Archive for June, 2005

The Case Against Circumcision

I’d like to talk about a slightly unusual topic today.  The subject is circumcision, and I’d like to explain why it’s an unnecessary procedure that ought not be performed on healthy little boys.

Circumcision has been fairly commonplace in this country in the last century.  Many people, even medical professionals, believed it was necessary and desirable to remove what they deemed to be a vestigial flap of skin covering the penis: the foreskin.  It has since been reevaluated, and more and more people have begun to realize that circumcision is not really necessary at all and need not be performed on a routine basis.

There are a few primary arguments for circumcision.  They are largely inaccurate, culturally-biased, or hyperbolic.  Allow me to explain:

Claim: The foreskin serves no function in modern life.
These folks argue that the foreskin was there to protect the penis back in the days before people wore clothing.  While this may, indeed, be part of the foreskin’s function, there is evidence to suggest that the foreskin participates actively in sexual intercourse.  Studies suggest that the foreskin’s “gliding mechanism” is “Nature’s intended mechanism of intercourse.”1 It is believed that the gliding of the foreskin can contribute to sexual pleasure:

Although still pleasurable for the man, intercourse without the participation of the prepuce lacks the gliding mechanism. The only source of stimulation is the glans rubbing against the wall of the vagina. The sensations from the specialized receptors of the frenar band, frenulum and inner foreskin layer are missing.2 

It is also possible that sex with a circumcised penis can lead to more vaginal abrasion, i.e., discomfort and pain for the woman.  On the contrary, intact penises offer benefits in this area.  “Since more of the loose skin of the penis remains inside the vagina, the woman’s natural lubrication is not drawn out to evaporate to a great extent, which makes sex easier without using artificial lubricants.”3 In fact, there are those who believe that the intact foreskin can actually prolong and control a man’s sexual gratification:

The foreskin contains sensory receptors called Meissner corpuscles. We believe that these nerves, similar to nerve endings in the fingertips, are there to provide pleasure, as well as fine sensory perception. This seems to help a man to enjoy sex longer without ejaculating prematurely, because he can more easily tell when he is approaching the threshold of orgasm.4 

Claim: Intact penises are too troublesome to keep clean, especially for little boys. This one is simply ridiculous.  The area under the foreskin is no harder to keep clean than any other opening or crevasse on your body.  Arguably, girls’ sexual organs are much harder to keep clean!  (I’m not suggesting this is the case, or trying to make any statements about women’s parts being somehow unclean.  I’m just trying to point out the illogical nature of this claim.  I’m sure all you ladies are fresh and clean in your private areas.)

This claim about hygiene is based largely on two points.  The first is the smegma-factor.  Smegma is the natural oily, waxy lubricant formed between the foreskin and the glans.  However, as this passage explains, smegma isn’t nearly the concern that uninitiated folks believe it to be:

Rarely does [smegma] exist in the uncircumcised child whose foreskin has not been forcibly retracted; the substance we are warned to carefully wash away is rarely produced during childhood. During puberty, these natural secretions tend to increase, providing a natural lubricant between the foreskin and glans for protection and to permit the foreskin to slide easily over the glans as nature intended for this age. By mid-teenage, the foreskin is retractable and hygiene is a simple matter. Any accumulation of these natural lubricating substances can easily be cleansed during the boy’s shower or bath.5 

Cutting off the foreskin to get rid of smegma is like cutting off your nose to get rid of boogers.  (Feel free to use that line at parties; it’s a real ice breaker.)

The second factor contributing to the “cleanliness” myth is purely cultural, and frankly, is a bit ethnocentric.  For quite some time, Americans have associated intact penises with so-called “third world” and other pre-industrial cultures.  For this reason, people have come to associate the foreskin with poor hygiene.  It’s a stupid claim, and it’s offensive.

Claim: Circumcision is necessary to prevent a host of medical problems. This one actually has a foundation in fact, though it’s been exaggerated quite a bit.  It has been touted that circumcision can reduce the risk of urinary tract infections, penile cancer, cervical cancer (in partners), and sexually transmitted diseases.

UTIs are actually  very uncommon in male infants — around 1% incidence.  Furthermore, the primary cause of UTIs in male infants is abnormalities of the urinary tract, which is also uncommon.6

Penile cancer is extremely rare.  It occurs mostly in older men, and very few doctors will recommend infant circumcision purely as a preventative measure against penile cancer late in life.

The theories about increased risk of cervical cancer and STDs have been disproved.7, 8

What’s really astounding about the claims of circumcision being a desirable preventative measure is that it ignores statistical figures completely.  The ailments circumcision is intended to prevent are exceedingly rare, yet the procedure is deemed necessary for all male infants.  However, the same folks who argue for these “benefits” also tend to dismiss the real dangers involved in performing unnecessary surgery on an infant because they believe them to be statistically insignificant!

Having looked at some of the arguments for circumcision, let’s understand some arguments against it.

