Posted: May 15th, 2015 | Author: Tony | Filed under: Ethics, Logic, Mission | No Comments »
This excellent post on activism by Freddie deBoer captures what I’ve been thinking lately. The context is different, and I largely disagree with his politics, but the larger theme remains activism and convincing people of ideas. If you only have time to read Mr. deBoer’s post or what’s below, click that link.
I’ve been frustrated about the direction of activism for genital integrity rights for a longer time than I’m willing to accept. I’m not going anywhere. I haven’t changed my mind. But it’s difficult to expend the effort when so many are fighting those who agree on the goal and demonizing those who we need to convince. Maybe there’s a cause where a punch in the nose is the right activism. This isn’t it. Doing so only makes the process harder and further pushes out the day we achieve full protection for all children, male, female, or intersex.
I remember many political fights over the last decade-plus that I was sure would turn out a specific way. The most recent example is the general election in the United Kingdom last week. I was convinced Labour were going to win. “Go Labour” was all I saw on Twitter. The Rise of Ed Milliband was everywhere in my news feeds. And then the election happened. David Cameron remains Prime Minister, but with an actual majority instead of a coalition government. The exact opposite of the expected result occurred.
British Politics Twitter melted down from the moment the first exit poll leaked. “How could this be? Impossible! We’re doomed!” And so on. I reacted this way in years past, and I felt justified in doing so. I’m right, after all. Except when this happens enough times, it’s wise to step back to figure out why expectation and result don’t match. We need to examine that chasm for genital integrity rights.
I believe the explanation for this experience is the same for politics and genital integrity. The Internet is not society. The Internet is a specific, motivated subset of society. It will change the world, probably. But this change will occur only if we realize that most of the people we need to convince don’t care about our obvious intellectual win in a long-running feud with oppositional trolls.
It isn’t that a large percentage of society is being obstinate, refusing to change. For most people the issues important to activists aren’t merely unimportant. They aren’t real. How many times have we heard, “I don’t know any men who miss their foreskins/regret being circumcised”? The answer is always, accurately, “Yes, you do. You don’t know who they are because it isn’t safe to say such a thing in most company.” Consider the immediate reaction in the UK election: “Why were Tories so afraid to tell pre-election pollsters that they’re conservatives?” It’s more reasonable to recognize that some people will not tell another their truth if they believe it will be dismissed or ridiculed.
That’s the crux. People aren’t evil. They’re unaware. It’s ignorance in the purest definitional reality. Perhaps there is a better way for them. We can show them. Will we show them?
With politics, we all believe that our views are correct. Maybe. With genital integrity, the truth is clear rather than subjective. Society should already be where we are on this issue. Of course. But it would be foolish to use that to inform our activism. We must educate. Antagonizing only keeps us out of the experience of those we need to convince. As I’m sure I’ve written before, would we rather be right or victorious?
It would be wonderful if we could explain ourselves to a sufficient number of judges and legislators. Boom, everything changes. That isn’t how change happens. Courts and legislatures lag society. Justice derives from those who refuse to participate in injustice any longer, not those who would command us not to participate. This is true even though providing legal protection for the inherent right to genital integrity to all citizens is the only ethical stance. The burden of proof shouldn’t be on us. The burden of proof is on us.
Where do we go from here? I wish I had the magic words that would fix this. However, if you read Mr. deBoer’s post, magic words are the opposite of what we need. We have too many magic words now. Cutter. Circumfetishist. Rape. Sexual crime. And so on, even to mutilation in many contexts. Using these words signals to a preferred segment of activists that only we understand how truly awful circumcision is. Perhaps. And it feels so good, right, so it doesn’t matter what the cutters and circumfetishists think, except what the people called cutters and circumfetishits think is all that matters. They have all the power to stop circumcision. We need to stop aiming to convince those who are already convinced.
How do we educate the people who need to be convinced?
Posted: February 5th, 2015 | Author: Tony | Filed under: Mission | No Comments »
When I complain about certain behaviors within our community, I’ve thought about them. I’ve witnessed them. I’ve seen fence-sitters become opponents. I’m working to figure out what is effective at getting our message across.
I also believe in decency and treating people with respect. I find it exhausting when people support circumcision, or merely parental choice, based on incomplete and/or wrong reasons. But outside of a few examples we can all immediately name, most people who accept such reasons are doing what they can. In the best sense, they don’t know yet. I don’t accept that as a sufficient defense, but we’re not going to achieve anything good by ignoring reality. Our job is to get people to full understanding, not to demolish them for not being there yet.
