Friday, June 28, 2013

Anticircumcision comes from a place of emotion?

Post: "Atheists that claim circumcision for boys is comparable to genital mutilation on girls are not coming from a place of fact, but rather emotion. I can understand the emotion.. but I recommend that atheists also embrace science and rational thought" (followed by a link to a news release of the AAP's policy statement).

My comment:

Let's go back to the original post, saying that the "claim circumcision for boys is comparable to genital mutilation on girls are not coming from a place of fact, but rather emotion"

Consent is a fact. Surgery without consent is battery. Now, parents are entitled to provide consent but they need to keep the child's best interest in their mind at all time. Consenting to non-therapeutic procedures is ethically troublesome, because it is unknown if the procedure is in the child's best interest or not, in other words if the child had the rational capacity to decide, would he/she undergo the procedure or not.

Circumcision is an elective surgery. It does not treat a disease or condition. Its preventive benefits are not that great for the AAP to recommend it, and if you read the technical report you will find out that those benefits come with the price of complications. Copying straight from page 14 of the report:

It is difficult to establish how many male
circumcisions it would take to prevent
a case of penile cancer, and at what
cost economically and physically. One
study with good evidence estimates that
based on having to do 909 circumcisions
to prevent 1 penile cancer event,
2 complications would be expected for
every penile cancer event avoided.121
However, another study with fair
evidence estimates that more than
322 000 newborn circumcisions are required
to prevent 1 penile cancer event
per year.122 This would translate into
644 complications per cancer event, by
using the most favorable rate of complications,
including rare but significant
complications.123 The clinical value
of the modest risk reduction from circumcision
for a rare cancer is difficult
to measure against the potential for
complications from the procedure. In
addition, these findings are likely to
decrease with increasing rates of HPV
vaccination in the United States.

So you see, to prevent ONE case of penile cancer, you are going to have to perform between 909 to 322,000 circumcisions and cause complications to an estimated 2 to 644 boys. That is hardly proportional!

So given the small preventive value of the procedure and the potential for complications, it is problematic to force it upon a child, who in case of complications is the person who will have to carry the consequences.

What's common between male circumcision and female circumcision is that both procedures are non-essential and both are forced upon minors who do not have the capacity to consent or to reject the procedure.

People think that what's bad about female circ. is that it's performed in the bushes, with unsterile equipment. This is true for some cases, but this is not the reason it's bad. In fact, female circumcision of minors used to be performed in the United States by doctors up to the 50s, and it is still performed in clinics in Malaysia and Indonesia. Does that make it right? No. It doesn't.

So what is wrong about it? Is it the removal of the clitoris? Well, that's not how they do it in Malaysia or Indonesia either, where they scrap the surface of the clitoris or pinch the clitoral hood. And yet that's not right to do and would be illegal in the United States.

So what is wrong about female circumcision?

Circumcision (both of males and females) can be done in many ways, on babies or on older children, with sterile equipment or in the bush or in the grandpa's kitchen table (as was the case of the son of Andrew Freedman, one of the members of the AAP task force on circumcision!)

So what is wrong then? The violation of consent. The violation of a right to self-determination. The removal of healthy normal erogenous tissue without the permission of the person.

And that, my friend, is a fact.

Sure there are decisions that parents take, such as vaccinations, religion, etc. Those decisions have one difference: they don't cut part of the body of a child. Trying to make it a parental right is an appeal to emotion and lack of rationality.

Circumcision interactions


"I'm curious why this is such a big issue all the sudden. I would have rather had it done while I was young. I don't regret being circumcised, and all my equipment works fine. I cant imagine it being more sensitive than it already is."

My answer:

It's not all of a sudden. "Medical" circumcision in the U.S. and English speaking countries started in the 1870's as a way to stop boys from masturbating. Some medical doctors opposed routine circumcision even in 1900. Intellectuals have been protesting circumcision at least since the 60s (see In the name of Humanity, 1967 book) and the intactivist movement can be traced to 1970 in Tallahassee Florida with the brothers Van and Benjamin Lewis. The only difference is that this information has been gaining momentum and more and more people are becoming aware of it.

When Europeans or Latin Americans come to the U.S. and find out that this is done to babies here, we are just shocked. I was circumcised in my country, and yet when I came to the U.S. I couldn't believe it when I learned this was done to most of the babies here. It just doesn't make sense to us.

Think about this: female circumcision was also advocated by those same British and American doctors in the late XIX century. The U.S. performed clitoridectomies of girls up to the 60s, although not in the same quantity as male circumcision. Then, in the 70s, "all of a sudden" people started talking about that thing that was done in Africa to girls. Nobody wanted to remember it had been done here too. And soon, it became almost universally condemned through the Western world, with the United States banning it in 1996, and a 2012 U.N. resolution to try to ban it globally. And yet it's still done in Africa and the Middle East.

The problem with these "cultural customs" is that it is difficult to break the inertia. Tradition has a power to obfuscate rationality, to see the harm. You can see it in Spain where people defend bull fighting as an art form and a sport. There are so many examples.

Circumcision here is mostly a social custom. Doctors say they do it because parents request it. Parents say they do it because doctors offer it, or because they want to prevent some horrible infections that don't appear to occur in the rest of the world, or because their son will be made fun of if they don't do it.... It's a vicious circle.

Oh and you say you can't imagine being more sensitive than you already are. I understand that. But let me explain something: the Meissners corpuscles in the foreskin are different from the nerve endings in the glans. They specialize in soft touch, in other words in the subtle sensations, while the glans needs stronger stimulation (pounding). They complement each other, like the bass and the guitar complement each other in a song. It's the quality of the sensation, not the amount of sensation.

