THE PRO-ANTI CIRCUMCISION DEBATE

The debate for and against circumcision is not new to the world, it has probably been going on since the operation was first introduced. Modern times and Internet has merely exaggerated the fronts, so that nowadays instead of partial circumcision being debated, the pro circs. want full circumcision, and the anti circs. want nothing at all.

Both sides are so sure they know the truth, and both sides feel so right in their assumptions that they feel justified in ignoring contrary evidence.

Before getting on line I had never seriously considered the question "Should all boys be circumcised or none?" It seemed (and still seems) a totally irrelevant question for a culture which has the intelligence and eyes to make a specific ands individual diagnosis, checking young children and in the individual cases where something was wrong to treat accordingly and specifically.

The debate between those who support circumcision and those who are against it, is the singular most destructive factor to clear thinking about circumcision. It misleads parents and every ordinary listener to believe that there is a routine answer which applies to every boy, and it misleads concerned parents to an uncertainty and unnecessary worry about if to circumcise or not.

The real problem is actually the question - not the answer!

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A BLESSING or a MUTILATION?
On the one side the pro-circers say with irrefutable logic "if kids were all circumcised, they wouldn`t have any problems" (cut off their heads and they never get headaches) ... this perversion of the normal sense of preventative medicine is balanced on the other hand by the anti circers who, basing there arguments on simple civil rights, they go to the extreme of maintaining foreskin problems are a rarity, which heal spontaneously, or can be treated as an adult if any individual so chooses. (which I as well as the pro circs. who are as aware of the problems as I am, find simply too late sometimes after years of embarrassing problems, arguing that a child needs early care).

The pros emphasise infections, - they tend to leave foreskin conditions out of the argument (probably because they realise that such can be cured without full circumcision - infections cancer and aids are the only possibly valid arguments for full circumcision). The antis prefer to minimise all and every problem with the foreskin because it could indicate a reason to operate, and so are happy to comply with ignoring foreskin conditions - and so has followed years and years of irrelevant debate about irrelevant infections.

While the pro-circers generally approve of checking boys (and then circumcising any with possible problems), for the anti-circ. sources checking implies medical interference and as phimosis is (supposedly) a rarity and doctors checking the foreskin causes "iatrogenic" problems (i.e. problems caused by a doctor), they recommend that foreskins and the penis are best to leave alone or ignore (23, 24) and eventually around the age of 17 most of the problems will somehow have resolved by themselves.

(If you check, all references to this theory about problems resolving spontaneously at 17 are referred to and based on one medical study by Øster, however the interpretation given is always the surface one. Øster himself describes how he educated and monitored his youths for 7 years and it was only after this care and education that he was able to record the lowest phimosis statistic in available medical history.)

Almost everyone who is actively involved with this subject has either an anti or pro circumcision bias. And though scientific arguments are presented it is obvious that a personal experience lies at the basis of a rationalisation : some men were circumcised as babies and not infrequently the operation was done badly; on the other hand some men needed circumcision and were thankful once they received it mostly as adult. For some circumcision was a mutilation; while for others it was a blessing.

Both groups have a number of medical doctors and university trained men writing studies and papers which provide the necessary scientific "proof". And I wish to note again my astonishment that so many doctors support one or other of these extremist diametrically opposed opinions. Writing now in 1998, Schöberlein in 1966 was the last doctor to emphasise the wisdom of pre puberty checks.

This site was the first "not strictly" anti-circ. site on line, and regardless the logic that I wanted boys checked and therefore I didn`t want them automatically routinely circumcised, just the mere mention that individually a circumcision could be necessary, prompted a lot of extremely horrible letters from anti circers, and a lot of inappropriate support letters from pro circers. (there are now around 12 real pro circ. sites, and my hate mail from the antis and my pro support mail has diminished accordingly).

How very confusing it all was, - the only people talking "openly" about male circumcision were extremists lost in an all or nothing, for or against, black and white question. Even so called moderates would define themselves in these one dimensional terms, saying they tend towards being anti. or pro. - clearly recorded on the Deja NewsGroups one man (a qualified psychologist and anthropologist) who wrote he started out pro then became anti and is now more pro again!

If it wasnt so sad, it would be fascinating how both extremes suggest routine approaches with no consideration for appropriate individual measures. And it is here I believe that the antis are making the big mistake in their thinking - they play into the pros hands exactly by trying to minimise the problems and present a routine answer, - instead of emphasising individual solutions to individual problems depending on the degree of severity etc., as in other branches of modern medicine:- individual patient related treatment.

The anti circ Theory

My discussion with the PRO-Circers. in some detail

The pro-circumcision argument is that infant circumcision provides a valid prevention against infections and diseases. They are generally aware that foreskin conditions dont require full circumcision, it is probably for this reason that they emphasise disease infection even cancer and AIDS arguing that a full circumcision is the best prevention of these. Even for foreskin conditions individual treatment is not considered, the modern options of corrective stretching, betamethasone, frenoplasty and/or the traditional cures of partial circumcision, a dorsal slit, or frenular incision are rarely recommended.

