The male circumcision debate
Some years ago, I presented a Triple J program about male circumcision. It was all relatively light-hearted; a young doctor fielded calls about ‘hoodies verses helmets’ and a producer dared me to say ‘d--k cheese’ on air. But the mood abruptly shifted when a listener rang in sobbing. The young man was so upset about being circumcised that he described it as ‘violation and mutilation’ and revealed he was attempting to stretch back his foreskin using special bands. All the men in the studio crossed their legs and winced while the doctor advised him to seek medical guidance as such a procedure was unusual and could be dangerous.
This young man’s pain, heartache and fury came back to me a few years later when I had a baby boy. I was thankful that circumcision wasn’t even discussed at the hospital, baby health care centre or in any of the literature I’d read; let alone offered as an option. It hurt to even have to consider someone cutting this beautiful, perfect body that had grown inside me. A man in the next room inquired about his son being made to look like him but was told their faces won’t match either. He let it go. I’d had Jewish friends who had circumcised their babies as a religious and cultural obligation, but I was glad we secular parents were not given the option as the practice was considered unnecessary and out of date.
On a world scale, medically rationalized circumcision is a minority practice that’s illegal in some countries. It became common in the late Victorian period in Britain and its colonies, initially as a control for masturbation. One advocate Dr John Harvey Kellog (of breakfast cereal fame) was so obsessed by self-pleasuring that he also advocated application of carbolic acid to girls’ clitorises, cold baths, cool enemas, electric shocks and even covering genitals with patented cages. Worth thinking about next time you are snacking on your Nutri-Grain.
In the 1970s, medical authorities began to recommend against routine medically unnecessary circumcision of baby boys. They pointed out that the foreskin protects, is a primary sensory part of the penis and that circumcision involved pain, bleeding, infections, damage to the penis and a violation of an infant’s rights. Parents responded to the advice and, within a generation, Australia changed from a country where nearly 90 percent of newborn boys were circumcised to one where circumcision is about 20 percent. The change happened so quickly that there are many families where one son is done and one isn’t.
But following a recent policy statement from the American Academy of Pediatrics, the debate is back on the agenda. It said the “preventative health benefits of elective circumcision of male newborns outweigh the risks”. The Academy stopped short of recommending circumcision but said parents should consider the literature and advice. A vocal minority of medical experts go a lot further, saying foreskin removal could act as a “surgical vaccine” to stop the spread of HIV, particularly in Africa. United Nations agencies in the subcontinent agree it should be considered.
Tonight on the SBS programme Insight, medical experts, religious scholars, parents and men will give their views on male circumcision. Some see it as a non-issue, a few as a health concern, others as a religious covenant and a couple as an unnecessary cruelty.
For those who are unsure, I’m sensing another new parental minefield that’s becoming increasingly vexing. Insight participant Desleigh had Elwyn 29 years ago and was soon told he had restricted urine flow that could only be fixed by circumcision. Elwyn is now an ‘intactivist’, who feels a part of him is missing while his mother feels guilty and still wishes there was another way. I understand Desleigh when she says ‘I kind of feel you can’t win. You’re damned if you do and damned if you don’t.
Tracey had her son Nathan in 1992. A single mother, she was worried she wouldn’t be able to teach him to clean his penis properly. Her grandfather had told her terrible stories of men during war time, stuck in trenches and unable to wash. “One of his air force buddies had to be circumcised in the field without anaesthetic and that horrified me”. Tracey was so confused that her decision to circumcise was motivated by the fact she didn’t want to do the wrong thing. She had initial regrets as the doctor nicked the shaft of Nathan’s penis and it needed a stitch. “He was distressed, I was beside myself – what have I done?”
Nathan’s scar has healed and he’s now happy with his mother’s decision, saying ‘You can’t miss what you’ve never had’. Tracey also has no regrets; especially in terms of hygiene as Nathan went off to boarding school and ‘God knows how often they washed’. She also feels girls prefer a circumcised penis, saying it’s cleaner and looks better. “If I had penis I would rather circumcised and would hope my mother make that decision before I was old enough.”
It’s a decision most parents would rather not have to make. But by putting it back towards parental choice, the American Pediatrics Organisation is setting us up for more confusion and angst. Taking out religion, the practice lies at the crossroad of human rights, health and ethics.
Advocates of circumcision talk of a significantly lower risk of becoming infected with HIV and other sexually transmitted diseases in high-risk populations. They also point to a slightly decreased risk of (extremely rare) penile cancer in men with foreskin retraction problems. These are points acknowledged by our experts at The Royal Australasian College of Physicians Pediatrics and Child Health Division. But after reviewing the currently available evidence, the RACP still comes down against the practice here. It advocates safe sex rather than an operation on a baby.
Sometimes being a parent is a Sophie’s choice of difficulties. There are decisions to be made that you know could be vitally important to your child’s future; decisions that once implemented cannot be reversed. In an age of option and information overload, where we are bombarded with many choices and an infinite amount of information from all over the world, such decisions become even harder. Witness the vaccination debate that meant parents fretted about a link to autism. The concerns turned out to be disproved.
In terms of circumcision, there are potential harms and potential benefits; but religious and cultural reasons aside, I believe there is not a strong enough case for bringing back medical circumcision. Yet I watch the debate with that common parental fear – of being proved wrong.
Watch 'The First Cut' on Insight, at 8.30pm tonight on SBS one.