Rabu, 22 Juni 2011

What About Circumcision ?




There's a local angle, here, which provides a tag-line for this post: On May 18, 2011, The City of San Francisco Elections officials confirmed that an Initiative that would ban the circumcision of males younger than 18 had received enough signatures to qualify for the ballot. The practice would become a misdemeanor.

This is apparently the first instance of a local or state jurisdiction putting the question of the legality of circumcision to the voters.

Full disclosure: I was circumcised at birth, and have never had any reason to regret that this was done. There are, however, serious scientific studies which have been conducted to try to determine whether this very painful, and unnatural, procedure--which has been practiced for millennia, in many different cultures--may cause deep psychological scars for those subjected to it as infants, or somewhat later in life--as children, teenagers, or adults.

Not being a medical expert, I read a little bit about the history of circumcision, to familiarize myself with the issues it raises, and what my own position might be with respect to the potential outcome of the San Francisco initiative.

Statistically, circumcision in America, as a "medically advisable procedure" grew in popularity between 1920 and 1965, at which point, it seems to have begun a slow decline, as a percentage of males subjected to it as infants.

When I was growing up, the idea was that it was a traditional, customary thing, practiced primarily for hygienic reasons, to prevent infections and sanitary inconveniences as a result of the enclosure of the penis in uncircumcised foreskin. No one seemed to question its efficacy, or whether its possible negative side-effects might outweigh its supposed advantages. Birth certificates routinely report a 1-2% silver nitrate aqueous solution administered to infants' eyes, along with the administered circumcision.

The question of circumcision is a complex one, with long historical roots, and it remains a hot topic. Medical science is a relatively new discipline, having grown up over the last 500 years, accelerating to our present highly health-conscious world of today. Procedures such as circumcision, then, were introduced and codified as desirable or routine, long before there had been any empirical studies done to determine whether they served any useful purpose. Wikipedia's long article details the religious, ethical, legal, and health issues which surround it, and how different societies have employed it, and why; so I won't go into all that here, except to note that there is no overwhelming scientific evidence, other than anecdotal, to support the notion that circumcision is "necessary" for the health of boys or men. Studies conducted to determine whether circumcised men suffer fewer infections, or are more prone to complications such as venereal disease, or even AIDS, are generally neutral. As with most other primitive prejudices and superstitions, good hygiene and sensible behavior usually neutralize any statistical evidence of the "risks" of not being circumcised. In "primitive" cultures, where poor hygiene is common or prevalent, circumcision may indeed constitute an effective "prophylactic" against genital problems, including serious infections and disease transmission, but again, those test samples founder on the anomaly of cultural context.

Historically, many of the reasons for circumcision in fact had nothing whatever to do with health or hygiene, but were practiced as superstitious rites of esteem, passage, and so on. Our inheritance of customs like these says more about our tendency to be guided by presumption and conformity, than our desire to consider rationally, practices and beliefs originating in pre-historic times, or before any science had been applied to them, or because some institution--such as the church--had incorporated them into its body of ritual and prescription.

Why, then, if there were no demonstrable benefits to being circumcised, would some people require or demand a barbaric surgery upon their infant children? The reasons, again, are historical and religious, for the most part. Both Jews and Muslims--including those who follow in their footsteps but may not be "devout"--practice circumcision, and it is among these groups, most noticeably, that loud and strident objections are now being heard against the San Francisco initiative. Cries of religious persecution, even anti-Semitism, have been heard. Exaggerated applications of the "rights of the individual" are perceived as being pitted against all other considerations--the rights of parents, of the family, of ethnic groups. In Judaism, it's regarded as a holy commandment (the bris), literally a covenant.

One man's covenant is another man's superstition. In America, where we value the freedoms which protect our independent way of life, it's not easy to separate the rights and welfare of the individual, from the rights and demands of religious doctrine. Is allowing parents to circumcise their children--to perform a barbaric, medically unnecessary procedure--an irresponsible, uncivilized position?

We once in this country, routinely removed the tonsils of pre-pubescent children, believing that these glands were the potential site of infection. We once encouraged people of all colors and skins to get lots of sun, because of the presumed benefits of vitamin D etc. We once told people that butter was bad, and margarine was good. In our public schools, recalcitrant children are now routinely given powerful psycho-active drugs to quiet them down and make them tractable. Dentists once routinely filled cavities with mercury alloy, which was cheaper than gold, and "just as good."

We know, though, that these practices turned out to be wrong. Well-meaning people accepted bad advice, based on no or inadequate science, and put themselves at risk. The "experts" turned out to be mistaken.

Who are the experts today? What do they tell us about circumcision? That it's medically unnecessary, and as such, a cruel example of religious superstition--of hocus-pocus. Were I to have any male children in future, would I choose to have them circumcised? Probably not. In much of Europe, Canada, and Australasia, circumcision has already been, or is being, phased out.

How much longer will we cling to this hoary old custom?

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