Modern technical engineering and plastics have enabled pro circ doctors to develop modern methods for performing full circumcision on even the tiny infant penis. The Tara Clamp has recently been added to Plastiibell and gomco clamp and is praised as being able to perform the perfect infant cut.

It is often argued that UTIs (Urinary Tract Infections) happen 10% more in uncircumcised boys. What does 10% more mean?
Are we talking about 10% more than 1 in 6 or 10% more than 1 in 60,000. - What does "10% more" actually mean in terms of how often problems of this sort are occurring?

This question has been on-line since 1996 and no pro circ. source has responded. When confronted, the only answer I have received has been -

... "Its AIDS, penis cancer infections etc. all added together."

I writhe in agony, please give a reliable answer which you can argue in some way. The important question to me is: Do foreskin related infections and diseases occur more than 1% of the total time?
I have never seen any reliable statistics. I have never found a pro-circumcision doctor or supporter who can give an answer, - is this true? are there no reliable statistics? - I know pro-circers read this, if you post me some sort of reliable figures then I`ll print them or link up with them! - (It is now 2005 - I have still received no answer)

Again I have never seen, read or heard any reliable statistics - and this is ridiculous when considering child health care.

On the other hand every pro circer who I have corresponded with has freely expressed their agreement that 10% of the uncircumcised male population have phimosis. - Such statistics are confirmed in The Encyclopedia of Phimosis Statistics, which is my collection of all the statistical studies on phimosis since 1920.

Surely if care for children is foremost in our thinking it would be appropriate to help make our culture aware of these common conditions which can be checked for. Surely you can continue any debate about a possible general advisability of circumcising every child or none as a prevention against infection for further centuries, once these proven actual common problems have been resolved.

In countries which are limited in their health care possibilities it would seem practical for pro circumcision sources to recommend a routine dorsal slit, - a dorsal slit would be most efficient cheap quick and practical, requiring minimal after care or expertise from the operator, allowing the glans to harden early against infection to comply with your apparent main caring intention, protecting children from infection.

Some pro-circers have complained of the price of checking children, In this respect note that a dorsal slit would again fulfil your arguments.

One significant comment came from a pro-circer who told me that the circumcised penis turned him on. This might well be a secret truth and also one of the most valid reasons for performing the operation. ... and from this perspective I could imagine the pro-circ movement would have some success, indeed from this perspective I would wish them success, ... the denuded penis is more interesting with more diversity of forms and texture of skin surface and thus a more interesting symbol of maleness, ... but in a modern culture which respects individual rights this choice must be made as an adult and NOT simply routinely peformed on infants.

Dr. Gerald N. Weiss, M.D. has written countless pro-circumcision publications and argues that babies do not feel pain when circumcised without anaesthetic, and masturbation (which often requires lubrication among the circumcised) is an unnatural substitute for intercourse. When one man stands at the head of the pro-circumcision campaign it is this doctor.

He proudly posted me the following story (a support letter he had received) 3 times, the third time in public on ARC Forum1 on 05 August 1999

.... >An E-mail message received from a medical student in Germany this past
>month illustrates the point:
> “Congratulations on your research on circumcision! I find it really deplorable that this uncomplicated but thus so beneficial operation is losing population so rapidly in our days. I am a 24 year old medical student from Germany and I have spent 18 years of my life with a foreskin...and with it with a great many problems. I am circumcised now and more than happy about it. I wish circumcision was the norm here in Germany, because it is - as you might know - very unpopular here. In my med school here circumcision is not even taught. Wish you all the best for your research,

My answer:
"... the importance of this anecdote cannot be overlooked - This potential doctor suggests a routine procedure ("I wish circumcision was the norm") on account of his personal experiences. We see very clearly here how personal prejudice on this subject can influence medical opinion and practice."

Dr. Weiss made no answer to this comment and also made no answer to the (above) question of statistics. (shame ... I am open to answers)

If any pro-circ. site or source feels they can answer these questions and ideas please notify me and I will link up, - until that time I can only deduce that all your argumentation is based on the personal preference, i.e. basicly that you like the look of the circumcised penis.

Address to the ANTI-Circers.
From an ethical or moral standpoint, RIC - Routine Infant Circumcision is certainly an infringement of personal rights. And where anti-circ sources are most certainly correct is when discussing their own field of experience: RIC - Routine Infant Circumcision.

Unfortunately often anti-circumcision sources make assumptions about the value of the foreskin thereby minimising any problems.

I would love to communicate and link up to a site which was against RIC without being against circumcision or other foreskin and frenulum operations. At present all anti circ. sites proliferate the idea of ignoring foreskin problems (24) or leaving a growing boy's penis alone (23). -
(Please give any new links - I stopped online research in 2000)

While I agree with your goals, your reasoning and approach are unrealistic. I am afraid that because you feel morally or ethically correct you are making the various mistakes of the self righteous where any means justifies the end.

It is ironical but anit-circ sources appear to be damaging their own cause by developing and spreading new myths and untruths - and thus maintaining the taboos and ignorance.

