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Many Layers, And S.D. Connections To Male Circumcision Debate

Many Layers, And S.D. Connections To Male Circumcision Debate
Male circumcision is one of the oldest medical procedures known to mankind. Despite the popularity of the procedure, there is a lot of opposition to neonatal circumcision. We speak to a local journalist, an urologist, and a member of the "intactivist" community about the arguments for and against male circumcision.

MAUREEN CAVANAUGH (Host): I'm Maureen Cavanaugh. You're listening to These Days on KPBS. The ancient Egyptians did it, the Hebrews did it and up until about 30 years ago, most American hospitals did it. I'm speaking about circumcision, the removal of the foreskin tissue from the penises of infant boys. The procedure is a commandment for the observant Jew and has been thought to improve the health and hygiene of all circumcised men. Since the 1970s, however there's been a move away from infant circumcision. Most American health organizations have taken a neutral stance on the procedure. But that may change as new medical studies indicate circumcision may indeed have health benefits. And, that news has alarmed people in the anti-circumcision, or intactivist movement. Joining us to talk about the new circumcision controversy is my guest David Maass, staff writer for San Diego CityBeat. Dave wrote an article for last week's CityBeat called "Circumspection" that documents the history and the San Diego connection to the circumcision debate. And, Dave, welcome to These Days.

DAVID MAASS (Staff Writer, San Diego CityBeat): Oh, I’m glad to be here.

CAVANAUGH: Great title, too, “Circumspection.” I love that.


MAASS: We wrestled with it a while, as well as the cover art.

CAVANAUGH: Yes. We’d like to invite our listeners to join the conversation. We’d especially like to hear from parents of young boys about how they decided whether or not to have their sons circumcised. Call us with your questions and your comments. The number is 1-888-895-5727. So, Dave, what was the motivation for writing on this topic?

MAASS: You know, in probably around 2006, I was in Seattle and I covered a sort of large anti-circumcision conference, and it wasn’t an issue I’d really thought about a whole lot until I was there and I was presented with a lot of people with very strong feelings about it. And so it’s something that I’ve been following ever since then because it is such a cultural issue for us that really doesn’t get as much thought as it probably should considering what exactly the procedure is.

CAVANAUGH: Yes, and you give us, in the article, a little bit about the history of circumcision. Tell us about that.

MAASS: Well, I…


CAVANAUGH: Ancient history, I mean.

MAASS: Well, I don’t do too much about the ancient history.


MAASS: I mean, it does go back thousands and thousands of years.


MAASS: You know, since, you know, probably since recorded history began. I started more about – a little more than 100 years ago, about 110 years ago, looking at the beginning of it in San Diego. And there was this scion of the San Diego medical community named Peter Charles Remondino, who wrote, first a paper, which he presented at the Southern California Medical Society. It was called “A Plea for Circumcision” or “The Dangers of the Prepuce” or something like that. And then he wrote a book called “The History of Circumcision,” which, you know, purported to be this history of it but really, he said in the introduction, you know, doctors, you should use this to ram the four-foot gauge of fact of the benefits of the circumcision through a parent’s two-foot gated understanding. So he was really pushing for this to be something that the U.S. started doing and which it did, you know, from – He died in, I think the late ‘20s or early ‘30s and from then on it took off.

CAVANAUGH: How surprised were you that there was actually a San Diego connection to the circumcision debate?

MAASS: Well, you know, I mean, I – you know, I don’t want to get into the intactivist stuff yet…


MAASS: …but that’s where I started. But I, you know, it was actually Dr. Kaplan, a urologist who worked on the American Academy of Pediatrics policy in 1999 who had told me about it. He had actually been a little bit of a historian about it and he said, oh, you got to check out this Remondino book and I was like, wow. And I – his – Remondino’s collection’s at Loma Linda University’s Medical Library right now. I was fascinated. You know, from the first like chapter of this book, I was fascinated.

CAVANAUGH: Now, can you, just so that we can set this up well for people, can you give us sort of a concise version of what the current arguments are for and against infant circumcision?

