Will Routine Circumcision for Baby Boys Promote Teen Promiscuity?
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Actually, not one enraged commenter on yesterday's NYT article about the possibility of the CDC recommending circumcision as an HIV preventative raised that question. But the fierce opposition that still surrounds the HPV vaccination for girls centers around exactly that. If both procedures might make unprotected sex marginally safer, why is the conversation so different?
I'm not actually opposed to the CDC recommending circumcision—especially since the main effect of the recommendation would be that an always-optional procedure would remain optional, but be once again covered by Medicaid. Circumcision appears to reduce the risk of contracting the HIV virus through sex with an infected (female) partner by about 60 percent. The HPV vaccine prevents "some types" of genital warts which "may" cause cervical cancer. Neither's a slam dunk, but both might make a night of unprotected sex a less risky proposition in the long term. And teens claim to consider the risks of HIV when making the decision about whether to have sex, while HPV remains low on their radar. So it wouldn't be unreasonable to suggest that being circumsized—along with a nice public health campaign promoting the reduction in risk—might make a teen boy feel even less mortal. But it didn't come up.
Granted, circumcision is an actual procedure—one I've watched twice, and one that's not accurately described by the word "snip." And we're talking about babies, not preteens, so the whole issue of sex seems less imminent. But still, a vaccine and a procedure with a shared goal of making unsafe sex just a little safer each caused a small but vocal minority to rise up in very different forms of protest. Girls might have more sex. Boys might feel less pleasure. Could the difference be any starker?
Photograph of a teenage couple by Stockbyte/Getty Images.
KJ Dell'Antonia Former Manhattan lawyer and prosecutor, Xxtra Small reviewer, parent of four. Lover of books and bacon.
Comments
Nice statement of the obvious
By: Restoring Tally | Fri, 08/28/2009 - 12:05
Nice statement of the obvious. Guys are considered oversexed and women are not. Duh.
But, the real issue is the author buying into the whole routine infant circumcision thing. The data is not so clear cut that circumcision has that much value, particularly considering the risk of the surgery on infants. The so-called 60% reduction of HIV was from some questionable studies of African adults. There is NO evidence that those studies are applicable to US males. The US has the highest circumcision rate in the world and the highest HIV rate outside Africa. So far, circumcision has not helped keep HIV in check in the US.
The difference between being circumcised and intact is very real. I was circumcised at birth and thought nothing of being circumcised until recently. I was wondering why sex was not as much fun and why my penis was not as sensitive as it was when I was younger (I was 52). I have since restored my foreskin and life is good again. Sex is much better with a foreskin. My female partner used to get sore from sex and we needed lubricant. Now, she does not get sore and we don't need lubricant. We both enjoy sex a whole lot more. The foreskin helps both men and women.
Many men are finding out that they miss their foreskin. They, like myself, are restoring their foreskin to regain what was taken from us at birth. See RestoringForeskin.org to read accounts of men who wish they had never been circumcised and are doing something about it.
Not all HPV strains are created equal
By: amandacastleman | Thu, 08/27/2009 - 17:44
Hello KJ,
I enjoyed your wry and thoughtful take on this topic. However, I encourage you to double-check your statement: "The HPV vaccine prevents 'some types' of genital warts which 'may' cause cervical cancer". Over 40 strains exist, subdivided into two categories: low-risk (which can lead to genital warts) and high-risk (which can spark cell-mutation). As the Center for Disease Control notes: "The types of HPV that can cause genital warts are not the same as the types that can cause cancer."
Just a week ago, I had surgery to remove cervical dysplasia, abnormal "precancerous" cells, so I admit to a semantics-nerd attack here ... But the amount of misinformation out there's staggering. I've had people ask if I have herpes (no) and inform me I'd suffer from HPV my whole life (also with the no. Most people kick the virus in 6-36 months. Only 10% of women with high-risk strains have recurring problems).
As a journalist, I'm eager to spread awareness on this topic, so stigma doesn't make a tough time tougher for other women.
Some other facts that surprised me:
1. HPV can sneak around condoms and transmit through contact like heavy petting.
2. My mother - who runs several oncology clinics - said: "No one has EVER died from cervical cancer caught by an annual pap smear. At that early stage, it's precancer and easily treatable. So PAP!"
3. Some experts guesstimate that up to 60% of sexually active adults may have HPV at any given moment. Around 80-90% of us will contract some strain during our lives. Even the most conservative figures still suggest half the population will encounter HPV.
4. Healthy bodies often can shrug off the virus. But it also can remain dormant in your system for up to ten years, then ignite when you're stressed. Big fun.
5. HPV often has no symptoms and is not part of the standard battery of STD tests. Detection relies on symptoms like warts (low-risk) or a wacky pap (high-risk).
6. Good news: once you've kicked one infection (6-36 months typically), you're resistant to that strain and maybe a handful of its closest cousins. That still leaves another 30-odd, however, which is why the vaccine ROCKS so hard. Ladies need all the ammunition they can get on this front.
OK, enough with the soap box. Thanks for letting me unload my factoids!
