Imagined Social Risks of the Foreskin

Posted: August 28th, 2012 | Author: | Filed under: Locker Room, Parenting | 1 Comment »

I don’t think much of the “Why I decided to circumcise my sons” side in CNN’s point-counterpoint approach to parental choice for circumcision. (“Why I decided not to circumcise my sons” is here. Both were originally published at Parenting.com.) Heather Aimee O’Neill discusses how she and her partner Abbie decided to circumcise their two sons. It’s fairly predictable, with the answer essentially being HIV, a cited benefit that has no significant applicability to her sons in the United States.

My takeaway is from something else:

My other sister, Meredith, an amazing mother of three boys who were all circumcised, agreed. “It’s unsanitary,” she said. “I can barely get my kids to brush their teeth at night. And imagine him in the locker room when he’s a teenager.”

Apart from the hygiene analysis being offensive, compare:

I don’t expect everyone to understand or agree with the choice that Abbie and I made for our sons. When Tommy and Teo are naked at the beach with friends, often they are in the minority because they are circumcised.

People believe many things about the social risks of having a foreskin that are simply not true.


One Unremembered Trauma: Emphasize Trauma, Not Unremembered

Posted: August 21st, 2012 | Author: | Filed under: Ethics, Locker Room, Logic, Parenting | No Comments »

Here’s a report from Jezebel on the Johns Hopkins study. It’s maddening.

Personally, I don’t give a care what kind of a penis any grown man currently has, because I am not in the business of telling people what to do with their genitals, or judging whether anyone’s genitals are “right” or “wrong.” That said, if I had a boy-baby, I think I would probably circumcise him (not, like, with my bare hands, but you know), because I can’t imagine one unremembered trauma could be more painful than a lifetime of a nasty, unfair, pervasive stigma. But that’s just me.

Did you catch that? She’s not in the business of telling people what to do with their genitals, except she would probably have her son’s normal genitals permanently altered. That is definitely tell someone exactly what he can’t do with his genitals.

That also reads like judging “right” and “wrong” to me. What someone else might say to her son could direct her to parent with a scalpel. Thinking with assumptions like this – that a parent can’t educate their children that the problem rests with the person who would stigmatize – creates the self-perpetuating cycle that parents “have” to cut to make their sons normal common to protect them from possible ridicule. This is especially ridiculous if we’re honest, because children will find ways to taunt, and about anything. If it’s not genitals, it’s hair color or fashion or ears or pimples or freckles or weight or whatever. We don’t expect parents to surgically alter other aspects of their children to avoid this temporary, not-guaranteed harassment. Normal genitals should be no different. Non-therapeutic genital cutting is an abdication of parental responsibility.

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Post Script: The predictable chaos ensued in the comments, apparently. I didn’t read them because I don’t read comments sections. But it’s obvious since the first comment addresses it. The Jezebel writer, Lindy West, replied:

Hey, screaming people. First of all, male circumcision and female genital mutilation are not equivalent. …

Ms. West is wrong.

(Advocates for genital integrity should not be screaming, literally or figuratively, in comments sections. I wish that didn’t need to be repeated.)


Economic Principles Applied to Circumcision

Posted: May 10th, 2012 | Author: | Filed under: Ethics, Locker Room, Logic, Mission | 2 Comments »

I’m a huge fan of economics because it provides useful, widely-applicable lessons. Economist David Henderson created a list of The Ten Pillars of Economic Wisdom that is quite useful. Several of the principles apply directly to the issue of genital integrity. The principles obviously connected to the basic human right of genital integrity, from the current version (originally published in The Joy of Freedom: An Economist’s Odyssey):

