone to be circumcised, yet you yourself said you had your son circumcised and required a lesbian couple that used your sperm to have that son circumcised as a condition for the sperm donation. You're contradicting yourself.

And you've ignored requests from me and Tony to disclose your motives for posting here, especially given your repeated endorsements of the anti-ban campaign.

Alaric, I described my motives in my most recent post above. Regarding choice, yes, my husband and I circumcised our own son and I asked my friends for whom I was a sperm donor to circumcise their son. However, I would never attempt to force other parents to circumcise their sons (as I would hope no one would ever try to prevent other parent from circumcising their sons).

But you did force somebody to undergo circumcision: your son, who could not offer informed consent. And you said that you made circumcision of the older biological son a "condition" (i.e. requirement) for your sperm donation, so you basically did force them to have him circumcised.

"I would no more force someone to have a circumcision than I would force him to marry someone of the same sex."

"yes, my husband and I circumcised our own son and I asked my friends for whom I was a sperm donor to circumcise their son."

See, this is part of the contradiction that I'm talking about. If I am to follow your logic here, that means that your son and your friends son don't count as "someone," to such a degree that you weren't even aware of the contradiction. The old youth rights activist in me takes great offense at that.

But in any case, my interests in this issue require me to ask you how consistent this position is. Would you please let me know:

a) Would you similarly support a parents right to have their infant child undergo non-consensual sexual reassignment surgery even when there is no medical reason not to wait until the child is capable of consenting (a practice often criticized by intersex activists)?

b) Would you support a parent's right to grant their child's request for sexual reassignment surgery if there child was, lets say 8 years old and had voiced a desire for such surgery since they were 4, and had fulfilled all the requirements for informed consent possible for someone of that age?

DB, Please. Your point "B" is funny-speak for wanting to protect parents' rights to mutilate their infant offspring with no regard for that infant's rights. Are you really saying that waiting until a man has the ability to choose for himself to be circumcised or not would really endanger his health?

I still feel that there is some motivation, some hidden factor, behind your comments here. Come clean (if you'll pardon the pun.)

My husband and I circumcised our son (14-months old today!) because the health benefits are quite overwhelming and the negatives are nonexistent (not because we wanted his penis to look like his fathers' penises). We also made it a condition for my other biological son (who is almost six years old) when I donated sperm to our friends, a lesbian couple who are awesome mothers. The health benefits are great for children so it would not make sense to wait till your son is an adult, just as you should not wait till the age of consent for vaccinations or dental cleanings. I don't think that circumcision of infants should be mandatory, but it certainly should be increased through education of parents and through mandatory health coverage of circumcision for all men and boys.

Why do you say that there is no controversy? On the Wikipedia page for circumcision http://en.wikipedia.org/wiki/Circumcision I could not find a single medical authority that recommended it being performed routinely. What authority do you have on the topic? Are you a medical doctor? Non of them saw the reasons you cited as being sufficient to warrant a recommendation, so I'm curious.

I am an epidemiologist and researcher who used to work at the CDC and has read the full studies. Everyone please read the definitive answer here: http://www.cdc.gov/hiv/resources/factsheets/circumcision.htm . Also, listen to this - http://www.kqed.org/a/forum/R201106080900. There is no doubt from a scientific perspective of the great health benefits of circumcision. Even so, many public health and medical organizations still do not say that every infant boy needs to be circumcised. They do acknowledge that is has health benefits though, along with no negatives.

If you're an epidemiologist, put your money where your mouth is, and conduct the following study:

1) Enroll 100 circumcised men and 100 uncircumcised men
2) Enroll 100 female prostitutes who are known to have sex without condoms and whose STI/HIV status is either unknown or who are infected with an STI/HIV
3) Get each group of men to have vaginal sex with as many of the prostitutes as possible, but have the uncircumcised men do it with condoms and the circumcised men do it without condoms
4) See how many guys in each group wind up infected with something
5) Conclude that condoms still provide greater protection than circumcision

Alaric,

We would never encourage any respondents to engage in high risk behavior. Indeed, we include prevention messages and dispense condoms in HIV and STD-related studies to both the study and control groups. There is no question that condom usage (if done correctly and consistently) is more effective than circumcision. My conclusion, and that of the researchers involved in the studies referenced by the CDC and WHO, is that, controlling for all confounding factors such as condom usage, circumcision dramatically reduces the transmission of HIV. I wish all men who are not in long-term mutually monogamous relationships with an uninfected partner would use condoms every time they have anal or vaginal intercourse. Unfortunately that is not the case. Circumcision is not the best or only way to end the HIV pandemic, but it can certainly help.

