To cut or not to cut? The age-old practice of circumcision has been hotly debated for some time, but in the past two years, as the country’s top medical committees and agencies have mulled the issue, the anti-cutters have grown louder. On Tuesday, a gavel tap sounded on the issue—albeit lightly—that could spark a new uproar from those who believe circumcision is a torturous practice and human rights issue.
In the first-ever proposed federal guidelines on the practice, the Centers for Disease Control and Prevention says it may ask doctors to inform both new parents and sexually active men about the benefits of circumcision in cutting down the spread of sexually transmitted diseases. The CDC argues that circumcised men reduce their risk of getting HIV from a female partner and lower the chances of transmitting herpes and human papillomavirus, among other benefits.
“The first thing it’s important to know is that male circumcision has been associated with a 50 to 60 percent reduction of H.I.V. transmission, as well as a reduction in sexually transmitted infections such as herpes, bacterial vaginosis and the human papilloma virus (H.P.V.), which causes penile and cervical cancer,” Dr. Jonathan Mermin, director of the CDC’s National Center for HIV/AIDS, toldThe New York Times.
The guidelines will be reviewed for more than a month before entering the books, but already, the anti-cutting movement has unleashed a small firestorm online.
Critics are pointing out that clinical trials used in the guidelines were conducted abroad and were focused on heterosexual transmission of HIV, though only one in 10 cases in the United States is spread that way. There is not yet conclusive research on the impact of circumcision in HIV transmission during homosexual sex.
The guidelines “are part of a long historical American cultural and medical bias to attempt to defend this traumatic genital surgery,” Ronald Goldman, executive director of the Circumcision Resource Center told the AP.
Under the Twitter hashtag #i2—which stands for “intact” and “not just one sex,” and represents “freedom from non-therapeutic circumcision”—activists have been posting reactions to the CDC recommendations. The supporters are an interesting mix, including anti-female genital mutilation activists and men's rights supporters.
“A male should choose for himself whether or not to be circumcised,” @IntactVoices tweeted, and then posted: “American #circumcision victim: ‘I am saddened. I am angry and I do weep for it all.’”
“The AAP [American Academy of Pediatrics] and the CDC have no ethics. They make it clear it’s about profit for them...not health. #i2,” @uncutbits posted.
“Condoms, NOT genital cutting!” another user added.
“The fact is that the trend of opinion on routine male circumcision is overwhelmingly negative in industrialized nations. No respected medical organization recommends infant circumcision based on the current body of medical literature,” a blogger named The Angry Intactivist posted. “Of course [the CDC] will overblow the dubious HIV/circumcision claims, but like the AAP, will continue to say ‘the parents should decide.’”
And that is accurate—the CDC has taken precautions against a potentially fiery response by stressing that the public health recommendations are not yet final. “Whatever the content may include, CDC’s final circumcision recommendations will be completely voluntary,” the CDC said.
Regardless, there could be a sidewalk full of sign-hoisting demonstrators outside the CDC if the recommendations are confirmed. Two years ago, the AAP issued a statement that “the health benefits of newborn male circumcision outweigh the risks, but the benefits are not great enough to recommend universal newborn circumcision.” Now, at the AAP’s annual conventions, anti-circumcision activists take to the streets to protect the findings. Last year in San Diego, they sported bloody pants and angry signs.
The activists’ Twitter handles and catchphrases may elicit a smirk, but theirs isn’t a fringe opinion—the number of male infants not circumcised in the United States is increasing. According to a recent study, 23 percent of baby boys don’t undergo the procedure after birth, and the number has been growing for the past half-century. According to the CDC, that figure could be even higher, around 42 percent.
And when that decision is in the hands of the individual, as the anti-cutters advocate, it probably won’t lead to a trip to the operating room. Uncircumcised heterosexual men are unlikely to go under the knife later in life—only 10 percent would consider it, according to the CDC’s own figures.