Category: Circumcision

Note the lack of self-examination from this story:

“There’s a lot of anti-circumcision propaganda that has affected doctors. These anti-circumcision people have killed a lot of people with their nonsense.” – Brian Morris, Australian scientist

Unless Morris can back up his statement with evidence, I’m going to suggest that he may be engaging in the same type of propaganda he believes opponents of unnecessary genital cutting are engaging in. More so, since the death of infants as a direct result of circumcision is provable with examples, while his assertion that people are guaranteed to die unless males have routine, non-medically indicated circumcision as an infant forced upon them is inherently unprovable.

Free Republic links to the flawed ABC News story I discussed a few days ago. There’s nothing to go on, since it’s exclusively an excerpt, so I want to highlight reader comments. A couple were intelligent but most are uninformed garbage. For example, this from user NonValueAdded:

Apples and oranges, friend. Cutting off a little skin is very different from injecting a virtually untested drug into a prepubescent child. Signed, DES baby. (Keep that in mind if you want to tell me how safe the new vaccine might be.)

When making comparisons, if one side is bad, the other side must be good. Injecting a “virtually untested” drug is much worse than the commenter’s opinion that is circumcision is just cutting off “a little skin.” It’s apparently not possible to be against both and accept that forcing either intervention on a child is fundamentally wrong. Debate must have a pro-position and a con-position.

Next, from dangerdoc:

Uncircumcised babies or their hygene [sic] motivated mothers pull the foreskin back, there is some swelling, the foreskin gets stuck in the retracted position and cuts off blood flow to the glans. I’ve never seen amputation as the result but I’ve seen some severely inflamed members and a few emergent surgeries.
…

There is risk to having an intact foreskin in the early pediatric years.

Before anything else, I refuse to respect a doctor who discusses the penis as the “member”. But to dangerdoc’s example, there is risk to having a parent ignorant of the proper care of normal human genitals in infancy. The blame in that case rests with the parent, not biology. Parents have a responsibility to care for their children. That means not retracting the adherent prepuce of an infant child. Circumcision is not a valid option for disposing of that responsibility. Every doctor should know this basic fact.

The winner in all the irrational comments, though, is Canticle_of_Deborah. First, this:

but to allow the children to make that decision when they reach age 18.

Uhh, what adult male is going to voluntarily undergo this procedure? It’s much faster and easier medically and psychologically to perform this on an infant. I’m female and I cringe for any adult man who has to have this done.

She does not, however, cringe for the infant males who don’t need it but have it done to them anyway. She also ignores that approximately 3 in every 1,000 intact males choose circumcision out of necessity or desire after reaching the age of majority. But she’s convinced that it’s better to circumcise all 1,000 at birth to save those three the cringe-factor as adults. Remember, it is medically necessary for only a subset of those three.

Still, I demand proof that it’s easier psychologically. The adult male’s ability to choose and understand the procedure is significant when compared to the infant’s inability to choose or understand. But Canticle_of_Deborah doesn’t much care for choice.

I believe there is an increased risk of urinary tract infections in uncircumcised men as well. I don’t think it’s worth delaying the procedure. Adult men are not going to have this done voluntarily.

She offers no context for the increased risk before deciding that it’s not worth waiting. Especially when adult men might choose something different for their bodies than what she would choose for their bodies.

Free Republic bills itself as “The Premier Conservative News Forum”. Cutting the healthy genitals of infants is the least conservative stance possible in the circumcision debate.

Wired’s Science Blog commented on the circumcision study I mentioned last night that allegedly clears up the controversial position that circumcision affects sexual sensation. In an intelligent twist, the writer agrees with me.

They criticized the study for not testing the sensitivity of the actual foreskin (which does seem like a bit of an oversight).

A bit, yes.

And then there’s the methodology:

They tested the sensitivity by having the men watch porn and then…

Might the use of porn make a difference? Not all men care for porn, so is one stimulus sufficient for the realm of human (male) sexual response? Did all of the men view the same porn, or did each man have a selection to meet his preference? Was the study group self-selected? Did the men in the study like their individual circumcision status? Was there an element of kink involved for the men in being studied? Can you think of any other questions that might factor into the study?

I’m not questioning the methodology here, because this is all I know of it. While the questions above may be – and probably are – easily answered, there are several glaring flaws that can never be explained away. What relevance does the study have to circumcision when the study didn’t research the foreskin, the anatomical part removed during circumcision? And what relevance does the study have in America, where the circumcision issue is an ethical dilemma? The circumcised is almost never the person choosing the circumcision. Let’s start there instead of looking for explanations that our ethical violations allegedly (and preposterously) don’t result in physical changes.

