So I am driving with my son (almost 18 y.o.) and NPR has news about the controversy in California. It is the normal routine. The radio mentions something about California and then say they will be back in a moment. So this gives me time to think and I assume it is about well prison overpopulation, homosexual marriage, legal marijuana (I mean medicinal)......you know, any number of topics  that we know of about California. But this time it is about circumcision. 

Then my son.."Why am I not circumscribed?" He is almost 18. This topic has never come up. We have had every other talk--sex, drugs, girls, anything. But circumcision. I assumed his father had talked to him.  Well I guess ASS U ME.

So, I said that when I was in Medical School, it felt like it was torture to the little babies.  And I really did not think that it was medically necessary and not necessary for religious reasons either. The only thing that a few of my friends mentioned to me had to do with teasing at school, gym, communal showers. But I thought that we could deal with it as it happened. I guess we did deal with it. A bit too well.

So then I started to think about it. Who invented it? What is the purpose? Is it still necessary?

So a quick search on my computer, mostly Wikipedia, gave me a lot of basic information. And nothing was really definite other than then perhaps some religious and cultural origins. In both Jewish and Muslim religions, circumcision is practiced. Christianity is neutral about it. Then there are some societies where circumcision is prevalent and signals the transition from child to adult.

For Circumcision

• Religious / Social / Cultural reasons 
• Freedom of religion
• Hygiene
• Prevention of HIV (less likely in heterosexual relations) and other STDs
• Decreases rate of penile cancer (yes, there is such a thing. And, yes, it sometimes does need surgery and/or radiation to treat.)

Against Circumcision

•  Lack of consent from child
• Not medically necessary
• Pain if not properly anesthetized (thus cruel)
• Side effects such as infections, scarring
• Sexual side effects (many nerve ends in foreskin, but this is controversial).

The rate of circumcision in the United States is about 75%. In the early 80's, it was higher but has since stabilized at about this value. The estimate of the world population is 1/6 to 1/3 of men are circumcised with majority being Muslim.

So the issues of hygiene...well not very important in this day and age.

HIV and STDs, of course important but circumcision does not prevent it or make it hard enough to transmit that proper measures should not be taken. So as a sole method, it is not good.

Penile cancer is rare and with proper hygiene, it should not make a difference. My guess is that penile cancer association with circumcision had to do with harboring HPV and hygiene and doctor's visits should prevent that. ALSO MY PLUG FOR THE HPV VACCINE WHICH IS NOW APPROVED FOR BOTH BOYS AND GIRLS. HPV IS THE LEADING CAUSE OF CERVICAL CANCER AND CANCERS OF THE ORAL CAVITY (I wonder how that got there?). IN FACT, MORE ORAL CAVITY CANCERS ARE DUE TO HPV THAN TOBACCO. SO PLEASE TAKE YOUR LOVED LITTLE ONE IN TODAY.

http://open.salon.com/blog/impaired_doc/2011/03/14/hpv_vaccination_cancer_birds_and_bees

 So then we come to consent. Well, we never consulted the baby to see if it wanted to be born. We never asked what religion the child should be. Should we require consent for that too? 

As far as the pain and suffering....anyone who has witness this will know that the baby is in pain. I think local anesthesia should be a must. It is cruel. We are required by law to anesthetize animals (mice used in cancer research, not my favorite job, but has to be done) prior to any procedure including injection of tumor cells. We should require a baby should be anesthetized before it is tied down, penis clamped, foreskin mobilized, and a quick circular excision made. 

So that kind of leaves the religion issue.

Is it illegal for a law that bans circumcision before the age of 18 unless medically necessary? Well, I do not know. The answer is a slippery slope. 

In Utah, the state constitution bans polygamy even though many Mormons live there and polygamy is part of religion.

If we start ruling on the rights of a infant, where will we stop? What about ear piercing for girls, removal of extra digits of hands/ feet, or  for any other surgery for infants/children that may not be considered medically necessary but is needed for cosmesis or religion.

In Great Britain, circumcision is not banned. But it is not covered by insurance and has to be self pay. Rates of circumcision have gone down to the single digits. If this is purely a religious/social practice then that is something we can do as well. We can also require mandatory anesthesia.

Then we come to Foreskin Man. A comic book created in order to  support a ruling in San Francisco that would ban circumcisions unless medically necessary in minors.

Kind of funny, but offensive at the same time.