It's summer -- time to get circumcised!

Circumcision, as demonstrated on a banana

Smack in the middle of the front page of Hangzhou's Metropolitan Express on July 8 was the headline: Summer's here. Should you cut off your foreskin? Next to the headline was the image shown above, of circumcision demonstrated on a banana.

According to the newspaper, the local children's hospital is reporting that it is performing the procedure on seventy to eighty children every day:

It is primarily elementary students between the ages of 6 and 12 who get circumcised in the summer. This is not a rare procedure; according to surgery records at the provincial children's hospital, 3,500 children were circumcised last year, and this year's number had passed 2,000 by the end of June.

The three-page feature inside the paper reads like an information pamphlet from the Children's Hospital of Zhejiang University College of Medicine (浙江大学医学院附属儿童医院, popularly known as Provincial Child Care, 省儿保).

Metropolitan Express, July 8, 2010

It's got testimonials from a father who suffered foreskin discomfort as a child, a mother who chose to put her young son through the ordeal because her 12-year-old nephew got all swollen "down there" because he was too embarrassed to tell anyone, and the hospital's Director of Urology, who recommends circumcision for males aged anywhere from three weeks to their mid-twenties (if necessary, of course).

Then there are the health benefits of circumcision: a reduced risk of HIV infection and lower rates of penile and cervical cancer (the last by a 20% reduction in HPV infection rates).

And finally, there's the issue of keeping pace with the international community:

43.09% of Urban Chinese Males Have Long Foreskins

In Chinese Andrology, the Kunming Male Circumcision Cooperative Research Group published a paper arguing that it is imperative that China promote circumcision.

According to a report from the WHO, 665 million men in the world have been circumcised, roughly 30% of the male population. In some countries, male circumcision rates are roughly 80%.

Reports published between 1997 and 2007 show that among urban males in this country, 43.09% have foreskins that are too long, and 8.99% have phimosis. But although a very high proportion ought to be circumcised, the actual circumcision rate is only 2.66%.

Director of Urology Xu Shan said that circumcision is a mature procedure that requires just 10-15 minutes under anesthesia and leaves no obvious scars. Stitches can be removed in just a week. In addition, circumcision has a long history. Tomb art from Egypt's Sixth Dynasty (2,345-2,181 BC) contains a depiction of two standing men getting circumcised. Male circumcision is recognized as one of humanity's most ancient and most common surgical procedures.

As for the possible impact on sensation and sexual performance, the article reports that experts disagree. However, says Xu Shan, "If you have a problem, the earlier you go to the hospital, the better. Otherwise, it will definitely affect sexual function."

At the end there's a FAQ that answers the most pressing question:

Q: How much does circumcision cost?
A: To get the procedure performed at Provincial Child Care, the surgery fee is 210 RMB, materials are around 200 RMB, anesthetic is 400 plus RMB, giving a total of around 800 RMB.

Baby: "Why isn't it growing?" Child: "What a pain!"
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There are currently 14 Comments for It's summer -- time to get circumcised!.

Comments on It's summer -- time to get circumcised!

This is what national medical organizations in other countries say about male circumcision:

Canadian Paediatric Society
"Recommendation: Circumcision of newborns should not be routinely performed."
"Circumcision is a 'non-therapeutic' procedure, which means it is not medically necessary."
"After reviewing the scientific evidence for and against circumcision, the CPS does not recommend routine circumcision for newborn boys. Many paediatricians no longer perform circumcisions.

RACP Policy Statement on Circumcision
"After extensive review of the literature, the Paediatrics & Child Health Division of the Royal Australasian College of Physicians has concluded that there is no medical reason for routine newborn male circumcision."
(almost all the men responsible for this statement will be circumcised themselves, as the male circumcision rate in Australia in 1950 was about 90%. "Routine" circumcision is now *banned* in public hospitals in Australia in all states except one.)

British Medical Association: The law and ethics of male circumcision - guidance for doctors
"to circumcise for therapeutic reasons where medical research has shown other techniques to be at least as effective and less invasive would be unethical and inappropriate."

The Royal Dutch Medical Association
"The official viewpoint of KNMG and other related medical/scientific organisations is that non-therapeutic circumcision of male minors is a violation of children’s rights to autonomy and physical integrity. Contrary to popular belief, circumcision can cause complications – bleeding, infection, urethral stricture and panic attacks are particularly common. KNMG is therefore urging a strong policy of deterrence. KNMG is calling upon doctors to actively and insistently inform parents who are considering the procedure of the absence of medical benefits and the danger of complications."

Drops in male circumcision:
USA: from 90% to 57%
Canada: from 48% to 32%
UK: from 35% to about 5% (about 1% among non-Muslims)
Australia: 90% to 12.6% ("routine" circumcision has recently been *banned* in public hospitals in all states except one, so the rate will now be a lot lower)
New Zealand: 95% to below 3% (mostly Samoans and Tongans)
South America and Europe: never above 5%

So according to the WHO, 70% of the world's men are NOT circumcised - and the vast majority are very glad not to be. Any discussion of circumcision should begin with the structure and function of the foreskin, uniquely placed and equipped with ~20,000 specialised nerves (like those of the fingertips or lips) to provide sexual pleasure.

