Stop Routine Infant Circumcision

Routine Infant Circumcision: What the Experts Say:

"There is no absolute medical indication for routine circumcision of newborns".

American Academy of Pediatrics, Report of the Ad Hoc Task Force on Circumcision, Pediatrics, vol. 56 no. 4, (October 1975)

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"There are no medical indications for routine male circumcision. It is a traumatic procedure performed without anesthesia to remove a normal, functional and protective prepuce."

(Royal Australasian College of Physicians - RACP- ; Australian Association of Paediatric Surgeons, New Zealand Society of Paediatric Surgeons, Urological Society of Australasia, Royal Australasian College of Surgeons, and Paediatric Society of New Zealand) - September 2002

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"Circumcision of newborns should not be routinely (i.e., in the absence of medical indication) performed." [Since there are no medical indications for circumcision in the newborn period, in effect, the CPS is saying that newborn circumcisions should not be performed.]

(Canadian Paediatric Society) - 1996

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(Routine infant circumcision's) "acceptability is rooted in traditional and cultural values. Circumcision should not be routinely prescribed on the basis of beliefs disguised as science".

Dozor, Robert, MD, "Routine Neonatal Circumcision: Boundary of Ritual and Science" American Family Physician, vol. 41, no. 3

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To circumcise... would be unethical and inappropriate .... Circumcision should be performed only for medical reasons."

British Medical Association

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"Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision". "We can not recommend a policy of routine newborn circumcision".

American Academy of Pediatrics.

RIC: it's history in recent times
Warning: the links below will activate a pop-up window which may show male genitalia in some cases.

82% of the world's males at the present moment are intact (i.e. not circumcised). Routine infant circumcision as a preventative or cure for masturbation was proposed in Victorian times in America, and soon became institusionalised. Over the years, circumcision has been seen as a cure or preventative measure for all manner of conditions including paralysis, insanity, epilepsy, tuberculosis, enuresis, masturbation and phimosis, through to the contemporary claims for prevention of urinary tract infections in boys, and penile cancer and sexually transmitted diseases in adult males.

The procedure of routine circumcision became commonplace in the US between 1870 and 1920, and it consequently spread to other English-speaking countries (England, Canada, Australia and New Zealand). None of the lattter countries nowadays routinely circumcise the majority of their male children for non-religious purposes, a distinction reserved today for the United States (in the UK, in fact, nonreligious circumcision has virtually ceased). Yet, there are still those who promote this social surgery, long after the masturbation hysteria of the past century has subsided.

In 1888, John Harvey Kellogg, MD, of breakfast cereal fame (photo at right), - who did more to popularise RIC thann anyone else - summed up the medical profession's opinion and gave justification for the next 60 years of foreskin removal: "A remedy for masturbation which is almost always successful in small boys is circumcision. The operation should be performed by a surgeon without administering an anesthetic, as the brief pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment. In females, the author has found the application of pure carbolic acid to the clitoris an excellent means of allaying the abnormal excitement." (John Harvey Kellogg, M.D., "Treatment for Self-Abuse and its Effects, Plain Fact for Old and Young", Burlington, Iowa: F. Segner & Co. (1888). P. 295)

Even before Kellogg, the Lancet published an article in 1860 recommending circumcision as both punishment and "treatment" for masturbation. "In cases of masturbation we must, I believe, break the habit by inducing such a condition of the (genital) parts as will cause too much local suffering to allow of the practice to be continued. For this purpose, if the prepuce is long, we may circumcise the male patient with present and probably with future advantages; the operation, too, should not be performed under chloroform, so that the pain experienced may be associated with the habit we wish to eradicate."

The circumcision advocates gained popularity, vigorously promoting the procedure with zeal as a cure-all for all ailments, and specifically "self-abuse" (masturbation).