In essence what I write on this is often me thinking out loud. My experience shows me lessons I believe are universal. I may not be expressing my ideas clearly enough, or acknowledging that I know the line is grey. I’m trying to find that line, if it exists. More than anything I want us to succeed. But I haven’t forgotten this possibility on what effective civil discourse means: I may be wrong.
Posted: February 4th, 2015 | Author: Tony | Filed under: Ethics, FGM, Mission | No Comments »
I like this post by Jonathan Friedman:
Friday, February 6 is International Day of Zero Tolerance for Female Genital Mutilation (FGM). There is a lot of positive momentum in the UK and around the world for education and prosecuting those who practice or aid FGM. This is a day for us to learn more about FGM, to listen to the victims and to learn how FGM is being eradicated. Many of us know very little about it and have never even met victims of FGM.
That’s correct. It’s too easy to forget that children are violated, not just boys, because of what is most familiar. It’s also critical to remember this reality:
Unfortunately, there’s also a great deal of sexism within the discourses on FGM, especially coming from cultures practicing male genital mutilation (MGM). Great care is taken to state that MGM and FGM aren’t comparable, while intersex genital mutilation (IGM) is virtually ignored. MGM has recognized health benefits, FGM does not, they point out. MGM is a religious requirement, FGM is a cultural practice. And so on.
Many women’s organizations recognize MGM for what it is and speak out. On December 12, 2012, I attended my first Bloodstained Men & Their Friends demonstration in Berlin, Germany, the day the German Parliament passed a new law enshrining MGM as a religious right. The event was co-organized by Terre Des Femme, a women’s rights organization. I can’t express how comforted I felt getting up there on stage in a bloodstained suit with a group that included a woman.
People are complicated. I trust that anyone opposed to FGM is – or can be – receptive to the truth that boys have the same rights as girls. We should challenge mistaken beliefs where possible. But we can’t make enemies of potential allies because it feels good to launch these wide, careless attacks. Everyone involved is justifiably angry to some extent. Some are angry, and others are more angry. It’s natural. We can’t allow that anger to become so righteous that we lose control. Don’t be an accelerant:
So to them I say: don’t be an accelerant. Be a passionate advocate when necessary. Speak truth to power when you feel it’s right. But train your powerful tools of criticism of others on yourselves, and be ruthless when it comes to your own good intentions. Ask yourself: when I intensify this conflict, when I beat my chest and declare someone evil, when I throw fuel on the fire, am I really helping the people of color and women I claim to speak for? When I go for the jugular again and again, am I actually helping to solve injustice? Is this kind of engagement from me an instrument of political progress? If not, why am I doing it? How am I contributing to this cause?
The context is different, but the same. It never helps protect children when someone spews hatred at a group of people united only by the attacker’s presumption of the group’s hatred of boys. Pick a group targeted for vitriol, whether it’s women as in the tweet linked above, or Jews, or doctors, or any group, really. When did smearing someone achieve a single helpful thing? Lazy accusations of misandry don’t help. How many times do any of us need to see images from issue two of Foreskin Man in news stories and blog posts to understand how damaging that vileness is? You think you’re making the point that circumcision is awful and how dare you not understand that circumcision is awful. You’re making the point that you’re unhinged and scary and best ignored.
Back to Mr. Friedman’s post, in this paragraph he states exactly what activism should be:
When space is created for talking about FGM, we need to respect the intentionality of that space. When that space is used to defend MGM or IGM, we must raise our voices as appropriately as possible. We have been accused of minimizing FGM by comparing it to MGM and taking resources away from FGM, as if we’re all in competition. Whether or not these allegations are true, people perceive these as being true (on the whole I think they’re false, but I can’t speak for everyone).
It’s correct for discussions of FGM. The concepts of appropriateness and respect are broadly applicable. That willingness to consider others and to understand that we need to explain our position will achieve more than “Shut up” ever could. Do we want to feel superior or do we want to protect children?
