Comment Of The Day: “Ethics Quiz: As The Founders Roll Over In Their Graves”

This was one of those times that a last minute addition to a post attracted more commentary than the main topic. Discussing a city ordinance permitting animal sacrifices for religious purposes, I asked, “Is circumcision the slippery slope that brought us to this ridiculous point of cultural confusion?” This sparked extensive discussion. “Male circumcision” has been a tag on two EA articles,  but the blog has neglected the issue, for reasons too painful to go into. Humble Talent, in a discussion with Ryan Harkins, remedied that failing with gusto, in two successive comments that I’m stitching together here as a single Comment of the Day on the post, “Ethics Quiz: As The Founders Roll Over In Their Graves”:

***

“Most of those men have to then have a circumcision, and as an adult, it is far more painful than as a baby.” [Ryan Harkins]

This is not true. It’s actually more painful for the baby. At the normal point in development the procedure occurs, the foreskin is adhered to the tip of the penis by the same kind of connective tissue that holds fingernails to nailbeds. If left, that tissue eventually breaks down, but the reality is that for babies, you’re doing something on par with pulling a fingernail out before doing the exact same thing that adult men who experience circumcision call extremely painful.

It’s the exact same pain, except in children it’s usually conducted without anesthesia. You just don’t remember it.

“Circumcision is often performed on infants without anesthetic or with a local anesthetic that is ineffective at substantially reducing pain (Lander et al., 1997). In a study by Lander and colleagues (1997), a control group of infants who received no anesthesia was used as a baseline to measure the effectiveness of different types of anesthesia during circumcision. The control group babies were in so much pain—some began choking and one even had a seizure—they decided it was unethical to continue. It is important to also consider the effects of post-operative pain in circumcised infants (regardless of whether anesthesia is used), which is described as “severe” and “persistent” (Howard et al., 1994). ”

But while you might not remember, your body does.

“We tightly strapped an infant to a traditional plastic “circumstraint” using Velcro restraints. We also completely immobilized the infant’s head using standard surgical tape. The entire apparatus was then introduced into the MRI chamber. Since no metal objects could be used because of the high magnetic fields, the doctor who performed the surgery used a plastic bell with a sterilized obsidian bade to cut the foreskin. No anesthetic was used.

The baby was kept in the machine for several minutes to generate baseline data of the normal metabolic activity in the brain. This was used to compare to the data gathered during and after the surgery. Analysis of the MRI data indicated that the surgery subjected the infant to significant trauma. The greatest changes occurred in the limbic system concentrating in the amygdala and in the frontal and temporal lobes.

A neurologist who saw the results postulated that the data indicated that circumcision affected most intensely the portions of the victim’s brain associated with reasoning, perception and emotions. Follow up tests on the infant one day, one week and one month after the surgery indicated that the child’s brain never returned to its baseline configuration. In other words, the evidence generated by this research indicated that the brain of the circumcised infant was permanently changed by the surgery.”

And that leads to measurable negative outcomes:

“Research has demonstrated the hormone cortisol, which is associated with stress and pain, spikes during circumcision (Talbert et al., 1976; Gunnar et al., 1981). Although some believe that babies “won’t remember” the pain, we now know that the body “remembers” as evidenced by studies which demonstrate that circumcised infants are more sensitive to pain later in life (Taddio et al., 1997). Research carried out using neonatal animals as a proxy to study the effects of pain on infants’ psychological development have found distinct behavioral patterns characterized by increased anxiety, altered pain sensitivity, hyperactivity, and attention problems (Anand & Scalzo, 2000). In another similar study, it was found that painful procedures in the neonatal period were associated with site-specific changes in the brain that have been found to be associated with mood disorders (Victoria et al., 2013).”

And it carries on throughout your life:

“Neonatal male circumcision is a painful skin-breaking procedure that may affect infant physiological and behavioral stress responses as well as mother-infant interaction. Due to the plasticity of the developing nociceptive system, neonatal pain might carry long-term consequences on adult behavior. In this study, we examined whether infant male circumcision is associated with long-term psychological effects on adult socio-affective processing.

Early-circumcised men reported lower attachment security and lower emotional stability while no differences in empathy or trust were found. Early circumcision was also associated with stronger sexual drive and less restricted socio-sexuality along with higher perceived stress and sensation seeking.”

