That’s not a joke: I really am going to discuss my very own penis–so don’t say you weren’t warned!
Last week, the New York Times reported some very good news indeed: although 80% of all American men are still circumcised, the rate of neonatal circumcision plummeted from 56% in 2006 (which was already down about ten points from the rate in the ’80s and ’90s) to just 32.5% in 2009. This qualifies as a big time trend (hopefully not just a “fad”).
Those in the pro-circumcision camp, including many male doctors who are no doubt themselves circumcised, have understandably gone into a tizzy upon learning this news. They know that a 33% rate is not stable in American society. Either they have to arrest the trend ASAP and get circumcising back into the majority position, or it will continue to drop precipitously until it’s in single digits. Because let’s face it: most Americans are not very invested in either side of this issue. They just want to stay with the herd, and do what is “normal” (that is, what the majority does, even if the minority has good arguments for why it is not normal at all, biologically speaking). This was the strongest weapon in the pro-circ camp for many years, until just this moment in modern history. Now that the majority has flipped decisively to the other side, and this has been made public via the NY Times and other media outlets (although in the case of NPR, in a despicably unbalanced way), there is likely to be a stampede away from the knife, unless the pro-circ side in their desperation can come up with some way to stem the tide.
One of the tactics they have been trying is to insist that there are myriad health benefits to circumcision. Hannah Rosin, a vocal proponent of circumcision (she had her son circumcised, which is where her emotional investment comes in), has even warned of a “potential public health crisis” if the circumcision rates continue to drop. As I told her at her blog, the only problem with that is that the four healthiest countries in the world are Iceland, Sweden, Finland, and Germany, all nations in which almost no one is circumcised. So much for that theory!
One argument I’ve seen bouncing around the blogosphere is a protest from Jewish men that the anti-circumcision campaign is “anti-Semitic”, or that at the very least, preserving circumcision has a “social benefit” by–get this–preventing Jewish (and Muslim) boys from being ostracised in the locker room! Wow. That’s just…no. I’m sorry, but that doesn’t cut it (no pun intended). I should be clear: I’m against circumcision no matter what your religion is. I’ve seen some fellow “intactivists” make an exception for religion, but I utterly reject that. A boy can grow up and decide to do that for his religion when he is 18; at age zero he has no ability to consent and may not even ultimately join the religion of his birth–which should be his right.
But wait, you ask: wasn’t this supposed to be about my penis? Okay, yes: I am an American man with a rare attribute at my age (GenX): I did not get any part of my genitals cut off when I was a baby (or at any time since, for that matter). Let me tell you that while I don’t want to get graphic, I know how my body works, and I can see how the equipment of guys in pornos works, and let’s just say they are not just missing some irrelevant bit of skin. The whole natural way it’s supposed to function is not possible with them (as graphic as I’ll get is to suggest Googling “gliding action” and say that given this latest news, a good financial tip would be to short the stock for companies that make “personal lubricants” in about fifteen or twenty years). So I am ecstatic about this trend, and like to feel that I had a small but significant part in it by giving testimonials like this one online over the past decade.
I have often wondered how insane circumcision must look to men in non-circumcising countries. Now, as long as the momentum continues, we’ll get to see how insane a younger generation thinks it was that people did this “in the olden days”. Arthur C. Clarke has a nice bit about this in his novel 3001, in fact.
For me as an intact American man in 2010, to listen to those who still desperately insist that circumcision is a good idea strikes me as what it would be like to live in a country where most people have traditionally had one eyeball removed at birth, but a growing number of people start questioning the wisdom of this tradition. The defenders of routine neonatal eyeball removal would make defensive comments that “you don’t need that ‘extra’ eyeball; I can see just fine–and my risk of eye cancer is cut in half”. Well, sure, you can get by pretty well without it, certainly much better than with zero eyeballs! But to get the full range of stereoscopic vision, you need both eyes. And it’s really the same with the foreskin. We are naturally formed the way we are for a reason, and to routinely remove a part of a boy’s healthy genitals (the most sensitive part, by the way) is a holdover of a barbaric religious rite being awkwardly shoehorned into modern times by desperate defensive medical rationalisations.
