THE XX FILES: Male genital mutilation?

Raquel Ronzone

“You can’t discuss female genital mutilation without addressing its counterpart, male genital mutilation.”

That comment on my article about female genital mutilation surprised me. Male genital mutilation? I was asked to consider something I didn’t even know existed.

Attribute my initial ignorance of the term to the taboo nature of the human body and to its unfamiliar name. 

But male genital mutilation actually refers to one of the most widely performed surgical procedures in the country: male circumcision.

Citing religious reasons, health benefits or aesthetics, parents opt for this procedure for their newborn boys. The practice appears to be a slight to significant norm, with national rates of neonatal circumcision estimated between 65 and 80 percent, though numbers vary across regions and ethnicities.

As the term male genital mutilation implies, however, there is another side to the circumcision story. Emerging from under the radar, the campaign against neonatal circumcision is publicly questioning the ethics and medical value of the custom commonly accepted as a social standard. The movement asserts that the permanent and nonconsensual removal of healthy tissue in baby boys is a violation of human rights that not only inflicts severe pain, but also fails to provide substantial medical advantages.

The issue has gained media attention with the recent decision of the Centers for Disease Control and Prevention and the American Academy of Pediatrics to contemplate, for the first time, the recommendation of the routine circumcision of baby boys as a means of reducing the spread of HIV.

Before these developments, though, circumcision advocates have often named health benefits, mainly the reduced risk of contracting HIV, as the foremost argument in favor of the procedure.

Their assertions are accurate. Three clinical trials in Africa showed that circumcision lowered a man’s risk of contracting HIV from heterosexual sex by 60 percent, but these conclusions, although promising, are not completely applicable to the United States.

First, this figure applies strictly to heterosexual sex, the leading mode of HIV transmission in Africa. In the United States, the disease is spread primarily through intravenous drug use and through homosexual sex between males. 

To date, studies have not found convincing data to determine the effectiveness of circumcision on homosexual sex.

Second, circumcision risks giving individuals a false sense of security by failing to acknowledge the value of comprehensive sex education and condom use. 

The Department of Urology at the UCLA School of Medicine even regards patient education and the practice of low-risk sexual activity as more preventative than routine circumcision in reducing the spread of HIV.

Advocates also cite decreased risk of urinary tract infections and penile cancer as justifications for circumcision. Surely, in males whose urological abnormalities predispose them to UTIs, circumcision has more pronounced medical benefits. For others, proper hygiene offers comparable protection from UTIs.

The argument that circumcision reduces the risk of penile cancer is more complex. Penile cancer is not associated with the foreskin itself but with a complication of phimosis in which the foreskin tightens to prevent retraction over the glans. Phimosis, in turn, is associated with poor hygiene.

Access to clean water and the practice of proper hygiene can reduce the risk of UTIs, too, and those two factors — in addition to a healthy, smoke-free lifestyle — can reduce the risk of penile cancer, which is already rare, accounting for less than 1 percent of cancers in men in the United States. (In fact, penile cancer occurs in about 1 man in 100,000 in the United States. Compare that to the lifetime risk of breast cancer for a man: 1 in 1,000 in the United States.)

All of the relevant facts about circumcision must be put in context and receive critical evaluation. 

As a surgical procedure, it comes with risks: in the United States, neonatal circumcision has an estimated complication rate between 0.1 percent and 35 percent, with infection, bleeding and failure to remove enough foreskin as the most common problems.

In America, the choice of circumcision is, and will be, personal. But we should not be mistaken: circumcision is not a cure-all. We cannot just eliminate private body parts because we are unwilling to provide young people with facts and proper health education or because we are too ashamed to foster a sense of sexual accountability in them. 

Despite our reluctance and the negative influence of political agendas, we still need to teach young boys — and girls — to care for their own bodies and the bodies of others.


Raquel Ronzone is a junior communication major from Philadelphia.  She can be reached at [email protected].