Posted: January 28th, 2015 | Author: Tony | Filed under: Ethics, Mission | No Comments »
I’ve written about how dreadful Lindy West’s thinking has been on male circumcision. But it’s possible she’ll understand the ethics involved and how it requires a slight-but-critical shift in her approach to the issue. There is a much better chance that will happen by challenging her mistaken idea rather than attacking her. In an interesting episode of This American Life where Ms. West tells of interacting with “her meanest troll”, she explains why this approach makes sense.
If what he said is true, that he just needed to find some meaning in his life, then what a heartbreaking diagnosis for all of the people who are still at it. I can’t give purpose and fulfillment to millions of anonymous strangers, but I can remember not to lose sight of their humanity the way that they lost sight of mine.
Humans can be reached. I have proof. Empathy, boldness, kindness, those are things I learned from my dad, though he never knew how much I’d need them. Or maybe he did.
I’d rather reach people, including Ms. West.
The same sentiment is in this post by economist David Henderson at EconLog. He discussed how his mother stood up for a student suspended for growing his hair long. She did so anonymously, and to the principle. When she had a chance to attack a man whose life contradicted his own defense of the suspension, this:
“Come on, Mum” (we used the British rather than the American version), I said, “Make it more direct. Say something like ‘others with our choices of scarves.'”
“No,” she said.
“How come?” I said, disappointed that she wouldn’t stick in the knife.
“Two reasons,” she said. “First, that’s mean. And that’s enough of a reason. Second, I want to convince not just the other readers but the person who will read this most closely: Harry. If I embarrass him, he’s less likely to reconsider his views.”
That is the activism in which I strive to engage.
NPR link via The Stag Blog, where Lucy Steigerwald writes, “Obviously I have major problems with Jezebel, and sometimes with Lindy West in particular, but I enjoyed her This American Life segment on talking to her meanest troll. Humans are humans! Just imagine!”
Posted: August 30th, 2014 | Author: Tony | Filed under: Ethics, Logic, Mission, Pain, Parenting | No Comments »
Here is another good video about circumcision from Dr. Lindsey Doe, a clinical sexologist.My only caveat: I’m not a fan of the book Dr. Doe recommends at the end. I’ll post a review here eventually to explain why.
Posted: August 10th, 2014 | Author: Tony | Filed under: Ethics, Media Marketing, Mission | No Comments »
8/12/14 Edit: I’ve edited the links in this post because the html was broken. All content remains unchanged.
Disclaimer: Based on what I documented in my last post, I’m unconvinced this disclaimer will be noted or accurately represented by paper0airplane, but I write it with the common usage of the words: The behavior in the linked screenshots is deplorable. It isn’t something I support.
I asked for evidence to support paper0airplane’s accusation that a “prominent intactivist … has decided to set up a database of circumcised boys.” I said it was deplorable and that “[m]y guess is that it’s true,” while asking for a source. That was a simple demand that brought a ridiculous response (that didn’t source direct criticism with a link to my post). That response, addressed here, included this in a comment:
… It’s not a problem to provide their sources. However, I am pretty sure that even if I were to, that fact wouldn’t make it into the blog post.
In what I presume is a passive-aggressive challenge, paper0airplane posted two screenshots to support part of the original claim. I encourage you to review them. They’re repugnant and deplorable. Learn from them what the behavior of an ass can include.
I, of course, expect it to be completely obvious that my original point stands. It is not appropriate to assign the bad behavior of a person to every person who shares a nominal goal. I expect paper0airplane’s behavior in this series of posts to reflect only on paper0airplane, and not well. But anyone else who also incorrectly believes parental choice is legitimate for non-therapeutic child circumcision is not responsible for paper0airplane. I expect the same basic courtesy, which reflects my belief that people are individuals first.
For the record, I do not know the person mentioned in the screenshots, as I wrote twice, nor am I aware of any alias Facebook accounts she might use. I do not use Facebook for my activism.
As for the database mentioned in the screenshots, I have questions.
- I’m with paper0airplane’s point from the original post. Why? This database doesn’t achieve anything toward ending the practice of non-therapeutic child circumcision.
- Where is she getting her data? Medical records are private. HIPAA is supposed to protect this data. Is it collected from what people post publicly on Facebook?
- Is there evidence that this website exists or is under construction? Is there a URL? Is it “merely” pointless, damaging trolling?
The comments in the screenshots aren’t dated, so I don’t know when they occurred. Also, this doesn’t provide evidence that the person was arrested for harassment.
