Circumcision in America

Some years ago, the issue of female circumcision was thrust into the international media spotlight. Americans were appalled and disgusted that such a primitive practice was continuing, for few (if any) legitimate reasons. I was right there in the middle of them - what butchery! What horror! What a nightmare for those poor women! When I started researching circumcision in general, was I in for a real shock!

Routine infant circumcision, in this part of the country, is very common. Female circumcision is not only looked on with horror and shock, but is actually illegal. On the surface we can say the two procedures are very different, but are they? Both involve altering the genitals of an infant or child, without that child's permission. Both involve the removal of genital tissue for aesthetic or religious reasons. Both are done for reasons of conformity. Both are medically unnecessary. Both are painful and can have potentially serious effects, including death. We would not dream of subjecting our infant sons to genital piercing, yet we do not hesitate to surgically remove a large portion of functioning genital tissue (noharmm.org).

Cultural relativity is the idea that there are no absolutes, that a culture must be judged by its own standards. Female circumcision, also frequently called female genital mutilation, is considered a norm in the countries that practice it. Even where it's been outlawed, women continue to circumcise their daughters surreptitiously. In our ethnocentricity, we've damned the one practice, upheld the other. Why?

The same reasons for routine infant circumcision are being espoused for female circumcision, according to noharmm.org. What are the main differences between the two practices? Female circumcision is generally performed at adolescence or later childhood. RIC is performed at birth. Female circumcision is considered a "coming of age," a rite of passage. RIC is simply a cultural norm for many of us, a religious practice for others. Female circumcision also comes in different forms, whether it is merely a removal of the clitoral hood, or the removal of all external genital tissue along with a clitoridectomy, and every possible variation in between. Male circumcision is either a complete removal of the foreskin or a partial removal of the foreskin, known as a loose circ.

Many of us labor under the assumption that there are medical reasons for RIC, but that is wrong. No major medical organization in the world recommends RIC. Routine male circumcision has been linked with a reduction of UTIs in males, a reduction of the instance of penile cancer, and a reduction in phimosis. However, the studies regarding UTIs and intact and circumcised males have shown no statistical difference in the frequency of occurrence. Penile cancer is profoundly rare and is also linked with sexual promiscuity and smoking. In fact, more infants die of RIC complications, than men die of penile cancer. More men die of breast cancer, for that matter, than penile cancer, yet we hear nothing about preventative mastectomies on males to prevent this from occurring.

RIC has also a societal link. Many women have their sons circumcised to fit into the cultural standard - daddy is circumcised, all their friends will be circumcised, they need to be circumcised. But is this so logical? For one, the circumcision rate for the US as a whole is roughly 56%; nearly half of all infant boys born today are left intact. (the rates in the Midwest are much higher, around 80%) ( Fiely). The reality is, we are close to having as many boys intact as are circumcised. Furthermore, how many boys are checking each other out in the locker room to see who is intact and who isn't? And how many would even admit they were doing that?

Men certainly have an interest in continuing the practice. For them to admit that their genitals are somehow "less than" (and they in truth are, as removing the foreskin takes away 30% of the penile skin along with the nerve endings and sensitivity that's included) (Wallerstein), would be a blow to the fragile male ego. It would be admitting that they are not perfect. It would be admitting that they were victimized by a society and a medical system that has much vested in keeping the status quo.

So what does the medical system get out of this practice? When no major medical organization in the world recommends RIC, why on earth are doctors still performing it? Isn't their first duty to "do no harm"? Routine infant circumcision is a multi-million dollar industry, as is most cosmetic surgery. Foreskins are sold off to biomedical companies who use them in the manufacture of insulin, biochemical analysis, creation of artificial skin, and foreskin grafting on burn victims (Deacher). Sure, it sounds good, but how would we feel if it was women having their genitals altered cosmetically at birth on a whim, for no overwhelming medical reasons, then having those parts sold to the medical industry? We'd be screaming from the rooftops against this violation of basic human rights, and justifiably so.

As parents, we have the right to make medical decisions for our children. Circumcision is one of those decisions. I've seen many, many people link the decision to vaccinate their children with the decision to circumcise their sons, but I believe that logic to be faulty. Vaccination has been proven to prevent illness and create herd immunity. Circumcision has not been proven to prevent anything. HIV is the one disease that has been linked to intact males, and not only is that study flawed, it also was done in Africa, where HIV is flourishing, HIV awareness is low, and there are cultural taboos against certain safer sex practices. In other words, this HIV risk reduction has not been duplicated in a western country, and there is nothing that will prevent HIV like education and safer sex practices will. This risk reduction would not be enough for me to alter my sons' bodies permanently.

What's the big deal about a tiny piece of skin being removed? First of all, it's not so tiny. That piece of skin, on an adult male, measures about 15 inches square. (Stark) That's right, more than a foot of nerve-rich skin. And yes, it performs a function apart from the male's sexual pleasure. It keeps the glans moist and sensitive, it provides an antibacterial layer of protein, which can help reduce infection, and it provides sexual pleasure to the female as well.

Where and how did the practice of male circumcision originate? I find that there are no written records of its earliest origins, but in most cases, it was for religious or rite of passage reasons. The first cases of infant circumcision were amongst the Hebrew people. Most boys were not circumcised until late childhood or early adolescence. The Hebrews were circumcised for religious reasons, as a covenant with their God. Muslims also perform RIC as a matter of religion. Other than those two religious groups, Americans make up the largest population that practices RIC, and there is largely no religious reason for it here; it is solely cultural. Many Christians mistakenly believe that circumcision is necessary, but they should examine the book of Galatians very closely, where Paul discussions circumcision in depth.

