The Great Foreskin Debate

In case you haven't heard, a large study recently proclaimed that male circumcision cuts the rate of HIV infection in half. A New York Times article quoting an aptly named scientist states: "Circumcision is “not a magic bullet, but a potentially important intervention,” said Dr. Kevin M. De Cock, director of H.I.V./AIDS for the World Health Organization."

A few thoughts come to mind, mostly fueled by some conversations I've had with Spanish men who, almost universally, still have their foreskins (the two that I know that don't had a "medical problem" when born. Don't ask what, because that's all I know). When they hear that in the States, very few guys (at least my age) are still wearing a hoodie, they are appalled, primarily on the grounds of lost sensitivity. They have heard horror stories about this lack of sensitivity. I'm no dude, so I can't judge, but if guys without foreskins are lacking in sensitivity, having a foreskin must be the equivalent to walking around in those remote-controlled vibrating panties. I mean, is there a too sensitive? I commented to my roommate that maybe a guy's being really sensitive may be a bit of a disadvantage for the female. He thought about it (it had clearly never occurred to him before) and then said (a bit flippantly), "Yeah, I guess you're right."

Next, if getting circumcised cuts the risk of HIV infection, what the hell happens to a foreskin during sex? All I can picture are a lot of bloody and terrifying sex sessions. I mean, there must be (wince) tearing, right? Here's what the article says: "Uncircumcised men are thought to be more susceptible because the underside of the foreskin is rich in Langerhans cells, sentinel cells of the immune system, which attach easily to the human immunodeficiency virus, which causes AIDS. The foreskin also often suffers small tears during intercourse." So foreskins are full of HIV-attracting cells and they do tear, though I guess maybe unnoticeably? (p.s. the mental picture I'm forming of anthropomorphized "sentinel" cells hanging out under a foreskin are hilarious)

Then I also think about the ethics of circumcision. This what not something that crossed my mind until a Global Health class a few years ago. Everyone is up in arms about female circumcision (granted, there are many different issues involved; I'm not getting into them here), but no one ever talks about whether male circumcision is unethical. You are cutting off a piece of a person's skin, usually without their consent (because they're babies, because they're minors, because it's a cultural tradition and they don't have the power to say something against it, etc.). The argument in the States, I believe, is that it's cleaner to not have a foreskin and that no one else has a foreskin, so the boy would feel weird having one (I remember an ex-boyfriend telling me about one uncut boy in his gym class that they called "Conehead"). But what about the "unnecessary" surgery (prior to this latest article, I think the cleanliness arguments were basically negligible) and the lack of sensitivity?

And here comes this article. This seems to be a pretty clear cut (pun not originally intended, but pretty funny) argument for male circumcision. HIV is a very serious disease, even though it's lost a bit of status as such among post-Ryan White youth in the West. Even with medication, it's a death sentence. Cutting foreskins off would decrease men's risk of HIV infection, which, down the line would cut down on women's infection rates as well. A simple, yet painful (they're advocating it for adults) surgery. Not any sort of solution, but something. Here are the drawbacks: "It only lessens the chances that a man will catch the virus; it is expensive compared to condoms, abstinence or other methods; and the surgery has serious risks if performed by folk healers using dirty blades, as often happens in rural Africa."
I see a lot of backlash resulting from public health practitioners going into African countries and cutting off part of men's penises. I imagine that there are some cultural beliefs against male circumcision in at least a few of the countries most affected by HIV. Maybe if they aren't using condoms, they won't really be into circumcision. Maybe if they get circumcised, they'll think they won't need condoms anymore. I don't really have an answer and I'm not going to post an opinion. I just think it's an interesting issue in light of the medical/public health, medical anthropological, ethical, and social ramifications.

And I would be lying if I didn't admit to thinking about one superficial, positive effect of the universalization of male circumcision: no one would freak out at the thought of encountering a penis unlike one they'd ever seen before.