What always frustrates me about this conversation is that this isn’t medically controversial, these studies have been replicated ad nauseum. Look at those dates! We’ve known this for more than 50 years. But it’s socially controversial, and I can’t tell whether it’s a religious thing, or a cultural thing, or a “it was done to me so it should be done to you” attitude, but the reality is that the United States of America is traumatizing 70% of it’s boys because they *might* have a sanitary issue later in life and need the surgery anyway, and it’s somehow butter to perform the surgery when it does life changing neurological damage, but you can’t remember it because it happens before you start to form memories….

Consider what would the control here would be: They’re telling you to cut the skin off your son’s penis because it might cause an issue later in life, and most American parents are doing it without a whole lot of research. I mean… Having a non-necessary surgery, consequences be damned, because it might cause a problem later in life *does* seem like the kind of control progressives love.

Why don’t we hear more about that? Well…. One of my sources above (I omitted links so the comment didn’t spam, but could share them if you’d like) addressed that directly:

“Our problems began when we attempted to publish our findings in the open medical literature. All of the participants in the research including myself were called before the hospital discipline committee and were severely reprimanded. We were told that while male circumcision was legal under all circumstances in Canada, any attempt to study the adverse effects of circumcision was strictly prohibited by the ethical regulations. Not only could we not publish the results of our research, but we also had to destroy all of our results. If we refused to comply, we were all threatened with immediate dismissal and legal action.”

Why would that be? I think it’s multifaceted, but two of the bigger reasons would be that:

1) The medical profession, at least in North America, has deemed the benefits of circumcision to outweigh the issues caused by it. This might change if we ever start to really address mental health in a serious way, or think about it for a while, but it is what it is.

2) Cultural reasons. If we started talking about circumcision as male genital mutilation or just generally as being abusive, you’ll inevitably fall on a a couple of third rails: Jews and Muslims. These are holy rituals for them, and it doesn’t take a whole lot of imagination to see how that might fall out, more for whatever reason America has really bought into circumcision*, and you’d risk offending a whole lot of parents who followed the advise of their healthcare professionals.

*Significantly more than anywhere else in the West, and more than most of the world. America has a 70% circumcision rate. Canada has a 30% rate, The UK has a 20% rate, France and China are tied at 14%, Germany 10%, Greece has a rate less than 4%. Meanwhile, you could draw a circle around the middle east and safely assume that the countries within that circle have a 90%+ rate. Majority circumcision rates outside that circle are relegated to Muslim majority African and Asian nations.

Which kind of takes me to the last obvious point: Most European Nations have circumcision rates less than 20%, and in most of those, the majority of circumcised boys are Jewish or Muslim. Europe doesn’t have a dick-sepsis epidemic. This idea that we have to cut half the skin off men’s dicks or they’re likely to face infection is not held up by the reality that most of the world doesn’t circumcise, and they don’t have dickrot epidemics. Unless… Again… American exceptionalism means that American boys are exceptionally unhygienic.

14 thoughts on “Comment Of The Day: “Ethics Quiz: As The Founders Roll Over In Their Graves”

  1. “Early-circumcised men reported lower attachment security and lower emotional stability while no differences in empathy or trust were found. Early circumcision was also associated with stronger sexual drive and less restricted socio-sexuality along with higher perceived stress and sensation seeking.”

    Being a longstanding member of the “hygienic American” cohort, that takes my breath away.

    • I am always extremely skeptical of these sociological studies as they generally suffer from a reproducibility problem (https://www.wired.com/story/social-science-reproducibility/) and generally can be made to say whatever the researchers want them to say.

      I’m also skeptical of “A neurologist who saw the results postulated that the data indicated that circumcision affected most intensely the portions of the victim’s brain associated with reasoning, perception and emotions. Follow up tests on the infant one day, one week and one month after the surgery indicated that the child’s brain never returned to its baseline configuration. ” This is not science but postulation by a particular scientist, as brain scans are notoriously unreliable as well (https://www.theguardian.com/science/neurophilosophy/2015/apr/09/bold-assumptions-fmri).

      I don’t want to pick on Humble, but it sounds like he/she is emphatically on one side of the issue and cherry picking studies that support a predetermined point of view. With respect to Humble, it reminds me a bit of the “listen to the science” about the Covid vaccine.

