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This week I stepped blindly into the circumcision debate, which, lately, seems to generate as much fervor as abortion. I am guest blogging at the Daily Dish, and wrote in favor of the CDC's proposal to recommend more circumcisions as a protection against HIV and STDs. My posts drew dozens of e-mails that ranged from vile to condescending. "You're a typical woman," began one, and went downhill from there.
Always a sensitive topic, it's gotten even more so during the health care debate. Conservatives have lately taken it up as the symbol of what Obama plans to do to them. Gabriel Winant of Salon writes a very funny piece on the subject, quoting Rush Limbaugh: "It is President Obama who wants [to] mandate circumcision. ... And that means, if we need to save our penises from anybody, it's Obama."
Since most of my responses came from outraged men, I want to poll lady DoubleX readers on the topic: Are you outraged by circumcision? If so, please write and tell us about it.
Photograph by Getty Images.
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On the Daily Dish, Hanna waded into fearsome waters when she suggested that the reaction to the CDC's consideration of promoting routine circumcision for babies in the United States has been hysterical. I generally find the anti-circumcision advocates to be on the crazy and rabid side, too. I have two circumcised boys, and I thought at the time that getting snipped bothered my kids a little more than their newborn vaccines and a little less than the spinal tap my older son had when he was a few days old. Plus, I'm prone to be defensive of this ancient Jewish carnal practice.
But on scientific grounds, I still think neutrality on circumcision is the way to go. Yes, the results of circumcising adult men in South Africa were stunning, in terms of HIV prevention. But as I wrote when those findings came out:
Circumcision is a lot trickier to implement widely than other preventive measures like vaccines. This is surgery, after all, which when done on adult men involves weeks of recovery. If the South African findings are borne out, says Seth Berkley, president of the International AIDS Vaccine Initiative, it may make sense to mount a public-health campaign to circumcise as many men as possible in places like South Africa where AIDS is rampant. But that says little about the United States, where the risk of contracting HIV is low for most people. Which is why the American circumcision debate probably will never be settled by science.
For babies, of course, there are no weeks of recovery (just ineradicable trauma, the antis would retort!) And so the CDC doctors who want to raise declining circumcision rates in the U.S. talk about this as one more "tool in the toolbox" of AIDS prevention. If it's a harmless enough intervention, why not? That rationale works for me, personally. But I don't think it really makes sense as medical policy. The CDC shouldn't push circumcision on American parents who don't want it until the agency has a better answer than, hey, it might help here, too—it just might.
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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.