In fact, in the uncircumcised penis, the foreskin moves over the glans up and down with each stroke. When this happens, the glans stimulates the foreskin and the foreskin stimulates the glans. They work together. But if you take off the foreskin, this mechanism is gone. Now the glans needs more stimulation, which often means more pounding, stronger strokes. I know this because I'm restoring my foreskin, and although I'm not finished, I have enough skin now to have been able to experience this mechanism at my age of 40, which I never experienced before. And yet I will never have those Meissner's corpuscles, I will only have regular skin that can glide over my glans, but I take what I can.

There's nothing wrong with enjoying the equipment that you have, but that's not reason to perpetuate a practice that removes some of the sexual function.

And you say "I would rather had it done while I was young". But what if you didn't need it at all? What if your foreskin, like the one of the majority of men, was perfectly normal and didn't need any kind of treatment to be able to retract? If you had experienced having a normal foreskin at your age of sexual debut, most likely you would never had wished to be circumcised. But once they circumcise you at birth, they took away your chances to ever know that. And that's not fair, it wasn't fair to you.


"I know a small handful of men that were circumcised later in life and they love the fact that they are now circumcised, wishing it was done as an infant. Not one of them say they've lost sensation or now, all of a sudden, sex just isn't good. Honestly, I think if we stop calling men mutilated, then they might be proud of themselves. No man should feel ashamed. But this is what many do, call men/boys mutilated. Circumcision is not mutilation."

My Answer:

Well, my own experience was going through this at 5 years and wishing it was never done.

I never questioned it until I started restoring, at 40. What I found, 6 months into restoration, is that having the ability to move the skin over the glans makes all the difference in the world, and I can only wish I had started restoring before. Once you experience the sensation that comes with being able to move the skin over the glans, you realize that taking away that ability from someone who has not even experienced it yet is definitively a mutilation, sorry to say.

I understand there are people who have pathologies and conditions of the foreskin where it cannot retract, this is something that is usually found out during adolescence and early adulthood, and for those people, circumcision can become a necessity and they will definitively appreciate becoming circumcised. However, they are a minority, and that's not justification to do it to newborns "just in case" they would grow up to need it. In fact, some men with phimosis (but not all) can overcome the condition in a more conservative way, without removal of tissue.

Monday, June 24, 2013

Why circumcision should be abhorred

Excellent article (prior to the AAP's statement of 2012). I want to call attention to a comment by Joseph4Gi:

Usually, research tries to find alternatives to surgery. Don’t doctors usually try to find a solution to cancer before it means a mastectomy? A prostatectomy? Don’t they run tests first to make sure that surgery is absolutely inevitable?

Researchers usually say “we have found the cause of x, and we’ve devised this pill, treatement etc., and now you don’t have to get this operation! Isn’t this great news?”

If a doctor told you this, would you be jumping for joy saying “yes! my son won’t have to be circumcised!”? Or would you take your child to a doctor that will circumcise your child for you and tell you the soothing words of all the “medical benefits” circumcision might have to justify what you want to do to your son? Pay attention to your answer. This will define whether you really are concerned for your child’s well-being, or merely your own.

It is peculiar that instead of searching for an alternative to surgery, “researchers” are busy trying to legitimize it, if not necessitate it.

Friday, June 21, 2013

To the (happily) circumcised males

"When you first learned of your own circumcision, you were somewhat confused, but came to accept it through the indifferent attitudes of those around you. You considered it an oddity, but believed that your parents would never have done something to you unless it was an indisputably good thing. You remained unsure of precisely what the foreskin was, because no one ever bothered to explain it you; indeed, most of the people you looked up to were unsure of it themselves. You resisted the urge to question the the procedure, and to ask why it was done to you, because you believed that whatever the reasons were, they must have been good ones. "  Read more:

Monday, June 17, 2013

Circumcision, HIV and AIDS

Did you hear that circumcision reduces the risk of contracting HIV through heterosexual relations up to 60%?

Do you know what's the absolute risk of a male contracting HIV from a female partner?

10 reasons why circumcision is not a good strategy against HIV and AIDS, courtesy of Intact America:

1. More effective, non-surgical HIV prevention methods already exist. Condoms and other safe sex practices protect all sexual partners over the long term.

2. Randomized controlled trials (RCTs) are not applicable to the real world. The three African “trials” have not been replicated anywhere and, because members of the “control” groups were either circumcised or lost to follow-up, there is no way of tracking long-term results.

3. Mass circumcision campaigns squander limited resources by failing to identify those most at risk, and failing to offer unbiased information. Supporting circumcision of children and men who are not at risk and may never be at risk is unethical and wasteful.

4. Mass circumcision campaigns are unscientific.Men are being circumcised regardless of their HIV status, putting their partners at risk, and making accurate assessment of the campaigns’ efficacy impossible.

5. Mass circumcision campaigns are unethical. Patient protections such as informed consent and follow-up for long-term complications are cursory or absent. Evidence is emerging that boys and men who refuse circumcision are being stigmatized and excluded from participation in sports and other social activities.

6. Mass circumcision campaigns attempt to normalize and sell circumcision in cultures where the intact male body is traditionally valued. Boys –like girls– should be protected from genital cutting to which they cannot consent, and which has lifelong consequences.

7. Male circumcision puts women at GREATER risk for contracting HIV. Women whose circumcised male partners erroneously believe they cannot spread the disease will be unable to negotiate safe sex practices.

8. Circumcision results in burdensome complications in boys and men. The World Health Organization has noted that clinical circumcisions have an 18% complication rate. A neonatal circumcision complication rate of 20.2% was found in Nigeria.

9. General population data show circumcision to be associated with higher rates of HIV in many countries around the world. In Zimbabwe, where a mass circumcision campaign is in full swing, recent government statistics showed an HIV prevalence of 12% in intact men and 14% in circumcised men.