Just*in Time: On Circumcision

Just*in Time

by Justin B. Terry-Smith

During the holidays I’m sure many of us had a Christmas tree, Hanukkah bush or Solstice scrub. But my question is, did you trim it or leave it untrimmed?

The controversy of wanting or having your penis circumcised has gone on for generations and will continue to happen. I’ve had boyfriends in my past that were cut and uncut, and personally I have no problem with either. I am cut myself and since I don’t remember being circumcised as a baby I really don’t have a problem with myself being cut. Also we must remember that in certain religions and spiritualities it is thought that a circumcision of a man’s penis is his covenant with G-d. There have been several anti-circumcision movements of men that are upset about their own circumcisions because they did not consent to having the procedure performed; also anti-circumcision activists cite that circumcision is painful and risky for babies. Fun fact: A 2012 Vice article states, “The U.S. circumcision rate (meaning how many newborns undergo the procedure) is officially placed at around 56%, which is lower than it once was but still far higher than other parts of the world. One-fourth of the planet’s men are Muslim and many are circumcised for religious reasons, as are most Jews, but the majority of European, Asian, and Central and South American countries don’t practice ritual foreskin removal, and the World Health Organization estimates only 30% of all men are circumcised.” In 2007 the World Health Organization advised heterosexual African males to get circumcisions in order to prevent against the transmission of HIV. Honestly, when I first heard that, it didn’t make any sense to me whatsoever. But it had me wondering, what are the public health positives and negatives of male circumcision?

Positive Effects
• Circumcision protects heterosexual men, by reducing HIV transmission by sixty percent
• Circumcision protects homosexual men, by reducing HIV transmission by fourteen percent
• Circumcision has been suggested for older boys and men to treat phimosis (the inability to retract foreskin), balanitis (inflammation), paraphimosis (inability of the foreskin to return to its original location), and/or infections.
• Easier hygiene
• Decreased risk of penile cancer and urinary tract infections

Negative Effects
• Some risks include bleeding, permanent injury, inflammation, and pain.
• Loss of nerve endings and nerve damage
• Keratinization, which is when a circumcision exposes a normally covered part of the skin which can cause glans to become abnormally dried out and thickened
• Premature ejaculation
• Decreased sexual pleasure and lower orgasm intensity

Circumcision continues to be a source of contention for some people. Many countries, especially in Europe, have tried to ban male circumcision. Iceland is slated to become the first European country to ban circumcision. This has sparked controversy in two main communities, especially. Iceland’s population of about 336,000 which includes very small Jewish and Muslim communities. It is estimated that about 250 Jews and about 1,500 Muslims live in the country. Circumcision in both religions is widespread. Circumcision is considered a sign of belonging to the wider Islamic community and a form of cleanliness. In Judaism circumcision is considered a covenant with G_d.

In the United States there has been no legislature on the books to ban circumcision. There was an attempt in San Francisco seven years ago to ban circumcision; however, in October 2011 California passed a law protecting circumcision from local efforts to ban circumcisions. Each state has its own laws focused on circumcision and are asked to sometimes intervene when the parents cannot come to a decision on whether or not to circumcise their son. The United States will probably have a tougher time at banning circumcision because foreskin removal is common practice throughout the country and also some people say the benefits far outweigh the risks.

I can see both sides of this argument, but as a doctor of public health I have to think about safety and long-term effects. Both are considered when coming to this decision. This writer, as of right now, is in favor of circumcision but only because of the medical benefits.

We all have our personal preference but what happens when personal preferences gets in the way of religious rites? Whether or not you’re cut or uncut, you need to know and be informed of the pros and the cons of circumcision. As for my personal preference…a dick is still a dick.

Justin B. Terry-Smith, MPH, DrPH, has been fighting the good fight since 1999. He’s garnered recognition and awards for his work, but he’s more concerned about looking for new ways to transform society for the better than resting on his laurels. He started up in gay rights and HIV activism in 2005, published an HIV-themed children’s book, I Have A Secret (Creative House Press) in 2011, and created his own award-winning video blog called, “Justin’s HIV Journal”: justinshivjournal.blogspot.com. Visit his main Web site at www.justinbsmith.com. He welcomes your questions at [email protected].