While I applaud your activism about a body part that you actually do have, I’m surprised you didn’t mention any of the recent studies showing that circumcision actually helps prevent transmission of HIV and other STDs. Those studies don’t exactly help your argument but you could reference them to attempt to dismantle them, at the very least. Given your viewpoint, I’m interested to hear your thoughts.
Also, I would caution against experiential examples unless you have first hand (no pun intended) experience with what you’re arguing. Without incriminating myself too far, you’re correct in saying that it’s not just an “irrelevant bit of skin” but you’re incorrect in assuming that being uncircumsized is always superior.
A recent meta-analysis was done using the African HIV trials and translating the reduction of HIV risk from circumcision to Americans. First you have to remember that the risk of HIV is very small in the US. (1.58% over a lifetime) Regardless though, after adjusting for all known confounders they determined that the reduction in risk for a circumcised American man was 0.29%- or less than 1/3 of percent.
That reduction is considered “statistically insignificant”.
In other words, unless you’re a man living in sub-Saharan Africa practicing high risk sex (like dry sex facilitated by astringent herbs in the vagina beforehand) with a population that has an almost 40% HIV+ rate, getting circumcised offers you nothing in terms of HIV protection.
~Huntress
However, the USA has one of the highest HIV rates in the Western World, and one of the highest circumcision rates. It does not seem to be helping them much so far.
The studies regarding HIV were inconclusive, in so far as being definite one way or the other. (Usually depending on the study)
Thirdly, even in circumcising DID have an HIV prevention benefit, it would not even be comparable to wearing a condom, which would be about 98% effective at preventing the spread of HIV. It still makes little sense to circumcise an infant.
Shasta, by that logic none of us can say it’s better to keep any of our normal, healthy body parts than it is to have them cut off. How do you know you wouldn’t like life better without your thumbs, until you try it?
The male foreskin is the only healthy, normal body part that is routinely removed from people when they are too young to know what’s going on, and certainly too young to consent. Shouldn’t the logical principle be that if you’re going to pick one solitary part to routinely remove, one part that you believe _____________ (God, or evolution, take your pick) has gotten wrong, you should have some overwhelming proof that it needs to be removed? How do you know female genital mutilation (which those who practise it call “female circumcision”) doesn’t leave you better off? Hadn’t you better try it before you knock it? Did you know that most women where this is a cultural norm say they prefer to be this way, and want the same for their daughters? They are essentially brainwashed by the culture around them, as Americans have been for so long about male circumcision.
I didn’t specifically address the HIV issue, because I felt I addressed the spurious idea of health generally by noting that the top four healthiest countries in the world have a male population that is not circumcised. Wouldn’t their stats be worse if it were a real problem? And since they aren’t likely the healthiest countries by accident but because of good health care and preventive health systems, don’t you think they’d be circumcising if it were needed for health?
But since you asked for the HIV issue to be specifically addressed, I have three points to make about it:
(1) Only HIV transmission from African women to African men has been shown to be reduced by circumcision. Not transmission from men to women, not from men to men, and not in Europe, Asia, the U.S., etc.
(2) The level of “protection” is fairly small compared to how well condoms protect men (and only condoms protect women, even in Africa).
(3) The reason this protection happens at all is because circumcised men have built their own “condom” on their penis by causing the areas on the end of the penis that are meant to be very soft, wet, and sensitive to dry out, and for the skin there to become much thicker and less sensitive. A man should be able to choose whether he wants a barrier like that in place.
By the way, I learned since I wrote this post that the number of American boys who die from circumcision each year (over a hundred) is greater than the number of American children ten and under who die from choking each year (about 75). Think about that.
First, I questioned your exclusion of the African circumcision stuides because you made a blanket implication that all circumcision is unnecessary and immoral because it’s not done by choice. If you can agree that certain African populations benefit healthwise by circumcision, then your claim that it’s unnecessary would appear to be wrong.
Further, you say that these studies only show that it reduces transmission of HIV between African men and African women. To me, it seem like a safe bet to generalize the African studies to the larger global population, unless you’re saying that the African men and women are structurally different from other ethnic groups.