Posted: September 5th, 2013 | Author: Tony | Filed under: Ethics, Logic, Mission, Public Health | No Comments »
Dr. Lindsey Doe, a clinical sexologist, hosts sexplanations on YouTube. It’s an excellent show that educates viewers on human sexuality. In the latest episode, “How to Deal with Sexual Injustices”, she talks about injustice with a focus on male circumcision. She is spot-on in her analysis and how to approach this injustice on a personal level. Please watch. (It’s obviously NSFW based on strong language and topics.)
The circle she created about circumcision is an excellent starting point. (Here’s a screencap of that circle.)
Posted: August 20th, 2013 | Author: Tony | Filed under: Ethics, FGM, Mission | 3 Comments »
This almost-good post from the AHA Foundation, FGM is Not Female Circumcision, and Other Thoughts on Terminology, is worth discussing for the reason it is not good.
The premise that female genital mutilation (FGM) is not “female circumcision” is correct. Language matters. In basic semantics, calling FGM “circumcision” is inaccurate. The etymology of the word circumcision means “to cut around”. That can be done to the female prepuce, in a sense, but that’s not how we understand it. I’m willing to grant this, and the result that the term circumcision doesn’t apply to females.
The gist of the AHA Foundation’s post is about the ethical implications from terminology:
A number of organizations and advocacy groups refer to the procedure as “female genital cutting”, or “FGM/C” to encompass both terms. The argument for “cutting” instead of “mutilation” primarily hinges on the belief that mutilation implies malicious intent on the part of parents or the community, or is otherwise demeaning or insensitive to the cultural particularities of any group that performs FGM. Some argue that referring to it as cutting is a less provocative and more balanced term. Particularly when speaking with those who have undergone the procedure themselves or in reaching out to affected communities, we do see the value in using the more neutral terminology of “cutting” rather than “mutilation”, but otherwise believe it important to state clearly that the procedure is a form of abuse.
I agree with that. What is done to the healthy genitals of females without their consent in any form of FGM/C is morally and ethically wrong. It is indefensible. We must be clear that this violence is abuse. It should never be tolerated.
The AHA Foundation’s post fails because of its next-to-last paragraph.
The argument for referring to FGM as “female circumcision” is blatantly off-base. Female circumcision was the popular term until approximately the 1980s, when FGM and FGC came into usage. As mentioned above, to perform a procedure that parallels male circumcision, one would only remove the prepuce of the clitoris, something that is hardly ever done. (The prepuce is the “hood” or fold of skin that surrounds the clitoris and has no impact on sexual arousal or pleasure.) In nearly all cases, at minimum, either part or all of the clitoris, labia minora, labia majora is removed. To use the term “circumcision” to refer to what is happening to these girls minimizes the brutality of the procedure and ignores the fact that is an act of violence.
First, the paragraph is likely factually wrong when stating the clitoral hood has no impact on sexual arousal or pleasure. It’s bizarre that this made it into the post. I suspect the connection is an implication that the male prepuce also has no impact on sexual arousal or pleasure. Whether the clitoral hood affects arousal or pleasure, its removal would alter the woman’s sexual experience. That is a reason removing it without the individual’s consent is unethical. The parenthetical makes no sense.
To my point, since the post brought it up, what parallels male circumcision is not the only consideration. There are recognized forms of FGM/C less harmful than male circumcision. Much, if not all, of Type IV is comparable to or less harmful than a typical male circumcision. The stated, correct argument against FGM/C in the post (and elsewhere) is that any genital cutting on a female without need or her consent is wrong. (Including removal of the prepuce.) Any lesser conclusion or implication for male circumcision is moral relativism.
The paragraph’s flaw is its implication that FGM/C should not be called circumcision because circumcision is not a brutal act of violence. I doubt this is what the author means. I trust that the AHA Foundation recognizes that males possess the same “basic rights and freedoms” listed on its About page, including “security and control of their own bodies”. But the argument in that paragraph is predicated on minimizing a form of genital cutting, and based solely on gender. The general thrust of the debate is that FGM/C is often done with crude instruments in unsanitary conditions. It is. However, no one suggests that FGM/C performed in a hospital setting with clean instruments is somehow acceptable. At its core, cutting healthy genitals without the person’s consent is the issue.
