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Thursday, February 16,2012

Foreskin follies

By Pamela White

Last year, when I wrote a column supporting an end to routine circumcision of male newborns, I got a letter from a reader who blasted me for being hypocritical. How can you support freedom of choice for women, the reader asked, and not support freedom of choice for parents?

I explained what ought to have been obvious — it was her perspective, not mine, that was hypocritical. I support a woman’s right to choose contraception and abortion. And I support a man’s right to choose whether or not he is circumcised. Circumcision, I argued, ought to be left up to the man whose penis is being cut. His body, his choice.

This exchange came at what was a high point in Colorado in the fight against routine infant male circumcision. The state had just cut Medicaid funding for circumcision in order to save money, making Colorado one of 17 states that does not cover the procedure. The decision resulted in sharp decrease in newborn circumcisions among Medicaid patients, who are required to cover the cost themselves if they choose to inflict the surgery on their newborns.

This wasn’t the ban on medically unnecessary circumcisions that I and many other Coloradans — many of them neonatal nurses who’ve witness circumcision, physicians who’ve performed them and circumcised men who’ve lived with lifelong complications from botched circumcisions — had hoped for, but it was a start.

Now, claiming to stand up for “choice” and “social justice,” liberal lawmakers, including Longmont’s Sen.

Brandon Shaffer, are working hard to refund routine infant circumcision. Senate Bill 90, introduced by State Sen. Joyce Foster, would restore Medicaid funding in Colorado for non-medically necessary circumcision.

But these lawmakers couldn’t be more misguided. They’re not supporting “choice,” but rather are eliminating choice for the one person who matters — the infant boy.

If they have their way, the state will spend another $250,000 it doesn’t have on a procedure that is not necessary and is rarely performed outside the United States.

These lawmakers claim that African studies show male circumcision has been proven to reduce the spread of sexually transmitted infections — results which even they admit have not been corroborated in the United States. In violently patriarchal parts of Africa where a woman can be beaten for asking her husband to wear a condom and where limited access to water can lead to less than optimal hygiene, perhaps circumcision offers medical professionals a tool they didn’t have before. (It is largely adult male volunteers who are undergoing circumcision there, not newborn infants).

But in the United States, condoms and good hygiene are less painful and more effective options for halting the spread of STDs.

As one Scottish talk show host said, “So I can either wash it and wear a condom, or I can cut it off?” The laughter of his audience and his own facial expression indicated quite clearly which option made sense and which was ridiculous.

Research on circumcision and its long-term effects cleanly refutes any medical “need” for routine circumcision, leaving only three reasons parents might choose to put their newborn baby through an invasive, painful and potentially risky procedure. The first is a desire for Junior’s penis to resemble Daddy’s. The second is religion. The third is for cosmetic reasons.

Medicaid does not cover cosmetic procedures. Families cannot get their little girls’ ears pierced and expect Medicaid to pick up the tab, for example.

As for religion, practicing Jews don’t circumcise their sons at the hospital, but rather in a ceremony called a brit milah, or bris, so this bill doesn’t help them.

The desire to have matching father-son penises, cited by Sen. Irene Aguliar, D-Denver, is nothing short of absurd. What medical function does matching penises serve? What interest does the state have in spending money on that?

This is an intensely emotional issue for some, but the people who get no voice in the debate are the little boys whose lives circumcision most directly effects. Contact your representatives in the State Senate and House, and urge them to kill SB 90.

Let’s let adult men decide the fate of their foreskins.

Go to for comprehensive information about circumcision.

Respond: This opinion column does not necessarily reflect the views of Boulder Weekly.

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It's illegal even to make a pinprick on a girl's genitals.  Why don't boys get the same protection?

Everyone should be able to decide for themselves whether or not they want parts cut off their genitals.  It's *their* body.

It's not like it can't wait - there are only two countries in the world where more than 50% of baby boys are circumcised - the USA and Israel.


