I have been noticing a very strange interpretation of “risks and benefits” in the AAP’s statements and also in various message boards. I would be interested in hearing if anyone else has found instances of this, and what you make of it.
Basically, it is the idea that “if you believe circumcision is not right, then the benefits do not outweigh the risks for you. But if you believe that circumcision is right, then the benefits do outweigh the risks for you.” Instead of “for you,” sometimes it says “for your son” or “for your family.” It’s very nebulous.
On the face of it, it’s ridiculous. How could a scientific fact or statistical calculation change based on one’s beliefs? It seems to fit with circumcision apologists’ fluid way of understanding the nature of scientific reality: Start with a belief and then create whatever scientific data around it you like, in order to support your pre-conceived conclusion. It’s actually an indirect admission that they know their policy is all fairy-tale thinking, anyway.
Of course, their own weird argument can be used against them, by saying, “OK, let’s just concede that you are right, that as long as someone believes that circumcision is not right, then the benefits will not outweigh the risks for that person’s child. If that’s true, then that means that you can spare your son the pain and harms of circumcision by just changing your own mind, educating yourself, and believing that circumcision is not beneficial. Because if you do, then, ta-da!, the risk/benefit ratio will alter for your child, and he won’t actually need circumcision anymore!”
A darker explanation exists for this apparent paradox, though. You could say that believing in circumcision does make the benefits outweigh the risks if you define benefits as “benefits to the parents in terms of their cultural identity, their egos, their aesthetic preferences, not having to displease the in-laws, not having to undergo cognitive dissonance by having their beliefs challenged through education, etc.” And perhaps in some twisted way, they also mean benefits to the child because if the parents and grandparents and religious community are happier with the child who has a circumcised penis (crazy, I know…), then the child will be happier because he has more acceptance and love in his life. Of course, if they really want to bring up the argument of the male’s (and his parents’) cultural, social and psychological well-being, then they really would need to state that explicitly, and include research data on how circumcision has negatively affected men and parents in those ways. Of course, they have not included any of that research in this report.
An example of this idea, that benefits and risks vary depending upon parental belief, appears in a very interesting exchange that occurred recently on the Facebook page of the Tennessee Chapter of the AAP. The AAP’s commenter stated: “So for Carolyn I would agree that for you risks clearly outweigh benefits and I would support your decision to not circumcise your child.” Mind you, Carolyn had not given any specific medical information about her child, so it was a statement not based on any inherent medical or physical specifics of a particular child. Obviously, the AAP representative was taking into account Carolyn’s beliefs and education in his analysis of the risk/benefit ratio for any child of hers.
Even in the AAP’s report, they actually do make it clear that the risks and benefits they are talking about are not purely medical, but are also religious, cultural, and based on parental preferences. They state: “Parents should weigh the health benefits and risks in light of their own religious, cultural, and personal preferences, as the medical benefits alone may not outweigh these other considerations for individual families.” This statement is very slippery, because they make it sound like if you disregard “religious, cultural, and personal preferences,” and ONLY look at the medical side, the benefits outweigh the risks. But they actually never mention the concept of risks in this part of the sentence. They just say the medical benefits may not outweigh these “considerations”… which is odd, because what else would the “benefits” be outweighing but “risks” or “contraindications”? They seem to imply that “religious, cultural, and personal preference” are common reasons for not circumcising, whereas actually they are, more often, common reasons people use to circumcise. Trying to evaluate this sentence is like wrestling a very slippery eel, because it doesn’t make logical sense or state anything directly, but it seems pretty clear to me that they are trying to introduce the idea that “religious, cultural, and personal preference” has a place in the risk/benefit calculation of circumcision.
Actually, the sentence makes perfect logical sense if you replace one instance of the word “benefits” with the word “risks” thusly (change shown with underlined italics):
“Parents should weigh the health benefits and risks in light of their own religious, cultural, and personal preferences, as the medical risks alone may not outweigh these other considerations for individual families.” In other words, if your religious, cultural, and personal preferences are in favor of circumcision, that tilts the risk/benefit ratio in your child’s case, because we are including benefit of religious and cultural factors, and benefit of the parents being pleased. Doesn’t that make much more sense? The way they actually wrote the sentence, the reader cannot logically interpret that any “religious, cultural, and personal preference” in favor of circumcision can be used to make the decision. Remember, they said “medical benefits alone may not outweigh these other considerations.” But how slippery they are, to avoid actually going on record as saying that those cultural considerations are part of the “benefits,” but to make it so complex and convoluted that 99% of people will read that they are.
I tend to think that is how they originally wrote it, and then changed “risks” to “benefits” to hide their true thought process, because otherwise, the sentence is nonsensical.
Of course, in a medical review, the concept of benefit to another person is completely ridiculous. With that logic, you could say that incest upon a pre-teen has more benefits than risks, because her abuser could say, “Well, it really benefitted me!”
The bottom line is this: Since they are doing a review of medical literature, and not a religious, sociological, cultural, or family dynamics review, then they really have no place in introducing the concepts of “religious, cultural, or personal preferences” and using those as factors influencing the decision to circumcise. They make it very unclear and slippery as to whether these non-medical considerations and benefits to the parents are actually included in their calculation about “benefits outweighing risks.” And they seem to state that those factors would only influence one not to circumcise, whereas actually, those factors are generally used in favor of choosing circumcision, and will definitely be read as such by anyone reading that sentence and not spending 2 hours analyzing it, as I did.
Strangely enough, many pro-circumcision parents seem to really resonate with this concept of how risks and benefits apply differently to different people. In a recent “Circle of Moms” thread, here are some of the comments: (from https://www.facebook.com/circleofmoms/posts/137461759730511)
- I did not feel it was beneficial for my son, you did. My choice was right for my son as your choice was right for your son. I definitely don't think you "abused" your son, as I hope that you don't think that I am "putting my son's health at risk". We can all be great parents and yet make different choices.
- [and the response to the above comment] of course I don't think you are putting your son at risk. :-) I respect your decision as well as your opinion that you as a mom made for your son. And thank you for respecting mine. I'm glad that some of us can have different opinions but still be respectful to one another. As a mom I know for a fact that you made the decision that's best for you son as do we all
- Respectfully to each their own. What works for one family does not always work for another. Do for your family as you see fit for you and yours.
The interesting thing about these posts is the concept they embrace, that whatever you do is actually the right thing objectively for your child, and is therefore “better” than if you had done the opposite. But how could that be, logically speaking? We are not looking at the different medical conditions of the different children, or even their different religions (of origin) or cultural backgrounds. It is understandable that these mothers want to avoid conflict or guilt at all costs, but their resulting statements are illogical. What is really unforgivable is when the AAP also trots out this convoluted logic, where just thinking something makes it true.