RIC: a dying custom

During the last 50-100 years, routine neonatal male circumcision thus became widespread in many English-speaking countries. Being circumcised was a sign that the individual had been delivered by a doctor rather than by a midwife. The rates of circumcision at present vary from country to country, being about 60% in the USA (with recent data suggesting falling rates, after peaking in the 1980's), 30% in Ontario, Canada, 6% in the UK (rates fell when circumcision became unavailable on the NHS), and less than 2% in Scandinavia. After peaking in the 1980's, circumcision rates in the US are rapidly falling as we entered the 21st century At its peak popularity during the 1980's, it was estimated that 69% to 97% of all boys and men in the United States had been circumcised, in comparison with 70% of those in Australia, 48% of those in Canada and 24% of those in the United Kingdom. The procedure is even being questioned among some non-Orthodox Jewish parents who are departing from the traditional bris, the ceremony of circumcision that initiates a baby into a covenant with God. Instead, they turn to Jewish laws that forbid the causing of pain to any living thing. Circumcision is uncommon in northern European countries, Central and South America and Asia. The procedure is more common in African and Pacific Island communities where traditional circumcisers are often used, and in the Middle East where it is performed as a religious rite.

In 1949, the important work of Gairdner appeared in Britain, which led to the virtual cessation of medically-motivated circumcision in that country. Australia and New Zealand now also have very low rates (5% or less, most of which are now performed under a general anaesthetic in boys older than six months). From its original roots in the ancient world and the 19th century anti-masturbation hysteria, non-ritual routine infant circumcision however continues in English-speaking western countries (the United States, and to a lesser extent Canada, Australia and New Zealand) because of mistaken beliefs and unfounded fears amongst a small part of the population about hygiene, disease, appearance and sexuality, and denial of the pain of infant circumcision. Even to this day, circumcision is still imbedded in outdated and unscientific beliefs tending on witchcraft and sorcery, but is still strongly promoted by the circumcision zealots, many of whom have a financial stake in the procedure.

By the early 1980's American medical doctors had grudgingly accepted that circumcision didn't prevent masturbation so they suspended their 130-year campaign against the "evils" of masturbation - and other ailments which circumcision was supposed to "cure" - but still promised that circumcision prevented (or at least reduced the likelihood of) sexually transmitted diseases (specifically HIV/Aids), penile cancer, cervical cancer in women, urinary tract infections, and kidney failure. On a more elementary level, circumcision zealots invented the smegma "problem" - something which is non-existent when normal body hygiene is practised.

The largest problem remains in the United States, where the procedure has become culturally entrenched. Each day in the US, over 3,330 male newborns (60%) still have their foreskin forcibly amputated without anesthesia in most (54% of) cases at the insistence of gullible parents; annually over 1.25 million babies, costing over $200 million.The American public largely still believes circumcision to be a useful procedure, even though the rest of the world does perfectly well without it. Most medical aid schemes regard it as a non-subsidised "cosmetic" treatment, rather than a medically necessary or even desirable procedure.

RIC: The modern day situation & scientific facts

What then are the basic facts about RIC as it is known today?

COMPLICATIONS AND RISKS OF RIC

Performing RIC has its short and long time risks. Reports of two large series have suggested that the short term complication rate (immediately following circumcision) is somewhere between 0.2% and 0.6%. [Another study showed a much higher rate: 2-10% for both minor and major complications.] Bleeding and infection, occasionally leading to sepsis, are the most common adverse events requiring treatment, but is not at all the only complications of RIC.

Therefore, the incidence of complications of circumcision approaches or exceeds the incidence of UTI among intact male infants. Although some of the complications are less severe than a UTI, the incidence and cost of complications need to be included in any assessment of the cost-effectiveness of routine circumcision.

SURGICAL SCARS

Apart from the short term complications of RIC, the most common permanent consequences of circumcision are surgical scars. An estimated 30% of circumcised males show surgical scars which range from minor to severe. Operating scars, skin bridges, skin tags , and excessive removal of foreskin are common, with at the other extreme surgical mishaps in which the penis head was almost severed from the shaft. Because of the interruption of the normal blood flow through the penis as a result of circumcision, varicose veins often develop. Although cosmetic surgery can reduce the impact of some of these surgical disasters, the victims have to live with it for the rest of their lives. The impact of surgical scars and penis mutilation is far more frequent in third world countries where routine male circumcision is often practised.

PAIN DURING RIC

There is considerable evidence that newborns who are circumcised without analgesia experience pain and physiological stress. Neonatal physiologic responses to circumcision include changes in heart rate, blood pressure, oxygen saturation, and cortisol levels.One report has noted that circumcised infants exhibit a stronger pain response to subsequent routine immunization than do intact infants.

