Cut the Penis, Cut the Risk: Why Circumcision Is A Good Choice

By Guest Blogger | August 31, 2012 11:22 am

Jesse Bering, PhD, is regular contributor to Scientific American, Slate, and other publications. He is the author of the recently released book, Why Is the Penis Shaped Like That? And Other Reflections on Being Human and The Belief Instinct, which the American Library Association named one of the “25 Best Books of 2011.” You can find him here.

spacing is important

For the past seven years, I’ve been in an “interpenile relationship”—I, the lesser of the two you might say, am circumcised; my partner is not. This contrast between our members is not exactly at the top of our list of concerns. But it is nonetheless interesting how my prepuce came to disappear into a medical waste bin in a bustling New Jersey hospital on some springtime day in 1975, whereas his, by contrast, has remained a fellow traveler all the long way from that tiny Mexican village where he slipped from his young mother’s womb on a chilly December morning in 1981. That womb, incidentally, belonged to a Roman Catholic. The one that I bathed in, the place in which I had my “bones and sinews knitted together,” in the words of Job, was the property of a Jew. So despite neither of us being particularly patriotic nor, certainly, religious today, the organs dangling so differently between us are nevertheless the very incarnations of our parents’ vast cultural differences.

Whatever the reasons that previous generations may have had for choosing to remove their infant sons’ foreskins, they were almost always unconvincing. All else being equal—and let me reiterate that caveat because it’s likely to go unnoticed, with some readers eagerly pointing out to me those rare cases of congenital defects in which circumcision can legitimately improve the quality of life for some males, which is of course true—all else being equal, any dubious benefits derived from religious, social, hygienic, or aesthetic reasons are clearly outweighed by the costs of male circumcision. Because of some rabbi in Hackensack shaking his head over my intact genitalia, my parents went unblinkingly along with the amputation of a fully operational, perfectly healthy, and probably adaptive body part, all to sacrifice an ounce of their son’s tender flesh to a god that he would never believe in anyway.

Today, however, all is no longer equal, and the balance between the relative risks and benefits of male circumcision has clearly shifted in the other direction. That is, it has according to the American Academy of Pediatrics, which just earlier this week put out its revised position statement on infant male circumcision. Here’s the money quote:

Systematic evaluation of English-language peer-reviewed literature from 1995 through 2010 indicates that preventive health benefits of elective circumcision of male newborns outweigh the risks of the procedure. Benefits include significant reductions in the risk of urinary tract infection in the first year of life and, subsequently, in the risk of heterosexual acquisition of HIV and the transmission of other sexually transmitted infections.

Many of our parents, it seems, may have actually made the right decision for the wrong reasons. Although the task force behind the Academy’s reassessment stopped short of advising “routine” and “universal” removal of the foreskin for all newborn males, and stressed that it remains a personal decision to be made by informed parents, its language represents an increasingly unambiguous endorsement of male circumcision among the world’s leading health organizations (including the World Health Organization and UNAIDS) . By contrast, many of the world’s leading parents remain skeptical of the findings reviewed by the Academy, questioning both the methodologies and the generalizability of studies conducted overwhelmingly with African populations, in which rates of infection are dramatically higher than those in the US. (For more information on this research, as well as a description of the physical factors responsible for the reduction of HIV acquisition in circumcised males, see my earlier discussion at Scientific American.) The more vocal “intactivists,” who’ve long been protesting what they regard as an antiquated, cruel and unnecessary ritual act against little boys that is just as abhorrent as female clitoridectomy, have also responded bitterly to this newest AAP development, seeing fresh strands in an ongoing web of conspiracy between the major health organizations, third-party insurance companies implementing the policy views of these organizations, and greedy practitioners who mislead parents about the benefits of circumcision only to reap insurance payouts for “mutilating” children’s genitals.

Nonsense. In light of mounting evidence for a significant preventative effect of male circumcision on the virus that causes AIDS, as well as herpes, genital ulcers, and the human papillomavirus (HPV), parents today who opt for the procedure for their sons—unlike the majority of parents in the past—should be fully supported in their decision-making, not slammed with the mutilation rhetoric of self-righteous intactivists out to shame them into joining their campaign. Yet, likewise, parents who have done their research, who have evaluated the pros and cons and concluded that the present science is still not convincing enough to justify circumcision, should be supported in their personal decision to abstain from the AAP’s recommendation.

I don’t have children. The closest I’ve ever come to deciding whether or not to have someone else’s genitals altered is getting my border terrier neutered. I do, however, have a best friend with a male infant, and this newly circumcised child happens to be my godson. What has become increasingly irritable to me, to no foreseeable end (just watch the reactions to this little essay of mine), are the rhetorical tactics of hardliner parents who brazenly intrude on the personal decision-making of other parents such as my friend and her husband, who shout and sermonize at them about male circumcision being an unforgivable choice done only by the uninformed or stupid, and who relentlessly, and with all the delusional conviction of fanatics, spin fanciful yarns about shadowy conspiracies and avaricious doctor-butchers.

What is vital to understand about the AAP’s recommendation is that the Academy is not discounting, in any way, the biological purpose or function of foreskin. What the task force has implied, rather, is that whatever the advantages to being an intact male—such as increased sensitivity of the glans, protection, lubrication facilitating better heterosexual intercourse (in addition to the lubricating properties of shed skin cells and oils that accumulate under foreskins, an accentuated coronal ridge may also retract more vaginal fluids during copulative thrusting)—these advantages are overshadowed in importance by the prophylactic benefits of removing highly receptive HIV target cells that are found on the inner mucosal surface of the foreskin. And when performed by a skilled physician on neonates under sterile conditions, circumcision is a quick, safe, minor procedure.

To circumcise, or not to circumcise? To me, at least, that’s no longer even a question. It remains as much a no-brainer as it was when I first wrote about this issue two years ago. If male circumcision reduces the probability of contracting the HIV virus even a fraction of a percent—let alone the estimated 60 percent reduction that scientists believe it does—then why on earth wouldn’t you choose circumcision? Have you ever seen a person slowly succumb to AIDS? The pain inherent therein is not even in the same galaxy of subjective experience as whatever minute qualia of pleasure may or may not be lost to such a “mutilation.” The sacrifice is no longer one made to a mythological deity, but to the child himself. HIV is not just an African problem, the logistics apply to any part of the world where the virus is found, and circumcision protects against more than this one virus alone. If you want to invest in the probability that your son will grow up to become so unfailingly logical that lust will never, not even once, overcome his level-headedness, and that he will always have both a condom on hand and use it every single time that an opportunity to have intercourse with a potentially infected stranger arises, that’s your prerogative. You’ve probably not interacted with many actual human beings in your life, but, hey, it’s your kid.

One can either listen to outspoken atheist bloggers who can’t seem to understand that this is no longer a religious or cultural issue, the overwrought intactivists attempting to intimidate new parents through strong rhetoric and graphic images of botched circumcisions, the endless stream of nosy polemical parents who are happy to share their judgmental attitudes, or one can take the advice of those who, you know, actually know what the hell they’re talking about. The AAP task force included accomplished pediatric bioethicists, urologists, and anesthesiologists who, in consultation with physician representatives from the Centers for Disease Control and Prevention, the American Academy of Family Physicians, and the American College of Obstetricians and Gynecologists, tediously analyzed mountains of data (and again, peer-reviewed data that were collected by highly trained epidemiologists) under the watchful glare of an American public, many of whom, the task force knew, would remain unconvinced. And yet, despite the anticipated reaction of skepticism and suspicion, still they arrived at their revised recommendation for male circumcision.