KJ, keep up the good work. Cheers, Amanda
PS: I should stress that while I'm a pro-writer who's researched this topic extensively, I'm not a medical expert. For solid intel, check out http://www.cdc.gov/STD/HPV/STDFact-HPV.htm
Uncircumcised guy here. I'm
By: manman10 | Wed, 08/26/2009 - 13:18
Uncircumcised guy here. I'm really surprised at how hell-bent women in North America are on lopping off foreskins. What ever happened to being natural? It isn't an appendix, after all.
FACT. Circumcised guys tend to have to use lube when they masturbate. Uncircumcised guys have the choice to use it or not, but don't have to, thanks to their foreskins.
FACT. The frenulum, the piece of skin that connects between the tip of the penis and the underside of the shaft, is incredibly sensitive. When thrusting during sex, the additional pulling motion, followed by the sensation of the foreskin coming back over the head, creates pleasure that is physically denied to circumcised men.
If men were agitating to hack off every woman's clitoral hood (or similar body part), any good feminist would be up in arms. Could we have a little solidarity here?
Keep on focus.
By: Mark | Wed, 08/26/2009 - 10:55
I worked as a legislative analyst for the Commonwealth of Kentucky. While there, I was frequently berated by the Republican elected officials because we could not, in good faith, produce any analysis that did not end if staff recommendation for making the vaccine mandatory with the ever-present opt-out for concerned parents.
Of course, bills supporting the vaccine failed to make it through. Rather than simply address the issue as a public health concern, it was treated as moral issue. Apparently protecting our daughters from a certain form of cancer and an STD somehow translates into promiscuity and deprivation. Never mind the fact that there are still plenty of STDs that can be gained through poorly planned promiscuity or even as the result of a non-faithful partner in a monogamous relationship.
Comparing circumcision to the vaccine is spurious and counterproductive. Circumcision has some perceived benefits and some perceived drawbacks. Studies supporting it as possible helper in the fight against AIDs are, well, mixed. The issue isn't really a public health one, but one regarding what level of intrusion the managerial state should have in the choice of parents to circumcise their children for religious or cultural reasons.
Anti-circumcision advocates have their arguments, as do the pro-circumcision availability ones. Any funding for the procedure through tax dollars will be made on a political level, not a medical one due to the sheer loudness of both sides. The issue, not unlike abortion, is dominated by political forces now. Conflating the HPV vaccine with a political battle only reinforces the nascent political struggle over it. Giving coverage to this conflation benefits no one. Keep it within the realm of public health and ignore the screamers.
Rhetorical flourishes are so nice.
By: bamber | Tue, 08/25/2009 - 22:40
Too bad at least one commenter on the NY Times website made the argument that you claim nobody advanced.
It sounds like there might be problems with the African studies. If it's true that the circumcised group had a shorter period of sexual activity and was taught proper condom usage while the non-circumcised were not, then it's hardly apples-to-apples (or bananas to bananas, if you prefer).
Circumcision is mutilation.
By: Dark King | Tue, 08/25/2009 - 20:21
Circumcising babies is a crime against humanity that must be completely and utterly eradicated. It is nothing less than adults inflicting a major body modification on a person with no consultation whatsoever as to their individual choice.
This is not "life saving surgery". It is purely optional. There are no valid health reasons to perform such mutilation - cleanliness? Teach your son to clean himself properly. AIDS? Teach your son to use a fricking condom!
Circumcision should be the choice of the boy/man involved. And only their choice, however informed or ignorant they choose to be. For parents to mutilate their infant children like this is a crime and the state should have no part whatsoever in funding it.
great points, but...
By: Adderall Apocalypse | Tue, 08/25/2009 - 19:49
Hey. Yes. You are correct. There is a double-standard here. The thing is that male circumcision is already the norm in this country. I think it's great that the frequency of the procedure is on the decline, though. Think of it this way: There is no risk that the HPV vaccine reduces sexual pleasure, *and* there are no people in the West who advocate routine infant female genital mutilation, which clearly does reduce sexual pleasure. I definitely don't think circumcision should be performed on infants. I don't think it should be performed on people who aren't able to make an informed decision for themselves.
By the way, let's not forget that male circumcision (and female "circumcision" too, of course) has in the past been promoted as a way to *reduce* sexual promiscuity (or masturbation) by reducing sexual pleasure. In sum: The Gardisil question is *solely* a matter of reducing risk whereas circumcision also has (at least in the past) had the goal of reducing pleasure.
Absolutely dead-freaking-on
By: Kit-Kat | Tue, 08/25/2009 - 15:36
I have very little to add to this article--I think it captures the double standard here beautifully. I understand that male circumcision is an elective surgery, often performed on an infant, and as such, many people oppose it. But not *once* have I heard anyone oppose it on the ground that it will encourage promiscuity, which is an argument I have heard countless times regarding Gardasil. Not *once* have I heard that it is bad to reduce boys' risk of contracting a potentially deadly disease because that deadly disease is a result of sex, which I have heard regarding Gardasil.