There is adequate evidence that the circumcision procedure also results in a disruption in the early bonding which occurs between the mother and child. The pain and trauma which the infant undergoes during and after circumcision usually interrupts breast feeding which can be a factor in interfering with bonding as well as causing a lessening of trust of the mother by her infant.

In the very rare few cases (less than 4% of newborn male babies) where circumcision is medically necessary ( the best recognised indication for circumcision is phimosis which cannot be treated otherwise), parents should insist on local or preferably general anaesthesia and proper pain-killing procedures.

HYGIENE

Circumcision has been suggested as an effective method of maintaining penile hygiene since the time of the Egyptian dynasties , but the AAP (American Academy of Pediatrics) says "there is little evidence to affirm the association between circumcision status and optimum penile hygiene". "The intact penis is easy to keep clean. . . . Caring for your son's intact penis requires no special action. . . . Foreskin retraction should never be forced." Circumcsion is most popular in countries with low levels of personal hygiene, warm climates and scarce water resources (where a daily bath is not the norm).

In one study, appropriate hygiene decreased significantly the incidence of phimosis, adhesions, and inflammation (all complications for which circumcision is often regarded as a "remedy"). In this study, 60% of parents remembered receiving instructions on the care of the intact penis, and most followed the advice they were given. Various studies suggest that genital hygiene needs to be emphasized as a preventive health topic throughout a patient's lifetime, despite the circumcision status. The daily care of the intact penis takes very little more care than that of the circumcised penis during the daily bath: roll back the foreskin of the intact penis and give the head a rinse with soap and water, just as you would in the case of a circumcised penis.

UTI's (Urinary Tract Infections)

Data for multiple studies suggest that intact male infants are more likely than are circumcised males to develop a UTI in the first year of life. Urinary tract infections are not life threatening and are easily treated in most cases. The incidence of UTI among male infants was significantly higher just after circumcision (from 9 to 20 days of life) than during the rest of the first month of life and significantly higher in the first month of life than during the rest of the year. An epidemiological study of UTI during the first year of life involving 169 children born in Israel found that 48% of the male infants presented with UTI within 12 days after ritual circumcision.

Published date from a population-based cohort study of 58,000 Canadian infants suggests an intact male infant has a 1 in 140 chance of being hospitalized for a UTI during the first year of life; a circumcised male infant has an approximate 1 in 530 chance of being hospitalized for a UTI during the first year of life. Using numbers from the literature, one can estimate that 7 to 14 of 1000 intact male infants will develop a UTI during the first year of life, compared with 1 to 2 of 1000 circumcised male infants. Although the relative risk of UTI in intact male infants compared with circumcised male infants is increased, the absolute risk of developing a UTI in an intact male infant is low (at most, ~1%). This is of the same order of magnitude as the risk of contracting a complication during RIC. Why risk the possibility of complications as a result of RIC when it is of the same order of magnitude as the risk of contracting a UTI? Stating the statistics above in a different manner: intact males have a 99,3% chance of NOT getting a UTI, whereas a circumcised male has a 99,8% chance of NOT getting a UTI. To perform RIC as a reason for limiting the chances of contracting a UTI is scientifically ujustified.

CANCER OF THE PENIS

Cancer of the penis is a rare disease (and much rarer than breast cancer in females); the annual age-adjusted incidence of penile cancer is 0.9 to 1.0 per 100 000 males in the United States. In countries where the overwhelming majority of men are intact, the rate of cancer varies from 0.82 per 100 000 in Denmark to 2.9 to 6.8 per 100 000 in Brazil and 2.0 to 10.5 per 100 000 in India. Statistics prove that penile cancer shows a far greater correlation with personal hygiene and smoking than it does to circumcision status. More men contract cancer of the breast than penile cancer, yet their breasts are not routinely surgically removed for this reason.

An annual penile cancer rate of 0.9 to 1.0 per 100 000 translates to 9 to 10 cases per year per 1 million men (the majority of which are treatable). In a developed country such as the United States, penile cancer is a rare disease and the risk of penile cancer developing in an intact man, although increased compared with a circumcised man, is low. Nevertheless, because this disease is rare and occurs later in life, the use of circumcision as a preventive practice is not justified, and in many countries where most men are intact, the penile cancer rate is lower than that of the United States, where RIC is still common.