What was once unquestionably “inhumane” and “unethical” has, oddly enough, made a complete about-face as a consequence of vitally important scientific data emerging over the brief span of two highly productive decades. Yet many parents continue to be emotionally sabotaged by the baby-harming language of intactivists and online blowhards, whose rhetoric primes them to either see these critical developments in conspiratorial terms or to indulge in amateurish debunking of complicated research.

So here’s one of those rhetorical devices that intactivists should appreciate: Cut it out. For every amazing prepuce you save, you’re adding an element of risk and uncertainty for the person attached to it. Nobody can possibly know what viral foes a man will come up against in his life, and if one of them is HIV, your crusade, admirable though you feel it is, may be costing some other parent their child’s life.

Image via Shutterstock


CATEGORIZED UNDER: Health & Medicine
  • http://bit.ly/uEDaEc FamilyPenls

    Nobody mutilates their children without reasons. And when the reasons run out it’s time to find new ones. That is what this new AAP circumcision policy is all about.

  • Elliot

    This article is outrageous and despicable. No matter the benefits, it must be left for the individual to decide, not taken from them never to be returned. Tell me, would you really advocated removing half the skin from a baby girl’s genitals if it produced a small advantage in some rare health conditions? I think not.

  • Paul

    Wouldn’t mandating proper sex education cut childrens risk for getting HIV even more than circumcision? A quick google search gives 78% risk reduction by using condoms — for that reason I would suggest mandating proper sex ed with higher priority than circumcision. Especially since my perception is that male circumcision is much more widespread in the US already than proper sex ed.
    Germany, (where I come from) has decent sex ed in school (at age 12) and nearly no circumcision and has less than 1/3 of the US number of HIV infections.

    Obviously the combination of sex ed and circumcision can decrease the risk even further, but I fear without a strong nudge towards sex ed some parents might leave it at circumcision, thinking they have done enough, while in fact they would be able to get more protection without surgery.

  • http://marchwinds.wordpress.com Jennifer D

    When my son was born, we were told that circumcision is not considered medically necessary, and if we wanted it done, we would have to pay for the procedure. So, we didn’t get him circumcised. I imagine with the right precautions, he will be able to avoid HIV, HPV, and STDs in general!

  • Melissa

    If it’s such a good idea, we can offer it to young men. I’m curious to know why your partner has not chosen to be circumcised? I would suspect he would rather keep his foreskin and use condoms, which are much more effective than circumcision at preventing HIV. I can’t even imagine having unprotected sex if you are worried about HIV. My understanding is that circumcision is a tactic in Africa mainly because people are unwilling to use condoms. It would be more accurate to compare rates of STIs from European countries, where circumcision is uncommon, but cultures are more similar to the US. And most of these countries have people who survive, reproduce, enjoy sex…and have the fraction of the HIV infection rates and healthcare costs of the US.

  • Not So Fast

    Jesse, overlooking any ethical questions about circumcising babies, you are aware that circumcision status doesn’t correlate well with HIV infection world-wide (not even in different parts of Africa!) and that circumcision has only been suggested as a way to decrease female-to-male HIV transmission and not male-to-female transmission (some studies show circumcision actually INCREASES transmission in this direction) or male-to-male transmission? That condoms are many orders of magnitude more effective than circumcision and protect in ALL directions, that being circumcised in the context of using condoms offers no additional benefit, that condoms are cheaper and have fewer side effects than circumcision, and that spreading the idea that circumcision is effective at preventing sexually transmitted diseases is literally an emerging public health disaster through the instillment of a false sense of security? That the chance that a circumcised American boy will grow into a man who encounters an HIV-positive woman and doesn’t use a condom or experiences condom failure and is saved from contracting HIV just by the absence of his foreskin is so tiny that he’s probably as likely to die or lose part of his penis in the circumcision itself? It’s like I’m sitting here in an alternate universe where there are no methods to prevent HIV acquisition other than bodily modification, and it’s perplexing.

  • http://www.realadultsex.com figleaf

    This bit was a little weird: “Systematic evaluation of English-language peer-reviewed literature from 1995 through 2010 indicates that preventive health benefits of elective circumcision of male newborns outweigh the risks of the procedure.”

    To the best of my knowledge circumcision huge in English-speaking countries, going back to Anglo/American adoption of circumcision in the early 19th Century as part of a gigantic anti-masturbation/semen-conservation initiative.

    On the other hand in other medical-journal-publishing countries in the 19th and 20th Centuries such as France, Germany, Russia, Italy, Spain, the rest of Eastern Europe, the rest of Western Europe, Japan and Korea, &etc., circumcision is not practiced. Nor, to the best of my knowledge, is not circumcising terribly controversial either socially or medically.

    Consequently I’m curious why in this case it’s a good idea for, you know, scientists to limit their background research on circumcision only to publications with an atypically strong tradition of cultural circumcision.

    “…and if one of them is HIV, your crusade, admirable though you feel it is, may be costing some other parent their child’s life.”

    Um, hello? Speaking of admirable crusades, what is the marginal impact of my crusade to get everyone (circumcised or not) to use condoms compared to your crusade to get everyone to circumcise?

    If you could promise me that adoption of universal circumcision would eliminate the need for condoms I’d be a little more sanguine about your crusade. Since I’ve got an awful lot of dead friends who were a) circumcised and who’s partners were also b) circumcised I’m unpersuaded that you’d be able to support such a promise even if you were motivated to make it.

    I happen to think circumcision is dumb. But then I think sleeve tattoos and gauge ear piercings are dumb too, and that doesn’t stop young men and woman from paying for them out of their own pockets in tattoo and piercing parlors. Still, I think it would be unforgivable for parents to tattoo or gauge their infant children and for the same reason I think it’s unforgivable for them to circumcise their infant boys (or girls!) However! As I told the doctor years ago when she asked if we her to circumcise our son “if he wants to do it when he’s older he can mow lawns or deliver papers and earn the money himself. By which time they’ll probably be doing it in tattoo parlors just to freak their parents out.” It was true then, it’s true now: if he wants to get it done, and if he is persuaded by the AAP’s arguments, then he can make that decision.

    But even if he does, he’d still better wear condoms, m’kay? Even though your campaign’s assertions about disease “protection” materially dilutes that message. Talk about costing some other parent their child’s life! Yeesh, Jessee!

    And, just one last time here, Jesse, because I want to be really, really, really clear: “Have you ever seen a person slowly succumb to AIDS?” Sadly, yes. Every one of them was white and circumcised. As were, to the best of my knowledge, 100% of the men who transmitted it to them.

    Condoms would have made kind of a big difference for every single person I know who died of HIV. Except possibly my uncle who, though gay and promiscuous in the early 80s, insisted to his dying day that he got it from early-80s blood transfusions for treatment of… advanced, undetected syphilis. And actually, even in his case condom use might have prevented him from contracting syphilis in the first place!

    figleaf

  • http://dianthus.co.uk Adam Jacobs

    Are you familiar with the notion of “informed consent”? It’s quite an important one in medical ethics.

    I suggest you go and read about it. And then ponder this question:

    “how can a newborn baby weigh up the pros and cons of circumcision and give a well considered opinion on whether he consents to the procedure?”

