Stacey and I have taken a very conscious, intentional approach to this pregnancy. In a lot of areas we have chosen to take the less common, more “natural” route – choosing to use a midwife, to have a home birth, to breastfeed, to “wear” the baby. It is natural, in such a carefully considered pregnancy, for the question of circumcision to come up. Especially when, as in our case, the expected baby is a boy. I was discussing our choice to circumcise with an online acquaintance recently, and I decided subsequent to the conversation that it was probably a good idea to put my thoughts on the subject in some kind of order.
I should preface this, first of all, with the disclaimer that these are my thoughts and reasons alone, not those of sagaloo. She shares my conclusion, but I can’t speak for her reasoning.
Circumcision is a contentious topic, and for those who care deeply about it can arouse some pretty strong feelings. Whichever side you stand on, I ask that you read this with an open mind. If you comment, please do so civilly and with the understanding that our decision is final and not subject to change. I am very much interested in other perspectives, but please refrain from condemnation or guilt trips. Thanks.
The anti-circumcision movement has gathered a lot of strength in recent decades. Not without reason. Most of the arguments that were used to make circumcision the norm in the US were flimsy at best, laughable at worst. The reconsideration of the practice of routine circumcision in light of current medical knowledge and cultural values is overdue.
The thoughts that follow are the result of a lot of study of both the pro-and ant-circumcision arguments, coupled with a great deal of thought, discussion, and soul-searching.
The first realization I had to confront when wrestling with this issue was that circumcision is mutilation; and mutilation of a particularly sensitive area at that. There’s just no other way around it. It’s not just a “little cut”. It’s a surgery. Like any surgery it carries a rare but real risk of serious complications. It causes pain. It forever and irreversibly alters the natural shape (and, according to some, the function) of the penis. I don’t feel that one can honestly engage with this issue without starting with the acknowledgment that what we are talking about is genital mutilation.
So with that fact in mind, what are some of the arguments in favor of this disfiguring procedure?
Fighting the scourge of Onanism
Reduction of masturbation was one of the justifications used by doctors popularising circumcision in the US at the turn of the 20th century. This argument ought to win some kind of prize for misguided public policy by being simultaneously wrong-minded and totally ineffective. Of course recent medical research has shown the importance of regular masturbation to prostate health; but even without that knowledge it takes a special kind of stupid to think that circumcision would make a dent in self-love.
Everybody else is doing it…
One argument in favor of circumcision that I have heard is that an uncircumcised boy will be vulnerable to self-image issues when he discovers that he is shaped different than his father; and/or the ridicule of his circumcised peers. One report in 1985 found this to be the leading reason US parents gave for circumcision.
Personally, I find this justification too stupid to devote more than a passing guffaw to it.
Health
Here’s where we start getting to the meatier arguments. Public health, particularly in regards to STDs, was one of the original reasons given for practicing widespread circumcisions in the US. Later, the American Associations of Pediatrics withdrew their support for the procedure, citing insufficient benefits to offset the risks. However, recent research, particularly in Africa, has shown a strong link between circumcision and reduced risk of passing STDs.
I find the most recent research hard to argue with. There is strong evidence that male circumcision can reduce the risk of contracting HIV by over 50%. That is not a small number. Quoting William Saletan in Slate:
Four years ago, an analysis of 38 studies by the U.S. Agency for International Development, mostly in Africa, concluded that circumcised men were less than half as likely as uncircumcised men to get HIV, apparently because of the susceptibility of foreskin. Last fall, reporting on a randomized controlled trial in South Africa, scientists found that circumcision reduced female-to-male transmission by 60 percent. “Male circumcision provides a degree of protection against acquiring HIV infection, equivalent to what a vaccine of high efficacy would have achieved,” they wrote. It was, they observed, “the first experimental study demonstrating that surgery can be used to prevent an infectious disease.”
On the other hand, proper sex education and use of safer sex practices can have even better results. In the final analysis, the health argument alone does not sway me.
