Summer's rituals

Pinoy Kasi : Summer’s rituals

First posted 01:30am (Mla time) May 17, 2006
By Michael L. Tan
Inquirer

Editor's Note: Published on Page A15 of the May 17, 2006 issue of the Philippine Daily Inquirer

THE weekend typhoon reminded us that summer may be ending soon, which means time is running out for that ritual of passage of “pagtutuli,” or male circumcision.

I’ve written in the past about this practice, mainly to point out that its medical basis has come under question. The American Academy of Pediatrics, for example, issued a statement in 1999 saying the health benefits of the practice “are not compelling enough.”

You should have seen the angry feedback I got from readers -- mainly men -- whenever I did a column questioning the need for circumcision. “It’s cleaner” was the most common argument, to which I’d say that you can be circumcised and still quite, uh, sloppy.

Others argued that circumcision was needed to produce children. To which I would respond that circumcision is not practiced in mainland China so how come we now have more than a billion Chinese? (A side story: Some angry readers asked if I had been cut and I’d say, with a bit of dramatic flair, yes I’ve been mutilated, as with most Chinese-Filipinos.)

‘Supot’

Another popular Filipino belief is that circumcision is needed, around puberty, to spur growth.

I should share a little story here to refute that argument. Many years ago, the NGO I worked with got a Dutch volunteer agriculturist, Michiel, assigned to us. He arrived shortly before summer and promptly noticed all the free circumcision missions being offered. When he asked about this one time, over lunch, the NGO staff explained that an uncircumcised boy would end up “bansot,” or with stunted growth.

Michiel mustered all his Tagalog to protest: “Hindi ‘yan totoo.” [“That’s not true.”] The staff broke out in hysterical laughter, realizing Michiel, who was like 6 feet 3 inches, was, as most Dutch go, uncut. And yet the Dutch are said to be the tallest people on earth. Really now, if circumcision produces tall people, why do we still have to import basketball players, some of whom are probably “supot” [uncircumcised]?

“Supot.” Paper bag. Let’s face it -- we drag our sons to get circumcised to save them from ostracism. The term “supot” stigmatizes people for life, marking them as poor lovers and poor basketball players (not only are they shorter, they’re also said to be poor shots). The word is even used to insult people, as in a sign I saw the other week posted on a wall as a warning: “Supot lang ang umiihi dito.” [“Only the uncircumcised will pee here.”]

The worst is when someone “supot” passes and naughty friends wrinkle their noses, claiming the poor hygiene wafts through.

HIV/AIDS

Some readers are probably now itching to tell me, hey, what about all these reports now that circumcision can prevent HIV/AIDS.

We need to be a tad careful here. Yes, it’s true: Medical researchers have found that there generally seems to be fewer HIV infections in countries where circumcision is practiced. In Asia, the lower infection rates have been noted in the “cut league” of countries, which includes the Philippines, Bangladesh, Pakistan and Indonesia (yes, circumcision is part of our pre-colonial Muslim heritage).

Generally, the studies seem to suggest some “protective” effect from circumcision, not just for males but for their female partners. The reduced risk isn’t just for HIV/AIDS. In a paper issued last month, the US Agency for International Development noted that circumcision has been known to “greatly reduce a man’s risk of penile cancer . . . and it also reduces risk of some other sexually transmitted diseases (STDs), including chancroid, herpes and syphilis. It eliminates problems such as phimosis (narrow foreskin opening) and balanitis (infected foreskin), and has been shown to significantly reduce the risk of cervical cancer among female partners of circumcised men.”

How does this protective effect work? It’s interesting that the anti-circumcision camp has argued that uncircumcised males experience more sexual pleasure because the extra skin is sensitive, but now the pro-circumcision camp says the foreskin actually has more “target cells” that attract infectious microorganisms like HIV. The foreskin is also said to be more susceptible to tears and abrasions, which means easier infection by HIV and other microorganisms causing STDs.

No magic bullet

Where does this leave us now? USAID is careful in saying “MC” (sigh, Americans probably gave Filipinos this love for acronyms) is not a “magic bullet” and that it “it will not provide full protection against HIV.” Rather wryly, USAID also points out that circumcision “will provide little or no protection against urethral STDs such as gonorrhea and Chlamydia [known locally as “tulo”] and obviously will not prevent unwanted pregnancies.”

It’s important then to keep repeating that just because Filipinos are “cut” does not mean we’re immune from HIV. The HIV epidemic in the Philippines, previously described as “low and slow,” is now considered to be “hidden and growing” so we need to continue to be vigilant and to promote a package of prevention methods, including condoms.

USAID, in fact, warns that there may be a need to have programs of behavioral “disinhibition” among circumcised males who might return to high-risk behavior thinking they’re adequately protected by circumcision.

Since circumcision is already being practiced here, I’d go a step further and look at how we might want to borrow from a program in Kenya, where circumcision, which is practiced as a traditional ritual, now integrates preventive health education.

In the Philippines, circumcision is only one of summer’s rituals of passage. It used to be that after young men had recovered from circumcision, their older male relatives would bring them to a brothel for their “binyag,” a second, more profane form of baptism.

Times have changed and we should be rethinking these rituals. Circumcision may be a good time to explain that the passage from boyhood to manhood isn’t just a matter of being brave during the cutting ritual, or of going off to conquer women in brothels.

There is a folk belief that the circumcised male should “protect” his wares from the female gaze, lest this swell and redden like tomatoes. That belief could well be used to explain that manhood is a matter of learning to be responsible, and of respecting women.

Tomato metaphors aside, I’ve found in the Philippines that it’s especially useful to remind young men to see, in every woman, their own mother or sister. That kind of thinking may yet be a more effective preventive action against HIV/AIDS and STDs than circumcision.