Then there are a host of other diseases that range from rare and deadly to ruin your life to annoying. Australian physicians give a decent summary: STIs such as carcinogenic types of human papillomavirus (HPV), genital herpes, HIV, syphilis and chancroid, thrush, cancer of the penis, and most likely cancer of the prostate, phimosis, paraphimosis, inflammatory skin conditions such as balanoposthitis, inferior hygiene, sexual problems, especially with age and diabetes, and, in the female partners, HPV, cervical cancer, HSV-2, and chlamydia, which is an important cause of infertility. The percentages vary in each case, but it’s clear that the foreskin is a public-health menace.
Edgar Schoen, now a professor emeritus of pediatrics at the University of California San Francisco, has been pushing the pro-circumcision case since 1989, when he chaired an American Academy of Pediatrics Task Force on the practice. The committee later found insufficient evidence to recommend routine circumcision, but to Schoen, this is the narrow thinking of neonatologists who sit on the panels. All they see is a screaming baby, not a lifetime of complications. In the meantime, sixteen states have eliminated Medicaid coverage for circumcision, causing the rates among Hispanics, for one, to plummet. For Schoen and Halperin and others, this issue has become primarily a question of health-care parity for the poor. The people whom circumcision could help the most are now the least likely to get it.
This mundane march of health statistics has a hard time competing with the opposite side, which is fighting for something they see as fundamental: a right not to be messed with, a freedom from control, and a general sense of wholeness. For many circumcision opponents, preventive surgery is a bizarre, dystopian disruption. I can only say that in public health, preventive surgery is pretty commonappendix and wisdom teeth, for example. If we could remove the appendix in a three- or four-minute operation without cutting into the abdomen, we would, says Schoen. Anesthesia is routine now, so the infants don’t suffer the way they used to. My babies didn’t seem to howl more than they did in their early vaccines, particularly the one where they milk the heel for blood.
Sexual pleasure comes up a lot. Opponents of circumcision often mention studies of penile sensitivity regions, showing the foreskin to be the most sensitive. But erotic experience is a rich and complicated affair, and surely can’t be summed up by nerve endings or friction or sensitivity regions. More-nuanced studies have shown that men who were circumcised as adults report a decrease in sexual satisfaction when they were forced into it, because of an illness, and an increase when they did it of their own will. In a study of Kenyan men who volunteered for circumcision, 64 percent reported their penis to be much more sensitive and their ease of reaching orgasm much greater two years after the operation. In a similar study, Ugandan women reported a 40 percent increase in sexual satisfaction after their partners were circumcised. Go figure. Surely this is more psychology than science.
People who oppose circumcision are animated by a kind of rage and longing that seems larger than the thing itself. Websites are filled with testimonies from men who believe their lives were ruined by the operation they had as an infant. I can only conclude that it wasn’t the cutting alone that did the ruining. An East Bay doctor who came out for circumcision recently wrote about having visions of tiny foreskins rising up in revenge at him, clogging the freeways. I see what he means. The foreskin is the new fetusthe object that has been imbued with magical powers to halt a merciless, violent worlda world that is particularly callous to children. The notion resonates in a moment when parents are especially overprotective, and fantasy death panels loom. It’s all very visual and compellinglike the sight of your own newborn son with the scalpel looming over him. But it isn’t the whole truth.