The Flap over Circumcision

American exceptionalism takes many forms. One of the least noticed is the preference for circumcision of boys. Other than among Muslims and Jews, for whom it is a religious or at least traditional requirement, cutting off part of the penis is alien to most other cultures and usually only carried out for medical, or occasionally aesthetic, reasons.

But the US is now trying to promote the practice in developing countries supposedly as a defense against AIDS. The Bill and Melinda Gates Foundation is supporting its propagation and the World Health Organization is being urged to do the same. The theory is that circumcised men have a roughly 50 percent less chance of contracting HIV.

Assuming that is the case, adult men may reasonably decide whether they are at risk and if so whether the loss of the penis foreskin and possible impact on sexual enjoyment is worth the lowering of HIV risk. But any such campaign carries with it the real danger that societies in Africa, where the AIDS prevention efforts are mostly focused, will result in the large scale circumcising of infants who have no choice in the matter.

Meanwhile resources are being invested in devising new ways of making circumcision easier and less liable to the complications which arise during surgery. That at least might be a benefit given the amount of hospital time being given to circumcisions in developing Africa which would be better used for dealing with essential surgeries or spending money on other forms of AIDS prevention. Thailand is well known for having dramatically reduced AIDS infection rates but has no tradition of circumcision other than among Muslims.

The US seems to assume that just because most Americans, regardless of religion, are circumcised as infants, other countries should be persuaded to do the same. What is ironic is that this push for male circumcision is being paralleled by US support for campaigns against the female equivalent practiced in many parts of north, northeast and west Africa and which is illegal in most western countries.

For sure, the practice of female genital mutilation is a gross insult to womanhood and stems from male fears of women’s sexuality. It usually involves removal of the clitoris though milder versions which only involve trimming the labia may have no more effect on ability to be aroused than the male counterpart.

But male circumcision has its sexual drawbacks too. A 2002 US report in the Journal of Health Psychology stated that "the genitally intact male has thousands of fine touch receptors and other highly erogenous nerve endings—many of which are lost to circumcision, with an inevitable reduction in sexual sensation experienced by circumcised males."

It cited studies reporting "female partners reported significantly greater sexual pleasure from intercourse with genitally intact men as compared with circumcised men" and "circumcised partners were significantly less happy about their sexual functioning than were genitally intact partners." The authors concluded, "intercourse is less satisfying for both partners when the man is circumcised".

Indeed just as Americans are trying to promote it in Africa, it has been declining in the US itself despite the claimed advantages of helping prevent HIV and other infections. In the 1980s it is estimated that 83 percent of newborns were circumcised but by 2005 this had fallen to 56 percent. It was particularly low in the west where Hispanic and Asian populations are concentrated. Among culturally western countries only Australia has a rate over 50 percent. In Canada it is just 20 percent and the European average is around 10 percent -- and almost zero in sexual health-conscious Scandinavian countries. It is also very low throughout Latin America.

As for non-Muslim Asia it is only widely practiced in South Korea and the Philippines, both as a result of past US influence rather than older cultural norms. It is rare in China, Japan, Vietnam and Thailand (other than among Muslims) and among Hindus and Sikhs in India.