And both countries are constantly involved in military conflict. Just like all tribes where circumcision is the norm.


Actually, the majority of boys are also circumcised in South Korea, the Philippines, the other Middle Eastern countries, and some of the African countries. But yes, it's in the minority worldwide.


None of those places do it to babies though - it's usually around puberty or adolescence, or occasionally the age of seven. Somehow American doctors keep telling people that it has to be done as soon as possible though, even though it seems to be safer, less painful, and to give better cosmetic results to wait.


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People cite cosmetic reasons. What is appealing about a scar? Are labia cosmetically aesthetic? Would we ever alter a female? Then why surgically change a male?


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This is one of the most mature, insightful, and intelligent pieces I have ever seen regarding circumcision, and I've seen many.  The Colorado initiative is so misguided, I can't even count the ways, but let me try.  Medicaid was never set up to handle elective surgery, or cosmetic surgery. Circumcision is "non-theraputic", according to the British Medical Association.  This is euphemistic.  it is destructive.  They are pandering to the voters, who have a fear that their 'parental rights' to cut up their kids any way they please might be taken away...or worse yet, they may have to pay for it.  I didn't hear these parents screaming when their right to circumcise their daughters was taken away by the Feds in 1996, or when insurance stopped covering it in the US.

To add to the crazy, there is an ethicist working for the AAP named Dr. Douglas Diekema.  He achieved a small measure of notoriety when he suggested that the Federal law regarding female circumcision be changed, to allow a nick to the clitoral foreskin.  There was an outcry, and it was denied he ever said it, but the published quotes persist on the net.  Here it is a couple of years later.  Dr. Diekema is on the circumcision task force of the AAP.  Why, is beyond me.  He let fly that the AAP is thinking of changing their stance to a pro-circumcision one shortly.  How many ethical violations can you count?  The genital belongs to the boy, not his parents or doctor.  What happened to 'first, do no harm'?  Or is removing what Dr. Diekema calls 1/3 of the skin, again, a euphemism, not harm?  What part of unnecessary surgery does the AAP not understand?  Like it carries no risks...infection, excessive bleeding, MRSA, taking off too much, skin bridges, meatal stenosis, to name a few.

Thanks for a sane article.  Reading it made my day.


Dr Diekema wasn't alone in recommending a token ritual nick for girls; he did it as the chair of the AAP's Bioethics Committee. The recommendation was tucked away in the body of the policy, not in the abstract or press release, and the recommendations were reorganised in a way that hid the fact the blanket ban on Female Genital Cutting - which accords with Federal law - was gone. (See ) The Chair of the AAP, Dr Judidth Palfrey, did not seem to realise that the policy had changed until Intactivists pointed it out to her, and it was quickly "retired". The suspicion arises that the Bioethics Committee - the Bioethics Committee! - had tried to put one across its Board. The same passage recommending that ritual nick described it as "much less extensive than male genital cutting". So how can it recommend male genital cutting? Tom Tobin left off another risk of circumcision: death.



I read in the 'Broward-Palm Beach New Times' this week that the AAP may come out with an updated policy statement this Spring that will be more in favor of circumcision for boys.  We will have to see if this is the case and how this development proceeds.


Rebecca: That was the same Douglas Diekema mentioned above. He's been saying that at least since last April. But if the AAP shifts its bottom on the fence a little towards recommending cutting healthy babies in America, on the basis of some dubious studies of adult male volunteers for circumcision in Africa, it will be doing bad science.


I didn't wait, Dr. Doug Diekema was one of two doctors, who made basically the same statement, that the policy was being changed to embrace changes in a pro-circumcision direction, because of HIV. I totally agree, it's bad science. Compounded by the fact that there is a small group of scientists, who were pro-circumcision before, and now keep endorsing each others' work. This is all amplified by the propaganda machine at the WHO working overtime. Their chief expert, Dr. David Tomlinson, invented 3 circumcision clamps. Did they think he was going to say no? Did the WHO not notice the conflict of interest? I sent a couple of strong letters of protest to the AAP. I had already written one when they got a new president. I plan on doing whatever it takes. If that is calling for demonstrations, and pointing out inconsistencies in their views to news outlets, let it rip. I'll tolerate a lot of stupid, but not when the genital cutting of babies is concerned.


