Should we still circumcise babies?

Summary

NO SUCH THING (iHeartPodcasts/Kaleidoscope)

Episode: “Should we still circumcise babies?” (May 13, 2026)

---

Episode Overview

This episode dives into a lively, deeply-researched debate among hosts Manny, Noah, and Devin: Should circumcision remain standard practice for babies? Using their signature mix of humor, friendship, and journalistic legwork, they examine the shifting cultural, religious, and medical landscapes surrounding circumcision in America—including declining rates, contrasting expert opinions, and fervent activism on both sides.

---

Key Discussion Points & Insights

1. Personal Perspectives and Cultural Shifts

[03:06–13:32]

• A generational change: The hosts share their own mixed backgrounds—Jewish heritage, African roots, and differing personal experiences with circumcision.
• Normalization & default decisions: For Manny, circumcision wasn’t common in his parents' home country, but U.S. doctors presented it as standard.
• Social influence: “If I'm having a baby and I have no idea what's going on, and they say, well, 80% of babies do this... I'm just gonna be like, it's the path of least resistance.” — Noah [06:38]
• Peer pressure and self-consciousness: Devin, who is not circumcised, recalls childhood embarrassment because circumcision was seen as the norm, but feels unaffected as an adult.
• Breaking cycles: Hosts describe a generational readiness to question automatic adherence: “This happened to me, but I wouldn’t do it to my child. … We have to break the cycle.” — Noah & Manny [04:03–04:08]

2. Why is Circumcision So Common in the U.S.?

[18:44–26:29]

• Historical roots: Ancient Egypt likely performed circumcisions as far back as 4000 BC—possibly for hygiene or as a rite of passage.
• Religious significance: Jews adopted circumcision as a covenant with God; Muslims and some indigenous groups also practice it with varying intent.
• American medicalization: The practice caught on in the late 1800s after a surgeon claimed (falsely but persuasively) that it cured paralysis in a boy. Hospital births and germ theory further normalized it.
• “By the 1950s and 1960s in the US you had, like, 80 to 90% of boys in the US being circumcised.” — Dr. Kate Grabowski (Johns Hopkins epidemiologist) [25:32]

3. Origins and Impact of the Intactivist (Anti-Circumcision) Movement

[27:17–31:11]

• Roots in 1960s activism: Counterculture, patients’ rights, and modern feminism fostered questioning of medical norms like circumcision.
• Key organizations: Groups like NOCIRC emerged, founded by medical professionals and parents disturbed by witnessing circumcisions and questioning their necessity.
• “The attending physician said, yeah, there’s no medical reason we do this.” — Story relayed by Laura Carpenter & Georgianne Chapin [29:54]

4. Motivations and Messaging Among Activists & Critics

[31:11–35:00]

• Profit vs. routine: Georgianne Chapin (Intact America) argues U.S. doctors and hospitals have a financial incentive, although prices vary widely.
• Aggressive marketing to moms: Surveys show mothers are asked an average of 8.4 times to consent to circumcision:
  • “They are told it's part of being a good parent. ... We have a bumper sticker that says 10 out of 10 babies say no to circumcision.” — Georgianne Chapin [35:00]
• Challenging parental consent: Intactivists cite bioethics that non-therapeutic procedures without medical necessity can’t be truly consented to by proxy.

5. Medical Evidence: Health Risks, Benefits, and Disagreement

[37:01–52:13]

Pro-Circumcision Perspective (Dr. Kate Grabowski):

• Randomized trials in Africa:
  • 60% reduced risk of HIV acquisition (for vaginal sex)
  • 30% reduced risk of HSV2, 25–30% for HPV, 50% for genital ulcers.
  • Side benefits for female partners (reduced BV, trich, HPV).
• Sexual pleasure: Most men in trials reported no difference; some reported improvement, often because of fewer STIs.
  • “The randomized trials are really what we consider the gold standard of evidence… It’s a one-time intervention that provides a sort of lifetime risk [reduction].” — Dr. Grabowski [37:50]
• Risks/harms: If performed in sterile settings, serious complications are rare and overall health benefits outweigh risks.

Anti-Circumcision Response (Georgianne Chapin):

• Challenges to African studies: Contests relevance/applicability to U.S. or European contexts; calls focus on Black men in Africa “the height of medical colonialism” [42:58].
• Refutes strong health claims: “There is no therapeutic or preventive purpose to removing a healthy, normal foreskin, which is the most sensitive part of the male penis.” [45:55]
• Points to high rates of patient satisfaction as social desirability bias—not hard evidence.

Contextual Clarifications:

• Applicability differences:
  • Reduction in HIV risk shown primarily for heterosexual vaginal sex in high-prevalence regions.
  • Western countries’ HIV epidemics skew toward transmission among men who have sex with men (receptive anal sex), with anal sex carrying higher baseline risk and circumcision making less difference.
• Follow-up and ethics of studies: Dr. Grabowski details: Studies had 90% retention, modest compensation (not contingent on procedure), and careful monitoring for adverse events. Large, high-quality body of evidence.