Additionally, my husband used to be a biblical scholar, and I seem to remember a discussion we had about Jewish traditions, which obviously included circumcision. The Hebrew tribes had lots of things that they did out of tradition because they served some sort of functional and/or health/safety purpose, and ritual circumcision is one of codes in Leviticus, which is all about doing things that are important for the proper function of their society. Now, I’m not the biggest proponent of the Levitical codes (namely that they condemn homosexual acts, though I can see why that code was included; homosexual acts don’t exactly help grow the population), but we can assume that circumcision’s appearance there means that it was important for some reason.
Also, the WHO, CDC, and UN HIV/AIDS programs do believe that male circumcision reduces the man’s risk of acquiring HIV.
And I’m not quite sure how to respond to your last paragraph. I would bet that more children die from circumcision complications than die by lightning strikes, too, but how is that relevant?
With regard to the question of why circumcision might have originally been important to the Jewish people, my husband has a really interesting theory: Apparently, it is documented that in Biblical times, many of the cultures that lived in the general vicinity of the Jewish people demonstrated their success in battle by collecting, not the scalps of their enemies, but their foreskins. (Ewwwww. Aren’t you glad somebody’s invented stamps since then?) When you slaughtered a man of the opposite side, you chopped off his foreskin and took it back with you to prove that you’d killed him. The more foreskins you could take back to your king, the greater the warrior you appeared to be. Of course, this meant that if you were slaughtering your way through a village and didn’t actually need to kill off the young boys who were no threat to you from the physical point of view, you could still gain kudos from chopping off their foreskins and taking them with you – and you weren’t going to take the time and effort to do that with finesse.
So, my husband theorises, removing a boy’s foreskin with as much care as possible in his infancy could potentially save him from having his genitals clumsily butchered ten years later. In that context, you can see how it would have made sense. Whether or not that’s the actual reason, none of us will ever know, of course; but I think it does illustrate the point that, even if there was a genuinely useful reason in the society of the time, we can’t assume that that reason would still be applicable today.
That’s fascinating, Dr. Sarah. Makes sense!
No, I don’t agree. The loss of a fully functioning sex organ is a negative effect that would require much more extreme health benefits to be worthwhile. And that’s not even addressing the pain and psychological trauma inflicted on a young baby. If that doesn’t matter because they are “too young to remember”, then why is there such social opprobation against inflicting unnecessary pain on infants in other contexts? By this logic, as long as a baby torturer was not putting the infant at risk of an early death, they should get off scot free because anything done before the age we consciously remember doesn’t matter. Right?
Yes, and I don’t deny that it does. All I noted is that no such effect has been shown outside Africa, and the reduced risk is for only for men who have unprotected sex with women (the women’s risk of contracting HIV is not reduced), and the risk reduction is less than that achieved by wearing a condom.
Also, I noted that the reason for this lies at least in part with the thickening and toughening of the skin at the head of the penis. From a generally pro-circ article in Scientific American:
“Specifically, the authors wrote, after the foreskin is removed the penis head develops extra layers of skin…”
That sounds just awful, as this is a very sensitive area for me. It cannot even touch something directly that is dry or rough at all or the sensation is too intense. But when touching something wet and soft, or when the contact is made through the foreskin, it feels fantastic to be so sensitive. Circumcised men literally don’t know what they are missing! This has been verified scientifically, btw, by an HIV/AIDS researcher:
http://www.ncbi.nlm.nih.gov/pubmed/17378847
“Circumcision ablates the most sensitive parts of the penis.”
Yeah…I’ll pass.
Shasta, would you like to have the most sensitive parts of your genitals “ablated”?
Because there is so much attention paid to preventing choking deaths in children, yet more needless deaths (mostly of helpless infants) could be prevented by ending this practise and emulating the nations which, as I keep pointing out, are the healthiest on earth.
I’m an atheist, so saying “it’s in the Bible!” doesn’t do much for me. For any Christians reading, though, I’ll note that the New Testament removes the requirement to be circumcised; in fact, that’s the main purpose of the Book of Galations. For any Jews reading, I’ll note that there are countless other “laws” from the Torah that are not followed* and suggest an alternative bris.