      • You can pick on individual assertions, but the reality is that the permanent neurological changes caused circumcision have been studied extensively, the studies have been reproduced, and the medical science is basically uncontroversial. The social aspect of it, the “what does that mean?” or “what do we do?” is, admittedly, much more controversial.

        But don’t take my word for it: Google it.

        Because you’re right, I’m biased on this. We talk about bias like it’s a bad thing, like someone having a bias means they’re being unreasonable, or their word is less trustworthy… But that’s not really what bias is. A jury walking into the courthouse the first time ought to be as close to unbiased as we can manage, but by the end of the trial, the process requires that they be biased enough, for or against the defendant, in order to supply a verdict.

        Once you dig into this, there are very few examples of something so obviously, callously indifferent to the suffering of children, so detrimental to their future development, that we could avoid by not performing an unnecessary surgery. If that doesn’t bias you, I think that says something about you.

    • I’m not blaming our current mental health epidemic on circumcision. I want to repeat that: I’m not blaming our current mental health epidemic on circumcision. I am. NOT. Blaming our current mental health epidemic on circumcision.

      But… North American circumcision rates peaked in the late 80’s coinciding with messaging from various health organizations that it was the right thing to do. That cohort of men is making their way to middle-age now. Circumcision *may* have *exacerbated* the current mental health crisis.

  2. Can’t say I’m shocked by what HT put together, though I didn’t know the literature about the downsides of male circumcision was prolific, old, or suppressed. There are a lot of issues associated with how routine the procedure is, and its negligible health benefits (and apparent health deficits), especially in modern societies and situations.

    One of the theories I am a fan of is that a lot of things probably did serve a hygienic purpose when the religious dogmas that pushed for them got enacted – a huge amount of the tenets of Judaism and other contemporary religions is dedicated to codifying standards of hygiene and hygienic behavior – but because the reasons behind the causes of the issues weren’t widely known, the default was to say “because god wills it!” Washing the feet of travelers? Lets you check for worms, avoids having anything they walked through come into your house and contaminate you and you livestock, and increases overall cleanliness of the household – also allows you to get shoes that might damage interior furnishings off. Dietary restrictions like kosher and halal? Helps to reduce food illnesses and bacteria from spreading between different types of food in a kitchen, so that when someone says the lamb at Abel’s food place is off today, you have choices of something else to eat (and Abel can throw it out, instead of having to throw out everything).

    So, I suspect that at one point in time, male circumcision probably did offer benefits to wide swathes of the population; looking through history, standards of cleanliness and hygienic behavior were often FAR below modern standards. As we’ve moved towards a better state, the need has been lessened. But here in America, where willingness to talk about anything involving sexual organs has always been relegated by puritanical prudishness? It may very well make sense that societally, we found infant circumcision the easier option. I definitely recall the few times that we got sex education in school for me, images of male anatomy depicted the circumcision of men as being common and normal state of things. That it had been done to me was not something I really came to understand until sometime when I was in college. When I asked my own non-religious parents about why I had been circumcised, the answer I got was revealing – they were never even asked if they wanted me to be, it was simply done by the doctors.

    Some day we’ll ditch the practice, recognizing it as the genital mutilation it is, and I would like to believe we’ll reach that day sooner than later.

  3. Data doesn’t prove values.

    “we now know that the body “remembers” as evidenced by studies which demonstrate that circumcised infants are more sensitive to pain later in life”

    Can someone demonstrate that this is a bad thing?

    “found distinct behavioral patterns characterized by increased anxiety”

    As compared to what? And to what level? Anxiety is going to exist in life regardless. Does this elevate people to an unhealthy level or does it bring people up from a “completely unanxious mindset” (that never seeks to improve their security ever). Again, can someone demonstrate that this is bad? Or is this just a “we noticed a little bit more than normal, but not outside of healthy ranges”.

    “altered pain sensitivity”

    Can someone demonstrate that this is a bad thing?

    “hyperactivity, and attention problems”

    As compared to what? “Hyperactivity” is a perennial ‘problem’ in boys since boys existed according to modern analysts who are eager to tamper boys’ natural inclinations. I question the motives of those who think boys’ energy levels are problematic. So I’d love to know the angle these researchers come from.

