The circumcision debate never seems to end. Once promoted as a cure for all manner of unrelated and often harmless conditions, it has repeatedly been proved unnecessary and damaging. Each time society appears prepared to abandon the practice, proponents seek out another excuse to continue it.
Now people have the ability to seek information about it online, compare notes, and form their own conclusions, and as a result there is widespread, open debate on the topic. As with many topics, that debate is riddled with myths and fallacious assertions. The goal of this article is to address some of those that are more commonly presented, using a combination of references and logic.
The CDC and American Academy of Pediatrics recommend circumcision. I think they know more than you do about it.
This is a fallacious appeal to authority, relying on the assumption that mistakes have never been considered best practices in medicine. The medical profession has a history of two things that contradict this appeal; learning new methods of medical treatment by discovering that old ones are mistakes, and the need for oversight because individual doctors, facility administrations, and medical associations can be just as easily corrupt or biased as any other people. Evidence against pro-circumcision arguments is not negated by medical recommendation, even if it’s widespread.
It’s a very profitable procedure. The physician doesn’t use up expensive supplies, takes very little time to perform it, and charges a few hundred dollars. The skin itself is very valuable to the medical and cosmetic industries. Sale of Neonatal Dermal Fibroblasts is quite lucrative.
Doctors and hospital administrators who can sell the skin would have incentive to recommend the procedure, there’s also an entire set of industries with an interest in keeping it common in order to maintain their supply. Those industries would have incentive to pour funds into initiatives to convince the medical community and the general public that the procedure is of great benefit. This not only means that medical organizations recommending the procedure shouldn’t be automatically believed, their supporting information should be carefully examined for bias and methodology which supports that bias.
Neonatal Circumcision protects the child from penile cancer.
This is a fallacious appeal to probability; treating possibility, however remote, as inevitable for the sake of the argument. In this case, it’s used to promote unnecessarily dramatic measures in response to small possibility.
Penile cancer is very rare. In the U.K. where circumcision is not routine but other modern medical practice is, it accounts for 3 out of every 1000 cancers diagnosed in men. It’s caused most often by human papilla virus, otherwise known as genital warts, for which a vaccination is available. Other risk factors include smoking, advanced age, poor hygiene, and weakened immune system.
Support for circumcision to reduce the risk of penile cancer offers an example of the biased research discussed under the previous argument.
That example is shown by this systematic comparison of circumcision studies. Researchers found indication it is not intact foreskin, but a history of phimosis which is a major risk factor for developing penile cancer. They also found that circumcision in adulthood may increase the risk. In contrast to these findings, the researchers went on to claim that expansion of circumcision services in sub-Saharan Africa, where the procedure is being performed on adult males whose history is unknown, would be indicated as a protective measure against penile cancer.
Phimosis may generally be prevented with good hygiene, meaning that it isn’t having a foreskin that is a risk factor for penile cancer, but not taking good care of it.
In other words, boys and men would be better served if HPV vaccination, safe sex practices, and education in proper hygiene practices were part of their routine medical care. Circumcision as a preventative measure is overkill. It’s also not consistent with the medical response to other cancer risks, such as breast cancer, which is far more common.
Neonatal Circumcision protects against contracting HIV.
This one involves a combination of fallacies; the argument relies on a lie, but is also a fallacious appeal to authority (researchers). Use of the argument also involves suppressing evidence; intentionally omitting relevant information that contradicts one’s assertion.
The studies credited with finding that circumcision protects against HIV suffered from serious methodological concerns, as well as ethical and legal. In one study, researchers sabotaged their own data by making participants sign a contract stating they wouldn’t have sex without a condom during 6 weeks following the procedure. Condom use among the participants doubtlessly affected the transmission rate.
In contrast, there are multiple studies which either did not show that circumcision protects against HIV infection, or indicated an increased risk. Further, the procedure does not protect against other sexually transmitted diseases and according to at least one Nigerian study, may cause overconfidence in its protection that will lead to increased risk-taking and incidence of infection with viruses like Hepatitis-C.
However, even if it were proved to reduce the chances of infection, this does not justify routine neonatal circumcision. There are other, more effective ways for men to protect themselves that do not involve damaging their bodies. Condom use is not only more effective, it’s still necessary even following circumcision.
The HIV argument is as applicable to female circumcision as it is to male circumcision, yet female circumcision is considered sexual abuse. That the victim is an infant boy rather than a little girl should make no difference in how we view the practice, and whether belief in a slight medical benefit that is unproved and achievable by other means justifies it.
The foreskin traps dirt and body oils, making the penis dirty. Neonatal circumcision will make hygiene better and easier for the boy.
Regular, standard bathing practices are sufficient to keep an uncircumcised penis clean. It is not necessary to remove what can simply be washed. Would you argue in favor of removing a girl’s labia to make it easier to keep her genital areal clean?
My X year old family member or friend had to be circumcised as an adult because he developed phimosis. That wouldn’t have happened to him if he’d been circumcised as an infant.
The potential for loss of healthy function due to injury or infection under uncommon circumstances is not an excuse for the removal of healthy flesh, especially in response to otherwise preventable conditions like phimosis (a commonly cited excuse,) which can be treated without resorting to circumcision.
Circumcision is painless and/or harmless. The foreskin is a vestigial piece of flesh and losing it will have no impact on the child. There is no reason not to do it.
This assertion misplaces the burden of proof. When arguing in favor of acting upon infants in a way that is objected to on the basis that it is abusive, it is your responsibility to provide justification for the action, not your debate opponent’s responsibility to justify arguments against it. However, justification for the anti arguments does exist. Neonatal circumcision is not harmless or painless. It is an act of damaging a healthy organ, and it is a painful procedure.
The foreskin is to the penis what the eyelid is to the eyeball, or the labia is to the vagina. It is also the most sensitive parts of the penis. There are specialized nerves in it that are not present in the rest of the skin of the penis.
Removing the prepuce subjects the patient to a host of problems, including loss of sensation, dryness, increased skin fragility/tightness, pain, scarring which can also be painful and create additional vulnerability to future damage, and sexual dysfunction. In addition to the physical problems, one study linked circumcision to alexithymia, difficulty in experiencing, expressing, and describing emotional responses.
It’s also a much riskier procedure than is commonly believed. Many patients end up with physical complications in addition to the intended loss of skin, including skin bridges that can make erection and sex painful, tight skin that splits or tears easily, scarring, and cutting of the glans or shaft. Worse complications, including the risk of dangerous infections, can lead to loss of the entire penis and even death.
Infant genital cutting is not a therapeutic medical treatment, but an unnecessary and cruel abuse. The procedure removes healthy flesh, the function of which is beneficial and important. The child is left with a painful injury that even when healed will never be made whole. His body has been permanently damaged, leading to physical dysfunction, possible psychological dysfunction, and endangerment due to the possibility of damaging and potentially deadly errors during the procedure. The only real benefit of making this practice routine is to the wallets of those involved in performing the cut and marketing the purloined baby flesh. There is far more evidence in favor of ending the practice than there are arguments in favor of continuing it.
In the next post I will examine social arguments for circumcision.
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