Just a little off the top, thanks

A few thoughts today on circumcision . . .

Charles Bragg: Doyle the Mohel

I'm plunging into the topic of male circumcision with more than a little bias. I like my pupik* the way it is, and I'm not about to change it by "foreskin restoration techniques," non-surgical or otherwise. My defensive hackles are raised whenever I hear this sort of inflammatory rhetoric from the anti-circumcision faction: The medical community has long based this protocol for obtaining consent on the assumption that a parent may legitimately give consent to the non-therapeutic circumcision of a child. There is, however, no basis in law to support this assumption. A male neonatal circumcision is neither a diagnostic procedure nor a treatment of a disease. Thus non-therapeutic circumcision is, in effect, an act of battery. No parent can grant consent for an act of battery. Such language makes me want to rant about the health benefits of circumcision, but Wikipedia has done that for me. Groups that oppose circumcision ('male genital mutilation,' in their parlance) counter that circumcision is tantamount to amputation: healthy erogenous tissue is removed for no immediate medical benefit, and arguments to the contrary are based on post-pubertal sexual practices. If the kid wants those health benefits, let him decide it for himself when he's older. I'm not so fanatical that I want all baby boys circumcised. I'm in favor of the British Medical Association's recommendations, which requires doctors to act in the child's best interests**, obtain consent from both parents, involve children in the discussion (for older boys, naturally), and 'act in accordance with good clinical practice and provide adequate pain control and aftercare.' This is in line with the recommendations of the American Medical Association and the American Academy of Pediatrics, who state: Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision. In circumstances in which there are potential benefits and risks, yet the procedure is not essential to the child's current well-being, parents should determine what is in the best interest of the child. To make an informed choice, parents of all male infants should be given accurate and unbiased information and be provided the opportunity to discuss this decision. If a decision for circumcision is made, procedural analgesia should be provided. While it's nice that my opinion sits squarely in the mainstream, I still find myself squeezing my thighs together when the Intactivists get rolling -- especially folks like Penn and Teller, whom I otherwise idolize. (In case you're not familiar with them, Penn and Teller are a something of a phenomenon: part magic act, Vegas show, force of nature, and Crusaders for Truth in their Showtime series, Bullshit!) Why do they care so much about what other people are doing to their kids' pupiks? Note: I'm trying to avoid using that other p word in the same sentence as 'babies' or 'kids.' You wouldn't believe the sickos who come out of the woodwork, searching for the sick crap. And yet, I can understand where the Intactivists*** are coming from. No, it's not fair that parents alter (mutilate, if you prefer) their children without the kids' consent. But, to quote David Bowie's character from Labyrinth, "Whoever told you life was fair?" Parents do lots of things to their kids without their kids' consent. Giving birth to them in the first place -- that's the real capper. Everything else is small potatoes. According to UNICEF's website, over half the kids in the world come into the world saddled with poverty, war, or HIV. That's more than one billion children. My question to the Inactivists: why get exercised over a snippet of foreskin when there are far worse crimes perpetrated against infants and children every day?

***

The controversy derives in part from the fact that male circumcision is (1) usually complication-free, and (2) also free of serious long-term adverse consequences. It's like ear piercing, another common body modification imposed on infants. The risks and benefits are equally slight. It's hard not to wonder what all the fuss is about. Not so female circumcision, but for me, that's a far easier ethical question. When parents doom their daughters to a lifetime of pain and impaired function, the word 'battery' seems not only apt but inadequate. Religious freedom does not mean a parent is free to harm those under his protection. This goes for those folks who deny their kids proper medical care, too -- not just the "healing prayer" folks, but those who refuse to vaccinate their children. As for male circumcision, I'm aware that I'm falling into a well worn pattern. Folks who oppose circumcision tend to exaggerate the risks and longterm ill effects, while those who favor circumcision downplay the very same, or emphasize the (admittedly minimal) health benefits of the practice. And so I'm left in my usual quandary when it comes to ethics questions. (Hmm. How about a blog entitled, Ethics, Shmethics?) I can see the merits of both sides of the debate. I have an opinion, but I have a hard time backing it up with anything more than wimpy protestations ("The AMA and the BMA think like I do -- nyaah, nyaah, nyaah!") I'm forced, ultimately, to justify my bias on the basis of a personal aesthetic argument: Uncut penises? Funky. D. *Pupik = bellybutton everywhere else in the Yiddish-speaking world; but in my family, it meant . . . well, you know. **Thus, if the child's health were too precarious to undergo the procedure, the doctor would refuse to perform it, even if both parents insisted. ***Thanks to Stephen for picking up on my misspelling.