*In the same passage that requires boys to be circumcised on their eighth day of life, it says that their mothers are required to “bring to the priest at the entrance to the Tent of Meeting a year-old lamb for a burnt offering and a young pigeon or a dove for a sin offering.” But I’ve never heard of anyone doing this. Why is that?
The reason for that last, if you’re interested (getting further off topic), is that the Temple was destroyed centuries ago and therefore it is not physically possible to make sacrifices there. So Jews are currently considered exempt from all of the commandments involving sacrifice. However, this is not considered to set any sort of precedent for exempting them from the others, so the religion still commands Jews to circumcise their sons despite not sacrificing animals at their birth.
By the way, linking to a page about Christian beliefs about the Jewish religion isn’t exactly going to be compelling to a Jewish believer. 😉 I’d leave that one completely out of the debate.
Whoops, that was not the URL I meant for that link! I was going to use that link for Christians to look at, but then decided to just refer them to Galations. Anyway, I fixed the other one now–thanks for pointing out my error.
I’ve heard the rationalisation about the Temple being destroyed (though no good explanation about why it has not been rebuilt–yeah, I know there is a Muslim holy site there but they could rebuild it a block away or whatever). But there are just so many other laws that are not followed. When’s the last time:
–a Jewish bride was stoned to death because her parents could not produce a bloody cloth proving she was a virgin on her wedding night?
–a former Jew was stoned to death by his or her family for converting to a different religion?
–a stubborn and rebellious son was stoned to death by his Jewish family and neighbours for his stubborn, rebellious, drunken ways?
–a rape victim was required to marry her rapist and never get divorced?
God makes it clear that these commandments are not optional–far from it.
From what I understand, the stoning laws are still technically in operation, but have been hedged about with enough Talmudic restrictions to make them effectively inoperable (you need two witnesses to the capital crime and if the two differ on *any* detail the accused goes free – all you need to do to dismiss a case, therefore, is to question the witnesses on tinier and tinier details until they contradict each other and the case gets thrown out on that technicality). I don’t know the reasons given for no longer expecting rape victims to marry their attackers, but I’m willing to bet that there are reasons.
That’s the way Orthodox Judaism works. You don’t just get to say that such-and-such a law is irrelevant in this glorious modern age, because the Torah as handed down is meant to be binding for all time – but you *can* use ingenious legal arguments to find legal loopholes in those laws that it would clearly be inhumane to follow too closely. The only way routine circumcision would ever be dropped would be by that route – by finding arguments within the format of Jewish law that would allow all Jews to be exempt from this particular commandment. Whether that will ever happen I don’t know, and I’m not optimistic about it – it’s such a fundamental of the religion – but, if it ever happens, that will be how. Listing laws that aren’t observed any more as supposed precedents for not observing this one isn’t going to do it.
The circumcision laws are no more “fundamental” than any of the others I cited. The real reason those others have been legalistically obviated is that they couldn’t get away with them in modern times. As circumcision becomes more and more outmoded and taboo, I’d expect the same thing to happen.
Additionally, I’d point out that most Jews are not Orthodox, yet they still circumcise. They don’t need those legalistic loopholes to stop, since they are blowing off most of the other rules already anyway.
BTW, the “way Orthodox Judaism works” (Shabbos goys; elevators that on Saturdays go up and down automatically, opening on every floor; and all the other insane nonsense they’ve come up with to sneak around their religion’s perceived rules) illustrates the insanity of religion better than anything I as an atheist could come up with. Orthodox Jews really do take the cake: I mean, coming up with tricks to get around God’s commandments, as if disingenuously following only the legalistic letter of the law is important when it comes to the Supreme Being and not the intent of the law?!? Oy vey.
You’ll get no argument from me about the “It’s in the Bible!” logic. I referenced this as a way of noting that circumcision does have a history among human groups; it didn’t just come about because someone thought it might be a fun new game. And I tend to favor cultural practices (whatever they are) over some moral or ethical ideal because cultural traditions are important for community cohesion and function. I believe that humans organize and run their societies best in small(ish) groups, so trying to make the world one big culture by saying Do This or Don’t Do That isn’t something I like.
And please don’t go into something about human rights or universal morality – I’m really far outside of mainstream on those topics and I care not to discuss them online.
