Friday, March 12, 2010

the politics of infant male circumcison

Infant male circumcision is commonplace in the United States. Since the 1970s, according to the US Circumcision Statistics Report, it is estimated that approximately 60% of infant boys had the circumcision procedure performed on them. However, within recent years, this trend has begun to decline as parents become more knowledgeable about the varied negative effects and untruths of the procedure.

As part of my postpartum doula training, I saw a circumcision procedure being performed on an infant boy. I kid you not--it was the most traumatizing thing I have ever experienced in my life. The helplessness and extreme pain that the child encountered was something I will never forget, though it is not the only reason I am against circumcision.

I came across this article, Would you Circumcise your Daughter? which presents an interesting perspective of highlighting the cruelty of female circumcision and then comparatively switches focus to the the circumcisions we have performed on infant boys for decades. When a circumcision is performed on an infant, it is just plain genital mutilation, and it indeed disregards the human rights of our children. As the author says, "We've trampled on the human rights of our baby boys, and we've done it holding our heads high and justifying ourselves." Whether for boys or girls, it is about time we rethink the circumcision procedure.

I firmly believe that you really do catch more flies with honey than with vinegar, so to say, but the author took a completely unique approach by bringing the subject of female circumcision into the picture before making the connection to the largely accepted practice of male circumcision. Many new parents are not even aware that they have the option to deny the procedure as it is so accepted in the US--and by taking an accusatory standpoint, the author really does run the risk of losing her audience's respect and causing needless guilt in certain members of her audience. However, you must also consider who the article was directed at--by the looks of the blog, it is likely feminists who are seeking passionate arguments that will rile them up and get them thinking about a new idea.

The author fortunately provided plenty of resources out there that site good, peer-reviewed information on the subject of circumcision, and as of now, it is parents' right to make the decision whether to leave their child intact or not. I firmly believe, however, that, as parents, we must make appropriate decisions to keep our children healthy and whole. It all comes down to informed consent. Our country's medical ethics state that it is absolutely unethical and illegal to perform an unnecessary procedure on an individual who does not have informed consent. Infants, as individuals, cannot give informed consent, and therefore should not be circumcised. If our own standards of ethics were unbiasedly applied to the common practice of infant circumcision, it would certainly be an illegal procedure. Our children's healthy bodies should be preserved as best as possible for them to make decisions of alteration when they are old enough to do so.

Additionally, not a single national medical association in the world recommends infant circumcision as it offers no significant health or medical advantage over the intact state for the vast majority of males. In fact, many European nations look down on the US for performing such a barbaric procedure. Circumcision is literally a painful mutilation of a healthy, functioning body part, and when performed on an infant, it is done so without the consent of the person whose body is being modified, risking complications (in an alarming 2-10%, a statistic believed to be under-reported), and botched circumcisions (>1%) which often result in the need for reparative surgery, and even, in some drastic circumstances, gender reassignment.

Some may argue that parents must make medical decisions on behalf of their children in order to keep them healthy until they are old enough to take care of themselves on their own. As such, circumcision is often compared to vaccination, another common childhood medical incident--the argument often being the administration of vaccine is often painful, and, if given the option, children would most likely choose not to receive them. My arguments against vaccination aside, inoculation is a completely different issue and not at all comparable with circumcision for several reasons.

Firstly, by administering a vaccine to a child, scientifically engendered toxins are actually added to the body. Circumcision, on the other hand, surgically removes an otherwise healthy and functional body part. As the author questions in the article, should you remove all the child's teeth as they come in just because someday he may end up with a mouth full of cavities? Probably not.

Secondly, vaccination does not deprive individuals of functional body parts. On the other hand, infant circumcision always deprives the male of the protective and sexually enhancing gliding mechanism of the foreskin, as well a substantial portion of genital tissue, hundreds of nerves and thousands of nerve endings contained in the foreskin. Consequently, infant circumcision reduces a male's full range of natural penile functioning.

Thirdly, inoculation can prevent common diseases over which individuals may have little control; on the other hand, circumcision does not prevent any disease--at best, circumcision is only alleged to "reduce risk" of certain rare diseases, all of which are behavior-related, and most of which take place after a man is mature enough to make the decision for himself.