Religion
As you all know Stacey and I are Jewish. It is impossible to overstate the centrality of circumcision in the religious experience of the Jewish male. In a sense, circumcision is his Jewish-ness. A lot of non-Jews probably think of the Bar Mitzvah as the Jewish equivalent to baptism; but in fact circumcision is a much closer analog. Just as baptism is the pivotal event that marks a person as a Christian, so circumcision is the act that sets a boy apart as Jewish. This point is stressed repeatedly in the Torah. Anyone arguing circumcision with even a marginally observant Jew needs to realize that they are likely going to come across as arguing for the de-Judaizing of Jewish sons. It would be like telling a Catholic that they shouldn’t have their baby baptized.
And yet… Our Judaism is in many other ways unorthodox and even (*gasp*) contrary to Torah. I do not believe in a God who would smite or forsake a child for being un-cut. This, too, is not a sufficient argument.
Tribal Identity
Humans are tribal animals. We thrive on a sense of family and community; we despair without these things. Tribes use physical markings – often permanent ones – as a marker of identity. Humans tribes have been subjecting their children to painful initiation rites since time immemorial. Many of them include mutilations more severe and painful than circumcision.
And this, for me, is the crux. I am a member of an ancient and tenacious tribe, the Jews. A tribe that has stubbornly kept it’s identity despite the attempts of almost every nation on earth to disperse or destroy that identity. When my parents chose to have me circumcised, they initiated me into that tribe, and forever gave me a sense of belonging that is as close to me as my own manhood. In retrospect, they have my retroactive consent – even thanks – for that act. I dearly hope that my son will come to feel the same way about it when he comes of age to appreciate the choice that we are making now. He may not, and I accept that possibility, and the moral responsibility for the choice.
So this, finally, is what it comes down to. Not health, not even religion, but identity. This is why I will have my son’s foreskin sliced off with a scalpel at the tender age of eight days. I hope that this serves as a sufficient explanation to anyone who wonders why an intelligent, informed individual could make the decision to circumcise in 2008. If not, I hope that you will choose to agree to peacefully disagree with me. Most of all, I hope my son agrees with me in ten or twenty years. Only time will tell.
EDIT: I will delete comments that fail to abide by the guidelines I set at the top of this post. If you’re a regular commenter or a friend of mine and you feel compelled to argue passionately against circumcision, I’ll probably cut you some slack because I know you. But if you’re some random stranger coming to my journal just to rant, either take a lesson from jwhispers, and learn to politely and respectfully disagree; or save yourself the effort, because it’ll only go in the bit-bucket.
Well, at least you thought about it first. I have three boys, none circumcised, but no strong feelings either way. When I was pregnant with our first, I told my husband the choice was up to him (seeing as I don’t have a penis and feel ill-equiped to make choices regarding one), but that I was not inclined to go cutting pieces off the baby. He did the research and couldn’t find any compelling evidence FOR circumcision and since we aren’t religious we opted against it. I figure if there comes a time in their lives where it becomes important to them to be circumcised, then they can do it then.
I, for one, support your decision, and the reason for which you’ve made it. And for those who might not know, I’m male. 😉
“make a dent in self-love.”
That’s where you started to lose me, then you said:
“meatier arguments”
and my inner Beavis and Butthead wouldn’t let me comprehend anything further…
heh heh
Here’s hoping you make a good decision.
In case you don’t remember my LJ username, this is Carrie (friend of Jamie’s). My husband and I talked about this a great deal when we found out we were having a boy, and I was pretty staunchly against having Roland circumcised. My husband Steve was mostly ambivalent but mildly for.
We eventually decided to have Roland circumcised under pressure from my mother. Her reasoning was health related, although not having anything to do with HIV. She argued that everyone she ever knew with a foreskin had recurring infections and other problems from poor care. Also there is a significantly lower chance of penile cancer in circumcised males. I argued that poor care was the result of poor teaching as a child, and my mom came back at me with my own brother. We were raised the same way and he is one of the most un-hygienic people I know.
So we eventually caved. I don’t know if we made the right decision, and it can’t be taken back now. Even afterward my son has a huge amount of skin around his penis and we still have to be very meticulous about cleaning it or he gets buildups of smegma. I’m hoping he’ll grow into that skin eventually.
health arguments are biggest for me…
and I do think that I’ve had to, in recent years, actually, think about the whole issue..
To me, the health reasons are very strong.. but I think your identity reasons are also really good.
