To cut or not to cut: The question of circumcision

Posted by Greg Laden on April 24, 2010
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Men circumcised at birth saying that they prefer being circumcised makes as much sense as a man deaf in one ear extolling the virtues of monophonic sound.


That is a quote from one of many interesting comments on the equally interesting article Is male circumcision a humanitarian act? by Jesse Bering. Worth a look.

Bering concludes on the basis of a couple of very preliminary studies that show large effects in terms of percentage but small effects in terms of hazard, in a dynamically changing situation, supporting circumcision to mitigate against HIV infection risks. Bering has misunderstood the studies and their implications, though it is not entirely irrelevant that circumcision seems to be related to HIV risk reduction. It’s just not clear, not large, and quite possibly not important because the difference is only see in what is likely situations of unprotected sex in very high risk heterosexual populations.

The interesting outcome, not mentioned in the article or in any of the comments I read, is that it is perfectly reasonable to conclude from Bering’s (and other’s) logic that first world heterosexual men should not necessarily get circumcised, and nor should homosexual receptive partners. But, first world insertive partners (tops) and all third world men should. The whole idea that one’s penis should be cut (or not) on the basis of one’s global socioeconomic status or sexual preference is stunning.

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Comments

  1. #1 Hank Fox
    April 24, 2010

    If there was no such thing as circumcision, and someone came up with it today, it wouldn’t matter WHAT the evidence was. Men the world over would laugh the idea out of existence.

    “You want to WHAT?? Oh, man, that’s FREAKY!”

  2. #2 Cain
    April 24, 2010

    To quote one of the commenters on the original article. “This is not a disease prevention issue, this is a human rights issue”.

    Parents don’t have the right to mutilate their sons just because it is a culturally prevalent act and the infant is unable to speak up or fight back.

  3. #3 Merle
    April 24, 2010

    Er, I think that you meant “circumsized”, not “circumscribed” in that last paragraph.

  4. #4 DuWayne
    April 24, 2010

    Whoo Boy!! This always turns into a rather contentious discussion. My favorite part is when random assholes come along and explain how all of us guys who are circumcised are less than men and/or are sexually dysfunctional.

    I have rather mixed feelings about it, but come down on being rather pleased to see circumcision slowly becoming an anachronism. Neither of my boys were circumcised. Ultimately I just don’t see much point in circumcision.

    I really get uncomfortable with the argument that it reduces the incidence of HIV transmission. It really doesn’t have enough of an impact on transmission rates to be anything approaching a valid safety precaution. And people being people, it is all too easy to see folks use circumcision as an excuse for engaging in unsafe sexual activity.

    That said, I really find a lot of the folks who come down on the anti side absolutely reprehensible. The smug sense of superiority is obnoxious and the claims that circumcision makes the circumsised somehow deficient are flat out disgusting. I have about as much evidence to indicate that a foreskin dramatically reduces mental capacity, as they do to suggest that a lack of foreskin makes one sexually deficient.

  5. #5 Cain
    April 24, 2010

    @4 DuWayne.

    Do you also find the opponents of female circumcision flat out disgusting as well? With their smug sense of superiority and their claims that the victims, after having thousands of nerve endings hacked off, are somehow deficient.

    I’m not trolling. I’m genuinely curious how your opinion of the two acts match up.

  6. #6 DuWayne
    April 24, 2010

    Honestly Cain, I have a lot of mixed feelings about that as well. Please understand that I am not advocating for either. And also understand that I do have a different attitude about male circumcision than I do about female circumcision. To some degree that is a double standard – what is “accepted” in my culture is obviously not as bad as something that is not.

    Where I have absolutely no problem coming down hard, is on someone who would claim that women who had their clit removed is deficient. It just isn’t that simple. And I think the feelings of the person who underwent the procedure count for something too.

    As it stands, I come down as apposing male or female circumcision. But I accept that as it is for most issues in life, it is complicated. I refuse to countenance the mighty and moral westerners trouncing their way in with their smug superiority and telling everyone who does things differently – even wrong, that they are horrible people who do horrible things. That is not the way to foster change.