    “Early circumcision was also associated with stronger sexual drive”

    Can someone demonstrate that this is a bad thing?

    “and less restricted socio-sexuality”

    Whatever that even means.

    “along with higher perceived stress and sensation seeking”

    Can someone demonstrate that this is a bad thing? Perceived stress? Compared to what? Some mellowed out dude that never leaves the couch? Ok.

    Data doesn’t inform values. It only allows people to decide if values are being pursued or not.

  4. Most European Nations have circumcision rates less than 20%, and in most of those, the majority of circumcised boys are Jewish or Muslim. Europe doesn’t have a dick-sepsis epidemic.

    They could probably afford to have some of the sex drive that comes with circumcision. And maybe a little bit of the elevated stress and anxiety.

    I’m not impressed.

  5. As promised, I spent some time looking into the papers that Humble Talent cited, and I have to admit right off that I cannot deeply comment on the field. Starting research into a new area take time. You start by reading some papers, you see whom they cite and who cited them. You look for surveys that examine a host of other papers in hope that gives a clear picture of the field. So, I was able to find and read in depth the Landry paper (Comparison of Ring Block, Dorsal Penile Nerve Block, and Topical Anesthesia for Neonatal Circumcision). I was able to find the abstract for the Howard paper (which I believe is Acetaminophen Analgesia in Neonatal Circumcision: The Effect on Pain), but in my limited search the only full text I could find was pay-walled. I also found the Taddio pay-walled, if it is Effect of neonatal circumcision on pain response during subsequent routine vaccination.

    I also looked for some surveys, and I found one not pay-walled from 2022, which I examined because it was so recent that hopefully it would have caught any latest developments. This survey, Critical evaluation of contrasting evidence on whether male circumcision has adverse psychological effects: A systematic review, was compiled by members of a group called “the Circumcision Academy of Australia, a not-for-profit, government registered, medical association that provides evidence-based information on male circumcision to parents, practitioners and others, as well as contact details of doctors who perform the procedure.” This group claims that they are neither for or against circumcision, but are trying to provide accurate information about what effects circumcision does and does not demonstrably create.

    I could spend a lot more time trying to argue one way or another about this topic, but again, I’m a relative neophyte in the field and need a great deal more research. But from my brief research, I will say that what discovered is the following.

    1. There is a group of people who are aggressively hostile toward circumcision, and the verbiage they use attacks they make lead me to believe their crusade is far more personal in nature than evidence-based. This is not to say they don’t have strong evidence. I have not reached a conclusion one way or another; people with a passion for a subject often are compelled to search and research everything they can on that subject.

    2. There is no doubt that infants suffer a great deal more from circumcision when there is no anesthesia. But that should come as no surprise. Thus current medical recommendations, since 1999, have been to administer anesthesia before circumcision.

    3. The papers that I have briefly looked at suggest that the long term pain sensitivity caused by circumcision, or any psychological problems thereafter, are not settled. There are papers that state that there are no long term psychological problems, and others that state there are. I’ve not done an extensive enough survey to conclude if there is preponderance of evidence one way or the other, but I have noted some complaints leveled against the studies. Namely: small sample sizes, self-selected sample pool, lack of rigorous longitudinal studies, and failures to exclude other possible contributing causes.

    4. I am already dead set against the term mutilation when applied to circumcision. Mutilation is to take a functional and aesthetic feature of the human body and either make it dysfunctional or deformed. Circumcision does not make the penis dysfunctional. Circumcision does not hamper urination or sexual conduct. In fact, the papers that Humble Talent cited state that circumcised men are more sexually active that non-circumcised men. Since I found that claim on both sides of the debate, I will take that as accepted, and proof that circumcision does not sexually stunt men. As for the aesthetics, apparently Williamson and Williamson (Women’s Preferences for Penile Circumcision in Sexual Partners) found that more than 70% of women find a circumcised man more sexually attractive.