Circumcision vs. Female Genital Mutilation:

• Medical consensus: FGM is categorically more severe—removal of the clitoris, intent to suppress sexuality, lasting harm; circumcision removes only the foreskin, with different risk/impact.
  • “Honestly, I think equating the two procedures really minimizes the severity and harms of FGM from a medical and public health standpoint.” — Dr. Grabowski [50:28]

6. Declining Rates & Shifting Norms

[54:47–61:18]

• Recent data: U.S. newborn circumcision rates dropped from 54.1% (2012) to 49.3% (2022). Rates vary—West Coast 25%, Midwest 70%.
• Driving factors:
  • Medicaid stopped covering elective newborn circumcision in several states, especially California [55:16].
  • Changing cultural attitudes, more questioning of medical orthodoxy, arrival of immigrants from non-circumcising cultures.
• Intactivist influence: Awareness-raising and reframing as a true parental decision (not automatic) proved influential.
  • “The anti-circumcision movement has been influential in terms of getting people just to sort of question this, oh, hey, why are we doing this?” — Laura Carpenter [60:27]
• Social trends: Now linked with broader skepticism about medical advice, similar to early vaccine resistance and ‘natural parenting’ circles.

7. Why is this Such a Divisive Issue?

[61:18–66:36]

• Symbolic politics/proxy war:
  • Circumcision encompasses debates about bodily autonomy, gender, religion, parental rights, and what it means to be “natural.”
  • “It enables people to fight about the importance of sexual pleasure… There’s almost nothing you can’t fight about with it.” — Laura Carpenter [65:39]
• Movement divides: There are left/liberal bodily autonomy advocates (aligned with pro-choice) and right/conservative “save the babies” strands within anti-circumcision activism.

8. What Should Happen Next?

[67:03–79:30]

• Intactivist priorities:
  • Focus on cultural change; legal bans are distant.
  • “We want people to not think that they need to circumcise their sons in order to be good Americans or good parents.” — Georgianne Chapin [67:24]
• Questioning medical establishment:
  • “[Doctors] have skin in the game…. So it's hard to change cultural norms. And that's why it's so important for people. … It's so important to think about this stuff and think, what exactly am I defending?” — Chapin [69:40]
• Consensus among hosts:
  • Acknowledging benefits for specific contexts and populations but skeptical about neonatal circumcision as default in the U.S.
  • “If I have a boy, I probably would not get him circumcised, but I also don't feel like I’m missing out on literally anything. There’s not enough of a reason to do it.” — Manny [74:22]
  • “People should just be able to make their own decisions, but also have access to all the information to make that decision.” — Devin [78:22]
  • “I feel like this kind of movement would basically be happy if, instead of being something you’re asked, [circumcision] was basically something you have to ask for—you opt in.” — Noah [78:37]
• The big picture: The episode closes with an appeal for open-minded, informed decision-making; while many guests feel passionately for or against, the trend is toward individual parental choice—armed with the most complete data available.

---

Notable Quotes & Memorable Moments

• “We have to break the cycle.” — Noah & Manny [04:05]
• “If you want to do it, you should have access to it. …But ultimately, this is someone’s penis. Like, it really should be a decision that’s left to parents and adults.” — Dr. Kate Grabowski [58:07]
• “If you don’t just willy nilly remove body parts from somebody, then that tells you what we should not be doing, which is assaulting a newborn baby and removing part of his ... genitalia.” — Georgianne Chapin [71:00]
• “People are very strongly—I mean, I guess it’s like if you think something really horrible is happening, you want to stop it.” — Noah [76:27]
• “Circumcision seems to be particularly dense with those meanings—it involves gender, parenthood, religion, bodies, all these things… that is some of where the intensity comes from.” — Laura Carpenter [66:37]

---

Timestamps for Key Segments

• [03:06]: Hosts’ personal stories & initial debate
• [18:44]: History of circumcision: from Egypt to America
• [24:10]: Dr. Kate Grabowski on circumcision’s medicalization in U.S.
• [27:17]: Sociologist Laura Carpenter: Activism & anti-circumcision movement origin
• [31:11]: Georgianne Chapin explains Intact America’s mission
• [37:42]: Medical benefits & gold-standard studies (Grabowski)
• [42:58]: Intactivist critique of medical studies (Chapin)
• [50:28]: Medical distinctions: Male circumcision vs. FGM
• [54:47]: Declining rates & demographic trends
• [61:18]: Why is this issue SO controversial?
• [74:22]: Hosts’ final opinions and parent-choice consensus
• [78:22]: Learning, education, and doctors' influence over parent decisions

---

Summary Takeaways

This episode gives a nuanced, well-researched, and balanced exploration of infant circumcision. The hosts move from questioning their own assumptions to untangling historical, religious, cultural, activist, and medical threads. Expert guests lay out starkly opposed views but all stress the importance of honesty, evidence, and informed choice. While medical benefits exist in certain contexts, declining rates indicate a cultural shift away from automatic circumcision in the U.S., and a growing sense that this—like so many things—should be a thoughtful, informed parental decision.

---

For more research links and extended expert responses, listeners are referred to the NO SUCH THING newsletter at www.nosuchthing.show.

Transcript

[Noah]

Just a quick note before we get started. This is a very complex and sensitive issue touching on all sorts of things sex, religion, culture, bodily autonomy, parenting, etc. Etc. We unfortunately can't include everything in this episode, so if you want to read more, check out our newsletter to continue the conversation.

[Laura Carpenter]

Kaleidoscope

[Manny]

I'm Manny.

[Noah]

I'm Noah, this is Devin and this Is no Such Thing. The show where we settle our dumb arguments and yours by actually doing the research this week. To cut or not to cut. That's the question.