If Jai and I have a male child, then we will probably get him circumcised–due to health reasons–but I guess I’ll have to think about it a bit more if that time comes..
nice post…
Re: health arguments are biggest for me…
I’m relieved to read that you truly considered the issue from all angles. As much as it’s your child (and should be his decision in some people’s minds) I think you’re trying to keep a clear mind and put his best interests at heart when you make this decision.
Granted, both of my boys are cut… but I did that out of “everyone else is doing it” and never questioned the mainstream (same with vaccinations and I seriously regret that). I don’t know that I would have them cut if I had to make the decision over again… but I would certainly put a lot of thought into the “why” than I did before.
Re: health arguments are biggest for me…
Nice icon. I would like to give the south park reason for being circumcised “IT LOOKS BIGGER!”. Someone had to make the immature comment.
Re: health arguments are biggest for me…
Thank you… I like yours as well. I actually have the cat tattooed on my leg; it’s my favorite. 🙂
Hum. I hadn’t heard those figures re: HIV – I’ll have to dig around and see how widely substantiated they are. Sam and I won’t be circumcising any hypothetical boys we have, but I like to know this stuff.
For the interested.
In the interests of disclosure, these links are from the site I work for, but I did not write the stories and am not, in any way, involved in Ars’ science coverage.
http://arstechnica.com/journals/science.ars/2008/05/08/25-years-of-hiv
http://arstechnica.com/journals/science.ars/2008/01/09/circumcision-doesnt-affect-sexual-satisfaction-performance
http://arstechnica.com/journals/science.ars/2007/08/01/study-shows-circumcision-results-in-no-loss-of-sexual-sensation
http://arstechnica.com/journals/science.ars/2006/12/14/6287
Jesse and I are having similar discussions…on one hand, insurance won’t cover the surgery if it’s not done in the hospital after birth before release…on the other hand, it can never be undone. It’s a very hard decision to make. Know that there are others out here trying to do the same thing you are and can empathize with the what ifs that go with making this choice.
Just for the record, I don’t recommend anyone circumcise their baby boy if they aren’t Jewish or Muslim. But that’s just a previously thought out comment from the top of my head.
I had my first boy cut, but that was at 2 days old (too young! there’s good reason for waiting until the 8th day as in Jewish tradition) & in the hospital (too impersonal for such an intimate procedure!), and for the reason that if we didn’t do it he would look different from his dad. Hindsight’s 20/20, had I to do it again with the knowledge I have now, I would not have him circumcised.
My feeling exactly…we’ve decided to hold off doing it. Jesse was especially convinced after we spoke with one of the midwives at the OB office. She was very knowledgeable and brought up some really good info which he didn’t know about at the time. My feelings personally is…hey, he’s born with it. It’s probably meant to be there. Most insurance companies consider it cosmetic surgery anymore and won’t cover it period.
Well I thought I would add that a few thoughts. First, I am glad to see you’re looking into things as throughly as you did. Though I’ll say up front that I don’t agree with your conclusion; at least you put to rest some of the myths for circumcision. It surprises me that these myths persist.
I would like to address the information you posted about HIV though and add a few interesting things about that. Not long after the results you discussed came out, a separate team of researchers in the Netherlands found that the Langerin cells, which line the foreskin and the authors of the studies you mention thought to be the primary route of infection, are actually protective. The news clip is here and the actual report can be found here. The Dutch researchers found that infection only occurred when challenged with very high viral loads.
When I think about that, it makes me wonder why HIV rates are so high in Africa yet in other countries (Europe, Australia, Japan, New Zealand) for example have much lower rates of HIV, even compared with the US, despite the fact that circumcision is very rare. My guess was that due to living conditions and such found in Africa immune functions are suppressed making Langerin production lower than usual and, for those infected, higher than usual viral loads. Meaning the normal protective function spoken of by the Dutch was proabably weakened. Then in the last couple weeks, it was also revealed that Africans may have a genetic predisposition toward infection and are frequently co-infected with parasitic worms which further degrade their immune function.
In any case, this is proabably why the Australian Federation of AIDS Organizations described the results in Africa as context specific. I suspect that when looking at something like this, we have to keep in mind that these are done in third world countries where over all health and living conditions aren’t too good.
In any case I can’t say I agree with your decision but I am glad to see you at least discussed some of the myths.
