The controversy over male circumcision has once again reared its ugly head. Once favored as a means to reduce the risk of infections and sexually transmitted diseases, then shunned in recent decades as unnecessary and painful for newborn baby boys, the cut is back and looking better than ever.
A new study, highlighted at last week's XVI International AIDS Conference in Toronto, has found that circumcision is almost as good as a high-quality vaccine at preventing HIV infection in South Africa. An earlier study had found that circumcised men in sub-Sahara Africa were less than half as likely than uncircumcised men to contract HIV. And the U.S. National Institutes of Health has green-lighted the continuation of circumcision studies in Uganda and Kenya.
While major health bodies such as the World Health Organization have not endorsed circumcision (yet), anti-male-circumcision groups are beefing up their efforts to minimize the procedure.
Male circumcision refers to the removal of most of the foreskin around the tip of the penis. This natural covering protects the sensitive tip, called the glans, but can also harbor the growth of harmful bacteria and viruses. Granted, circumcision is not a life-saving procedure in the United States, where much of the anti-cut sentiment is based. The risk of a urinary tract infection is low, and the choice of sexual practices is the far greater determinant of contracting or spreading sexually transmitted diseases.
Nevertheless, the comparison of male circumcision to female genital mutilation by some groups, such as the International Coalition for Genital Integrity, is shameless and appalling. Female genital cutting is an act of subjugation, the removal of part or all of the genitalia and, sometimes, the near-complete suturing of the vulva, leading to high rates of infection and, during childbirth, death.
The stance that male circumcision is unbearably painful, leads to an epidemic of infections and leaves lasting mental scars borders on the ludicrous. This seems to have been dreamt up by reasonably well-off white guys complaining that they have nothing to complain about in this world.
I remember a similar, desperate movement in my college days with the formation of the white student union, an answer to the black and Asian student unions. "Hey, if they get to have one, we should too," the stupid argument went.
Some anti-circumcision groups go as far as recommending foreskin restoration, a surgical procedure far more useless than circumcision could ever be. They argue that circumcision exposes the glans and numbs its sensitivity, making sex less pleasurable. That sex could be even more pleasurable is the least of my worries; it would only get me in more trouble.
Other anti-cut groups include Mothers Against Circumcision, Musicians United to Stop Involuntary Circumcision, the neutral-sounding Circumcision Information and Resource Pages, and Catholics Against Circumcision (apparently not ruffled by the more pleasurable sex).
On the website for the International Coalition for Genital Integrity, there's testimony from the group's director about waking up in a hot sweat from recurrent nightmares about his procedure as a newborn. Few U.S. health organizations advocate for circumcision. They are generally neutral, citing little benefit. The American Academy of Pediatrics, for example, states that there are potential medical benefits from circumcision but the procedure is not essential. But scientists aren't dismissing circumcision because of possible long-term effects.
Admittedly, the modern Western circumcision movement had its origins tangled with anti-masturbation organizations in the late 1800s. Yet modern organizations such as MGMbill.org, which advocate for a law criminalizing circumcision, punishable by jail time, serve to minimize the benefits that circumcision can bring. Even in the United States, there is considerable evidence that circumcision helps prevent the spread of the Human Papillomavirus, the most common sexually transmitted disease and the main cause of cervical cancer.
Ideally, the spread of HIV could be halted by monogamy, a reduction in the number of sexual partners, or the proper use of condoms. Apparently, humans being humans, this isn't happening. A circumcised penis, minus the warm and moist protective foreskin, is less likely to accommodate the AIDS virus.
Health advocates in Africa are actually worried that knowledge of the effectiveness of circumcision will lead to lower condom use. This is a serious concern in a continent where leaders have denied the connection between HIV and AIDS, have suggested that showering washes away the virus, and have recommended garlic, lemon and beetroot as HIV treatment. In this regard, circumcision might be too effective for its own good.
Christopher Wanjek is the author of the books “Bad Medicine” and “Food At Work.” Got a question about Bad Medicine? Email Wanjek. If it’s really bad, he just might answer it in a future column. Bad Medicine appears each Tuesday on LIveScience.
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Christopher Wanjek is a Live Science contributor and a health and science writer. He is the author of three science books: Spacefarers (2020), Food at Work (2005) and Bad Medicine (2003). His "Food at Work" book and project, concerning workers' health, safety and productivity, was commissioned by the U.N.'s International Labor Organization. For Live Science, Christopher covers public health, nutrition and biology, and he has written extensively for The Washington Post and Sky & Telescope among others, as well as for the NASA Goddard Space Flight Center, where he was a senior writer. Christopher holds a Master of Health degree from Harvard School of Public Health and a degree in journalism from Temple University.