First the Bagel, Now the Mohel

The Jewish Daily Forward is reporting that more and more non-Jews are calling in the mohel, or ritual circumciser, to have their sons circumcised. The reasons for this include a desire for cleanliness (mohels operate outside of hospitals) and adding a bit of spiritual pizazz, even if the pizazz comes from outside a family’s own religious tradition.

An excerpt:

Nearly two years ago, Jeannie Noth Gaffigan and Jim Gaffigan gave birth to their first son at home through the assistance of a nurse-midwife. Though the decision to circumcise wasn’t a religious one, as Catholics the Gaffigans wanted more than a simple medical procedure. “We felt a mohel would lend a high level of dignity and significance to this very important moment in our lives,” Noth Gaffigan said in an e-mail to the Forward. [The mohel] Blake, 52, arrived at a house packed with food, drink and family — a gathering that, were it not for the priest in the corner, would have looked like nothing less than a Jewish bris.

I believe the U.S. is the only country in the world where the majority of boys are circumcised even if the parents have no religious reason to do so. This has long been a puzzling issue, and a contentious one, too. This site gives a good look at circumcision rates in the U.S. in the past several decades, which have been falling but are still high.

Here’s one sentence from the site that gives an indication of just how contentious the issue is: “Circumcision hit its highest level in 1965, at which point the genital integrity rate was just 15 percent.” The phrase “genital integrity” is a bit more suggestive than “uncircumcised,” wouldn’t you say?

So here are two questions:

1. Why is it that, in a country with such a relatively small population of parents whose religion requires them to circumcise their sons, have so many boys historically been circumcised?

2. According to the circumcision stats Web site, circumcision rates vary widely from region to region in the U.S. Here are the approximate rates in 2004 for the following four regions:

Midwest: 80 percent
Northeast: 68 percent
South: 59 percent
West: 32 percent

What can account for such a high Midwest rate and such a low West rate? I am guessing it is a combination of cultural preferences (influenced perhaps by immigration), and some degree of religious dictate of course, but also insurance policy and hospital culture. (See Shannon Brownlee‘s book Overtreated for examples of huge regional differences in various medical treatments.) But I am still astonished at this vast diversity in the circumcision statistics. Can anyone explain it?


JorgeM

pdm also brings up Meatal Stenosis.

According to eMedicine, the frequency of meatal stenosis is about 1 in 10 circumcised boys. A boy is far more likely to need correction for meatal stenois than he is to get penile cancer (as an ancient man), a (antibiotic treatable) UTI, or teased in the locker room (in the nonexistant gang shower). Unlike his circumcision, a boy is guaranteed to remember getting his urethra opening stretched since the correction takes place at around age 4 or 5.

http://www.emedicine.com/ped/topic2356.htm

D

To get to Dubner's question directly and leave aside the issue of whether circumcision is "good" or "bad," here are some variables to consider in observing this pattern:

1) Ethnic and gender composition of medical doctors. I suspect that female doctors are less invested in the issue of circumcision than male ones (many of whom were themselves circumcised) and therefore more willing to put it out there as a neutral matter for parental choice (which would, from a high rate of circumcision at least, lower the numbers of the clipped.) Ditto on the changing ethnic make-up of the medical profession: the Jewish doctor of the post-War stereotype has been replaced by the "Indian doctor" stereotype of today (at least in California, where I'm from). Most Indian doctors are Hindus and therefore uncircumcised and unwilling to advocate circumcision very readily.

2) People living on the coasts - esp. the W. Coast and California - are the cultural innovators, the first-stop for influences from over the ocean. More of us from these parts travel, have immigrant friends, went to college with significant international student populations, and move in educated, professional circles. We're exactly the demographic that's stopping the routine circumcision of our children, and therefore conforming to a global norm. With the exception of Jewish parents, then, these areas will likely have (in a little time) the *lowest* rate of circumcision (no doubt with faddish things like Mohel jobs for those who want to dress up the ceremony - indeed, the fancy Crate & Barrel circumcision of the future is probably Mohel-performed, not the old routine hospital hack job that most Americans once got.) By contrast, the Midwest is preserving an older tradition but, given a half generation or so, it will probably fall in line with the culturally innovative/elite norms because of emulation of the richer coasts.

3) More specifically, on the issue of the reduced rate on the coasts, we should recognize the fading of American exceptionalism - which is fading wherever we come into contact with the rest of the world (which is, apart from the Muslim world, uncircumcised) especially with educated and often more sophisticated (and richer, given the dollar!) Asians and Europeans. These healthy and sophisticated folk don't cut their kids, which raises the obvious question why we should, especially once we stop thinking that Americans have a superior take on most issues.