The risk of contracting a complication during RIC is far more than the risk of contracting penis cancer. In fact, in 1996, representatives of the American Cancer Society wrote a letter to the American Academy of Pediatrics pointing out that, "fatalities caused by circumcision accidents may approximate the mortality rate from penile cancer.... Perpetuating the mistaken belief that circumcision prevents cancer is inappropriate.'"

"There is no proven, documented medical reason that says circumcision is better," says Karin Blakemore, director of the maternal-fetal medicine division at Johns Hopkins University School of Medicine. Between an estimated 2 and 50 infants die every year in the U.S. due to complications from circumcision - more than the annual fatality rate in intact males due to penis cancer.

STD'S AND HIV/AIDS

Evidence regarding the relationship of circumcision to STD's in general is complex and conflicting. Claims that intact males have a higher risk for HIV infection have not been confirmed. Fleiss et al. have described the many natural immunological protective mechanisms provided by the prepuce against infection.The prepuce has many immunological protections against disease.1These mechanisms may explain why surgically-altered, circumcised men seem to have a greater incidence of many different STDs. Dried-out mucous membranes are more prone to infection than naturally moist ones (which is the reason people tend to get more colds in the wintertime!).The foreskin naturally moisturizes the glans penis, keeping it in optimum healthy condition to resist infection. The subpreputial moisture also contains lyzosyme, an enzyme that attacks and destroys the cell walls of bacteria.

Laumann et al. reviewed data from the National Health and Social Life Survey.They found no evidence of a prophylactic role for circumcision. In fact, there was a slight tendency in the opposite direction. The absence of the foreskin was significantly associated with bacterial STDs among men who have had many sexual partners in their lifetimes. Tanne reported on the epidemic of STD's, including herpes, human papillomavirus infection, hepatitis B, and HIV infection in the United States. The incidence of STD in the United States is amongst the highest in the industrialized world. This should not be surprising, considering the high incidence of circumcision in the US:

Regardless of these findings, behavioral factors are far more important risk factors for acquisition of HIV and other sexually transmissible diseases than circumcision status, and circumcision cannot be responsibly viewed as "protecting" against such infections. It is documented that circumcised adult males exhibit a greater tendency to engage in risky sexual behavior. The only sure safeguard against STD's and HIV/Aids is practising safe sex, not having the foreskin amputated. And circumcision does not equal safe sex. The chances of contracting HIV/Aids during unsafe sex only differs between a circumcised and an intact male; circumcision does not provide protection agains HIV/Aids. If that was the case, how do we explain the far higher incidence of HIV/Aids amongst American males (of whom 60% are routinely circumcised nowadays) as opposed to the far lower incidence of HIV/Aids amonst European males, of whom 90% are intact? And how do you explain the excessively high rate of HIV/Aids in Ethiopia, where virtually all males are circumcised?

The National Organization of Circumcision Resource Centers (NOCIRC) finds that, based on currently available data, male circumcision is not effective in preventing the transmission or reception of any sexually transmitted disease, including HIV. Furthermore, the promotion of circumcision to prevent HIV transmission/reception is likely to provide a false sense of
security in circumcised males and to divert attention and resources from effective proven measures of disease control. Moreover, male circumcision has many adverse physical, sexual, and psychological effects. In view of these adverse effects and lack of efficacy, the use of male circumcision as a disease control measure is contraindicated and inappropriate.

HUMAN RIGHTS

Even if it was made to be painless, George Denniston - a Seattle physician and founder of Doctors Opposing Circumcision -
asserts, "The practice (of RIC) violates all seven principles of the American Medical Association's code of ethics." As currently
practiced in U.S. hospitals, circumcision is essentially cosmetic surgery not only done without anesthesia, but done, obviously,
without the informed consent of the patient. According to the American Academy of Pediatrics Committee on Bioethics,
"Parental permission [as proxy consent] is only acceptable in situations where medical intervention has a clear and immediate
medical necessity." The latter occurs in between 4 to 6 out of every 1000 male babies.

When an infant or child is circumcised, they did NOT make the decision. This makes it a VIOLATION OF HUMAN RIGHTS. If parents are so sure the child would approve, why not wait until he's old enough to make up his own mind?

Furthermore, unlike necessary interventions such as inoculation and vaccination against diseases, circumcision is a totally unnecessary procedure.

