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Letter to Pediatrics: A goldfish knows nothing of water

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Published on Apr 1, 2013

eletter published in Pediatrics, March 27, 2013

A goldfish knows nothing about water. The American Academy of Pediatrics Task Force on Circumcision is unaware of the peculiar circumcising culture in which it is immersed. For example, characters in American TV sitcoms may exhibit a casual vindictiveness toward the foreskin, or the man with one, that would cause widespread outrage if it involved race.1 American medical texts portray "normal" penises as circumcised, and may define the foreskin as "the part removed by circumcision".2

This unawareness permeates the Task Force's 2012 circumcision policy.3 Dr Morten Frisch and 37 eminent European pediatricians, speaking for 22 pediatric associations, and for 17 countries from Iceland to Lithuania, have accurately pointed it out. The Task Force's reply amounts to "Tu quoque" ("You're another").

Those countries have "a clear bias against circumcision" the same way they have "a clear bias against parentally-elective infant toe amputation". They have no Task Forces on Leaving Boys' Genitals Alone.

The reply, like the policy itself, discounts the only study that actually attempted to measure the sensitivity of the foreskin itself, by ignoring its main, uncontested, finding: "male circumcision ablates the most sensitive part of the penis."4

The Task Force admits the role of the innervation of the foreskin in experiencing pain, but not pleasure. Frisch et al. do not need to "speculate" about it: they almost certainly have foreskins, or partners who have them. Human lips also "have nerve fibers". Whose first thought about those would be how to minimise the pain of lip-removal? Who needs proof that the nerves of the lips are intimately involved in the pleasure of kissing? To deny that a richly innervated structure, near the head of the penis, with a unique rolling action, is involved in sexual pleasure, is perverse. Impairing that pleasure was one of the purposes of circumcision, explicit for 1900 years until "medical" circumcision became customary and a generation had grown up that had never experienced sex unimpaired5

The Task Force now admits that the basic right to physical integrity is an important one, but it ignored that important basic right in its 2012 policy.

It contrasts the harm of being circumcised (without any measure of the worst of that harm, such as major complications and death) with a new, undocumented and unmeasured "harm of not being circumcised", but such harm could equally apply to failure to amputate any other less-than-vital body parts, such as the earlobes.
The Task Force offers no rebuttal to Frisch et al.'s substantive case, based on the AAP's own policy, that the diseases circumcision reduces (if the studies the Task Force cites are to be relied on) are so rare, or of such late onset, or so readily prevented or treated, that circumcising infants to prevent them is a bad option compared to letting the child grow up to decide the fate of his own genitals.

Its original claim that "the benefits outweigh the risks" was made with no actual weighing. It is now nowhere to be seen, and goes undefended.

References
1. Young, H. "That Thing": portrayal of the foreskin and circumcision in popular media, in "Human Rights Under Assault: The Atrocity of Circumcision" (Springer 2008), and online at the Intactivism Pages
2. Roberts, A. The Complete Human Body, DK Publishing (2010): Guyton, AC, Hall, JE. Textbook of Medical Physiology Saunders (2000): McCracken, TO ed. New Atlas of Human Anatomy MetroBooks (2001)
3. American Academy of Pediatrics Task Force on Circumcision. Male circumcision. Pediatrics. 2012;130(3).
4. Sorrells ML, Snyder JL, Reiss MD, et al. Fine-touch pressure thresholds in the adult penis. BJU Int. 2007;99(4):864-869
5. Philo of Alexandria, Of the special laws, Book I (ii), in Works of Philo, trans. F. H. Colson, Loeb Classical Library, 1937, Vol. VII, p. 105

Conflict of Interest:
I edit the Intactivism Pages ("Circumstitions")

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