Very often, arguments so stupid as to warrant little more than an eye roll and a click to the next article come along to annoy the intelligent reader. Those are easy enough to set aside. Sometimes, though, someone will make an argument so mind-numbingly pointless that highlighting is necessary in an effort to remind others that such drivel will be exposed for what it is. Today, I found such an argument arrived in my rss feed.
Among pediatricians and obstetricians and some insurance companies, there are few topics that generate more controversy than whether newborn boys should undergo circumcision. In this country at this time it is the most common surgical procedure being done. Having done duty with troops in the tropics, the writer has some very strong opinions about the benefits of this operation, whereas most of the physicians (primarily pediatricians) who are opposed to the routine circumcision of boys seem to have escaped the experience of heat, humidity, dirt, and poor opportunities for good personal hygiene that is often the story in the tropics. Circumcising a 20 year old is a far more formidable procedure than taking care of a 20 hour-old baby. And the 20 year-old will be disabled for duty for about 20 days, which is a great loss to the overall effectiveness of the unit, plus misery for the 20 year-old.
The perpetrator of this irrelevant tangent is Dr. Richard S. Buker, Jr., Health Officer for Liberty County, Montana. That scares me. A doctor providing information to the community should provide factual information for use by patients. This is anecdotal hooey aimed at parents with blatant disregard for the child’s medical needs and rights.
Dr. Buker thinks it’s correct to hold every boy to a standard that might – might – be appropriate in a tropical environment with limited access to proper hygiene facilities. I’m fairly certain that Liberty County, Montana does not meet that requirement. (Money should be spent on proper hygiene facilities instead of circumcision, if that’s a problem.) As for any potential decrease in troop effectiveness if soldiers are intact, Dr. Buker posits that forced surgery on infants is a benefit in case he joins our volunteer army. This is not rational. The boy can have himself circumcised before joining the military, if he so chooses.
Good evidence keeps increasing to support the argument for routine circumcision, which people should be aware of. The single biggest recent finding is that HIV/AIDS transmission is 80% less when men are circumcised. The big push in Africa and South East Asia is to get all males circumcised to decrease the spread of this horrible scourge. What works in Africa works here as well.
I’m going to be kind to Dr. Kruger and say that he is mistaken instead of lying when he quotes an 80% decrease in HIV transmission. The rate mentioned in the few studies done so far indicate a decreased incidence of between 50 and 60%. That extra 20% or more is huge, aside from the obvious arguments against the other 60%. Dr. Buker is a public health official. He must get his facts correct. The burden is especially important when he’s advocating unnecessary, permanent alteration of a child’s body.
It has long been established that the statistical risks of circumcision are considerably less that the risks of not being circumcised. Cancer of the penis is almost unknown in circumcised men. Sexually transmitted disease is less common in circumcised males. In the experience of the undersigned, who has served as a venereal disease control officer (in the tropics), chancroid was 80 times as common in uncircumcised males as in circumcised men.
Cancer of the penis is almost unknown in intact men. Sexually transmitted disease can be prevented with condoms and responsible sexual behavior. No surgery necessary.
Urinary tract infections in children under 5 years of age are less common in circumcised males. Paraphimosis (the writer hated getting up in the middle of the night to treat this problem), balanitis, and getting foreskin caught in a zipper can all be avoided by routine circumcision plus it is no fun being teased in the locker room, all of which are arguments for circumcision of newborns. What about arguments against the procedure? It is a bit cruel to overpower a helpless baby and do an operation on him, and like all operations there is a small risk. As all readers will readily have concluded by this point, the writer is highly in favor of the procedure.
UTIs are more common in girls than in intact boys. Paraphimosis (the writer should not be a doctor if he doesn’t want to treat patients) and balanitis can be avoided by procedures less invasive than circumcision. Getting the penis caught in a zipper can happen with or without circumcision. Being teased in the locker room is not a medical condition justifying surgery. The only argument against infant circumcision that Dr. Buker can come up with is that it’s a bit cruel, and there are risks. No kidding. That should be enough, since it’s also medically unnecessary at the time it’s performed.
These are the arguments of a man who’s already made up his mind and is looking for excuses in the face of logic and facts.