Whether childhood circumcision is acceptable or not is an ethical question, not a medical one. Chuck Ross asks, why did we ever circumcise boys?
As Joanna Schroeder noted recently on The Good Feed Blog, the American Association of Pediatrics has dropped its neutral stance towards neonatal male circumcision after determining that the health benefits of the procedure outweigh the risks.
The AAP’s change on male circumcision is a response to studies conducted in Africa which show that circumcised men experienced a 40-60% reduction in HIV/AIDS transmission rates.
But Dr. Morten Frisch of Statens Serum Institut and Aalborg University in Denmark is critical of the AAP decision. In an email, he told the GMP that “in my view, the conclusions drawn and the public health recommendations made by the AAP are strongly culturally influenced.”
Dr. Frisch disagrees with the application of findings in non-Western countries to public health policy in the West. “Most, if not all of the claimed medical benefits in relation to childhood circumcision are highly questionable in a Western context.”
According to Frisch, the four main arguments in support of neonatal circumcision are penile cancer, urinary tract infection in infancy, HIV/AIDS, and other STDs. “First and last,” says Frisch, “whether childhood circumcision is acceptable or not is an ethical question, not a medical one.”
Frisch believes that the only valid reason to ignore the boy’s right to decide is the urinary tract infection issue “which … could have been easily treated with antibiotics.”
In research recently published in the International Journal of Epidemiology by Dr. Frisch et al. found that circumcised men and their partners suffer from higher rates of sexual difficulty than uncircumcised men and their partners.
Eleven percent of circumcised men and only 4% of uncircumcised men reportedly experienced frequent difficulties reaching orgasm. Thirty-eight percent of the female partners of circumcised men versus 28% of female partners of uncircumcised men experienced incomplete sexual fulfillment; 31% versus 22% experienced frequent sexual difficulties; 19% versus 14% experienced difficulties surrounding orgasm.
The question, as always, is why. Why has male circumcision become commonly practiced in our society? While today only about half of baby boys in this country experience the procedure, a large majority of men are currently circumcised. As recently as the 1970s, more than 80% of baby boys underwent the procedure.
As gender discussions have centered the past few decades on feminism and female sexuality, we often lose sight of how society places limitations on male sexuality, the removal of the foreskin of the penis serving both symbolic and functional purposes.
Medieval Jewish scholar Moses Maimonides provided a clue for the ritual’s underlying purpose in the Jewish tradition:
Similarly with regard to circumcision, one of the reasons for it is, in my opinion, the wish to bring about a decrease in sexual intercourse and a weakening of the organ in question, so that this activity be diminished and the organ be in as quiet a state as possible. It has been thought that circumcision perfects what is defective congenitally. This gave the possibility to everyone to raise an objection and to say: How can natural things be defective so that they need to be perfected from outside, all the more because we know how useful the foreskin is for that member?
The fact that circumcision weakens the faculty of sexual excitement and sometimes perhaps diminishes the pleasure is indubitable. For if at birth this member has been made to bleed and has had its covering taken away from it, it must indubitably be weakened. The Sages, may their memory be blessed, have explicitly stated: It is hard for a woman with whom an uncircumcised man has had sexual intercourse to separate from him. In my opinion this is the strongest of the reasons for circumcision.
Dr. Christopher Wilson published research linking the incidence of male genital mutilation (MGM) and polygyny, or the marriage of one man to multiple women.
Wilson found that 25% of societies practice some form of MGM. Forty-eight percent of highly polygynous societies practice it, and sixty-three percent of societies in which wives live separately from their husbands practice some form of male genital mutilation. Only ten percent of monogamous societies perform circumcisions. As Wilson finds, the mutilation can be as harsh as a crushed testicle, an incision at the base of the penis used to limit the quantity of ejaculate, or, as is more familiar to us in the West, the removal of the foreskin.
Wilson hypothesized that genital mutilation served as a signal of sexual obedience. When paternity was much less certain, adult males hoped to keep potentially competitive males at bay. Submission to social norms helped keep them in check, mentally, and the mutilation of their genitals (we can assume that the mutilations would have been much more severe back then; we’ve inherited the ritual but polished it up a bit) limited their reproductive capability compared to a man who shared a home with his wife (wives).
Wilson writes, “the idea that substantial amounts of male sexual tissue can be abated without [loss of sexual potency] is hard to reconcile with our understanding of sexual selection for genitalia, and any such argument must bear the burden of proof.”
So there existed in history a basis for the limitation of the male sexual drive—or at least that of up-and-coming “young bucks.”
The mechanism by which the ritual—mixed along the way with medical dogma—diffused from our ancestors to both monotheistic and polygynous societies alike and then to Northern Europe and the U.S. is unclear. What is clear is that the practice spread dramatically during the 19th and early 20th century through Victorian England and its cultural siblings (U.S., Canada, Australia, New Zealand, etc.)
European and American medical literature makes it clear that doctors sought to impose Puritanical limitations on male sexuality. Circumcision rates in the Anglo countries increased dramatically during the 19th century. Journals from the era are full of doctors touting circumcision in order to curb expressions of male sexuality, including masturbation.
One example, the aptly named R.W. Cockshut wrote in 1935 in the British Medical Journal:
I suggest that all male children should be circumcised. This is “against nature,” but that is exactly the reason why it should be done. Nature intends that the adolescent male shall copulate as often and as promiscuously as possible, and to that end covers the sensitive glans so that it shall be ever ready to receive stimuli. Civilization, on the contrary, requires chastity, and the glans of the circumcised rapidly assumes a leathery texture less sensitive than skin. Thus the adolescent has his attention drawn to his penis much less often. I am convinced that masturbation is much less common in the circumcised. With these considerations in view it does not seem apt to argue that “God knows best how to make little boys.”
Thomas Szasz, a psychiatrist famous for his criticisms of the medicalization and pathologization of natural human behaviors, noted the adoption by Northern European Christians of the historically Jewish and Muslim practice. By the end of the 1700s, he wrote, it had become medical dogma that masturbation caused medical problems ranging from blindness to acne to suicide. According to Szasz, the causes of this dogmatic overdrive:
The same thing that has turned youthful male exuberance into the dreaded symptoms of dangerous attention deficit disorder in our day: parental annoyance and anxiety combined with medical imperialism and furor therapeutics.
Male genital mutilation—including circumcision—stems from a historical desire to control the sexuality of males. Once having accepted the arguments for genital mutilation, however slight, as compelling enough to contemplate, the potential medical benefits must be weighed against the risks. We must also consider the cultural or national specificity of these risks, as well as the social message and individual trauma of circumcision.
Is something wrong with the natural male form? I don’t see how.
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