From the beginning I knew this story would be a logical disaster. From the title (“Study: Circumcision Doesn’t Reduce Sexual Sensation”) to the opening paragraph, this will cause trouble.

Controversial new research casts doubt on the long-held belief that circumcision reduces sexual sensitivity for men who have undergone the procedure.

Unfortunately, there is no “long-held” belief that circumcision reduces sexual sensitivity. Most Americans hold the opposite belief, that circumcision causes no change. When people in that large group concede that it reduces sensitivity, this is generally viewed as somehow good because it’s assumed to mean longer times to climax. That’s a subjective valuation, and I don’t remember when subjective valuations became fact.

The story continues:

Now, in a Canadian study appearing in the most recent issue of the Journal of Sexual Medicine, researchers found that the glans, or head of the penis, is just as sensitive on a circumcised man as on an uncircumcised one.

Let’s assume the findings are correct. I haven’t read the study or assessments of the methodology, so I’ll temporarily conceded the point, for the argument. So? Circumcision targets the foreskin, and the majority of the foreskin is removed during circumcision. Not the glans. (Usually.)

Based on factual understanding of the surgery, this study fails to analyze the proper context. Circumcision removes the many nerve endings that exist in the foreskin. Might this possibly, somehow, just maybe affect sexual sensation?

While psychologist Kimberley Payne, one of the study’s authors, said the research seems to refute the idea that the foreskin keeps the penis sensitive, she was hesitant to draw a broader conclusion from her study.

“This just scratched the surface, and there is so much more to look at,” she said.

No kidding. Like ethics, for starters. But I also addressed a study, with due caution, that demonstrated the opposite of this study. Who to believe is the question being thrown around, instead of what. For example:

But both Payne and [June Reinisch, the former director of the Kinsey Institute] criticized the Van Howe’s [sic] study, which was funded by the anti-circumcision group the National Organization of Circumcision Information Research Centers, as biased.

“Scientific study must be conducted dispassionately and without bias. The motivation of this group is highly suspect,” said Payne.

I’m going to assume that motivation was simply poor word choice. The motivation – ending forced genital cutting without medical need – is not suspect. Question potential methodological errors that permit a preferred conclusion, if you want. That’s worth debating. But Reinisch might want to undergo a little self-examination.

As for the failure to measure the foreskin’s sensitivity, Reinisch said that was irrelevant, as it rolls back from the glans during arousal.

“The foreskin’s job is to cover the penis and protect it,” she said. “Its job is not to be a part of the sensitivity.”

Let’s pause here. She is wrong. During intercourse, does a man insert his penis only until his glans is stimulated, or does he actually insert further because the foreskin (remnant) feels good? Seriously, is Ms. Reinisch going to assert the former? Is she also unaware that the glans can move in and out of the foreskin during intercourse, if the man still has his foreskin? What might occur there?

“Of course nerve endings are lost,” she said of circumcision. “The question is: Does it make any difference in satisfaction? In pleasure?”

Oh, that. Remember, of course, that this study only looked at the glans, which is not removed during circumcision. But she can draw conclusions with the painfully obvious questions pertinent to circumcision still unanswered to her satisfaction. Still, only NOCIRC is biased pre-disposed to its own conclusions.

“Nature has certainly provided an enormous amount of sexually sensitive tissue,” [Reinisch] said, calling the brain the most powerful sex organ of all.

“I’m not suggesting everyone be circumcised,” said Reinisch. “I’m suggesting that there are some benefits. I believe it’s really a personal choice.”

The value of the potential benefits are subjective, but I won’t get sidetracked there. I agree that it’s really a personal choice. But the inevitable result of this study is that some parents will circumcise their sons because circumcision “doesn’t reduce sexual sensation.” That isn’t personal choice. That is parental direction. There is a difference. I wonder if Ms. Reinisch will concede that.

P.S. Click here to see the image that ABC News attached to the story. It’s sinister enough that I think it might make people pause a bit, except I think it’ll be seen as funny. You know, cutting genitals is funny. Hahaha. No?

Following on recent examples, The Forward posted a story about Jews who choose not to circumcise their sons.

A few months before his son was born, Thomas Wolfe of Wheeling, W.Va., consulted the rabbi of his Reform congregation to discuss plans for the baby’s circumcision. “I had the perception that a circumcision was just an innocuous procedure, with no risk,” he later told the Forward. After the rabbi had recommended that Wolfe find a ritual circumciser, or mohel, to perform the newborn’s bris, Wolfe did a little Internet research. “It wasn’t really until that time that I became aware of all the controversies,” he said.

