Monday, June 14, 2010

DCMM: Hey AAP: Ready to Reverse Course on Male Circumcision, Too?

I run in a pretty “crunchy” crowd. Or rather, I used to run in an ultra-crunchy crowd. You know - the kind that grows vegetables in the backyard, argues about the conservative media bias, and generally considers Birkenstocks to be perfectly acceptable for the office. I never seriously considered a hospital birth because I knew from the start I wanted my babies born at home if at all possible. But I knew when I was a new mom I needed to flap my social wings a bit. I found myself socializing with other mamas, if only for the reassurance that my son’s (remarkably poor) eating and (remarkably poor) sleeping was normal. (It was). Imagine my surprise, then, as I sat with a group of moms at a Friday jazz program at the National Gallery of Art when the conversation turned to circumcision.

One of the moms of a girl asked the group (which formed from a lunchtime gathering at the Breastfeeding Center of Greater Washington) about whether folks had their sons circumcised and at the point when I was about to say “of course not, I’m friends with the author of the MGM bill, and he has convinced me the procedure is unnecessary and potentially harmful”, I was interrupted and another woman answered (and I do not think I will ever forget this) “Of course I did! I don’t want my son to be a freak! I want girls to like him!”, and then the next woman spoke up about her son’s bris, and a third chimed in about how her son didn’t even blink during the procedure which clearly showed it wasn’t painful (though others would argue her son might have been in shock). At this point, I looked down at my glass of wine, blinked back a tear, and took it as one more sign that life as I knew it before a baby was gone. If I wanted to have some mommy friends, which I desperately did, I was going to have to take a step to the right and bite my tongue. Or at least bite my tongue.

I was reminded of this conversation a few weeks ago when the American Academy of Pediatrics (AAP) put out a position statement —which they subsequently reversed—regarding female circumcision, or female genital cutting (FGC). After a loud public outcry, the AAP has reaffirmed their opposition to all forms of FGC, noting that it is forbidden by federal law in the United States.

But I wonder, what will the AAP say in the revised policy on male circumcision that is due out later this year? Currently, the AAP’s policy indicates that circumcision is not essential to a child’s health and furthermore, scientific benefits of the procedure are not sufficient for the AAP to recommend that all infant boys be circumcised. Yet, at least in this country (though few other Western countries), circumcision remains the norm (though that majority is getting slim). Contrast this with Canada, where fewer than one-third of infant males are circumcised. And that’s true of many European countries as well.

How did I make the decision? I thought about a few things. My son could only reasonably expect to be able to reverse my decision to not circumcise. A choice to have him circumcised would be a lifelong one. My husband and I thought this decision ought to be his. As a mom that often looked like a deer in headlights, I often go back to the mantra “first, do no harm” – and this pointed me in the direction of not having him circumcised. I dismissed the argument that my son wouldn’t “match” his peers the same way my mom dismissed me when I used this logic as a girl “If Suzy jumped off a bridge would you follow her?”. But most of all, it just never made sense to me. The routine removal of a body part wasn’t something my husband or I could justify. And so we didn’t. I'm crossing my fingers that when the AAP's new policy statement on male circumcision comes out, they agree with me.



This is an original DCMetroMoms post. Elaine writes about less controversial topics at Connor and Helen!


These were the original comments on the post:

Jessica C./Claire Jess said...
This mama of an intact boy says thanks for writing!

Reply June 14, 2010 at 05:44 AM Tiffany said...
Oh, I know that feeling. Making non-mainstream decisions regarding your children puts you in a veeerrryyy awkward position in mommy groups. Comments like the ones you heard make me cringe as well. It saddens me that the choice to remove a normal healthy body part is based on the desire to look good for the girls.....Gah!

Reply June 14, 2010 at 05:57 AM ElaineMM said in reply to Tiffany...
How girls may or may not perceive my son is not - and hopefully never will be - grounds for a decision like this.

Reply June 14, 2010 at 07:02 AM Rebecca said...
Great post. I am a mom four uncircumsised boys. I'd like to think the woman they pick to marry would look past that part of them to the men they will be. (In answer to your friend's reasoning.)

Reply June 14, 2010 at 06:26 AM ElaineMM said in reply to Rebecca...
Me too. In all the conversations I had about this, how a woman would perceive my son never came up.

Reply June 14, 2010 at 07:01 AM Marilyn Milos, RN said in reply to Rebecca...
Any woman who understands the importance of the foreskin and recognizes how much better sex is with an intact man will thank their mother-in-law for protecting her son! My grandson and his wife have both thanked me!