    I think you’ll find that the answer is “he can’t”. Which makes circumcision unethical.

    Does circumcision have any health benefits? Possibly, although the evidence that it reduces HIV transmission is pretty darned weak. But here’s the thing: it’s completely irrelevant to a newborn baby, because newborn babies don’t have sex.

    Once boys reach the age where they have sex, then they are probably old enough to decide for themselves whether they wish to have the end of their John Thomas cut off. If they do, then that’s fine. But it has to be their own decision. No-one else has the right to make that decision for them.

  • ben

    IF it is such a good choice, then let men make it for themselves. Last time I checked infants are not a high risk group for catching HIV.

  • Chuck Winters

    I’m a 60+ guy who was uncircumcised until age 55. At that point I had to be circumcised for medical reasons. Despite any medical arguements I can state unequivocally that I couldn’t support the infliction of this surgery on any male anywhere.

  • http://twitter.com/tuuli1 Suvi-Tuuli Allan

    The baby will grow up and decide whether they want that particular surgery. DO NOT f*ck around with someone else’s body!

    I say this as someone who later in life needed that skin for a vaginoplasty. Thank the gods, I still had it! DO NOT do this to your kids, parents!

  • Human_Rights

    This is an astonishingly ill-researched article.

    You begin by telling us that the balance between the relative risks and benefits of male circumcision has clearly shifted in the other direction, according to the American Academy of Pediatrics. But this is a vast overstatement. The AAP are not recommending circumcision, they stop short of that, claiming that the benefits are not great enough for such a recommendation.

    So whatever shift in balance you perceive from the AAP, it is not a big enough one to lead them towards any solid change in policy, and therefore is hardly even significant, never mind the great sea-change of opinion you seem to be heralding.

    It is worth pointing out also that the American Medical Association also do not recommend the practice. In fact, no medical health authority in America recommends it. Why not, if it’s benefits are so great? Why is the whole of Europe against it? Some sea-change! (Or perhaps the USA is all that counts to you).

    In addition, the rest of the world go further in the opposite direction. It is not recommended by any other country’s health advisory board. The Australians seem to have made it illegal; as have the Germans. And many other European countries refuse to endorse or support the practice.

    You go on to tell us that “what was once unquestionably “inhumane” and “unethical” has, oddly enough, made a complete about-face as a consequence of vitally important scientific data emerging over the brief span of two highly productive decades. Where are you getting this nonsense from? Are you aware of the situation in Germany right now? Are you aware of the attempt to outlaw circumcision in San Francisco last year?

    You acknowledge that the practice was once “unquestionably” inhumane and unethical. Well if it was unquestionably so then, how can it no longer be inhumane and unethical? One set of doctors in one location in the world suggest there is evidence the benefits outweigh the risks – although not so much that they would recommend the procedure, and you consider this to be great enough to immediately and incontrovertibly cancel out the unquestionable “inhumanity” and “unethical” aspects? Apart from being an appalling argument, from a logical perspective, your view is itself morally suspect.

    You brought morals into this discussion by suggesting the practice is inhumane. How does this new opinion by one medical group (who fall short of advising the procedure) cancel out the ethics? Because it is saving future lives? But children do not have sex – they are not at risk of HIV/AIDS or sexually transmitted diseases. So why not let children decided for themselves as young teenagers if they want their penis mutilated. Who are we to impose this risk-protection on them? We don’t automatically remove the appendix at birth in case our kids die from a ruptured appendix later. We don’t slice off a little girl’s breasts to prevent her from breast cancer later.

    Your entire argument is that a procedure which you acknowledge to be inhumane and unethical is now utterly justified by one group of Doctors in one location in the US who feel that it has more benefits than risks, although still don’t recommend it?? This doesn’t even attempt to address the ethical position. The ethical position is that it is a child’s first amendment right to have their body protected from another person’s altering of it without their consent, particularly in the name of a religious belief the child has not been given the freedom to choose.

    You know, I am sure, how medicine works in the USA. Has it occurred to you that these doctors might be financially motivated in their new statement? That they might not want to lose the money they receive from circumcisions? Or the money they receive from selling the foreskins to cosmetic companies? (Did you know that’s what they do?) When they talk about the billions of dollars in costs due to the fact people no longer circumcise as much as they used to, they are not talking about the costs of HIV and cancer treatment for uncircumcised victims, they are talking about the loss of revenue to the medical profession by this barbaric procedure going out of vogue. And they are trying to encourage insurance companies to continue funding the procedure, and hence paying them, for an inexpensive and very quick (hence highly profitable) procedure.

    Has it occurred to you also that these doctors might have secular motivations?

    The only reason circumcision has been suggested to prevent AIDS/HIV and other STD’s is because it is easier to clean a penis that is circumcised. But you will know from the evidence of your partner, anything can be clean if you wash it. In Africa they do not always have access to water, so cleaning is not always possible, but here in America there is not the same HIV risk and we all have the ability to wash our genitals.

    And in any case, there is no hurry to go circumcising a boy. Let him decide for himself if he wants to be “protected” from these risks when he is older.

    Circumcision was originally conceived as a religious ritual which deliberately reduced sexual pleasure from a boy. Hence it was motivated by sexual repression and a desire to curtail masturbatory and sexual impulses in a man.

    I am an intact man. The foreskin of my penis provides dazzling sexual sensations when I so much as touch it with a finger tip at the frenulum. I would honestly prefer to lose an arm than I would that piece of skin.

    Circumcised penises experience up to a 75 percent reduction in sensitivity, according to a study published in the British Journal of Urology International. This makes sense, given how much less sensitive the frenulum is when my foreskin is retracted.

    Circumcision severs the perineal nerve – located on the underside of the penis and responsible for the majority of sexual sensory input. A recent study published in the International Journal of Men’s Health found circumcised men had a 4.5 times greater chance of suffering from erectile dysfunction than non-circumcised men.

    The truth is, you cannot change form without altering function.

    The dark truth is that this described loss of sexual sensation was the original justification for circumcision: to discourage sexual behavior for reasons other than procreation, and to curtail masturbatory impulses. In other words, it was carried out in the name of SEXUAL REPRESSION.

    Let’s be completely clear: If religion were not involved, no healthy or civilized society would permit this primitive mutilation, or allow any surgery to be practiced on the genitalia without the full and informed consent of the person concerned. THIS is why the practice is unethical.

    I think it is telling that you are a man without a foreskin who has written this article. No man who has NOT had a piece of him forcibly removed without his consent in a procedure he believes to be unethical could possibly write your article, because being intact we understand how important it is. I fear you have been won over by a very poor new medical announcement (which actually says very little, and is out of touch with the rest of the planet – except maybe Africa, which let’s face it has very different problems to the US (we are far closer to Europe in our modern society). And you have been won over by it because you are quite rightfully still angry at having an “inhumane” procedure carried out on you.

    But the AAP are NOT recommending it and they offer no overwhelming evidence. They also do nothing to counter the outrageous fact that more boys die in the US from botched circumcisions than die from Sudden Infant Death Syndrome. http://www.examiner.com/article/new-study-estimates-neonatal-circumcision-death-rate-higher-than-suffocation-and-auto-accidents

    If you think this barbaric, unethical and inhumane procedure is suddenly NOT unethical and inhumane, then you need to address the ethical arguments themselves. And using the informal words from a few doctors, who STILL fall short of recommending the procedure, hardly cancels out the myriad arguments of First Amendment human rights, appalling secular justifications of sexual repression and annual deaths caused by this inelective procedure.