In short, with this pattern emerging and these social dynamics, I think this is an American tradition on the way out. Affluent kids (with the exception of the small number of Jewish kids) will be uncircumcised, and the US will come to mirror more closely the European pattern in this regard - the majority will be uncircumcised (and consider the practice bizarre), but religious minority groups will continue the practice (e.g. Muslims and Jews).

This trend represents an interesting problem for some of my Jewish friends. They are torn up about having to circumcise, and I know many of them (from precisely the sort of affluent, educated, coastal communities I'm familiar with) hope for little girls so they don't have to decide whether to anger the grandparent generation (by refusing a bris) or to do something they don't really want to do because of pressure to conform. Who knows what the solution to that is - I hear they have a "bris shalom" now, which is a naming ceremony without circumcision, which can be performed in the same way for both boys and girls. It may not satisfy grandma, but, hey, it's cultural continuity with more compassion. Americans should like that.

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Marilyn Milos, RN

Re #84 and 87 responses. In 1991, as the coordinator of the International Symposia on Circumcision, Genital Integrity, and Human Rights, I presented Dr. Benjamin Spock with our first Human Rights Award for having the courage to admit he'd made a mistake and for saying, "My own preference, if I had the good fortune to have another son, would be to leave his little penis alone." When he received the award, he said, "It's not easy to admit you're wrong because so many people get mad at you!"

Today, with more and more boys being left intact, the question I receive more often than "What can I say to my son when he asks why he's different in the locker room?" is "What can I tell my son, who just asked me why I let someone cut off a part of his penis when his friends have all of their penis?"

I am still amazed, in the 21st century, with our recognition of human rights, including the rights of children, that parents think they have a right to cut off normal parts of their son's normal body. Granted, parents buy into the propaganda that perpetuates this billion-dollar-a-year industry because they want to do what's right for their son. But, is circumcision right? Man has evolved since the beginning of time with a normal, protective, sexually functioning foreskin. Circumcision makes the penis smaller in both size and sensitivity. Ask, any man if that's what he wants and what do you think he'll say? And, all you have to do is listen to the screams of a baby being circumcised or when he urinates or defecates into the raw wound while it heals to recognize that, given the choice, the baby would say "No!"

As for sex for the female, imagine if men asked women to cut a part of their sex organs off to make a male's sex better? Women would be up in arms! Why aren't men? And, is it better for women? European women ask me, "How can American women have foreplay without a foreskin to play with?"

Bottom line: Every person has a right to his own normal body and it is wrong to violate that human right!

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John

One of the potential benefits of staying uncircumcised, "more sensitivity", has always seemed like a negative to me. Enough men have a problem with premature ejaculation without the added sensitivity.

In fact, one of the reasons that I was circumcised late in life (at 22) was to last longer during sexual intercourse. (the health benefits didn't hurt either, but those have been mentioned by several others) I can speak from personal experience to tell you that the ladies like it much better. ;)

Paul

As a 37 year old uncircumcised male, I believe that Tom, in the 12th comment, hit every point about not being cut on the head(pun intended). Other than for religious reasons, there is no reason for circumcision except for cosmetic reasons.

Child Protector

Steven Dubner asks us, "Why is it that, in a country with such a relatively small population of parents whose religion requires them to circumcise their sons, have so many boys historically been circumcised?"

#90 says, "As for sex for the female, imagine if men asked women to cut a part of their sex organs off to make a male's sex better? Women would be up in arms! Why aren't men?"

