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.
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.
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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.
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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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Image of newborn baby boy courtesy of Shutterstock
Most of the world is intact, and natural, as it should be.The US and old time 1980’s Australia are pretty much the only archaic countries that still mutilate boys because their fathers are cut as well, This must stop. Getting mutilated for religious purposes MUST also stop as we are no longer in the middle ages. I find it ironic that we still talk about this with boys as it is nothing really but in women it is an affront! talk about a double standard. You cut a foreskin off, no one bats an eyelid, BUT cut a hood off… Read more »
I think it is barbaric to even contemplate mutilating something just in case something may happen later in life. Firstly you make the penis ugly by cutting off the foreskin, leaving a scar as well, also you have now removed 19 of the 21 most sensitive points on the penis. Why would you want to do this? Realistically if any gender needs a circumcision, it would be a female, remove the hood of the clitorus so sensitivity gets reduced by 20% plus, or remove the excess flaps of the labias to make the vagina look more acceptable and inviting. The… Read more »
The heart of the issue is rooted in Islam not circumcising .But some how the Muslim has no problem circumcising woman .Which is clearly a violence against woman .Somehow a woman having a clit is evil .Guess their false god Allah made a mistake .The Who ALL Need To Know http://www.chick.com/reading/tracts/1087/1087_01.asp
The study in Africa that “showed” that circumcision reduces the chance of HIV-infection flies flatly in the face of common sense as well as statistics. It is also a flat-out, fraudulent and incomplete study performed by not a biologist but a women’s studies/social studies major as well as man-hating radical feminist. What’s the country with the most male circumcisions? The US. What the country with the most HIV infections? You guessed it. And now the UN is going around circumcising 18 million African men because it prevents HIV, lying to them that they can no have unprotected sex without having… Read more »
The party line coming out of the Harvard and Johns Hopkins Schools of Public Health is that the USA underclass is undergoing an exponential increase in heterosexually transmitted AIDS. Young men and women at the bottom of American society are assumed to be either too poor or too demoralised to use condoms, and too lecherous to give up casual sex. The AAP has endorsed the position that a way forward is to make sure that boys born to underclass mothers are circumcised at birth, with Medicaid covering the cost. None of this can be stated on the record, under pain… Read more »
Bravo!!! Excellent piece and great analysis…and thank you for looking for GLOBAL facts and evidence…it is only when you read info outside the US do you realize that we circumcise because so many decision makers are in fact circumcised…so it must be good. Most of the world’s men are natural and intact and the sky HAS NOT FALLEN!!!
Sorry to be a grumbling outsider (it’s not an issue in the UK), but this issue gets me more and more annoyed the more I read about it. It’s bad science and bad argument. IF there’s any higher risk of contraction of infections, then it’s only if you’re exposing yourself to these infections in the first place. It’s utterly misguiding the issue. It’s hiding under a genuine issue to pardon a what I would argue is a socially accepted physical abuse. The foreskin performs at least two functions – the removal of something functional when there is no problem with… Read more »
My understanding is that most health insurances stopped covering it after 1999 when AAP in it’s previous statement on circumcision stated that it’s not necessary. That increase in non-coverage is considered a major contributor to the decrease in circumcision one has seen in the US the last decade or so. The new statement from 1999 will perhaps change this as this statement from Dr. Douglas Diekema (who is a not exactly neutral member of the academy’s circumcision task force) states: The tone of the policy certainly shifts somewhat in favor of circumcision in that it recognizes that there are clear… Read more »
Errata: The new statement is of course from this year (2012).
An important point about polygamy that some may be missing here — in polygamous societies, there is always the problem of large numbers of unattached males with no access to women. Polygamous cultures deal with the problem in various ways: (1) develop customs that permit a certain amount of sexual promiscuity to married women (this is apparently common in some subsaharan African cultures), (2) prostitution (forms of which have existed for centuries in Africa, e.g. independent women or widows selling their sexual services), (3) send the boys off to war where they can steal women from enemy tribes (a very… Read more »
That’s 100% mythical and in fact hysterical. In fact, you can’t point to any such society, citing actual facts where wars were waged due to shortages of women because of polygamy, as one example. The reason you can’t point to any such society is that there are more female than males, almost always. Hence, men marrying multiple women actually serves to keep there from being large numbers of unattached women. Further, you can only marry as many spouses as you can deal with and afford. Therefore, even people who are born poly, even where it’s legal, are limited to how… Read more »
sorry, but please show me statstics that there are more available women than men in polygamous societies where the men with resources all have 3 or more wives. What do you do with the extra men? And although I agree wars are about wsy more than women, in tribal societies, attacking neighboring tribes for women was quite common, the Bible even talks about how to treat women csptured in war — you have to wait 30 days or something before you can rape them, which I guess was supposed to be civilized and godly.
I repeat:your claim that (and I quote), “in polygamous societies, there is always the problem of large numbers of unattached males with no access to women” is mythical. There is 0% truth to that statement. “sorry, but please show me statstics that there are more available women than men in polygamous societies where the men with resources all have 3 or more wives.” As for this statement, It is YOUR claim that here are “ALWAYS LARGE NUMBERS of unattached males with NO access to women, so YOU must show ME statistics to support it.” Thus, you are the one that… Read more »
A shortage due to polygamy.