    Even one death from a procedure which did NOT need to be carried out is a death too many.

    Let every man decided for himself how much of his penis he wants to keep. It is not the job for you, the government, the rabbi or the doctor to decided such a fundamental and personal thing.

    You are right that the procedure is inhumane and unethical. I applaud you for recognizing it. Please remember all the reasons you felt that way and stay true to your initial concerns. They are far from cancelled out by one small group of Earth’s doctors making a statement at odds with much of the rest of the world.

  • Chromesthesia

    No, I will not cut it out. You act like condoms don’t exist. You act like you can’t sit a child down when they are old enough and explain to them about safe sex. Would you really want to risk having unsafe sex just because you’re circumcised?
    Also, why shouldn’t the final decision lie with the person who owns the penis when they’re old enough to decide for themselves? You can’t even get a tattoo until you’re at least 18, why not something like this?
    It’s probably more dangerous to insist that by not having a foreskin one is protected from HIV and STDs when that is not the case at all.

  • http://mexicointacto.blogspot.com Clara Franco

    Using the very same logic for your title, we could adequately say:

    “Cut the breasts, cut the breast cancer risk!!… Why prophylactic mastectomy on infant girls is a good choice”

    Actually, we could cut off lots of parts from the human body so they won´t get diseased.

    Does that make it ethical to impose it on a non-consenting minor?… NO.

    His body, HIS choice. It´s such a wonder that the whole of intact Europe has much, much lower rates of EVERY sexually transmitted disease than cut-happy America. It´s time to stop the insanity.

  • Blair

    In baseball it is readily understood that Tommy John surgery results in a stronger arm…so why doesn’t the parent every young male who may want his son to throw a fastball be forced to have Tommy John surgery at age 6?

    As an author you provide a number of significant advantages to being not circumscised and disease preventage as the sole positive. Well I can get my disease prevention through other means (correct use of a prophylatic device perhaps), but cannot do the same to increase glans sensitivity and the other positives mantioned. As a menmber of a low-risk group the benefits of an intact foreskin greatly outweigh the negatives. Seems like a no-brainer to me. Should you later in life make a decision that disease prevention is a more important consideration, then make the change later in life. But making a decision like this for a child, who has no oppotunity to input his opinion, seems wrong-headed to me.

  • Jesse Bering

    Well this thread is going exactly as I anticipated it would. I’ll address briefly an issue that continues to crop up in this discussion, the gist being, “If he wants to do it to his own body as an adult, that’s his right, but it’s not the parents’ decision to make.”

    I’ve no doubt the rate of circumcisions would plummet as a consequence of making it something to be decided solely by the individual as an adult. But this drop-off would be owed to fear of the procedure, cognitive biases minimizing personal risk of HIV acquisition, body image concerns about a new penis morphology, and worry about the inestimable loss of sexual pleasure. It would not be due to 18-year-olds (or 21-year-olds, or whatever) being able to objectively evaluate the pros and cons of their own circumcision in some miraculously clearheaded way, processing complex scientific findings at a level commensurate with epidemiologists, AAP advisors, or even parents. This also assumes, needless to say, that males would only face these STI risk factors once they are of legal adult age, so you’re either betting on your child being abstinent until that legal age, or at least completely reliable with wearing protection.

    None of these anticipatory factors—fear of the procedure, cognitive biases, adjustment to a new body image, the loss of sexual pleasure—haunt the male neonate. Additionally, because the infant is years away still from the cognitive developmental milestone of having an autobiographical memory, the event will not even be incorporated into his self-concept. If there is some deep, lasting psychological trauma arising as a result of being circumcised as an infant, it’s yet to be detected by science.

    There’s no data on this of which I’m aware, but I bet you this: The majority of people who see infant male circumcision as a human rights violation do not have penises, and those handful who do, are not circumcised. I’d also bet that—and again, pure speculation here—that most of us who grew up without a foreskin, by contrast, feel neither violated nor “mutilated” and have no complaints whatsoever about our ability to experience sexual pleasure. It’s not something I’ve ever given a second’s thought to, aside from being asked to weigh in on issues like this.

    But in any event, thanks for your feedback, everyone. It’s a heated topic. As I said in the piece, it’s your kid, do what you want, just don’t step on the rights of those who have evaluated the same research as you have and, heeding the AAP’s policy revisions, make the other decision.

  • Steven

    Shall we remove babies lips at birth in order to make smoking more difficult? Maybe remove men’s testes to make them less likely to want to have intercourse in the first place? Men have foreskins because evolution has seen fit to gradually and lowly develop this appendage to protect the head of the penis in order that it remains sensitive in order to provide the optimum (and quickest!) level of stimulus during mating to basically get it over with before another male comes along and ruins the party. It’s only because we are living unnatural lives where we can quite happily live with someone of the same sex or have frequent sexual encounters with other men that disease is becoming more prevalent (not that there’s anything wrong with that, each to their own). What I have a problem with is generalisations being made about circumsition because this man and his partner are putting themselves at a higher risks by having anal sex which is however you want to cut it; unnatural (not that there’s anything wrong with that).

  • Human_Rights

    This article is pure blather. At least do your research before advocating the mutilation of a baby boy’s genitals. You’re only searching for a justification because part of you is still so furious the procedure was done to you without permission. You may deny this but at some level, you know it’s true.

    Of all industrialized nations, the U.S. has both the highest circumcision rate and the highest AIDS rate. How do you figure that when circumcision is such a great prevention? How do you figure the fact that Europe has fewer incidence of STD’s in general when circumcision is rare in Europe?

    You are one more doctor seeking a pseudo-secular justification for a secular practice, and a wicked one at that. You know as well as I do, if you chose to be honest about it, without the approval of religion, there is no way in our right minds, we would be cutting off pieces of our boy’s penises just a few days after they are born.

    And your “It prevents HIV” argument is poor. The evidence in Africa isn’t even consistent that this is true. But it’s completely inconsistent with the westernized world, in particular America, which has the highest HIV and circumcision correlation.

    But you’re not interested in science. And you’re not interested in ethics (even though, outrageously you acknowledge that the practice is “unethical”).

    Do what you want to your penis, my friend. Leave mine alone, and leave a newborn baby’s alone. It’s perverted, barbaric and disgusting for us to have any business whatsoever with our childrens’ genitals in this way.

  • Steve

    I’m astonished at how ill-thought this author is on the subject. Physically removing a portion of another person’s body, without their permission, is a violation of human rights. Touting health benefits, real or imagined, is no justification for taking a choice away from someone else. The position to stand on this issue couldn’t be clearer. It is up to an individual to decide whether or not to hack away at their own body and no one elses.

  • http://www.accendi.net/ cfc

    Let’s take a hypothetical for a moment: Let’s say it was discovered that amputating your child’s left ear would decrease their risk of contracting an ear infection. As a side effect of the amputation, they’ll have a little trouble picking out the direction of sounds sometimes, but the effect on their hearing would be minimal. Oh yeah, and those ear infections? Easily preventable by wearing earplugs every time you go swimming.

    Would you consider amputating your child’s ear to be a reasonable action to take?

  • CircIsGood

    The people who think the AAP made a mistake should read the report.

