Circumcision Symposium Questions an Ancient Practice
By Ephrat Livni
NEW YORK, Dec. 7—No matter how you cut it, circumcision has become a controversial practice.
Circumcision—surgical removal of the foreskin that covers the head of the penis—is widely performed in the United States for health and religious reasons. Today, about 65 percent of newborn American boys have their foreskins snipped in hospitals and religious ceremonies, down from nearly 90 percent a quarter century ago.
With mounting evidence that the practice may not be medically beneficial, more doctors are speaking out against a practice they call "barbaric." This week, anti-circumcision activists are meeting at the Sixth International Symposium on Genital Integrity in Sydney, Australia, to discuss the ethical, social and psychological ramifications of this and other forms of "sexual mutilation."
The gathering of politicians, lawyers, sociologists, anthropologists, ethicists, psychologists and physicians will consider topics such as the history of sexual mutilation in religion and medicine, foreskin restoration and counseling approaches for acute post-circumcision stress. NOCIRC—the National Organization of Circumcision Information Resource Centers, a San-Anselmo, Calif.-based nonprofit circumcision education group sponsoring the symposium—will also be handing out awards to people who have campaigned to end genital mutilation worldwide.
An Ancient Practice
Traditionally, Jews and Muslims have circumcised their sons as prescribed in the Book of Genesis by God in his covenant with Abraham: "Every male among you shall be circumcised." The practice gained popularity in America in the 19th century among doctors who believed it stopped males from masturbating. It became culturally entrenched during both World Wars as a way to help maintain soldiers' hygiene, as material collects under the foreskin and can cause infection.
Today, widespread circumcision is still performed for health concerns. Circumcised boys have a lower risk of urinary tract infections and of getting cancer of the penis—a very rare disease—as well as a slightly lower risk of contracting sexually transmitted diseases later in life.
But some experts say the main reason the practice persists is because circumcised fathers are in denial. Similar to a cycle of abuse, says Dr. Ronald Goldman, executive director of the Circumcision Resource Center in Boston and author of Circumcision, The Hidden Trauma, many men have a "compulsion to repeat the trauma on the next generation."
Goldman believes the pain baby boys feel during this procedure is stored in their unconscious throughout their lives. Dr. George C. Denniston, president of the Seattle-based nonprofit Doctors Opposing Circumcision, agrees, saying that by encoding a boy's pleasure center with violence in his first few days, parents are fundamentally changing his whole outlook on life.
Denniston, who admits it took him a long time as a physician to come round to this view of circumcision, now believes it is a violation of medical ethics—a needless operation performed on an organ that is perfectly fine as it is. "I don't discriminate between body parts. I wouldn't cut off fingers or toes either."
Goldman agrees, adding, "No national medical organization in the world recommends [circumcision]."
Task Force on Circumcision
In fact, in 1999 the American Academy of Pediatrics formed a Task Force on Circumcision. Reviewing almost 40 years worth of studies, the task force concluded: "Circumcision is not essential to a child's well-being at birth, even though it does have some potential medical benefits. These benefits are not compelling enough to warrant the AAP to recommend routine newborn circumcision."
Carole Lannon, an epidimiologist and pediatrician at the University of North Carolina at Chapel Hill who chaired the AAP circumcision Task Force, says she encourages parents to discuss the benefits and risks of the operation with a pediatrician before making the decision.
But because there are sensitive cultural and religious issues in the circumcision debate, the pediatricians organization's policy paper does state: "It is legitimate for parents to take into account cultural, religious and ethnic traditions, in addition to medical factors, when making this choice."
The American Urological Association and the Canadian Pediatrics Association agree with AAP's position.
Despite the controversy, same doctors say circumcision will continue to be widespread and that the decision should be made by parents.
"Very few doctors or medical establishments recommend infant circumcision on a routine basis, but at the same time they recognize there are benefits and advantages as well as disadvantages and risks. Therefore the decision to circumcise or not should be left to the parents," says Circumcision Online News, a Web site started by doctors and researchers concerned about possible misinformation disseminated by the blossoming anti-circumcision movement.
From the Mouths of Men
Those traditions are centuries old and many men—even some who do not consider themselves religious—would like to see them preserved.
Guy Vidra, a 26-year old secular Jewish man living in New York, writes in an e-mail to ABCNEWS.COM: "When and if the time comes with my child, I will have him circumcised to go through the religious rite." He says he has no recollection of the ceremony performed on him and has a hard time imagining that a young child could feel "violated" by circumcision.
For Catholic-born John McCloskey, circumcision seems "mostly harmless" as a religious ritual. "But," says the 28-year-old Brooklyn resident, "as a medical operation performed on millions of American baby boys, it's insane."
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