Anthropologist Underground

Anthropologist Underground
Birthday
October 13
Bio
I'm Terrie Torgersen Peterson. I hold a BA in Anthropology from the University of Wyoming. I've done archeological field work at Haluzta in Israel, San Juan River cliff dwellings in the American Southwest, and in the Big Horn Canyon in Wyoming. I'm currently a writer and stay-home mom to two gorgeous, laughing children. I enjoy exploring the intersection of science and culture and my own life as ethnography. I also write for Shethought.com. and DoesThisMakeSense.com. You can email me: anthropologistunderground [at] gmail [dot] com.

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JUNE 17, 2010 12:48AM

Incredulity of Privilege VI: I Am A Girl--Updated

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Last night I attempted to post a comment response to reader JackieNO on my previous post.  I may have exceeded the word limit, or for some other reason the comment didn't post.  I think the discussion is important enough to warrant a new thread.  

Again, I'm not advocating in favor of male circumcision, but I am trying to point out that the argument isn't as cut-and-dried as many against circumcision often assume, and that male circumcision is not equivalent to female genital mutilation.

I'm ready to move on, but Jackie No presents some common arguments against circumcision, some of which are not supported by the scientific literature, and some for which the literature is ambiguous.  Here's Jackie NO's comment and my response.

Jackie NO, 6.15.10 05:07 PM:

Anthropologist Underground,

The purported health benefits are controversial. I believe they are contrived by those trying to keep the mutilation practice going. A Dutch doctor group (KNMG) is this month calling upon doctors to actively and insistently inform parents who are considering the procedure of the absence of medical benefits (and the danger of complications). 

The partS that are called the foreskin have a very high concentration of nerve endings (about 20000) and these are all about pleasure -- they provide pleasure sensations based on fine touch and stretch. A part --the ridged band -- is touched and stretched (back and forth) during sex. These parts are also critical during masturbation. Sorry to be graphic, but I am not sure why you don't understand "how much of it is accessible for stimulation during intercourse" -- it all is. 

Does sex without the natural parts (circumcised men) allow one to experience fulfilling and pleasurable sex lives? If they think so great (of course many women that have undergone female circumcision say the sex is great). Sex after genital modification is not the standard. I am certain it is bad to be lacking the stretch and fine touch pleasure. The anecdotal evidence is that circumcision presents significant sexual dysfunction issues. This is an area men are talking about more with the internet. The number of men in the US restoring their foreskin is huge. The evidence is strong that circumcision messes with the dynamics, pleasure and capacity to have sex.

What is certain is that the foreskin parts feel so good. Sex and masturbation are certainly better with those 20000 nerve endings. 

 My response:

Thanks again for commenting.

According to KNMG's statement (pdf available here), they argue against male circumcision primarily based on concerns about ethics and child welfare, which is a legitimate argument IMO.  They acknowledge that there are medical benefits, but suggest that men should be able to decide for themselves whether circumcision is worth the purported benefits:

 Insofar as there are medical benefits, such as a possibly reduced risk of HIV infection, it is reasonable to put off circumcision until the age at which such a risk is relevant and the boy himself can decide about the intervention, or can opt for any available alternatives. 

I am intrigued by your assertion that potential medical benefits are contrived, and I'm very curious about who are "those who want to keep the practice going," and why? 

 I did another search of the medical literature for "benefits of male circumcision" and found many studies supporting my assertion that the medical benefits are well-established; however, as I said before, there are legitimate arguments about whether or not the benefits warrant the procedure. When I similarly searched for "risks of male circumcision," the articles tended to be about the well-known and obvious risks of the procedure itself and, again, the ethics.  

Your assertion about sexual dysfunction sounds really plausible, and I agree that self-reporting about sexual function might be unreliable. However, three factors give me pause: 

1) If circumcision significantly undermines sexual function, I would expect to see a sharp decline in birth rates in the US that is correlated to the peak male circumcision rates of the 1980s.  Although the birth rate has been steadily declining since the early 1900s, there are no sharp decreases corresponding to the time when the largest number of circumcised males reached childbearing age.  Nor does there appear to be any indication of an increasing birth rate corresponding to a decrease in circumcision rates.

I realize that this point ignores other confounding factors as well as myriad forms of non-reproductive sexual pleasure.  The birthrate data do indicate that many circumcised men are functionally able to participate in sex at some level and to achieve ejaculation.

 2) Sexual function is quantifiable, and we don't have to rely on anecdotal self-reporting alone.  (I'm thinking here of research methods like measurements of blood flow and rigidity.)

 3) I recall reading that a significant number of men in some African countries are seeking adult circumcision based on the evidence of reducing HIV transmission. It seems to me that someone must have asked them about their sexual function after circumcision or employed quantifiable measurements to assess that. I found some recent studies here:

Adult male circumcision was not associated with sexual dysfunction. Circumcised men reported increased penile sensitivity and enhanced ease of reaching orgasm. These data indicate that integration of male circumcision into programs to reduce HIV risk is unlikely to adversely effect male sexual function.

