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Top Medical Journal Pulls Out Scalpels for Circumcision Smackdown

Posted by Madeline Holler

There’s a high-level smackdown going on in a respected medical journal. Two doctors make their case for and against something regulars on parenting message boards and websites have been hashing out for years: circumsizing baby boys.

But instead of calling each other vicious mutilaters or cultural imperialists, they use big words, studies and analogies to make their cases.

One of the writers points out that non-therapeutic foreskin removal continues throughout the world, while body mutilations – female circumcision, scarring – have been widely condemned or made illegal.

He asks:

The law and principles pertaining to child protection should apply equally to both sexes, so why do society and the medical profession collude with this unnecessary mutilating practise?

He says the U.S. and U.K. laws discriminate against boys when it comes to protecting children from genital mutiliation.

As for the evidence that circumcision reduces risk for HIV infection in sexually active adult males, he argues the boys, not their parents, should make that decision for themselves when they are men.

Ding! Next round.

The other writer argues that, if expertly done, male circumcision doesn’t carry significant risk and is nothing compared to female circumcision.

Also:

In terms of evidence of benefit, male circumcision has been associated with a reduced risk of sexually transmitted infections, such as human papilloma virus, chancroid and syphilis. Robust research has also shown that circumcision can reduce the spread of HIV.

Also, no robust research exists regarding psychological impact of the circumcised life for men, so quit claiming that it does.

She says nowhere in the world is male circumcision illegal. She says that considering the long tradition of the practice, it should never be outlawed as a way of ensuring that it will continue to be performed safely by experts.

What do you think? Is male circumcision comparable to female genital mutilation? Should it be outlawed? Are we discriminating against boys when we allow it for them but ban it for girls?


Comments

 

Larissa said:

I don't think that male circ is comparable to FGM - who does it, how it effect the health & functioning of the recipient's body, and what is removed are different in both cases.  

But I think if you aren't going to circ your boy (we didn't) then you have an obligation to teach him responsible sex practices so he doesn't spread HPV and other STIs to his partners.  

My theory is that people should be able to make the choice for themselves.  If you can't imagine a grown man choosing circumcision, why is it acceptable for a male infant?  

December 10, 2007 3:25 PM
 

HDCS said:

Larissa's on the mark, but I have to slightly expand on point two. I think all parents should strive to make their children as knowledgeable as possible on being sexually responsible.

We had our little guy snipped. But if I had to do again, I wouldn't have had it done.

December 10, 2007 4:14 PM
 

Kate H said:

We had our little boy circumcised.  I was generally against it, and my husband was generally for it.  Several studies came out just before he was born that indicated circumcision has a protective affect against HIV.  As long as the procedure has benefits for my son, I felt that it was okay to get it done.  Female genital mutilation has no protective effects, and tremendous harmful effects (infection, difficulty urinating, menstruating, painful sex, death in childbirth, loss of sexual pleasure).  The two procedures are not equivalent.

December 10, 2007 4:54 PM
 

SKU said:

Madeline,

The fundamental principle here is individual rights.

Male circumcision removes specialized sexual tissue which nearly all adult males still possessing it recognize as highly valuable.  Those who cite medical benefits (and there always are some benefits to anything: remove a finger, it'll never get a splinter or infection) fail to mention that no medical society recommends it, and that any potential benefits don't even outweigh the real risks.

Males are entitled to the entire penis they were born with.

That doctors are publicly voicing the need for their profession to get out of the business of medically unnecessary amputations is quite important.

December 10, 2007 6:01 PM
 

Jen said:

It's quite a stretch to compare a reduced risk of AIDS with a splinter.  

My husband and I agonized about whether to circumcise our son. We ended up deciding against it, and then found ourselves in the ER when our 5-week-old spiked a fever. After a spinal tap and a week in isolation at the hospital (necessary for any infant that young with a fever), we discovered that the fever was caused by a urinary tract infection. It turns out that uncircumcised boys are at a much higher risk for urinary tract infections than circumcised boys.

We were thankful to find the cause of the fever and be able to treat it, but our son then had to be on prophylactic antibiotics for six months until he could be circumcised. Despite all he went through, he's now a happy 2-year-old with no recollection of his ordeal - the least of which was his eventual circumcision.

Of course our son's situation is not the norm, but there are some seldom-mentioned health benefits to circumcision beyond the potentially life-saving benefit of reduced risk of STDs. I only wish I'd know that before my son was born.

December 10, 2007 7:31 PM
 

Autumn said:

It would only be equal to female genital mutilation if they entire penis was removed with out anesthesia and using a jagged piece of glass to remove it.  Oh and they must be about 8-12 years old.  Then it is the same.

December 10, 2007 11:59 PM
 

Courtney said:

I have to weight in here with my limited 2nd year medical school knowledge.  When we're looking at this HIV study, we have to remember that it was done in South Africa, where HIV prevalence in certain areas is as high as 30% (!).  In the US, our prevalence is closer to .4%, which significantly changes the playing field.  We can't assume that circumcision would have as dramatic effect here with our small #s (these things usually aren't linear relationships.)

Besides, the only reason that being circumcised would be of any use is if kids are having unprotected sex, as HDCS hinted at.  Now, it's fine as a public health official to assume that you can't change behavior (because it's very hard, and it's easier to just do something like circumcise.)  But as a parent?  You better believe my future kids are sticking anything in anywhere without a condom.

December 11, 2007 1:25 AM
 

Hugh said:

Of course the worst of FGM in tribal conditions is much worse than surgical circumcision, but the mildest form (removal of the clitoral hood in aseptic conditions) is quite comparable - yet all are illegal, without regard to religion or custom, or even an adult woman's informed consent in some jurisdictions. It's also illegal to circumcise a domestic animal or a non-consenting man or remove any other small projecting body part such as an earlobe from a baby. As a human rights issue, there is no good reason a baby boy's foreskin should be an exception.

Female Genital Cutting has been shown to be associated with reduced HIV transmission, but researchers were at pains to try to explain the anomaly - not to propose Randomised Controlled Trials or mass FGC campaigns.

Jen, the association with Urinary Tract Infections is also dubious. Your son was unlucky.  

December 11, 2007 3:49 AM
 

gracep117 said:

"Female Genital Cutting has been shown to be associated with reduced HIV transmission, but researchers were at pains to try to explain the anomaly"

How about the fact that this causes sex to no longer be pleasurable, and may even make it painful.  Painful sex=less or no sex=less HIV infection.

December 11, 2007 2:25 PM
 

Mylo said:

It may be true that no where in the world is male circumcision illegal, but it is certainly prohibited in many cases. In Australia, for example, in five out of seven states public hospitals are prohibited from performing elective circumcisions.

December 12, 2007 1:43 PM
 

Jane said:

It was being heavily discussed in the Netherlands as well, as there was a feminist reformed Muslim politician who saw the human rights as comparable, and it's also heavily frowned upon in Sweden and all of Scandinavia - there is a law in Sweden that forces Jewish circumcisions to take place with a proper anesthetist and I think bans non-therapeutic circumcisions on boys until they are 8 years old. Of course, any 'ban' would infringe on religious and parental rights, just as banning female circumcision, if we are talking clitoral hood removal, which is exactly comparable to the male foreskin, being as the clitoris and glans are what are saved during sex change operations, does - FGM is comparable to the removal of the glans, a not uncommon result of male circumcision. Death is another risk - just a few weeks ago, a baby boy died in Canada from a Plastibell operation, and there have been Jewish deaths from male genital cutting in the UK this year.

December 16, 2007 9:12 AM

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