There was only one road that ran around the small town that Joel Sale lived in as a child. On the tiny island of Bohol in the Philippines, where his mother was from, is where he spent the first shame-filled years of his life. When noisy trucks or busses would drive into town, he and the few other boys that were different would run to the road to see if the man who everyone was promised would someday come, had indeed arrived. Like children awaiting Santa Claus—only better. This stranger had something more important than presents. He was going to circumcise Sale.

Sale’s siblings had been all born in cities that had hospitals with medical services. Sale had been born at home in his mother’s bed, thus missing the traditional medical practice of circumcising newborn males. To Sale, this was the cause of ceaseless torment as a child. His brother and sisters often told him he was adopted or that he wasn’t strong enough or man enough to be like everyone else. He couldn’t wait to have it done.

“I can remember hating my parents for not taking care of it,” says Sale. “I felt different.”

The importance of circumcision is a debate that has increased in recent years in the United States. Many religions consider circumcision a tradition of the highest importance. The medical field argues there is no true reason to have it done but lists multiple infections and diseases that often accompany an uncut penis. Others argue it’s more natural and has increased sensitivity. These are the pros and cons of circumcision that parents weigh everyday, without any definite answers from authorities.

Eighty-five percent of the world’s male population is not circumcised. Yet, during the 20th century, more than 120 million foreskins were severed from American penises. Today, close to 66 percent of newborns are circumcised with the parents consent. But this philosophy is changing in America with new parents looking to make a more informed decision about their child’s best interests. Sale not only made the choice for himself as a child, he later chose differently when he had a son of his own.

Sale talks openly about growing up with a natural penis and the events that led him to decide to be circumcised. He describes the usual after-school activity as the worst part of the day for him as a kid.
In the heat of the tropical weather, the children would all go to the beach and strip naked to swim. Sale would be left on the shore being teased and taunted by the other children for not swimming. How could he? He didn’t want them to know he was different. Eventually he would just enter the water fully clothed. The other kids knew the truth despite having never seen the evidence, but Sale never confirmed a thing. He continued to swim in his school clothes only to be ridiculed while dripping wet on the walk home.

“I was always covering myself,” says Sale.

When the man eventually did arrive to snip his manhood at the age of 7, Sale says the procedure consisted of hot water and a pair of scissors. Nothing else. In total there were eight boys that had it done together that summer. And while Sale says they were all close before the procedure, they had something more memorable in common after the stranger’s visit.

Sale doesn’t regret the decision to have it done. Although he says the recovery was painful, he was happy that he was finally like everyone else.

Years later, Sale moved to the Hawaiian islands to finish high school and was introduced to the idea of individuality, that being different was not only okay, but a good thing. This concept was one of the main reasons when his son Kai was born he opted to not have him circumcised, a view that contradicts the culture he came from. Rabbi Larry Kushner of Temple Emanu el in San Francisco says that the ritual of circumcision is so important that it takes precedence over everything else, saying that he has gone to a ceremony on Yom Kippur, the holiest of holidays in the Jewish faith.

The custom, which is called a “bris” by European Jews and a “brit” by American and Israeli Jews, goes back over 4,000 years. Sometimes the procedure for Jewish newborns is done in the hospital, but usually it happens at home. In the beginning, the cutting of the penis was performed by the child’s father. Nowadays it is usually done by a “mohel,” who is a designated ritual circumciser.

“God told Abraham to circumcise his son on the eighth day to create a covenant with God,” says Kushner. “This is when the male child is traditionally given his name.”

While the Jewish and Muslim religions and culture have a tradition of circumcision, Sale says religion had no part in the decision to not have his son circumcised. It was solely out of love for his child. “I couldn’t cut a piece of him off,” says Sale. “Something that belonged to his body.”
The other reason that Sale decided not to have his son circumcised was the tour of the hospital before the birth. He and Kai’s mother saw where the circumcisions take place. There was a small table in a room no larger than a closet. The table had tiny wrist and ankle clamps to hold the baby down. Sale says the sight of the table seemed so brutal that the idea of strapping his newborn child to it was not even a consideration.

At that point, they were positive their decision was the right one. The major argument in support of circumcision is sanitation. With a natural uncut penis, dirt and fluids can get caught under the extra skin, which can lead to problems not only for the man, but also for sex partners. Dr. Edgar Schoen, former head of pediatrics at Kaiser Hospital in Oakland and author of the book On Circumcision, points to a recent report by French and South African researchers.

The report states that male circumcision reduces by 70 percent the risk that men will contract HIV through intercourse with an infected woman. It has also been reported that other sexually transmitted diseases (such as chancroid, syphilis, human papillomavirus, and herpes simplex virus type 2 infection) are more frequent in uncircumcised men. Although opponents say that sexual tendencies, promiscuity and safe-sex practices are a better inclination of possible STD infection. Stating that being careful and maintaining personal cleanliness are better philosophies to prevent infection than relying on circumcision to erase the dangers.

More recently there have been multiple organizations that are strongly voicing the anti-circumcision position. Groups such as the National Organization to Halt the Abuse and Routine Mutilation of Males (NOHARMM.org) and Mothers Against Circumcision are saying the procedure is unnecessary, barbaric and “a human rights violation.” While many will state the benefits of a cut penis, occasionally side affects of the surgery can occur. The open painful wound can become infected in the first few days after having it done. In addition, some of the procedures on newborns are botched, leaving the child to grow up with an abnormally shaped or curved penis. Although reported as a rare occurrence, (approximately 1 in 300 cases) occasionally, the cut is placed wrong or heals incorrectly and as the boy grows, causes the penis to curve at the tip when erect. This is not only embarrassing to the man, but is often times painful for his partner during intercourse.

J. Markin, (first name is a single initial) a 28-year-old student from San Francisco, says that he was embarrassed of his genitals growing up because of the shape due to a poorly executed circumcision after birth. He asked his doctor about it at the age of 17 and was assured by his physician that it functioned fine and was therefore nothing to worry about.

Markin later decided to seek a second opinion. The next doctor did help correct the problem and thus alleviated some of Markin’s insecurity, but the whole thing has left a permanent emotional scar.
“It was the most humiliating experience of my life,” says Markin. “The entire thing. I didn’t even tell my best friend who drove me to the appointment what I was going for.”

The risks and benefits are nearly equal and the vote has yet to swing fully to one side or the other. This is a parental decision, to be made by parents after looking carefully at all the information available. Sale says being circumcised is a huge part of the culture in his homeland. He also says his parents never talked to him about being different, something he says he plans to do with Kai.

“Maybe if my parents had talked to me about it, to help me understand why I was different and that it wasn’t such a big deal,” says Sale. “Maybe it would have been easier for me.”

Sale says that he plans on talking opening with his son when the conversation comes up.

“I will support him no matter what he does. If he decides later that he wants that [to be circumcised] I will support that too.”