America's practice of RIC apparently originated in the 18^th century, becoming more common in the 19^th and 20^th century, peaking in the 1970s at 90%. Why did it start, if not for religious reasons? Plainly speaking, it started as a way to prevent masturbation. Masturbation was linked with a host of ills, from mental health issues, to neurosis, to STDs, to rebellion, frigidity, and warts. Circumcision was the simplistic cure for all these problems. Unfortunately, it continued, and while the beliefs about its preventing masturbation may have died out, the beliefs about the other problems it is able to prevent or "cure" have not (Paige).

I know many people probably see it as a very simple procedure, and I want to delve into that a bit.

Most disturbingly, few babies are given anesthesia for this procedure -- as many as 96% of RIC are done without pain relief (Salvatore and Reuters). No surgery, even minor surgery, is never without complication. The process of peeling away the foreskin (akin to removing your fingernails without painkillers, since the foreskin is literally fused to the glans in young children) is incredibly painful and can cause a newborn to enter a state of shock. Many mothers mention that their babies slept peacefully throughout the surgical procedure, but this isn't quite accurate - babies, particularly newborns, retreat into sleep when their senses are overwhelmed, in moments of intense pain or fear. After the foreskin is peeled away, it is either cut off completely or partially. It is an incredibly painful procedure that most definitely can and does have complications. I can't find any hard statistics on complication rates, although they are thought to be quite high, since some do not appear until adulthood. Adhesions, "hidden penis," nerve damage, etc. can all result from circumcision, not even to mention the risk of botched circumcisions.

It's a choice I left up to two of my sons. It is their body, their business. An intact male can, at any time in his life, choose to be circumcised. A circumcised baby does not have that right. He's lost the ability to make that choice for himself, and he can never actually re-grow his foreskin, in spite of the cosmetic surgeries that attempt to do just that.

I'd like to share some quotes that I found chilling, because they are all about female circumcision, which our society decries as a horrific human rights abuse; but they sound eerily similar to things people in our society have said about male circumcision.

"Our mothers, aunts, and sisters have been doing this for years, and no one was complaining." - Dr. Munir Fawzi (Dallas Morning News).

"To defend themselves from feelings of inferiority, many women deny that female genital mutilation damages their bodies or their sexuality." - (Lightfoot-Klein).

"They (parents) do not want her to suffer the stigma of being different from other girls. She ... comes to accept that what has been done is in her best interest." - Dr. Hassabp, psychiatrist (Lightfoot-Klein).

"I did not know anything about the operation at the time, except that it was very simple, and that it was done to all the girls for purposes of cleanliness." - research worker

"It is a normal occurrence that happens to everyone." - Dr. Yahia Oun Alla, Sudanese psychiatrist (Lightfoot-Klein).

And how do men, the ones who are most affected by this, feel about it? According to one survey, 38.3% of circumcised men were unhappy with their status. Another 41.4% were ambivalent - nearly 80% who can't say they are unequivocally happy with being circumcised. Compare those numbers with the 3.2% of men who are unhappy being intact (and keep in mind, they always have the choice to change that state, whereas a circumcised man does not), 17.3% ambivalent, and you get an even clearer picture - nearly 80% of intact men are completely happy with their status. How many circumcised men would remain ambivalent if they knew the extent of what circumcision has taken from them? (noharmm.org). Of the men who were circumcised in adulthood, a full 66% of them were unhappy with the results of that surgery ().

The bottom line, as I see it, is either both male and female circumcision are both wrong or they aren't. Simply because something is our cultural norm does not make it right. Just because something is not our cultural norm does not make it wrong. If we can accept routine infant circumcision on a religious basis, why can we not accept female circumcision on a religious basis? If we allow one, should we not allow another? If we outlaw one, should we not outlaw the other? A conundrum, indeed.

"Common Denominators between
Male & Female Circumcision"

Fiely, Dennis. "No Longer Routine." The Columbus Dispatch Sunday Jan. 15, 2006.http://www.columbusdispatch.com/live/contentbe/dispatch/2006/01/15/20060115-H1-01.html

Wallerstein, E. "Circumcision: Uniquely American Medical Enigma." Urologic Clinics of North America, Feb. 1985; 12:123-132 http://www.cirp.org/library/general/wallerstein/

Deacher, M. "Ego: Circumcision" ICON Magazine, April 1988, www.cirp.org/news/1998.04__icon/

Paige, Karen Ericksen. "The Ritual of Circumcision," Human Nature, pp. 40-48, May 1978. noharmm.org>

Dr. Steve Salvatore and Reuters. "Circumcision Study Halted Due to Trauma" Dec. 23, 1997. cnn.com/health/9712/23/circumcision.anesthetic/>

Dr. Munir Fawzi, gynecologist atr Cairo's Ain Shams University, Dallas Morning News, 12-25-96 (noharmm.org> "How is Female Circumcision Trivialized?")

Lightfoot-Klein, Hanny "Prisoner of Ritual: Odyssey into Female Genital Circumcision in Africa," 1989, published by Rainbo, 1995, p. 37, p. 143 (noharmm.org> "How is Female Circumcision Trivialized?")

"Body Image Surveys Examine (Dis)satisfaction with Circumcision"

"Circumcision Uncut," Men's Confidential, March 1996, pp. 10-11 noharmm.org/bodyimage.htm>