Most of the 30% are circumcised for religious/cultural reasons. The English-speaking world tried it, found it did no good, and has given it up. (It was nearly universal in Australia and New Zealand in the 1950s, now it's hard to find a doctor willing to do it.)

Any "health benefits" have to be weighed up against the amount of benefit (usually less than claimed) and the rarity of the disease, and then benefits must be weighed against risk and harm.

Who says how long is "too long"? The Greeks used to prize a long foreskin, and thought a short one was a defect (they had a word for it: "lipodermos"). Phimosis can be readily treated with other surgery, or without surgery, if it needs to be treated at all.

See the Intactivism Pages for more information.

Or rather "The English-speaking world tried it, found it did no good, and has given it up" - except for the USA, where the profit motive and conservatism keep it going.

"the surgery fee is 210 RMB, materials are around 200 RMB, anesthetic is 499 RMB, giving a total of around 800 RMB."

I am not a math crack in any way, but is 210 + 200 + 499 not somewhere between 890 and 910?

9 too close to 0 on the keyboard of a hasty typist. It should be 400, not 499. I've made the correction.

Pardon the pun, but does the 'Kunming Male Circumcision Cooperative Research Group' have skin in the game?

Foreskins are too long? Who is the judge of that? I think the ONLY person to judge that is the owner of the foreskin. That would be the child.

The sad thing is that Chinese are so well-trained by their government, they're sheep. Right now the Chinese are trying so hard to gain the international community's eye, they're doing everything they can to become "modern." It's happened before. (Google "Great Leap Forward")

I bet they must be real excited now that they've hosted the Olympics, and now the World Expo in Shanghai. It would be real sad if Chinese started doing this to their children to "keep up with the Joneses."

"Too long." So, what are they using for scale? The Chinese disappoint me. That last picture is so sad. It isn't GROWING because you're a BABY, and having your normal organs isn't PAINFUL. Where are the Chinese getting this! I have a feeling they might have an American working at that hospital. Pro-circumcisers infect like the flu.

A little insight to the stupid bamboo reference: In the Sinosphere, the penis whose foreskin hasn't retracted yet is called a "wrapped stalk." This is confusing, because even after the foreskin becomes retractable, a penis, when it is covered by the foreskin, is called "wrapped stalk." And "wrapped stalk" has become a euphemism for phimosis.

At least in Japanese magazines, men are told to rid themselves of the problems of a "wrapped stalk," but what they mean is phimosis. I'm afraid some men that don't have ANY problems whatsoever are getting circumcised. This thing is spreading like the plague and we need to warn these people of the quackery that is circumcision.

It's a bad economy, and it's really sad to see a nation of millions of people in the hands of greedy charlatans. Poor, poor children...

China does not have socialised medicine. Surgeons are paid per operation, same as the USA. I trust you get the venal picture.

There is almost never a valid medical reason for circumcising a boy who is too young to have a responsible sex life. Phimosis and chronic balanitis can be treated nonsurgically. Circumcision is in no way an effective protection against STDs; condoms are. It is possible that circumcised men are more reluctant to use condoms.

Chinese medicine, like English speaking medicine over much of the 20th century, and like many USA doctors down to the present day, is ignorant of the sexual role of the bits sacrificed to circumcision. Those bits stand at centre stage of the male sexual experience.

In China, they at least use anesthesia.

South Korea circumcises boys between 10 and 16, and the Philippines does so between 7 and 10. Cultural contagion anyone?

Does the Chinese government do anything to prevent medical fraud? Charging money to perform circumcision on healthy, non-consenting children is precisely what this is. The Chinese and their children are being preyed upon by charlatans.


They do try to prevent medical fraud but there are the usual implementation problems.

The gov invests a relatively small proportion of GDP in health care, and as a result hospitals and doctors are always looking for other ways to earn money - mainly kickbacks from drug companies.

The ministry of health is working to try and reduce this profiteering culture, but don't seem to have come up with any decent regulations so far. The latest rules apparently make it too difficult for pharmaceutical companies to make a profit, and are much criticised.

There is much blather, but to me it seems a zero-sum game until the government simply invests more in health care. However, that is rarely offered as a solution despite all the discussion in this area, maybe because it's too sensitive and concerns the top levels of government.

And why does it being summer have anything to do with choosing to get circumcised? Is it an auspicious time of year to lose one's foreskin?

Interesting article! We brought home our newly adopted Chinese son 7 months ago, and he will need a circumcision for Phimosis, even though it had not been our intention to ever circumcise him. He has the extra long, infantile-like foreskin they talk about. Knowing firsthand the inflammations he has off and on, which would likely be worse in hot, humid weather, I can understand the concerns of this article. BUT the article's focus should have been on just such issues.... NOT a blanket recommendation for all children IMHO.

I had our son circumjcised at birth.He has no problem about being circumcised.I had him done to avoid problems.It is also healthier for him and any future partners he may have.

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