    Telling people they are deficient is a good way to just piss them the fuck off (having been told this, I can attest). Close the mind and close the ears to anything else you have to say. Unfortunately also closing their minds to what someone who comes along later and with far more respectful language and rational arguments has to say. We westerners have a ridiculous fucking tendency to get all up in arms and decide that the only response behavior we don’t like is righteous indignation and moral judgments.

    Personally, when people have claimed that I am deficient – whether because I was circumcised, because I have substance abuse issues or because I have mental problems that are cause for occasionally rather profound negative consequences when I am unmedicated – I get rather pissed off and/or feel the urge to mercilessly mock the asshat who made that claim for being an ignorant fucking git. I certainly don’t have any reason to take anything else that person has to say seriously. Indeed I won’t listen to anything else that person has to say. Pretending I am rather sold on circumcision, nothing they have to say about it is going to convince me not to have it done to my kids. I am not and my boys have not been cut, but if it was relevant, telling me I am deficient, when I am well aware that I am not is not a good way to convince me.

  7. #7 DuWayne
    April 24, 2010

    I do want to be clear that I am not an ethnocentric asshole who doesn’t see the similarities between male and female circumcision. I just wanted to be clear that I probably do have some cultural biases that impact my opinion…

  8. #8 Greg Moore
    April 24, 2010

    Call it what it is: GENITAL MUTILATION

  9. #9 Ian
    April 24, 2010

    So, all things being equal, circumcision can reduce the risk of AIDS infection to non-homosexual males by as much as 62%. But all things aren’t equal, are they?

    But in medical settings, these complications are extraordinarily rare

    Great, but I thought we were talking about sub-Saharan Africa. Proper access to drugs can also vastly reduce the risk of transmission, right? But that’s not reality.

    The reality is that condoms use is much more effective than circumcision, and protects not only the person putting his penis in someone else, but also the person into whom the penis is put. Does a condom affect sensation? Sure, but doesn’t circumcision as well? And you can take off a condom.

    How would promoting circumcision affect rates of condom use? I imagine that circumcised males might feel like they didn’t need to use a condom, which would increase their risk and that of their partners. It’s not like circumcision is unknown in Africa. It seems pretty safe to assume that a pro-circumcision message would dilute a pro-condom message. And would the Catholic Church, which already opposes the condom message, use this to add weight to their argument?

    Honestly, I think it wrong to perform any sort of genital mutilation to children.(unlike adults, who can make their own choices). But the whole disease prevention angle ignores the fact that nothing exists in a vacuum.

  10. #10 kleer001
    April 24, 2010

    I was circumcised as a baby. I wish I hadn’t been.

    I readily support any cultural changes that encourage parents to leave their children’s genitals alone.

    Doing things just because they’re “done” or “that’s just the way we do it” is an affront to compassion and consciousness.

    Sure, cultural, racial, and religious dogmatic programming (CRRDM) WAS important for territory disputes, gathering food, staying healthy, and finding a mate. I don’t think we could have survived the last hundred thousand plus years without CRRDM, but we need to shed that shit like an old cocoon.

  11. #11 cgauthier
    April 24, 2010

    This is fucking ridiculous and the first comment got it right.

    If an adult male becomes weary of the extra few seconds of hygiene necessary to maintain a foreskin, or, wants to have unprotected casual sex and really thinks circumcision will protect him from AIDS (WTF? How about wearing a fucking condom or having your partner tested?), then he can march into a doctors office and get mutilated under anesthetics and his own cognizance.

    Non-consensual mutilation should not even be allowed on religious grounds. It is far more reprehensible than polygamy or sacramental drug use, for instance.

    Or, maybe anything should be allowed, in a religious context… I think I’ve suddenly seen the light! Quetzalcoatl demands blood!

