Friday, April 6, 2007

The Unkindest Cut--For a Good Cause?

Cicumcision is not something I spend a whole lot of time thinking about, except as it presents itself in my mind as a question (as in: if I had a son would I have him circumcised?), but today's news brings the issue right to the front of my mind. A recent study in Africa has shown that circumcision seems to cut the rate of HIV infection in men having heterosexual sex by as much as 60 percent. That's a pretty startling statistic, and now NYC--referred to some as still being the "epicenter" of the disease--is taking steps to but this new info to use.

As the NY Times reports today, NYC's Dept. of Health and Mental Hygiene is "planning a campaign to encourage men at high risk of AIDS to get circumcised", potentially by offering them free circumcision at hospitals around the city. There are some predictable concerns from some corners that promoting circumcision in this way will be stymie safe-sex initiatives (because men and women alike may come to think that if a man is circumcised then they are protected from HIV), but if the data is indeed correct, the campaign has a chance to save lives.

Other questions still on the table: does the impact of circumcision carry over to men having sex with other men? And what, if any, impact is there on women's HIV infection rates? Salon's Broadsheet reports that a somewhat dubious study has been released showing that women's HIV rates actually increase when their partners are circumcised--but the evidence doesn't quite seem to be there yet to back this one up (not least of all because there could be a whole host of non-biological reasons--see above--for this kind of uptick in infection rates among women).

I don't know what's "right" here but I will say that this news has definitely shifted my thinking about this question of whether I would ever circumcise my own son. Previously, I'd been of the mind that, minus a religious attachment to the practice, circumcision is pretty much a vanity play on the part of fathers who want their sons to "look like" them. Add up the facts that, in our family, there will be no other penis to compare to and that there is real pain involved for the male infant, and I was fairly sure that this was not something I would make a part of our ritual of birth.

And yet, now I find myself feeling somewhat differently about the situation. Part of what really stopped me in my tracks here was being reminded, if I ever really knew the exact number, of just how prevalent HIV is among black males in New York City. The Times reports that 20% of black men
in NYC who are between the ages of 40 and 50 are HIV+. That's one in five. And that's terrifying--particularly as someone who will, if she has a son, be producing another male member of black community.

When one in five folks who more or less look like you are infected with an essentially deadly--and highly preventable--disease, I think one's feelings about waiting around to see if the data are exactly right begin to fade. I'm sure I'd feel differently, more cautious, if circumcision was a new and untested practice, whose effect was as yet unknown. But stats like the ones we're seeing here are enough to make your head spin. Luckily, none of this is a decision, in my life, that bears any real weight at the moment, but it should be interesting to see how adult men, when faced with these numbers and the choice, respond--and how that response will differ in communities of color, poor communities, etc.

1 comment:

Tracey said...

Hi there. I've been reading your blog for a while now, and I really like it. This was a really interesting post, because I have been trying to decide where I stand on the issue of circumcision as well.

The first time I really stopped and thought about its practice was when a gay male friend of mine explained to me that he is very angry that his parents chose to have him cicumcised without giving him the choice. He felt that it denied him an entire set of sexual sensations that he might be able to have if he had not undergone the procedure. He also did not think that his was done very well, and it left him feeling unhappy with it for cosmetic reasons. It makes one wonder if perhaps this is a decision that a male should make for himself in his adulthood.

But you're right that this study makes the whole situation much more confusing. HIV prevention is a pretty powerful reason in favor of it.