Sunday, November 20, 2011

Neonatal Male Circumcision: Harmless Tradition or Child Abuse?

For the purposes of this blog post, I am defining ‘neonatal male circumcision’ as the ‘nonreligious tradition of surgically removing the foreskin from a male newborn baby’s penis as practiced in American hospitals’. Let me just say that I firmly believe that circumcising a male infant is wrong. Period. It’s really an issue of consent for me. The infant cannot consent to having a piece of their penis cut off. I really cannot think of any significant reason why infants should be circumcised. I think it’s just another way for medical practitioners to make a little money and just another tradition that most people follow without truly thinking of the their reasons for doing so. In this post, I am going to list three of the most common arguments for male circumcision that I have heard personally and then I will pick them apart. Enjoy.

Common Arguments for Neonatal Male Circumcision:

  • Protection Against Future STIs


In their meta-analysis of multiple research studies, “How Does Male Circumcision Protect Against HIV Infection?,” Robert Szabo and Roger V. Short state that “…circumcised males are two to eight times less likely to become infected with HIV. Futhermore, circumcision also protects against other sexually transmitted infections, such as syphilis and gonorrhea…” (1593). HIV is thought to initially attach to CD4 and CCR5 receptors found in genital and rectal mucosa and much of these receptors are found in the foreskin of the penis. So the assertion that circumcision has the potential to act as protection against STIs is valid. However, there are confounds to this research. Most of the research that focuses on male circumcision and HIV are conducted in Africa with adult men. As Robert S. Van Howe asserts in his article, “A Cost-Utility Analysis of Neonatal Circumcision,” “The HIV pandemic in Africa demonstrates distinct epidemiological differences from the outbreaks in North America or Europe. For example, most infections in Europe and North America are transmitted by nonheteroexual means” (591). Stephen Moses et al agrees, “It has been pointed out that different sexual practices or hygienic behaviors can confound the association between circumcision status and HIV infection…different risks of becoming infected may be due to behavioral factors, not circumcision status” (369). In short, it would be inaccurate to take research conducted in Africa and try to apply it in America. The cultures, traditions and sexual practices differ. For example, in Africa, HIV is mostly transmitted though heterosexual PV intercourse. In contrast, MSM (men who have sex with men) are one of the main high-risk groups in the US. Also many of these studies conducted in Africa are with adult males who are already deeply embedded in a widespread HIV pandemic, not currently seen in the US. One major thing easily overlooked in this research is the role of condom-use. Although, in the studies conducted in Africa, condoms are readily available to the participants, it is admitted that most of the men “never used condoms, and condom use did not seem to influence the rate of transmission of HIV” (Szabo and Short 1592)”. Of course, condom-use did not influence the rate of HIV transmission. They were not being used! According to the CDC (Center for Disease Control and Prevention), “Laboratory studies have demonstrated that latex condoms provide an essentially impermeable barrier to particles the size of HIV... [and] particles the size of STD pathogens”. Condoms protect against HIV and other STIs. Is surgery really necessary? Those who support neonatal circumcision as a preventative mechanism against HIV in America are basically using the argument: ‘Circumcising a male infant will probably protect males from possible future transmission of STIs if your son decides to have unprotected sex’. Neonatal male circumcision costs, on average, between $200 and $400. Condoms are given out freely at any healthcare facility and college. How is it in any way preferable as a parent to spend at least $200 on a painful surgical procedure to protect your son from possible future STIs when the same protection could be given for much cheaper with a condom and a lesson in proper bodily and sexual hygiene? And, for that matter, how can one ever be certain that one act in infancy will really protect adult men against anything in the future? The individual has an entire life’s worth of behaviors to confound any kind of neonatal protection. And let me restate, the baby is being put through a painful procedure that they cannot consent to. If it is not ok to cut off a piece of an adult’s anatomy without their permission, why is doing it to an infant perfectly fine? If an adult male wants to be circumcised to lower his present risk for HIV by undergoing this procedure, than that’s fine. That’s his decision. However, putting a male infant through a painful (and costly) procedure that may or may not protect him for possible future STI transmission is sick in my opinion. Also there is a risk of complications, like accidental (further) mutilation of the genitals, infections and, rarely, death. The risks, at least in my opinion, outweigh the benefits of possible future protection.

  • Aesthetics


People seem to be concerned about whether or not a penis is circumcised for aesthetic reasons, i.e. circumcised penises are believed to look better. Let me tell you a secret: All erect penises look the same. Problem solved. Cutting off part of your infant’s genitals just because you think they will be more sexually appealing in the future is disturbing. Please stop thinking the aesthetic appeal of your infant’s genitals.

  • “Oh, they won’t feel/remember the pain.”


Really? Although at first glance, their status is questionable, newborns are definitely humans. Therefore, they have nerves and they can feel. In their article, “Circumcision Practice Patterns in the United States,” Howard J. Stang and Leonard W. Snellman reveal, “all too frequently, the physician performing the circumcision denies the infant the benefits of anesthesia because of inaccurate perceptions of the risks of anesthesia or denial that the procedure warrants such amelioration of pain” (3). The idea that infants are denied anesthesia just because it is assumed that they probably won’t feel the pain is troubling. And as for the belief that circumcision is ok because the infants will not remember the pain: So I can hurt anyone I want as long as they forget about it later?