  12. #12 P D Hoath
    April 24, 2010

    Drop the bronze age religious voodoo this is the twenty first century. Condoms people, condoms.

  13. #13 Azkyroth
    April 24, 2010

    My favorite part is when random assholes come along and explain how all of us guys who are circumcised are less than men and/or are sexually dysfunctional.

    I’ve seen a lot of pro-cutters defend against this assertion where it was never made. I’ve yet to see it made, though.

  14. #14 Restoring Tally
    April 24, 2010

    I was circumcised at birth and I do not like it. I dislike my circumcision so much that I am restoring my foreskin.

    It is my penis, not my parents. I use my penis, not my parents. I want to decide if any healthy body parts should be cut off me, not my parents. My body, my choice. I would choose to keep my whole sex organ.

  15. #15 DuWayne
    April 24, 2010

    I am not sure if PalMD has a tag for it, but it happened to me on one of his threads as well as a couple he had linked to. And for the record, I am not pro-circumcision.

  16. #16 dean
    April 24, 2010

    Perhaps it is the giddiness that comes with finishing semester grades, perhaps it is the second single malt talking, but I am reminded of this old joke (I forget from whom I first heard it.)

    Circumcision is a serious surgery. I couldn’t walk for almost a year after it was done to me.

    (Not an attempt to diminish the previous comments – just trying to inject a little humor).

  17. #17 Birger Johansson
    April 24, 2010

    I am told that during WWII, when American servicemen were exposed to sandstorms, it was noted that non-circumcised men were more likely to get inflammation after urinating and geting sand into the penis. The risk was substantially reduced for circumcised men. If this is true, it would explain the origin of (male) circumcision in the middle east.
    This is of course of academic usefulness for men not likely to be exposed to sandstorms…

  18. #18 Salmo
    April 24, 2010

    I’m circumcised, and very happy with it. And my fiancée raves about it, for what it’s worth. As far as our future children go? Probably not. It’s not necessary in this day and age. But I’m not going to get all whiny about it as it has no real effect on me whatsoever.

  19. #19 Andy
    April 24, 2010

    “And my fiancée raves about it, for what it’s worth”

    So I have heard.

  20. #20 Irene
    April 24, 2010

    It is my penis, not my parents.

    For want of an apostrophe my meaning was lost!

  21. #21 Westie
    April 24, 2010

    …the similarities between male and female circumcision.

    But they are nothing close to similar. Both are, yes, gentile mutilation, but they are very different.

  22. #22 Westie
    April 24, 2010

    Help! Help! Were is the “edit” button!

    Genital. Genital mutilation. Not Gentile.

    Except it is, I suppose.

  23. #23 Irene
    April 24, 2010

    One would think Scienceblogs would have an “Edit Comment” button by now.

  24. #24 Val
    April 24, 2010

    The author of that piece got it VERY wrong. He is comparing apples and oranges, and is ignoring that one decides to “cut” one’s child today, but many years goes by before HIV is an issue. A simple medical answer could be devised that is even better than condoms to address this particular problem by that time.

  25. #25 Salmo
    April 24, 2010

    “So I have heard.”

    You been talking to my fiancée?

  26. #26 Patricia
    April 24, 2010

    Agreed. Look for a viral antibiotic add on to condoms in the near future. How difficult can that be?

  27. #27 Carl
    April 24, 2010

    Foreskin restoration? Is that for real?

  28. #28 DuWayne
    April 24, 2010

    Westie –

    Editing button indeed, I worded that poorly. I really should have said parallels instead of similarities.

    And in all honesty, “gentile” mutilation made my evening. I am glad it stood, as it really works somehow.

  29. #29 Westie
    April 24, 2010

    Perhaps the blogger will be kind and fix this all up for me.

  31. #31 sublimaze
    April 24, 2010

    My husband insisted on having our son circumcised, and I still feel horrible about it. Our baby was “technically” anesthetized (local), but screamed horribly when the string was tied tightly around his foreskin. I wanted more than anything to stop his pain.