MAASS: Okay, so the first thing you need to realize is that we are talking about healthy tissue. If the Hippocratic Oath is first, do no harm, then why would you do surgery on healthy tissue? Why would you amputate healthy tissue whether it’s a finger or anything else? Now some people in the health community would say, well, there are medical benefits. It can – it’s cleaner, less urinary tract infections, things like that, as well as emerging studies showing that perhaps, you know, it can prevent the transmission of STDs. Now, the other side of it is – takes a sort of a human rights perspective saying, you know, it is healthy tissue you’re removing. You know, if, as an adult, you wouldn’t want it, then it shouldn’t be done to you as a child and that it requires consent to do something like that. And they say that, well, if people want to get circumcised they should do it when they’re 18 and they’re able to and parents should not be making that decision.

CAVANAUGH: Now as I said in the opening, you know, American hospitals from, I think, in your article, from about the 1930s up until about the 1970s routinely circumcised infants in the hospital days after they were born, I would imagine. But it’s kind of stopped. It fell out of favor after the 1970s. Why is that?

MAASS: Well, the big thing was in the 1970s, the American Academy of Pediatrics came out, I think that’s the one people most point to, they came out and said that there was no medical evidence of any benefits to it. And from then, you saw, you know, a steep decrease. And then, you know, that gave – you know, those sort of positions gave insurance carriers the ability to say, well, it’s an elective procedure, we can cut that out. I mean, and, you know, at $300 a pop, that’s a lot of money that that insurance company would have to pay for. So, for example, MediCal, you know, California’s Medicaid program, does not cover circumcision.

CAVANAUGH: We are talking about circumcision. Most infant circumcision is what we’re talking about. And I’m talking with David Maass, he’s staff writer for San Diego CityBeat. He wrote an article called "Circumspection" and it was in last week’s CityBeat right on the cover. 1-888-895-5727, and let’s take a call right now. Mary is calling us from Carmel Valley. Good morning, Mary, and welcome to These Days.

MARY (Caller, Carmel Valley): Thank you, Maureen. I’m calling to say that as a parent I had my son circumcised almost immediately after birth. We did not do it in the hospital. We took him to his pediatrician and had it done in his pediatrician’s office. We had some good friends who rebelled and decided they weren’t going to have their son circumcised and he later had to be circumcised when he was five because he was having severe pain and I think the foreskin wasn’t retracting correctly. Needless to say, he’s a little bitter even now. He’s about nine now and he still remembers that procedure, whereas my son has no clue. So earlier, I think, the better.

CAVANAUGH: Now, what – Mary, I’m interested in what kind of arguments did you hear when you were making this decision for your son?

MARY: Well, here’s what I thought, and my husband and I both agreed on this, is that as far as what you do, you do what you’re familiar with. My husband had been circumcised so our son was going to be circumcised because we were familiarized with a circumcised penis. And that was our argument, that we do what we’re familiar with and are better able to care for what we know and what we’re familiar with. That was our main argument.

CAVANAUGH: Well, thank you for the call. I appreciate it. And, Dave, what is the medical community’s stance on circumcision now?

MAASS: Well, that’s what’s a bit complicated.


MAASS: I mean, the general principle is that you give parents the pros and the cons and allow them to make the decision themselves. I don’t think there are many doctors who actually push one way or another. It’s just sort of flat out here’s what it is, here’s what it isn’t. Now the controversy is, well, what are those, you know, benefits, what are those risks, you know, and that’s what they seem to be arguing over. However, you know, it depends on, you know, some people do want to move in a direction of, you know, getting closer to full-on recommendations.

CAVANAUGH: We have another guest on the line right now. I want to welcome Dr. Mo Bidair. He’s a urologist at Alvarado La Mesa Urology Center. I think he also was quoted in your article, Dave. And, Dr. Bidair, welcome to These Days.

DR. MO BIDAIR (Urologist, Alvarado La Mesa Urology Center): Thank you. Thanks for having me.

CAVANAUGH: What do you think are the most compelling arguments in favor of circumcision, Dr. Bidair?

