To Cut or Not to Cut?

The decision to circumcise your new baby boy is difficult for many parents. Religious, emotional, naturalistic, societal, hygiene, parental personal motivations, and side-effect concerns are a part of a decision that will affect your child for the rest of his life.

As a single woman with no children (and no upcoming plans for any), I have very little opinion on this topic. I've always been a "to each his own" on the matter -- Circumcision is, oddly, one of the rare parenting (or lack thereof) decisions upon which I've not yet passed judgment. My non-opinion might be changed, though, by a couple recent articles in Science Daily.

The first Science Daily article discusses an intervention review published by Wiley InterScience and available from The Cochrane Library that discusses clinical trials between 2002 and 2006 in Kenya, South Africa, and Uganda that included more than 11,000 (presumably adult) men who underwent circumcision. The results of the trials indicate that circumcisions reduced male HIV infection rates by 54% over a two-year period when compared with non-circumcised men. The researchers say that the 54% figure is a best-estimate average, and that the true reduction in male HIV infection among circumcised men would be 38 - 66%. More research must be conducted to determine if male circumcision will reduce HIV infection rates among their female partners.

Because the foreskin contains cells, called Langerhans cells, that have receptors favorable to HIV, current thinking is that the mechanism by which male circumcision reduces male HIV infection rates is that the tissue containing these cells is removed during cirmcucision.

The second Science Daily arrticle gives us more health news on the benefits of circumcision, describing a paper published in the New England Journal of Medicine that built upon previous research funded by the National Institute of Allergy and Infectious Disease (part of the National Institutes of Health) that found that circumcision reduced the heterosexual transimission of HIV by more than 50%. The New England Journal of Medicine paper describes an experiments showing that circumcision reduces the male infection rates for HSV-2 (which causes genital herpes) and HPV (a group of virii that cause cervical cancer and genital warts). Their experiments with approximately 5,000 circumcised and non-circumcised men showed that circumcision reduced the male infection rate for HSV-2 by 28% and the male HPV infection rate by 35%. The experiment did not show a difference in the infection rate for syphilis between the non/circumcised.

Much like vaccinating your daughter again HPV , if there's the slightest chance that something you do for your child (i.e. circumcision) could prevent a likely terminal illness or a life-long painful/embarrassing one, how could you not do it?

~Riot.Jane

7 comments:

  1. Riot,
    I completely see your point on this issue. However, I must disagree. I'm the mom of 2 boys and firstly, let me say that they are both circed. However, if I could go back and change that I would. To me, the issue is one of it being THEIR bodies, not mine. Removing a piece of their penis is much the same as going in and removing a section of girl's vagina. It's an issue of where you stand as a parent. Do we OWN our children? Do we OWN their bodies and therefor their genitals? My answer is no. The HPV shot is one thing, my girls will most certainly have it. It's a shot, not a surgery. Allowing the removal of a sacred and very personal part of our son's bodies (the foreskin) b/c of "what if's" or especially vanity reasons, to me, is something that is just plain wrong. Something I feel a lot of guilt about.
    I refuse even to pierce my daughters' ears because I will not modify their personal bodies without their permission.

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  2. I'm tired of people trying to justify cutting parts off other people's bodies. Babies aren't going to be getting any STI's before they're old enough to decide for themselves whether or not they want part of their genitals cutting off. It's their body; it should be their decision.
    It's not like cutting off a kid's earlobe - it's the most sensitive part of a boy's penis that gets removed (it's not just there to protect the glans).

    2) These latest studies are from Africa. A 29 year study of males in New Zealand showed a slightly *higher* rate of STI's among circumcised men:
    http://www.jpeds.com/article/S0022-3476(07)00707-X/abstract
    There are also seven African countries where men are more likely to be HIV+ if they've been circumcised: Rwanda, Cameroon, Ghana, Lesotho, Malawi, Swaziland, and Tanzania. Eg in Malawi, the HIV rate is 13.2% among circumcised men, but only 9.5% among intact men. In Cameroon, the HIV rate is 4.1% among circumcised men, but only 1.1% among intact men. If circumcision really worked against AIDS, this just wouldn't happen.

