Despite the acceptance of circumcision among Black men in the United States (81%), the topic remains a taboo when discussing, drawing debate on medical, cultural, and ethical fronts that have persisted for centuries. Embedded within these discussions also lies a convoluted racial history often overlooked.
Consider, for instance, the advocacy of physician Peter Remondino in 1891 for widespread circumcision. Remondino suggested that circumcision helped with bedwetting, masturbation, and nocturnal emissions. However, the most offensive aspect of his theories were based on his specific targeting of Black men. Remondino suggested that the foreskin of Black men harbored a distinctive vitality, and its removal could ostensibly act as a preventive measure against what he perceived as an inherent inclination toward raping, particularly of white women. Despite the passage of over a century since his statements and publications, they still promote misinformation and underscore the ongoing stigmatization of Black men concerning sexual prowess.
With this historical context, we must examine the motivations behind advocating for or opposing circumcision within our community. Let’s look into the complexities, underlying issues, and potential reasons for reassessing circumcision.
Reasons for Circumcision
In order to understand the nuances of circumcision among Black men we have to recognize four key areas of influence within our community:
- Cultural
- Religious
- Medical, and
- Socioeconomic factors
Cultural and religious beliefs deeply combine circumcision for many Black men with traditions passed down through generations, manifesting an unspoken ritual to circumcise their sons simply because our fathers were circumcised. As Black church is historically the center of our families, it significantly shapes attitudes towards circumcision, potentially contributing to its prevalence within our community.
Meanwhile, medical recommendations tend to emphasize the alleged benefits of circumcision in reducing risks such as urinary tract infections, penile cancer, and certain STIs. As such, most healthcare practitioners promote circumcision, particularly in regions with high STI rates or limited healthcare access, such as Black communities. However, socioeconomic factors also complicate the idea of circumcision in regard to access to healthcare, education, and economic resources impacting circumcision rates among Black men. Disparities in healthcare utilization and quality, influenced by limited access or lack of insurance coverage, may deter individuals from seeking circumcision. Additionally, cultural beliefs and social norms intersect with socioeconomic factors, shaping attitudes towards circumcision within communities.
Problems Associated with Circumcision
While circumcision is a common procedure for many males, especially within the Black community, it is important to acknowledge that there are also potential complications that may arise. The average male receives circumcision within two weeks of birth. Most often, at this early stage, circumcision surgery occurs because of cultural, religious, or social Impact. With Black men, the cultural significance of circumcision can vary widely. As such, we must remember that even though we are Black men, we still have various cultures within our group. For example, while some of us may embrace circumcision as a tradition, others may reject it due to cultural assimilation or personal beliefs. This cultural divide within our own community can lead to social stigmatization or ostracization for those of us who may not adhere to perceived norms.
Despite the fact that circumcisions are performed so often, there are also medical risks and complications that should be considered. Like any surgical procedure, circumcision carries inherent risks, including bleeding, infection, and adverse reactions to anesthesia. While the overall risk of complications is relatively low, studies have shown that Black men may be more susceptible to certain complications, such as excessive bleeding or delayed wound healing, due to genetic factors or underlying health conditions. Finally, circumcision performed in nonsterile conditions or by unqualified practitioners (which happens more often than not in our community) can increase the risk of infections, including sexually transmitted infections (STIs) such as HIV. Two of the main concerns that have been addressed by adult men who have been circumcised include:
- Loss of Sensation and Sexual Function: One of the most debated aspects of circumcision is its potential impact on sexual sensation and function. While proponents argue that circumcision can reduce the risk of certain STIs and improve genital hygiene, others suggest that it may lead to decreased penile sensitivity and sexual pleasure. Several studies have suggested that the removal of the foreskin may result in a loss of specialized nerve endings, potentially diminishing sexual satisfaction for some men. This concern is particularly relevant for Black men, as studies have shown that we already face disparities in sexual health outcomes, including higher rates of STIs and lower rates of sexual satisfaction.
- Ethical Considerations: The ethics of circumcision, especially when performed on infants or young children without their consent, are a matter of ongoing debate. Critics argue that circumcision violates the individual’s right to bodily autonomy and infringes upon their ability to make informed decisions about their own bodies. This issue is compounded for us as Black men, given historical injustices and systemic inequalities that have disproportionately affected our community. Some argue that imposing circumcision on Black men without our explicit consent perpetuates a legacy of medical paternalism and undermines efforts to promote health equity and self-determination.
Solutions and Recommendations
- Informed Decision-Making: Become a better patient for yourself and your sons by asking questions. Ask your healthcare provider for comprehensive information about the risks, benefits, and alternatives to circumcision. Make educated decisions based on unique circumstances not what others in your community are doing. Discuss your cultural, religious, and medical factors. Specifically ask about misconceptions.
- Access to Safe and Affordable Healthcare: Having safe and affordable healthcare services is critical to reducing disparities in circumcision rates and promoting health equity among Black men. Community-based initiatives, outreach programs, and educational campaigns can help raise awareness (and even funds) about the importance of circumcision and facilitate access to healthcare services.
- Addressing Socioeconomic Disparities: Research and address underlying socioeconomic disparities of Black men within our community. Strive to improve access to education, employment opportunities, and economic resources, which can empower us to make informed decisions about our health and well-being. After all, it’s all connected–if we have better jobs, we will have better healthcare, lessening the disparity gap.
The decision to undergo circumcision is a complex and deeply personal one, influenced by cultural, religious, and medical factors. For Black men, navigating the circumcision debate requires careful consideration of these factors, as well as an awareness of the unique challenges and disparities that may shape attitudes towards circumcision within their communities. By promoting informed decision-making, having open communication to address stigma and shame, improving access to healthcare, and addressing socioeconomic disparities, we can work towards ensuring that all of us have the autonomy to make choices about circumcision that are consistent with our values and beliefs, ultimately promoting health equity and well-being for all Black men.
Additional Reading:
- https://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/Pages/Circumcision.aspx
- https://www.cdc.gov/hiv/risk/male-circumcision.html
- https://www.who.int/hiv/topics/malecircumcision/en/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3036761/
- https://www.intactamerica.org/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6224543
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5938266/