“Male genital mutilation—including circumcision—stems from a historical desire to control the sexuality of males.”
I can think of one (modern) example where this is true, but ancient MGM and FGM exist in a wider pool of body modifications which were used as a rite of passage and a badge of ethnicity. If it were as simple as controlling sexuality then wouldn’t it be limited to genitalia?
If it were as simple as controlling sexuality then wouldn’t it be limited to genitalia?
Um….do you really mean to say you don’t consider the foreskin to be part of the genitalia?
He’s saying there were other modifications too. For instance scarring the face or putting those big plates/hoops in the ears, lips or nose.
They might have had a different function though, unrelated to sex. Some clothes are very thin and see-through- that doesn’t prove that no clothes are intended to keep you warm and covered up.
Is this possibly a reason behind the scenes in the US? [On Germany’s ban]
“Women’s rights groups and social policy makers also condemned the decision, but for the reason that it would have the effect of putting male and female circumcision on the same footing, when they were “in no way comparable”, said Katrin Altpeter, social minister in the state of Baden-Württemberg. Female circumcision she said, was a far more drastic act. It is already outlawed in Germany.”
OMFG: Did that person just say that “Women have it worse” and we can’t allow boys to receive any kind of acknowledgement of pain and suffering because it might take the focus off women and girls. Wow, we really do live in one screwed up world don’t we. People really do believe this is all a zero sum game. “Women’s rights groups and social policy makers also condemned the decision, but for the reason that it would have the effect of putting male and female circumcision on the same footing, when they were “in no way comparable”, said Katrin Altpeter,… Read more »
Agree 1000% John. Especially considering that the quoted pundit admits that female circ is already illegal. How does making forcible circ illegal for *both* genders constitutes stealing thunder from women.
Apparently, if we give men full human rights then women will have to share the stage and this devalues women’s human rights??
I’m a feminist but I agree that giving women rights does not rely on taking men’s rights to good health away.
“First and last,” says Frisch, “whether childhood circumcision is acceptable or not is an ethical question, not a medical one.” The AAP will never agree, and put Diekema on the panel as a bulwark against ever having to admit this. If American admits that circumcision is primarily an ethical issue, that puts Jews all around the world in an extremely delicate position, and we can’t have that. It would also complicate the USA’s dealings with the Moslem world. I agree with Frisch when he asserts that cultural bias is to blame for the AAP’s new stance. I also believe that… Read more »
given that judaism managed to survive and even sometimes thrive in hostile environments for many thousands of years, perhaps circumcision is less effective at weakening sex drives and fertility than you imply.
Men slaving away 72+ hours a week in mines also survived usually long enough to sire children. Does this mean we should undo union’s work and make 72 hour weeks mandatory and remove sanitary and security requirements because it doesn’t kill entire populations?
ditto what Schala wrote. people can survive *despite* such conditions. it becomes a more meta question of whether they are being treated properly in a system that takes something away from them without their consent.
I think dhex’s point was that the “weakening sex drive” idea may not really work in the first place, so not only is the anti-male-sexuality motivation immoral and outdated, it doesn’t work anyway. I suspect she agrees with you about circumcision?
The hormonally-driven libido is unlikely to change. The “not in the mood for it” and “would prefer better conditions for it” might have higher standards, maybe due to pains when erect and such.
But never doing it? I doubt. Unless complications make it completely impossible.
How often do you need to have sex to sire a child? Once if at the right time.
my point was that the dancing around decreased fecundity – much less sex drive – is a red herring. whether circumcision is a good idea or a bad idea, this particular line of argumentation is complete bunk.
You are misunderstanding the argument. The problem with weakened sex drive is not reduced fecundity. I am sure you can see the difference between the two.
Even in a polygynous arrangement not a lot of male sex drive is necessary to keep all the wives pregnant, so that is not the issue.
Moslems circumcise, and Moslem nations have the highest birth rates on earth. The effect of circumcision on the male sex drive is highly variable in extent and age of onset. In most cases, the problem is not evident until a man is past his reproductive prime. The variability I speak of is so high that few of us are aware of the nature and extent of the problem. The signal to noise ratio is too small. I remain astounded that there has never been a study in an English speaking country of the possible correlation between circumcision and ED/PE. This… Read more »
The decreased risk of certain medical conditions may be true, but then the question for me is how common are these conditions, and how much of a decrease does circumcision really bring? I suspect that this is a case in which millions are circumcised, but maybe a hundred cancer cases are prevented.
By this logic, we should immediately take out every newborn’s appendix, a part of the body that is inherently dangerous. It can kill you, after all. Or remove the penis completely, which ought to seriously reduce the transmission of HIV if you did it to all boys….
Or perform mastectomies to prevent breast cancer down the road. Goes to show you that once a tradition or ritual is entrenched people will go to great lengths to rationalize its purpose.
