Back to the News 2007 page.SAN FRANCISCO CHRONICLE, Thursday, June 21, 2007.
When Nancy McIlvaine told her parents that her
newborn son wouldn't be circumcised, her mother gasped.
McIlvaine, who lives in Napa with her husband, Willem
Maas, said she consulted with health professionals
about circumcision and never heard a compelling reason
to snip her baby's foreskin.
"It's just inflicting pain to a newborn when there
doesn't seem to be any evidence of it being
beneficial," said McIlvaine, who gave birth to Theodore
on June 8.
McIlvaine is part of a growing trend away from male
circumcision. According to the Centers for Disease
Control and Prevention, the circumcision rate in the
United States dropped to 55.9 percent in 2003 – an
all-time postwar low. In the early '60s, it peaked at
90 percent.
In the Bay Area, the numbers are even lower. Dr.
Laurence S. Baskin, chief of pediatric urology at UC
San Francisco, said, "I would say it's only 40 percent
in San Francisco. People are more educated about the
reasons for it now. In the past it was part of the
package: You had a boy, he was circumcised and you
would be sent home with a car seat, and that was
it."
Immigration also is a big factor in the decrease in
male circumcision nationwide, Baskin said. Among Asian
cultures and Latin American cultures, circumcision is
the exception, not the norm.
During the 1950s, the rate of routine infant
circumcision leapt from 50 to 90 percent in response to
the advice of medical doctors, like the author Dr. Benjamin Spock, who argued
that it was beneficial.
But in 1999, after decades of debate, the American
Academy of Pediatrics issued a policy statement on
circumcision stating, "Existing scientific evidence
demonstrates potential medical benefits of newborn male
circumcision; however, these data are not sufficient to
recommend routine neonatal circumcision."
When Baskin speaks to parents of infant boys, he
describes the pros and cons of the procedure. On the
pro side: Circumcision can decrease the likelihood of
urinary tract infections, penile cancer, HIV and
sexually transmitted diseases. On the con side:
Circumcision has a small risk factor, like any surgery,
and in most cases is unnecessary. With good hygiene, an
uncircumcised male can maintain good health throughout
life.
Baskin said that most of the
clinical studies measuring the reduction of HIV, STDs
and penile cancer were conducted in sub-Saharan Africa
and "not really germane to people living in San
Francisco." Penile cancer, he said, is a problem in
Africa but almost unheard-of in the United
States.
Dan Savage, a popular sex adviser whose Savage Love
column is syndicated to 70 newspapers, has a 9-year-old
adopted son, Daryl. When he and his partner, Terry
Miller, made the decision not to circumcise, he said,
"My parents didn't interfere. They had their three sons
circumcised because that's what everyone did, but
they're informed enough now to know that it's not what
everyone does. It's a choice that parents make."
Initially, Savage said, "there was some discussion on
my boyfriend's part of wanting him to look like us. All
I had to tell him was, 'I don't remember ever comparing
penises with my dad. You don't sit around the
Thanksgiving dinner table, haul it out and say, 'Hey,
don't we all look alike!' "
Stacy Nye of Redwood City agrees. She has an
uncircumcised 8-year-old son and says the
like-father-like-son argument is absurd. "Dr. Dean
Edell (the talk-show host) made a good point on his
show once when he said the penis is the last thing that
others see to compare a father and a son, unless you
hang out at a nudist colony."
Even among young Jewish parents, there has been a
change. Jonathan Marks, a Marin County real-estate
agent, said he and his wife, Paula, did a "vast amount
of research" when their son, Gabriel, was born five
years ago.
"I can't say we were torn about it. Actually, we were
torn, but only in the expectation of others around us
and especially my Jewish heritage. But after doing the
research and speaking with midwives and others around
us with boys, we decided that the trend at the time was
moving away from this blanket circumcision edict that
comes down from God knows where."
"It comes up frequently in my column," Savage said.
"Where it really creates conflict and stress for my
readers is when they're young, hip, alternative-scene
Jews who may not even be practicing. But suddenly
they're having a boy, and they get all this pressure
from their families. I know one couple who were
disinherited, and they went ahead and didn't do the
circumcision anyway."
Jeff Lewis, a San Francisco optometrist who practices
in Orinda, is Jewish and is expecting a daughter with
his wife, Shem. If they have a boy in the future, he
said, "We would circumcise, not only for the sake of
tradition, but also because I've seen in hospital
training too many elderly men go through the
circumcision process for hygiene reasons. The trauma is
measurable."
For a lot of parents, the notion of inflicting pain on
their newborn son is loathsome. David Fortner of
Berkeley, whose son Wyatt was born seven months ago,
said, "He was such a small, little, delicate guy that
the last thing I'd want to do was start carving up his
little ween."
"I'm not going to buy the argument that it's brutal,"
Baskin said. "There's a general anesthetic involved, so
they're not going to experience any pain, because
they're asleep. And afterwards, with good nerve blocks,
they basically do fine." Infants 3 to 6 months old are
given a general anesthetic; newborns 1 to 8 days are
given a local anesthetic.
Baskin also dismissed the argument that circumcised
men experience less sexual pleasure because of the loss
of foreskin. "I think that's been pretty much debunked
by a number of articles in the British Journal of
Urology and the Journal of Urology." Regarding men who
endeavor to restore their foreskin in their adult years
-- Web sites are devoted to the practice – Baskin
said, "In my mind that would go under the heading, 'Get
a life.' "
"It's pretty hard to scientifically quantify pleasure
under any circumstances," said retired San Francisco
urologist Dale McGhee, "and particularly hard to
compare pleasure quantitatively between circumcised and
uncircumcised penises. I know that in all my career in
medicine, I never met one man who was circumcised in
adulthood and who said he experienced less sexual
pleasure after than before."
Curiously, one of the least-mentioned factors in the
cut versus uncut debate is the sexual experience of
women. "Friends who have made love to men who were
not circumcised have told me it felt a whole lot better
to them than men who were circumcised," said Nye. "That
may have more to do with the skills of the man than the
circumcision. But who knows?"
E-mail Edward Guthmann at eguthmann@sfchronicle.com.
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