1. TANSTAAFL: There ain’t no such thing as a free lunch.

Circumcision is commonly sold in the U.S. with a long list of benefits and a tiny list of supposedly rare risks. The challenge is that the former is only potential and the latter is incomplete. There is no such thing as a free lunch. Circumcision is more than a bunch of benefits in exchange for “a useless flap of skin”. In addition to the inherent risks of surgery, circumcision has permanent costs that last long beyond the surgery itself. This is what’s ignored. Most advocates of non-therapeutic child circumcision omit this. (Brian Morris is probably the most egregious offender on this point.) They treat the surgery as a free lunch. “Look at the potential benefits” they say. Even this, which is better than most lists, omits the full range of costs. There is no discussion of the mechanical change. There is no discussion of the foreskin as a normal anatomical structure or what’s lost. It’s just ignored, as if it’s not a cost. This omission is incorrect. (This is related to another economic principle.)

2. Incentives matter; incentives affect behavior.

The most obvious example is the third-party payment system within the United States that generally pays for non-therapeutic circumcision of children. Parents don’t see the full financial cost because it’s spread out among the full range of insured Americans. It’s as if it’s a free lunch because the direct cost is hidden.

This is also seen with Medicaid. Where it’s not funded by the state, fewer low-income parents impose non-therapeutic circumcision on their sons. (I reject the nonsense offered by advocates like Dr. Edgar Schoen¹ and Colorado State Senator Joyce Foster – for reasons related to several of these economic principles – when they say Medicaid funding is a matter of social justice.)

As an aside, I do not accept the argument that a single-payer government insurance system in America would automatically result in the near-extinction of non-therapeutic circumcision in America, as it has in a country like England, by removing the financial incentive. I’ve long voiced a level of skepticism on this for reasons influenced by this economic principle. Incentives matter. The hidden financial cost of circumcision is not the only incentive in America. The idea that circumcision is “patriotic” (to cite Schoen, among several) rests on a non-financial incentive. The fear that family, classmates, and/or future sexual partners will shun an intact male is an incentive. These are cultural and will not disappear if the only change in society is that parents will carry the full financial cost of imposing circumcision on their (male only) children. I’ve encountered too many examples of parents complaining that they “have” to pay for their son’s unnecessary circumcision because their insurance plan won’t cover it to think otherwise.

6. Every action has unintended consequences; you can never do only one thing.

This is related to the no free lunch principle. Parents and medical professionals think that allowing proxy consent on this involves doing what’s best for their son. Parents who circumcise are assumed to achieve this – and only this – outcome. However, the action eliminates the child’s personal choice. That is not generally intended, on the “parents are well-intentioned” fallacy that ignores the act of circumcision. But circumcision is not just reducing risk X or whatever argument parents use. It’s also whatever the child decides about circumcision. Perhaps his opinion will align with his parents’. Perhaps not. Either way, his choice is gone.

Also, the funds and labor used for circumcision are no longer available for therapeutic treatments or other pursuits. This is an unintended consequence.

7. The value of a good or a service is subjective.

This is the key point here. This applies to all circumcisions, but with non-therapeutic circumcision, it’s especially true. There is no objective need, no reason to impose this on someone who can’t consent. The value of the intervention rests with the recipient. Again, perhaps his opinion will align with his parents’, but perhaps not. Society permits (and often encourages) parental proxy consent. The value is placed exclusively on the parents’ subjective valuation of the potential benefits and (often ignored) costs of non-therapeutic circumcision. The child’s possible objection is ignored in favor of his parents’ preferences about his body. In my case, my parents paid for a circumcision that I wouldn’t choose to accept if I were paid an enormous amount of money to undergo the procedure. Their valuation doesn’t match mine for the service.

These principles help make the ethical case. A permanent, non-therapeutic alteration should never be imposed on someone who does not consent.

¹ Dr. Schoen, especially, since he writes “[t]his means that many poor families are unable to choose to receive a circumcision…”. The family doesn’t receive the circumcision. The child does. Dr. Schoen’s position on the ethics of non-therapeutic circumcision is idiotic and untethered from anything other than is subjective valuation. As economic principle number seven shows, the valuation of everyone other than the patient is irrelevant in the imposition of circumcision.