The accurate approach would’ve been to leave out male circumcision and focus the paragraph accordingly. It would not be difficult. For example: “The term circumcision minimizes the brutality of genital cutting without need or the individual’s consent and ignores the fact that it is an act of violence.”
I do not believe those focused on ending FGM/C are required to actively advocate against male
circumcision genital cutting. I expect them not to state or imply that male genital cutting without need or consent is acceptable. I expect them not to do this, from an exchange that started with the bottom tweet¹:
They responded to me:
We’re not advocating for anyone to be cut, only trying to point out the severity and harm done with #FGM.
I recognize that, as I indicated. But the response to Mr. Cummins was incorrect. There is no excuse for saying something false. (Or following up in agreement to his ad hominem.)
An organization that carelessly ignores the broader foundational principle to its work deserves no credibility. Every point that rejects FGM/C in the post applies to male genital cutting. In the points where the severity between the two is almost always different, and radically so, that is a critical distinction I’ve highlighted before. But something that should inform punishment rather than legality should not be used so recklessly. FGM/C isn’t made less terrible just because generally less-severe male genital cutting violates the same principle. Yes, those against forced male genital cutting need to be responsible when interjecting into a discussion on FGM/C, including by doing so less often. The same need for responsibility holds true for those who advocate against FGM/C.
¹ Contrary to Mr. Cummins’ rant, the argument is that non-therapeutic genital cutting on a non-consenting individual is wrong. There is almost always a difference in the degree of harm imposed from male and female genital cutting. It is often significant. But as the information in the AHA Foundation’s post also demonstrates, there is no difference in kind.
Posted: May 8th, 2013 | Author: Tony | Filed under: Mission | No Comments »
There’s a scene early in the film version of Abraham Lincoln: Vampire Hunter that illuminates an important lesson within the journey to full protection and respect for the genital integrity rights of all people. (Warning: Minor movie spoiler ahead.) Early on, Henry Sturges trains Lincoln to hunt vampires. It begins with chopping a tree down. Sturges asks why Lincoln wants to hunt vampires. “So, tell me, Mr. Lincoln, what do you hate?”. Lincoln answers and begins to chop at the tree. Sturges continues talking with every chop, forcing Lincoln to refine his answer. “Tell me what you hate.” “Inadequate.” “Pathetic.” When Lincoln finds his motivation, Sturges explains: “Power, Lincoln, real power, comes not from hate, but from truth.”
This resonates with me. I hate being circumcised. I hate it so much that I avoid writing or saying “my circumcision”. It is not something I want to possess or own. I express my hatred through semantic choices. But that can’t be the driving motivation for me.
Likewise, I hate that my parents thought this was their choice, or that I’d be thankful for it. I hate the doctor who circumcised me, although I have no idea who he or she is. I will never understand why someone thought it was acceptable to mutilate me. My only comfort there is that, being almost forty years on, that person is probably retired and unlikely to circumcise anyone else. To be fair, I’d like to express myself directly to that person, like this, but there’s little reason for me to focus on that now. It can’t drive me forward. It also can’t help me convince others to respect their son’s body and choice.
I want to focus on truth. I don’t even hate circumcision, considered independent of scenario. I don’t understand why someone would want it, but context matters. Non-therapeutic genital cutting on a non-consenting individual is unethical. That much I know. I don’t need to assume anything. I can assign good intentions to anyone considering circumcision for their son (or anyone who has already circumcised). That doesn’t mean I concede it could be (or was) a valid choice, or that the decision is defensible based on the ignorance that supports its continuation. The moment I learned of circumcision, I knew it was wrong and why. I don’t think it’s too much to expect others to reach this obvious conclusion. But I want to convince people who, for whatever reason, haven’t reached it yet. To do that, I need truth, not hate.
Yesterday I saw a tweet that said “The most disgusting thing ever is a female doctor who enjoys her own intact prepuce, but happily cuts a baby boys off”. I can’t think of a scenario in which this sentiment – and stated in this manner – eases the path to full genital integrity rights protection. Even ignoring the hyperbole and misogyny, this focuses on something hated rather than truth. It’s a good way to convince a doctor who fits that description that she may ignore the person saying it, that she doesn’t need to reconsider her decision to participate in circumcising healthy children. It’s a good way to convince parents that our activism is based in emotion rather than truth and facts. They can think the only science involved is that which shows some potential benefit somewhere down the line for some tiny minority of males, except they can also ignore absolute risk and assume circumcising their son saves him from some inevitable harm. It might feel good to say, but do we want to feel superior or do we want to protect children?
