Thursday, August 9, 2018

To Cut or not to Cut: the Circumcision Debate

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Thank God I am not a man, especially a Jewish man. And thank God I wasn’t born in the United States as a man, or I would have joined the millions who have undergone a medical procedure that irreversibly alters the body for the rest of one’s life, without personal consent. It’s called circumcision.

A few days ago a friend told me about a researcher at Harvard University who was fired as a result of a show he performed called Sex & Circumcision: An American Love Story. It is a gripping, 2 hour long explosion of anger by a young American male who went under the knife as an infant. Eric Clopper is Jewish, but that doesn’t mean much in a country where as recently as 2010, 77% of baby boys were routinely circumcised as part of the delivery process.

Since then I haven’t done much else with my time than learn about circumcision and what it really is. What is it’s history? Why is it so prevalent in America and not in Europe?

I have to admit that I now know more about male genitalia than I do about my own equipment, so at the risk of sounding presumptuous, I will share with you what I have learnt.

The word ‘circumcision’ comes from the Latin circumcisus, past participle of circumcidere "to cut round, to cut off". What exactly gets cut off, you may ask, when circumcising an infant in America in 2018?

In order to answer this question you need to be familiar with the anatomy of the foreskin. The function of the foreskin is to a) protect the glans, b) make the back and forth motion during intercourse smooth and gliding and c) make sex pleasurable. It contains more nerve endings than any other parts of the male genitalia, making it an extremely erogenous zone.

Pict. 1

In picture 1, the foreskin retracts over the ‘glans’ when a man has an erection. The part that is normally removed during a circumcision is where you see the dotted line.

The foreskin consists of a double layer of skin, with the under-layer attached to the base of the glans. It’s a bit like a sock that you pull off of your foot.

It’s a pretty ingenious mechanism. It allows the shaft to move back and forth like a piston, but it also provides a lubricating barrier between the vaginal wall and the penis so that friction between the two surfaces is minimized.

So what is the reason to remove such a valuable part of the male anatomy?

One of the reasons is history. It probably began as a religious sacrifice and/or a rite of passage. In Judaism it was a means of differentiating a circumcising group from their non-circumcising neighbors. There are many other historical reasons which you can find here: History of Circumcision

Why in America and not Europe?

How did a religious practice of a minority spread so far and wide in American society? There is a very complex answer to this which has to do with a very American obsession with cleanliness, the false belief amongst medical professionals of the 19th century that many ailments (including hernia and insomnia) could be cured by circumcision and, above all that it was a cure for masturbation. Masturbation was not only considered sinful but it was thought to cause severe disability, insanity and even death.

After the Second World War, the practice declined in many European countries who now view it as barbaric and consider it a violation of human rights. Sweden, Denmark and Germany have severe restrictions on the practice and Iceland is considering banning it outright.

What are the benefits of circumcision?

There is evidence that circumcision can reduce the risk of UTI (urinary tract infection), penile cancer, HIV and sexually transmitted diseases (STDs) and both the American Pediatric Association and the CDC recommend its practice. Here is a comparison chart:

country
% of circumsised males
rate of penile cancer
HIV
Sweden
5%
2%
.20%
USA
77%
1%
.30%.

The table shows that even if there is a correlation between circumcision and slightly reduced risks of penile cancer (not HIV), is that worth sacrificing such an important part of your anatomy? There are 266,000 cases of breast cancer a year in the US. Does that mean we should remove the mammalian glands of every baby girl as a prophilactic measure?

You might argue that circumcision is nobody’s business except the person involved, just like abortion, which should be left up to the individual. Except that the individual involved in the case of a circumcision is just 8 days old and his parents are on the hook for making a decision that might or might not totally backfire.

The Human Body

Both male and female genitals develop from the same embryonic tissue, and the male genitals are anatomically homologous with the female: the clitoris corresponds to the glans penis, the clitoral hood to the foreskin, the labia to the scrotum, and the ovaries to the testicles.

There are 4 types of circumcisions ranging from mild to severe. Type 1 is a relatively mild form of penile mutilation, such as slitting of the foreskin without excision of tissue. Type 2 is called Meliah and consists of cutting away the skin of the penis that extends beyond the glans. Type 3 is called Periah in which the foreskin is cut higher up to expose the glans. Type 4 is called subincision and consists in a slitting open of the urinary tube from the scrotum to the glans. It is still performed by the Australian aborigines. See: A Rose By Any Other Name? Symmetry and Assymmetry in Male and Female Genital Cutting

The type of circumcision that is routinely performed in America is type 3, where the foreskin is cut high so as to expose the entire glans. This is the equivalent of removing the clitoral hood in a baby girl. The clitoral hood plays an important function in copulation: it protects the ‘over’ sensitive clitoris from coming too directly in contact with the shaft of the penis, which would cause more pain than pleasure. So why are we calling the latter ‘genital mutilation’ and the former ‘circumcision?’

Here is another dilemma for you. Originally, circumcision was supposed to make sure that sexual pleasure would be decreased. Then, when the American Medical establishment made it part of their practice, it was maintained that it did NOT reduce sexual pleasure, hence it was recommended for its supposed health benefits.

So circumcision is like a sail in the wind whose direction is determined by its underlying purpose, which is a desire for control: a religion’s control over its disciples or a doctor controlling what procedure he should get paid for and the parents’ need to control their children’s destiny.

It is clear that the world is moving away from this type of assault on a person’s bodily integrity. Knowing what we now know about male sexuality, it is only logical that we begin to question the practice of circumcision and no longer see it as a minor, inoffensive, trivial intervention.
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