Alex Steelsmith
The Cutting Controversy
Published in The Honolulu Advertiser in 2008

What is circumcision? Why is it done, how common is it, and what are its effects? I've heard that it has become controversial and is on the decline. Can you give me a summary of why?

Circumcision is the removal of a portion of the genitals by cutting or surgery, usually from infants or adolescents. Statistically, its highest incidence is in Islamic cultures. In parts of the world both girls and boys are circumcised, but in America only boys can be circumcised legally. (U.S. legislation has criminalized the removal of any portion of girls' genitals.) In America, the only Western country where circumcision is still widely perpetuated, circumcision removes the retractable outer portion of the penis, or foreskin. "Foreskin" is a misnomer; it also contains tissue beneath the skin.

Circumcision was introduced in America during the anti-sexual Victorian era; doctors hoped to prevent masturbation by reducing penile sensation. It has become controversial because it raises issues of infant trauma, unnecessary risks of antibiotic-resistant staphylococcus infections (potentially fatal), and numerous ethical concerns. The part of the genitals removed serves a natural, protective anatomical function, and may have immune functions. Research shows that circumcision removes the most highly-innervated portion of the penis, containing thousands of specialized nerve endings. Once removed, they never grow back. A recent study in the British Journal of Urology found that circumcision diminishes penile sensitivity by 75 percent. Ethicists point out that circumcision deprives unconsenting minors of a fundamental human right-that deciding whether to keep one's genitals as nature intended is an individual's inalienable birthright, not their parent's or doctor's.

"Nowhere else in modern medicine do doctors routinely remove normal, healthy tissue in hopes of preventing statistically unlikely conditions that are more effectively prevented through more conservative approaches."

Historically, rationales for circumcision have shifted repeatedly. Circumcision has been erroneously claimed to prevent not only masturbation but epilepsy, cancer, blindness, urinary tract infections, and insanity. Most recently, it was even claimed to prevent HIV. The National Organization of Circumcision Information Resource Centers refuted this: circumcision may increase HIV risk.

Claims for circumcision as a preventive measure raise serious medical-ethical problems. Nowhere else in modern medicine do doctors routinely remove normal, healthy tissue in hopes of preventing statistically unlikely conditions that are more effectively prevented through more conservative approaches. Circumcision, oddly out of place in a rationally-based healthcare system, hasn't been held to the same ethical standards and scientific scrutiny expected everywhere else.

Much is changing: articles in national publications, including Men's Health, have raised awareness, and parents are increasingly demanding that their sons be left intact. Statistics show U.S. circumcision rates have dropped below 32 percent in some areas. Many states now refuse Medicaid funding for circumcision, and we've begun to see lawsuits against doctors who circumcise. Today no national medical association recommends routine circumcision, and doctors increasingly oppose it.

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