And now for something completely different

N.B. - This one comes from my brother - soon-to-be PhD student in bioarchaeology at SUNY Stony Brook. Look for him and his crazy smartness next fall, in the meantime, try to digest this (it honestly might take me that long to do so . . . )

I think that most of the arguments against male circumcision stem from the idea that it is a strictly medical procedure, as opposed to a cultural expression of identity and a signifier of belonging. The argument for male circumcision as a medical necessity is admittedly shaky, though there are reasons to be skeptical of the claims of the evils of male circumcision.

First, some background. Male circumcision is a practice that has been used by many non-related cultures to signify group membership. Reasons for this mainly stem from circumcision's role as a public sign – one that is impossible to fake, as well (beyond aposthia – the condition of being born without a foreskin). Sociobiological theories (the science of behavioral evolution – based on assumptions that social behaviors undergo the same evolutionary processes as biological traits) seem to center on the role of male circumcision on the sensitivity of the penis, which could lead to a smaller chance of being cuckolded in a polygamous society; by accepting the procedure, children would gain access to greater social benefits. Frankly, I think that this is a weak explanation, with most of the effect probably being related to perceived effects on male sensitivity. As a costly surgery, however, male circumcision acts as a public sign of group identity, which may be associated with marriage structure or marriageability (given the association with polygynous societies). But that's just speculation, given some personal knowledge with Jewish marriage customs.

Practically every religious group, as well as cultural affiliations and groups have public ceremonies that induct people into them – most of these ceremonies induct children, regardless of the child's true ability to make a conscious and well-researched choice. Baptisms, circumcisions, first communions, and b'nei mitzvot are a small sample of ritualized behaviors taken from just two religions – cross-culturally, research can bring forth orders of magnitude more ceremonies that induct a child into a cultural group. At a more general level, many of the actions that parents make for their children act to induct them into cultural groups – whether it be deciding which school to enter a child into, what extra-curricular activities to join, whether and what kind of instruments, languages, or other skills should be learned. These activities are not necessarily without the child's consent, but it can hardly be said that a child would be making a completely objective choice about what activities (and cultural groups) in which they engage.

So why all of the outrage? All men are freaked out about things that happen to their penises, for good reason. Evolution would dictate that since men require a functional penis for successful insemination (at least in a competitive environment where all the other males have functional penises), there is a considerable pressure to maintain a healthy and happy penis throughout a man's reproductive life. That said, the biological role of the foreskin is what concerns people skeptical of male circumcision – obviously, there is a trade-off resulting from male circumcision, which involves the loss of the foreskin's biological function and would be balanced by social benefits bestowed by a group that practices male circumcision (such as inclusion into a society). This ignores cases of foreskin maladies, where the foreskin interferes with normal sexual behavior and its removal may be of physiological or biological benefit to the man.

The sexual effects of circumcision (as well as the biological roles of the foreskin) are still debated topics in scientific literature, with claims ranging from circumcision being beneficial, detrimental, and many of the studies finding insignificant differences. One of the major issues that cloud studies about circumcision is that sexual behavior and practice is extremely variable in humans, within and across cultures – therefore, it's extremely difficult to claim that a study has isolated circumcision as the sole variable affecting sexual performance in its participants. Another issue is that many circumcision studies require self-assessment, which is particularly tricky for humans because of the aforementioned uneasiness with anything that has affected one's penis. Another issue comes from the terms people use for evaluating circumcision's sexual effects, namely “satisfaction” and “pleasure”. These are not terms that have any scientific meaning nor do they have discrete scales that mean anything from one person to another. Sexual satisfaction and pleasure can be seen as evolving throughout a person's lifetime, changing as they have more sexual experiences, as well as other experiences and mental states that are unrelated to the physical state of one's penis. This becomes increasingly tricky when people complain about a loss of sensation and pleasure due to a circumcision performed on them within the first month of life (or after 8 days, in Jewish traditions): because someone has had practically their entire conscious life (and definitely their entire sexual life) with a circumcised penis, it is difficult, if not impossible, to determine how much sensation has been lost or how much pleasure they would have received had their foreskin been intact. Since satisfaction and pleasure are emotions felt in the brain, not the penis, studies should focus solely on the amount of stimuli sent from the penis, shaft, and foreskin rather than how those stimuli are perceived and interpreted by the test subject.

Some conclusions:
- Male circumcision has been associated with the loss of nerve endings that were present on the foreskin, prompting reports of a loss of sensation or pleasure – these effects may be caused by other reasons or not have a very large effect, because scientific studies do not show consistent significantly detrimental effects associated with circumcision.
- Because of the nature of sexual performance and perceived pleasure and satisfaction – which involves much more than just the physiological state of the penis, circumcision may be used as a scapegoat to blame a perceived lack of sexual prowess and pleasure on a procedure that was not willingly elected for by the person.
- In cultures that regularly perform male circumcisions, circumcision is a ritualized behavior that gives the recipient access to many social benefits, especially entrance into the society and access to marriageable women. These trade-offs outweigh physiological and medical risks associated with the act within that society, prompting the continuation of the practice.

Discussion of circumcision's legality:
For a society that does not regularly practice circumcision – or does not have associated social benefits to the practice (uncircumcised men are still considered Americans), the question of whether to allow circumcision as a practice becomes less based on individual benefits from circumcision; instead, the decision rests on the benefits of allowing groups that practice the custom to continue their practice without outside intervention and the same costs related to the real (as opposed to perceived) losses in pleasure, satisfaction, and reproductive function. Concerns about a child's right to a choice in the matter is not a concern of the society at large, rather of the members of a community where there are social benefits to circumcision. Obviously, groups where circumcision does not grant access to anything would be likely to not undergo the procedure, since there are only risks. However, this does not mean that a society in which the majority of the people do not receive a benefit from circumcision should ban it altogether in a heterogenous society, since that act – rather than reflecting the cost-benefit analyses of the majority of the individuals in that group – determines that groups where the practice of circumcision does impart social benefits are not welcome in the larger society.

To be specific to the case at hand, since all of the general terms were blending together above, San Francisco is not deciding whether or not they want all of their children circumcised, nor are they deciding whether they want to allow Jewish children (or Muslim children) to be circumcised. Jewish and Muslim parents will continue to circumcise their children as long as they see social benefits to it, such as the inclusion into a larger community of Jews and Muslims. San Francisco's Male Circumcision Bill instead asks residents to determine whether their city would be a welcome place for Jews and Muslims to practice their religion freely – and such a bill flies in the face of the city's history and the American Constitution.