The article is mostly good, although the concluding quote is an absurd abuse of logic I’ve addressed before. (I can’t find the link right now.) Still, it should become apparent that not all Jews are circumcising their sons.

It isn’t, judging by the comments left on the article. Or, I should say that many Jews believe that Jews who reject circumcision aren’t really Jewish anymore, either because they’re not following this particular commandment or because they’re not practicing Jews in other regards. It’s strange that this is the one that matters, and that it’s impossible to reject it, even though there are many actions prescribed by the Old Testament that are no longer followed because they’re not consistent with modern understandings of rights and facts. Instead, we’re stuck with something like this, from Bill in the comments:

Frankly, I am shocked that a man could hate his son and the children of others, so much as to deny him the medically established protection of circumcision!

Especially to make this denial at a time when the media is filled with mention of HIV/AIDS and the fact that circumcision is a proven transmission preventative – just as it has proved to be in the case of many other STD’s.

If you don’t cut your children sons, you hate them. If you advocate against others cutting their children sons, you hate their children sons. Ignore the obvious truth that routine/ritual infant circumcision is surgery that is not medically indicated. You hate your sons unless you cut them because you’re denying them now (even though they can still choose later).

Or they can achieve the same results with less invasive methods. There might be options other than circumcise and don’t get HIV or don’t circumcise and get HIV. Just because I advocate against infant circumcision does not mean that I want people to get HIV. I’ve been accused of that more than once, and it’s the same shallow, unintelligent thinking.

Personally, I’d rather teach sons (and daughters) that safe sex is far more effective at preventing HIV and STDs than genital cutting. I’d also teach them a healthy dose of skepticism in believing the latest fantastical scientific breakthroughs reported by the media. Reporting doesn’t imply they’re false, but it doesn’t guarantee that they’re correct, either, or that they’re reported in the proper context. A 50% reduction may sound amazing, but when it’s a 50% reduction of a 1% risk, it’s not nearly as exciting. Shouldn’t we question why that 1% risk is always ignored?

There is some common sense in the comments¹. From S.K.:

Having been born in the Soviet Union, my parents did not give me a bris out of fear of the authorities. Upon arriving in America, I proudly had a bris in a hospital.

It was painful, but worth it. I’m sure that if given the choice, the majority of the uncircumcised children of these ultra-Reformists would also opt for a bris when they get older. The bris is our covenant. It’s a permanent reminder of who we are.

I get the impression that S.K. is advocating for infant circumcision. If so, he is wrong, no matter how much he values his bris. However, I’ve said what he said in the second paragraph. If we refrain from cutting Jewish infants, a majority of them would likely have themselves circumcised. It would have meaning and value to many Jewish men. I don’t reject that or seek to prevent that. Adults should remain free to do to their own bodies whatever pleases them, for whatever reason.

If circumcision has religious meaning to an adult male, he should do it. If it has cosmetic value to him, he should do it. If it’s merely a time-saver during his daily shower, and he thinks that is worth more than his foreskin, I don’t care what he does. I am only against forced genital cutting without medical indication². In America that means infant circumcision, for whatever social or religious reason.

¹ There is also a great deal of irrational thinking. Shriber stated:

Infants are totally dependent on their parents. I didn’t know who I was till I was given a name and more importantly a language in which to express myself. I didn’t choose either my name or my language. My parents imposed English on me. I might have been more comfortable with Chinese or Swahili. Are dare my parents force me to speak English? They took away my autonomy. Tough they will say. If you didn’t like English you should have been born to a Chinese or Swahili speaking couple.

Just like a male can’t replace his now-removed foreskin, he can’t learn Chinese or Swahili. Such pro-circumcision advocates simply aren’t interested in recognizing that children might have rights that include being free from unnecessary surgery.

² Potential benefits, or “medically established protection” to use Bill’s more convincing but less factually accurate term, are not a medical indication. Potential benefits are also not a social justification. If no less invasive intervention is available to treat a medical problem, circumcision passes proxy consent in the American context of children. Otherwise, we must value human rights more.

I’m quoting a plaintiff’s press release, so yes, I understand the one-sided nature of this news. As such, I will only quote the facts:

The infant was a healthy seven pound newborn who was delivered without complications on February 14, 2007. The following day, a routine [sic!] circumcision was performed on the infant by Dr. Malek using a Mogen clamp, a metal, hinge-shaped device used during the procedure. At the completion of the circumcision, hospital records indicated there was significant bleeding. Inspection of the penis revealed nearly all of the glans had been amputated at the time of the circumcision. Three months later, the infant required penile skin transfer surgery at the University of Illinois, with need for future procedures, some of which are only appropriate at the age of puberty.

