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Flip Flop on Foreskin Snip: Pediatric Group Now Recommends Circumcision

Posted Aug 29 2012 4:15pm
As for the American Academy of Pediatric's shift on male circumcision , their flip flop on the  foreskin snip, I just can't go there today. Only an expert task force could make a policy statement  about sex parts sound dry. It's of such critical societal importance, at least in San Fransisco and possibly Park Slope, it's free. I will gladly forgo any further tasteless comments and instead, in short, re-run my post on the controversial procedure from last summer. Anyone else kinda miss Andrew Weiner?

Foreskin Conclusions: The Pros, Cons and Inflated Claims of Male Circumcision


Now that Weinergate has died down, let's turn to another pressing drama involving male anatomy recently arousing considerable ado.

Circumcision.

Come November San Francisco voters will decide whether the age-old practice of snipping foreskins should be banned. For a good review of the two sides of the parental bugaboo, see the recent LA Times article (Pro / Con: The debate over circumcising baby boys). FYI, the title is misleading.

It's more like Not Recommending Ban versus Con.

Most doctors aren't exactly pushing parents to snip-snip. Health authorities have been walking a fine line. While most fall back on the "not medically necessary" they do cite some small health benefits, especially for the transmission of sexual diseases. Ones that worry the World Health Organization that isn't exactly pleased by the declining circumcision rates as the practice is tied to lower rates of HIV infection.

Personally I can't decide which side has done more disservice by exaggerating the data. My vote probably goes to the "intactivists" - those behind the ban (why do the extremists always get the best names?). It's not like they're just sitting in their offices forming panels to issue policy recommendations. They're out gathering signatures.

Take Matthew Hest, the San Diego-based intactivist behind the new ballot measure. He not only wrote the measure but writes an online comic book, “Foreskin Man” that I kid you not, features the evil “Monster Mohel" (see a recent article in the New York Times).

Speaking of comics, there is plenty of comedic relief from both sides here. Take grass-roots intactivist Jena Troutman who has wandered the beach preaching her anti-snipping sermon
“I am just a mom trying to save the little babies,” Ms. Troutman said. “I’d rather be on the beach, but nobody is talking about this, so I have to.” (The New York Times, Efforts to Ban Circumcision Gain Traction in California).

As if Ms. Troutman, a former lactation educator and doula - big surprise - could just slather her young boys with sunscreen and forget about all the other little penises in the surf.

You wanna do the snip-snip to your son, go for it. You think it's genital mutilation, obviously you won't.

Either way I hope you do so with a fully informed conscience. Easier said than done given the river of drivel on this one. Some of it spouted by health authorities - like the health benefits.

Are there benefits to circumcising male infants?

Absolutely. If your son may at some point have unprotected sex in Sub-Saharan Africa or is otherwise at risk for HIV infection (by a woman, not another male).

Or if there's a chance he'll wind up without access to running water.

You know, should he turn into a nomad wandering a drought-plagued wilderness, an Into the Wild wannabe minus the flowing streams and excellent sound track. Forget the starvation, the psychological effects of isolation, the random grizzly attack. No, this is a mother's worst nightmare: How will my child keep his penis clean? Maybe that's what drove the poor young man to despair up in Alaska. He just didn't feel fresh.

But freshness and for that matter hygiene may not be as important to the penis owner as the penis cleaner according to the LA Times article
...And in a study of nurses in a U.S. geriatric unit, about 90% were strongly in favor of circumcision because it was difficult to bathe uncircumcised men in their 90s. When we look at a baby and we think about circumcision, we have to think not just about that baby but that he's going to turn into a man and, eventually, an old man. (Daniel Halperin, lecturer in international health at the Harvard School of Public Health).

Not only do circumcised men curry favor with geriatric nurses but possibly also sexual partners. Our health expert above, Daniel Halperin, reported circumcised men "enjoy a wider range of sexual activities." Though I cannot even begin to fathom an explanation for those results a few rather graphic images come to mind. Presumably evidence the circumcised male still enjoys an active and diverse sex life.

Seriously, circumcised men as sexual adventurers? Ninety year-old penises? Really?

Ladies and gentlemen, the debate now has left the realm of serious scientific inquiry.

On both sides.

Witness the allegations from the anti-snip side
Some men even say that they have post-traumatic stress disorder that they associate with their circumcision as infants. I think we would have no trouble believing that from a woman, but we write off men's trauma and recollection as being whining and unmanly. (Georganne Chapin, founding executive director of Intact America in the LA Times article)

Actually Georganne, I do have great difficulty believing any adult, male or female, could experience post-traumatic stress related to memories from a minor procedure during the first weeks of life. If this were the case, who could ever get over being pushed/pulled/cut out of the womb? Circumcision is a walk in the park compared to being born. So, at the risk of being contradicted by freakish future evidence of negative psychiatric long-term side effects of memories produced in infancy - RUBBISH!

Some men may resent having been circumcised. Some may have suffered a rare physical injury (most are very mild). Some may even have been led to believe by suspect therapists they suffer from circumcision-induced PTSD and that is unfortunate.

But it is ridiculous to suggest circumcision contributes to or even sets off post-traumatic stress, a disorder associated not with merely emotionally or physically painful episodes but severe, unspeakable trauma the likes of war, hurricanes, plane crashes, rape.

Or being held down as a 10-year old by your relatives while your Nana cuts off your labia and clitoris with a sharp piece of glass putting you at risk of significant blood loss, severe infection, chronic sexual and reproductive impairments and oh yeah, death.

To equate male circumcision with the horrific practice of female genital mutilation is an assault on our rationality. End of discussion.

Let's admit it, the risks of male circumcision are quite small and limited to those associated with minor medical procedures and basically zilch in childhood and adulthood. Just as there seems little harm, the benefits are few and overblown. And by the way, it's on the wane anyhow. Just like so many other parenting issues, there is no black and white here, no right, no wrong. No one size fits all.

As for the countless perfectly legal means by which parents imperil their children's future health and well-being, removing the foreskin seems rather tepid in comparison.

Second-hand smoke.

Harsh parenting devoid of affection.

Too much sugar, fat, empty calories (e.g. editorial in JAMA arguing some obese kids should be taken into protective custody).

Not enough sugar, fat, empty calories (hello, bulimia and anorexia).

Not teaching kids how to avoid pregnancy and sexually-transmitted diseases.

More worrisome - what's next, a ban on infant formula here in the US? If only it were a joke.
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