Because in this society now, most men grew up from earliest infancy already genitally mutilated. They had normal penises only for hours or a few days after birth. They were cursed with the unquestioned presumption that their obviously mutilated, dysfunctional, damaged penises were normal. Then, when they finally did become aware of circumcision, they were more than ready to swallow the fraudulent cultural brainwashing that "mutilated penises are better, for men and women both". We, women and men, never had the opportunity to learn any better. When women grow up genitally mutilated, they usually also support female genital mutilation. It isn't that women are smarter about their sex organs than men. It's that abusing children makes children grow up thinking they're supposed to be abused, that being damaged and mutilated is not only normal, but preferable. What sex the child happens to have been born is irrelevant. Growing up in genitally mutilating cultures makes it very hard to question, learn about, understand and finally reject genital mutilation, whether one is male, female or otherwise. Genital mutilation is one of the most dramatic demonstrations of the power of culture to influence and control thought and perception. If people could actually see what circumcision and circumcising really are, no one would tolerate it. People just can't see it. We are carefully trained not to, and most of us go along with the cultural brainwashing we get. Only a few escape it. It is up to those few of us who have escaped the society's blinders to help our brothers and sisters take theirs off. Yes, that can be an horrendously painful process, for many reasons, but the rewards can be even greater than the pain. We lose the bliss of ignorance, true, but through facing and experiencing the pain - the many pains - we acquire the precious opportunity to gain the wisdom and the courage to protect children from what we have suffered, and that is what really counts here. It isn't anyone alive today that is the real issue. The real issue is the future of the human race long after all of us alive today are gone. That is what is at stake, whether we will bequeath to our posterity the possibility of living good and holy and peaceful lives where full human development is possible, or whether they will continue to be cursed forever to live in a truncated, evil caricature of the magnificent, masterful, peaceful and blissful creatures that we are supposed to be as human beings.

Finally, I have to ask a question of my own. What, exactly, do parents and doctors think they are trying to accomplish by mutilating the sex organs of children that, even IF in fact accomplished, is worth the risk of killing them? Seriously. WHAT? Can anybody tell me?

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Child Protector

#106 - To answer your question, I have no Google alerts.
#102 - If you want to see real hysteria and panic, and a whole lot worse, watch a few circumcisions. I seriously doubt you will be able to see what your eyes are looking at, but give it a try anyway.

The obscure we see eventually, the completely apparent takes longer. - Edward R. Murrow

If the doors of perception were cleansed, everything would appear to man as it is, infinite. - William Blake

We say, “Seeing is believing,” but actually ... we are all much better at believing than at seeing. In fact, we are seeing what we believe nearly all the time and only occasionally seeing what we cannot believe. - Robert Anton Wilson

“It's absolutely horrible. I didn't know how horrific it was going to be. It was the most gruesome thing I have ever seen in my life. I told the doctor as soon as he was done, if I had a gun I would have killed him.” - Melissa Morrison, seven months after watching the circumcision of her baby son

History teaches us that men and nations behave wisely once they have exhausted all other alternatives. - Abba Eban

Mankind has always been ready to discuss matters in inverse ratio to their importance, so that the more closely a question is felt to touch the heart of all of us, the more incumbent it is considered upon prudent people to profess that it does not exist. - Samuel Butler

No one can terrorize a whole nation, unless we are all his accomplices. - Edward R. Murrow

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JorgeM

Al, what would these discussions be like if people like me weren't here?

Al - "I love being cut even though I never knew the other way!"
MD - "I love making money cutting babies!"
JakeW - "Circumcision protects against HIV, bed wetting, and makes your breath fresh!"
Mommy - "I circumcised my son because I was too chicken to stand up to daddy!"

Boring, eh?

Richard Russell

Ref. No. 97, January 4th — Posted by Al

"My god, the anti-circumsision lobby really comes out in full force on these news items, don't they!"

"Do you all have Google alerts set up, dutifully reporting to the comments section upon mention?"

Why gee golly, Al. What an interesting perspective. And why are you here? How did you find out about it? It's a conspiracy if the antis show up? And it's just good, neutral citizens speaking their minds when the pros show up in force?

You don't seem to be much of a member of the "anti-circumcison lobby." So one might be forgiven for believing you are a real, bona fide pro-circumcision type. Actually you seem much more like that chap in Australia who has a really hysterical website set up for wringing his hands in every direction about the declining circumcision rates there and calling Aussie doctors all sort of libelous things because they are letting the practice slowly but surely disappear. For him, every person in favor of circumcision is a "circumcision expert." Those opposed are fanatical idiots. But anyhow while we are at it, he has become so desperate for allies that he has joined with a circumfetish organization in Britain so they can connect their batteries in series to try to jump start The Great Cut in both places. And help preserve it in the Great Home of the Great Cut, the USA.

Wondering what "circumfetish" is? It's obtaining great pleasure from being circumcised as you watch it being done, with your friends and lovers gathered around to watch too. It's having several revisions to get it just right; each one being more pleasurable than the last one, and your friends enjoy watching each revision too. It's obtaining vicarious pleasure in knowing that an infant is being circumcised at almost any time you think about it. Don't believe it? Google up Gilgal Society in UK, or Dr Cornell and circumcision in Atlanta. Put on your BS detector lenses and be prepared to read between the lines. The hard core stuff is illegal or unethical and not blatantly advertised for what it is. But it can be wrapped up quite innocuously in "medical" need, just as is Routine Infant Circumcision in the USA.