You acknowledge that condoms prevent the spread of STIs, so what's the point of using circumcision in the first place? Some men fail to use condoms in the heat of passion or because they're intoxicated. But generally, improper condom usage or lack thereof is the result of poor sex education and a generation of kids being taught that the only way to prevent STIs is abstinence, without being taught how to use condoms. That's why telling people that circumcision will prevent STIs creates a very plausible risk of young circumcised guys taking that as a license to go out and engage in risky sexual behavior.

As I did in the post, I'll point out that other developed Western countries where circumcision is rare -- like Western Europe and Australia -- have much lower rates of HIV infection than the United States. Obviously, they're doing something that we're not, like offering kids proper sex ed.

Promoting circumcision to prevent STIs is just an excuse not to do the same in this country so that we Americans can go on being squeamish about sexuality in general.

"... because the health benefits are quite overwhelming and the negatives are nonexistent ...

OK -- so what exact health benefits are "quite overwhelming"? We are all adults here, and can handle the info whatever it may be.

And isn't the testimony from adult men who wish they hadn't been circumcised, enough of a "negative" for you to think carefully? In my book, your claim that "negatives are nonexistent" has already been disproved.

What hasn't been mentioned here is parental rights over the medical care of their young children -- I won't go into it, but that is an American "sacred" principle that many politicians wouldn't want to go up against.

= = = = = = = = = =

Finally, if there is a religious exemption for Jews and Muslims, then I am sure there will be Christians, probably fundamentalists, who will insist they be included in the exemption, citing Bible verses.

Actually, one can cite Bible verses to argue either way. Specifically, during the first Christian century there was a debate about whether gentile Christians should be required to observe the Jewish holiness codes [= see Wiki: Circumcision controversy in early Christianity =] and to make a long story short, it was decided at the Council of Jerusalem in 50 A.D. that for gentile Christians circumcision would be voluntary. Apparently, the Christian gentiles were given the religious exemption which is logically converse to the exemption we are here discussing for the San Francisco initiative.

Moreover, the Apostle Paul was vehemently against circumcision, writing: "Mark my words! I, Paul, tell you that if you let yourselves be circumcised, Christ will be of no value to you at all." (Galatians 5:2). (Even so, no Christian denomination today is known to reject members who are circumcised.) [Wiki, loc. cit.]

On the other hand, Genesis 17:9-14 includes the commandment to the Jews to be circumcised, and states that these commandments are "eternal" and that "No uncircumcised man will be one of my [God's] people." (Verse 14)

So, as is so often the case, one's viewpoint depends upon which Bible verse you want to cherry-pick. In other words, baby boys should be circumcised for the same reason that God hates shrimp.

charlotte | June 16, 2011 6:10 AM

It boggles my mind that this issue is even controversial.

For those who think it's okay for parents to non-consensually mutilate their child, I have not heard anyone give a direct answer to the following:

1. As A.J. and Alaric stated, what overwhelming health benefits do circumcision give that cannot be more simply and effectively addressed by condoms, water, and education?

a. Bonus follow-up: if you are citing any study about HIV transmission, would you agree with making the age of consent for circumcision the same as that for sex?

2. There are (even in this very thread) people who wish they had not been circumcised as an infant. Please explain why it was a good idea to circumcise them when they had no say in the matter.

charlotte, are you really suggesting that access to safer sex and protection from STD's (such as circumcision) must wait until someone is age 18? So, parents should not be able to vaccinate their kids for HPV, Hepatitis A, and Hepatitis B till their eighteen? I guess you also believe that children who are not 18 should not be allowed to have access to condoms, morning-after pills, birth control pills, and sex education.

Are you really suggesting that a big strawman argument is an effective way to advocate your position?

On the contrary, it is the same issue. Do parents get to make health care decisions for their children or does a conservative 'Big Brother' government? This is specifically relevant in the case of the examples I gave; there really are people trying to prevent those below the age of consent from getting access to STD prevention (such as circumcision, condoms, and the HPV vaccine).

DB, even most people on the religious right have long since had a change of heart and come out in favor of the HPV vaccine. Those opposing it and trying to deny access to it are a very, very tiny minority.

Alaric, Those opposing circumcision and trying to deny access to it are also a very, very tiny minority. Regarding the HPV vaccine, it is still not covered by most health insurance and is still not recommended for boys and men at all. The percentage of girls in the target age groups being vaccinated remains quite low and for boys it is nearly infinitesimal (I will definitely have my son vaccinated for HPV though - even though he will still be too young for informed consent). The controversy on the HPV vaccine does persist though (see http://jama.ama-assn.org/content/302/7/795.full?home from 2009 and http://video.foxnews.com/v/3908753/gardasil-controversy/ from late April 2011). JAMA is an extremely respected journal. Fox News of course has no connection to science or truth but they are influential in terms of public opinion and can affect the health practices of their viewers.