    5. I haven’t found “dickrot” in a medical journal yet, but I have found that the World Health Organization is strongly promoting circumcision to battle the spread of HIV. (That the WHO promotes circumcision is, in my mind, the strongest argument against circumcision.) But circumcision seems to be effective at significantly reducing UTIs, the spread of HIV and other sexually transmitted diseases, and even penile cancer. But the condition I was referring to, phimosis, when the foreskin “gets stuck” and does not allow the glans to emerge, is far from uncommon, especially among the elderly. For children under 3, apparently there are studies that state anywhere from 4% to 11% of uncircumcised boys suffer a form of phimosis that requires medical treatment, with circumcision being the most common. (cf Prepuce: Phimosis, Paraphimosis, and Circumcision, by Hayashia, et al, 2011.)

    6. Regarding the pain an infant suffers versus and adult, two factors stand out to me. First, an adult will require a fair amount of stitches, whereas for an infant a special cone is used. Second, an adult will be required to minimize movement for up to six weeks. An infant doesn’t do a great deal of moving around, and so is nowhere as encumbered by the process.

    So, that’s my report. It isn’t worth writing up a new survey, much less to start into a research paper or a master’s thesis. There body of literature isn’t small, and it will still take some time to sort through what is out there.

    • 1. There is a group of people who are aggressively hostile toward circumcision, and the verbiage they use attacks they make lead me to believe their crusade is far more personal in nature than evidence-based.

      I feel this. I think it’s because there’s an issue, an obvious issue, in something that is, at best, neutral, being touted as not only beneficial, but necessary, and preferred. Sons are being circumcised without parental consent. People will even bristle at the idea that circumcision is “neutral”, it has hygienic benefits! It could prevent UTIs. Sure… We could also remove the gallbladder and appendix, orders of magnitude more people die from either than UTIs, it would be safer, cheaper, the scar would be smaller and you wouldn’t remember feeling the pain. Sound absurd? It is. That’s not how we think about anything other than circumcision.

      And were we talking about almost anything else, we would not have these hang-ups. This is cultural.

      If circumcision were not a religious ritual, if prior to 2023 no one had ever heard of it, what likelihood, do you think, would there be of it passing muster?”

      2. There is no doubt that infants suffer a great deal more from circumcision when there is no anesthesia. But that should come as no surprise. Thus current medical recommendations, since 1999, have been to administer anesthesia before circumcision.

      Medical recommendations, which are not uniformly adhered to. And chew on that for a second… Why are we ever supplying anesthesia? Why is not even an option?

      3. The papers that I have briefly looked at suggest that the long term pain sensitivity caused by circumcision, or any psychological problems thereafter, are not settled. There are papers that state that there are no long term psychological problems, and others that state there are. I’ve not done an extensive enough survey to conclude if there is preponderance of evidence one way or the other, but I have noted some complaints leveled against the studies. Namely: small sample sizes, self-selected sample pool, lack of rigorous longitudinal studies, and failures to exclude other possible contributing causes.

      The difference is that the pro-circumcision lobby never tries to prove that there aren’t any adverse experiences stemming from circumcision. Not for many things in science, that’s OK: Someone has an assertion: “The pain caused by a circumcision is so intense that it permanently changes and damages brain function”. You have to prove that. Like you said, there’s a whole lot of studies out there that does just that, and there’s a whole lot of studies poking holes in them. I hesitate to call your link a study, but they do this exact thing over and over again:

      O’Connor described a study of 1,072 Filipino boys who were circumcised under medical conditions, and 505 who underwent ritual circumcision.The researchers reported that a majority of the boys fulfilled the diagnostic criteria for PTSD. [37] The CDC was “unable to determine whether the results show any statistically significant differences.” [19] And given the lack of a control group of uncircumcised boys, the study is unusable.

      Ok. Fair. There’s no control group because the circumcision rate in that area is 95% and no control group is functionally possible. Do we have any inkling on what might be causing a majority of infant boys across the entire country to exhibit symptoms of PTSD? How could it be that the majority of an entire nation’s boys are traumatized and no one seems to have any idea what happened or express any curiosity on why?

      Remember what I said before? Someone has an idea, you have to prove that idea?

      If circumcision were not a religious ritual, if prior to 2023 no one had ever heard of it, what likelihood, do you think, would there be of it passing muster?”

      4. I am already dead set against the term mutilation when applied to circumcision. Mutilation is to take a functional and aesthetic feature of the human body and either make it dysfunctional or deformed. Circumcision does not make the penis dysfunctional. Circumcision does not hamper urination or sexual conduct. In fact, the papers that Humble Talent cited state that circumcised men are more sexually active that non-circumcised men.

