Circumcision
Male circumcision is a procedure in which the foreskin of the penis is removed, usually for religious or health reasons.
Some groups claim that circumcision is a form of genital mutilation and should be ended.[1][2][3] These groups often cite a perceived decrease in sexual pleasure and the lack of consent on the part of the often infant child as evidence of child abuse. However, no major medical organization agrees. None of the American Medical Association, American Association of Pediatrics[4], WHO[5], or the British Medical Association[6] condemn circumcision, citing variously potential minor health benefits and the right of parents to make choices for their children. Others[7] actively defend the practice, as they claim the alleged detriments of the procedure are entirely based on dubious anecdotal evidence and woo.[8] More importantly, in sub-Saharan Africa, where HIV/AIDS is a serious public health issue, circumcision has been found to be an effective way of lessening the risk of the transmission of the virus.[9][10]
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[edit] Groups that circumcise
An estimated 30% of the global male population is circumcised,[11] with the most circumcised areas being the Middle East, Africa, Southeast Asia, Australia, Canada and the United States of America.
In the U.S., the majority of males are circumcised.[12] The percentage circumcised has changed little in the last decade,[13] though this has more to do with tradition than religious requirement. It is virtually non-existent in most other Western nations, except among Jews and Muslims.
Judaism requires universal male circumcision, as commanded in Genesis 17:10-14, in order to be a member of the religion.[14] Islam, through ordering followers to uphold the religion of Ibraheem and respect of the hadiths, similarly strongly supports circumcision.[15][16]
[edit] Medical issues
[edit] Various issues with the foreskin
By removing the foreskin, circumcision does remove any risk of cancer in the foreskin.
Furthermore, removal of the foreskin ensures that problems such as phimosis[wp] and Paraphimosis[wp] cannot occur.
[edit] HIV prevention
Circumcision is sometimes promoted as a way of reducing HIV transmission, especially in endemic regions. This is because the cells of the underside of the foreskin especially susceptible to the virus.[17][18] By removing this portion of the foreskin, circumcision may reduce HIV transmission rates by up to 70%.[19] In another study, HIV incidence decreased by 51% in all sociodemographic, behavioural, and sexually transmitted disease symptom subgroups.[20]
The World Health Organization is quite clear on the role of circumcision in reducing HIV transmission in epidemic regions:
“”There is compelling evidence that male circumcision reduces the risk of heterosexually acquired HIV infection in men by approximately 60%. Three randomized controlled trials have shown that male circumcision provided by well trained health professionals in properly equipped settings is safe. WHO/UNAIDS recommendations emphasize that male circumcision should be considered an efficacious intervention for HIV prevention in countries and regions with heterosexual epidemics, high HIV and low male circumcision prevalence.
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However, for those living in areas where HIV infection is not endemic this is less of an issue. Indeed, the BMA has this to say
“”There is a spectrum of views within the BMA’s membership about whether non-therapeutic male circumcision is a beneficial, neutral, or harmful procedure or whether it is superfluous, and whether it should ever be done on a child who is not capable of deciding for himself. The medical harms or benefits have not been unequivocally proved except to the extent that there are clear risks of harm if the procedure is done inexpertly. The Association has no policy on these issues. Indeed, it would be difficult to formulate a policy in the absence of unambiguously clear and consistent medical data on the implications of the intervention. As a general rule, however, the BMA believes that parents should be entitled to make choices about how best to promote their children’s interests, and it is for society to decide what limits should be imposed on parental choices.
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So, in short, outside of high risk areas, the jury is still out on medical circumcision.
[edit] Sexual pleasure
In a meta-study spanning 40,473 males, the best studies found that "circumcision had no overall adverse effect on penile sensitivity, sexual arousal, sexual sensation, erectile function, premature ejaculation, ejaculatory latency, orgasm difficulties, sexual satisfaction, pleasure, or pain during penetration."[23]
[edit] Lack of safety
Unfortunately, non-medical circumcision performed by rabbis, imams and shamans is unambiguously risky. In New York City, at least 11 baby boys were infected with herpes over an 11-year period in the early 21st century due to an Ultra-Orthodox Jewish circumcision ritual in which a mohel sucks blood out of the incision.[24][25] (Yes, you read that right—Ultra-Orthodox Jews suck blood from baby penises.) And as with any medical procedure, while extremely rare things can go wrong with medical circumcision; the tragic story of David Reimer began with a botched circumcision due to phimosis, which left his penis so badly mutilated that it necessitated removal.[26]
[edit] Biblical references
In Judaism, the call for circumcision is first found in Genesis 17; specifically, Genesis 17:10-14, as a covenant (or contract) between God and Abraham, and unto his descendants (e.g., all male children of Israel).[27] Where his son Ishmael was circumcised at the age of 13, Isaac was seen as more holy for being circumcised on the 8th day of life. Isaac was not as holy as Shem though; Shem was born without a foreskin, a rare medical condition called aposthia.
