Wednesday, November 29, 2006

Circumcision as STI Prevention?

The New Zealand study which found that circumcision reduces the risk of STI infection in males has been showing up everywhere. When I first saw I thought about blogging it, but I couldn't quite gather my thoughts enough to be coherent.

Generally speaking, I've had better luck with circumcised men. Since my most serious relationship was with a Jewish man, I spent years assuming that my little baby boys would be circumcised. I gave some thought to it at that point -- what it meant as a sign of the covenant, whether it made sense even if the children wouldn't be raised Orthodox -- but since then I haven't had the opportunity to reevaluate my thoughts on the subject. The only way it enters my consciousness now is when I hear about anti-circumcision activism, which often likens the removal of the foreskin to female genital mutilation. That kind of rhetoric terrifies me. They're not comparable. Period.

So when a close friend told me this afternoon that his sons would never be circumcised, I was surprised. And nervous. I asked why, but I wasn't sure I wanted to know the answer. If he said anything about FGM, I was going to be pretty upset. Instead, he shocked me by offering an incredibly sensible argument against circumcision:
There was a recent study published that uncircumcised men are more likely to end up with STIs and I fear that parents will run with that. If your son knows how to protect himself he doesn't need to lose his foreskin for it. And if he's taught how to clean he'll be clean. And if he's taught that it's ok for his to look different than his classmates' he'll be ok with that, too. It doesn't make sense to change someone's anatomy for your own comfort.

And suddenly, my entire perspective shifted. He's right! Sure, circumcision can reduce the risk of STI infection in men. But using a condom can too, and if we would just instate comprehensive sexuality education maybe we wouldn't need to perform genital surgery on infants. How silly does it seem to surgically alter the bodies of our children rather than just educate them about safer sex?


Ron Low said...

Female "circumcision" is less harmful than male circumcision, which removes over half the sensual nerve endings. Female circ (removal or slitting of the hood only) actually has some medical indications and some people who rationally choose it for cosmetic reasons. The reason male and female circ are NOT comparable is that even a pin-prick is illegal for a female while a risky amputation in a male is allowed and often celebrated.

Female "mutilation" on the other hand (clitoridectomy and infibulation) is by any rational standard always monstrous.

Fergusson has basically recanted the NZ results already. See his note in Pediatrics:

He re-affirms the AAP policy that the benefits/risks don't justify routine circ.

Amanda said...

Thanks for pointing out the authors' response to peer criticism. I think it's important to note that while "we are of the view that it would be premature to use our findings to promote the view that circumcision reduces risks of less severe forms of STI, until further research clarifying this issue is conducted," they're also clearly indicating that there's a good chance that the problem lies with the other contradicting studies and not with their own. They haven't "recanted" at all, they only aknowledge that more research is needed.

Anonymous said...

I was circumcised with the best medicine and intentions available for a baby on the cusp of the boom and Gen X.

In other words, I was molested. If I ever see that obstetrician, I'll sue the bastard!

Tanya said...

Just to play devil's advocate, have you taken a look at all the studies that show how unsuccessful education and knowing one's status has been in actually changing behavior, regardless of condom availability, in most places?