Also, I disagree with you that the infant is tortured and traumatized during circumcision. Isn’t there’s a topical numbing agent applied? If so, seems like the child’s only memory of the incident might be that his penis went numb for an hour or so. And (potential) desensitization is hardly child abuse.
And re: genital ablation – I gave birth and had a giant episiotomy which didn’t exactly heal up like it was before. Yes, I was numb, and yes, I consented to it, but there was a medical reason for it, just as there appears to be a medical benefit (to men, no less) for circumcision; I stand by my statement that if there’s a correlation between circumcision and infection reduction among one population, it can be generalized to other populations. Maybe those healthy nations you mentioned would be even healthier if they circumcised routinely?
This is a typical modern-day circumcision… they are using the plastibell which is a modern circumcision device. Please view it, it was video-taped by medical professionals to teach medical students and parents about what happens during a circumcision.
http://video.google.com/videoplay?docid=5933355699286047639#
Then come back and tell us that that infant isn’t being tortured and traumatized.
I’m usually not particularly squeamish, but I can’t quite bring myself to click that link! Sounds awful.
I think a logical starting point would be to assume that if the healthiest nations on earth don’t cut anything off of healthy baby boys or girls, then a nation which lags down the list despite its wealth is not going to have much credibility lecturing those healthiest nations about how they could be “even healthier”. Give me a break.
And have you noticed that the doctors who speak out about what an important health issue circumcision is appear to have Jewish names? That raises an eyebrow with me.
The vast, vast majority of baby boys circumcised in the U.S. never had any anaesthesia. And I’ve seen evidence that the “topical numbing agent” does not do a lot of good. But what really astonishes me is that you think a baby could have the most sensitive part of its genitals scraped off, and (even assuming the “numbing agent” is perfect) that there would be no pain an hour later! I mean, I had moles taken off my back (the least sensitive part of the body) and though it didn’t hurt while they were removing them, after the anaesthesia wore off it was extremely painful for weeks.
And yes, desensitisation of one’s sexual organs against their will is certainly child abuse. Let me put it this way: if I were captured by one of those maniacs in the movies and given a choice between being circumcised and amputating an arm (either way, with anaesthesia), I’d have no hesitation in losing the arm. It’s THAT important a body part to keep.
One more thing: since when does someone have the right to set the terms of a debate like you did, telling me we can’t discuss human rights or universal morality? If your views are outside the mainstream, then why not defend them? Or else don’t debate topics in which they come up! Jeez.
Wow. And I thought we were having a nice conversation.
Now we’re done.
Or is that setting the terms of the debate again?
Have fun gloating about your assumed victory.
I don’t know that I ever thought it was a “nice” conversation. I didn’t think it was especially nasty or personal, though; I still don’t think anything changed in that regard in the comment you seemed so offended by. Can you explain what has gotten your nose so bent out of shape?
I think there’s one major thing people always over look in the African HIV/circ studies, and its kind of a really big deal. Actually, in many circles, its enough to make the entire study null and void. The men (note, not infants) circumcised in Africa also received information on safe sex, condoms, and were made to abstain from intercourse for a minimum of 6 months while the circumcision healed. The men in the control group were basically just told they were being studied and to check in after a certain amount of time. They were not given information on safe sex, they were not told how unprotected sex puts them at a higher risk of contracting HIV, they were not given condoms, and they did not have to abstain from sex. Had the study been done correctly, both the control group and the study group would have had equal information, and the only difference would have been the circumcision. For all we know, the information alone is what created the difference in numbers. As a matter of fact, in basically every other country, its the information that *does* make the difference. The US is one of the only places in the world that practices routine infant circumcision. Circumcision, from a strictly physical standpoint would only cause the risks to rise. The intact penis allows for transference of fluids meant for lubrication. When the foreskin is removed, the glans of the penis becomes “dry” and susceptible to cracking. For the woman, the drying effect causes abrasions to the vaginal wall. Abrasions in the vagina, and abrasions to the glans of the penis creates blood to blood transfusion. When you study how the normal penis and normal vagina work with each other during intercourse, it truly becomes painfully obvious how circumcision is not something that should be done routinely. I usually compare the eyelid to the foreskin, as both have such similar purposes. Both are there to protect and lubricate their destinated organs. An eyeball without a lid will react much in the same way as the glans of the penis. The body will create layers over the eye to protect it since its normal barrier has been removed. The eyeball would essentially dry out, and most likely many would lose their ability to see out of that eye. Do all circumcised men lose function of their penis after circumcision? Well no, obviously not, but they do lose *normal* function. I believe the actual statistic is that 94% of circumcisions have complications in one way or another. The majority of circumcised men will have either curvature as a result of scar tissue, skin bridges, or adhesions. 100% of men will experience toughening of the penile glans.
