I personally don't think there's any medical need. There have been some studies that may suggest slight health benefits, but then there are plenty of studies disproving this theory. I find it very odd that people in the U.S. are so outraged by female circumcision done in other cultures, but don't even bat an eye at male circumcision done here in our own country. Why is one mutilation and the other a routine medical procedure? I don't judge anyone for making that choice - be it for medical, religious or purely aesthetic reasons - but I don't think I could do it because I believe that the cons outweigh the pros.
Of course when I flipped open the October 26, 2009 issue of New York magazine, I was intrigued to find that they had devoted several articles and features to this topic. (If this was Cosmo they would've called it "The Foreskin Issue!") The more I read, the more disappointed I grew. The articles - even the so-called "anti-circumcision" ones - were pretty biased and slanted toward the pro-circumcision stance. So I decided to write them a little letter:
Although the New York article suggested that there were vast health benefits of circumcision, medical experts are actually torn on the issue. The American Academy of Pediatrics found both potential benefits and risks, coming to the decision that there was insufficient data to recommend it. The American Urological Association has basically the same stance: there are benefits and risks.
Dear New York Magazine,
I think it was a great idea to weigh the pros and cons of circumcision in your October 26, 2009 issue, however the feature was unfairly slanted toward the "pro" stance. Anti-circumcision activists and parents were negatively portrayed as squeamish, anti-religion, overly "child-centric", suspicious of mainstream medicine and even just plain old trendy. (Circumcision was even described as a growing blue-state-red-state issue. Really?)
Unproven medical theories were repeatedly presented as fact (such as the alleged benefits suggested by studies done in sub-Saharan Africa being used to support circumcision in developed countries like the U.S.) with one author even going so far as to refer to the foreskin as a "public-health menace". Even the sections that were seemingly "pro-foreskin" didn't give the actual, compelling reasons not to circumcise, instead harping on the religious aspects or downplaying the risks.
Perhaps the most misleading was Hugo Schwyzer's before-and-after accounts of his own adult circumcision. The foreskin tearing issues he suffered pre-circumcision are relatively uncommon so his opinion is hardly objective enough to merit much weight in the overall decision-making process.
Thank you for addressing the issue of circumcision and attempting to show both sides. Unfortunately your apparent biases showed through just a little too much.
The Canadian Paediatric Society does not recommend routine newborn circumcision. According to the College of Physicians and Surgeons of British Columbia, current understanding of the benefits, risks and potential harms no longer support the practice of preventive infant male circumcision. They consider it a "non-therapeutic, medically unnecessary intervention" when performed on a healthy infant.The STD studies can be misleading. Some research has suggested that male circumcision reduces the risk of acquiring HIV by men during penile-vaginal sex. It seems that the reason uncircumcised men are more susceptible is because the foreskin has a higher density of Langerhans cells (target cells for HIV infection). There's also a risk of tearing the foreskin during intercourse.
However, many doctors feel the circumcision-prevents-infection claims have been exaggerated. The American Urological Association has stated that evidence associating neonatal circumcision with "reduced incidence of sexually transmitted diseases is conflicting". It's important to remember that the bulk of the studies on the subject were done on adults in sub-Saharan Africa, so the results aren't exactly comparable to infants in more developed nations, where there is better education on and access to contraception and healthcare.
It's also worth nothing that male circumcision might only reduce infection in female-to-male heterosexual transmission, so the overall influence on the HIV epidemic (in Africa or otherwise) would at best, be slight. In fact, some studies have suggested that circumcision may increase the risk of female HIV infection (due to reduced lubrication and increased friction) especially in sub-Saharan Africa where "dry sex" is practiced.
The U.S. is the second highest circumcising country in the world, next to Israel. The U.S. also has one of the highest HIV infection rates of all the industrialized countries. So while the science might suggest that circumcision prevents HIV infection, the numbers just don't add up in reality.
The more these "circumcision prevents HIV" claims are exaggerated, perhaps the more likely it is for men who have been circumcised to develop a false sense of security. There is also evidence that circumcision causes a loss of sexual sensitivity and function (as it removes nerves from the penis) so some have made the claim that circumcision may reduce condom use and therefore have an adverse effect on the the overall incidence of HIV infection. It's important to remember that condom use is effective at preventing HIV transmission for both partners, regardless of whether or not a male is circumcised.
Even though we think of infant circumcision as a routine medical procedure, it's important to remember that it is surgery: the use of local anesthetic in and of itself can be a risk for infants and any open wound is at risk for infection. And then there's the pain...
Circumcisions are painful. (One study on infant circumcision was actually stopped before completion because of the amount of trauma they witnessed the babies going through.) Some research has suggested that newborns feel pain more intensely and for longer periods of time than adults. In fact, some studies have suggested that intact boys and girls have higher threasholds of pain than circumcised boys. Even with anesthesia, we still do not know the full permanent, psychological and emotional impact of infant circumcision.
I don't expect everyone to make the same decision that I would make and I'm certainly not discounting the importance of religion in people's lives. (Not in my life, but to each their own.) I just think that if a magazine is going to publish an entire section on the "pros and cons" of any topic, they should show the pros and the cons.