Forgiving (and Ignoring) Bullies

Posted: July 3rd, 2011 | Author: | Filed under: Locker Room | 6 Comments »

I was bullied as a child for being poor and having red hair. Both were out of my control, with the latter being normal and part of who I am. My childhood would’ve been easier if neither fact had been my reality. A postcard in today’s PostSecret shows why I don’t mind either.

Forgiving Bullying

The argument that healthy children should be circumcised to avoid being mocked in the locker room is flawed because such mockery is neither guaranteed nor as (permanently) harmful as circumcision. (It’s even less likely now that more children are being left intact.) If the child is mocked for being normal, it doesn’t have to be damaging. Good parenting works better than circumcision at building self-worth.

The other side of the postcard is here.


Flawed Circumcision Defense: LZ Granderson

Posted: June 25th, 2011 | Author: | Filed under: "Voluntary", Ethics, FCD, FGM, Locker Room, Logic, Parenting | 1 Comment »

The editorial I analyze in this post is several weeks old now, but it’s been referenced elsewhere a few times. It’s worth a response.

LZ Granderson wrote an editorial at CNN on the proposal in San Francisco to prohibit non-therapeutic male child circumcision. It’s an embarrassing piece, largely because Mr. Granderson never considers the healthy child as an individual who might not want to be circumcised.

Once he gets going:

Besides the measure having no provision for religious practices — thereby making it unconstitutional — …

This is armchair lawyering, and easily refuted. There are the merits of the First Amendment and parental rights, which are summarized quite well in these two posts at The Volokh Conspiracy from last week. The religious freedom to act on another is a lot more complicated than simply claiming a religious requirement. There are competing rights involved, including a right to be free from unnecessary harm that is not yet adequately (or equally) protected. Mr. Granderson’s dismissal is flawed. It doesn’t disqualify his opinion, but it suggests the level of research he has (not) performed on this topic.

We chuckle, but from interracial marriage to masturbation, politicians have been trying to tell us what to do with our genitalia for centuries. …

Here, parents are telling their sons what to do with their genitalia. If the male does not want his genitals altered, his genitals are still altered. Since his body has been violated, what difference is it to him that his parents did it than if his government had ordered it? The proposed government involvement leaves that choice to individuals rather than dictates how he must be, which is what parents have been doing for more than a century in the U.S. Proposals like this that protect individual rights possess the stronger liberty position.

I get the science behind not having the procedure done: There are nerve endings that are being severed during the procedure, and it is normally not medically required. But generally speaking it has not been proven to be medically harmful either, though there have been rare occasions of infection and excessive bleeding requiring stitches.

Surgery is harmful. How can Mr. Granderson acknowledge that in sentence one and then deny it in sentence two? In the space between writing those two sentences, did severing nerve endings become not harmful? It’s more frustrating because his denial includes examples of medical harm. Other, more severe, outcomes are possible, too, including death. Mr. Granderson seems determined to believe what he wants to be true, regardless of facts.

Besides being an important aspect of some religions, circumcisions improve hygiene, …

Access to proper hygiene facilities is not a modern American problem in significant numbers. The same hygiene that females use to maintain their bodies works for males. To think that surgery is justified is simply begging one’s own question.

… which is effective in limiting urinary tract infections and the transference of STDs. …

The same treatments we use for UTIs in females work for males. For STDs condoms work better. Not all males engage in unsafe sex, so the potential benefit is useless for them. It is unethical to impose it because it may not be desired.

…And speaking of sex, having a circumcised penis saves the young man of the potential embarrassment of having a new partner look at his nude body and say “What in the hell is wrong with your… penis.”

Or something like that.

Maybe.

