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Monday, July 16, 2018

Preemptive male circumcision debate: No compelling scientific arguments strongly for or against this practice

More than half of American boys are circumcised, as per the American Center for Disease Control and Prevention (although the numbers are dropping now), compared to 2-3% in Finland and Britain.

Written by Nandini Rathi | New Delhi | Updated: September 6, 2017 12:40:36 pm
male circumcision, anti-circumcision, neonatal circumcision, Source: Facebook

Female genital mutilation or FGM, which refers to the practice of partial or complete removal of the clitoris, captured indignant international attention, including categorical opposition towards it in the last couple of decades. Another set of activists, meanwhile, in the United States and elsewhere, have been actively drawing attention to the injustice of ‘male genital mutilation’ or what is generally known as male circumcision.

Why Circumcision?

The belief has held a steadfast sway in many communities. Men did it to their sons as it was done to them, and for the fear of rendering them vulnerable to ostracisation in the locker room and the bedroom. Circumcision among men, which refers to partial or complete surgical removal of foreskin of the penis, has been an age-old practice in Judaism and Islam and has often been treated as a marker of that religious identity and belongingness. Besides within religion, it has been performed by ancient Egyptians, and other ancient cultures such as the Aztecs and the aboriginals of Australia — often a rite of passage for men. As a secular practice, male circumcision is uncommon (under 20 percent) in South America, Europe and Asia — but widespread in Canada and the US, where well over half of all newborn boys undergo a preemptive surgical removal of foreskins in hospitals supposedly for health reasons.

The debate on male circumcision is a complex and contested one, including among medical practitioners and experts. The last decade witnessed special advocacy internationally in favour of male circumcision based on various study results from developing African countries that the practice provides protection against sexually transmitted infections (STIs), including the most concerning of them all: HIV. According to these studies, removal of the foreskin could reduce the risk of contracting these diseases by up to a whopping 60 per cent. It is also supposed to slightly reduce the chances of urinary tract infections (UTI) and penile cancer, although the disease is uncommon and fairly treatable. Ultimately, however, the evidence is regarded as short of substantive due to a want of robust control for confounding factors such as social background, sexual behaviour and penile hygiene of the studies’ participants in developing countries with a high incidence of HIV.

A long and contested terrain

The logic behind FGM can be traced to the control of female sexuality, as the removal of the clitoris would significantly reduce a woman’s libido and thereby reduce the temptation of ‘illicit’ sexual acts leading to a premarital loss of virginity or marital infidelity. The pre-scientific religious basis of male circumcision has also included sexuality in part. For instance, the great Jewish sage Rabbi Maimonedes believed that it counteracted ‘excessive lust’ and promoted spirituality. As a secular practice in the US, circumcision was first promoted as a means of preventing ‘harmful’ masturbation.

As a New York magazine feature puts it, “its history is driven by wildly shifting rationales: from tribal rite of passage to covenant with God to chastity guarantor to paralysis cure to cancer guard to unnecessary, painful surgery to a Hail Mary pass in the struggle with the AIDS pandemic”. Unlike the insignificance it seems to initially inspire, circumcision has caused its share of chaos throughout history through an enforcement of hierarchy and distinction. As Sociology and Public Health expert Peter Aggleton from University of London writes, “During the Ottoman and Moorish Empires, in Nazi Germany, in India at partition and in the recent genocides of Bosnia and East Timor, a man’s circumcision status had serious consequences for how he was treated: with violence, torture and death being the consequence for those who fell short of the mark”.

Modern opponents of the practice call it an unnecessary operation to remove a healthy body part and frequently refer to it as permanent body alteration without consent, “genital mutilation,” “barbaric,” and a violation of bodily integrity without consent. Many would not hesitate to go as far as to claim its ethical equivalence with FGM. Even within Judaism and Islam, there are small but growing movements against the practice.

 

Stop Infant Male Circumcision Protest in front of the White House at 1600 Pennsylvania Avenue, NW, Washington DC on Saturday afternoon, 30 March 2013 by Elvert Barnes PROTEST PHOTOGRAPHY. Source: Wikimedia Commons

More than half of American boys are circumcised, as per the American Center for Disease Control and Prevention compared to 2-3% in Finland and Britain. The American Academy of Pediatrics (AAP) in 2012 opined in a policy statement that the benefits “outweigh the risks” but also that they are too low to justify routine circumcision. The body leaves the decision up to the parents and most still choose to go with the norm. Whereas, European countries on the whole view neonatal circumcision as an infringement on the child’s bodily integrity that cannot be justified on medical grounds. The dominant American perception of circumcision leading of cleaner, nicer-looking and more socially acceptable genitals does not hold there. For instance, a major doctors association in Denmark last year recommended an end to male circumcision on the grounds that the procedure should be an informed personal choice for young men to make as it alters the body irreversibly.

neonatal circumcision, genital cutting, circumcision health Thinkstock image for representational purpose.

Away from the vociferous movements on either side, there aren’t strong, compelling scientific arguments for or against circumcision among male newborns. Benefits and risks are scientifically small and tend to cancel each other, even as the non-scientific arguments for and against circumcision are loud and exaggerated.

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