Circumcision debate redux.

If you're at all interested in the debate about circumcision, the following two pieces are must-reads. The article from Slate by a freelance writer lays out all the points made by those who support circumcision, referencing the relevant research, and sharply criticizes those who speak out against it. The piece from the Good Men Project, written by an Oxford academic whose work includes psychology, philosophy, and ethics, is a response to the Slate article. It counters many of the points made and addresses the research cited.

So first, the article from Slate:

How Circumcision Broke the Internet

A fringe group is drowning out any discussion of facts.

By Mark Joseph Stern

There are facts about circumcision—but you won’t find them easily on the Internet. Parents looking for straightforward evidence about benefits and risks are less likely to stumble across the Centers for Disease Control and Prevention than Intact America, which confronts viewers with a screaming, bloodied infant and demands that hospitals “stop experimenting on baby boys.” Just a quick Google search away lies the Circumcision Complex, a website that speculates that circumcision leads to Oedipus and castration complexes, to say nothing of the practice’s alleged brutal physiological harms. If you do locate the rare rational and informed circumcision article, you’ll be assaulted by a vitriolic mob of commenters accusing the author of encouraging “genital mutilation.”

How did it come to this? For years, circumcision was a private decision, encouraged by many doctors, practiced by most families (in America, at least), but little discussed in the public sphere. Yet in the past two decades, a fringe group of self-proclaimed “intactivists” has hijacked the conversation, dismissing science, slamming reason, and tossing splenetic accusations at anyone who dares question their conspiracy theory. For doctors, circumcision remains a complex, delicate issue; for researchers, it’s an effective tool in the fight for global public health. But to intactivists, none of that matters. The Internet is supposed to be a marketplace of ideas, where human reason leads the best ideas to triumph. There are plenty of other loud fringe groups that flood the Internet with false information, but none of them has been as successful as the intactivists at drowning out reasoned discourse. In the case of circumcision, the marketplace of ideas has been manipulated—and thanks to intactivists, the worst ideas have won out.

Like most fringe groups, the anti-circumcision faction is almost comically bizarre, peddling fabricated facts, self-pity, and paranoia. The intactivists also obsess about sex to an alarming degree. Still, some of their tactics are shrewd. The first rule of anti-circumcision activism, for instance, is to never, ever say circumcision: The movement prefers propaganda-style terms like male genital cutting and genital mutilation, the latter meant to invoke the odious practice of female genital mutilation. (Intactivistslike to claim the two are equivalent, an utter falsity that is demeaning to victims of FGM.)

Read the rest here.

And the response from the Good Men Project:

An Open Letter to the Author of ‘How Circumcision Broke the Internet’

By Brian D. Earp

Dear Mr. Stern,

I recently read your article, “How Circumcision Broke the Internet” for Slate magazine [republished as "'Intactivists' Against Circumcision" in Canada's National Post]. I understand your concern about overheated rhetoric in public debates as well as the misuse of science to support untenable positions. As a scientist and ethicist who studies circumcision professionally, I will admit that I have seen this happen on both sides of this particular controversy. I think, however, that in your hurry to admonish “the intactivists” for pushing their anti-circumcision arguments too far, you may have fallen prey to some of that very same rhetorical excess (as well as misuse of science) in your own piece.

First, when you said that circumcision used to be “practiced by most families” I’m glad that you added the qualifier, “in America at least.” This is an important point. Circumcision is extremely uncommon in most parts of the world, and about 70-80% of men globally are left intact. Over 70% of those who are circumcised come from the Muslim world where it is done as a rite of passage; it is also a rite of passage in countries like South Africa, where at least 39 young men recently died from complications related to circumcision, such as excessive bleeding from their penises. Europeans, by contrast, (including the British; as well Latin Americans, Canadians, Australians, New Zealanders, the Japanese, the Chinese, Russians, and Indians–that is, most of the developed world) very rarely circumcise outside of religious communities (if at all). A majority of doctors from these countries insist that any “health benefits” conferred by circumcision–even when the procedure is performed correctly–are dubious at best. In fact, 37 of Europe’s most pre-eminent medical authorities (along with the distinguished Canadian pediatrician, Dr. Noni MacDonald) have recently expounded on this point in the flagship journal Pediatrics:

Only one of the arguments put forward by the American Academy of Pediatrics [concerning potential health benefits for circumcision] has some theoretical relevance in relation to infant male circumcision; namely, the possible protection against urinary tract infections in infant boys, which can easily be treated with antibiotics without tissue loss. The other claimed health benefits, including protection against HIV/AIDS, genital herpes, genital warts, and penile cancer, are questionable, weak, and likely to have little public health relevance in a Western context, and they do not represent compelling reasons for surgery before boys are old enough to decide for themselves.

Read the rest here.