      I’m not set against it, but I don’t use it because it’s awkward. Food for thought though: The exact argument you made could be made about female genital mutialtion: Women can still urinate and perform sexually, after all.

      As for the aesthetics, apparently Williamson and Williamson (Women’s Preferences for Penile Circumcision in Sexual Partners) found that more than 70% of women find a circumcised man more sexually attractive.

      I’m not sure about you, but I’m not exactly thrilled by the idea of an elective plastic surgery to net shallow women. Particularly one I have no say in. Maybe that’s just a me-thing.

      5. I haven’t found “dickrot” in a medical journal yet, but I have found that the World Health Organization is strongly promoting circumcision to battle the spread of HIV. (That the WHO promotes circumcision is, in my mind, the strongest argument against circumcision.) But circumcision seems to be effective at significantly reducing UTIs, the spread of HIV and other sexually transmitted diseases, and even penile cancer. But the condition I was referring to, phimosis, when the foreskin “gets stuck” and does not allow the glans to emerge, is far from uncommon, especially among the elderly. For children under 3, apparently there are studies that state anywhere from 4% to 11% of uncircumcised boys suffer a form of phimosis that requires medical treatment, with circumcision being the most common. (cf Prepuce: Phimosis, Paraphimosis, and Circumcision, by Hayashia, et al, 2011.)

      The entire global incidence rate of deaths caused by UTIs is about 40,000 a year. There are more than 250,000 burst appendixes every year in America alone, and every single one is life threatening.

      If circumcision were not a religious ritual, if prior to 2023 no one had ever heard of it, what likelihood, do you think, would there be of it passing muster?”

      6. Regarding the pain an infant suffers versus and adult, two factors stand out to me. First, an adult will require a fair amount of stitches, whereas for an infant a special cone is used. Second, an adult will be required to minimize movement for up to six weeks. An infant doesn’t do a great deal of moving around, and so is nowhere as encumbered by the process.

      Infants wear diapers.

      • Blech…. Too much typing too fast… something something….

        First paragraph:

        “I feel this. I think it’s because there’s an obvious issue with something that is, at best, neutral, being touted as not only beneficial, but necessary, and preferred. It’s frustrating to watch people have this conversation as if what’s happening is fine.

        Sons are being circumcised without parental consent. In what universe is that OK?

        Meanwhile, people will even bristle at the idea that circumcision is “neutral”, because it has hygienic benefits! It was done to them. It increases sex drive. It’s more physically appealing. It could prevent UTIs. Choose your fallacy, because that’s all they are. You’re still performing an excruciating, mind altering surgery on an infant for really tenuous reasons.

        Take the UTI prevention: Sure! We could also remove the gallbladder and appendix while we were at it. Orders of magnitude more people die from complications with either than do from UTIs. It would be safer, cheaper, the scar would be smaller and you wouldn’t remember feeling the pain. Sound absurd? It is. Because that’s not how we think about anything other than circumcision.”

        Second paragraph:

        “Medical recommendations, which are not uniformly adhered to. And chew on that for a second… Why are we ever supplying anesthesia? Once you have the answer… why is not using it ever an option?”

        • Yeah, I hate when I’m trying to lay out an argument, and I’m in the groove, and then discover (half the time after posting) that I have a ton of typos or other errors. My most common at the moment are leaving out the word “not” (THAT doesn’t change the meaning of sentences at all, does it?) and leaving -ing endings off of verbs.

          I just have a couple of brief replies here, and then I’ll leave this be until I have a chance to research more.

          The difference is that the pro-circumcision lobby never tries to prove that there aren’t any adverse experiences stemming from circumcision.

          The papers that I have seen briefly (and have not evaluated quality or substance) seem to refute that there is any long-term adverse effects from circumcision. In regards to my earlier comments regarding science and its role, the first question regarding some observed phenomenon is “Is it real?” Those who are proposing that circumcision is harmful are putting forward research saying it is. Those who argue against any harm from circumcision seem to be either pointing out flaws in those papers or taking the same data and re-crunching the numbers and coming to different conclusions. But the real question here is even, what is the phenomenon we’re looking at? With climate change, we have at least the phenomenon of rising global temperatures. With circumcision, the phenomenon is…what? All the claims regarding the harm of circumcision make links with conditions such as heightened pain sensitivity, emotional disconnect, sexual dysfunction, poor body image, and other things that all have a thousand other possible explanations. There is nothing that I have seen claimed by the circumcision-is-harmful lobby that stands out as a “this could only be caused by circumcision.” Thus it seems difficult for the circumcision-is-not-harmful lobby have any positive research in that direction, as that would be an effort to prove a negative.