DR. BIDAIR: Well, I just want to say my practice really primarily deals with adult circumcisions…


DR. BIDAIR: …more than pediatric circumcisions, so I see more of the older teenagers or 20-something, 30-something who have never had circumcision for whatever reason and they want to do it mainly for cosmetic reasons but some for medical indications. However, of course, as a urologist, as someone who gets asked that question all the time and I try to be as familiar as much as possible with the literature on the topic, I have my own views about it. In my mind, clearly, it has to be a decision made by the parents with, hopefully, an informed consent, meaning they need to know the pros and the cons and make an informed decision, which, unfortunately, I think is lacking right now. A lot of times there is very little input given to the parents by the pediatrician or whoever, you know, the obstetrician, whoever is offering them the option to or not to circumcise about why one way or the other. My own personal view, I think it’s a good thing.

CAVANAUGH: Dr. – Let me ask you, though, Dr. Bidair…


CAVANAUGH: …about the people who say, you know, this is healthy tissue and why would you – why would a doctor basically cut healthy tissue from an infant, you know, opening up the possibility of complications of one thing or another.


CAVANAUGH: Isn’t this a risk that baby infants, baby boys, don’t need to take?

DR. BIDAIR: Well, that’s absolutely what we have to look at, is the risk/benefit ratio favorable in one way or the other. Well, I kind of look at it from more of a little bit of the philosophical angle, as like, you know, why vaccinate people? You’re introducing foreign material into them. Isn’t that going to open up the door for possibly complications? Why do it at all?

CAVANAUGH: Well, some people do have that feeling, yes.

DR. BIDAIR: Exactly. Exactly so. But it is based on informed, you know – information like, you know, when you get vaccinated, for example, the chances of contracting a certain disease falls tremendously. And there is a risk one way or the other and you’re willing to take that risk for your children, and you’re making the decisions for your children. I look at it in a similar context. It is a healthy tissue, it is, for whatever reason, when it’s removed, there are some medical benefits to it. And I’m not even going to attack the social benefits, I’m just going to focus on some of the medical benefits. The way I look at it is, one of the earlier benefits that were discovered with circumcision was really the lack of penile cancer. If you’re circumcised as a neonate, you never will get penile cancer. It’s almost reportable, very rare. And so that’s one big argument that was initially proposed and that’s argument seen in adulthood rather than when you are a child. The other argument was the STDs and how it prevents – or helps decrease the rate of STDs, particularly recently with all the HIV-AIDS studies, that most of the studies show that it does have a huge benefit that way, up to 60% less, as well as transmission to the female partner, HIV going from a female – sorry, going to – from a female to a male is 8 times less in the United States than in Europe because of the fact that in North America we’re mostly circumcised, in Europe they are not.

CAVANAUGH: I wonder, let me ask you, Dave, there is some controversy about those studies that show that there’s a lesser instance of transmission of sexually transmitted disease including HIV. Tell us about what is the controvery surrounding those studies?


CAVANAUGH: I was asking Dave, Dr. Bidair.


CAVANAUGH: I’ll get back to you in a second.

MAASS: Well, there are a lot of studies, a lot of studies, and that’s part of it. I think there were two reviews of the literature that came out recently and they – polar opposite views of what they, you know – polar opposite interpretations. You know, one’s like, well, you know, there are these three studies that were conducted in Africa shows that it can prevent AIDS up to 60%. The other ones were like that’s not enough studies, like there’s a, quote, paucity of evidence. Now I guess the overall controversy is whether – you know, to what extent we can apply studies that were done in Africa with a, you know, socially related epidemic, you know, to an American population. There’s cultural issues, there’s specific practice issues, there’s a whole range of things that people say, well, it can’t be applied.

CAVANAUGH: And would you like to comment on that, Dr. Bidair?

DR. BIDAIR: Well, I think that’s very important and I think with – to look at a multitude of studies and to have the controversy on trying to figure out how the studies were conducted. In just about any scientific topic, you will find studies that will present different opinions. And I think with time and more studies being done, we get the better and better picture but you’ll never find, or very rarely will there be an issue where all the studies are going to point towards just one conclusion, only one conclusion.


