Tuesday, July 17, 2012

Circumcision myths

Circumcision is in the news again, because of a judge in Germany who ruled it was illegal.  I'm still not sure how I feel about banning circumcision legally; on the one hand, I believe it is unjust to alter a child's body without his consent without grave need, but on the other I feel the law is a very clumsy tool for getting what you want, especially when opposed by religion.  That's the libertarian in me coming out.  But on the other hand, libertarianism is about giving liberty to adults, over their own bodies ... not about handing the rights of children over to someone else.  I go back and forth; it's a very tough call for me.

But in reading blog posts about this topic, I found myself getting frustrated for another reason.  The same myths keep getting tossed around about circumcision, and people just accept them.  I guess they assume people wouldn't speak with such assurance if they didn't know what they were talking about.  But ... let me just tell you ... they don't know what they're talking about.

Here are a few myths about circumcision that I saw bandied about.  [Warning: I do discuss medical details in this post.  It's my opinion that squeamishness about circumcision contributes to ignorance about it.  If it's too gross to read about, I think it should be too gross to do.  But I'm giving you fair warning: if you don't want to know the details, stop reading.]

Myth #1: "Better to get it done when they're younger -- circumcision is so much less complicated when done on an infant."

Fact: Circumcision is much more difficult and complicated when performed on an infant.  First, anesthesia is not always given to a baby, and when it is, it is not always effective.  It's unsafe to put the baby under, but with a local, you can't be sure the area is completely numb.  Think about it -- how do they test a local anesthetic?  Normally, touch you with ice and ask you if you felt that.  If you're a baby, you can't answer.  An adult is normally completely numb for a circumcision.

Second, a baby's foreskin is not yet retractable.  It is fused to the glans, in a similar way as your fingernails are fused to the finger.  So in addition to the cutting we think of, there is also the extremely painful procedure of tearing the foreskin from the glans.  An adult's foreskin is retractable and may simply be cut and removed.

Third, a baby's penis is very tiny -- less than two inches long.  It's much easier to make mistakes on such a tiny organ, which is why we occasionally read about baby boys losing their glans or entire penis to a slip of a scalpel.  It's not always clear where the foreskin ends and the rest of the penile skin begins -- so there is a lot of variation in how circumcisions are done: some painfully tight and some rather loose.  On an adult, the demarcation is clear and a man can choose beforehand how much skin he wants removed.

Fourth, an adult man can spend his recovery period keeping the area scrupulously clean and taking vicodin. He will immediately notice any complication.  An infant's surgical site is inside a diaper, which invariably will be wet or dirty sometimes.  His parents may not notice an unusual appearance until some time has past.  And only a few ounces of bleeding is enough to kill a newborn -- an amount easily concealed in a disposable diaper.

There is no risk whatsoever in delaying circumcision till adulthood -- except, of course, the risk that a man wouldn't do that to himself if the choice were left up to him.  In which case it is rather strange to do it on him before he is able to withhold consent, if we suspect he would withhold consent if he could speak.

Myth #2:  "Male circumcision is nothing like female circumcision.  Female circumcision is much more drastic."

Fact:  Actually, it depends.  There are three types of female circumcision.  The most drastic is indeed a more serious affair than male circumcision: the entire clitoris is removed, and often the labia are as well and the vagina is stitched half-closed.  This is extremely brutal and causes pain later in life.  However, the more common form of female circumcision is the removal of part or all of the clitoral hood, which is the same basic body part (called the prepuce) as the foreskin on a man.  This is not done to destroy all sexual pleasure, but for mainly aesthetic purposes.  Some women who advocate it claim it is more hygienic and increases sexual pleasure.  The least drastic form of female circumcision is a "ritual nick" which does not leave any permanent change in appearance.  ALL of these forms of genital cutting are illegal in the US, even though some religions insist on them.  Boys do not have the same protection under the law as girls do.

Myth #3:  "Doctors recommend circumcision for health reasons."

Fact: Some individual doctors may recommend circumcision based on their own opinions.  But no medical association in America recommends it officially.  The AAP's statement on the matter is that there is insufficient medical cause to recommend routine infant circumcision, and that the parents can make the decision for their own cultural reasons.

Myth #4:  "Most Christian men are circumcised, even though our religion doesn't require it."

Fact: Worldwide, circumcision is religiously based.  In Muslim countries and in Israel, nearly all men are circumcised.  In Africa, certain tribes practice circumcision as well.  Aside from these countries, hardly any men are circumcised.  Rates are low in Europe and are easily accounted for by assuming Jews and Muslims are circumcised, and Christians are intact.  Routine infant circumcision among Christians is mostly limited to English-speaking countries, and rates are falling fast even there.  Circumcision is becoming uncommon in Canada, Britain, and Australia.  Even in America, less than half of baby boys are circumcised now.

