A Debate Not for the Faint of Foreskin

Okay, here goes. Ready? The length of what follows should make this obvious: gird your loins.

“Barefoot Intactivist,” from New York, wrote in last week about Gordon Haber’s ever-controversial essay “Uncovered” (see other discussions here and here):

I applaud that you tried to approach this subject with logic, reasoning, and facts, but unfortunately you had a number of missteps along the way. I will suggest just a couple of sources that strongly contradict your conclusions about both the harms and the purported trade-off benefits of circumcision.

First, you should have read Sorrells’, et al, study on the sensitivity of the penis, that very much focused on the sensitivity of living men’s penises, and found that the five most sensitive areas to fine-touch are contained in the foreskin. http://onlinelibrary.wiley.com/doi/10.1111/j.1464-410X.2006.06685.x/full

Also, any statistics you quoted about complication rate are complete garbage—nobody collects real data. Is somebody waiting there to ask you how your circumcision went 16 years later when you become sexually active? And isn’t having part of your penis amputated a complication?

You reveal your inherent bias when you call the foreskin “a bit of skin” that covers the end of the penis. Actually, it’s 12-15 square inches in the adult male. That’s not just a “bit of skin,” that’s a whole helluva lot of skin that is a vital part of the contiguous penile skin system. You could call the entire infant penis just “a bit of skin” since it is so tiny. The point is what it will become in an adult.

Second, the evidence against a circumcision-HIV link are hardly “bullshit.” Circumcision as HIV prevention simply does not work in the real world, outside of a clinical trial setting. USAID found that in 10 of 18 countries with data available, circumcised men were actually MORE likely to have HIV. http://www.measuredhs.com/pubs/pdf/CR22/CR22.pdf

As far as the comparison to female circumcision: please leave your emotions at the door and really look into this. There are forms of female circumcision that are both more and less harmful than male circumcision. A very common form of female circumcision involves removing a tiny piece of the clitoral hood. This is clearly less harmful than male circumcision. The most severe form (<10% of cases according to WHO), involves cutting off all the labia, clitoral hood, and clitoris, and sewing up the vagina, leaving only small hole for urine. This is clearly MORE harmful than the typical male circumcision.

Both male and female circumcisions vary in severity, involve cutting of erogenous genital tissue from a minor, are promoted for reasons of “cleanliness” that appears more moral in nature than hygienic, and both can lead to death and serious sexual dysfunction. Nobody is claiming that the average male circumcision compares to the more serious form of female circumcision (called “infibulation”), but why can’t we begin discussing genital cutting in terms of severity, rather than gender? Are you claiming it is impossible to cut a penis as badly as you cut a vulva? You’ve let your emotions get the best of you in this area, keeping you from an honest analysis. I suggest this video for a quick tutorial on the differences between male & female circumcision: http://youtu.be/98f3IavuEgQ

Again, I applaud your effort to address this issue in a logical and honest way. You’ve certainly made great progress. But you’re not there yet and are making some significant leaps of faith in order to justify cutting off part of the genitals of a non-consenting minor. I hope you’ll dig deeper.

Not that size matters (that’s dick pun #3!), but Haber came up with an even longer response:

The Barefoot Intactivist’s response to my article evinces a global error: he assumes that if I disagree with him, I must be biased. Nevertheless I gave his criticisms a careful read, as I always want to own up to my own “missteps.” In the end, while the Barefoot Intactivist (hereafter referred to as “the B.I.”) does make one or two decent points, ultimately his letter suggests that either (a) he has some issues with reading comprehension or (b) he’s batshit crazy.

As much of his letter was tangled, I’ve numbered my rebuttals:

(1) The B.I. points to a study that at first glance demonstrates that uncircumcised men have more penile sensitivity, which would help prove the intactivist assertion that circumcision destroy sexual pleasure. I actually thought this study was interesting until I got to the bottom and read that it was funded by the National Organization of Circumcision Information Resource Centers (NOCIRC), and that this organization “was involved in the design and conduct of the study; collection and interpretation of the data; and review, or approval of the manuscript.”