    They looked at over 1000 articles/studies, evaluated them from poor, fair, good, excellent and came to the conclusion that there are lifelong health benefits to being circumcised at birth with no down side.

    So unless you have evidence to support your “belief”, it’s time for you to concede defeat.

    Having been circumcised as an adult, I only wish it had been done at birth.

    Circumcision is like a vaccination for life and parents should have to right to give this benefit to their children.

  • John

    Fine article Dr Bering. Lucid both in a common sense take on which competing viewpoint to prefer and with regard to human nature and what men really do. As regards the latter I recall producing a condom in a sexual encounter and being told by my about to be partner that they had never known anyone to use one before.

    Why is it that when one of the most influential national medical associations in the world “tediously analyzed mountains of data” they came to the same conclusion as a Medical Science Professor who has 280 published papers on the topic? Coincidence? I doubt it. Yet some people who confidently reject that conclusion after being converted by unsubstantiated information on websites claim that anyone who subscribes to it is not interested in science.

    One respondent considers that “Using the very same logic for your title, we could adequately say:“Cut the breasts, cut the breast cancer risk!!… Why prophylactic mastectomy on infant girls is a good choice”” In my view that would be avoiding your logic. By simply removing the prepuce from the penis you are avoiding the risk of a penectomy to treat penile cancer. The equivalent to the suggested prophylactic mastectomy would be a prophylactic penectomy and that is the opposite of what you are advocating.

    You are accused of being perverted yet the minor medical intervention you advocate to protect child health is the same one advocated by one of the most influential national medical associations in the world and often described as a “surgical vaccine”. So is it you with the perverted interest in children’s genitals or your opponents who seem so fixated on the genitalia just because of the proximity of the “surgical vaccine”.

    I can’t help noting that the concept of a sexually advantageous foreskin wasn’t my experience with a prepuce and I did not suffer from a medical condition that would compromise my perspective. Anything that is continually covered will be more sensitive in the way a finger covered in a bandaid will be temporarily more sensitive but that type of sensitivity doesn’t make a penis any more erogenous than it does a finger.

    Finally I’m at a total loss to understand your opponents’ view that something that very credible authorities seem to consider analogous to vaccination (if the tone of their policies is anything to go by) is the same as a tattoo for the purposes of ethical assessment of whether or not it should fall within normal parental authority to consent on behalf of their baby for most things. Is that a deliberate straw man?

  • roger desmoulins

    Jesse Bering, you stop pretending that you, the AAP, and the studies it cites, know things that are simply not so! The AAP and the studies they cite simply do NOT know what they are talking about. A major problem is that the leading lights of American medicine and public health are circumcised men or married to circumcised men. This fact has warped their judgement.

    The research the AAP invokes and that you are in awe of, is only an odds changer. The game changers are condoms and fidelity. To exalt odds changers when there are simple and evident game changers, is the road to public health disaster. Unless millions of parents rise up and ignore the AAP’s profoundly erroneous conclusions.

    Continental Europe and Japan have never circumcised. The UK and New Zealand used to but gave it up 1-2 generations ago. In Australia and Canada, RIC is a majority practice that has become a minority one. The USA is the only nation that routinely circumcises a majority of its boys at birth. If the circumcised penis were healthier, a comparison of USA data with European and Japanese data would reveal a USA advantage holding steady over time. A comparison of USA data with data from Australia, Canada and New Zealand would show a growing USA advantage, as the gap between the circ rate in the USA and in those countries widened.

    The WHO, UNAIDS, and the small clique at Harvard and Johns Hopkins that are pushing routine circumcision as a prophylactic measure, have stubbornly closed their ears and eyes to the possibility that circumcision can detract from sexual pleasure and functionality, can make foreplay and sex less thrilling, and can make PE and ED more common and have earlier onsets. The long run adverse effects of RIC on sex are not known; the technical report admitted as much. Hence the costs of RIC are not known, so that a balance cannot be struck between the benefits and costs.

    “—these advantages are overshadowed in importance by the prophylactic benefits of removing highly receptive HIV target cells that are found on the inner mucosal surface of the foreskin.”
    Then why does intact Europe have a much lower rate of HIV positivity than the circumcised USA? Moreover, I submit that the ready availability of condoms, and the availability and respectability of committed relationships as a lifestyle, “overshadow” your arguments for removing the foreskin.

    “And when performed by a skilled physician on neonates under sterile conditions, circumcision is a quick, safe, minor procedure.”
    The true rate of serious accidents, of circumcision “revisions” performed by pediatric urologists, of long run adverse effects on sexual pleasure and functionality, are all unknown. Hence we have no business deeming RIC a safe procedure.

    “To circumcise, or not to circumcise? To me, at least, that’s no longer even a question. It remains as much a no-brainer as it was when I first wrote about this issue two years ago. ”
    You are begging the question.

    “If male circumcision reduces the probability of contracting the HIV virus even a fraction of a percent—let alone the estimated 60% reduction that scientists believe it does—then why on earth wouldn’t you choose circumcision?”
    Because I do not believe in these shonky studies, which were riddled with errors of design and execution, as documented in Boyle & Hill (2011). Because African findings are not relevant to the USA. Because the USA has the highest proportion of circumcised men, and the highest rates of HIV positivity. Because circumcision is only claimed to be an odds changer, and game changers exist, namely condoms and fidelity. Because something called “risk compensation” (look it up) is all too real.

    “Have you ever seen a person slowly succumb to AIDS?”
    Last century, a quarter million American and Canadian gay men died of AIDS. The vast majority of them were circumcised. I rest my case.

    American boys should all enjoy the anatomical advantages your lover enjoys. If they want to discard certain parts of their intimate anatomy when they attain their majority, that is their choice. I am amazed that you can write as you do while in a long term committed relationship with an intact man.

    It is too bad that Chris Hitchens is dead.

  • roger desmoulins

    The link is to a blog post by a gay man who totally disagrees with you:
    http://www.theweeklings.com/tgualtieri/2012/08/31/our-bodies-our-choices-part-i/

  • FrogTale

    Circumcision is not a mutilation like excision, the barbarous mutilation of young girls in Africa, whose big lips are being cut off. Those poor girls suffer great pain, risk infection and death and will never enjoy sexual intercourse when they grow up to become women.

    More than 90% of muslim egyptian girls suffer this awful fate today. This happens in many other islamic and non-islamic african countries.

    Circumcision of very young male infants on the other hand, is a healthy and highly recommendable procedure.

    King Louis 16 of France was circumcized in his twenties because of a congenital malformation, that prevented him from having normal sex. After that operation, everything went well and he made 4 children to his wife.

  • AG

    The logic of article is disease prevention through prophylactic surgery. Thus, we should remove all infant appendix to prevent appendicitis, tosils for autoimmune disease; then where is the end of such prophylactic surgery? Partial gastrecotomy for future obesity? Tongue for obesity? Eyes for traffic accidents? Finger nails for scrachting injury?

    Messing with nature due to one data point is reckless. Does human truely understand other function of foreskin?

    One thing for sure is that foreskin is a sexual sensory organ. If author has his foreskin removed young, he is like blind man talking about benifit of beining blind.

  • Er

    Israelite circumcision was originally only the cutting of the foreskin.  However, after Hellenistic Jews tried to cover up their circumcision by various means of stretching the foreskin, the Rabis added in another step. This procedure is called priah (Hebrew: פריעה), which means: ‘uncovering’, and consists of peeling back the epithelium after the foreskin has been amputated. 