[Manny]

There's no no such thing. No such thing. No such thing. No such thing. No such Thing.

[Dr. Kate Grabowski]

This is an I Heart Podcast Guaranteed

[Noah]

Human Amazon Health AI presents Painful Thoughts

[Dr. Kate Grabowski]

why did I search the Internet for answers to my cold sore problem? Now I'm stuck down a rabbit hole filled with images of alarmingly graphic source in various stages of ooze. I can clear my search history, but

[Georgianne Chapin]

I can never unsee that.

[Sponsor/Advertisement Voice]

Don't go down the rabbit hole. Amazon Health AI gets you the right care fast. Healthcare just got less painful.

[Dr. Kate Grabowski]

Aging is real and so are the benefits of adding Vital Proteins Collagen peptides to your daily routine. New Vital Proteins Collagen sparkling water. Your daily gloup now in three fresh flavors, Strawberry blossom, lemon, lime and blood orange. Improved skin health in as little as 30 days thanks to Collagen Peptides. Cheers to that. Or go with our classic Collagen Peptides so you can stay vital. Stay you. Visit vitalproteins.com to learn more and where to buy these statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

[Sponsor/Advertisement Voice]

Support for the show comes from Public, the investing platform for those who take it seriously. On Public, you can build a multi asset portfolio of stocks, bonds, options, crypto and now generated assets which allow you to turn any idea into an investable index. With AI it all starts with your prompt. From renewable energy companies with high free cash flow to semi semiconductor suppliers growing revenue over 20% year over year, you can literally type any prompt and put the AI to work. It screens thousands of stocks, builds a one of a kind index and lets you back test it against the S&P 500. Then you can invest in a few clicks. Generated assets are like ETFs with infinite possibilities, completely customizable and based on your thesis, not someone else's. Go to public.com podcast and earn an uncapped 1% bonus when you transfer your portfolio. That's public.com podcast paid for by Public investing brokerage services by Open to the Public Investing Inc. Member FINRA and SIPC advisory services by Public Advisors, llc. SEC Registered Advisor Generated Assets is an interactive analysis tool. Output is for informational purposes only and is not an investment recommendation or advice. Complete disclosures [e-mail] disclosures

[Noah]

all right, we're talking about circumcision. I actually remember a while ago talking to my then girlfriend, now wife. I don't know why I brought this up. There is no reason for me to bring this up. But I was like, I think, you know, within the next 50 years, circumcision is gonna be much less common in the United States. I was just like, you just had a hunch. Yeah, I was. I don't know why I brought this up over dinner, but I was like, I just think that's the way things are gonna go since then. It'll come up once in a while and I'll hear from people who say, oh, yeah, like, I would never let my kid get circumcised.

[Devin]

Yeah.

[Noah]

And most of these people, and I haven't asked or confirmed, but most of them are circumcised.

[Manny]

Yeah.

[Devin]

You haven't checked?

[Noah]

Like I said, I haven't checked. Probably.

[Manny]

Yeah.

[Noah]

Sometimes. Yeah. Sometimes it's at least intimated that that's the case.

[Devin]

Yeah. This happened to me, but I wouldn't do it to my child. Yeah, yeah.

[Noah]

Not as. Not even so dramatic, but yeah, basically,

[Manny]

like, we have to break the cycle.

[Noah]

Yeah. So. So, you know, and then I'm wondering, okay, well, why is it, you know, obviously, you know, I'm Jewish. It's common practice to do so. Most people in the United States are not Jewish.

[Manny]

Yeah, a lot.

[Devin]

Based on the numbers.

[Noah]

Yeah.

[Sponsor/Advertisement Voice]

A large amount of them are not.

[Noah]

Same with Islam. Similar, you know. And I do know that in Europe it's much less common for babies, you know, where I think it's a bit more restricted to kind of the cultural, you know, or religious reasons. I was curious, like, how that even happened. Like, why in America did this take hold so strongly? And then, you know, you've heard ambiently over the years, like, it, you know, reduces HIV and aids.

[Manny]

Yeah, right.

[Noah]

Which I've always wondered about, like, how. How. Yeah, how does that work? Like, what about this piece of skin or not would impact that? No idea. And then arguments about how it affects pleasure.

[Devin]

Yeah.

[Noah]

Then you'll see in, you know, Union Square here in New York or else, player, you'll see people protests, you know, activists, intactivists talking. Yeah. That's what they Call.

[Manny]

Incredible.

[Noah]

And, you know, saying. You know, saying, like, we need to end this barbaric practice.

[Manny]

Yeah.

[Noah]

Because, you know, it reduces your pleasure. It's. It's really brutal to the babies. And also my sex life is ruined because of this. That happens. Yeah. And I've always been kind of like, maybe that's. I think you're. Maybe it's like a grass is greener situation where it's like. I don't know. It seems. It seems okay. I guess I'll never know, but. So these are things that have been swirling around in my mind. So research from Johns Hopkins says from 2012 to 2022, circumcision rates among newborns have dropped from 54.1% in 2012 to 49.3% in 2022. So about 5% less.

[Manny]

Wow.