Males should be allowed to make the decision of whether or not to be circumcised on their own when they are adults. At the point of adulthood, they will be able to assess their own risk for STIs and will make the decision of whether or not to be circumcised. In an area facing an HIV pandemic, like Africa, where condoms are simply not being used, than it is easy to see why circumcision could be a viable option for adult men who want to lower their risk while still having unprotected PV sex. However, in the United States, where condom-use is mostly encouraged and there is better access to sexual health education materials, neonatal circumcision is unnecessary. Also it is extremely interesting to compare Western views regarding male and female circumcision, also known as Female Genital Mutilation, (I’ll make a post about this at some point in the near future). Nearly everyone in the US will agree that FSM is wrong. Most people will say it’s a nonconsensual act that causes physical and psychological scarring to innocent young girls. However, these same people will argue that male circumcision is perfectly normal and safe ‘in the right hands’. So what’s the difference? At the end of the day, a child is still getting parts of their genitals chopped off without their consent. Is it just because it has become a tradition in Western society? And are parents being properly informed of the extent of the benefits and risks of circumcision? Doctors should inform them of current research and give them the information needed to make educated decisions. And parents should not take every single thing their doctor says as law. Do some research. Weigh the pros and cons and make an educated decision. An infant should not have to suffer just because of possible future STI transmission and shallow societal aesthetics.




2 comments:

  1. The problem with this argument is that it brushes aside both (a) religious practice, which is protected _unless_ it is found to be child abuse (compare the Branch Davidians at Waco, Texas; the SeaOrg of Scientology, which was raided in the 1980s after minors as young as eight years of age were found working off the sin of the beings they had been in their past lives in L. Ron Hubbard's "Rehabilitation Rundown Centers" (translation: "Concentration/ Forced Laborious Camps"); the Children of God, who encouraged minors to have sex with their siblings, so that they could keep power within the Founding Families), so that, if circumcision of infant males were classified as abuse for any group, be it secularly or religiously defined, it would be judged abusive for any and all parents to circumcise their infant males. Equal Protection mandates this.

    And (b) you don't seem to take into account that many to most of the persons leading the charge against circumcision and "finding scientifically," in their studies, that P or Q about circumcision is harmful, have agendas of their own, which are usually (ahem) "Masculinist" in nature, which is to say that they give credence to the Freudian notion that they are monumentally passive-aggressive because their mothers were "Castrating Females," and their "reminders" of this are that their mothers sometimes told them that they were wrong, and that their matrilineally-determined religious heritage demands the sacrifice of a foreskin as proof of their parents' intention of raising them Jewish. Also, if I recall correctly, one of the leaders is Heidi Fleiss's father, who started his "earnest crusade" when his daughter's notoriety began to wear off.

    There is also the matter of hurt: We give children vaccinations and draw blood for tests all the time. We also force them to undress for a stranger in a white coat who prods at them and make them open their mouths for another who sometimes cannot avoid making them gag, and must, as part of the procedure, make them hold a toxic and poisonous-tasting mixture in their mouths so that their teeth won't rot out before they're eighteen.

    If doing all that spiritual and psychological harm is necessary beyond discussion so that a greater social need may be served, then why so much fuss when the hurt is done to a specific body part that we in the West retain some taboo about (I.e. the genitals of a male child) in the service of a Primary Need, the Need To Belong?

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  2. Hello leatherargento! First of all, thank you for reading my blog!

    A) Honestly, the reason why I decided to not discuss religious motivations for circumcision in this post is that I am an atheist and already very biased in terms of religion. I want to keep discussions in this blog focused mainly on sexuality and I didn't want my biases for or against anything else to take away from the main topic at hand. I will only discuss religion when absolutely necessary and with the proper personal disclosure so everyone knows where I stand.

    B) Admittedly, I don't know about the other agendas of these people who don't support male circumcision. Please give me a list of them so I can do some research myself. I'd love to learn more about that. However, it can also be argued that doctors who support circumcision have the hidden agenda of wanting the extra $200-$400. Comparing circumcision to vaccines seems a bit flawed to me to be honest. Vaccines and visits to the dentist (if that's what you are describing) have more immediate and more reliable benefits. Without regular trips to the dentist and proper dental hygiene, a child's dental health will go south pretty quickly. I wouldn't have to wait until they were well into adulthood to see if the procedures might be helpful. Also vaccines have eradicated diseases like polio and have been proven to be extremely effective. As I stated before in my post, neonatal male circumcision's benefits are not immediate or guaranteed. The research is based on correlations that were discovered with adult men in Africa (the study populations being compared [babies in the US and adult males in Africa] are so drastically different that they cannot be sufficiently compared). There have been no (to my knowledge) longitudinal studies in the US (or another similar Western society) that have shown that male babies who were circumcised are sexually healthier as adults than uncircumcised males. My problem with neonatal male circumcision is that the supposed benefits are not statistically and practically significant enough to force an infant to go through the painful procedure. This isn't a guaranteed protection and the child could be suffering for no reason. It also doesn't make sense to put a child through all of that when condoms are cheaper, not painful and are pretty much guaranteed to protect against STIs. Here is the stance of the American Pediatric Association: "Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision. In circumstances in which there are potential benefits and risks, yet the procedure is not essential to the child's current well-being, parents should determine what is in the best interest of the child. To make an informed choice, parents of all male infants should be given accurate and unbiased information and be provided the opportunity to discuss this decision. If a decision for circumcision is made, procedural analgesia should be provided." (http://aappolicy.aappublications.org/cgi/content/abstract/pediatrics;103/3/686)

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