Several United Nations resolutions, conventions and declarations appear to forbid routine infant male circumcision. These prohibitions are based on such critical rights as the rights of the child, the right to freedom of religion, the right to the highest attainable standard of health, and the right to protection against torture.

The Convention on the Rights of the Child - which the United States had signed but not ratified - imposes various obligations which are violated by male genital mutilation, including sexual abuse, torture, interference with privacy, the right to safety while under the care of a parent or guardian, and the right to health.

LONG TERM PSYCHOLOGICAL EFFECTS

Without published studies, current knowledge of men's feelings about their circumcision is generally based on reports from self-selected men who have contacted the Circumcision Resource Center (CRC) and other circumcision information organizations. The feelings reported generally include anger, sense of loss, shame, sense of having been victimized and violated, fear, distrust, grief, and jealousy of intact men.

The overwhelming majority of these men were circumcised as newborn infants. The memory of this event is not in their conscious awareness. Consequently, the connection between present feelings and circumcision may not be clear. However, some men attribute many negative feelings to their circumcision. Based on the responses of men who contacted the CRC, the origin of this attribution is in the impact of discovering one's circumcision as a child. If a child grows in a community that has children who are not circumcised, it is probable that someday the circumcised boy will notice the difference. Under certain circumstances the realization that part of the penis was cut off can have trauma-like consequences, such as recurrent unwelcome thoughts and images.

The effects of the operation are not restricted to the sexual sphere, since psychologically, circumcision is a trauma which can result in a great variety of post traumatic stress disorder (PTSD) symptoms, as can other traumas. Those include learned helplessness, tendencies towards sado-masochistic behaviors, impotence, lost of trust, avoidance of intimacy due to fear, rage, domestic violence, rape, child sexual abuse, suicide, and a range of psychosomatic disorders.

ETHICS

The international ethics code for medical practices is based on four criteria:

Beneficence
Non-maleficence
Justice
Autonomy

How does RIC stand up to these four criteria?

Beneficence: any medical procedure must be beneficient. The American Academy of Pediatrics stated clearly: "There is no absolute medical indication for routine circumcision of newborns", i.e. there are no clear cut medical benefits as a result of circumcision which justifies its application. RIC is unneccessary and fails this test.

Non-maleficence: As well intended as they may be, parents who force RIC on their newborn male babies allow a violent and painful act to be performed on them, often without the application of anaesthesia - one which modifies their bodies irreversibly. RIC fails this test.

Justice: Justice is clearly NOT served by performing RIC on a baby boy; it is NOT a just act. RIC fails this test.

Autonomy: i.e. having a say over one's own body. Clearly RIC fails this test miserably: the autonomy of baby boys are taken away when non-consensual RIC is performed on them. RIC fails this test.

The scoreboard: on the ethics question, RIC fails all four internationally accepted criteria, scoring nil out of four.

UNINFORMED DECISIONS

A majority of boys born in the United States still undergo nonritual routine circumcisions. This occurs in large measure because parental decision-making is based on social or cultural expectations, rather than medical concerns. Studies from the 1980s suggested that the presentation of medical information on the potential advantages and disadvantages of circumcision had little influence on parents' decisions. This finding was recently confirmed. In another contemporary study, nearly half of those physicians performing circumcisions did not discuss the potential medical risks and benefits of elective circumcision prior to delivery of the infant son. Deferral of discussion until after birth, combined with the fact that many parents' decisions about circumcision are preconceived, contribute to the high rate of elective circumcision [The other major contributing factor is the willingness - even keenness - of doctors to do it.] Major factors in pppaarental decision-making are the father's circumcision status (fathers who mistakenly believe that their sons would like "to look like daddy"), opinions of family members and friends, a desire for conformity in their son's appearance, and the mistaken belief that the circumcised penis is easier to care for with respect to local hygiene. [All of these become irrelevant if the penis's owner later decides he would prefer his penis to have been left alone.] Circumcsion as a "remedy" for medical reasons are indeed unwarranted, since modern medicine has adequate circumcision alternatives to treat and prevent penile problems.