[Devin]

And this is in the U.S. yeah,

[Noah]

in the U.S. okay. That kind of confirms that we're on. You know, 5% is big, but not huge. But if that continues, you know, pretty sizable. Yeah. And I feel like now, with maybe the way things are going culturally, I would imagine that rate would increase. And my guess would be, once it's less common, where it's like, okay, less than half are done. If you're on the fence or you don't really feel strongly and the doctor is not really pushing it on you or whatever, it'd be easy to just be like, yeah, there's no. Like, we don't need to do this. Yeah, yeah, yeah.

[Devin]

No longer will be the norm.

[Noah]

Yeah. So, you know, it's like, if I'm having a baby and I have no idea what's going on, and they say, well, 80% of babies do this.

[Manny]

Exactly.

[Noah]

I'm just gonna be like, it's the path of least resistance. It's like, yeah, just do it less to deal with, you know?

[Manny]

Yeah. That's what. That's why I'm circumcised. I actually asked my parents why. Because in. It's not common in East Africa, where they come from. So they. They were just like, well, the doctor told us that's what most kids. That's what. That's what you're supposed to do.

[Noah]

Yeah.

[Manny]

And that's.

[Devin]

And that's what I did.

[Manny]

And now I'm half. I'm gone.

[Devin]

Sorry to hear that, man.

[Noah]

Yeah. And look at your life. Yeah. Think of what you.

[Manny]

I definitely remember.

[Devin]

Think about who you could have been at.

[Manny]

Like, at Ohio State, when I was in college, there was so many activists slash protests about.

[Noah]

Really?

[Manny]

Yeah.

[Devin]

Wow.

[Manny]

They would. Yeah. They were. Why At Ohio, at school, it's common for like people like the kind of anti abortion activists too. It's common to go to colleges to

[Noah]

like get, I guess to put in

[Devin]

questionable, I guess to implant it. I'm like, because, you know, you think of people at colleges not having children, but yeah, if they say something at that time, maybe down the line, I

[Manny]

remember being like, okay, these guys are crazy. Because like, of course, some of the behaviors in these protests, I was like,

[Noah]

it's an eccentric thing to focus on.

[Manny]

Yeah, of course. And then. But then like now that I'm older, I'm like, well, yeah, I guess. Why do we do that?

[Noah]

Yeah, yeah, it's a valid question. And yeah, it's like the people that I've spoken with that are, you know, of a similar milieu, they aren't like crazy people. They're like normal people working.

[Manny]

Yeah.

[Noah]

Have, you know, long term partners. They're not like, wow, I can't find a girlfriend because of what happened to me or I can't enjoy sex or, you know, it's like, it's not like these kind of hang ups that I imagined had, you know, some of the more fringe characters were exactly focused on. It's like more of a normal thing. Like it's just unnecessary.

[Manny]

Yeah.

[Noah]

And yeah, it's painful for the babies. So. Yeah. I mean, what. What do you guys think?

[Manny]

And I remember the first phase of even learning that people were upset about this. Me just being like, they're weird because this, you know.

[Devin]

Yeah. Everyone does.

[Manny]

We all do this one thing and they're weird for not for being upset about it now. You know, as an adult, as someone with a more open mind, I'm also like, yeah, I guess. I mean, I don't know. If I had a son, I don't think I would do it at this point now. You know, I would say like when he gets old enough or whatever. Here's what the doctors used to say. If you want to do that, you

[Devin]

would support him in his journey.

[Manny]

Yeah, I wouldn't give a shit. I mean, I' Hey, I'm circumcised. I have a great life. There's no. I'm not really upset about it.

[Devin]

I have a great life.

[Noah]

I love you, son. No matter what you choose to do.

[Manny]

It hasn't really. I can't imagine a scenario where it affected my life at all.

[Devin]

You can't imagine a life in which your sex life is better.

[Noah]

Yeah, it's so good.

[Manny]

I guess everything can be better.

[Devin]

Yeah. Yeah.

[Noah]

But you don't Feel like you're missing out.

[Manny]

No.

[Noah]

Okay.

[Manny]

No.

[Noah]

Sensitive enough, but I don't know what I. It's like, that's what they. That's what they say. It's like sensitivity, the nerves. It's like the nerve endings. Maybe if I like, walked around naked all the time. So, like, you feel the breeze?

[Manny]

Yeah.

[Noah]

I don't know. Like, it's insane.

[Manny]

Feel more of the breeze.

[Devin]

My non circumcision journey. I'm outing myself as uncut gem.

[Noah]

Crazy. Yeah.

[Devin]

It was a similar thing, though. Like, you talked about how your parents were like, I don't know, they just told me me to do it because it was like, I have me. It was a few family members around that time where I guess wherever hospital they were going to, they were just sort of like, well, you don't have to do it now. Like, you can do it down the line. So for a while I thought I was gonna do it sometime in like middle school or college. And then I just kept waiting. Cause I was like, well, there's not really a great time to do this.

[Noah]

Yeah.

[Devin]

Like, I was like, am I gonna have to miss school? Cause my parents, the assumption was I would. Well, they were like, we can leave it up to you, but like, you would probably get it done, but just when you're older. And it was a sort of thing where.

[Noah]

Yeah.

[Devin]

My mind. When I was younger, I was like, okay, I'm definitely gonna get this done. It's just a matter of when.

[Noah]

Yeah. Plotting.

[Devin]

Yeah. I was like, all right, you know, I gotta figure out. And then it just like, never happened. And it was a thing I would say when I was younger, I was very self conscious about.

[Noah]

Yeah.

[Devin]

Because. Yeah. I think the norm and especially in the US at the time was like, everybody else is circumcised. Like, why aren't you?