First and foremost, circumcision is painful and frightening for a child.  The infant is strapped into an immobilizing device called a circumstraint which binds the arms and legs of the infant.  It has been noted that simply strapping a child down in this manner can be extremely distressing to a days-old infant — even without performing surgery.  Once strapped in, the surgery begins — in some cases without anesthetic.  (Some people have believed that infants do not experience pain in the same way that adults do.  However, some studies suggest that they actually experience pain more intensely than adults do.)

If you really need any further convincing that this is something that is stressful and painful for a child, I suggest you take a look at some of these disturbing photos and videos.  I’ll warn you now, they are not for the queasy.  Try watching those
videos and tell me that you think circumcision is a good idea.

Second, as illustrated above, the procedure isn’t medically necessary.  It’s primarily a cultural/religious phenomenon.  Now, I won’t try to talk you out of practicing your religion, but I’ll simply point out that, over the years, many awful things have been done in the name of religion.

The available data indicate that times may be changing.  People are starting to realize the error of their ways and circumcisions are no longer universally viewed as a necessary procedure.  Circumcisions rates are declining nationwide, with only 55.9% of males in the US being circumcised in 2003.9 This number went down every year since 2000, and is sharply down from roughly 85% in 1965.10 Nationwide, it is estimated that about 44% of all boys in 2003 were intact, with regions like the west coast boasting over 68% intact!11

One final bit of information that I find interesting: One of the major reasons for the rise of circumcision in America is because it was viewed as a different sort of preventative measure — to prevent masturbation or “self-abuse.”

Masturbation was thought to be the cause of a number of diseases. The procedure of routine circumcision became commonplace between 1870 and 1920, and it consequently spread to all the English-speaking countries (England, Canada, Australia and New Zealand). None of these countries now circumcise the majority of their male children, a distinction reserved today for the United States (in the UK, in fact, nonreligious circumcision has virtually ceased). Yet, there are still those who promote this social surgery, long after the masturbation hysteria of the past century has subsided.

[…]

In America, foreskins were not rare at the time circumcision was introduced into widespread practice. Paradoxically, then, the understanding of the intact male organ at that time was somewhat greater than it is today. (In particular, it never would have been possible to promote circumcision on the basis that it was “necessary for hygienic reasons”— this came later, when doctors themselves were mostly circumcised men.)

Further, in proposing circumcision as a preventative against self-abuse, physicians of the day understood very well that male masturbation involves stimulation of the foreskin. However they were incorrect in assuming that, by reducing the pleasure, masturbation itself could be reduced or eliminated.12

I hope this information has been helpful, especially to those who are planning to become parents soon.  I’d encourage you to read more about these topics at the sites provided in the references area below.

A Note to Parents of Circumcised Boys: If you’re reading this and you are the parent of a circumcised boy, chances are you’re feeling somewhat uncomfortable.  Please understand that I am not trying to chastise you in any way.  What’s done is done.  Chances are that you never even considered not circumcising; it’s simply the norm to have it done.  This post is intended to inform parents who will be faced with this decision — especially if they don’t realize there’s a decision to make.  I didn’t write this to point fingers, lash out, criticize, or offend.  I apologize if I’ve come across as doing any of these things.

References

Just about all of the information in this post is pulled from the Circumcision Information and Resource Pages at http://www.cirp.org.  They have a wealth of information and links to further reading on the subject.

1. Anatomy of the Penis, Mechanics of Intercourse, http://www.cirp.org/pages/anat/

2. Ibid.

3. Ibid.

4. Ibid.

5. Care of the Intact Penis, by James E. Peron, Ed. D., http://www.cirp.org/pages/parents/peron1/

6. Cultural Bias and the Urinary Tract Infection (UTI) Circumcision Controversy, by Martin S. Altschul, http://www.cirp.org/library/disease/UTI/altschul/

7. Cancer of the Cervix in Reference to Circumcision and Marital History, by Elizabeth Stern, M.D., and Peter M. Neely, Ph.D., http://www.cirp.org/library/disease/cancer/stern1/

8. Circumcision in the United States: Prevalence, Prophylactic Effects, and Sexual Practice, by Edward O. Laumann, PhD; Christopher M. Masi, MD; Ezra W. Zuckerman, MA, http://www.cirp.org/news/1997.04.01_AMA/

9. United States Circumcision Incidence, http://www.cirp.org/library/statistics/USA/

10. Ibid.

11. Ibid.

12. What were the original motivations behind routine infant circumcision in the West?, http://www.cirp.org/pages/whycirc.html

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Anti-Intellectualism, Narcissism, and the Presidency

This week, our esteemed President decided to thumb his nose at educated Americans everywhere when he participated in the following exchange:

Dubya: I appreciate the Secretary of Energy joining me today. He’s a good man, he knows a lot about the subject, you’ll be pleased to hear. I was teasing him — he taught at MIT, and — do you have a PhD?Secretary Bodman: Yes.

Dubya: Yes, a PhD. (Laughter.) Now I want you to pay careful attention to this — he’s the PhD, and I’m the C student, but notice who is the advisor and who is the President.