    The claim that circumcision is a continuous bond with the times of Abraham is false.  It has changed before and can change again.

  • Sten

    Jesse certainly made an accurate prediction about the response he would get from his article. I think it was very well written however and make the following observations:

    People get very emotional about this subject and it is easy to understand why. A mother or father who had not had their boy “done” will defend their decision, and a man who is uncircumcised will be reluctant to admit that his condition is less wholesome than it could be, or that his parents did not do the right thing.

    Those who argue against circumcision tend to be very strident and emotional in their posts. They talk about mutilation, child abuse, and staying “intact”, with little effort at fleshing out their arguments. They frequently bring up the issue of female circumcision being banned in Western countries, so as to introduce the idea that some sort of gender selective abuse is happening.

    The pro circumcision people just cite the evidence and refer to the studies (of which there are very many) showing the positive health benefits from the procedure. There are a few that argue from a religious perspective: the Jews and Muslims coming out strongly in favor as you would expect, but the Christians are quite divided about it. Some Christians are guided by the Bible to circumcise their boys, but others feel they are strongly guided against the practice by the same book.

    I was born in Sweden so was not circumcised as a child, and when my son was born in Australia his mother and I decided not to have him done either. I was circumcised in my mid thirties and my son a few years after me when a child. We both had medical conditions that demanded this action although different conditions.

    In spite of my personal experiences I remained anti routine circumcisions until some years later when I chanced upon a debate about the subject in a magazine. I found the argument in favor of circumcision absolutely compelling and the argument against as described above.

  • Howard

    So then let’s have all teenage girls have their breasts cut off when they are fully developed, this will reduce breast cancer by almost 100%. I wonder how that would fly?

    And those HIV studies are seriously flawed. Google it and you’ll see.

  • http://www.circinfo.net they had it coming..

    the anti circumcision lobby has for the last 15 or so years been able to get away with a raft of shameful and evil methods of promoting their campaign against male circumcision. from shady ‘studies’, threatening parents and doctors, even using vulnerable men as pawns in their thoughtless quest to influence the lives of people they don’t even know.

    For years they have used the internet as a vehicle to present all kind of fanciful, desperate claims; often based on ‘studies’ that have been overseen or conducted by fellow anti circumcision lobbyists. the studies are of poor quality, often biased beyond belief and none have been high enough quality to be included in any serious scientific review. surprise surprise..

    Due to the way they have presented their ‘information’ they have been able to convince people very easily of their stance, using emotive language, imagery etc, they have managed to suck gullible people who don’t bother to look beyond the anti circumcision facade to see that its all based on hot air.

    What they didn’t count on is that their, biased studies, cheap manipulative websites, along with a bucket full of desperation is no match for high quality, peer reviewed scientific evidence. the wheels have finally fallen off the anti circumcision movement as more and more science based organizations are reviewing the relevant studies and are finding in favor of circumcision.

    the cat is out of the bag, the anti circumcision movement has been proven to be based on nothing but certain peoples opinion and not *evidence*, its about time because i am sick and tired of mindless pawns running around trying to convince circumcised men that they have been ‘mutilated’ and should be angry about it. really.

    anyway, thanks for writing this Jesse, im glad you can see how abusive the anti circumcision movement is and aren’t afraid to say it. im sure your inbox will fill up with endless emails from no circ sheep, but after reading your article, im pretty confident you will see straight through it.

    oh and ‘Human_Rights’, australia has not made circumcision illegal, circumcision is available in every state and has never been nor will ever be illegal.

  • Dan Bollinger

    The article’s premise is false. It assumes that every boy child will be in a high risk group for HIV. I’m pretty sure that babies aren’t having sex–or at least we hope not, and if they are you have a bigger problem than a possible STD.

    As for when he eventually grows up, the greatest HIV vector in the USA is sharing IV needles, so, unless you know your baby is going to grow up and be a drug addict…

    No first-world study shows any benefit to circumcision. Any possible benefit (sic) is only in Africa where viral load is very high. And even then, you have to wear a condom. And if you have to wear a condom (99+% effective), then why should you cut babies in the first place? Makes no sense to put children at risk for complications.

    The argument supporting the premise is that forced prophylactic surgery is ethical. Well, infant mastectomies would save thousands of lives, and vasectomies prevent abortions, and… Well, you get the idea.

    In the end, this is just another self-aggrandizing hand-wringing “Parents should chose to mutilate their son because his body belongs to them” article.

    PS: Your intact partner enjoys sex more than you do.

  • BigRed

    You write in your Scientific American piece:

    “For me, if one fully appreciates the scientific findings reported by these landmark studies with sub-Saharan African men, circumcision is the more humane decision.”

    I am not an expert so I rely on people who can appreciate the findings of these studies, people like this guy: http://blog.practicalethics.ox.ac.uk/2012/05/when-bad-science-kills-or-how-to-spread-aids/

    His claim is that the findings are an artifact of trial design (part of which you mentioned, i.e. the healing period) and execution (part of which you mentioned, i.e. the earlier termination). In addition, he points out that the belief that circumcision protects from HIV infection will be counterproductive if men forgo condom use.

    In light of this and the fact that boys could be vaccinated against the HPV, it seems like circumcision has negligible benefits and non-negligible risks. Not a health intervention to be recommended.

    Btw: nice pre-denunciation of your critics: “What has become increasingly irritable to me, to no foreseeable end (just watch the reactions to this little essay of mine), are the rhetorical tactics of hardliner…”

  • http://dianthus.co.uk Adam Jacobs

    “It would not be due to 18-year-olds (or 21-year-olds, or whatever) being able to objectively evaluate the pros and cons of their own circumcision in some miraculously clearheaded way”

    And neonates can????

  • BobN

    60% sure sounds like a lot when you stick it out there out of context.

  • http://forthesakeofscience.com Michael Hawkins

    I have no idea why you cite me as believing this is a religious or cultural issue. I addressed the scientific concerns and the scientific concerns alone. Moreover, you and I don’t even disagree about this. I accept the conclusion of the AAP and other major organizations, not only because I respect their opinions, but because I have looked into a number of these studies and I agree that the evidence is strong in favor of circumcision. Furthermore, if you bothered to search my blog for the word “circumcision”, you would see a post where I dismiss religion and tradition as valid reasons for the minor surgery. Or to put my position in the words of someone else, “Many of our parents, it seems, may have actually made the right decision for the wrong reasons.”

    Ed: Bering was referring to PZ Myers, the subject of your post, not to you yourself.

  • Julie

    Seeing as how babies aren’t having sex, can’t we leave this decision up to adult men whether they’d like to cut off part of their penis rather than use condoms? (Although, since it isn’t exactly rare for circumcised men to be infected with HIV, I suspect a condom would be a good choice either way?)

  • Rosanna

    It is up to parents to decide whether to have their boys circumcised. Perhaps that will change one day many years in the future, but at this point in time the law makes it clear that parents are responsible for making health decisions for babies who cannot do so themselves. It is the parents’ choice one way or another.

  • Art

    Well said Jesse Bering, PhD. I agree on all points.

    To maximize benefit and minimize risk, as any good parent would want to do, anyone looking at the literature would have to conclude that circumcision should be done as early as practicable. The risk and discomfort, not to mention the cost, of circumcision only increases as the boy gets older. The people claiming that you should just wait and let the kid decide when they are 18 haven’t read or understood the available material.