[Noah]

Yeah.

[Devin]

And then. Yeah. Like, as an adult. Adult, you know, like Manny said, it's like, has not affected my life and in any way.

[Manny]

You would have been a perfect test case if you did go through with it.

[Devin]

I know. For the podcast, I should get circumcised to see.

[Noah]

Yeah. So after the break.

[Manny]

Come on in, doctor.

[Devin]

Oh, man. So when I was younger, my parents like, emphasize like a, you know, because my dad was circumcised. But they emphasized like, you have to, you know, pull back your foreskin, whatever, to clean it. So it just became a part of the process. Right. It wasn't like, it's like, you know, we were talking about shower, you wash your legs. It was like, okay, I Gotta wash my legs.

[Manny]

That's why he's in the shower so long.

[Devin]

Yeah.

[Noah]

You know, lots to wash. A lot more folds. Folds. Let's see here.

[Devin]

But, yeah, so it wasn't. To me, it wasn't like a sanitary thing. Like, for me, it was more of a concern. I was like, oh, when I start having sex, is this gonna be weird?

[Noah]

Yeah, yeah.

[Manny]

The social.

[Devin]

Yes.

[Noah]

Yeah. That, to me, seems like the bigger issue.

[Devin]

Yes.

[Noah]

You know?

[Devin]

Yeah. So that was the thing that was top of mind for me.

[Noah]

Yeah.

[Devin]

Before I was having sex. Keep it pg. But it has not been an issue. No one has ever complained.

[Noah]

Was there ever, like, did anyone ever ask you. Or, like, seem confused or, like. Or did it just. Because I would imagine someone. If that was happening, I don't think I would say anything like, oh, if you encountered.

[Devin]

Yeah.

[Noah]

And I was surprised. I'd probably. Then I'd probably talk to my friend afterwards and be like, yeah, what's up with that?

[Manny]

Just to keep us going. Like, I'm definitely interested in the bigger picture here, the decreasing rates. Is there actually a good reason to be circumcised? Or is this more like antiquated practices from the past that, like, we don't do. That we don't need to do anymore.

[Noah]

Yeah. Because I've read and I've read pieces by men who are circumcised to basically echo what we've been talking about of, like, I wouldn't for my son. I was reading a piece in Esquire and there was a guy, I think, in his 60s who had his son circumcised. His son's now in his 20s, and he was like, saying how I think he's Jewish, and he just did it because it was like, what people did. And he was like, yeah, I really regret it. And I wish I hadn't done that to my son. It made me just think about it because I was like. My default was always like, yeah, it's true. Yeah, definitely.

[Devin]

Yeah.

[Noah]

And I think we'll see how I feel having some research. But right now, I think if I had a son, I would do it for all the reasons. Not that I'm so religious, but it's like. I know there's something to it where it's like, why change it if it's not causing harm to me? I mean, so we'll see. Maybe my mind will be swayed.

[Devin]

Yeah. It's funny, I feel like I don't know that much about it.

[Noah]

I want to do some research on the. The real historical history of it, the. Especially the American history of it. And then look into the health and sexual pleasure aspects and what's behind the

[Manny]

declining rates that I am very curious about. Yeah, I guess I'd be pretty pissed if I found out that it's like so much better. Three times better.

[Noah]

Yeah. But then it's like you.

[Devin]

Well, you don't know what you never had.

[Noah]

Yeah. And it's good to. It's good to cut out some vices, you know, it's like.

[Manny]

Yeah, that's true. Sex crazed.

[Noah]

Yeah. You know, you won't be able to hold a job.

[Devin]

You don't know what it's like.

[Manny]

Yeah, it'd be crazy.

[Noah]

It's better, you know, sick life to live.

[Manny]

Or maybe having the foreskin means you get a fuller experience that you don't need as often.

[Noah]

No, you'd be begging for a fix.

[Manny]

Maybe we're. We need it more because we don't. Maybe we're not getting the real.

[Devin]

Yeah, exactly. It's like a. It's a tenth of what you could be getting.

[Manny]

Yeah.

[Devin]

So you do it ten times instinctively.

[Manny]

Our brains are like, why isn't this.

[Noah]

Let me try this again.

[Devin]

Let me run it back.

[Noah]

So in this episode we're going to hear from a few different people. One, an epidemiologist who studied the health impacts of circumcision. Two, a sociology professor who's researched the anti circumcision movement. And three, a leading member of the so called intactivist movement. And just one quick note, this is an issue, as you'll hear, that people are extremely passionate about in this episode. We're not going to be able to cover all of the complexity of the issues, but we're doing our best to hear everyone out and get their viewpoints across. If you want to look into this more, I'll be linking to research and other analyses in the newsletter to get more insight and decide how you feel about it. We all have our own views here, but we're not trying to force any particular agenda. With that said, we've got a lot to get through, so let's get into it after the break.

[Devin]

All right, fellas, I need you to help me with a problem that I got. You know, usually we're the ones helping other people with their problems, but I'm about to go abroad and I want to watch Met games. Noah, how can I watch them?

[Noah]

That's a tough one. Maybe get a really large telescope.

[Devin]

I don't think that's the best way to do it. Manny, do you have any solutions on how I could watch Mets games abroad.

[Manny]

I think I've got a slightly more practical solution for you, Devin. If you use NordVPN, you'll be able to change the location of your laptop's IP address and watch the content with no problem.