Thanks for the comment, and for the additional data. Like I said, for me it ultimately isn’t a health issue. But for most people thinking hard about circumcision health is probably going to be the biggest factor, so it’s important that as much information as possible is available.
By the way, do I know you, or did you just wander in off the interwebs?
Your welcome. No you don’t know me, I just wandered in I hope you don’t mind. I happened to be googling HIV and circumcision after reading this distressing article. I agree many people seem to be concerned with health but I doubt there is any substantial benefit in first world countries. Again hope you don’t mind the drop in.
Deleting because you explicitly ignored my stated guidelines for discussion. If you were someone I knew by previous acquaintance I would cut you some slack, but you apparently only wandered in to my journal in order to advocate, rudely. If you don’t have the respect to either a) do as I asked or b) *earn* the right to take me to task, I don’t have time for your arguments.
I am intensely anti circumcision. My boys are both intact and I waged war with my parents over my choice. They were sure that they’d have some dread infection due to it. The oldest is 5 and had a mild infection that I cleared up with some salt water.
The ONLY reasons I can see for circumcision are purely cultural. Even then, I personally wouldn’t choose to do it, but I can understand why people would choose to do it.
I am glad that you did your homework and didn’t fall victim to the usual “everyone is doing it” or “OMG he’ll get AIDS” hysteria. Cultural tradition is important and if not practiced it’s often lost to the winds of time.
When I was in Junior High (yes, I am THAT old!), a non-Jewish friend who was not previously circumcised, had a series of infections that ultimately required him to be circumcised. Obviously, this doesn’t happen to everyone. I distinctly remember his commenting to me that he wished his parents had done it as an infant and spare him the substantial pain (both of the infections and the surgery) later on. I also remember him telling me that is parents (first-generation immigrants from Central Europe) didn’t have him circumscribed specifically so he wouldn’t be mistaken for a Jew (at that time in NJ, it was pretty much done to all male children unless there was a parental objection).
Obviously, you have thought this through, which is always a good thing. Hopefully, you will not need to deal with any ‘retribution’ in the future, but you are prepared with a valid reasoning. And, like many other forms of ‘cosmetic surgery’, this too can be ‘repaired’ when the child grows up (if it is sufficiently traumatic to him).
First, let me say your arguments, pro and con, appear sound. Who am I to argue your reasoning? As an uncut male, I can tell you that I have never had a related infection. I cannot speak to any difference in sensation as I have not experienced both sides of the coin. If someone where to mock me for having a different looking penis, I would be forced to ask why they were checking it out and why it mattered to them. I am the first of my family born this side of the Atlantic and I am quite happy with the complete state of my penis. Perhaps it is part of my identity. I am from a family of uncut males. I do know some people who have had circumcision related infections, nerve damage and such, but they seem to be in a minority.
Ultimately, you raised the strongest point for circumcision. You are making your son a part of your family, and giving him an identity. Whatever he feels later in life, he’ll know you thought this through thoroughly, and that you made the best decision you could with the information you had. That is what parents do. Nobody knows the “right answer”, only the answer that is right for them at the time.
By the way, I find it amusing you mentioned “cutting some slack” in this context. Heh heh.
Umm…
Well I’ve read your guidelines and I am indeed just a passing stranger come to rant. Your message makes me so SAD, it’s hard for me to stay polite. Here’s my riskiest question first: why do you invite comments, and ask us to read yours with an open mind, when yours is made up?
Most of your post quite admirably disposes of all the stupid reasons. It almost seems as though you were looking for a reason to circumcise and grasped at this one. With circumcision, it has ever been thus, and circumcision will continue as long as people can do this.
So, to tribal identity: “When my parents chose to have me circumcised, they initiated me into that tribe, and forever gave me a sense of belonging that is as close to me as my own manhood. In retrospect, they have my retroactive consent – even thanks – for that act. I dearly hope that my son will come to feel the same way about it when he comes of age to appreciate the choice that we are making now.”
Imagine for a moment that you had decided NOT to have him circumcised, deciding that you trusted him to remain a member of the tribe without having it “marked in his flesh”. Don’t you think that would give him an even greater sense of belonging, that was still “as close to him as his own manhood”? It would mean you had thought of him as an individual person in that tribal context. (It would actually give him something tangible, instead of taking something away.) Then if he wanted to embrace the tribe in the conventional way, he could, and it would be that much more meaningful to him, but either way, he would thank you so much more for giving him the choice.