    Those claiming circumcision was intended to reduce sexual pleasure, presumably to limit sexual excess, don’t really have much to say. This is simply after-the-fact speculation over motivation and, even if it was true, irrelevant. Why any group in the past may have wanted to use circumcision doesn’t have any bearing on the situation today. Circumcised populations simply don’t show any decline in interest in sex, sexual pleasure, or any difficulty having children. Which tells you that if the intention was to reduce interest in sex by reducing the pleasure of the act, the procedure was a complete failure. It didn’t make it less pleasurable and it didn’t change behavior.

    Autonomy, parents are in the business of making choices as to what is done with their children. Outside obvious and egregious harm parents are pretty much free to do the best they can by their own lights. I see a lot of kids damaged physically, mentally and emotionally by parents through ignorance, carelessness and superstition. Circumcision, done early in a medical setting, isn’t even in the same league. It is a minor procedure that causes very little discomfort while providing lifetime benefits.

    Circumcision closes the window on infections by modifying the penis in a way that causes the skin most vulnerable to infection to toughen and become more resistant. I am not advocating anyone circumcise their boys if they don’t want to. But I also think it needs to remain an option for a family. No matter what the current medical understanding may be.

  • Sten

    Well I certainly agree with Art – “The people claiming that you should just wait and let the kid decide when they are 18 haven’t read or understood the available material.”

    It is tedious to read all the posts claiming sexual pleasure is lost with the loss of the prepuce. This is stated by these learned posters as if it is a self evident truth, when in fact the opposite has been found to be the case. This is stated repeatedly by guys, like myself, who can speak with some authority on the subject – having experienced sexual activity with, and without, a foreskin.

    There are those that suggest that the foreskin has some purpose. If this is so it would be interesting to know what that purpose is. Perhaps it gave some protection our ancestors appendages when running naked through the jungle, but as modern man (well most of us anyway), don’t do this anymore.

  • http://www.duh.org/ Todd Vierling

    I’ve posted a direct rebuttal to this piece on G+ at:

    https://plus.google.com/117688216801810769488/posts/H8ScYJoenVU

  • http://forthesakeofscience.com Michael Hawkins

    Please either correct the link to my blog or retract. “Outspoken atheist blogger” refers to both PZ Myers and myself, something you did not research. Be more clear or do not reference me.

  • http://dianthus.co.uk Adam Jacobs

    A question for those arguing that parents have a legitimate right to make decisions about circumcision and that no-one else has a right to interfere with those decisions:

    Would you make the same arguments about parents’ rights to have their baby girls circumcised? And if not, why do boys deserve less protection from their parents than girls?

  • Sten

    This is a very tired argument Adam Jacobs that has been delt with comprehensively before and in some of the comments above. Do you bother to read any of them?

  • mre54

    ….And because the man I watched slowly waste away with AIDS..WAS circumcised……makes me ask the question, “If circumcision doesn’t prevent HIV infection…..why the hell is circumcising infant boys even being put forth as a prevention of AIDS or any other STI? It doesn’t work! Leave natural boys the way nature intended and let them decide if genital alteration is in their best interest when they are mature enough to know the facts. It only makes sense!

  • http://dianthus.co.uk Adam Jacobs

    Yes, Sten, I did read the comments.

    If you believe those comments have dealt with that issue comprehensively, then I guess that speaks volumes.

  • dreamer_fla

    Are you aware of the religious bias of the Task Force that wrote the AAP Policy Statement?

    At least 3 of the “accomplished” members (out of 8) have strong religious bias:

    Andrew Freedman, who circumcised his own son (in spite of the ethical issue of pediatricians tending to their own family members). His words: “I didn’t make any excuses that this was to avoid a UTI, or for medical reasons. My rationale was this: As a Jewish male in a long line of tradition, I didn’t want to be the link in a chain that broke.” http://articles.latimes.com/2008/mar/31/health/he-circumcision31/3 and who also stated that “As a practicing pediatric urologist, 20% of the patients I will see today are here because of something related to their circumcision”

    Doug Diekema, who has twice advocated for a “ritual nick” to be performed on female minors, even though this is prohibited by federal law.

    Susan Blank, Jewish with documented religio-cultural bias in favor of circumcision.

    The AAP Statement also indicates that “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 families.”

    So is this new AAP Statement really about science, medicine and protecting the well-being of the child? Or is it about protecting the cultural practice in light of the World moving progressively away from it, as the ruling in Cologne, Germany, the citizen initiative to ban circumcision of minors in San Francisco, and the several international medical associations who oppose circumcision of infants, like the Royal Dutch Medical Association that “wants to discourage male circumcision, because it is an unnecessary procedure with complications, which violates the integrity of the child”?

  • rg7890

    As a circumcised male, I strongly resent many of the comments by the anti-circumcision crowd. It seems they have never spoken to one circumcised male about this supposedly horrific event. I have absolutely no recollection of any trauma, no lack of sexual pleasure, no sense of mutilation, NOTHING at all to suggest there is or was anything bad about being circumcised. There is absolutely no justification to compare this procedure, which typically has NO effect on a male’s life, to the true horror of female mutilation. Please stop exploiting the torture suffered by those girls to further your case! As for having it done as an adult, of course I wouldn’t want to do it now! That’s why I’m thankful it was done as a newborn. As far as I can tell, it was a non-event…it seems in every sense that I was just born this way.

  • Sten

    Well Adam Jacobs, it may not have been dealt with “comprehensively” (the female circumcision comparison) in the statements above but it has been elsewhere. I did refer to it in my first post and Jesse Bering did make mention of it in his article – “cruel and unnecessary ritual act against little boys that is just as abhorrent as female clitoridectomy” – just to illustrate what a fallacious argument this is. This, however, is about as good as it gets from the anti circumcision zealots.

  • Pingback: Choose Intact » Blog Archive » Flawed Circumcision Defense: Jesse Bering()

  • Kelev

    Well, circumcision sure hasn’t “cut the risk” for men in the United States. Despite (or because of) the fact that the US has the highest rate of circumcision in the western world, the US also has the highest rate of HIV and other STDs (as well as infant mortality and medical costs) — far higher than in Europe where circumcision is rare. If there was anywhere that circumcision was going to work, it would have been in the US after generations of near-universal circumcision. Instead you see just the opposite.

  • http://joseph4GI.blogspot.com Joseph4GI

    This article is pure tripe. It’s pure opinion that Jesse Bering, and a few others present, are trying to clothe with “science.”

    Let’s first begin with this author’s bias.

    “The [womb] that I bathed in, the place in which I had my “bones and sinews knitted together,” in the words of Job, was the property of a Jew.”

    Jesse Bering has more than one reason to have a strong bias in favor of circumcision. He is of course circumcised, and he comes from a culture where having a foreskin is viewed with disdain. It is surprising to me he has remained with his lover from Mexico. Perhaps he hopes to convince him to part with his foreskin in the future, using the so-called “evidence?”

    It is no surprise, then, that he cheerleads the AAP in this piece of pro-circumcision pablum.

    What’s interesting to me is how selectively he quotes the AAP. While he repeats much of the nonsense regarding the so-called “medical benefits,” he seems to have missed the part that says that “…health benefits are not great enough to recommend routine circumcision for all male newborns.”

