“The Sorcerer’s Apprentice: Why Can’t the United States Stop Circumcising Boys?” by Robert Darby. Canberra, Australia: SJF Publishing. 61 pages. Published only as e-book and available from Amazon.com. $4.77. Review by J. Steven Svoboda.
Medical historian Robert Darby (author of the 2005 University of Chicago Press book A Surgical Temptation: The Demonization of the Foreskin and the Rise of Circumcision in Britain, which upon its appearance I reviewed, describing it as “spectacular”) has recently published a short electronic book (e-book) about circumcision, “The Sorcerer’s Apprentice: Why Can’t the United States Stop Circumcising Boys?”, expanded from a 2005 article he published in the journal Contexts. Full disclosure: I have collaborated with Rob Darby on some peer-reviewed articles, met him personally in Canberra in 2000, and consider him a friend as well as a colleague.
Darby’s work uniformly evidences a well-honed sensibility, erudite knowledge of his topic, and a smooth writing style, and “Sorcerer’s Apprentice” is no exception. The author offers a felicitous, even pleasant read about what for many of our readers will be the unpleasant topic of neonatal circumcision, which Darby shows us is a wasteful and harmful procedure.
The Sorcerer’s Apprentice is not primarily intended for the same audience that is likely to be reading this review, but rather for people who have never really questioned or thought much about the US’s most common surgical procedure. Nevertheless, it is undeniably useful to have a short, accessible, reliable source to which to refer intelligent yet uninformed friends and acquaintances who may wish to learn more about this peculiar American practice.
Darby underscores the inapplicability to a non–therapeutic procedure of a risk-benefit analysis, given that the latter is a framework devised to determine the appropriateness of therapeutic medical procedures treating pathological conditions. The author trenchantly points out the egregiousness of seeking reasons to justify foreskin removal, arguing, “Medical authorities should start at the other end, as they do with any other body part: the foreskin is normal male anatomy… let us see what we can do to protect it from the mechanical faults and disease processes to which it may be at risk.”
As an Australian author, Darby may have been particularly well-positioned to analyze this practice with objectivity. The author briefly yet effectively surveys such topics as the significant differences in the incidence of circumcision in different regions of the US, the invalidity of “medical” arguments that attempt to justify the practice, the HIV shibboleth, and financial incentives for the perpetuation of the practice. Darby does not refrain from contextually noting the US’ remarkably poor performance relative to comparable countries on various health indicators.
Any defects in this fine work are vanishingly minor, such as the author’s failure to elaborate on his reference to the lamentable suicide of Brian Reimer. The readers for whom this book is designed are surely a disjoint set from the readers likely to know that Brian Reimer was the intact brother of David Reimer, the latter being the “John/Joan” who was the subject of John Colapinto’s book about how he lost his penis from a circumcision and then was further traumatized by Dr. John Money’s egregious “treatments” of him and his brother as well as by Money’s attempts to convince the world of his ostensibly smooth conversion to a “girl.”
The author goes into some detail in discussing the historical context in the US and the development of what Darby terms the medical establishment’s “demonization of the foreskin.” He usefully summarizes an article by Geoffrey Miller about the norm entrepreneurs who successfully introduced into society the meme that the foreskin is “polluted, chaotic, and bad.” Darby then goes on to review Sarah Waldeck’s intriguing work extending Miller to consider how the current American frame might be changed to support the right to an intact penis. The concept of doctors as cultural brokers is discussed at some length, with the author providing some useful analyses to deepen and refine our understanding.
Historical discussions and issues relating to HIV are analyzed at a deeper level, followed by a reflection on the remarkable coup pulled off by which the burden of proof regarding circumcision now appears to lie with those who would protect the child’s right to bodily integrity. Darby concludes with a lengthy appendix prepared by Doctors Opposing Circumcision (DOC) commenting on the AAP’s 2012 circumcision policy statement. As this appendix was not authored by Darby, and as it is available online, and as more complete and authoritative refutations of the AAP’s 2012 statement have appeared since the DOC commentary was published, it might have been preferable not to have included it as part of the e-book.
Robert Darby’s electronic book is an invaluable tool in any intactivist’s toolkit yet costs under five bucks, and receives my highest possible recommendation. Don’t miss it!