Instead, we should show that our position is based in a broader, stronger grasp of science. Healthy children do not need surgery. There are more effective, less (or non-) invasive ways to achieve the same protection. The risks of a normal foreskin are similar to any risk inherent in simply being alive, whether male or female. A normal foreskin, whether male or female, has functions. Truth is on our side. It’s more powerful than hate.
Posted: March 25th, 2013 | Author: Tony | Filed under: Mission, Parenting | No Comments »
You’re having a baby. It’s a joyous event. You’re excited and unsure if you’re up to the task. There will be a lot of on-the-job learning, as well as mistakes that will be more amusing with the passing of time. You’re not supposed to have all the answers, and with experience, it will be clear you can’t plot them all in advance. The discovery is part of the process that makes parenting so exciting and strange and human.
Strangely, we assume parents should make a choice on circumcision if their baby is a boy. Our culture declares that the decision is for the boy’s parents. I’m asking you to make a choice against circumcision because it’s not a choice parents should make for their healthy son(s). Rightly considered, the choice belongs to the individual, not his parents. He should retain his choice absent some medical need for which circumcision – the most radical intervention – is the only available solution.
There are numerous reasons to reject circumcision for your healthy newborn son. The easiest summary comes from a basic principle and an economics concept. First, the principle: non-therapeutic genital cutting on a non-consenting individual is unethical. The problem is not that circumcision is bad, per se. Healthy men who choose to have themselves circumcised are correct for their bodies. Men circumcised as infants who are happy (or indifferent) about being circumcised are also correct for their bodies. But when circumcision is performed on a male without immediate medical need or his consent, there is no guarantee he will be happy with his parents making his choice. That’s the economic concept. All tastes and preferences are subjective and unique to the individual. The boy may like being circumcised, but he may not. It’s impossible to know which a son will prefer.
As the decision is commonly framed in America, circumcision is a referendum on the father’s penis and should be performed on his son if dad is circumcised so that their genitals match. The assumption is that, if it’s good enough for dad, it’s good enough for his sons. However, we know more now than we did when dad was born. We know that circumcision, being surgery, inflicts some guaranteed amount of harm by removing the foreskin and possibly the frenulum, as well as leaving a scar. There is also the possibility of complications inherent in every circumcision. Adhesions, skin bridges, bleeding, infection, greater-than-expected damage to the penis, and worse are all possibilities. Aesthetic symmetry between father and son is insufficient to justify surgery on a child. Rejecting circumcision for a son is sensible, not a referendum on the quality or functionality of his father’s penis.
When those inherent risks are considered, they’re often discussed as a minor trade-off for the potential benefits. The problem is that infant circumcision is almost always non-therapeutic. There is no malady to be resolved, no objective trade-off to be made. Every benefit supposedly in favor of circumcision involves something that might happen or might be desired by the individual. It’s an aggressive intervention on a healthy child whose foreskin will likely remain healthy throughout his life.
Every potential benefit from circumcision can be achieved through less invasive methods that prevent or treat the uncommon ailments cited. Many of these methods, such as condoms, are still required after circumcision. In the unlikely situation where the child eventually requires intervention, a doctor up-to-date on treating an intact penis will still likely be able to resolve a foreskin problem without circumcision. Should circumcision be necessary, he will experience some pain. Leaving him intact does not guarantee that he will eventually experience this pain. Circumcising him when he’s healthy guarantees he will experience pain. The choice is imposing pain that he will feel or exposing him to risk that he might experience pain later. The latter involves pain that he’d likely be able to ameliorate with pain management that an infant can’t have. Even if we assume there is no pain during the procedure, there will be pain during the healing process. Add to that the presence of urine and feces in repeated contact with a healing wound, and the choice to wait until it might be necessary becomes clearer.
For the claimed medical benefits, I accept all of them as possible, even where, for example, I believe there may be flaws in the methodology of the relevant studies. The analysis still leads to the same conclusion if all benefits are assumed to be possible. The details of each matter against circumcision and reveal their flaws. When considered in context, the proposed benefits are weak compared to the availability of prevention methods and treatments both more effective and less invasive than prophylactic circumcision. As Dr. Morten Frisch et al state (pdf), the “cardinal medical question should not be whether circumcision can prevent disease, but how disease can best be prevented.”