But don't be too hard on the fetishists. At the core of it, every circumcision is to some degree done for fetishist reasons. So he can look like Dad? Get real; suppose Dad lost an arm in an automobile accident? Junior gets his arm amputated along with his foreskin? I don't think so, but the penis is an exception. Why, I wonder?

"As a circumsized male, I honestly don't think it's that big of a deal either way…meanwhile, you're setting up websites detailing how my circumsized member INJURES women?"

Al! Al, my man! It's not about your penis. Maybe yours is alright. Maybe not and you are unlikely to own up to any limitations you have noticed until you have worked your way through all the denial and projection you have been indoctrinated with from birth. What it is about is the penis of the next boy set up for a circumcision because his parents think it's a cool idea, or because some doctor wants the cash and did a better selling job on circumcision that any door-to-door vacuum salesman ever did.

Some circumcisions go comparatively well, many do not. And US medicine keeps the wraps on those that do not. Even the best outcome destroys thousands of nerve cells and turns the remaining preputial cavity into an external organ subject to extensive loss of sensitivity over time. For those who oppose circumcision, it's as simple as ending the unnecessary pain and unnecessary risk of catastrophic complications. No conspiracy; no fanaticism. Simple pragmatic compassion, simple common sense. As Canada is now coming out from an under-the-wraps systsem, more and more is being learned about how things go wrong with circumcisions. Check out _As Nature Made Him: the boy who was raised as a girl_, by John Colapinto. New York: HarperCollins, 2000. Or look
into "Paediatric Death Review Committee: Office of the Chief Coroner of Ontario. Circumcision: a minor procedure?" _Paediatr Child Health 2007;12(4):311-2_. For cyber access, http://www.pulsus.com/journals/index.jsp?origPg=journalHome.jsp&jnlKy=5&/12_04/Pdf/zwol_ed.pdf&

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Informed Citizen

Again. I bring this up old habits die hard.

However, a girl's clitoral hood is analogous to a foreskin, like Indonesia they cut off clitoral hoods.

It's American ignorance and stupidity, although thankfully, attitudes are changing. The nytimes had a good article on fgm in africa, and clitoral hood cutting off in indonesia for example.

Although that might not fly because people laugh at the arguments comparing mgm v. fgm. The Anthropolgy association , had someone say well do you call circumcision mutiliation,

Americans run out of excuses for things, healthcare insurance, iraq , circumcision, atleast some people are waking up, but old habits die hard for a lot of people.

Richard L. Matteoli

If this wasn't so serious it would be funny. I can just see it now: "The Gathering" where everyone with their own particular quirk may participate equally.

JorgeM

Al writes that in "it's my understanding that women (every single one that I've ever spoken to about this), prefer circumsized to not."

So what? If a guy wants to get cut to match up with the shallow cornfed preferences of Al's female acquantances, then that's his choice. I hope my son will have higher standards in women, but the choice is his to make when he's an adult.

tom joad

I would just like to point out that the medical profession introduced routine infant male circumcision (for a variety of baseless reasons) - parents didn't go asking for it. At the point where the medical profession started to back off on promoting circumcision (because of the baselessness of the initial reasons) they did little or nothing to put an end to the practice (like refusing to perform unnecessary surgery) let alone encourage and facilitate informed consent. All they have done is issue statements that it is the parents' choice. To me this is the height of irresponsibility. Parents want to do right by their children but can often make decisions based only on emotion or less than accurate information. There are few doctors who will take responsibility and refuse to perform this surgery or even counter the parents misinformation.

And finally, all the discussion on circumcision tends to focus on potential benefits with the assumption that there are no "side effects" or harmful consequences. I always wonder what the basis for this assumption is.

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Informed Citizen

Well, we in American are the laughingstock of the WORLD, we are falling behind in education , healthcare, etc. Why, becuase we have comfort and just do things to go with the flow.

Ya, I'll bring up the mutiliation argument, why not circumcise girls?, cut off their clitoral hoods? The history of circumcision in america also mentioneds articles in the late 19 and early 20 century of circumcision of girls. The same reasons, hygiene, clealiness ,etc just like John Kellog " the application of carbolic acid to the clitoris will cure excitement" .

The PRO-CIRCUMCISERS ARE BIAS becuase they won't consider circumcision (clitoridectomy) for a girl. This is not to be confused with FGM.

