Thu, Aug

Circumspectly Circumnavigating Circumcision

ANATOMY POLITICS - Despite humanity’s eternal aspirations to achieve and excel in all things cerebral, there are very few things to which we are as emotionally and psychologically attached to as our own sexuality.  Add to that the physical and emotional attachment of our sexual organs, and issues like the circumcision measure being proposed for Santa Monica become hot button topics that raise all sorts of obvious and hidden agendas that affect us all.

The Santa Monica measure being proposed for its November 2012 ballot emulates the San Francisco measure that recently garnered enough signatures to show up on the November 2011 ballot, which would (to quote the LA Times) make it a misdemeanor to circumcise a boy in Santa Monica before he turned 18. The maximum penalty would be a year in jail and a $1,000 fine. Circumcisions would be permitted only for medical reasons, with no religious exemptions. (Link)

These ballot initiatives are led by those activists who describe male circumcision as MGM, or Male Genital Mutilation, and who equate male circumcision with female circumcision that is performed predominantly in Africa and which involves removal of either part or all of the clitoris.  

While there are no documented medical benefits for female circumcision (and therefore it is disallowed in the state of California), there are indeed documented medical benefits for male circumcision—but yet no medical group has promoted a policy of medically-based mandatory male circumcision for ALL males (and it’s doubtful that any medical group ever will).

However, there IS a cultural requirement of male circumcision for Jewish and many Islamic communities, which is why the proposed Santa Monica initiative has some alarmed that it is touches on anti-Semitism.  

Add to this a comic book entitled “Foreskin Man” (which is premised on a blond superhero taking on the “Monster Mohel”) from Matthew Hess, a prominent member behind the Santa Monica initiative, and the fears appear to have some validity. (Link)   http://articles.latimes.com/2011/jun/04/local/la-me-circumcision-20110604)

(A mohel—pronounced “moil”, which rhymes with foil or toil—is a Jewish person trained in the practice of Brit Milah, which is the ritual of circumcision that is performed for religious reasons as part of the covenant between the Jewish people and God.)

The issue of male circumcision is one that is so very complicated that no one can really spell it out in easy and straightforward terms—which is why the Santa Monica and San Francisco measures are so very troubling.  

To simply state that male circumcision, which virtually ALL physicians would acknowledge does have SOME scientifically-documented health benefits, is the same thing as female circumcision, which entirely ALL physicians would acknowledge has NO scientifically-documented health benefit (and should therefore similarly be outlawed in California or any of its cities) is promoting a falsehood by oversimplifying a complicated issue.

To simply state that male circumcision, which is NOT a medically-essential procedure, should be OUTLAWED for all male babies is as inappropriate as it is to state that circumcision should be MANDATORY for all male babies.

To simply state that male circumcision, which is defined by anti-male circumcision activists as removing two-thirds of the nerve endings and half of the penis, is not medically true and it is a fair statement that most dermatologists and urologists, who regularly address issues of the skin and deeper structures of the penile organ, would disagree.

To simply state that male circumcision, which removes the foreskin from the distal end of the penis, is the same as removing the penis itself (which is what occurs with the clitoris in female circumcision), is scientifically inaccurate.

To simply state that circumcision is unnecessary for cleanliness purposes because boys can be trained to clean themselves by regular retraction of the foreskin during bathing doesn’t remove the scientific data, anecdotal observations and common understandings that boys aren’t too clean when left to their own devices, and infections and scarring do become an issue for some (not the majority, but some) boys and men.

To simply state that circumcision isn’t mandatory doesn’t take away the alarming data of increased female-to-male transmission of HSV, HIV and other infections, squamous cell carcinoma, painful rashes and other medical problems that pose a risk to uncircumcised boys.  For example, it’s a sobering but scientifically-supported fact (including findings from the World Health Organization) that much, but hardly all, of Africa’s devastating HIV epidemic has been aggravated by lack of widespread circumcision.

To simply state that skin and nerve endings are removed with circumcision (and therefore lessen the sexual experience) doesn’t detract from the similar reality that rashes, irritation and scarring that is caused by remaining uncircumcised can equally lessen the sexual experience, and that no scientific data supports the contention that either circumcised or uncircumcised males differ in their sexual experience or satisfaction.  There is considerable anecdotal data and opinions, but no good scientific data addressing this often-discussed issue.

To simply state that circumcision isn’t medically necessary doesn’t obviate the many, many, MANY doctor visits that uncircumcised men have to dermatologists and urologists for rashes, infections and even painful erections (because of scarring) that is sometimes cured only by circumcision.

To simply state that circumcision should only be limited to those 18 years of age or older is particularly alarming, because while local anesthesia is indeed the humane thing to do for a male baby undergoing the procedure, the physical and psychological pain of circumcision for an adult is by far, far greater than for a baby.  

(Adults are best cautioned about the postoperative discomfort and psychological adjustment, but millions of families and their doctors have had their male babies circumcised without any of the pain and suffering described by the anti-circumcision activists.  These families and doctors are left scratching their heads in bewilderment as to what on earth these activists are screaming about.)

And to simply state that an uncircumcised penis is by far more attractive to both genders ignores the reality that cultures with a high preponderance of circumcision have both genders that are more used to (and therefore prefer) the appearance of the circumcised penis.

For men, it’s probably the desire to have their sons look the same way as they do, and for women it’s probably a matter of what they’re used to seeing in their intimate experiences that socially influence the decision to have circumcision performed on their children.  

Furthermore, as with the differing size of the flaccid penis among men versus the very similar size of the erect penis, the erect uncircumcised penis looks pretty much the same as the erect circumcised penis.  In other words, the “final result” during the sexual experience is pretty much the same in all groups.

So while it’s inevitable that the debate over whether circumcision is good, bad or anywhere in between will never end, it’s hoped that the citizens of San Francisco (and perhaps Santa Monica, if enough signatures can be obtained) will NOT pass a measure that oversimplifies an issue which…apparently…really carries a lot of weight in our everyday sexual, medical, social and now political lives.

(Ken Alpern is an Associate Professor at UC Irvine Department of Dermatology Residency Program and Chair of the Department of Dermatology at Talbert Medical Group.  He is also a former Boardmember of the Mar Vista Community Council (MVCC), previously co-chaired its Planning and Outreach Committees, and currently co-chairs its MVCC Transportation/Infrastructure Committee.  He is co-chair of the CD11 Transportation Advisory Committee and chairs the nonprofit Transit Coalition, and can be reached at [email protected].    The views expressed in this article are solely those of Mr. Alpern.)

Tags: circumcision, ballot initiatives, mohel

Vol 9 Issue 45
Pub: June 3, 2011