[Noah]

What about my privacy online? I'm worried someone's watching me.

[Manny]

First of all, no one is watching you, Noah. But in case someone was watching you, NordVPN provides you with privacy online, leaving no digital footprint by hiding your IP address. It's like wearing an invisibility cloak while you're surfing the web.

[Noah]

Sounds comfy.

[Devin]

So Manny, I've heard about these VPNs and how they're super slow. How do I make sure my Internet is not throttling?

[Manny]

If you want to use a VPN without slowing down your Internet, Devin, you're going to want to use NordVPN. Because whenever I use it, I don't see any buffering or lagging while I'm streaming my favorite content.

[Devin]

How do I get NordVPN?

[Manny]

Devin, if you or our listeners want to get the best discount off of your NordVPN plan, go to nordvpn.com nst Our link will also give you four extra months on the two year plan. And there's no risk because Nord has a 30 day money back guarantee. The link is in the show notes. That's nordvpn.com NST.

[Sponsor/Advertisement Voice]

Amazon Health AI presents Painful Thoughts I

[Laura Carpenter]

I can't stop scratching my downtown. Yeah, but I'm not itching to go downtown and tell a receptionist I'm here

[Noah]

to talk about my downtown.

[Laura Carpenter]

Some things you'd rather type than say out loud.

[Sponsor/Advertisement Voice]

There's no question too embarrassing for Amazon Health AI. Chat your symptoms and get virtual care 24. 7 Health care just got less painful. Support for the show comes from Public, the investing platform for those who take it seriously. On public, you can build a multi asset portfolio of stocks, bonds, options, crypto and now generated assets which allow you to turn any idea into an investable index. With AI, it all starts with your prompt. From renewable energy companies with high free cash flow to semiconductor suppliers growing revenue over 20% year over year. You can literally type any prompt and put the AI to work. It screens thousands of stocks, builds a one of a kind index and lets you back test it against the S&P 500. Then you can invest in a few clicks. Generated assets are like ETFs with infinite possibilities, completely customizable and based on your thesis, not someone else's. Go to public.com podcast and earn an uncapped 1% bonus when you transfer your portfolio. That's public.com podcast paid for by Public Investing Brokerage Services by Open to the Public Investing Inc. Member FINRA and SIPC Advisory Services by Public Advisors llc. SEC Registered Advisor Generated Assets is an interactive analysis tool. Output is for informational purposes only and is not an investment recommendation or advice. Complete disclosures available at public.com disclosures.

[Noah]

Before we get further ahead, I want to talk through the history of circumcision as a religious practice and a medical one, how it became so common here in the US where it being so common makes the US an outlier compared to other nations. And then we'll talk through kind of the perceived risks involved, the potential benefits and impacts on sexual pleasure and, you know, all the other concerns people have. So we've got a lot to get through, so let's jump into it.

[Manny]

Dive right in.

[Noah]

All right, so I'm going to run through really quickly kind of the ancient history to get us up to speed. Circumcision dates back thousands of years. I write a book called Circumcision A History of the World's Most Controversial Surgery by David Gahler. Sorry if I'm pronouncing that wrong, sir. And it points to evidence that Egyptians may have been forming them as early as 4000 BC. Wow. No one's really sure why, but some idea of a transition into manhood, a mark of elite status and. Or just hygiene and cleanliness.

[Devin]

So this was later in life though.

[Noah]

Yeah, so it'd be like, I mean there's like great like in carvings and it's like. Yeah, it looks like probably 13 year old boys about there.

[Manny]

And this is. Maybe my timelines are wrong, but 4000 BC would have been before like a Judeo Christian.

[Noah]

Exactly, yeah.

[Manny]

So ritual.

[Noah]

So that basically it's thought that Jews adopted it from the Egyptians, I see a bit later, and their use was mainly as a covenant with God. So it's basically like you do this for me, like to prove you're. You're really about this and you're one of us. You know, you're about that. Yeah. So it's like literally a mark. And then there's also theories that it's kind of about either like fertility or just like sexual power. Yeah. Originally they were doing it a little bit older, but then they chose to do on newborns because it was like easier to do. Because if you're like, well, you got to do this when you become a man. It's, it's Tougher. So you still hear about that today. So Moses, who gave this decree, he was not circumcised himself. And there's interesting stuff where people used uncircumcised as an insult. So like, people think he had a speech impediment and they said, like, he's speaking with uncircumcised lips. Or then, like, if someone's being ignorant, they'd be like, oh, like you're using your uncircumcised ears right now. So I need. I'm gonna start using that. That's a great. That's good stuff.

[Manny]

Real uncircumcised. Yeah.

[Noah]

Like, if they're not paying attention to something, it's like, oh, you're man.

[Devin]

Y' all just unlock the new.

[Noah]

Yeah.

[Devin]

A new insult for the pie.

[Noah]

Or like, you know, you got a filthy, filthy mind or something to like any. Any sort of. Kind of. Like, there's obviously always a link between like, kind of cleanliness or hygiene and then like dirtiness and in all that encapsulates. So, yeah. Links to fertility and also sexual virility. So on the flip side, to discourage sexual pleasure later on too, you hear about this as an idea to curb masturbation and kind of impure sexual thoughts

[Manny]

that didn't pan out.

[Sponsor/Advertisement Voice]

Yeah.