Reply June 16, 2010 at 10:47 AM Robin (noteverstill) said...
We're Jewish and religious(ish) and my son had a bris. We never considered otherwise - I just can't turn my back on a multi-thousand year tradition and what we are taught is God's commandment. I wonder, though, if I wasn't Jewish... I think I probably would be against it for many of the reasons you describe. My first two kids were girls and I never had to think about this. With #3 it was only a philosophical discussion because we do feel religiously obligated, but it was an interesting philosophical discussion to pursue. I so understand about biting my tongue re: parenting opinions. I hope those of us who circumcise for religious reasons, at least, don't make you uncomfortable with our decisions. I think the most important thing is that you're putting so much thought into how you'll care for your son - that's what will make him turn out right.

Reply June 14, 2010 at 06:31 AM ElaineMM said in reply to Robin (noteverstill)...
Because I'm not Jewish, I never had to think about it, so it's hard for me to truly be in your shoes. I do, however, appreciate that thoughtful parenting will go a long way. And yes, biting tongues. Always biting tongues in new crowds.

Reply June 14, 2010 at 07:00 AM Marilyn Milos, RN said in reply to Robin (noteverstill)...
I suggest you read Marked in Your Flesh: Circumcision from Ancient Judea to Modern America, by Professor Emeritus Leonard Glick, MD, PhD, in which he discusses how circumcision was inserted into the Bible in Genesis 17 by the priests (P text)about a thousand years after Abraham allegedly lived. The original covenant was Genesis 15, which said nothing about circumcision. Many Jews today are now welcoming their babies with a bris shalom, a celebration of peace, a naming ceremony, without the cut. It's not being circumcision, but being born of a Jewish mother that makes one a Jew.

Reply June 16, 2010 at 11:01 AM Marilyn Milos, RN said in reply to Marilyn Milos, RN...
Oops, that should be been "It's not being circumcised but being born of a Jewish mother that makes one a Jew."

Reply June 16, 2010 at 11:02 AM Kiki La Roo said...
Good for you, from a mama of an intact boy.

The "I want girls to like him" excuse kills me. My daughter has seen her brother's parts many a time...it will be normal to her, when the time comes.

It's the penis owner's choice in my book. The end.

Reply June 14, 2010 at 06:41 AM ElaineMM said in reply to Kiki La Roo...
This is the reason that kills me most as well. Seriously? I like to think I would not have cared about this, even as a 20-something. GAH!

Reply June 14, 2010 at 06:59 AM Vickie said...
Hmm. I have no memory of this conversation, but I can sympathize with the tongue-biting.

T's circumcised. We never thought he wouldn't be, because where we come from, ALL boys are circumcised (or at least, all catholic/christian boys are; am not sure about the Muslim population). In his dad's time, it's a rite of passage, typically done before setting foot in high school. Most families nowadays have it done soon after their boys are born, though.

We always thought we'd be headed back home within a few years, so it made sense to me that T ought to resemble what I thought would be his peer group. I don't think anyone thinks twice about this back home. I've also never heard any stories of circumcisions gone wrong back home. I did read that book about twin boys in the midwest where one was mutilated during his procedure and his parents decided to raise him as a girl with horrible consequences.

Reply June 14, 2010 at 10:28 AM ElaineMM said in reply to Vickie...
You read the most interesting books, Vickie! I can tell you more details about the conversation. I remember a lot. But I do not remember you being there, so possibly you weren't. It really bummed me out at the time, and I didn't have the confidence to engage anyone in a debate about it, so I just sat there quiet and stunned. Now, I wish I had challenged the person in question a bit.

That's interesting that the procedure used to be rite of passage that took place at a time when a boy could understand what was happening. I wonder what motivated the change to it being an infant procedure.

Reply June 14, 2010 at 02:25 PM Vickie said in reply to ElaineMM...
Haha! The book was nonfiction (and I am too lazy to google it now) but I remember the impression it made on me--back in the 60s when the mutilation happened the thinking among psychologists that gender identity is tied to genitals. But the boy who was forced to become a girl grew up unhappy and aggressive and not comfortable in his own skin until he found out the truth. As an adult he decided to be who he really was (a man), got reconstructive surgery, etc. and last I heard had a family.

Quite possibly I wasn't there--I don't remember making NGA Jazz until T was older, and never with a big group.

In the less urban areas back home, I think this is still a cusp-of-teenage years ritual for many boys. (Who don't even go to a doctor for this--sometimes it's a barber, sometimes a faith healer.)

I think as people become more affluent, they make the decision to have it done early to spare their sons the spectacle of spending the days after the procedure wearing their sisters'/mothers' slips or skirts. And they may rationalize it by saying that the baby won't remember the pain.

For us it was also an insurance decision! Circumcision is covered completely when performed within a certain number of days following birth, but my brother-in-law found out the hard way that if you wait till your boys are teens or tweens AND you live in the US, it costs minimum $700 per kid.

Reply June 14, 2010 at 08:00 PM Deni said...
This is a personal choice and we all need to allow it to stay out of the list of things we judge! I am the sister of 6 brothers (dad and brothers not circumcised) mother of 6 (4 boys all circumcised) our decision was because we had seen a friends boy that had to have it done at 4yrs old for medical reasons and thought better to prevent with it done early. We realize that it is the exception to have issues either way and left the decision for our 4 grandchildren to their parents without judgment!