While I do think that it’s reasonable to suggest that uncircumcised penises are more sensitive, I’m not going to put much stock in this particular study.

(2) The second paragraph of the B.I.’s letter is a mess, three ill-considered sentences that will take ten to refute. Here goes:

The B.I. argues that the complication rates from circumcision that I quote “are complete garbage—nobody collects real data.” However the study in question did indeed use “real data” from hospital records. In addition, the authors acknowledge some limitations of the data—one sign of a good-faith study. And yet still they conclude that circumcision is a “relatively safe procedure.” In other words, the B.I. rejects a disinterested study because it doesn’t support his bias.

He then asks, “Is somebody waiting there to ask you how your circumcision went 16 years later when you become sexually active?” This question is a non-sequitur—it’s less about the data than about the fallacious intactivist belief that millions of circumcised men can’t possibly be enjoying sex with their horribly mutilated penises.

Finally the B.I. asks, “And isn’t having part of your penis amputated a complication?” Well, no, since a complication is a result of a procedure, not the procedure itself.

(3) The B.I. writes that the size of the foreskin is 12 to 15 square inches in an adult male. (From what I could learn it’s more like 10 to 15 square inches, but never mind.) That does sound like a of skin—until you learn that the average human has about 3000 14 to 18 square feet of skin.

(4) On the relationship between circumcision and HIV, the B.I. contradicts himself. First he claims that there is evidence against the link between circumcision and lower rates of HIV infection. Then he claims that circumcision to prevent HIV doesn’t work “outside of a clinical trial setting.” Which means that it works in a clinical trial setting. Which means that there is evidence that circumcision makes it harder to contract HIV.

The USAID study does indeed assert that “There appears to be no clear pattern of association between male circumcision and HIV.” However, the study looks at a number of factors—socioeconomic characteristics, risk behaviors, protective behaviors, etc.—involved with HIV contraction. Thus it is disingenuous to claim that this study refutes the link between circumcision and HIV prevention—especially if the link has been proven in a clinical setting.

(5) On the topic of comparing male to female genital cutting, I find it a little strange that a grown man who runs barefoot and emblazoned with anti-circumcision slogans is telling me “to check my emotions at the door.” Anyway, my point was simply that male and female genital cutting are not analogous. Why? Because men and women have different parts and are circumcised for different reasons.

Intactivists like to obfuscate these facts by focusing on the “severity” of circumcision, not gender. I suppose they believe that if they can erase the difference then everybody will be just as incensed by male circumcision as they are when a female is mutilated. But most females are circumcised out of a male obsession with sexual purity and fear of female sexuality. Ultimately female circumcision is about patriarchal control. Male circumcision is about religion, or a rite of passage, or (yes) a misplaced obsession with hygiene. Of course there are similarities between male and female circumcision, but it is ridiculous to suggest a direct analogy.

The Barefoot Intactivist ends his letter by suggesting that I’ve made “leaps of faith” in my discussion of circumcision. Perhaps this is a not-so-subtle-reference to my religious leanings, perhaps not. Either way he forgets that I end my piece by writing that I wouldn’t blame anybody for not circumcising their children, even Jews—not exactly a ringing endorsement for circumcision. But that’s not good enough for him. Like a lot of obsessed cranks, intactivists are unable to comprehend such subtleties.

If the Barefoot Intactivist wishes to run around without shoes in order to save little boys from the alleged horrors of circumcision, he is free to do so. But he might do well to read a little more carefully—and perhaps even take a class in critical thinking at a local college. Because clearly he doesn’t really understand terms like “evidence” or “bias.” And until he gets this stuff straight, he’s just another kook co-opting the language of argumentation and science.

Discuss amongst yourselves? Do you dare?