DR. BIDAIR: So we have to keep that in mind. There’s another point I just want to bring up before I have to go.


DR. BIDAIR: Which is one of the social issues that I know Dave had mentioned in his article or – and now too is making the decision for an infant at the young, you know, when the infant cannot make a decision, why not wait until they get older and socially, you know, if, you know, make them get, you know, make their own decision. And my opinion of that is it’s really in many ways naïve to think that we are not making major decisions in our infants’ lives since the time they are born. And I say it – I said it, I think, in the article, I was quoted, but I say we give them names, we decide what kind of education they get, what moral values they have, how they grow up, whether to vaccinate them or not to vaccinate them, who their friends are, and to think that by not making this one decision we are actually giving them all their freedom, you know, that particular freedom, is a little naïve in my mind. I mean, it’s something a parent should feel comfortable making for the child if they really believe it’s the right thing for them to do.

CAVANAUGH: Right. Before you have to go, Dr. Bidair, you mentioned that you perform circumcisions on adult men. They come to your office for reasons of health or hygiene and they want this procedure done. I’m wondering, what’s the difference between having a circumcision as an infant and having one as an adult? Is there – How much longer does it take to heal? Etcetera.

DR. BIDAIR: As an infant, it really takes just a few days to heal. And as an adult, it will take longer. As an infant, you don’t need to put any sutures when – Up to the first two months of life, the blood pressure is very low in an infant that the instance of bleeding is really very low to not at all, so we don’t have to worry about that very much. As an adult, you have to make – put a – We use absorbable sutures that dissolve in time and it takes a week to two weeks to do that. But, in general, infants do heal much faster than adults when they are injured or have any kind of procedure done on them.

CAVANAUGH: Can you stay with us for one call, Dr. Bidair?


CAVANAUGH: Okay, let’s take a call now. We’re taking your calls at 1-888-895-5727, and we’re also taking your comments online, Let’s hear from Nathan in El Cajon. Good morning, Nathan, and welcome to These Days.

NATHAN (Caller, El Cajon): Good morning. Thank you for taking my call.

CAVANAUGH: You’re welcome.

NATHAN: Well, I have really interesting views on this because I was given the choice by my mom. She basically let me choose whether or not I was going to be circumcised and I had an older brother who was circumcised and I ended up, for reasons of wanting to fit in, getting circumcised when I was 7 years old.


NATHAN: And I have to say, it was pretty painful. It was not enjoyable. I – I, now, as a adult, would’ve probably not done it if I’d thought back on it, that it was all for esthetic reasons. But I have 3 sons now and none of them are circumcised and, really, it’s just matter of still, again, wanting them to have their choice. It is their – it affects their sexuality and their later life much more than it would ever affect me. And making that choice for them when they’re babies doesn’t seem right to me still.

CAVANAUGH: Well, thank you for that comment, Nathan. And I wondered if, Dr. Bidair, you could comment?

DR. BIDAIR: The – I think, I mean, that’s a valid argument. As I said in my last comment, I think we make major decisions for infants and this is just another one and I don’t think we should feel bad about making it for them. My other argument, medical argument, if I were to add the benefits when it comes to penile cancer, as low as it is in North America mainly because most people are circumcised, it really happened with neonatal circumcision. If someone gets circumcised at a later time in life, the benefit for penile cancer goes, you know, goes away or decreases. So when you’re circumcised as a neonate, you pretty much have a zero risk of having penile cancer. And so that’s a benefit that may, you know, you will lose on if you don’t do it at a younger age.

CAVANAUGH: I want to thank you so much, Dr. Bidair.

DR. BIDAIR: My pleasure.

CAVANAUGH: Thank you for speaking with us. I’ve been speaking with Dr. Mo Bidair, urologist at Alvarado La Mesa Urology Center. We have to take a short break. When we return, I’ll continue speaking with my guest, writer David Maass, and welcome Matthew Hess, author of the Male Genital Mutilation bill. And we will continue talking about circumcision here on These Days on KPBS.

