Andron dismisses the anti-circumcision crowd as a "noisy minority." Jewish boys, he says, might be mocked for not being circumcised, and Jews need to be circumcised before being buried in Jewish cemeteries. At times, Andron has even been called to perform the grim task of circumcising a stillborn baby.
If God is omnipotent and omniscient, why would he make baby boys born imperfect and in need of a surgery at birth? Andron takes a moment to answer. "God wants us to be part of the creation... Creation is incomplete. God doesn't give it to us finished."
Courtesy of Michael Andron
Michael Andron after a bris.
Deirdra Funcheon
Dr. Helen Salsbury circumcises a baby.
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Back at the bris, the baby unleashes a piercing cry, breathes rapidly, and squawks like a parrot. But only for a moment. True to his word, Andron completes the procedure in seconds. The foreskin is set aside for the family. It is typically buried.
In a short speech, Andron announces the baby's Hebrew name: Jacob. This is his "user ID to get into Heaven. Today he begins his spiritual journey — who he is, why he's here, and what he came to accomplish."
Andron lights a candle, passes a glass of wine, and holds the baby in the air like a trophy. The little one has stopped crying and fallen asleep.
Great-grandma blows out the candle, everyone claps, and Andron shouts, "Mazel tov!"
John D. Geisheker keeps a database of "foreskin-friendly" doctors. In some states, such as Iowa, there are none. As the executive director and general counsel for Doctors Opposing Circumcision, he spends a lot of time fielding calls from parents of intact babies. He also files complaints against doctors who forcibly retract infants' foreskins in a misguided effort to "clean" them. That creates a "wound," equivalent to breaking a girl's hymen, Geisheker says.
A native of New Zealand, where the circumcision rate is almost nil, he says he's stunned at how few doctors here know how to care for an intact penis and scoffs at the American notion "that boys have a birth defect."
Geisheker says his all-volunteer group is constantly waging intellectual war against circumcision proponents. The Doctors Opposing Circumcision website lays out medical arguments against circumcision: It removes 50 percent of the foreskin, including the most sensitive areas of the penis. The foreskin protects the penis from infections and keeps the tip of the penis soft and moist.
But the biggest hurdle to the anti-circumcision movement is research indicating that circumcision has a protective effect against sexually transmitted diseases, particularly HIV. And in that battle, it's a smattering of intactivists such as Geisheker going up against the World Health Organization, the Harvard School of Public Health, presidents Bush and Obama, Bill Gates, and Bono. Their weapons are studies and research; their battlefields are websites and medical journals.
Studies have indicated that circumcised men have lower rates of penile cancer and urinary tract infections. However, infections are easily treated with antibiotics, and penile cancer incidences are so low that Geisheker's group argues it's unethical to perform 100,000 circumcisions to possibly prevent one case of cancer. "A number of infants will die in the process, and many (200) will sustain significant, serious complications," the Doctors Opposing Circumcision website claims. "Nowhere else in medicine is this type of prevention practiced."
Proponents of circumcision often cite three clinical studies done in the past decade on adult males in Kenya, Uganda, and South Africa. The studies made headlines around the world with claims that men who were circumcised could reduce the risk of HIV infection from heterosexual sex by 53 to 60 percent.
Critics found many reasons to attack the studies: African men felt invincible after circumcision and mistakenly believed it made them immune to AIDS. Circumcised men in the studies still contracted AIDS. And it's far more cost-effective to use money on condoms instead of circumcision. One analysis said that "preventing one HIV infection via circumcision would cost an estimated $5,845 — more than 100 times the cost of preventing a single infection with condoms."
But the critics were drowned out. The three African studies have led to tens of millions of dollars being invested in a massive scale-up of circumcision throughout the African continent. Much of the funding comes from the Gates Foundation and U.S. taxpayers, via the President's Emergency Plan for AIDS Relief. Circumcision camps have popped up from Zimbabwe to South Africa to Botswana.
Geisheker says the Africa research shouldn't be used to justify circumcision of infants. This spring, however, a big announcement is expected that will likely thrust the matter into the national news again. The American Association of Pediatrics is widely considered the leading authority on medical matters related to children. In 1999, the organization announced there was insufficient data to recommend routine neonatal circumcision, a stance that was reaffirmed in 2005. In the ensuing years, 18 states' Medicaid programs have stopped funding it.
In 2007, the American Association of Pediatrics convened a task force of experts to revisit its stance yet again. Dr. Doug Diekema, a pediatrician who practices emergency medicine at Seattle Children's Hospital, is one of a dozen people on the task force. He says the panel's "work is 95 percent done." Their new official stance has been drafted, and he expects it to be released this spring.