    So, I’m not sure what the big hullabaloo is with Bering praising the AAP. It must be that they said positive things about the kind of penis that hangs between his legs, and the historically problematic Jewish “tradition” that caused it.

    The culmination that was the latest policy statement on circumcision by the AAP can be summarized to this: 5 years of mulling it over, and “We don’t recommend it, but it should still be an option for brainwashed parents, and the state should flip the bill.” was the best the AAP could do? Seriously? Mr. Burns put it the best: “Spicy, yet spineless.”

    The confusing policy statement raises a few questions, as does this very article. How is it the AAP couldn’t bring itself to recommend infant circumcision, but it should be this “option” for parents which the state and insurance companies should cover?

    How is it parents are supposed to weigh the same “evidence” that health professionals at the AAP couldn’t use to endorse circumcision, and somehow come up with a more reasonable conclusion?

    Without any medical or clinical indication, can a doctor even be performing surgery in healthy, non-consenting minors, let alone be giving their parents any kind of a “choice?”

    For a medical board so concerned with a child’s future sex life as a man, why is it they didn’t even talk about other options he may have for protection? The word “condom” does not appear once in either the policy statement, nor the technical report. Somehow circumcision is supposed to be the only option, or I’m led to believe.

    Why wasn’t the foreskin, its function, its parts etc. not discussed at all? Bering says it was, but he is either oblivious to this, or he is knowingly lying. Perhaps the policy satisfied his requirements of talking about the function and mechanics of the foreskin, which is not to talk about it at all?

    The new AAP policy statement on circumcision raises many questions, but Bering does not make any effort to ask them.

    Which raises new questions; why is it Discover decided to come to Bering for any insight on the new AAP statement?

    Who IS Bering? Is he a medical doctor of any kind? A surgeon? A urologist? A pediatrician? An epidemiologist?

    Just what makes his word on what the AAP has to say of any value?

    At the very least, why didn’t Discover have a dissenting voice write?

    While Bering commits argumentum ad verecundiam, he seems to be oblivious to the fact that the AAP stands alone in stating “the benefits outweigh the risks.”

    The trend of opinion on routine male circumcision is overwhelmingly negative in industrialized nations. No respected medical board in the world recommends circumcision for infants, not even in the name of HIV prevention. They must all point to the risks, and they must all state that there is no convincing evidence that the benefits outweigh these risks. To do otherwise would be to take an unfounded position against the best medical authorities of the West, as the AAP has today.

    Discover couldn’t find a more inept person to address this issue. All Bering offers is pure one-sided, biased opinion which he poorly veils with carefully-selected “research.” It is obvious he only chose the parts of the AAP statement that he liked.

    While he would like to emphasize the so-called “health-benefits” of circumcision, when all is said and done, the AAP statement still says the “…health benefits are not great enough to recommend routine circumcision for all male newborns.”

    It raises the question as to why, even though the AAP can’t bring itself to “recommend” circumcision, it still insists parents should have “access” to it, and the state should fork over the cash.

    I posit that the AAP would like to have its cake and eat it too. While it does not want to go against the world consensus that there isn’t enough evidence to endorse infant circumcision, it still would like to justify the actions of its “fellows,” a great majority of which profit from the act.

  • http://forthesakeofscience.com Michael Hawkins

    Mr. Bering, I have updated my link to reflect 1) that my post does not support your contention about PZ making this a religious/cultural issue and 2) that you are not clear in which “outspoken atheist blogger” you mean. That is the best I can do until you correct your mistake.

    Ed: Link now goes to Myers’ blog.

  • Tim

    1) All that uncircumcised, non-monogamous men have to do to avoid contracting HIV is to keep their “highly receptive HIV target cells” covered with a condom. If there is an alternative to surgical intervention, isn’t the rule to use it first?

    2) Can we at least develop some standardized rules about what parents can do to their children in the name of their personal beliefs? If Jews and Muslims can circumcise their babies, then why can’t a white supremacist tattoo a swastika on their infant’s forehead? (Or to compare apples to apples, their groin area?) Both sets of parents have strong beliefs and presumably have the right to inculcate them in their child without its consent.

  • Mookie

    Increased sensitivity in the glans is not “what ever advantage.” Pleasure is the ONLY thing that matters in life!!!!!!

  • Kingsley

    I am willing to wager that the author of this pap is a circumcision fetishist and a pathological liar.

    The African studies that are so beloved of, and conducted by fetishists are so flawed they are nothing more than scientific fraud.

    The AAP is nothing more than a trade association. It’s only concern is the profits of it’s ‘stakeholders’.

    Nobody has a right to another persons body for any reason. Forced genital cutting of a minor is a gross human rights abuse and anybody who is unable to understand this fails the humanity test.

    Any adult who has this done to their son is an unfit parent. I was mutilated as a baby and I resent what was done to me. I am now middle aged and sex for me is *not* OK.

    Julie – September 6th, 2012 at 12:26 am
    The option of leaving it up to men to decide for themselves is unacceptable to the fetishists. They get sexual gratification from the act of cutting genitals and since only a tiny minority of seriously mentally unbalanced men would opt for circumcision it has to be forced on infants and children who can’t object.

    Finally, below is a comment by a woman I found elsewhere regarding the circumcision fetishists mindset and their pathological lying:

    “In and of itself there is nothing at all erotic about the lie. They don’t believe the lies they spread, they know they are lies but they know that certain people are vulnerable to believing those lies and when they do they cut the penises of their own babies. Having a hand in the sale that results in a circumcision is the fetishist’s erotic thrill. It’s a game to them, a kinky game that results in the agony of infants. It’s just a twisted mind f**k game.”

  • KL

    This article is again, an example of American ignorance, ethnocentricity and self-delusion.

  • Hayley Dawn Kolarik

    Infant Circumcision- why you think it’s done:

    1.
    God wants it done. FALSE. “God made you perfect and in his image.” God
    wouldn’t give it to us if he didn’t want us to have it. Disfiguring the
    body is prohibited in many religions including Judaism, Islam, and
    Christianity.

    2. Foreskin serves no purpose. FALSE. Millions of
    years of evolution have given foreskin to every man and most mammals.
    Evolution doesn’t make mistakes like that.

    3. Babies don’t feel pain. ARE YOU RETARDED? Babies feel pain more intensely than adults.

    4. Babies won’t remember. YES AND NO. ‘Repressed memory’ is a more appropriate description: and some do remember.

    5.
    Circumcision reduces risk of std’s. FALSE It INCREASES the risk.
    Foreskin is a mucus membrane. Mucus TRAPS pathogens – it HELPS prevent
    disease.

    6. For hygiene. MAKES NO SENSE. How lazy can you
    possibly be? Taking care of a bloody wound in a diaper is easier? What
    else shall we amputate to stay clean – perhaps the labia?

    7. A
    deluge of other equally random and ridiculous excuses. -Circumcision has
    probably had more claims of benefit than any other medical procedure in
    history: that alone should tell you something.

    Infant Circumcision – Why it’s actually done:

    1.
    Infants cannot defend themselves. – How many sane men would submit to
    cutting off healthy bits of themselves (some of the most sensitive bits
    no less..) for no benefit and without painkillers?

    2. The circumcision room is one of the most profitable areas in a ho$pital.

    3.
    Shame / Guilt / Maintaining an image / Stockholm syndrome. – It is
    easier to maintain a lie, than to admit having done harm to your child
    (or one of your parents having done harm to you).

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