CAVANAUGH: I'm Maureen Cavanaugh. You're listening to These Days on KPBS. We’re talking about the controversy over circumcision. My guests are staff writer for San Diego CityBeat, David Maass, who wrote an article for last week’s CityBeat called “Circumspection,” about the circumcision debate. And I’d like to welcome a new guest, Matthew Hess. He is author of the Male Genital Mutilation bill, which is a bill that's been submitted to congress and 14 state legislatures to ban neonatal circumcision. Matthew, welcome to These Days.

MATTHEW HESS (Intactivist): Thank you, Maureen.

CAVANAUGH: I want to let everyone know that we are still taking your calls but there’s so many people who want to talk to us, we’re urging you to post your comments online at Matt, would it be fair to call you an intactivist?

HESS: Yes, absolutely. That’s…

CAVANAUGH: What does that mean?

HESS: …how I describe myself. Well, basically an intactivist is someone who’s fighting for the rights of a person to decide for themselves whether or not to alter their own genitals and that’s kind of what our legislation is all about.

CAVANAUGH: What can you – Can you tell us a little bit more about the Male Genital Mutilation bill you co-authored?

HESS: Yeah. The federal version is basically an amendment to the current Female Genital Mutilation Act, so that law basically protects girls against any form of genital cutting, and we just altered that language to include genital cutting of boys as well so it would make it gender neutral.

CAVANAUGH: Now even though the bill is against neonatal circumcision, are you opposed to circumcision altogether personally?

HESS: No. I think it’s an elective procedure if an adult decides that he wants to do it for any reason, really, no different than liposuction or breast implants. I think that’s a person’s right to do that if they choose to do so. Our only opposition comes when circumcision is forced onto another person who cannot consent to it, and that’s 100% of the cases when it’s done to infants.

CAVANAUGH: Dave, you spent a lot of time speaking with people in the intactivist community. I wonder, I think that the emotions are really high in a lot of people who are against especially neonatal circumcision, is that correct?

MAASS: I would say so. I mean, they’re – You know, no offense to Matthew but…

CAVANAUGH: No, certainly.

MAASS: …they are a very, very interesting group of people. You know, I was at this conference. You met, you know, everything from – I think I met Heidi Fleiss, you know, the Hollywood Madame’s (sic) father. He’s a big, big anti-circumcision activist. I think I might’ve met Matthew there. You know, they’re – they have incredible bumper stickers and posters and whatnot and, you know, they’ve been known to protest and make a big noise and, you know, when you speak to urologists, they’re like, oh, those people, like the anti-circumcision folk. So, yeah, I mean, they make themselves known.

CAVANAUGH: Do you get that kind of a reaction, Matt, when you tell people what it is your cause is?

HESS: I do, yeah. I think at first there was kind of this, what are you, obsessed with penises?, kind of reaction. But I think it’s changing. I think the message is growing and spreading and I think people are first sort of reluctant to look at the issue and just sort of want to laugh at it or be angry about it when they first hear it but, you know, as the message is repeating over and over again, we’re starting to pick up a lot more supporters than we’ve ever had in the past. I think just, you know, posting videos on YouTube, showing what this surgery actually entails and, you know, the magic of Facebook and social networking is really spreading the message far more rapidly than it has ever spread in the past just in these last few years. So I think that was true at one time but I don’t think it’s so much the case anymore. I think it’s getting harder to argue with that also because courts around the world are beginning to recognize male circumcision as being very similar in principle to female circumcision, and I think that the legal landscape is shifting slowly.

CAVANAUGH: We are taking your calls at 1-888-895-5727, also your online comments at Let’s take a call now. Richard is calling from San Diego. Good morning, Richard, and welcome to These Days.

RICHARD (Caller, San Diego): Good morning, folks. I just wanted to tell you I’m not originally from this country so I was not circumcised at birth and I had some – experienced some serious difficulty with intercourse and everything. I had issues of not fitting in when I was in the locker room at high school. It just was a tough battle for me. But at 30, I was circumcised and I have looked at it as the best decision I’ve ever made in my life outside of the pain that I went through. And I’ve had three boys since then and all three boys I’ve had circumcised. And I have to tell you that now they get together with play groups and go to the pool and all that and they see other kids that aren’t circumcised and they end up making fun of them. So I’ve…


RICHARD: …tried to make it less of an issue, as much as tried to make them – comfort the other boys as much as I can but I see that they’re being out – ostracized as well. So…

CAVANAUGH: Well, thank you for that comment, Richard. And I wonder if you would like to comment, Matt?