Moreover, while it can be argued that a parent must make decisions based on what they believe is best for the health and well being of their child, it must be considered that, unlike vaccination, the motivation for circumcision is based primarily on religious and social customs, and alarming little research was done on the medical aspects of the procedure before it became wide-spread in the US.

I will not argue the pros and cons of vaccination here. I do, however, feel it is completely necessary to understand how drastically different circumcision is from vaccination, and how completely incomparable the two procedures are.
It should also be acknowledged that infant male circumcision is a medically unnecessary procedure with Biblical roots (Leviticus) based on the Kosher laws of cleanliness--essentially to prevent boys from masturbating by removing the pleasure the foreskin naturally adds. As such, it is a ritual that is not unlike the many other customs of childhood bodily modification from around the world.

For instance, there is the practice of foot-binding common in China in the 10th through 20th centuries, a fashion trend that caused painful disabilities in millions of young girls and women over that time period. There is the skull shaping and artificial cranial modification common in ancient Andean and Egyptian societies and still practiced in some cultures around the world today, a gradual procedure that is performed on children, whether to designate spiritual maturation or simply to be aesthetically pleasing. Also, there is the practice of neck stretching on girls from neck rings in certain African and Asian cultures; the elongated neck is a symbol of beauty in these cultures. When neck stretching is performed gradually, starting at ages three or four and continuing through puberty, it is not a painful modification (though rapid neck stretching, occurring when a girl reaches puberty as a right of passage, is extremely painful) and it does weaken the neck muscles and inhibits the ability to hold up the head once the rings are removed.

Despite their social popularity throughout history, we now find many of these traditional modifications to be barbaric and disabling. We, as parents in the US today, would not perform these procedures on our children because they would cause them pain and visually mutilate their bodies. However, it is considered perfectly acceptable to surgically remove the genital foreskin of our vulnerable baby boys in a painful procedure.

So why, when so much of the world does not circumcise their baby boys, does society and the medical community in the US still believe circumcision to be necessary? It always comes down to this one thing: Money. As Thomas Wiswell, MD, said back in 1987, "I have some good friends who are obstetricians outside the military, and they look at a foreskin and almost see a $125 price tag on it. Each one is that much money. Heck, if you do 10 a week, that's over $1,000 a week, and they don't take that much time." Over the two decades since Dr. Wiswell admitted this honest observation, the cost of the procedure has tripled, and in some areas, quadrupled, and is still on the rise.

Not only do they charge a pretty penny for a circumcision procedure, the foreskin itself is sold by the hospital for profit for medical research; one single Neonatal Foreskin Epidermal Keratinocytes goes for a profound $250 at the Coriell Institute for Medical Research. If you consider that 55% of boys are circumcised these days, that is a stark statement of how much medical professionals and hospitals are making on a 15 minute procedure.

My father was born and raised in Germany, and, as infant circumcision is nearly nonexistent in continental Europe, he has an intact foreskin. I once asked him, when we were discussing the politics of circumcision in the US, if he had the option, would he have his foreskin removed. Not surprisingly, he said no. He also does not regret that he was not circumcised as an infant. If you asked me if I wanted my labia removed, I would sure as hell say no. If an infant boy had the mental competency to make an informed decision on whether he should remain intact or not, what do you think his answer would be?

I believe it all boils down to one thing: Informed Consent. As parents, we should respect our children's bodies. Medical reasoning for infant male circumcision has not shown me any research to make me feel that the procedure is necessary or even warranted. Quite the contrary, actually. Informed consent is a beautiful thing, but is so often disregarded by the medical community, especially in obstetrics and pediatrics.

Unfortunately, much of our society does not even know they have a choice--a choice that should be a basic human right. Educate yourself. Research unbiased information. Spread the word.

Choose informed consent.


Would you Circumcise your Daughter? Woman Uncensored, 12/28/09
US Circumcision Statistics Report, The Circumcision Reference Library
Estimated US Incidences of Neonatal Circumcision Complications,
There's Money in Circumcision, Circumstitions Intactivism

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