National Post Letter

The National Post, one of Canada's major newspapers, published an article (http://fullcomment.nationalpost.com/2013/10/04/j-steven-svoboda-the-perils-of-circumcision/) I was invited to write after submitting a letter in response to the National Post's reprinting on September 19 (http://fullcomment.nationalpost.com/2013/09/19/mark-joseph-stern-intactivists-against-circumcision/) of Mark Joseph Stern's article, "'Intactivists' Against Circumcision," which originally appeared in Slate on September 18 (http://www.slate.com/articles/health_and_science/medical_examiner/2013/09/intactivists_online_a_fringe_group_turned_the_internet_against_circumcision.html).

Below is the text of the article as published today by the National Post.They did a nice job with the presentation including graphics.

Thanks to several helpful folks who reviewed drafts of this piece and made useful comments.

J. Steven Svoboda
Attorneys for the Rights of the Child

(http://fullcomment.nationalpost.com/2013/10/04/j-steven-svoboda-the-perils-of-circumcision/)

 


 

Last month, the National Post published Mark Joseph Stern’s article (“’Intactivists’ against circumcision, Sept. 19) criticizing  anti-circumcision activists, whom Mr. Stern dismissed as “fringe,” “paranoid” and “bizarre.”

But individuals committed to safeguarding children from unnecessary surgical interference includeleading scientists, pediatricians, public health researchersbioethicistsmedical historians, and human rights advocates from countries around the world.

Mr. Stern makes much of the so-called “health benefits” of circumcision, but he completely ignores the scientific controversy surrounding their very existence – as detailed by Brian D. Earp of the University of Oxford in a point-by-point rebuttal of Mr. Stern’s intemperate polemic.

Indeed, as a team of 37 European experts (along with the eminent Canadian pediatrician Noni MacDonald) recently wrote, infant circumcision cannot be justified as a “medical procedure” on non-consenting patients. The only health concern of even theoretical relevance to uncircumcised infants is the existence of urinary tract infections (UTIs), which are not only rare for boys, but can be effectively treated with antibiotics rather than pre-emptive surgery — just as they are for girls.

“The other claimed health benefits,” these authors write, “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.

Since Mr. Stern cites only studies showing potential benefits for circumcision, and fails to cite any studies showing drawbacks (such as pain and loss of 50% of the penile covering) or the many potential complications, his objectivity must be questioned.

Legal authorities in the United States and elsewhere have questioned even the basic legality of non-therapeutic circumcision of children. Two German courts and one Dutch court have endorsed the principle of delaying circumcision until a boy is old enough to make his own decision. In Australia, a comprehensive report on the ethical and legal status of circumcision recommended that it be prohibited except for conscientious adherents of religions and cultures that practise it as a traditional rite.

Countless men are unhappy that they were deprived of such an intimate part of their body without having had any say in the matter.

Stern derides the suggestion that circumcision has an adverse impact on sexual satisfaction, yet a recent paper in the International Journal of Epidemiology found that “circumcision was associated with frequent orgasm difficulties in Danish men and with a range of frequent sexual difficulties in women.” While the foreskin does not have “mythical powers” (as Mr. Stern sarcastically puts it), it is a complex genital structure consisting of sensitive, erogenous tissue, and is an integral part of the penis; its permanent removal, therefore, is not the “simple snip” beloved of headlines. Countless men are unhappy that they were deprived of such an intimate part of their body without having had any say in the matter.

The strictly monetary costs of circumcision include not only the immediate fees, but also the cost to repair complications, and sometimes legal expenses. The makers of the Mogen circumcision device were the target of so many successful actions for botches that they were driven out of business. A recent study in the Canadian Urological Association Journal found: “Most physicians performing neonatal circumcisions in our community have received informal and unstructured training, [leading to] unsatisfactory results [being] witnessed in our pediatric urology practice. Many practitioners are not aware of the contraindications to neonatal circumcision and most non-surgeons perform the procedure without being able to handle common post-surgical complications.”

Far from being the concern of some “vitriolic mob,” circumcision has caught the attention of highly respected moral philosophers. The Journal of Medical Ethicsrecently published a special issue on circumcision that included several articles voicing strong opposition to the removal of healthy tissue from children’s genitals.

Moreover, several recent landmark events have confirmed the “mainstream” nature of concerns about circumcision. On September 24, Sweden’s Ombudsman for Children as well as representatives of four leading Swedish physicians’ organizations declared that no medical reason exists to circumcise boys, and that the procedure causes a range of problems and violates human rights. On September 27, the children’s ombudsmen from the five Nordic countries, along with associations of Nordic pediatricians and pediatric surgeons, agreed to work with their respective national governments to achieve a ban on non-therapeutic circumcision of male minors. And on September 28, Swedish legislators introduced a bill that would outlaw circumcision of males younger than 18 years of age for non-medical reasons.

Mr Stern did get one thing right: “intactivists” certainly are winning this battle for children’s rights. More and more people are discovering the truth about circumcision for themselves, and are coming to realize that a pre-Enlightenment ritual has no business masquerading as medical treatment in the 21st Century.

National Post

J. Steven Svoboda is Executive Director for the group Attorneys for the Rights of the Child, http://www.arclaw.org

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