Should Circumcision Become Public Health Policy?

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I completely agree with the tone and content of Ms. Kotz's post. When it comes to policy, credibility of the source is as important as the policy itself. Why would the CDC make such controversial policy on the basis of sketchy evidence that doesn't obviously apply to our context? It could reduce their overall credibility. It's not only crucial with health care reform, but the CDC could have to make hard decisions during flu season.
I also would like to say that I welcome the contributions of women to this debate. No other group should be more aware of issues concerning personal control over one's body. Crucially, the women's movement have been concerned for years about parents and the state legally overriding this control.
What is exasperating is how some commentators invoke psychoanalytic explanations regarding people's feelings on circumcision. I've observed that men and female commentators do this equally. But, usually, women commentators who do this get picked out for being women while they should get picked out, with their male cohorts, for being condescending.
Guys like me who care about this sort of thing ought to have no problem with anyone who comments on this topic in the professional way Ms. Kotz does. Men have sexual health issues too. It's a sign of progress if they can be discussed intelligently and openly by both men and women. Further, I think women have a lot more experience holding these kinds of discussions civilly.
Also, women who are not mothers also have a dog in this fight. Foreskins may make men more likely to transmit HPV to women. (HPV greatly increases cancer risk in women). I hope women agree with me that recommending HPV vaccinations for men (which are not available yet, but are in the works) is preferable to recommending routine circumcision. As any resident of NYC in their 30's knows, this issue is not child's play. Neither is recommending a routine surgical procedure.

Dan of NY 12:09PM September 03, 2009

Circumcision is an act of violence against children. The head and foreskin are joined at birth. The medical term for separating the two during circumcision is called "blunt trauma".
What does that tell you? The CDC is advocating blunt trauma for the penises of American newborns.
I witnessed a circumcision accidentally, 35 years ago. I thought the baby was being murdered. Every hair on the back of my neck stood up. I can still hear his screams.
In case you think, 'well, that was then, this is now", and "the AMA has pain relief guidelines now", only 14% of doctors follow that guideline. Without going for the dramatic, this fits the guideline for torture defined in the Geneva Conventions, about flaying people alive. For those who have a hard time picturing how something so routine can be thought of this way, is genital skin the most sensitive part of a human body, or not? I believe it is.
Would you stick a pin through your genital skin? Of course not. But, every day, thousands of boys have their genitals surgically reduced. Every person has the right to determine which healthy body parts they get to keep, and which they get to have removed, ethically speaking. That right is violated so often, no one can keep count. And now, the CDC is advocating it. Absurd, cruel, silly, and more than a little sick!
If most men knew how good it felt to have a foreskin, there would be more lawsuits against doctors who perform this outdated and empty practice.
Why are Americans by far the largest consumers of Viagra worldwide?
Circumcision has been a cure looking for a cause in the US, since 1870. It used to cure insanity, masturbation, paralysis. Then cleanliness. Then penile and cervical cancer. Now, HIV. Perhaps it is time to retire it, with foot binding, female circumcision, and skull shaping. Perhaps someday, we will have a CDC which looks forward, not backward, for answers, and can analyze data from multiple sources.
I may not know the answer, but I know that cutting off healthy tissue in anticipation of a problem is something Americans do with no other body part. We don't remove the breasts of girls whose mothers had breast cancer. Why should we cut off part of our boys?

Tom Tobin of MA 11:43AM September 03, 2009

Name another amputation of healthy body parts which is recommended routinely by any medical group on planet Earth.
Shouldn't this give the CDC pause? It violates the Hippocratic Oath, "first, do no harm", by removing 50% or more of the skin of a penis. What other human part can have 50% of its skin removed, and still have people look you in the eye and say, "Studies have shown that it doesn't lessen sensitivity." Think how absurd that would be, if we were talking about a hand. We're not. We are talking about genitalia.
Why does the CDC think this is a good idea, when it flies in the face of ethics, and of the scientific studies of countries like Britain, Canada, Australia, New Zealand, Sweden, etc?
This is another case of the circumcised becoming the circumcisors, whether or not it makes any medical sense. In case you think of the unfinished African studies designed by Daniel Halperin and other unabashed circumcision cheerleaders as evidence, compare the HIV infection rates of typically uncut European countries, like Denmark for example, with the HIV infection rates of mostly circumcised America. America's infection rates are much higher, and condom use is not popular in Europe. Shouldn't these things be giving the CDC reason to think? A rational person would think so. Perhaps we need some rational, thinking people at the CDC...people who care how our money is spent, and do not see unneeded cosmetic surgery on an unconsenting baby as a cure all. If you have to wear a condom to be safe in addition to the circumcision, and you do, then why perform the surgery at all? Condoms are much, much more effective than circumcision, and you get to keep all of your parts.
What were they thinking? This is truly obscene. Anyone who has seen a circumcision video with the sound up should know that this is the wrong thing to do. Why is it a felony to remove the clitoral foreskin of a girl, but "in the interest of the child's long term health" for a boy? Sexism. Prejudice. The desire to make a fast buck.
Pick any of them. They all apply.
When are we going to wake up? There are at least 4 billion men with foreskins on this planet. If they were really a problem, we would be hearing of their plight, or the complaints of their partners. We are not. What does that tell you? That 120 years of mammal evolution provided nearly every male with a foreskin which is beneficial for his health. We are not born defective. The HIV infection rate in Africa, as measured by the countries themselves, shows no difference between circumcised and uncircumcised men.
American studies show that the HIV infection rate for gay men is not improved by circumcision. African studies show the women of circumcised men to be more likely to get infected, because the men are less likely to wear a condom after being circumcised.
And so the dumb drama continues, with the fires being stoked by the CDC. And one wonders who benefits from the $250 million plus a year cut industry