  32. #32 TW
    April 24, 2010

    I’m married to a man with permanent nerve damage from his circumcision. His sense of touch on the penis is messed up and keeps him from fully enjoying sex but no one, not even him, knew this until he became sexually active which is years too late. Never will there be a good reason to do this on non consenting infants.

  33. #33 MM
    April 24, 2010

    There is nothing benifical about genital mutilation for either sex. Babies can be harmed as mentioned above someone said that her husband has degraded feeling. You have degraded feeling even if not injured.

    This all comes down to Bronze Age middle eastern desert nomad rules. It might have been better to cut, so they didnt have to waste water washing all the nooks and crannies of thier bodies, but now we live in modern society with running water where most people can take a few extra seconds to pull back the skin and wash. Funny how in areas that are more religious are more poor.

    The bible in the New Testament says in 2 places that you should not be circumcised:

    Galatians 5:2 Behold, I Paul, say unto you, that if ye be circumcised, Christ shall profit you nothing.

    Colossians 2:10-11 Ye are complete in him … In whom also ye are circumcised with the circumcision made without hands … by the circumcision of Christ.

    I wish my mother did not have me circumsiced but I do not have any injury other than lack of skin. My son will not be cut. I will not do that to him. The practice is nothing more than genital mutilation and nothing more!

  34. #34 tioedong
    April 25, 2010

    in one sentence: It’s the cleanliness, stupid.

    In dry areas (parts of Africa, Egypt, Israel) the problem of balanitis is common; balanitis increases female to male transmisison of HIV.

    In Europe, they wash, so less of a problem.

    In the US, the educated and cleanliness obsessed tend to circumcize, the midwest, rural, and immigrants don’t.

    Why not compromise? A dorsal slit is the best of both worlds.

  35. #35 MM
    April 25, 2010

    “in one sentence: It’s the cleanliness, stupid.

    In dry areas (parts of Africa, Egypt, Israel) the problem of balanitis is common; balanitis increases female to male transmisison of HIV.

    In Europe, they wash, so less of a problem.

    In the US, the educated and cleanliness obsessed tend to circumcize, the midwest, rural, and immigrants don’t.

    Why not compromise? A dorsal slit is the best of both worlds.

    Posted by: tioedong | April 25, 2010 1:19 AM”

    You made your own point moot! You=Fail!

    You said it was cleaniness, then mentioned about hetro transmission from woman to male. What you said dosent make sense!

    Men need to wash thier dicks and pull the skin back on the foreskin and get rid of all the junk. Use condoms if not in a monogamous relationship.

    The LIE of genital mutilation to stop spreading a disease is bullshit! Wear a condom!

  36. #36 MadScientist
    April 25, 2010

    But not so stunning when it’s a matter of religious policy?

    One of my favorite bits from “Robin Hood: Men in Tights”

    What do you sell?

    I do circumcisions; it’s all the rage with the ladies.

    I’ll have one!

    Me too!

    I’ll have two!

  37. #37 Greg Laden
    April 25, 2010

    Mad: No, I certainly did not say that. I would say it’s the same. More of the same.

  38. #38 Armand
    April 25, 2010

    The same arguments for health can be made for any body part. A lot of children break their arms. This can be avoided by cutting off the arms at birth.

  39. #39 Carl
    April 25, 2010

    In the US, the educated and cleanliness obsessed tend to circumcize, the midwest, rural, and immigrants don’t.

    What? What about cleanliness obsessed immigrants to the midwest? What do they do?

  40. #40 Anton Mates
    April 25, 2010

    Salmo,

    And my fiancée raves about it, for what it’s worth

    AFAIK, from what little survey work has been done on the subject, American women tend to prefer circumcised penises. I think it may be different in Europe, though; probably largely a matter of what they’re used to.

    In my circle of acquaintances I know one woman who prefers circumcised, two who prefer uncircumcised, and quite a few who don’t care very much. But who knows how that generalizes.