The male foreskin is analogus to the female's clitoral Hood. Why not cut your daughter and have her scream in the room or pass out due to shock. It's bias , tradition, old habits die hard, but they will die hard eventually.

Health reasons? That's like flipping a coin on heads and tails to see if you'll get the disease rather than using a condom. Why not cut off your lips or teeth so you'll get fewer cavities.

Bring the arugment on.

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CG

I'll answer the women's preference question (#61) as a Gen-X female - meaning that I and women I know were in a population of mostly circ'd men: we did talk amongst ourselves about this and the general feeling was a sort-of "gross" prejudice about intact. I say prejudice because no one I knew had personal experience with it, but there was talk like "my cousin said her boyfriend's penis had a smell" or "there's always smegma". No one would consider circ'd to be "dry and scarred" so much as "regular."
So "preference" of this nature exists, but isn't really informed and wouldn't hold up when the population changes as it is currently.

Jeff

#61 asks about female preference.

The natural penis is designed by nature to maximize the sexual pleasure for the woman, as well as the man, during intercourse.

Conversely, circumcised sex is known to harm women in at least 10 ways:

http://www.Top10WaysCircumcisedSexHarmsWomen.com

If a woman will take a few minutes to educate herself on how the two kinds of penises perform intercourse differently, she'll know what to look for, and be able to make a clearer judgment on which penis is more likely to give a woman greater sexual pleasure.

Betsy

First - #61 asks about female preference. Every single female friend of mine who has been with both cut and intact men (if they've only been with one or the other they have no way of knowing which they prefer) has informned me that I am very lucky that I have never been with circumcised men. From pictures I have seen of circumcised penises, the intact adult penis looks just as exposed as the circumcised penis when erect. The look is the same except when flaccid. The intact penis only lacks the dryness and scarring of the circumcised penis. I don't see any reason why any woman would prefer dry and scarred to moist and whole. I have no complaints and my friends with circumcised men often have complaints.

If an intact son of mine ended up someday being rejected by a woman who wouldn't be with him because he retained his full penis he would have two choices. DTMFA (dump her immediately, for those who don't read Savage Love) OR choose to be circumcised (I had a friend who chose that and he said it wasn't too bad since he slept through the whole thing and had good pain meds for the healing time).

However, if a circumcised man ends up with a woman who prefers intact, they're both pretty much out of luck. He can partially restore what was lost, but it takes years, is painful, and also quite hard psychologically to face that something so important was taken without consent while he was a baby.

About immigration:

I live in a town near Seattle, WA and I only know one family who circumcises their sons for non religious reasons. This town I live in is as white and well-educated as a town can get. So perhaps it isn't immigrants who are affecting the circumcision rates in the West after all.

The well-educated people in my town appear to know full well that there are no solid reasons compelling enough to justify the removal of a healthy part from another person's body.

If/when I have sons they will remain intact (not circumcised). Not so that they will match their father, but because I believe they should have the final word in such extreme cosmetic surgery on the most sensitive part of their badies.

My father-in-law is circumcised and my husband is not. My husband thinks that the "look like daddy" reason is about as weak an argument as anyone could think up. He's very happy and proud (of his father for not perpetuating the cycle) to not "match" his father in that way. He has his father's face-shape and nose after all. A face is much more visible than anyone's penis since a face isn't kept covered most of the time.

Thank you for taking the time to read my post.

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edelrc

Part of the claimed medical benefices could be the population itself. In Africa (were AIDS is ramping) people that do circumcision are a little better off either economically and educationally, therefore , least exposured to AIDS. If the claim is medical reasons, why hasn´t natural selection gotten rid of it already? Surgical operations should be performed for rare anomalies not to mainstream.

Don´t take me wrong, I do believe circumcision may indeed reduce some infections and even AIDS, but the main reason is because of lack of hygiene… mostly on those societies where “touching” that thing is considered too “filthy” even in the shower.
Also, to a lesser extend… it is like if I cut you off a finger, you will have a 10% less probability of developing a finger infection.

For my kids, I would not circumcised them for sure, not even perforate my daughter´s ears... that is a decision they should take of their own, at puberty. That is because, rather than medical, it is entirely a social/religious manifestation.

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Charles

Any alteration of a minor's body that it is not for proven medical reasons should be illegal.

Al

I'm going to step out on a limb here, but putting all the "practical" concerns aside, it's my understanding that women (every single one that I've ever spoken to about this), prefer circumsized to not.

Can I get some feedback on that one?