Or remove one testicle/ovary to reduce the chances of ovarian/testicular cancer by 50%. Sure that means if you develop cancer in the remaining one you better hope you already had kids but what’s that matter when “PREVENTING FUTURE AILMENTS!!!”.
Or remove the penis completely, which ought to seriously reduce the transmission of HIV if you did it to all boys….
Don’t joke. There are already people (and not lone nutters as HeatherN like to call them sometimes) that regard the penis as a weapon that has killed more women than anything in history.
I know the ‘slippery slope’ argument can be a logical fallacy, but it sure is tempting. It’s one of my favorites when it comes to the ‘shoe on the other foot’ scenarios. Perhaps FGM, in making orgasm more difficult, also reduces the likelihood of sex addiction among young women. I’m sure if some African subcultures made that argument, they would be roundly denounced as barbaric and misogynistic. Thought, to be fair, this issue may have very little to do with women whatsoever. I only bring them up as a point of contrast. I bet dollars to donuts that 95% of… Read more »
I bet dollars to donuts that 95% of the male circumcisions in America are performed by men, just as the vast majority of FGM is done by women. But the trick there is when talking about women that perform FGM on girls that gets pushed to the side because patriarchy. Seriously how often do you hear about calling those women out as if they actually play a part in it? I know the ‘slippery slope’ argument can be a logical fallacy, but it sure is tempting. It’s one of my favorites when it comes to the ‘shoe on the other… Read more »
As I understand it, in the case of some very ancient forms of foreskin removal still practiced in a few subcultures in the U.S., the mohel follows hallowed practice and places his mouth on the bloody penis after the removal of the foreskin. (Admittedly, I’m getting this from Christopher Hitchens, not the most balanced of sources on such topics….) Perhaps this became part of the ritual because human saliva has coagulant properties that would have had few substitutes 3000 years ago. In most cases outside of religious doctrine, I’d call that a form of child abuse.
I seem to recall that there was a case a few years back where one mohel had transmitted a sexually transmitted disease (Herpes Type I)to a child while doing this practice. There was talk about a prosecution against him, but apparently it didn’t go anywhere. And a quick google confirmed my memory. A report from CDC ( http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6122a2.htm ) found that 11 newborn boys were diagnosed with an HSV infection from November 2010 to December 2011. 10 of them were hospitalized and 2 of them died. In 6 of these cases it was confirmed that the practice wellykaythen mentioned (metzitzah… Read more »
I seem to recall that there was a case a few years back where one mohel had transmitted a sexually transmitted disease (Herpes Type I)to a child while doing this practice. There was talk about a prosecution against him, but apparently it didn’t go anywhere.
Yeah I remember a few times hearing moms complaining about not being able to have it covered by med insurance anymore. So it may not be covered by as many companies as was in the past. But still, it’s pretty sad that you can possibly claim a violation of a boy’s body on med insurance.
God the designer/creator said on the Why the eighth day? New Born Babies peculiar susceptibility to bleeding between the early days of life.Then on the eight day Vitamin K and prothrombin levels are at their peak..So the baby does not bleed to death .God know how the human body works . Genesis 17:12, God commanded Abraham to circumcise baby boys on the eighth day of their lives. The eight Day .. Is there good, medical scientific rationale …. The Who You Need To Know http://www.chick.com/reading/tracts/1087/1087_01.asp
What we focus on, what we find horrible and what we accept is decided by the powerful.
The reason we left male victims behind is because people in power, as in people that decide and shape our discource of who and what a victim of genital mutilation is, found it convinient to theit goals to leave out males. Why it was convinient?
dunno really. Can be because male victims doesn’t mesh vhit their over arching filosophy, or any other reason.
I think the reason female mutilation is seen as more barbaric than circumcision is that the process is more violent/bloody/harmful- It can cause severe bleeding and problems urinating, and later cysts, infections, infertility as well as complications in childbirth increased risk of newborn deaths.
I’m not saying male circumcision is good, but I get a feeling you think men are being ignored by those flaming feminists and I don’t think that’s case.
I’m not saying male circumcision is good, but I get a feeling you think men are being ignored by those flaming feminists and I don’t think that’s case. I can’t speak for Nistan but I think the problem is that said feminists on one hand say they want rights for men and boys but then turn around and defend circumcision. If you bring up cultural and traditional justifications…. FGM: The culture doesn’t matter, it’s bad. MGM: Well there Jewish people and Muslims that practice it….. If you bring up sanitation: FGM: Look at how unclean the conditions are. MGM: At… Read more »
Nail on head,
I would also guess that the reason mutilations only really happen to men in N. America and W. Europe is that this extra discouragement from sex wasn’t necessary for women: In these times women couldn’t access contraception so their dalliances would be obvious and therefore punishable. I also think that women didn’t find so much pleasure in sex in centuries past- at least judging from old literature it seems to me sex was something you let your husband do to you as part of your “duty”, not something to seek out for pleasure.
The Muslims acting like the Islamic god Allah …. http://www.chick.com/reading/tracts/1058/1058_01.asp