Is it a cheap shot to wonder whether or not the boy will be happy that at least he will not be laughed at in the locker room for having a foreskin? And his risk of becoming infected with HIV is now reduced by 50% or more. The scars and likely imperfect results from trying to reconstruct a glans? No, that won’t bother him at all, and the assholes who would tease him for having the body he was born with certainly won’t mock him now that his penis is disfigured. (I almost wrote mutilated to describe his penis, but luckily I remembered that only female genitals can be mutilated.)

Turning off the snark and sarcasm now, I’ll stick with just anger:

According to medical expert witness, Dr. David Zbaraz with Northwestern Memorial Hospital in Chicago, who reviewed the Sarah Bush medical records of the infant, “The Mogen clamp when used properly cannot amputate a male infant’s glans. The injury to this boy was completely preventable.”

Completely preventable? Of course it was completely preventable. But that would’ve involved not circumcising without medical indication rather than relying on “when used properly”. Doctors are human. They make mistakes. To face the risk (and outcome) of such mistakes, the surgery should be necessary or requested by the patient. Anything else is madness.

Link via the embarrassing Medgadget. Any doctor who would analyze this story by saying the following should be embarrassed:

Maybe the doc should have been less stupid and used the SmartKlamp.

Maybe the doc should’ve been less stupid – and less unethical – and not performed surgery on a child based on the non-medically indicated whim of someone other than the patient. But such a rational belief makes me a “moonbat”.

Somali-born model Waris Dirie, a victim of childhood FGM, uses her celebrity status to campaign against FGM through the Waris Dirie Foundation. She’s doing noble work, but I’m struck by the over-simplification of the debate by this sentence on the main page of her foundation’s website.

If genital mutilation were a problem affecting men, the matter would long be settled.

Of course it affects men, and I mean only FGM. The statement is too simplistic to be anything more than a biased piece of feel-good cheerleading. It’s a sound bite without substance. Saying it dismisses the fact that FGM affects men. Many men see this as positive. They are wrong, but we will not convince them by isolating FGM’s harm as exclusive to the women who’ve been mutilated.

Still, there is an argument to be made using that statement in reference to male genital cutting. To get there, consider this quote from Ms. Dirie:

“Every day I still struggle to understand why this has happened to me – this cruel and terrible thing for which there is no reason or explanation – whatever they tell you about religion or purity. I can’t tell you how angry I feel, how furious it makes me.”

I could’ve said that. I will say that. Every day I still struggle to understand why this has happened to me – this cruel and terrible thing for which there is no reason or explanation – whatever they tell you about religion or purity. I can’t tell you how angry I feel, how furious it makes me.

I am not minimizing what happened to Ms. Dirie or any other victim of FGM, although I know some will read it that way. I do not care. Forced genital cutting without medical indication is barbaric and unacceptable. The violation and horrific injustice is not unique to females just because the damage is more significant.

Male genital mutilation is a problem affecting men (and women). The matter is not long settled, except that it continues without restriction. Most men are fine with that. Many women, too. They are all mistaken, whether or not the genitals being cut belong to a girl or a boy. I will never consider a societally-dependent gender bias before I consider the act of genital mutilation itself. The latter is wrong, so the former is irrelevant.

**********

In a related story, read this quote by a nurse from Nigeria, a victim of female genital mutilation. She disapproves of FGM, but her quote is useful (from this article):

You see, there are times that I want to agree with the people that are advocating for female circumcision. By virtue of my profession, I have been opportuned to see the vagina of a lot of women, and I must confess that some of them can be very ugly. Some of them are so big and long, as if competing with the men’s penises. Sometimes it is the labia that looks funny. Some even come with colours different from that of their body part. For some women, there is nothing that can be done to it, it cannot close up. Once she unfolds her legs, that is it. The thing will just be open like that. Like a big sore between the thighs. But just as you have the ugly ones, so you have the beautiful ones. Someone once told me that a beautiful woman will definitely have a beautiful vagina. So, once you see a beautiful woman, be sure that her vagina will look beautiful too. Maybe it is because of this ugliness that they actually started circumcising women. One can never tell.

It is not because of that ugliness, but the thought process is informative. In greater detail, this analysis mirrors a common theme found in deciding to circumcise male infants. The natural genitals are ugly, so it is society’s duty to eradicate this problem, to “fix” them. Presumably the child will not do so if given the choice, even though it allegedly means he’ll be resigned to a sex life that does not involve another person. So we must do it for him or her. Of all the possible opinions, only the child’s opinion is irrelevant.

That is no way to make a medical decision for any child.