DB, what you're talking about with regard to Gardasil are issues of healthcare accessibility, and the fact that you're advocating circumcision to make up for current difficulties in obtaining it shows that you're really grasping at straws to defend your position.

It is intellectually dishonest to pretend that there are no other issue involved than a health care decision. If circumcision had no other effects than to prevent disease then people would be all for it and you know that.

Comparing circumcision to dental cleanings is absurd. A better comparison would be something like forcing a child to get a rhinoplasty so they can "improve their breathing." And anyone still bringing up inoculations, even after the case against them causing autism has been completely discredited, is just being disingenuous. Polio is a reality... all the horrors of non-circumcised men is a sick fantasy. Most of the western world doesn't encourage circumcision and their genital health is certainly no worse than ours and their boy children haven't been brutalized by this archaic practice.

The problem with SF's approach to circumcision is not the lively discussion of the issues involved. It's the ill-advised decision to legislate a complex personal issue. While many will reject the parallels with the abortion debate, they are all too obvious to ignore. So if circumcision is to be decided by referendum, then it's legitimate to rule on the legality of abortion, locality by locality, in the same manner? Personally, I believe that a fetus is indeed a human being, and, if I were a woman, I imagine that I'd be extremely loathe to have an abortion. But I remain adamantly pro-choice because I could never imagine imposing my view legally on millions of women and couples. In the same way, I respect the views of people who find circumcision to be undesireable and even barbaric and choose not to perform it on their own child, but I'm appalled that they would seek to legally intervene in my life. I am a Jewish man who circumcised my son. It was deeply important to me. If it had been illegal in my jurisdiction, I would have gone to another jurisdiction. If it had been illegal there too, I might have resorted to a "back-alley" circimcision, just as women used to have to resort to "back-alley" abortions. Is that a road we really want to go down? If we are to accept Father Tony's suggestion that Orthodox Jewish children wait until they are 18 to decide if they want to be circumcised, then it's equally logical to posit that people wishing to abort their fetuses must allow those fetuses to be born and reach the age of 18, when they can then decide for themselves if they wish to be aborted. If removal of a piece of skin should require such consent, then removal of the entire child should certainly require it. This is where I see san Francisco heading.

Actually you've misplaced your parallel. The issue is consent of removal of something from ones own body, so the infant that's having his foreskin removed from his body is parallel to the mother having a fetus removed from her body. There is no contradiction because the issue is the bodily autonomy of full individuals, not potential individuals.

Ugh, I meant to say "woman" rather than "mother". Fell for the pro-life rhetoric there for a sec.

No, Sas, my parallel is not misplaced. You've simply decided not to deal with it, apparently because you've also decided not to deal with the inconvenient fact that tens of millions of people believe that a fetus is a complete individual and not a potential individual. This is simply denial. If we all agreed on the underlying issues involved in these controversies than there'd be no arguments, would there? The challenge is to recognize that we passionately differ on the fundamentals and yet still find a way to live with each other without bitterness. Criminalizing people who seek either abortions or circumcision is hardly the way to accomplish that.

I would add that I often find a great deal of simple nonsense involved in this debate. While I know that some genuinely feel that circumcision is mutilation, those who facilely compare it to female genital mutilation simply don't know what that practice entails. Even in its mildest form, it often leads to a lifetime of pain, a complete loss of sexual pleasure, and the premature death of the little girl involved. In its more extreme form, it involves sewing up the vaginal opening, causing a lifetime of intense pain, agony upon intercourse, repeated and severe infections, and an inability to maintain vaginal hygiene. The comparison is either ignorant or disingenuous.

In addition, the frequent use, with apparent relish, of terms such as primitive, superstitious and barbaric when referring to the circumcision practices of observant Jews betrays an animus that crosses over into genuine bigotry.

On a lighter note, my own experience simply does not match that of some others involved in this debate. I'm a circumcised man who has always enjoyed intense sexual pleasure and who still does at 62. I've slept with many men, both circumcised and not, and, to paraphrase Will Rogers, I've never met a penis I didn't like. For me, it's definitely a case of Vive la Difference.

Since I didnt mention female genital mutilation, I don't see what you hope to gain by refuting an argument I didn't make.

As for not dealing with things, I explained why your parallel does not work and you ignored it. A woman and an infant are individuals who have bodily autonomy, a foreskin and a fetus do not. I realize that many people maintain the belief that a fetus is a full human being with the same ethical rights as a born person; it is just completely irrelevant because a woman cannot be forced to let another person use their body against their will. We don't let ANYONE do that.

The comparison to abortion is spot-on, I think.

I'm an atheist, and I'll admit a lot of religious ideas -- including circumcision -- don't make a lot of sense to me. But I realize they make perfect sense to someone who's Jewish, especially in the case of Orthodox Jews, who tend to be a strongly religious lot (I frequently see them on the subway muttering their way through Hebrew prayer books and carrying big, heavy volumes of the Talmud to read on the way to work).

