The media takes it upon itself to convey to the public what “healthy behavior” is. Protect your skin from the sun. Wash your hands. Maintain a well-rounded diet. Get regular doctor’s check-ups. Have protected sex.
How an individual responds to these health messages all comes down to the individual himself. The United States government—as it should—takes a step back, promoting a very Millian philosophy that the “individual is sovereign.” (An exception to this rule is the Center for Disease Control’s immigration requirements concerning vaccination against illnesses such as polio and measles.)
However, the government is currently reevaluating this philosophy of individual autonomy when it comes to health. This past year, US health officials have considered requiring routine circumcision for all baby boys born in the United States.
This deliberation stems from new studies that suggest that male circumcision reduces the spread of HIV. An Australian study reasons that the inner foreskin of the penis has the largest concentration of Langerhans’ cells, the initial cellular targets in the sexual transmission of HIV. If these cells that are most susceptible to the virus are removed, the chances of contracting the virus will be reduced. Peter Kilmarx, the CDC HIV/AIDS Division’s chief epidemiologist, finds that mandatory circumcision would be another “tool in the toolbox” to contain the HIV epidemic in the United States.
Contemplating the implementation of mandated circumcision does not only give rise to issues concerning an individual’s right to control one’s body, but also requires a closer examination of the studies that propose such a procedure.
Trials in African countries where HIV is endemic including Uganda, South Africa, and Kenya have found that male circumcision reduced HIV infection by 50 percent in heterosexual men. The sample population was comprised of men who were at high risk of contagion from HIV-infected women. However, individuals with the highest risk of contracting HIV in the United States are men who have sex with men. Furthermore, there is no evidence that circumcision prevents the spread of HIV among homosexuals. The United States government should further research the means of disease transmission before implementing such a policy.
Also, nearly 80 percent of adult American males are already circumcised; therefore, an initiative that mandates circumcision would not target a large portion of the population. Since circumcision is such a widely accepted practice in the US, the 20 percent of men who refrain from circumcision may have cultural and religious grounds for rejecting such a procedure, such as believing that circumcision is a form of genital mutilation. If government officials required circumcision, they would infringe on a person’s beliefs by enforcing a medical procedure of questionable health value without their permission.
Although it would still be a stretch, if mandated circumcision guaranteed the prevention of the spread of HIV, then perhaps the sacrifice of individual control would be worth the social gain. However, at best, circumcision potentially reduces the risk of HIV infection; it does not eliminate it. It is actually possible that the reduction plan can backfire: men may decide not to use condoms because they have been circumcised, causing HIV transmission to increase in the long run. Along the same logic, an attempt to reduce HIV transmission would reduce a woman’s ability to negotiate condom use.
With all of these potential repercussions to a medical procedure that remains to be proven effective under the current conditions in the United States, the CDC should not conclude that circumcision be compulsory. However, this should not thwart the CDC and the media from heavily pushing for education concerning circumcision either.
The list of actions that are conducive to “healthy behavior” is quite long. Rather than forcing male newborns to undergo a medical procedure, adding another criteria would simply make the list a bit longer.
Lara Fourman is a sophomore Biomedical Engineering major in Saybrook College and a Content Editor for the YJML.