On the Radio, Discussing Circumcision and HIV

One of the great things about being a magazine writer is that it allows you to develop quirky areas of expertise. And indeed, I've been covering the HIV/circumcision story on and off for over two years, since I first wrote for In These Times about Mayor Bloomberg's attempt to encourage circumcision among gay men of color in New York. (Incidentally, that article was my first for editor Phoebe Connelly. A few months later, we both joined the Prospect.)

With the Times reporting this week that the CDC is considering recommending routine circumcision of American infants, the issue is gaining wider media pick-up. My boyfriend reports that he saw talking heads debating the topic on MSNBC. And this morning, I was a guest on the BBC/Times NPR show "The Takeaway," alongside Dr. Roy Gulick, chief of the Division of Infectious Diseases at Weill Cornell Medical College. You can listen to the segment, which is about 10 minutes long, here. It's a good introduction to the current research and public health debate around circumcision.

If you've been reading me periodically, you know I'm skeptical about whether circumcision is the right HIV-prevention strategy within the United States. After all, the United States already has the highest circumcision rate in the developed world — 79 percent — and also the highest HIV-infection rate. That's why advocates have been focusing on a message of "condoms, condoms, condoms" for three decades. I worry about promulgating the misconception that circumcision is a miracle cure against the AIDS epidemic, especially in communities — such as among immigrants and the poor — where encouraging regular condom use is already an uphill battle. And especially because gay men were not included in the most promising circumcision/HIV studies.

When Takeaway producer Molly Webster called me yesterday to discuss coming on the show, she asked me how I got interested in this topic — one that raises a lot of people's eyebrows, and can lead to very heated arguments in families and between partners. (Joseph O'Neill wrote a wonderful short story for Harper's dealing with the question of whether to circumcise a son.) There are a few reasons. First, I've been living for over three years in Washington, D.C., the city with the highest HIV-infection rate in the United States — 1 in every 20 adults. That horrific number inspired me to follow more closely the HIV/AIDS research coming out of Africa. I was excited and encouraged to read that among heterosexual men, circumcision can decrease HIV contraction rates by as much as 60 percent.

But that news came at a time when, on a more personal level, I was questioning the practice, especially since I am Jewish and it is considered an absolute give-in — even among totally secular Jews — that baby boys will undergo the procedure. Why is it that even as Jews have assimilated and rejected many religious practices, such as strict Kashrut, we continue, as a community, to cling to circumcision? In large part, it's because of the understandable desire for sons to look like their fathers, especially on a part of the body that carries so much psychological weight. But there's also a deep emotional tie to circumcision; a feeling of pride that Jews are physically marked as such — that a Jewish man can never totally escape his Jewishness, because it is inscribed on his body through circumcision. During the Holocaust, this was one way in which Jews were identified by the Nazis. We Jews are rightfully attached to that history. One of my friends, who is studying to become a rabbi, recently told me he considers circumcision the single most important Jewish religious obligation.

There have been discussions about circumcision in my own Jewish family, as intermarriage and new births forced some of the older members of the clan to question the practice for the first time. I don't have a firm conclusion on any of this stuff. Public health and cultural concerns need to be balanced with the reality that circumcision is surgery without consent, and that it removes a natural, though not totally essential, part of male anatomy. I suspect that circumcision rates, after declining over the past several decades, will go back up. After all, most parents would like to give their children any weapon they can to fight disease. In any case, those are my thoughts on all this, since I'm often asked why I write periodically about this topic.

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