We are all free to be individuals so just base your decision on who you are not what others think!

Reply June 14, 2010 at 10:57 AM ElaineMM said in reply to Deni...
That's true often, right? We ought to base our decisions on who we are, not what others think. Now that's a lesson I'd like to figure out how to pass on successfully. Could apply in a lot of contexts.

Reply June 14, 2010 at 02:26 PM Marilyn Milos, RN said in reply to Deni...
Now we're beginning to understand circumcision as a human rights issue, so we've begun to recognize that it is not our right but a choice that actually belongs to the person who will live with the loss and consequences of a decision made by someone else.

Initially, we didn't understand how the pain, trauma, or harms of circumcision affected our sons but, during the past 30 years, thousands upon thousands of men have voiced their complaints. They describe their scars, skin bridges, missing pieces, the problem of premature ejaculation in the early sexually active years, and the problem of sexual dysfunction leading to impotence later. Form cannot be altered without altering function. Circumcision disturbs the normal sex life of both the male and his sexual partner.

Believe me, I am not sitting in judgment, I have three circumcised sons. But, after witnessing a circumcision when my sons were 10, 17, and 20, during which the baby screamed horrifically and the doctor looked into my tear-streaked face and said, "There is no medical reason for doing this," I devoted my life to bringing an end to non-therapeutic genital cutting of non-consenting minors, whether they are boys, girls, or intersex children.

Now, I have four intact grandsons, so we learn.
Reply June 16, 2010 at 11:19 AM ohslowburn said...
Thanks for this - I wasn't aware the AAP had reversed it's recommendation, something I care and blogged about (whole other subject!).

As for the male circumcision thing, I take comfort in something my husband said when we decided not to have our boys clipped - "honey, no one will say a thing, it's really not like men walk around looking too closely at one another's shlongs." Okay then. :P

Furthermore, if he really really wants to "be like the others" he can choose to do it later in life. I imagine it's an ordeal, but at least he'll have a choice and will go into it with his eyes open.

Reply June 14, 2010 at 11:07 AM ElaineMM said in reply to ohslowburn...
Wow! Those are some powerful posts. A friend and I went down this same debate road right after the policy came out. It is all about protecting young people, in the end. And wouldn't life be easier if we knew exactly how we could do this best? Thanks for writing! You've given me more to think about.

Reply June 14, 2010 at 02:32 PM Jenni said...
Mom to two intact boys. We never even considered it. We just felt like the foreskin is there for a reason and we did not feel comfortable with the procedure.

You know, I heard that the AAP is actually going to alter their recommendation to the "for circumcision" category as some studies show it may reduce the spread of AIDS. I can't help but think that teaching our sons to practice safe sex would go a lot further with regards to AIDS prevention.

Reply June 14, 2010 at 11:32 AM ElaineMM said in reply to Jenni...
I know about the study that made a big splash in Africa about AIDS prevention. Two subsequent studies had the opposite findings, and of course, you point out that there are more direct ways in the US we can think about AIDS prevention. I'm definitely curious about what the AAP is going to say.

Reply June 14, 2010 at 02:19 PM Marilyn Milos, RN said in reply to Jenni...
You're absolutely correct that safe sex practices would go a lot further to protect against AIDS. In fact, the spread of AIDS has been curbed in Thailand, Senegal, and Eastern Uganda because those governments took a strong leadership role, educating about the dangers of HIV/AIDS, with a new campaign of "100% condom use 100% of the time!" Then, they distributed free condoms.

The African studies, done by researchers who were promoting circumcision for other reasons before they used AIDS as the excuse, are suspect!

The horror is the vast numbers of men who are being circumcised in Africa now because they've bought into the hype. Our NOCIRC of Kenya director, Prince Hillary Maloba, reports that Kenyans who have been circumcised to prevent AIDS are wondering now why they've acquired it, even though they were circumcised. How many more will be harmed, have their sex lives diminished, or die because of this misuse of funds. In addition, those men who think circumcision will protect them may very well be even more promiscuous because they're circumcised, believing they're protected.

Education, not amputation!

Reply June 16, 2010 at 11:26 AM Jenni said...
Glad to hear they retracted that bogus position on FGC, though. Ridiculous.

Reply June 14, 2010 at 11:34 AM Ladybug Crossing said...
My husband and his brother both had to have circumcisions at the age of for medical reasons. Trust me, it was not pleasant for either of them. When our son came along, both my husband and my BIL were adamant that our #1 get circumcised as an infant. I absolutely agreed. Genetics were not in our favor for leaving things alone.
Do I care if you circumcise your boy? No. Will I tell you what happened to my Mr. and his brother? Sure I will. But, when it comes right down to it, the choice is yours.
LBC

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