What would you do if it were illegal to circumcise your son?

The debate around circumcision, at least among the parents I know, is mostly a private, polite discussion. Although I've known parents who have adamantly argued why their son (or son-to-be) absolutely should or should not be circumcised, it hasn't led to the same kinds of confrontational disagreements that breastfeeding or naming your child Elvis. Perhaps it is because there are so many sensitive factors (other than the obvious) surrounding the procedure, including health, the horrible possibility of something going awry, explanations about looking similar to or different from dad or other kids, and of course, religious traditions.

The conversation has ceased being polite and private in California, however, with a ballot item that could prohibit circumcision in San Francisco. Thought to be the first of its kind in this country to make it to the ballot (and it did with nearly 8,000 petition signatures), the proposed ban would make circumcision of males under the age of 18 a misdemeanor that is punishable by a fine up to $1,000 or up to a year of jail time. While the proposed ban and potential repercussions have garnered plenty reaction, the fact that there would be no religious exemptions has been explosive.

Opponents say that the ban would be a violation of religious freedom, causing deep conflict in the Jewish and Muslim communities. Lloyd Schofield, the man leading the charge on the proposal, however, says that it is a matter of personal choice -- by the child. His group says it has spurred a "conversation that needed to happen" and dubbed the proposal the San Francisco Male Genital Mutilation bill (it will be reduced to "Male Circumcision" during the November election).

Is banning circumcision even legal? There's a great outline on Slate.com of the Religious Freedom Restoration Act and what could happen if voters agree that all male children in San Francisco should have to keep their foreskin (at least until they are legally adults). After digging into all that, author Jeremy Singer-Vine concludes that "the proposal's proponents might have a tough time making their case," in part because of how much scientific evidence of the dangers of circumcision would inevitably be required for such a ban to be presented to the state's Supreme Court, but also because medical organizations haven't issued anti-circumcision recommendations.

International health organizations have advocated circumcision as part of a worldwide effort to reduce the spread of AIDS. And the American Academy of Pediatrics has, for more than a decade, made this neutral recommendation that seems counter to every claim made by Schofield's group:

Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision. In the case of circumcision, in which there are potential benefits and risks, yet the procedure is not essential to the child's current well-being, parents should determine what is in the best interest of the child. To make an informed choice, parents of all male infants should be given accurate and unbiased information and be provided the opportunity to discuss this decision. It is legitimate for parents to take into account cultural, religious, and ethnic traditions, in addition to the medical factors, when making this decision. Analgesia is safe and effective in reducing the procedural pain associated with circumcision; therefore, if a decision for circumcision is made, procedural analgesia should be provided. If circumcision is performed in the newborn period, it should only be done on infants who are stable and healthy.

I'm surprised that the business aspect of the procedure has not yet made it into this circumcision debate. Sources say that 80% of American males are currently circumcised (as compared to 30% worldwide). While a portion of circumcisions are performed outside the hospital setting, for example by mohels who perform the ritual for some people of Jewish faith, couldn't a ban on a procedure as widespread as this one have a significant impact on the business of birth?

It seems like the proponents of the proposed ban have a lot of work ahead of them now that they've attained thousands of signatures and plenty of media hype. But if this conversation is elevated or if their campaign to ban circumcision is successful in this city or in others, how could that impact parents?

Of course, it is all (dare I say it?) forecasting, but what would you do if your city banned circumcision?

Would you be exempt, either by belief or having daughters or adopting an older child or some other circumstance, from worrying about it?

Would you be outraged? Plan to give birth in another city outside the borders of the ban?

Would you be relieved, glad to see support for what you consider an unjustified or unhealthy procedure?



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