When my editor asked me to write about circumcision this week, in response to a new statement on the subject by the American Academy of Pediatrics, my first thoughts were rather superficial. And panicked.
“I feel a little weird about this,” I told her. “Because I suppose the obvious thing for me to do is to write about the decision we made for our sons.”
“Yeah?” she said.
“Well, that means I, essentially, have to … for this article … undress my sons. And myself. We kind of made the decision based on me.”
“I would have just assumed you are,” she said, laughing.
And at this stage, I need to offer a couple of quick notes. Number one, ladies, don’t laugh when a man is discussing his penis. The context is irrelevant. Penis talk demands—if not an expression of awe from you—at least a straight face. Two, as embarrassed as I felt in that moment, things got worse after I looked over the material she sent me.
My wife, Lisa, and I did our research and picked a fight or two during pregnancy. Lisa made a difficult decision to press for a natural childbirth, for instance, and we hired a doula. But I must admit, when it came to the decision of whether or not to circumcise our boys, I never hesitated. In fact, I never even thought to look at the literature.
“What do you think, honey?” my wife asked.
I answered based solely on what was in my own pants. And I only learned after my editor gave me this assignment that the subject is fraught with controversy. In fact, that new statement from the American Academy of Pediatrics had sparked myriad articles and responses. Breaking from strict neutrality, the AAP issued what might be best interpreted as a politic recommendation in favor of circumcision. And at first glance, the stats do seem unequivocal.
After reviewing studies conducted between 1995 and 2010, the AAP found the circumcised enjoy significant reductions in the risks of acquiring HIV, herpes, syphilis, penile cancer and urinary tract infections. But, it turns out, there is plenty of reason for confusion. Opponents of circumcision claim the procedure is religion-fueled barbarism, removing functioning skin and causing unnecessary pain and risk of infection. The infant emerges traumatized. And the operation forever reduces the patient’s sexual pleasure. As Ronald Goldman, executive director of the Circumcision Resource Center in Boston, recently told the Daily Beast: The adult foreskin is highly erogenous tissue. “We’re talking about a double layer of skin with specialized nerves that is completely foreign to circumcised men,” Goldman said. “[The circumcised] literally don’t know what they’re missing.”
Worse, a group called Doctors Opposing Circumcision released a statement of its own condemning the AAP:
“The AAP, despite its high-sounding academic name, actually is a trade association of pediatric doctors. Its primary duty is to advance the business and professional interests of its 60,000 members… . The interests of its child-patients are a distant second to their primary interest.”
Through the ’70s and ’80s, the circumcision business was booming. The great majority of American boys got their foreskins snipped. But that number has dropped, and perhaps fewer than half of boys born today undergo the procedure. The upshot is that an organization like the AAP could have a profit motive for pooling the data that supports circumcision while giving less credence to studies that undermine the operation. And of course, that is what the “leave your son’s penis whole” chorus—the most strident of whom call themselves “intactivists”—are hollering now.
The result, for me, is that I’m taking a couple of parenting lessons from this episode.
Number one, I’ve been put in charge of two brand new-boys, through no particularly impressive qualifications of my own, and in one of my first tests I acted without thinking. So the first lesson is obvious: When possible, I need to do the research ahead of time and be prepared for the decisions I’ll face. To find that I made a call like this so quickly, with so little forethought, is deeply embarrassing. And simply put, I know better.
The second lesson, however, is subtler and perhaps even more troubling: The second lesson is that, sometimes, the research won’t yield a clear picture.
We tend to traffic these days in a romanticized vision of science, describing it in its most idealized terms as a rational process in which fair-minded practitioners gather data and follow where it leads in an impressively analytical, dispassionate frame of mind. But up close, science is messy and practiced, without fail, by us humans—who are usually anything but ideal. So when the data isn’t entirely clear—do the health benefits ouweigh the risks?— a debate like the one on circumcision takes on the tenor of a hair-pulling contest.
The truth of this leaves me in a difficult position as a new parent: I know that I should dig into the data whenever it’s available. But I also need to question those numbers, and accept that scouring medical journal archives at PubMed could ultimately lead me back to where I started: my own gut.
I don’t particularly like this conclusion. I wish our science was so powerful that I could data my way through this entire experience, playing the odds and ticking off the statistics to be the world’s greatest dad. But that doesn’t seem possible. In this instance, for example, my wife and I made an instinctive decision on what should be an empirical question. Yet whether we made the right choice, or the wrong one, remains a subject for debate. And no, I’m not saying which choice we made. Because after all this, the one thing I am sure of is that out here, in public, the Volk family should keep its pants on.