Friday, July 19, 2013

My responses to the Gentleman Scholar on "The Unkindest Cut"

I appreciate that the author recognizes that the AAP statement relies mostly on foreign data that doesn't apply to the American conditions.

As a disclosure, I don't blame circumcision on every frustration of my life. In fact, I'm not frustrated at all, I've had a quite enjoyable life, and I didn't question circumcision until I was in my early 40s.

As for the AAP Technical Report, I'm most surprised by an interesting sentence:

"Parents should weigh the health
benefits and risks in light of their
own religious, cultural, and personal
preferences, as the medical
benefits alone may not outweigh
these other considerations for individual

This is a statement that requires some thoughtful reading, because it's deceiving. What it really means is that the "health benefits" alone may not outweigh other considerations UNLESS you have a cultural or religious bias towards circumcision.

The AAP remains blind to the sexual effects of circ on the adult male. When 38 non-U.S. physicians questioned this (and pointed the cultural bias), the AAP responded:

"However, the task force
did not move beyond what these
studies actually reveal (the foreskin
has nerve bundles and pain fibers,
the foreskin contains Meissner corpuscles,
the inner surface of the foreskin
resembles a mucous membrane)
to speculate about the effect that circumcision
might have on sexual function
or pleasure."

Cultural Bias and Circumcision: The AAP Task
Force on Circumcision Responds,
doi:10.1542/peds.2013-0081, published April of 2013

Isn't this interesting? Basically they acknowledge that they don't know or understand what sexual role the foreskin has. Isn't this an important question to research by a task force that is going to provide a recommendation about the routine excision of this tissue? If they didn't have an answer to this question, should they have even published a Policy Statement?

Be it also the chance to remember that one of the 8 members of the Task Force, Doug Diekema, was also the Chairperson of another committee that in 2010 presented a policy statement on "Ritual Genital Cutting of Female Minors", advocating for physicians to be able to provide a "ritual nick" which would have been less extensive than male circumcision - and which would have been a federal crime based on the FGM law of 1997. Public outrage (including the WHO and UN) forced the AAP to retire this Policy Statement.

Add to this guy Diekema at least 2 physicians from a cultural group that practices religious circumcision, and 5 other physicians who were likely denied the right to experience their own foreskins, and you have the task force that presented the new Policy Statement. Is it any surprise that there would be some kind of cultural bias?

A reader commented:

This is what makes this such a headache issue.

There are bad things that can happen if you get circumcised, but they're vanishingly rare.
There are bad things that can happen if you don't get circumcised, but they're vanishingly rare.

Whichever decision you make, the vast majority of the time it's going to turn out fine.

But for some reason, to certain people, these vanishingly rare outcomes are the most important thing in the entire world. Even moreso, arguing endlessly about them on the internet is the most important thing in your life.

The people who REALLY care about this stuff are absolutely OBSESSED with it. There is no rational discussion with them; it's all in hysterical, apocalyptic terms

I responded:  

If one of those bad complications occurred to you, you would still only have one body and one life. Once chance. So it wouldn't be a big deal. As it happened to David Reimer, who lost his organ during his circ. and was raised as a girl for a while. He committed suicide at 39.

But even without complications, circ removes erogenous tissue that has functions during intercourse. That's not a small deal.

I recently met a new friend who tells that he always experienced pain during m** since he was a teenager, but he never thought anything about that because it was the only way he head experienced it. Until he became open to the information and realize that it was the result of an otherwise successful circumcision. How many other males experience pain like this, we will never know.

There is a reason to be this obsessed: stop the cultural inertial. If this procedure is not necessary and can cause harm, why continue doing it? But how do you stop the snowball rolling down the hill?

Another person commented:

I love this notion that circumcised men have "inferior" orgasms.  
It may be a slightly different path to orgasm town, but when they get there they're there. 

I responded:

One interesting little known fact is that the foreskin and the glans interact during intercourse, as the foreskin glides over the glans, causing friction between two very innervated areas: the ridge of the corona and the tip of the foreskin.

Without the foreskin, this mechanism is destroyed.

If you only had one eye, would you enjoy 3D movies equally, or less? You wouldn't be able to see the 3D effects, you know. The foreskin has nerve endings that are different from those on the glans: the ones in the glans perceive rough sensation, the ones on the foreskin perceive soft touch. Remove the soft touch, and you are listening to the bass but are missing the guitars in the song

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