    3) If we found out that cutting off part of a girl's genitals reduced her risk of contracting an STI, would that make it acceptable?
    This study shows exactly that: http://www.ias-2005.org/planner/Abstracts.aspx?AID=3138

    If female circumcision had caught on in the USA (it was promoted in medical papers till at least 1959, and practised till the early 70's), and western researchers were now looking for benefits of female circumcision as enthusiastically as they are looking for benefits of male circumcision, we'd now be getting news articles about how female circumcision help prevent STI's. It wouldn't mean that there aren't better ways to prevent STI's, and it wouldn't make it right.

    News from April: A jury in Atlanta has awarded $1.8 million to a boy whose penis was severed in a botched circumcision five years ago.

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  3. Mark,
    You have completely justified my point and backed it up with research. Fantastic!

    Even if the research that Riot used to illustrate her point is spot on, I believe teaching our boys about sex and sexually transmitted diseases would be equally as beneficial as anything gained by removing their foreskins.

    As far I'm concerned, this is an issue that should weighed the same as female clitorectomy.

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  4. My only problem with circumcising boys to "prevent" HIV is that as a nurse I've taken care of more than a few circumcised men with HIV (I know the status of their penis due to having to catheterize them). I've never taken care of an uncircumcised HIV+ patient, although I'm sure they exists. But at least in the US, circumcision does not prevent HIV or any std's.
    I've also seen a couple of botched circumcisions. One that went so horribly wrong that the child was in danger of losing about half of his remaining penis (infection and necrosis). I had no way of following up with him to see how he healed or if he needed plastic surgery.
    Because of these issues, I personally think it's best just to leave well enough alone. I'm not a fan of preventive surgery "just in case". Because it seems there is just as much of a chance to have something go horribly wrong. Why risk the complications of surgery unless there is a dire medical reason?
    You'll probably get some good arguments for circumcision but I wanted to just offer my reasons why I personally and professionally don't find it a good idea.

    Thanks!

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  5. There is no justification for removing a functional, healthy part of a non-consenting minor. End of story! You can site all the studies in the world that show a possible benefit but this does nothing to change the fact that each person has the right their whole body. Mark makes very good points. The recent AIDs/STD studies are just another in a long slew to try to find some type of justification for this horrific crime against children. Circumcision is a "cure" in search of a disease. No single surgical procedure has been said to prevent the amount of illnesses and conditions as circumcision. Just take a look at the history of the medicalization of circumcision: http://www.youtube.com/watch?v=f4unKTMpBGA
    In America we cite exactly the same "reasons" to circumcise boys as are cited in countries where girls are circumcised. Studies that show no benefit to male circ and studies that show the functions of the foreskin are hidden from the view of the public. As a 300 billion dollar (per year) business their is little interest in uncovering the faults of circumcision. Oprah spreads a face cream that contains male infant foreskins on her face ever single day, you think she would use it if it contained baby girl's foreskins?

    Amputation of a body part is not a parental choice for any other body part, why should it be for the male foreskin? Further, amputation is not preventative medicine, it is only a last resort for when a part is decaying, frostbitten, cancerous, or has serious trauma.

    Give boys the choice over the function and the appearance of their most private area. Bodily integrity is a HUMAN right.

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  6. If your going to stand on non circumcision. Then stand on it! I hate listening to women state that they will leave it up to thier sons to decide. As an adult it's an extremely painful procedure to endure, where as for an infant it's not as bad and at least becomes a forgotten experience. Take the right stance, you just don't want to do it and quit whining about leaving it to your kids to decide, it makes you look very wishy washy.

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  7. It hurts adults less to be circumcised. They can have general anesthetic for a start. It's safer too, and the results are cosmetically better. I've never heard of anyone dying as a result of adult circumcision in a western clinical setting.

    Just because babies don't remember doesn't mean it hasn't affected them btw. They have more problems breastfeeding, and also show more reaction to injections years later.

    I'm certainly glad I was given the choice. I'd rather have one of my ears cut off than be circumcised.

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