HESS: Yeah, I think actually the norm is beginning to change, particularly western states. Like in California, for example, the circumcision rate’s about 22% whereas in other states it’s, you know, still upwards of 80%. So, I mean, you know, the norm now is actually to be intact, at least in California and a few other places in the west. But I think that that reason alone is not a reason to amputate a healthy, functional body part from a child. I know that the caller was just doing what he thought was best for his child and I think that’s what most parents are thinking when they have a circumcision performed. But there’s nothing wrong with letting your son choose for himself when he becomes an adult. That foreskin is there for a reason. It serves several functions. You know, we don’t amputate other body parts for appearance reasons or hygienic reasons or so-called potentially medical benefit reasons. So I don’t see why there’s this double standard with the foreskin. I think it’s just best to leave it alone and let each person decide for himself whether or not he wants to undergo circumcision when he’s an adult.

CAVANAUGH: Dave, Matt is right, if I remember the statistics in your article, about the fact that the number of circumcisions in the United States has gone way down.

MAASS: Yeah. Yeah, it has, and especially in California. It is about 21, 22%.

CAVANAUGH: Let’s take another call…

MAASS: And that’s…


MAASS: …and that’s, you know, annual infants circumcised.

CAVANAUGH: Right. Let’s take another call. Susan is calling from Fallbrook. Good morning, Susan, and welcome to These Days.

SUSAN (Caller, Fallbrook): Hi. Thanks for taking my call. I’m calling as the mother of two young boys, and when I was pregnant with my first son, I didn’t really have any ideas about circumcision so I started doing some research. And as soon as I saw the images on the internet of what the actual surgery looks like, I knew I would never let anyone do that to my child. I think it’s absolutely barbaric, and I think any parent that’s considering having it done to their child needs to see exactly what happens because the doctors make it sound like this very simple surgery, they just cut a little bit of skin off. But when you see – You know, they strap down this baby. They don’t get them anesthetic. It’s just awful. And, you know, I know parents that say, oh, I wouldn’t vaccinate my kid, I couldn’t stand to, you know, give them a shot but then they’ll let the doctor take away their child and do a circumcision in a back room. I think that parent should have to stand there and hold their child down if they’re going to choose to do that to their kid because I think it’s a horrible thing to do. And in reference to the doctor that you had on, I think it is irresponsible for a doctor to be saying that these studies show that circumcision can reduce the risk of getting AIDS. In this day and age, we have an epidemic. We need to be teaching kids to wear condoms and not messing around with this kind of misinformation that is going to cost lives.

CAVANAUGH: Susan, thank you. Thank you very much for your calls (sic). And I’d like to speak to Heidi now in San Diego. Good morning, Heidi. Welcome to These Days.

HEIDI (Caller, San Diego): Thank you so much. I was a parent also—I am a parent—of a boy, and I was not – did not feel strongly one way or the other and the – we chose not to circumcise even though my husband is circumcised. And the argument that was compelling to me, and I don’t know that anyone’s addressed this, is just penile sensitivity. It was my – When I researched it, it – what I saw was that it actually does reduce penile sensitivity, and I thought, well, why would I want to do that to my son? And, in fact, the pain that the doctor talked about earlier with adult circumcision is most likely the pain that those infants are suffering also as this very sensitive body part is getting exposed to clothing and friction and basically producing a callus that reduces sensitivity. And so I’d like – I wish the doctor was still here to discuss that but it certainly wasn’t something that I wanted to do to my son and I figured, well, he can decide later if he decides that’s important enough to him.

CAVANAUGH: Thank you, Heidi. Thank you for the call. Matt, I’m wondering, is the sensitivity another issue of the intactivists?