Interestingly, Christians who get circumcised are actually going against the Bible, as Paul of Tarsus specifically speaks against it (as synecdoche for the Law of Moses) in Galatians. Galatians 5:6 suggests that Jesus did not care about whether you were cut or not, but Paul's words paint him as suffering from a little butthurt dickhurt.
It is worth considering that originally, only the very tip of the foreskin was cut away. It wasn't until the Hellenization period that periah, the removal of the entire foreskin, caught on. This was because a fair number of Hebrew traditionalists were upset with how younger men were restoring their foreskin under advice and/or pressure from the Greeks, who viewed even the slight circumcision as a vile travesty against the sacrosanct physical body. Despite the end of Hellenization, reversion to pre-periah has been... slow.
[edit] Female genital mutilation
The procedure sometimes called "female circumcision" (FGM) involves excision of parts of the female genitalia, usually including but not necessarily limited to the clitoris and the inner labia. The vast majority of such procedures are carried out without the consent of the individual involved. Most studies conclude that FGM is significantly more dangerous than circumcision. This alone should not be used as an excuse for performing male circumcision, naturally; it must be judged on its own merits.
Interestingly, circumcision is not banned in most countries where FGM is. Circumcision's a touchy point with men's rights activists[28], because they believe that outrage over FGM and acceptance of circumcision is proof of anti-male bias. Needless to say, this is a false equivalence, as circumcision generally does not cause the serious damage commonly seen with FGM. More congruous procedures would be a penile subincision[wp] or a dorsal slit[wp], but although not entirely dead traditions involving these have mercifully disappeared in many of the cultures previously featuring it.
[edit] See also
[edit] Footnotes
- ↑ http://nocirc.org/
- ↑ http://www.circumstitions.com/
- ↑ Federal circumcision guidelines meet with opposition, San Fran Chronicle
- ↑ http://jama.jamanetwork.com/article.aspx?articleid=1730514
- ↑ http://www.who.int/hiv/topics/malecircumcision/en/
- ↑ http://jme.bmj.com/content/30/3/259.full
- ↑ http://www.circinfo.net
- ↑ PUBMed: Circumcision in adults: effect on sexual function.
- ↑ [1]
- ↑ [2]
- ↑ http://whqlibdoc.who.int/publications/2007/9789241596169_eng.pdf
- ↑ O’Donnell, Hugh. "The United States' Circumcision Century". Circumcision Statistics of the 20th Century. BoysToo.com. April 2001. Web. 09 October 2014.
- ↑ http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6034a4.htm?s_cid=mm6034a4_w
- ↑ "Circumcision in Judaism". ReligionFacts.com. 01 July 2013. Web. 09 October 2014.
- ↑ See the Wikipedia article on Khitan (circumcision).
- ↑ "Male circumcision - the Islamic View". ConvertingToIslam.com. Studio-S. n.d. Web. 09 October 2014.
- ↑ http://www.nytimes.com/2006/04/28/world/africa/28africa.html
- ↑ http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(04)15840-6/abstract
- ↑ http://www.sfgate.com/health/article/Circumcision-may-offer-Africa-AIDS-hope-2657030.php
- ↑ http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(07)60313-4/abstract
- ↑ http://www.who.int/hiv/topics/malecircumcision/en/
- ↑ http://jme.bmj.com/content/30/3/259.full#xref-ref-3-1
- ↑ http://www.ncbi.nlm.nih.gov/pubmed/23937309
- ↑ http://healthland.time.com/2012/06/07/how-11-new-york-city-babies-contracted-herpes-through-circumcision/
- ↑ http://www.nytimes.com/2015/01/15/nyregion/mayor-de-blasio-and-rabbis-near-accord-on-new-circumcision-rule.html?_r=0
- ↑ http://documentarystorm.com/dr-money-and-the-boy-with-no-penis/
- ↑ Somehow, Abraham found this agreeable — apparently the act was a "gateway" into being able to be convinced of the less-reasonable killing of his son, Isaac, later in the same book.
- ↑ http://www.womenagainstmen.com/medical/male-genital-mutilation-circumcision.html