Surgery or savagery?

A day after he came into the world my son Myles was due to have a small operation. The procedure, male circumcision, sounds innocuous enough. I certainly thought so until the paediatric surgeon walked into our hospital room for a pre-op chat. “I just thought you should see what’s involved before we go ahead,” he said, firing up his iPad. “It is a pretty routine operation – but you need to understand the risks involved.” 

The images that flashed before me were truly gruesome: bloodied and scared penises; the faces of baby boys contorted in pain. I looked at my tiny son sleeping in the crib and felt numb with guilt. Was I really going to expose my tiny child to such a harrowing ordeal?

Our surgeon explained the procedure, possible complications and the recovery process, which can take weeks. Like other medical professionals in Australia he was careful not to express a personal opinion about the merits or otherwise of male circumcision – given its immense cultural baggage this is understandable.

But I had one burning question I needed answered. “What are the medical benefits of putting my son through this horrible ordeal?” I asked. The surgeon thought for a moment before replying carefully. “Well, none really,” he replied. “There are some American studies showing that circumcised males are less prone to contract sexually transmitted diseases – but plenty of other studies that contradict those findings. I cannot give you a compelling medical reason for doing this operation.”

My mind was made up. I would not consent to the operation. My son was a day old, small and vulnerable. I turned to my wife expecting some resistance – although born and raised in the UK, Vina’s family is from Nigeria where male circumcision is universally practiced. Perhaps exhausted by the delivery or maybe just sensing my emotional outrage, she agreed with my decision and Myles was saved from the snip – and a long and painful recovery. His foreskin would remain unmolested.

Our paediatrician looked equally relieved not to wielding the knife, even though he would forego the modest surgical fee, which incidentally was not covered by our private medical insurance. “Put it this way, when a boy is around 12 he falls in love with his penis – whether its circumcised or not,” he said. “It’s a lifelong obsession.”

Over the past few months I’ve read widely about the politics of male circumcision and canvassed the opinion of friends, family and work colleagues. The issue is deeply polarizing. Some of those opposed to the procedure describe it as little more than “butchery” – a medieval practice which is on a par with female circumcision and one with devastating results for male sexuality.

Advocates, including Professor Brian Morris from the University of Sydney, point to a number of recent American studies which suggest that circumcised males are less likely to contract diseases, such as herpes and syphilis, and have lower rates of urinary tract infection and even penile cancer.

Apart from the US, where two-thirds of boys are still circumcised, male circumcision is becoming less and less fashionable in the western world; only around 32 per cent of Australian men under 30 are circumcised. This is in stark contrast with the 1950s when the procedure was almost routine – the legacy, it has been suggested, of the many clean-living American GIs who were stationed on these shores during World War 2.
Male circumcision is still widely practiced in both the Jewish and African communities where the ritual has compelling religious and cultural significance. But the medical consensus, at least in Australia, is that the procedure is unnecessary and in many ways undesirable – the Royal Australasian College of Physicians says, based on available evidence, that the level of protection against disease offered by circumcision does not “warrant routine infant circumcision in Australia and New Zealand”.

So why do otherwise sane and rational people subject their baby sons to such a painful and potentially dangerous procedure? According to the BUPA website around 4 per cent of all newly circumcised babies suffer complications, such as bleeding, infection and permanent damage to the penis. Death from uncontrolled bleeding, meningitis and septicaemia are rare, but not unheard of.

Given the advances in personal hygiene (and the questionable benefits mentioned above) male circumcision should be as popular in 21^st Century Australia as witch burning. So why is it still being practiced?
Could it be, as Professor Morris argues, that vital facts about this ancient and controversial procedure are being withheld from us by the medical establishment? Or does it simply come down to aesthetics? Does the world still prefer the neater look of a circumcised penis?