[Noah]

Jury's out on that. Whoops. So you won't be distracted with that when you should be focused on God

[Devin]

and other things and the thinking being. It doesn't feel as good. So not as much temptation.

[Noah]

Exactly. So, yeah, you won't be so worried about it. So fast forwarding. Of course, Muslims also adopted it. Some scholars there saying the force can trapped impurities in the body. And many Aboriginal tribes in Australia and across Africa also practice it reasons. And, you know, specifics and customs vary, of course, but a lot of times it's like a manhood ceremony as a test of bravery. So that's like we're waiting for you to become a man. And then it's like to prove it, you're gonna have to do this. And, you know, it's gonn. Painful and hard and scary.

[Manny]

So fascinating that different parts of the world.

[Noah]

Yeah. Like I originally assumed it kind of all stemmed from like the Judeo.

[Manny]

Yeah. And then spread thing.

[Noah]

And then just spread. But yeah, it's like kind of this thing where lots of people had this idea for whatever.

[Manny]

Yeah.

[Noah]

Yeah.

[Manny]

That is so weird.

[Noah]

Yeah. So then moving along to our boy jc Christianity drops circumcision, even though we know our boy was a cut king.

[Manny]

Yeah.

[Noah]

King of kings. There's lots of paintings of this,

[Manny]

paintings of the depiction, like of him getting circumcised.

[Noah]

Yeah. So some people think that they replace circumcision with baptism as a way one to include the ladies, because you could do that. And then also it's because Christianity is more outgoing and, you know, mission based, where you're trying to spread the word and get people involved, which you don't really have as much of in Judaism. But it kind of follows that, you know, they wouldn't want anything that's restricting and kind of daunting like circumcision to be in the way as a barrier.

[Devin]

Five year old man. So it's like you're saying you got to get circumcised.

[Noah]

Yeah. Versus just be like religion, dip your head in some water.

[Manny]

Much nicer experience.

[Noah]

You're good. So now we're fast forwarding hundreds and hundreds of years to why America, which is not famously a majority Jewish or Muslim country, as you guys are probably aware. So why and how did it become so popular here in America?

[Manny]

That's what I'm interested in here.

[Noah]

So to learn about this, I talked to our first guest, Dr. Kate Grabowski. She's an associate professor at Johns Hopkins University and an epidemiologist. She studied impacts of interventions on HIV and sexually transmitted infections, including male circumcision. So here's how circumcision took over the US.

[Dr. Kate Grabowski]

Prior to the 1870s, it was really uncommon. So it was mostly practiced for religious reasons among people who are Jewish or people practicing Islam, which is where it's still very common today. And then in the 1870s, there was this orthopedic surgeon, Louis Serre, and he was treating boys who had problems walking. And he had this one boy who had a lot of trouble and was experiencing paralysis. And he had this idea to circumcise him for whatever reason. And he did. And for some unknown reason, the boy was able to walk afterwards. There's no to believe circumcision cures paralysis. So I don't know what happened here. But anyway, he thought it was this like amazing cure. And he apparently did this several other times and noticed benefits. And then he started going on the conference circuit and really getting circumcision into the forefront of the medical community's mind

[Noah]

in the US So the practice started to gain some traction. And then around the turn of the century, germ theory started to take hold in the U.S. lots of concern about cleanliness and hygiene, and people viewed circumcision as one way to improve it. Next, births moved from the home to the hospital, and circumcision became a bit more routine in those settings.

[Dr. Kate Grabowski]

So that sort of reinforced what was happening. And so it was this whole sort of spiraling of things happening all at the same time that sort of led to these really high levels of circumcision. And by the 1950s and 1960s in the US you had, like, 80 to 90% of boys in the US being circumcised.

[Noah]

No one's really sure why it seemed to cure that paralysis back in the 1870s. There's theories that it was like there was some inflammation, and then once that cleared up, it, you know, freed up the rest of his body. I don't know, but no one's really sure. It is kind of just a strange thing, but that's kind of where it first took hold and then spread from there.

[Manny]

So if it didn't help that kid randomly in the 1870s, there's a world where, you know, there's no domino effect.

[Noah]

Yeah, I would have never caught on necessarily. Yeah, to that degree.

[Manny]

So that is fascinating that the doctor was like, you know what I think is going to help?

[Noah]

Yeah, they were just trying anything, but. Yeah. But then it makes sense. Once we're moving from home births to the hospital wide, then it's like, okay, we know this is pretty good and helps with hygiene or whatever and germs and all that were known then. So it makes sense that, like, we'll offer this and kind of just do it, and then it becomes the standard. Just because then I do think then there's a huge factor, just, well, it's common, Everyone else is doing it, and then it spreads that way. So that's how we got this major rise in circumcision rates and how it became standardized here in America. But believe it or not, not everyone agreed with this. So once the circumcision rate peaked in the 50s and 60s, the decline then began. So to learn about the burgeoning intactivist movement, I spoke to someone who studied this extensively.

[Laura Carpenter]

I'm Laura Carpenter. I'm a associate professor of sociology at Vanderbilt University. And my research is about gender and sexuality and health over the life course. And one of those health and body issues is circumcision First.

[Noah]

Can you give kind of an overview of the intactivist movement? When did it kind of start rising up? And just how would you describe that?