Circumcision will never fill the place of safe sex practices and condoms. To physically alter the body of my son because he *might* turn out to be an idiot who doesn’t know how to use a condom, is foolish. Instead of circumcising our sons, we need to be teaching them how to be responsible.
Good comment, Britt. Isn’t it that circumcision is said to reduce transmission of HIV from a woman to a man, but not from a man to a woman? That would make a little more sense, in that it is harder for a pathogen to penetrate the harder, thicker, dry skin on a circumcised man’s penis (plus having no cells in the foreskin itself to attack). But I feel certain that the tradeoff is reduced sensitivity and reduced pleasure. The same is true when wearing a condom, of course; but at least one can still have condom-free sex with one’s wife, not to mention the intense pleasure that can be had from manual stimulation (which is so different from the jackhammer “hand job”, with artificial lubrication, a circumcised man requires).
@Britt: Very good post, altho I can’t buy your 94% complication rate.
The conservative rule of thumb in Australian medicine is that 1% of circumcised babies grow up to be men with damaged penises (too much skin cut off, lack of sensation, PE, ED, a tendency to jackhammer sex, etc.) Organised medicine in Australia considered 1% to be high enough to discourage the practice and to have Australian socialised medicine cease paying for it.
The reason why there is little awareness of how damaging circumcision is, is that the symptoms often occur several decades later. Nobody makes the connection with infant circ.
American routine circ is a ticking time bomb of eventual malpractice lawsuits.
And the African clinical trials are a scientific scandal waiting to detonate. For one thing, they were called off far too early. A fundamental problem with circ and AIDS in Africa is that it feeds the vulgar misunderstanding to the effect that “a circumcised man cannot contract AIDS.” Circ strongly discourages condom use in populations already reluctant to use them. I am confident that in 30 years time, the WHO-CDC enthusiasm to circumcise Africa will be seen as a public health failure.
@slackerinc: just why so many Americans were and are uncomfortable with the natural penis and want to make it bald, is a rich and difficult question in the social psychology of American sexuality. I surmise that the cult of the bald penis is very much bound up with the following American beliefs:
* A squeamishness about urine and smegma and the attendant odor;
* It is undignified for a mother to have to pay attention to the penis of her young son;
* The bald penis is seen as a cattle brand signaling that a man was born in the urban middle class. Ipso facto, the natural penis carries a stigma. (In recent years, being intact can mean either that one was born in poverty in a state where Medicaid does not pay for it, or that one’s mother was unusually sophisticated);
* Ignorance about how nature intended sex and foreplay to work;
* “No self-respecting woman will give a BJ to an uncircumcised man. The taste is just too awful.” I have been told this a half dozen time!
* Leonard Glick has argued in print that American routine circumcision is evidence of a semitophilic strain in American gentile thought, and I incline to agree with him.
These are interesting hypotheses. I think most of them are spot on, though I don’t know about that “semitophilic strain in American gentile thought”–do you have evidence for that?
I’ll cop to the thing about odour being true. OTOH I imagine much of a woman’s characteristic (and stronger IMHO) genital odour is removed if you get rid of enough of a woman’s genital flesh but we (at least in the West) rightly see that as a horrific, unacceptable “remedy”.
@slckerinc: I am intact and would much prefer to give up more foreskin to my arm. One can live without a foreskin. Adult circ, performed under general anesthesia, is often not the end of the world. Infant circ is more error-prone.
Last century, around 100 million baby boys born in English speaking countries were circumcised in infancy. In the vast majority of cases, this was done without any anesthesia whatsoever. This was unspeakably barbaric and unethical and raises grave doubts in my mind as to the basic decency of the common run of American obgyns. I blame this ethical train wreck on medical school profs.