          How could it be that the majority of an entire nation’s boys are traumatized and no one seems to have any idea what happened or express any curiosity on why?

          The study, from what I can tell, describes not infants, but boys who are 7 years old or so, and are circumcised in mass. Also, these boys are from the Philippines, which is a very poor country, and has seen trouble. In glancing over the study, over half the boys initially considered for the study had shown supposed signs of PTSD prior to their circumcisions. The study gave a questionnaire to boys in an age rage, asking them to rate their emotional health and how their circumcisions impacted them. From those surveys, the diagnosis of PTSD was determined. To me, this study reeks of poor science. And it did not address anything along the lines of, “if half the boys surveyed were rejected because they showed prior trauma, what the hell is going on in the Philippines in the first place, and how might that figure into perceived circumcision trauma?”

          On the other hand, the CDC rejected this study, and (given my biases) that lends more credibility to the study…

          The exact argument you made could be made about female genital mutilation.

          Full stop. Female circumcision removes some combination of the inner labias, outer labias, the clitoral hood, and the clitoris itself. The only part of that anywhere close to analogous to male circumcision is maybe the removal of the clitoral hood. But the rest actually impairs the function of the woman’s genitalia because it is both intended and succeeds in preventing a woman from feeling sexual pleasure. The practice itself is meant to force a woman into a faithful relationship with her husband by preventing her from seeking sexual pleasure with another man. And when you get into some of the world cultures where a woman’s vagina is sewn shut and only her husband is allowed to remove the bindings so he can have sex with her. These processes are intended to be demeaning, degrading, and dominating. There are no medical justifications here. So no, the exact argument could not be made about female circumcision. Not in the slightest.

          The entire global incidence rate of deaths caused by UTIs is about 40,000 a year. There are more than 250,000 burst appendixes every year in America alone, and every single one is life threatening.

          If the point here is that if we promote circumcision to prevent UTI deaths, we should promote proactive appendix removal to prevent deaths caused by burst appendices, then to a degree I agree. However, even done laparoscopically, the removal of the appendix is an invasive surgery. That is a factor to weigh. But given the short amount of time between when appendicitis is recognized and the appendix bursting, I almost think it makes more sense to do an appendectomy ahead of any infection. But then again, I don’t know the rate of complications from the surgery, or how that would change if we did them proactively, or the rates of appendicitis, and so on.

          If circumcision were not a religious ritual, if prior to 2023 no one had ever heard of it, what likelihood, do you think, would there be of it passing muster?”

          A counterfactual like that is not terribly helpful. If it had never been heard of, did some small fraction of men just have to accept their shrinking foreskin cutting blood flow to their glans? I know that’s not a huge number of people, but it does show just one tiny problem with trying to imagine a world in which circumcision had never been heard of.

          And where we are at today is unbelievably weird. We’re entering into a society where it is acceptable to cut off penises and breasts to give one the appearance of the opposite sex, and while that is currently being met with disapproval by the vast majority of people, it is gaining traction. We’re also in a society where politics is so intermingling with the perception of science that it seems the general acceptance of some scientific proposition is almost entirely party line.

          Maybe circumcision would be proposed as a possible remedy for some geriatric foreskin issue. Maybe it would be found to be a reasonable approach to similar issues that crop up in younger and younger people. (My wife’s cousin was not circumcised as an infant, but due to some problems had to be circumcised at 8.) Maybe people would start wanting elective circumcisions in the way some people today do all kinds of weird elective surgeries. Maybe it would grow a following. Maybe there would be data that convinces a wide swatch of people to do the procedure on infants because it heals so much faster and is easier to do on infants than 8-year-olds. Maybe the research will show there are potential emotional or psychosexual consequences to doing so, and maybe we’d be right back to where we are today, with people on both sides of the issue, and parents caught in the middle while trying to do the right thing for their children.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.