And here:

Because of our statistic limitations and mix indications for circumcision in the study, we cannot conclude that circumcision might bring certain benefit on sexual satisfaction by itself but certainly does not bring deleterious effects and, when dissatisfaction is associated with local problems, some benefit could be expected.

Admittedly, my search criteria may not yield results that are representative of the literature, and I'm not qualified to thoroughly evaluate the research methods. I saw two earlier studies that seemed to indicate some risk of dysfunction.  These seemed to rely more heavily on self-reporting.  

The issue of male infant circumcision is complex. I think ultimately the argument against the practice is strongest when it confines itself to ethical concerns. Male circumcision is not equivalent to female genital mutilation.  Asserting equivalence belittles the grave horrors FGM. 


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A.U., this is a fantastic post. I think you did a great job on separating the ethical and cultural considerations from the well-founded medical data that demonstrates real health benefits of circumcision. This is definitely not a black and white issue, and I think you have addressed all viewpoints well.
Linda: Thanks! It's going to be interesting to watch the ethical/cultural debate continue to unfold.
AU,
I want to thank you for posting on this.

What exactly are the bnenefits that Linda says you have mentioned? The benefits of doing this to an infant are?

I question if you have really considered the concept of the loss of erogenous tissue and all of those nerve endings. This is taking a natural source of pleasure from a human, before they can experience it. Is there any debate on that point? Is the risk of loss of pleasure worth the unnamed benefit? How about the risk of death of the child ? (A study estimates about 120 boys die in the US each year from the practice)!

Of course male and female circumcision are not really comparable just as male and female genitals are so different. I have a sense of the pleasure of my partners clitoris, but I don’t really know the pleasure. It is a fact that the parts removed by MGM take away more pleasure giving nerves than the female clitoris has. Does that make it worse? I think NO, but it gives one a sense of the harm. Is it not curious that this harm is not mentioned much in the places you did your research? The harm to the clitoris is always mentioned as to FGM (even though some FGM only cuts the clitoral hood and labia). Why do they not even mention the anatomical parts that are amputated and the nerves and erogenous function when discussing MGM (see i.e., MAyco clinic BS). Are those that have an altered penis or are participants in the culture trying to keep it going to justify it? I think yes. I think many women that have had it done to their sons try to rationalize that it is beneficial to justify what they have done. That some of the benefits are myth (cleaner) or don’t exist (less STDs) is overlooked. That the kid will grow up to be a man missing 2/3 rds of his genital pleasure sources, is ignored.

As to sesual pleasure, I don’t follow your point 1 and 3. 2 has been quantified – consider the paper by Taylor and the study done by Sorrells.

As to the Dutch Doctors, they do not say that there are benefits, they say that to whatever extent benefits are claimed, they do not justify the risk.

As to alleged benefits, many that are alleged to be shown to exist in one study are shown to not exist in another study. Real benefits are on the level of the benefits as noted with FGM -- benefits that are not worth the mutilation.

The most recent US study shows uncircumcised men are not at a higher risk of acquiring human papillomavirus (HPV). In AUS:Circumcision is not justified in the Australian context because it has no protective effects against STIs. The Laumann study (USA, 1997), based on over 30,000 American men, showed no advantage to the circumcised group as to STDs. The most recent comparative study from Dunedin, New Zealand (cohort of about 500 men) backs this up, concluding: "Circumcision does not appear to shield men from most types of STDs in developed nations". Complications and death of the infant from circumcision are more common than death of an old man from penile cancer. The Africa studies purported to show almost 60% relative change in HIV risk (this is actually about a 1.4% risk change) but this has not been observed in the industrialized world (probably because the study did not take into account the down time of the mutilated men). In US populations, the cut have no advantage as to HIV and STDs. The risk for cut and natural as to HIV in the US is the same. The same circumcision pushers that did the Africa study halted an African study that was indicating that circumcised men pass HIV to women at a much higher rate than natural men. Do you still trust these as certain facts? Why is the real world so different? Finally, if you think the HIV issue is compelling, is it reasonable for cultures that practice the lesser (most common) form of FGM to push FGM for HIV issues (same type of cells as male circumcision are removed and moist places are removed...). Stallings et al. (2009) reported that, in Tanzanian women, the risk of HIV among women who had undergone Female Circumcision was roughly half that of women who had not. Kanki et al. reported that, in Senegalese prostitutes, women who had undergone Female Circumcision had a significantly decreased risk of HIV-2 infection when compared to those who had not.

I am against all cutting of the genitals, certainly against all cutting of the genitals without the consent of the person being cut. I ask that those against FGM also voice their disapproval of MGM. The rest of the world sees the selective treatment as hypocrisy, which it is. The main fact to be considered is the human that owns the parts should determine if pleasure giving parts of their body are removed. In that way, FGM and MGM are certainly the same.
Jackie No: Thanks for the discussion. Like I said, I just did some Pub Med searches of the medical literature. You can use your own search terms, and your results might be different than mine.

I think we can agree that there are serious ethical concerns about the practice.

I'm going to move on and do a bit more reading about FGM before the next post.
ame i: Thanks for commenting!