Some call it genital mutilation. Others, a lifesaving STD stopper ( for men and women ). Whether or not you still have your foreskin, you have a stake in the battle over circumcision. Circumsition, of course is the surgical removal of the penile foreskin from the glans – the fleshy crown of the penis. It is one of the most commonly performed procedures in American hospitals, and except abortion, it may be the most controversial. The procedure has long been known to reduce the spread of a few rare, serious diseases and to prevent a few annoying, uncomfortable ones. But in 1999, the American Academy of Pediatrics (AAP) determined that the risk of surgical complications, though small, nearly canceled out the banefits. They neither discouraged nor recommended the precedure. Since then, 16 states have eliminated. Medicaid coverage for nearly all circumsicions.

But two years ago, a consortium of experts convened by the World Health Organization and UNAIDS ( the United Nations’ HIV program ) announced that circumsicion should indeed “be part of a comprehensive HIV prevention package.” It did so because three separate, meticulous medical trials in Kenya, Uganda and South Africa, involving more than 10,000 men, had proved that circumsicion should reduce the risk of female-to-male HIV infection by approximately 60 percent. This discovery is one that, over the next two decades, could save three million lives in Africa alone.

Now, no one believes that the potential health benefits for American males are nearly as great or as urgent as they are for men in Africa, where HIV is spread mostly through heterosexual intercourse. Still, similar study results are turning up on this continent, as well. A team of researchers from the CDC, John Hopkins and the Baltimore health department examined the records of more than 1,000 African American males – all heterosexual – who are tested positive for HIV at Maryland clinics. Uncircumsized men were 50 percent more likely to be infected. These result have caused many U.S. doctors to reconsider their positions.

Pain, of course, is the first question that comes to mind whenever the word ‘cut’ and ‘penis’ are used in the same sentence. Ask Marilyn Fayre Milos about pain or better yet don’t. The founder of the National Organizations of Circumcision Information Resource Centers (NOCIRC) first witnessed the procedure in 1979 while training for her nurse’s degree. The unlucky baby, she later wrote, was “strapped spread eagle to a plastic board… struggling against his restraints-tugging, whimmpering and then crying helplessly” while awaiting the knife. Then as doctor began cutting into the penis with a scalpel, ” the baby began to gasp and choked, breathless from his shril continuous screams….” But I think that was in 1979. From what I see back in 2005 in a nursery, it doesn’t look that painful like what had been described.

Circumsized or not, every man owes his foreskin in a great debt of gratitude for its service in the womb. In the 3rd month of gestation, when the nascent penis begins to bloom, the foreskin forms a little protective blanket under which the rest of the penis can safely grow. But once you and your penis are fully baked, the advantage of a foreskin is not clear. Some scientists speculate that it protected the prehistoric penis as it swung, naked, through thick forest and over tall grasses; and unless you take your penis on that sort of excursion, they argue, you don’t need a foreskin.

That perceived a uselessness may be one reason circumsicion has such a long and varied history. Archeological evidence suggests that the practice may be at least 6,000 years old. Muslims and Jews, along with the aborigines of Australia, the Aztecs and the Mayans of this hemisphere and many other cultures all independently adopted this squirm-inducing practice and it seems unlikely they’d have done so unless they were convinced that it conferred some earthly benefit.

Here in the United States, foreskins were left mostly undisturbed until second half of the 19th century. But it wasn’t until the North Africa campaign of World War II that American doctors turned into enthusiastic circumsicers. More than 145,000 American GIs based there slacked off on their cleaning regimens and came down with foreskin related ouches chiefly balanoposthitis (inflammation of the foreskin and glans), phimosis ( a foreskin too tight to retract over the glans) and paraphimosis (a foreskin stuck in the retracted position). After the war, doctors advanced a theory that circumcision reduces rate of cervical cancer- a hypothesis now confirmed by scientific research.

Circumcision became routine, but anaesthesia wasn’t part of the plan. That, more than any other factor, may have provoked the fiery anti-circumcision movement that casts its long shadow over the Internet.

So what’s the verdict? Should all males be circumcised? That is for an individual to decide. But whatever you  decide for you and yours, do not let anyone tell you circumcision can’t slow the march of HIV. At a time when billions of American tax dollars are pouring into Africa to fight AIDS, it is extremely important that money is spent on methods that have been proved to help. For millions of men, circumcision could be a matter of life and death.

every safety has its price