To circumcise a boy without anesthesia should be a felony.
One can also live without an arm. And while I would obviously prefer to keep both, I’d be more unhappy without my foreskin than without one of my arms.
My husband & I chose not to circumcise our son. Why? Because we did not, and do not, believe we have the right to make such an alteration to his body. That is something for him to decide for himself, if he would even want to in the first place, when he is older. We are merely the custodians of our son’s body, not its owner.
Basically, I think about circumcision this way… If I wouldn’t want someone to mutilate, and permanently damage my genitals, then why would my son want that done to him?
PS: I love how people who are pro-circ will pull anything out of their asses to justify circumcising their non-consenting children. They make me sick.
Obviously I very much agree with you, Anne! Thanks for adding your two cents.
@shasta: “And I tend to favor cultural practices (whatever they are) over some moral or ethical ideal because cultural traditions are important for community cohesion and function.”
So female genital cutting is OK by you? You did say “whatever they are”, so please (anyone) don’t pull “you can’t compare them” now. It is as human rights abuses they certainly can be compared, and in the varied anc crazy reasons for doing them, and in severity in the lower range of FGC, as perfomred in Malaysia and Indonesia.
@slackerinc: Interesting you compare circumcision with removing one eyeball.
“Errol Morris, the filmmaker, was born with strabismus and subsequently lost almost all the vision in one eye, but feels he gets along perfectly well. “I see things in 3-D,” said. “I move my head when I need to – parallax is enough. I don’t see the world as a plane.” He joked that he considered stereopsis [3D vision] no more than a “gimmick” and found my interest in it “bizarre.”
“I tried to argue with him, to expatiate on the special character and beauty of stereopsis. But one cannot convey to the stereo-blind what stereopsis is like; the subjective quality, the quale, of stereopsis is unique and no less remarkable than that of color. However brilliantly a person with monocular vision may function, he or she is, in this one sense, totally lacking.
…
With prismatic spectacles and exercises, Sue Barry recovered stereo vision after a lifetime of using her two eyes separately:
“I went back to my car and happened to glance at the steering wheel. It had “popped out” from the dashboard. I closed one eye, then the other, then looked with both eyes again, and the steering wheel looked different. I decided that the light from the setting sun was playing tricks on me and drove home. But the next day I got up, did the eye exercises., and got into the car to drive to work. When I looked at-the rear-view mirror, it had popped out from the windshield.
“Her new vision was “absolutely delightful,” Sue wrote. “1 had no idea what 1 had been missing.”
– Oliver Sacks, The Mind’s Eye
@Britt: “The men in the control group were basically just told they were being studied and to check in after a certain amount of time. They were not given information on safe sex, they were not told how unprotected sex puts them at a higher risk of contracting HIV, they were not given condoms, and they did not have to abstain from sex. ”
It was bad, but it wasn’t quite as bad as that. They knew it was a study of circumcision (they had to be willing to be circumcised before they could take part) and they would be circumcised sooner or later. They were just randomised into “sooner” (the experimental group) or “later” (the control group). By and large they were given the same information, but the men in the “sooner” group (and in the “later” group, but later) were told to abstain from sex for six weeks after the operation, and to use condoms if they couldn’t abstain. But at the end of six weeks, you can be sure they weren’t told “you can stop using the condoms now” so they had that much more reinforcement to use condoms. It wouldn’t take much to make the small differences they found.
Another important factor is that several times as many men dropped out of the trials, their HIV status unknown, as were known to be infected. Circumcised and intact men could have dropped out for quite different reasons – circumcised men because they’d found out outside the trials that they were HIV+ (they were encouraged to get tested outside the trials, because their results were not disclosed within the trials), the intact men because they’d simply changed their minds (perhaps after talking to the circumcised men). This could easily undo the results.
@slackerinc: “Isn’t it that circumcision is said to reduce transmission of HIV from a woman to a man, but not from a man to a woman?”
Wawer et al. (Lancet 374:9685, 229-37) started to show that it could greatly INcrease transmission from a man to a woman, but they cut their study short before that could be established (for “futility”, not for any ethical reason).