LOSS OF SENSITIVITY

Circumcision ALWAYS causes irreparable loss of sexual pleasure because of a loss of sensitivity. Men circumcised in adulthood say this loss is as much as 90%! Male circumcision removes 33 - 50% of the penile skin, as well as nearly all of the penile fine touch neuroreceptors. The foreskin protects the head of the penis, enhances sexual pleasure, and facilitates intercourse. Men circumcised as adults report a significant loss of sensitivity. People who say that circumcision doesn't affect or only slightly affects sexuality have NOT experienced both worlds.

The foreskin is erogenous tissue filled with nerve endings called stretch receptors. These nerve endings fire when they are stretched, rolled, or massaged. The only purpose of these nerve endings is to make sex more enjoyable. The stretch receptors are unlike the nerve endings in the head of the penis which are very sensitive to friction but can be so sensitive that the sensation can be irritating or painful. The nerve endings in the head of the penis tend to trigger orgasm much more than the nerve endings in the foreskin that can enhance penile sensations during sex.

This flesh is like the hood of the female clitoris in function and anatomy. Both are comparable to the sensitive tissue of eyelids, inner lining of the tips and palms of the hands. No sane person would consider female circumcision as necessary, but yet many regard routine male infant circumcision as a "necessary" procedure.

Unlike the penis intact, the circumcised penis is not protected by a sheath. The constantly exposed glans grows layers ofnerveless, leather-like cells (cornification) in an attempt to protect itself and [over time] the head becomes an abnormal, unnatural,desensitized and toughened organ .” Men circumcised later in life have complained that the removal of their foreskin dramatically reduced their sensual experience. This is an irreversable, life-long sentence.

IMPOTENCE

Circumcised men are FAR more likely to acquire erectile dysfunction (impotence). For one thing, during circumcision, the blood supply of the penis is DRASTICALLY altered, and many blood vessels are destroyed. Since erection relies on blood, it's easy to see why this is so detrimental. More importantly, erectile dysfunctions can be caused by the severe loss of sexual pleasure from circumcision, and the constant callusing of the glans penis.

Circumcision is an act of DESTRUCTION. It destroys flesh, blood vessels, muscle tissue, sexual nerves, and much more. It destroys the victims sense of wholeness and their rights. It is destruction and mutilation. A circumcised penis is LESS PENIS.

YES, BUT WHAT ABOUT SMEGMA?

The circumcision zealots, in desperate efforts to "justify" the operation (now that it is no longer regarded as a "cure" for masturbation and its supposed dire consequences) has focused on smegma. All mammals produce smegma, including the cirumcised ones (both male and female)

"Analogous to tears, smegma is the compilation of secretions by ectopic sebaceous glands located in the prepuce, the seminal secretions of the Cowper's gland and the prostate, the mucin content of the secretions of the urethral glands, and the sloughed epithelial cells. It provides the necessary mucosal lubricant and moisturizer and is rich in sexual pheromones. The prepuce normally prevents detection of this phenomenally charged scent until the glans is exposed at the time erection takes place." (Routine Neonatal Circumcision: An Update, by Robert S. Van Howe, MD)

Not only is smegma (a Greek word meaning "soap") not harmful, it is actually beneficial, serving as a protective coating and lubricant for the glans.Its antibacterial and antiviral properties keep the penis clean and healthy. Circumcisions do not end the production of smegma; it merely gets smeared off on the underclothes. Women also produce smegma, quite a bit more than men actually (and they are not circumcised for doing so!). Smegma is not dirty: smegma is a combination of natural glans lubrication and discarded cells. The production of smegma is part of the process of cellular regeneration. It is natural and healthy. A daily bath would get rid of any smegma accumulated under the foreskin by rolling it back and rinsing the glans penis. After all, you don't pull your teeth out simply because plaque forms on them; you clean them with a toothbrush.

BEAUTY IS IN THE EYE OF THE BEHOLDER

Opinion polls amongst women living in countries where circumcision is not routinely practised, show an overwhelming preference for the appearance of the intact penis. For 85% of the women all over the world, the circumcised penis is ugly and unnatural. Besides, by simply rolling back the foreskin any intact male can indeed emulate the "circumcised look"; the opposite is impossible. This, to some extent, explains the popularity of internet websites promoting foreskin restoration. Besides, in countries where circumcision is the exception, "cut" boys are the target of jokes of lockerroom nudity.

Conclusion: There are no medical indications for routine male circumcision. For every good "reason" proposed by the pro-circumcision zealots, there are ready answers.