Dubya then proceeded to knock Bodman’s glasses on the floor and give him a massive wedgie.  Metaphorically speaking, that is.

The first thing that I found offensive about this comment is that it’s part of a broader pattern of anti-intellectualism in America.  Intellectuals are viewed as a small, conceited group of elitists.  They are seen as arrogant, pretentious, and out-of-touch with the problems of “real folks.”  One who dares consider the nuances or subtleties of a given issue is seen as a navel-gazing “flip flopper.”  Look no further than our recent election for clear evidence of this trend.

The next thing that jumped out at me about Dubya’s remark is that it sounded familiar.  A little investigation reveals that Dubya’s been recycling this same quip over and over.  Let’s go back to earlier this year, in March:

Dubya: I’ve asked Jeff Brown to join me. He is a professor. He can tell you where — where do you profess? (Laughter.)

Dr. Brown: I have a PhD in economics, and I teach at a business school.

Dubya: Yes. It’s an interesting lesson here, by the way. He’s an advisor. Now, he is the PhD, and I am a C-student — or was a C-student. Now, what’s that tell you? (Laughter and applause.) All you C-students at Auburn, don’t give up. (Laughter and applause.)

. . .  and before that in February . . .

Dubya: Andrew Biggs is with us. He is the Associate Commissioner for Retirement Policy of the Social Security Administration, Washington, D.C. In other words, he is an expert on the subject….

George W. Bush: By the way, this guy — PhD. See, I was a C student. He’s a PhD, so he’s probably got a little more credibility. I do think it’s interesting and should be heartening for all C students out there, notice who’s the President and who’s the advisor.

So, in addition to being offensive, he’s repetitive.  I find it disingenuous how he tries to cover for this insult by pretending he’s just trying to encourage C students to persevere.  He’s not fooling me; in reality, he’s saying, “You eggheads aren’t better than me — I’m the president, and don’t you forget it.”

After considering Dubya’s ridiculous behavior, another idea occurred to me.  I think there is something else going on here, something deeper than simple anti-intellectualism.  I think Dubya’s behavior — in this matter and others — strongly suggests a pattern of narcissitic tendencies.

Consider: Dubya feels threatened by those who have achieved higher academic standing than he has.  When forced to rely on their input to lend credibility to his discussions (like the situations above), he feels compelled to act in an aggressive manner as a response to this perceived threat to his ego.  This is something narcissists often do.

Another interesting point to ponder: Narcissists rely on what is called a “Narcissistic Supply”.  “The Narcissist actively seeks to furnish himself with an endless supply of admiration, adulation, affirmation and attention.”1 Now consider the following practices:

  • Requiring citizens to sign a loyalty oath before being admitted to events where the President is speaking
  • Barring protesters from areas where the President might actually see them

These and other actions seem to clearly support a concerted effort to maintain Dubya’s narcissistic supply.

Dubya exhibits other traits that imply a narcissistic personality, too.  Consider the following:

Narcissism is fundamentally an advanced version of the splitting defence mechanism. The Narcissist cannot regard humans, situations, entities (political parties, countries, races, his workplace) as a compound of good and bad elements. He is an “all or nothing” primitive “machine” (a common self metaphor among narcissists). He either idealises his object – or devalues it. The object is either all good or all bad. The bad attributes are always projected, displaced, or otherwise externalised. The good ones are internalised in order to support the inflated (“grandiose”) self-concepts of the narcissist and his grandiose fantasies – and to avoid the pain of deflation and disillusionment.2

Gee, that sounds familiar.  Remember this?

“Every nation, in every region, now has a decision to make. Either you are with us, or you are with the terrorists.”  — Dubya, September 20, 2001 

Furthermore, this theory explains Dubya’s apparent detachment from the real world.

The Narcissist’s earnestness and his (apparent) sincerity make people wonder whether he is simply detached from reality, unable to appraise it properly – or willingly and knowingly distorts reality and reinterprets it, subjecting it to his self-imposed censorship. It would seem that the Narcissist is dimly aware of the implausibility of his own constructions. He has not lost touch with reality; he is just less scrupulous in reshaping it, remolding its curvatures and ignoring the uncomfortable angles.3 

It has been observed that narcissists also tend to seek out special and preferential treatment.  Um, can you say Texas Air National Guard?

There are also well documented links between the narcissistic pattern of self-indulgent behavior and substance abuse and addiction.  As we know, Dubya has dealt with these issues in his past.

The list goes on and on.  Check this out:  How to Recognize a Narcissist.  See if it reminds you of any Presidents you know.

While it’s enlightening to see Dubya’s behavior so succinctly explained, it’s a bit disturbing at the same time.  When you consider how this President’s personality has influenced the perception of the US around the world, it’s doubly upsetting.

References:

1. A Primer on Narcissism, by Sam Vaknin, Ph.D., http://www.mentalhelp.net/poc/view_doc.php/type/doc/id/419

2. Ibid.

3. Ibid.

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