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They seem to have been taking forever to make a decision & sitting on the fence for years.  The confusing policy in recent years has left a lot of parents unsure what to do.Parents need more guidance, and if there are more medical benefits, a recommendation in favor of circumcision would help parents decide to have their boys circumcised.  I think more Latinos would have their boys circumcised if the AAP  were to recommend it.  At the moment, people are unsure where the medical community is going on this.


Are you really saying that a Latino boy shouldn't be able to choose which healthy body parts he should be able to keep? You must have missed that discussion between Mario Lopez and George Lopez. It's worth looking for on You Tube. They both think circumcision is something ridiculous, that non-Latinos do.


Most first generation Latinos will stick to their original culture of origin, but the more Americanized they become the more they are open to hearing what the American medical community is saying. Latino families who are 2nd or 3rd generation are much more likely to circumcise their boys than were their parents. For example, you are correct that Mario Lopez is not circumcised, because his parents were not in favor of it. But his nephew (his sister's son) IS circumcised. Mario's sister was in favor of it after talking with her doctor and her husband. Therefore, among the younger Latino generation, there is more openness to circumcise, and you will find many Latino families who circumcise their boys. I don't see the rate increasing, but it would increase if the medical policy becomes more in favor.


Why would someone Latino or Latina want to look to a medical society, to take the freedom to choose which parts of their body they want to keep, away from them? Would you wish to have a medical society recommend that girls' clitoral hoods be removed? I simply don't get it. It is the most basic of human rights, the right to your own body. Even putting that aside, there is no medical evidence that circumcision benefits anyone. The medical society of no country finds it medically beneficial. It is simply an amputation. No one finds it healthier than washing with water. If we don't subject our girls to genital surgery, why should we subject our boys to it? Am I missing something special to Latin culture, or something?


I think you misunderstand what I'm saying. I'm saying that all communities in the United States, including Latinos, listen to what doctors and medical associations are saying. I know many Latino families who have circumcised their boys and there are some Latino celebrities in the US (eg. Eddie Cibrian, Nicholas Gonzales etc.) who are circumcised. Once a Latino family has been in America for several generations, they become more Americanized and more accepting of circumcision. It is true that the large majority of first generation Latinos do not circumcise, but the farther the connection from the original country, the more likely they are to become open to circumcision. Therefore, my point is that a medical recommendation in favor would accelerate this process, even if that may be wrong.


Yes, Dr Ed Schoen even pushes circumcision as "the American thing to do" but when he tried it on at Berkeley, the students laughed at him. That's a damnfool reason to cut part off a baby's genitals. The rest of the the English-speaking world has given it up - without any ill-effects - and the rest of the developed world has never done it.


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I appreciate this article and I wrote several Colorado senators about SB90. Shaffer was  the only one who responded with 'agree to disagree' comment. I was flabbergasted. The question we should be asking isn't arguments of HIV reduction, or aesthetics, or any other flimsy argument. We should be asking ourselves if decent, informed, civilized people in the 21st century cut the genitals of non-consenting children. The obvious and unemotional realization is no, we don't, and that is the real reason circumcision rates are falling. 


Why was Shaffer the only one to respond? Anyway, at least he was courteous enough to do so. So even those that agreed with you didn't write back?


I don't know why no one replied. I'm a Colorado resident, a registered voter, and frequently campaign for the Democratic party. I made these details known in my emails expressing my great disapproval of this legislation, since it was being spearheaded by Dems. They clearly don't care about what their constituents think, but that's no big surprise. Since I'm not a millionaire backing their campaigns with loads of cash, who gives a shit, right?


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