Seriously, I have no problem with people debating the role of government and the rights of religious groups.  That's a valid debate and I hope to continue following it in the hopes of coming to some opinion myself.  But I wish people would stop spouting ignorance about circumcision.  The whole internet is wide open -- it's not hard to find this stuff out.


Anonymous said...

But the issue here is with RELIGIOUS circumcision. Of course it is extremely important for Jews to initiate their children into their religion this way. It is commanded of them. As Christians, sure, we know it is no longer needed, but if I were a Jew, I would definitely see this law as persecution. I think this law is specifically designed to persecute Jews, and in Germany, no less. I utterly believe we have a right to train our children in our own religion.

Sheila said...

Train, yes. Sever body parts? Not so sure. I don't really know WHY Germany made this law, and I admit it is kind of suspicious, coming out of Germany, where both Jews and Muslims threaten the "cultural purity" of the country. Religious freedom is important to me. But so are babies. That's why I'm so darn conflicted.

In any event, I think the debate will go much better with actual facts, which is why I wrote this post -- not to argue one point of view or the other.

some guy on the street said...

An opposite misconception is the actual force of the ruling in question: it would seem that Judicial rulings in Germany do not have force of law over later cases --- the principle of "precedent" as binding (modulo superior review) is not accepted there. Put another way, the incident is as harmless (and fully conveys all the harm) of one judge acting carelessly in one case. There is scandal and the overall context is obviously wrong, but it's not as though Justice Roberts found that congress can levy a tax on sitting down (... which, effectively, he did) and the only folk who can say otherwise are a majority of the Supreme Court or two thirds of Congress (... and of course, they won't, this year).

Of course, I'm confused as to how this case was first brought to court. Surely there'd be no way if the question were over a bris performed by the relevant figure. I suppose I could find out for myself, but it seems more likely that the couple asked a doctor to inflict the wound, who might then have objected on medical grounds, whereupon they sued him...

Another thing about circumcision in Judaism: that it is painful, that blood is shed, that it results in some limitation of particular sensitivity is part of the point. By the ritual, the men of God's Chosen People are proclaimed as belonging to the Divine in their whole being, even within the blessing to "be fruitful and multiply"; particularly, it's a reminder that the blessing of fruitfulness is vastly superior to the fun you might have along the way. To be sure, it may be a question of "socialization" for some people now, but as that sounds too much like "fashionable", I'd prefer to discourage that sort of argument.

Sheila said...

It might have been part of a divorce/custody battle. I hear it was a very minor judge.

My theology professor said the commandment for circumcision was given as a punishment for sin, I think the sin of Abraham begetting Ishmael on Hagar instead of trusting in God's promise. It wasn't part of God's original covenant, but added onto it because of the sin of man. That makes sense to me and easily explains why that commandment was lifted for Christians.

some guy on the street said...

Oh, custody... that is rather more sad a story than I had imagined.

I can well believe your professor's more narative version, too, not that it contradicts what I understood from Jewish friends; it occurs to me also, now, that a potential origin of the "hygiene" myth may be due to the occasional translatability of kosher and treyf as "clean" and "unclean", resp. A casual or materialistic listener might hear the englished words and easily get the wrong idea...

But it's easy to establish that I'm no great authority on much of anything; hence, take with salt as needed.

Anonymous said...

Thank you Sheila!

I think discussions of circumcision NEED to be happening. Don't we try to get the facts about other decisions we make for our children?

I have long been baffled that anyone would modify a child's body (long before they can consent) without having researched procedures and risks.

Becky said...

Sheila, The basic law (or constitution) in Germany fiercely protects children's rights. That's the motive behind all of this I'm sure. However, with the targets being Jews and Muslims, I'm pretty sure that Angela Merkel will do (or already has done) something about it.

I'm pregnant with my second baby. The first was a girl, which I'm so grateful for. My husband and I hadn't made our minds up about circumcision. We don't know the gender yet, but we've decided to not circumcise (if it's a boy) and the more I read about it, the better I feel about this decision.

Becca said...

Great article! I really appreciate your addressing of #1; there are some ideas there that I had never considered. I added a link to your post to my article on choosing not to circumcise. My son is 7 now and occasionally tells us how glad he is that we didn't get it done to him!

Anonymous said...

The case came up when the couple brought the baby to the hospital AFTER the circumcision because of some bleeding, which was quickly taken care of there.

Anonymous said...

There was another case years ago when a father took his child out of country to get circumcised at age 12, which did involve a difference of opinion and faith between mom and dad. This was also in Germany, and it also ruled for the child's making his own choice. I find that case very different, because the parents did not agree. In that case, I can see the government being a final arbitrator for the minor.

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