The case for eliminating circumcision, male or female, is complex.

However, here are the facts as I know them.

1. Male and female circumcision actually limit or eliminate certain natural functions of the tissue damaged.

2. Male circumcision is arguably healthful in people already performing high risk behaviors which should be considered effectively pathological in society - particularly having sex with multiple partners in an environment rife with HIV. Because the context is that of a behavior over which there is so much obvious choice and control, male circumcision should not be considered prophylactic.

3. These are religious procedures designed primarily to stamp people permanently with a group identity. They are designed to separate and set apart the people on whom they are performed.

4. These procedures are typically performed by elders on children, though that can be performed as an adult in the act of initiation into the group.

So... what is to be done? Certainly, there are people who argue that the behaviors are heinous but that banning them just forges the group identity more strongly and that left to their own devices the groups will abandon the practices more quickly, without the threat of returning to them. This is a sort of pragmatic 'leave them alone and they'll grow out of it' stance. I don't think it is correct, particularly for close knit groups, since in those groups circumcision is an important way of asserting ownership and control over the child in a fundamentally invasive way.

Still, we can't claim to respect these groups of people, their beliefs or practices, their collective identity, and also impose an individualist ethos, or even a secularist ethos, on them.

So we are torn between the claims of secularism and the claims of ... secularism. Should the practice remain but only for adults who do it willingly and freely? But can it be willing and free if it is compelled as a part of being accepted into society? In other words, is the only way to destroy the compulsion and coercive behavior to ban the practice?

But then, this is the most invasive way of dealing with religious practice - and we are claiming the right and need to do it _outside US borders._ Neocolonialism in the name of secularism. Forgive me, but at least I understood Christian missionary colonialism. Secularist colonialism has everything that secularists criticize missionaries for, bound up in a blanket of hypocrisy.

So, what to do?

I'm generally inclined to defend male circumcision, but that's a really good case against it.

Thank you.

It's been so hard to have a frank discussion about this on other forums, because everyone is essentially defending their own penis, or a penis they know.

I don't think there is anything in favour of female genital mutilation, often euphemistically referred to as 'circumcision', that would make it permissible in a society. Male circumcision is hardly the same, but is still unnecessary, except in cases of phimosis or similar conditions. The recent evidence presented about HIV transmission is interesting, and will probably contribute to circumcision spreading in and of itself. However I don't think it should be enforced in regions with high AIDS prevelances - surgeries in many of these regions would more likely result in infections, and condoms are a much more effective and safe alternative (although getting people to use them is always a cultural challenge). Foreskins served us throughout human evolution and I'm hesitant to actively rid children of them.

I'm going to re-post a comment from a couple of weeks ago regarding male circumcision, because for some reason that earlier posting behaved oddly (the number of listed viewings declined with time).

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As a biologist, I find the debate about whether male circumcision is damaging to be frankly bizarre. Like every other part of the body, the genitalia have been shaped by strong selective pressures. Circumcision removes a substantial chunk of highly innervated genital tissue, so of course there are effects on sexual function and sensation. This fact has been appreciated for centuries. The reduction in sexual pleasure was actually considered a benefit in Victorian times because it was thought to divert young men’s attention to more productive pursuits.

The common justification for male circumcision is that it helps to protect against urinary tract infections and HIV. There may be some such protection, because removing a body part will inevitably cause changes, some of them beneficial. But what is the cost? Apart from the damage that is done to every circumcised male, some circumcisions are “botched”, causing permanent disfigurement. The percentage is small, perhaps 1 in 1000... but more than a million circumcisions are performed each year in the U.S., so there are probably hundreds or thousands of such cases annually. A vaccine that caused permanent side effects at that rate would not stand a chance of approval. Therefore, the argument that circumcision is like a vaccine does not pass muster.

Saletan does seem to have a pro-circumcision bias. But he wrote a nice piece recently about “liberals” and “progressives”, where he claims that he keeps an open mind and is always willing to modify his opinions... so maybe he will reconsider his support for this little barbarism.

I am circumsized, but I would probably not wish for my son to be, if I had one. However, this loss of sensation business is a load of crap. Firstly, circumcision is not largely practiced in the UK so your "Victorian Era" bit is probably poorly researched or made up. Secondly, I experience plenty of sexually pleasurable sensation in my johnson--in fact, if I were more sensitive, it may impact my performance in a negative way (I like to be able to last as long as my partner needs me to--being too quick is not that attractive). In fact, circumcision is a plus for that reason alone. However, I find it odd and wouldn't put my kid through it.

Circumcision removes a structure called the ridged band, which is one of the most highly innervated parts of the penis. A loss of sensation is inevitable.

Circumcision is rare in the UK these days, but it used to be much more common. A good summary is found in a Wikipedia article: <link> There is also an excellent book on the topic called "A Surgical Temptation: The Demonization of the Foreskin and the Rise of Circumcision in Britain", by Robert Darby. The bottom line is that male circumcision declined in the UK because it was deemed to be medically unnecessary and sometimes caused severe side effects.

Many circumcised men are defensive about the practice because it is difficult to accept that they might have been damaged. I'm happy to see that you would not condone such an operation on your own son.

songster:

Many circumcised men are defensive about the practice because it is difficult to accept that they might have been damaged. I'm happy to see that you would not condone such an operation on your own son.