    Westie,

    But they are nothing close to similar. Both are, yes, gentile mutilation, but they are very different.

    More precisely, female genital mutilation is a much broader category than Western-style male circumcision. Most Type IV (under the WHO’s classification system) female genital mutilation is less drastic than male circumcision; Type I may be less drastic, equally drastic, or more drastic; and Types II and III are way more drastic.

    There are some cultures that perform full-length penile subincisions on their boys, which rivals (I would say) almost any example of Type I FGM for severity. But I can’t think of any culture anywhere that’s done the male equivalent of Type II or III FGM.

  41. #41 Greg Laden
    April 25, 2010

    But I can’t think of any culture anywhere that’s done the male equivalent of Type II or III FGM.

    That’s done on more of a case by case basis.

  42. #42 Mark Lyndon
    April 25, 2010

    Circumcision is a dangerous distraction in the fight against AIDS. There are six African countries where men are *more* likely to be HIV+ if they’ve been circumcised: Cameroon, Ghana, Lesotho, Malawi, Rwanda, and Swaziland. Eg in Malawi, the HIV rate is 13.2% among circumcised men, but only 9.5% among intact men. In Rwanda, the HIV rate is 3.5% among circumcised men, but only 2.1% among intact men. If circumcision really worked against AIDS, this just wouldn’t happen. We now have people calling circumcision a “vaccine” or “invisible condom”, and viewing circumcision as an alternative to condoms. The South African National Communication Survey on HIV/AIDS, 2009 found that 15% of adults across age groups “believe that circumcised men do not need to use condoms”.

    The one randomized controlled trial into male-to-female transmission showed a 54% higher rate in the group where the men had been circumcised btw.

    ABC (Abstinence, Being faithful, Condoms) is the way forward. Promoting genital surgery will cost African lives, not save them.

  43. #43 Sarah
    April 25, 2010

    My two cents as a woman.
    I’ve been sexually active with circumcised men as well as uncircumcised (husband is uncircumcised). In all honesty, I prefer the uncircumcised. (Although I know a lot of women who prefer “cut” men, although I don’t think many of these women have ever seen an intact man so can’t really compare).

    I say keep baby boys intact and if they want to chop their willies up when they grow up then they can get it done.

    Okay, amusing (to me) anecdote time: I did know a young man who wanted to get circumcised because he kept getting his foreskin caught in his zipper (I was working in a doctor’s office at the time) he’d managed to slice the poor thing all the way from the tip, about a quarter way up his penis. I don’t think he cared much about HIV when requesting his snip and his mom was pitching a fit because their religion forbids body mutilation.

  44. #44 Greg Laden
    April 25, 2010

    Technically, it is possible that his religion also forbade zippers, so whatever.

  45. #45 Hugh7
    April 25, 2010

    @ Birger Johansson: That is called “the Sand Myth”. See http://www.circumstitions.com/sand.html . Where sand is a problem, an open wound is the last thing you want.

    The similarity between male and female genital cutting is ethical: both are human rights violations. (But when you compare apples with apples, tribal with tribal, they are quite similar. 80 boys died of tribal circumcision in one province of South Africa alone last year, and they’re just as dead as all the girls who’ve died of FGC. “Medical” FGC was covered by Blue Cross Blue shield till 1977, but now it’s illegal.)

    @Azkyroth: Neither have I ever seen circumcised men called “deficient” or “sexually dysfunctional”. They seem to jump to that conclusion when you point out that cutting a richly innervated part off the penis can only do harm to their sexual experience. It is the ones who are angry about that who are reacting appropriately, not those who deny it.

  46. #46 DuWayne
    April 25, 2010

    Hi Hugh, Fuck You. I have more than adequate reading comprehension skills, I am perfectly capable of parsing what people actually fucking say.

    http://scienceblogs.com/denialism/2008/11/why_male_circumcision_and_fema.php#comment-1206772

    I am not going to wade through the shitstorm of a thread on the “Science Based Medicine” thread he linked to again, but the same fucking shit showed up there too.