A recent study conducted by a Centers for Disease Control and Prevention researcher suggests the number of circumcisions performed dropped from 56% in 2006 to 33% in 2009. So chances are you or someone you know is uncircumcised, a fact that is really none of the business of complete strangers — government officials and busy-body voters alike. Why someone would sign a petition making it their business is beyond me.

This is just ridiculous. If a man reveals his normal nude body to a new sexual partner and the response he gets is “What in the hell is wrong with your… penis?”, I hope his parents will have taught him enough self-respect to treat his new partner as the person with the (hopefully correctable) defect. Would we accept that thought process if we started surgically altering girls so that they wouldn’t be shamed by their eventual sexual partners?

I could see the government getting involved in the decisions parents make about their children if there was evidence that circumcisions were a life-threatening practice — like failure to use car seats for young children. …

The standard is not whether the action is “life-threatening” or not. A punch to the face isn’t life-threatening, but it’s still wrong. Genital cutting on healthy female minors is illegal (and wrong), even where the damage is equally or less harmful than male genital cutting, which is to say, not life-threatening. (Typically.) This is once again question-begging.

Of course, some boys do die from circumcision. Circumcision is not usually life-threatening, but the risk of death exists every time it’s performed, which is why we generally avoid inflicting surgery on healthy people. Especially without their consent.

… I could see if the proposed ban was addressing a patriarchal practice such as female genital mutilation.

Male circumcision is a patriarchal practice. Aren’t many boys circumcised by their parents, at the father’s insistence that the child’s genitals match his genitals? Some doctors advise undecided parents to make the decision based on the father’s penis. Is that the rule of the male? Does it subordinate children? Mr. Granderson’s view here seems to be the mistaken belief that there is no harm if a practice is being imposed by someone onto someone else of the same gender. Do I need to link to examples of women imposing FGM on their daughters to demonstrate the fallacy of relying on this faulty standard?

This is about choice and preference and opinion and I am really tired of being subjected to ridiculous laws instituted by religious conservatives pandering to a bunch of crazy people or by meddling liberals who have nothing better to do.

This is about choice and preference and opinion? In what way? The child being circumcised does not choose. No one cares about his preference. No one waits to hear his opinion. The child is subjected to the choice, preference, and opinion of his parents. Permanently.

Seriously, if municipalities in San Francisco or Santa Monica honestly believe parents can’t be trusted to decide what’s best for their newborn’s foreskin, why on earth would they let them leave the hospital with the rest of him? It just doesn’t make sense.

California law already believes that parents can’t be trusted to decide what’s best for their newborn’s foreskin, but on the discriminatory view that only the female prepuce should be untouched without need or consent of the patient.

No wonder these anti-circumcision organizers have their sights on the rest of the country. We’re a bunch of nosy busy bodies who believe in an abbreviated version of freedom where we’re free to publicly debate what someone else should do with their private parts or the private parts of their newborn.

The status quo is the society with an abridged version of individual freedom. Again, the law in California (and most other places) already ended the public debate on what someone may do with the private parts of their daughters. Does that restrict parental “rights”? This debate is about fixing the status quo into a legitimate version of freedom where every individual, male or female, gets to decide which unnecessary genital surgeries they undergo or reject.

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To address a point Mr. Granderson raises, the issue of the “Foreskin Man” comic book series is relevant to the discussion. It is not the end of the discussion, as some are suggesting. That the series is embarrassing, and that issue two uses anti-Semitic imagery, is undeniable. The comic book is disgusting and has no place in the discussion by anyone advocating against non-therapeutic male child circumcision. It is a shameful mark on its creators.

That said, I hope it’s abundantly clear that only a minority of people opposed to non-therapeutic male child circumcision accept this type of filth. As the Jewish Circumcision Resource Center states, “there is no organization that controls, or could control, what individuals who oppose circumcision may say or do.” The first issue of “Foreskin Man” is probably unhelpful, but issue two is unacceptable. But it’s not reflective of the principles involved or the majority of those who support and advocate those principles. I have commented elsewhere on this, and will let that stand as my personal defense. I also recommend this post from The Volokh Conspiracy as a useful guide on objectionable material.