HESS: Oh, yeah. Yeah, that’s really one of our primary arguments and that’s really what got me involved in the movement. I, myself, have been restoring my foreskin as it’s called. You can never truly restore the nerves that are cut away but you can stretch what remaining skin you have left to kind of create an artificial foreskin that recovers your remaining penis, and that’s what I did for a couple of years until I realized there was quite a difference between having no artificial foreskin and having one, the main benefit being you reverse all that callus that the caller was just speaking of. As you build up layer upon layer of keratin over the years, and it’s just a progressive, continuing process, you obviously lose sensitivity. It’s like getting callus on your fingers if you’re working doing difficult labor, or if you can imagine having your eyelid cut off and your eyeball no longer has a covering to keep it moist. So, you know, at that point, any sort of shred of doubt that I had that there was really some benefit to circumcision and that it didn’t affect sexual sensation just completely vanished. And at that point, I really realized I had to do something. If, you know, if I was just remaining quiet about it, I was now part of the problem so that’s what kind of got me thinking and I wanted to do something that was really going to have an impact and that’s when the idea of the MGM bill came.

CAVANAUGH: Now, I want to ask you, Dave, another interesting aspect, in the remaining minutes we have left, of the story is how discarded foreskins are being used by the local biotech community.

MAASS: Oh, can I address what he just said real quickly?

CAVANAUGH: Oh, please do.

MAASS: Okay. So, you know, I did find a lot, in doing my research, a lot…


MAASS: …of the evidence of this keratinization, of these calluses, but it’s important to note that when they do studies and try to figure out how it affects people’s sexual experience, I mean, it’s nearly impossible to measure. You know, if you ask somebody, well, how did you feel about sex before and how do you feel about sex after, people are just happy to have sex. So you don’t necessarily get a very good gauge. And then people who’ve been circumcised their whole lives, they don’t know what it would be like to have it, so they can’t gauge either way. But as far as this – to move on to how the biotech industry…


MAASS: You can’t Google foreskin or circumcision in San Diego without hitting on a company called SkinMedica, and there’s actually a few of them here. But SkinMedica makes a skin facial, skin cream, you know, anti-aging product that is derived from by products from a process using a foreskin. And basically what happened was about 20 years ago, a company that made, you know, fake skin to heal burn wounds and things like that, you know, realized that if they used infant tissue, they could grow the cells and the cells could be used to make this skin healing stuff. But they acquired one foreskin and it has been going on for like 20 years now. And there’s another company here that uses it to treat diabetic foot ulcers. And, yeah, so it is…

CAVANAUGH: So just that one foreskin.

MAASS: One foreskin and it, you know, 20 years later it continues to, you know, manufacture, you know, be creative to manufacture healing supplies. So…

CAVANAUGH: And, Matthew, I want to ask you in closing, where – what kind of interest have you gotten in the Male Genital Mutilation bill? I mean, where is it? Has it been introduced in a lot of places? Is anybody going to vote on it?

HESS: Well, it has been picked up by one state. Massachusetts has introduced the bill formally. It does have a sponsor and it’s in the hands of the joint committee on the judiciary now. In fact, we’re just waiting for the public hearing date, which should be sometime within the next few months. So that would be – You know, if it does pass committee and passes both chambers and it’s passed as a law, that would be the first law in the country that would protect boys and girls equally from unnecessary genital cutting. Other than that, we have introduced it various places just as a proposed bill both in state legislatures and at the federal level but no lawmaker has agreed to sponsor it as of yet other than in Massachusetts.

CAVANAUGH: Well, Matthew Hess, thank you so much for speaking with us today. I really appreciate it.

HESS: Thanks for having me, Maureen.

CAVANAUGH: And I’ve also been speaking with David Maass, staff writer for San Diego CityBeat. We’ve been speaking about his article called “Circumspection.” Thank you.

MAASS: Thank you.

CAVANAUGH: And earlier in the program, I spoke with Dr. Mo Bidair, urologist at Alvarado La Mesa Urology Center. And we urge you, we had so many people who wanted to get involved in this conversation, if you’d like to post a comment online, please do so at Stay with us for hour two of These Days coming up in just a few minutes right here on KPBS.