To illustrate the weakness of the proposed benefits, consider two commonly cited potential benefits: UTIs and HIV. The benefit for UTIs is a risk reduction from 1 percent of boys in the first year of life to between .1 and .3 percent of boys in the first year of life. Even for the intact boys, this risk is already significantly less than it is for girls. Most UTIs are easily treated without surgery. The same treatments that work for girls also work for boys.
The Canadian Pediatric Society states that, within every 1,000 circumcised boys, two will be admitted to the hospital for a UTI before their first birthday. Within every 1,000 boys left with their foreskins, seven will be admitted to the hospital for a UTI before their first birthday. Factor in the circumcised boys who will need some further treatment for complications, and the risks become clear. Circumcision can cause more problems than it seeks to prevent. As the CPS states, of the 1,000 boys who keep their foreskins, only ten of them “will have a circumcision later in life for medical reasons”. Prophylactic circumcision to avoid a one percent risk of needing that circumcision later is odd.
For the reduced risk of HIV, there are several significant problems related to non-therapeutic child circumcision. This potential benefit has only been found for female-to-male transmission in high-risk populations, and the studies only looked at voluntary, adult circumcision. None of those three aspects describes the situation in the United States or other first world nations. Our sexually transmitted HIV epidemic is male-to-male, and circumcision has not been shown to have any benefit there. Further, the relative risk reduction from circumcision for female-to-male transmission in the U.S. is an estimated 15.7%, far less than the often-cited 60% relevant to Africa. The absolute lifetime risk of HIV infection is already low in the United States. The lifetime absolute risk reduction is small. This summarized table provides the details. And what will science know about preventing or curing HIV by the time a child born today is sexually active?
As stated before, condoms are still necessary after circumcision. Circumcision doesn’t change the male’s required sexual behavior. Parents retain their responsibility to teach him the importance of safe sex practices (and proper hygiene techniques). Nor is there proof that infant circumcision has the same benefits found for voluntary, adult circumcision. Apart from research on UTIs, the potential benefits have been found only in studies using adult volunteers. Despite both being “male circumcision”, the two are not quite the same surgery. The significant difference in consent is most critical, but the foreskin hasn’t separated at birth and must be forced free from the rest of the penis to circumcise an infant. This introduces additional physical trauma and risks for an infant.
The proposed cultural benefits suffer under examination, as well. He has his normal genitals? Women won’t date him, or his peers will make fun of him, the thinking goes. We forget to consider whether he’d prefer his foreskin more than a partner who requires him to be circumcised or if he’ll even encounter a partner who prefers circumcision¹. Parents can build enough self-worth into their children to withstand teasing. That’s essential because children will always find something about their peers to tease. If it’s not his foreskin, it’ll be his height or hair color or clothing or whatever else is easy. Anyway, the locker room fear is rooted in the experiences of prior generations when communal showering was common in schools. It’s best examined in the present rather than holding to a scenario that no longer exists, especially as fewer parents circumcise their sons. Half or more of his peers will be intact. If he is “different”, he’ll be different like many of his peers. As children grow, parents realize their goal is not to teach their child to conform, but rather to help him become an independent person whose differences make him who he is. Making a major, irreversible decision for him before parent and child have grown to that point in their relationship may become something the parent or the child regrets.
The premise of this approach is “I don’t know”. None of us knows. We don’t know what we’ll want in the future. We don’t know what science will discover that makes circumcision even more unnecessary to achieve the possible benefits. We don’t know who we’ll be or who we’ll meet. Not circumcising sons in the absence of medical need prioritizes optimism over unfounded fear. It’s about keeping their choices open until they can express their personal preference about what they want and what will make them happy. It’s a realization that “what if” can be about a good future rather than succumbing to a fear of unlikely dangers.
Your son will be born with a foreskin. His prepuce is normal. It will belong to him, just like every other normal part of his body. It has functions. You want what is best for your children. Your son can always have his foreskin removed later, either for need or choice. He can’t put it back if he wants it after circumcision. Choosing to leave your son intact is the better choice.
¹ Many non-Americans are flabbergasted when they learn that circumcision has been so prevalent in the U.S. Their primary experience is with men who still have their foreskins. Given the declining rate of circumcision, the future American partners of a child born today will likely mirror that acceptance.