Basically, as long as they don't start telling me that I can't marry a man and that I have to follow kashrut law and get circumcised, then I can live and let live.

Eli, One small point...I wouldn't call it 'SF's approach'. Every single elected official here in the City, along with all civil rights and public health groups, is opposed to this initiative. Despite the highly inflammatory and misleading wording of the initiative, I don't expect it to win many votes in November. There is no way to know, as I have not seen any polls on the initiative. However, I live in the City and have discussed the initiative with several people, including at least one uncircumcised guy, and have not met a single person who supports this anti-choice ban.

Thanks for making that point, DB. It was unintentionally ignorant on my part to tar a whole city on the basis on one initiative not yet voted on.

Wolfgang E. B. Wolfgang E. B. | June 17, 2011 6:41 PM

Eli wrote, "Personally, I believe that a fetus is indeed a human being, and, if I were a woman, I imagine that I'd be extremely loathe to have an abortion. But I remain adamantly pro-choice because I could never imagine imposing my view legally on millions of women and couples."

I must admit that this is the best argument I've yet seen from the anti-consent side. But there are significant differences between abortion and circumcision. In the case of a pregnancy, two bodies are involved, those of the woman and the fetus. Pregnancy can put a woman's health or even her life at risk. In such a case, she needs to be free to choose abortion to protect her own health. Conversely, circumcision only involves one body, that of the infant. The presence or absence of his prepuce does not have any potential impact on the bodies of his parents.

Pregnancy affects everybody. If a woman is forced to bring a child whom she is unable to care for into this world, who foots the bill for that child's care? There is no parallel to this in the circumcision debate.

If preventing STIs is the main concern, why not remove the entire penis? If everyone did that, it would probably lead to the extinction of every STI causing microbe on the planet, and eliminate unplanned pregnancies as well. Of course, it would also severely diminish sexual pleasure...

Eli, Yes, you can check out a partial list of declared initiative opponents at http://www.stopcircban.com/coalition.htm. As with the state-wide Prop 8, it does seems we may want to consider adding constitutional filters to state, county, and city initiatives in California, but for now there is not a particularly high bar to get propositions on the ballot. Incidentally, there is also a petition going around town to put an initiative on the 2012 ballot to make infant circumcision mandatory (also a ridiculous and anti-choice invasion of privacy if less egregious in its substance).

A law mandating circumcision would be "less egregious" than one banning it? A statement like that raises serious questions, DB, and makes me wonder what your motives here are.

You've said you're an epidemiologist and researcher who used to work for the CDC, but you haven't given any details about who, exactly, you are or what your current professional activities are. That, in and of itself, isn't too important, and if you prefer to remain anonymous, I don't mind.

However, you've repeatedly made references to the campaign against the current initiative and requested donations to it. Please disclose what your relationship with the campaign is.

I'll state for the record that I'm just a writer with an opinion, and though I have a day job, the opinions expressed in this post are completely independent of it.

Alaric, I only mentioned that I am an epidemiologist because one commenter had asked whether I had relevant expertise. I am not speaking for my current employer (also a public health agency) or for the CDC. To be clear, there are medical benefits from circumcision that are not disputed in the field, but they do not rise to the level that universal infant circumcision is a recommendation by most agencies either. Regarding the Committee for Parental Choice and Religious Freedom website, I have neither contributed to them nor volunteered for them, but thought that readers might want to get involved or read more about the issue and thus provided the link (I heard about them during the KQED Forum show to which I also provided a link). If this were a post about, for example, the possible pending vote to legalize marriage in New York, I might have posted a link to http://www.meny.us/. And yes, I do think that a mandatory infant circumcision law would also be egregious, as is the infant circumcision ban.

You didn't just give links to the Committee for Parental Choice and Religious Freedom, you repeatedly requested donations to it. Whether you're volunteering for it or not, this indicates a clear political motive on your part.

Despite the relatively nuanced tone you take with this comment, you also previously wrote "[If] you are having a son, please circumcise him as an infant." So you're obviously strongly biased in favor of circumcision, thus leading me to conclude that your goal is to advocate for it, not just to educate people in your capacity as a public health expert. This is further evidenced by the fact that you said mandatory circumcision would be less egregious than a circumcision ban; I would view both as equally egregious.

Medical benefits from circumcision? Two of those -- UTIs and penile cancer -- have been debunked, and it's common sense that condoms offer protection against STIs several times greater than circumcision, such that unless you can prove that circumcision reduces the risk of STIs/HIV at a rate comparable to or in excess of that of condoms, studies showing it reduces the risk are basically irrelevant.