I would venture to guess that many circumcised men are defensive in part because of the terms used by the anti-circumcision crusaders to frame their arguments. It is the same reaction you would have if I were to describe uncircumcised men as "at risk." While both terms are technically true, neither is really accurate. A circumcised man does not know empirically that he is missing out on any sensation (unless he was circumcised as an adult), and therefore any "damage" is really only psychological in the sense that some men fixate on their lost foreskin and dwell on what they are missing, while others do not. Most circumcised men of my acquaintance are pretty fond of sex, even missing those nerve endings (and never have a thought that their experience of sex might be somehow incomplete). And as I am sure you can rant at length, "at risk" is a misleading term used to engender fear about risks that in reality are fairly small.

I really don't have a dog in this fight, but it annoys me to watch the proselytizers on both sides.

A few responses:

I think we need to be careful about equating male and female circumcision. Female circucision, which itself is praciced in different varieties, is frequently dangerous and of itself impairs sexual function. Male circumcision is not life threatening surgery and claims of sexual impairment are dubious.

I know, what about the 'lessened sensitivity'? There has been no defintive studies showing decreased sensitivity. And as penile sensitivity exists to stimulate arousal and achieve orgasm, short of showing a deficiency in these two areas I'm not sure what it means to say a circumcised penis is less sensitive. Can we realy quantify how good it feels?

In terms of the health benefits: There is a lower incidence of penile cancer in circumcised men, although it is already rare and most of the benefits can be approximated with regular cleaning; this can also prevent the presence of smegma.

Lower incidence of HIV transmission is very important. Sure, the behavior of men in countries with very high rates of HIV can be mind bogglingly stupid and condom use would be a great and effective way to mitigate against the spread of HIV in Africa. It would also be better if we prevented people from using heroin, but that doesn't mean we shouldn't have clean needle programs for those who do.

There are many reasons a male might be circumcised including but not limited to health, religion, culture. As a society that is not only secular, but pluralistic we must allow various cultural groups to make their own decisions, without recrimination.

Why is female circumcision an exception then? I think the answer is that because it is so dangerous, and because the act itself impairs function, it crosses an admittedly blurry threshold where society must step in to protect the individual from the cultural group and themselves.

Also the status of women in these societies is important to consider. If an adult German woman said she was going to have a circumcision, I think our reaction would be very different. We might not understand what she was doing, but we would allow it. In the case of a North African woman doing the same thing, we are understandably suspicious. She is a second class citizen and not free, legally or culturally, therefore her decisions are suspect. If she were a free and equal member of her society, it would be much harder for us to condemn the practice.

Why is male circumcision on a child not the same thing then? The difference is the lack of danger and demonstrable impairment.

This is a difficult question, that involves many overlapping concerns. I doubt we will ever have an easy answer.

This is a difficult question, that involves many overlapping concerns. I doubt we will ever have an easy answer.

Sorry, but it IS an easy question, with a very easy answer: EVERYONE has a right to integrity of their bodies. EVERYONE has a right to decide these fundamental questions for themselves.

I cannot believe how blinded people in the US are, acting as though there's a legitimate debate on the subject. Why are circ rates almost nil in nearly every other industrialized nation? Why? Because it is entirely a cultural sickness relegated to the US (and yes, Muslim nations).

All the health rationales are completely ridiculous. There are no epidemics of UTIs, penile cancer, or cervical cancer in nations that don't circumcize. As for HIV, even if true, that is NO reason to permanently alter someone's body. WEAR A CONDOM.

I'm tired of Americans perpetuating the belief that somehow there's a debate here. Circumcision is wrong. Flat out wrong.

So then would an adult be allowed to have a circumcision, if they so chose? If they have a right to control over their body then neither society nor government should not interfere.

I think it's true that male circumcision is, in large part, a question of cultural practice.

If we're talking about Western culture, though, what bothers me about the practice is the lack of really solid justifications for it. Nobody has proved that it's necessary. Granted, we do a lot of medically unnecessary things to ourselves, but I've just never heard a good case made for doing it routinely in developed Western countries, absent any cultural considerations. Even when the case is made for it, it's full of caveats.

That tells me that there's no really good reason for it as a routine procedure.

Sure, an adult over 18 can choose.

No one should have one done who cannot consent to it. Period. End of story.

We don't allow female circ in this country. And what right does anyone have to tell a man his own cutting is less extreme than female circ.

Think for a minute. Why does the ONLY surgery we routinely perform on infants involve... the cutting of male genitalia? On its face that should tell you something is very, very suspect about the practice. We don't amputate any other permanent part of the body at birth.

"Society and the government" have a right to prohibit practices that are criminal. And this practice is utterly criminal.

Why do defenders of circumcision so often characterize opposing arguments with the terms "rant" and "polemic"? There is no reason to paint anti-circumcision advocates as irrational fundamentalists. In fact, the core arguments against routine circumcision are quite rational: it is medically unnecessary, and it is a permanent body alteration performed on an unconsenting infant.

Male circumcision can also be dangerous. I know a couple of men who were severely damaged by the procedure. An acquaintance mentioned that she had done a pediatric urology rotation, and spent the entire time trying to repair little penises that had been damaged by "botched" circumcisions. That's not exactly a statistical analysis, but it indicates that the procedure can be dangerous... like every other surgery. To my mind, it is hard to justify subjecting infants to that risk.

Why do defenders of circumcision so often characterize opposing arguments with the terms "rant" and "polemic"? There is no reason to paint anti-circumcision advocates as irrational fundamentalists.

It is part of the inherent insanity of the practice. Those who advocate leaving infant boys alone, and not cutting their bodies without any relief from pain are somehow the fanatical ones.

Those who DO believe in a barbaric, ritualistic, superstitious practice are somehow considered mainstream.

In addition to the specifics of the issue, I find it fascinating how a deeply sick practice can be so embedded as to overturn all logic and reason and even have its own momentum that defies logical debate. Meaning, that those criticisms of the practice are labeled extreme.