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The Great Circumcision Debate

13 Apr

In the last couple of months Zimbabwean men have been inundated left, right and centre with calls to undergo voluntary medical circumcision. Every time you turn on the TV/radio your ears assaulted by the pro circumcision jingles that are reminiscent of the ‘Hondo yeminda’/ ‘Our land is our prosperity’ jingles that were the soundtrack to the early days of the Zimbabwean land reform in early 2000’s. Every time you but the papers you are confronted by full spread ads encouraging men to become “smart champions” by getting circumcised. According to statistics currently only 10% of Zimbabweans get circumcised at birth. This particular circumcision drive however is directed at adult men.

It is an unusually direct and candid campaign for a country with a culture that has always leaned to the conservative side when discussing issues of sex and sexual health. Kudos to them for that. It is about time we exercised some liberalism when it comes to discussing sexual health. We have been silent for too long. We choose to pretend that we are not getting our freak on between the sheets, or as the shona term for sexual issues will have you believe, (Nyaya dezepabonde) on our mats. Since last year, more than 200,000 Zimbabwean males have been circumcised. Officials are hopeful their goal of 1.3 million circumcised men can be achieved.

Popular musicians such as Winky D, Jah Prayzah, Suluman Chimbetu and Albert Nyathi have all been recruited as brand ambassadors for this circumcision drive. (They are all being paid to be brand ambassadors)The drive is being spearheaded by Population Services International (PSI) and the Ministry of Health and Child Welfare. These ‘smart champions’ as the brand ambassadors are known all recently got circumcised in the last few months including Albert Nyathi who is at the very least is in his late forties. They are clearly not targeting just young men but even our fathers. The point is all these guys mostly in their all got circumcised as adults. This, when taken with the statistic that only 10% of Zimbabweans are circumcised serves to only highlight that circumcision has never been a big part of either traditional or contemporary Zimbabwean culture. So why the sudden drive to get Zimbabweans men to get circumcised all of a sudden? What is the motivation behind the drive?

Before I continue and in the interest of full disclosure let me state for the record that I am not circumcised. It is not something that has really been on my radar before and therefore I have never thought about it twice. Before this intensive media campaign as far as I knew neither my culture nor my religion encouraged this. As an adult in university I learned that nearly all my Muslim friends had been circumcised at birth on religious grounds. They also didn’t drink alcohol. Each to their own. That was my attitude. I was never inclined to investigate the process or form an opinion. I was happy being uncircumcised.

When I lived in Cape Town I also learned that most of my Xhosa friends where circumcised as teenagers. It was part of their initiation ceremony in which they went from boys to men. The whole process lasted a few weeks in which they retreated to the mountains as boys and came down as men. Their circumcision was on cultural and traditional grounds. You are not considered a man amongst the Xhosa until you get circumcised. This I admired and respected but I wasn’t Xhosa and neither did I want to be so again I never gave it much thought. I quietly envied the cultural significance of the process and not the actual process itself.

Fast forward to the present day.

I am finding it harder and harder to not give the whole idea of circumcision a second thought. The campaign has clearly got my attention. I find myself wanting to take an informed stand on the whole idea of voluntary medical male circumcision. From some of the things I have picked up from the debates in the local media it is a controversial and polarising issue. People in either the pro or anti circumcision camp often seem to show nothing but contempt for the other. There hardly seems to be any middle ground. The issue of circumcision is as controversial as it ever has been. But why now? From what I have picked up from the media campaign, one of the main arguments being put forward is that circumcision reduces the risk of HIV infection by 60%. Another is also reduces the chances of other sexually transmitted diseases as well also reduce the risk of your partner getting cervical cancer. It is also supposedly more hygienic, hence the “smart champions” moniker.

Whilst there are well-known religious, social, and medical reasons to recommend circumcision; however, most major medical societies have taken an “impartial” view of the procedure, neither recommending nor renouncing the practice. On a personal level I don’t find myself compelled by the pros of circumcision. And no it’s not because I am not afraid of getting cut. I just like my penis the way it is. I have also done my own reading on the subject and I haven’t been swayed either way.The issue of cervical cancer was probably the most compelling but I failed to find literature that actually backs up this argument convincingly so the jury is still out on that one. A 60% reduced risk of HIV is not even a motivator. 40% is still huge and they are more efficient ways of reducing the risk of HIV in my opinion.

I remember reading some time ago that most circumcised Zimbabwean soldiers are now reportedly having more and more unprotected sex because of the belief that you won’t get HIV if you are circumcised. It’s a gross and worrying misinterpretation of the facts if you ask me.
And then there is the hygiene angle. As an owner of an intact penis, I can confidently say that my cleaning habits are as good as anyone else and are more than sufficient to get the apparatus as clean as a whistle. If the goal is to remove people’s folds of protective, functional skin to prevent the possible accumulation of secretions then we should also go after the girls with a scalpel. I didn’t think so.

After doing my own research I am choosing to stay uncircumcised. I don’t judge those who chose, in the same way I don’t expect them to judge me for having an intact penis, which is the default. I am choosing to be pro choice when it comes to this debate. I think every man has the right to choose whether to be circumcised or not without being pressurised by anyone.

Below is some of the information available on the “Internets” on circumcision that I found helpful.

Circumcision: medical pros and cons facts

• Inability to retract the foreskin fully at birth is not a medical reason for acircumcision.
• Circumcision prevents phimosis (the inability to retract the foreskin at an age when it should normally be retractable), paraphimosis (the painful inability to return the foreskin to its original location), and balanoposthitis (inflammation of the glans and foreskin).
• Circumcision increases the chance of meatitis (inflammation of the opening of the penis).
• Circumcision may result in a decreased incidence of urinary tract infections (UTI’s)
• Circumcision may result in a lower incidence of sexually transmitted disease and may reduce HIVtransmission.
• Circumcision may lower the risk for cancer of the cervix in sexual partners.
• Circumcision may decrease the risk for cancer of the penis
• There is still no absolute medical indication for routine circumcision of the newborn.

There are some caveats though
“Touch sensitivity tests have identified the most sensitive regions of the male genitalia; in intact participants, these are all on the foreskin. Circumcision removes approximately 50% of the nerve endings on the penis, among these, fine touch nerve receptors called the Meissner Corpuscles. We all have Meissner Corpuscles in our fingertips; in the penis, they are only present on the foreskin. These are unique nerve endings which provide very nuanced feedback. Partners of intact men report that they have a better ability to pace themselves and greater control than do circumcised men, and this is almost certainly due in part to the presence of Meissner Corpuscles.”

There is a reduction in the likelihood of UTIs and penile cancer such that your risk drops from already-infinitesimal to slightly-less-than-infinitesimal. If we’re going to employ that line of reasoning, then there are a number of body parts that we must preemptively strike down before we rid ourselves of foreskins. Risk of penile cancer: 1 in 1000. Risk of breast cancer: 1 in 8. And yet I hear no one advocating for the forced removal of breast buds in children who have the abnormal genes that indicate a very high risk of breast cancer.”

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Posted by on April 13, 2014 in Culture Vulture

 

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