Tom Tobin of MA 11:30AM September 03, 2009

I wonder if the CDC will recommend female genital circumcision [called "female genital mutilation" by hypocrites here] as a routine procedure? After all if you chop off a woman's clit then she'll feel less sexual pleasure; leading to less sexual activity; and a lower incidence of transmission of HIV.
I say that we should leave it to each individual person to decide whether the loss of sexual pleasure, and irreversible body modification is worth the benefit of having a slightly lower chance of contracting Aids. Especially considering the current odds of a heterosexual male becoming infected with AIDS after one episode of penile-vaginal intercourse with someone in a non-high-risk group without a condom are one in 5 million. With a condom it's even safer--one in 50 million. According to a report by researchers Norman Hearst and Stephen Hulley in the Journal of the American Medical Association.
Because circumcision lowers the sexual sensitivity of a penis, therefore lowering the numbers of males who use condoms [have you ever tried to take a relaxing shower with a raincoat on?], one could argue that circumcision has facilitated the spread of aids more then it has hindered it. The fact that males here are circumcised and males in Europe and Asia largely aren't helps explain the much higher condom usage rates there.

Mike Hunter of FL 10:56AM September 03, 2009

There is a reason the rest of the civilized world looks at the US like the backwards nation we are. 85% of the males on this planet are intact, and fewer than 1% of them will ever require surgical intervention on the foreskin. Meanwhile we are cutting just over half of our baby boys, killing about 200 of them every year from the procedure, while we protect our girls' genitals from so much as a ceremonial pin prick. Anyone else notice the hypocrisy?
We've tried circumcision in this country for 150 years, and it's never been proven to prevent anything but normal sexual function. Half the skin system of the penis, the 4 to 5 most sensitive areas of the penis, anti-viral Langerhans cells (shown to capture and consume HIV-1), the Ridged Band of muscle, a rich blood supply, protection of the glans from abrasion and UV (as the glans is a mucous membrane and has no pigment since it's intended to be internal 99% of the time), all of those benefits: gone. Along with his right to a healthy, intact body, and his choice to alter it as an adult. Cleaner? Myth. Penile & cervical cancer? The American Cancer Society says no. STDs? UTIs? Studies are conflicted at best and nothing has been proved. And now we're going to base public health policy on the flawed study of a culture totally foreign to our own?
What we are seeing are the death throes of our for-profit medical system as we join the 21st century and start focusing on real cures and real science.

TD of WA 10:49AM September 03, 2009

In terms of the science, it is inaccurate to say that "the virus is largely transmitted through homosexual contact."
I guess that what Deborah Kotz meant was that a lot of transmission occurs through anal sex, which is performed both by homosexual AND heterosexual men and women.
As such it is indeed fundamental to find out how much circumcision will protect American men from being infected with HIV when engaging in unprotected anal intercourse with other men AND women.

Roger 9:30AM September 03, 2009

Circumcision is the most damaging epidemic. In 100% of all cases it destroys the healthy glans and urinary tract protecting shield of the victim's genitals. Circumcisers amputate highly erogenous and sexually important skin from the penis and the painful procedure leaves physical and emotional scars for life and in many cases children even die from this insanity of genital torture, some have even lost their genitals. Evil lies and profit don't justify the torture and mutilation of children. Time to bring those evil pricks to justice!

Michael WarriorOfLove of CA 4:04AM September 03, 2009

What a stupid and antagonizing question? Do those sick psychopaths that stand behind this evil sex crime really think they get away with those brain sick, sadistic and cruel proposals? Paragraph 18USC116 protects girls from genital mutilation. According to the 14th amendment of the American constitution boys and inter sexed children are therefore automatically protected too. I ask in response to this insult on all people of America and the world, should the government enforce the already existing laws against genital mutilation and child abuse and throw all circumcising genital torturing pricks into prison for life so they can think about the evil pain and injuries they have inflicted on children's genitals and the damage they done to this world or should the death penalty be mandatory for all of them? We, the awakening and uniting people of this world have had enough of watching those sick perverted parent deceivers and child torturers doing their evil work and smearing their deceiving lies all over the media. We will bring all the promoters of this disgusting sex crime and their evil adjutants, those who actually have the nerve to stick knives into helpless crying children's genitals, to justice! Enough is enough!

Michael WarriorOfLove of CA 3:36AM September 03, 2009

Circ decreases F->M HIV transmission rates but more than compensates by INCREASING M->F rates via vaginal abrasion. This is supported by both lab and field studies, most notably the fact that the US has the highest HIV rate in the industrialized world and the second highest rate of circ, second only to Israel.
By the way, FGM reduces M->F transmission by the same amount as circ reduces F->M transmission, which is probably indicative of the similarity of the type and amount of genital tissue which each type of mutilation removes. I don't know of anyone who would consciously consent to the removal of ecstatic erogenous genital tissue from themselves or their children.

Rich Winkel of MO 11:45PM September 02, 2009

Why can't everyone, especially the government, just leave little boy's penises alone? It is their penis and if they choose to have part of it cut off when they are adults, that is their choice. For those that say it needs to be done as a baby because adults won't go get it done, maybe that is because men that have foreskins like them and are not interested in parting with them. Keep your recommendations and you hands away from our penises!

Damon of NC 11:56AM September 02, 2009