But I do give you a lot of credit for your careful thinking.
Heh. I’m a bit saddened that no one referenced our stories–woe is me. 😉 Beyond that, I have to admit that the amount of focus people put on this issue boggles my mind. It’s not that I’m unwilling to think about or discuss it, and obviously such a discussion would take on a great deal more importance if I was having a boy child (or was even married).
Given that the most recent and thorough data points towards circumcision having absolutely no impact on sexual performance, sensation, or health, and indicates that circumcision may help defend against AIDS, it seems to me that the entire issue boils down to culture and personal preference, as you (Avdi) concluded.
So some folks are circumcised. Some aren’t. As an issue of cultural identity, sure, I see the importance. But take one step past that, and I don’t understand why anyone cares. It’s not as if getting circumcised = massive amounts of unprotected sex; the best way for anyone to avoid getting AIDS is to choose his or her partners carefully.
As for trauma…I don’t mean to offend anyone, especially you, Avdi, but the idea makes me laugh. Losing a parent at the age of three is traumatic. Having an alcholic/abusive parent (even if the child is not the primary target) is traumatic. Watching a parentt contract a terminal illness, or dealing with one’s own potentially terminal illness (cancer, etc) is traumatic.
Losing a bit of skin at 8 days old is so far from traumatic, it’s not even funny. If I may draw an analogy:
When I was eight years old, we moved from Munster, IN to Newburgh, IN. On our first day there, after we’d finished unloading the truck, my Dad and I unpacked our bikes to go for a ride. I was still learning, even at the age of eight–a really nasty fall when I was a child caused some brain damage and slowed my motor skill development–and I was drop-dead terrified of falling. Still, I went with Dad, we got some speed built up, and I was moving pretty good–really good, in fact.
Our house was at the midpoint of a long and steep (to an eight year-old) hill. At the bottom of the hill there was a fair bit of straightaway, the street curved slightly to the right. I took the curve just fine…and slammed into a section of the road that had been turned *entirely* to gravel. Big chunks of the pavement were everywhere. I panicked, flipped off the bike, and took virtually all the skin off my knees and elbows, bloodied my nose, and cut my forehead–you can still see the scars, 20 years later. It was agonizing, I had to walk a quarter-mile home (again, long to an eight year-old), and it hurt like hell for at least a week.
I still learned how to ride a bike, and that incident cost me far more skin and blood than circumcision. Ultimately, I think the issue is entirely overblown.
For the record I am very anti-circumcision.
My main issue with it is that you are making an irreversible choice on behalf of your child. This choice will stay with him for the rest of his life. Like you said, I hope they agree with it.
Speaking frankly as an un-cut male.
i) I’ve never had any kind of UTI.
ii) In my experience, about 70% of sexual stimulation comes from the skin which would have been surgically removed.
It’s not the skin on the outside that is hyper-sensitive, it is the skin on the inside. When the penis expands with an erection the foreskin does not expand with it which is what exposes the head.
This means that the first 3 inches or so of the shaft from the head is actually the “skin” which is in direct contact and protecting the head while flaccid.
fwiw, if I try and walk around “retracted” the friction is unbearable and as such I find it hard to believe people who say there is no loss of sensitivity from infant circumcision. Not to mention however many square inches of higher sensitivity skin you lose.
Avdi’s circumcision
This is Avdi’s father. If Avdi’s mother had not been Jewish, he would not have been circumcised. No, she did not “force the issue”. His mother is Jewish, therefore Avdi is Jewish, therefore he was circumcised on the eighth day. Q.E.D.
I made no comment to Avdi until AFTER he had posted all this, I didn’t think I needed to. When I saw the title (but had no time to read the post), I did send him an email, then later I read all this and found he had made his decision in exactly the same way and for exactly the same reasons that I was urging.
Re: Umm…
In response to hugh7, the ranter here has has no concept of what tribal identity really is. But then, when I was in my twenties, I also thought that tribal identities, and all of the rites of passage that make human society function, were subject to redefinition at the whim of each generation. But now that I have seen a bit of life, I can see that tribal identity and rites of passage only work when they are accepted from our forbears, and not when they are our own invention.