  47. #47 DuWayne
    April 25, 2010

    Oh, and I am curious about what exactly I am denying?

    No, I am not the least bit upset that I have a circumcised penis. It has always done what I wanted it to and with very reasonable results. While I have come to conclude that male circumcision is ultimately not something that should be inflicted on infants, I am not going to pretend that I am somehow lacking or feel bad that mine was cut.

    So what the fuck exactly am I denying here?

  48. #48 John
    April 25, 2010

    As much sense as some of the arguments are against male circumcision…they just ring hollow to me. I’m cut, and after researching it myself am damn happy about it. I remember watching a Penn & Teller Bullshit episode on it. Their argument was “hey you might have smegma…but that’s a natural lubricant!” and “every woman we asked was repulsed by an uncircumcised penis but..they’re wrong!”

    I’m going to be honest. I like getting laid. The pro-smegma argument and the pro-thewomaniswrong argument are not going to accomplish this for me. They will actively hinder me. It’s not “natural” to cut hair or to shave with a laser etched razor either…and that goes for the face and the nether regions. These are cultural inventions that have become convention…and I will be fitting in thank you very much. …I just noticed a wicked double entendre I stumbled upon there… yay me :)

  49. #49 zeb
    April 26, 2010

    Conversation seems to have dried up so:

    Eunuchs anyone?

  50. #50 Hugh7
    April 26, 2010

    @Anton Mates: “AFAIK, from what little survey work has been done on the subject, American women tend to prefer circumcised penises.”
    All we have is one study (Williamson & Williamson) of 145 Iowa new mothers (54% of those sent the survey). 97.9% were Caucasian, 1.4% (2) were black, and 0.7%(1) was Hispanic. Only 24 of them had ever encountered an intact man. 77% preferred a circumcised penis because it “seems more natural” and 54% because it “stays softer”! Yet that is the whole basis for the claim about “American women”.

    @DuWayne: Charmed, I’m sure. Yes, I’d forgotten that post from November 2008, just as I imagine you forget it was in response to a blog claiming the Intactivist movement are “foreskin worshippers”.

    And for what you are denying, I refer you back to the quotation at the top of this page.
    “Men circumcised at birth saying that they prefer being circumcised makes as much sense as a man deaf in one ear extolling the virtues of monophonic sound”

    That has a particular resonance :) for me, because I’m old enough to remember when stereophonic sound was new, and I was very skeptical that another channel could add anything of value to music (which is, after all, only sound) – until I actually heard it.

  51. #51 DuWayne
    April 26, 2010

    Glad you were charmed, I was not. I could give a damn whether you remember jack shit, nor do I give a fuck what the asshole was responding to. I said that the jackass was claiming that cut men are less for it and sexually dysfunctional, which garnered a skeptical response. This happened on a couple other threads around that time, including the huge thread on the post Pal linked to.

    I don’t like being accused of reading comprehension problems or flat lying.

    And for what you are denying, I refer you back to the quotation at the top of this page.

    Shy of an uncircumcised man getting circumcised later in life, the uncircumcised have no idea what sex is like sans foreskin either. And even then they have no idea what sex is like for someone who grew up without one. I am not denying it is possible it might be better or at least different. I am simply saying that I really could give a fuck. I have no problems with sexual function or any other functionality.

    It really seems to me that the problem you are having is that I’m not traumatized by my lack of foreskin. I am not sure why you find this so very threatening or problematic, given that I don’t support circumcision. Or are you saying that the only way to not be against your position is to cry into my pillow at night, mourning that foreskin I lost so many years ago? Or do I just need to accept and admit that I am less of a man?

  52. #52 ginger
    April 26, 2010

    Sarah@43 – Oh dear. Didn’t anyone at the doctor’s office think to suggest underwear or button-fly pants or getting up earlier so he could dress more slowly and carefully? Surgery seems like a drastic solution to what sounds like a sartorial rather than a medical problem.