Please see Anti-Circ Theory for a summary text which is easier to read than the following

NEW FANTASIES to CONFUSE me MORE and MORE
I believe if your information had been planned to prolonge the chaos for doctors and patients for another hundred years, then it could not have been better planned. It is often totally irrational - and it is frustrating to try and argue rationally against such angry emotions.

Most anti circers will admit that they have never experienced a foreskin and know little about how they work, - however they have "researched" and present a set of ideas on how the "normal" foreskin works, and then present theories and advice for parents on how to care for the uncircumcised child!

People must learn to think about this subject clearly and with common sense, not with mumbo jumbo.

Please see The Anti-Circ Theory which discusses Taylor`s "highly sensitive" ridged band. Information for parents and children in more than a hundred internet sites is based on this one study of 22 dead bodies.

The phimotic ring is referred to by many anti circumcision www sites as either Taylors ridged band or the frenar band. The word frenar can easily be confused with frenulum. How can this help clarity and education?

All anti circ sites I have seen ignore refences to all 26 collected studies on the frenulum - all except for one by Paul M. Fleiss, MD 90 this is still referenced and quoted by every important anti-circ. site.

" ... The foreskin's frenulum holds it in place over the glans ... ".

A frenulum which when flaccid holds the foreskin forward, is going to be really very very short on erection - actually the condition is impossible.

In the flaccid state, the foreskin covers the glans from the weight-bundle of its own skin. This is the case among both those men who are born without frenulums and those who have had it removed, the foreskin covers the glans of its own accord, by its own "weight-bundle". It is obvious that during erection a healthy frenulum does not hold the foreskin forward. ...

What is the good doctor talking about? why do so many blindly follow?
and look how one short irrational sentance takes ages to disprove rationally

Anti circ. sources maintain that phimosis is a rarity occurring at a frequency of only 1%.

Only someone who has done no unbiased research could maintain such ideas. Between 2.4% and 14% of uncircumcised youths have phimosis. This is obvious from every study on statistics since 1920. You cannot use only one study on statistics (Øster); ignore Schöberlein (28), Osmond (86), Bokström (91) and Parkash (88), AND claim any validity for your statistics. - Neither Øster nor anyone else in a phimosis study has ever measured statistics of 1% in an unselected group.

Øster is essential reading for any anti-circer, it is recommended by all important anti-circ. sites and referred to by many other medical studies - however the interpretation given is always the surface one, that phimosis cures by itself over time.

Øster himself describes how he educated and monitored his youths for 7 years it was only after this care and education for this selected group, that he was able to record the lowest phimosis statistic in available medical history. This shows the validity of monitoring and educating boys, not of ignoring foreskin conditions (24)

A surface interpretation of Øster is not only untrue but harmful - with such info. the next generation of kids could all grow up with foreskin conditions.

So, to summarise, while I agree with your intentions far more than the pro routine circumcision movement, you are doing far far more damage to clear thinking and open mindedness on this subject ... this is more than ironic.... it is tragic ...

I would ask those who are campaigning to end RIC to learn about foreskin conditions and help educating about them, covering up their existence only perpetuates the taboos.

Lastly,
If routine circumcision or no circumcision is more ridiculous or even dangerous is an irrelevant and bizarrly misleading question. Because,

A diagnosis of any malformation is possible and advantageous before puberty, before the majority of the problems have occurred.

If boys were monitored, the anti-circers idea of conservative treatment would then have a realistic basis, and instead of a hurried operation, there would be ample time to encourage preventative stretching - use of steroid creams - educate about paraphimosis - previous to the last operative resort.

If any anti.circ source feels they can respond to my criticism I will link up with or print your ideas ...

Other Related Files: Foreword on Routine Circumcision

and The different Psychological Perspectives of anti and pro circumcision mentality appear to be related to their presonal experience

IN ANSWER

Vernon Quaintance a pro-circ site manager - wrote

"I am wholeheartedly in favour of checking boys well before puberty to give them the best chance of entering puberty with a fully functioning penis.

"Quite apart from the specific need to check for genital development and knowledge before puberty, I have long felt that all children should have regular complete medical checkups (at least every 2-3 years). Detailed examination of the genitals should be included in these checks and the opportunity taken to get corrective action as early as possible when any problems are found."

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Occasional individual anti circers have said they have nothing against checking, some have said they favour checking but that I should include the checking of circumcised boys.

I agree and have now started collecting information on this subect. I feel I still do not know enough about the problems of a circumcised penis to be able to advise parents on this, so please tell me your personal experiences.

I would find it far more appropriate for one of the anti circ sites to consider a section on the subject of checking circumcised boys, I would happily link to such a site.

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And just a closing note from 2007 - The antis are far more emotionally involved; the pros are cool and rational and really enjoy winding the antis. up, which drives the debate to extremes which suits the pro-circ. cause far better. I always wished the antis would see that the simplest way to break the circle is to demand individual treatment, (even if this occasionally means an individual circumcision) ... but im a dreamer ...