Locker Room Rules

Posted: February 26th, 2011 | Author: | Filed under: Locker Room, Logic, Parenting | No Comments »

Warning: This post contains strong, colorful euphemisms for penis in the quoted excerpts. I have not hidden any letters within the words because the words are legitimate and within context.

Chris Jones, a writer for Esquire magazine, has an interesting post – THE LOCKER ROOM RULES – identifying a few key rules for reporters to remember when venturing into the locker room of a professional sports team. The most obvious point about being in a locker room after a sporting event is that there will likely be naked athletes. That makes it an easy comparison to the commonly used excuse that infant circumcision is reasonable to prevent boys from being teased in the locker room. The argument is silly, since an assumption about teasing and peer pressure are not good reasons for non-therapeutic circumcision. But it’s also flawed because it’s an inaccurate assumption of what actually occurs within a locker room. From Mr. Jones’ list:

4. Okay, let’s get this out of the way: Don’t cock peek. When I was a beat guy, there was one poor reporter who got labeled as a cock peeker. (He claimed that he was just staring into space when he was tabbed, which, knowing the guy, I actually believe; unfortunately, that space happened to be occupied by a middle infielder’s wiener.) Whatever happened that terrible afternoon, the guy’s lot was pretty miserable after. (To steal an old line, You peek at one cock, and you’re a cock peeker for the rest of your life.) …

That is the unwritten-yet-understood code of the locker room. Don’t look. If you accidentally see, stop looking immediately. It’s a separate discussion for analysis, but the fear of being labeled as gay is much stronger than the temptation to mock someone for having a penis that’s different in any way from what’s “normal”.

It’s simple:

“Hahaha, you have an anteater!”
“Why are you looking at my [penis]?”

The locker room code commands the teased to respond this way and to continue until the point is made that the problem rests with the teaser, not the teased. There are exceptions, of course, but this is what really happens in locker rooms. Or would happen, if boys actually commented on another boy’s penis. Or if most boys got naked in locker rooms during school.

Mr. Jones continues his rule, which counters my point here a bit. However, the comparison and perspective are worth confronting.

… Now, if we’re all being honest here for a moment, sometimes it’s really hard not to notice that a guy has an enormous schlong, because it will fill your field of view, and it’s one of the dirty little secrets of the profession that reporters will make jokes about our coverage area’s more distinctive members. (Ever wonder why […ed. note¹…] nickname was Snuffy? Ask Snuffleupagus.) But even if some guy’s dick taps you on the shoulder and asks for a peanut, you should probably look at the ceiling and sing “Yes, We Have No Bananas” until it goes away.

The same would be said of an individual who still has his foreskin. That may even be primarily what Mr. Jones refers to here. But in a professional sports locker room where the team has athletes from different parts of the world, such as baseball and hockey, the odds of encountering a uniformity of circumcised men is unlikely. The same is also starting to be true in American grade school locker rooms, to the extent that any male is likely to get naked in one.

As Mr. Jones states, some amount of talking is inevitable. This, I suspect, is what parents really fear when they claim the locker room excuse. The “why were you looking at my penis” defense still works here. However, it’s also clear that kids will tease each other for any difference. Unless parents are surgically altering for all visible physical differences, and accounting for other differences like economic class, kids will be teased. Too short? Teased. Too tall? Teased. Too fat? Teased. Too thin? Teased. And so on, with any possible difference.

Kids want to fit in because they’re scared. They haven’t learned that all the other kids are scared, too. The proper response is to teach them that they have value because they’re who they are, not in spite of it. Parents must teach them to not be afraid. Kids can overcome being scared because of the locker room. They can’t overcome being scarred because of the locker room.

¹ I removed the player’s name. You can find it in Mr. Jones’ original blog entry.