[Laura Carpenter]

Okay, nice pun there, by the way. In the 1960s, there was a big wave of things that we would associate with the 1960s almost. But in medicine, right. You start Seeing physicians particularly challenging male circumcision and saying, why are we doing this? At least if we're going to do it, we need to demonstrate that it works or does what people say it's going to.

[Noah]

Professor Carpenter described this swirling of ideas all contributing to a ripe environment for anti circumcision activism. Hippies and the idea of going back to nature and things like the gay rights movement, speaking more openly about men's bodies and sexual pleasure, then women's health. And the book Our Bodies, Ourselves and

[Laura Carpenter]

the patients rights movement is ramping up at this time. So, you know, in the 1960s, it wasn't uncommon to not tell patients who had cancer that they had cancer. Informed consent, as we know it, didn't exist. Physician beneficence was really the test for whether a medical procedure was appropriate or not. And people started questioning that as well.

[Noah]

So a combination of things leads to a questioning of circumcision within medicine and outside medicine. A grassroots movement around patients rights doesn't morph exactly into the anti circumcision movement, but it does feed it.

[Laura Carpenter]

In organized pediatrics in the 1970s, you get in the Canadian Pediatric Society and the American Academy of Pediatrics, both produce statements that say circumcision isn't really medically necessary. People started talking to each other. Basically. There was a group of nurses in Santa Fe, New Mexico, who became conscientious objectors and, you know, refused to assist with circumcision because they didn't think it was useful, in fact, thought it could be damaging. So it's sort of the 70s when this really gets going in the United States. And then Marilyn Milos founded an organization, the Abbreviated nocirc, National Organization of Circumcision Information Resource Centers. She was a nurse who was pretty appalled the first time she witnessed a circumcision. And the attending physician said, yeah, there's no reason we do this.

[Noah]

Ha ha ha.

[Georgianne Chapin]

The day that I witnessed the circumcision

[Laura Carpenter]

in changed the life that I knew was gone.

[Georgianne Chapin]

When I started to cry and the

[Laura Carpenter]

doctor said, there's no medical reason for

[Georgianne Chapin]

doing this, and I realized my own sons had suffered this.

[Laura Carpenter]

In other words, I'm going to start

[Georgianne Chapin]

to cry probably, but that my own

[Laura Carpenter]

sons had experienced this and that I

[Georgianne Chapin]

hadn't known enough to protect them, I

[Laura Carpenter]

didn't want one more parent or one more baby to feel like that. Now, there are, of course, people who think that there are still good reasons to perform a routine circumcision. So the debate about whether or not it's medically useful continues. No Circus. Founded in 1986, I believe. And then there's sort of like little organizations all kind of popping up.

[Devin]

Circumcision's got to go.

[Manny]

Hey, hey, Shade, shade, shade.

[Devin]

So the only mammal in the whole of the earth.

[Noah]

And are you not suspicious that men,

[Devin]

human males, are the only mammal where

[Noah]

this is supposedly necessary immediately after they're born?

[Laura Carpenter]

Some focused on helping men restore their foreskins, some focused on sort of working with medicine, some focused on working with legal issues. And so there's this sort of proliferation of groups in the 80s through the 90s.

[Noah]

And I had the chance to speak with the founder of one of these anti circumcision groups myself.

[Georgianne Chapin]

My name is George Ann Chapin and I am currently the founding executive director of Intact America, which is a not for profit organization that wants to change the way that America and Americans think about circumcision or male genital mutilation.

[Noah]

She told me she's been interested in circumcision from age 10 when she saw her baby brother come home from the hospital circumcised.

[Georgianne Chapin]

I just started thinking, at that age, why would a newborn baby, why would all boys, essentially, which Howell explained to me, need corrective surgery right after birth? How could all males be born needing surgery? It made no sense to me. And believe me, I knew nothing about evolution. I certainly knew nothing about medicine. I was 10 years old and it just seemed weird. And then when I was in college, I studied anthropology and I was always interested in medicine sort of as a social phenomenon, and I was always interested in equity. And I started hearing about female genital mutilation and how horrifying it was. And the same people who talked about how horrifying female genital mutilation was thought that male circumcision, a lot of them, most of them, thought male circumcision was different, that it was fine, that it was for the boy's own good, that female genital cutting was discriminatory, but male genital cutting was good. And it just, it just was crazy to me.

[Noah]

Decades later, Georgeanne went to law school and became involved with the fight against infant circumcision herself, founding Intact America with a few other people in the movement. So I had to ask Georgen, like, why does she think the medical establishment in the US is so insistent on this procedure? Like what's the motive?

[Georgianne Chapin]

Around the end of the Second World War, the United States established a profit driven fee for service medical system, whereas most other Western countries have some kind of universal healthcare system with a large public supported component Whereas the US Has a fee for service, privately driven medical system. And circumcision is charged for what we call fee for service. Right. The doctor does something for a person and collects a fee. Hospitals collect fees. They collect from insurance companies, they collect from individuals. So circumcision generates money for doctors and hospitals. People will say to me, how much does a circumcision cost? And it's like, depends. You know, that's a lawyer's answer, but it depends. So I've heard of Beverly Hills urologists who will charge $3,500 for a circumcision. And I've heard of obstetricians or pediatricians in a poor southern state who will charge $40 or $75 for circumcision. And insurance sometimes covers it. Some insurance does, some doesn't. Some states, Medicaid systems cover it, some say they don't cover it, but they subcontract out the healthcare to private insurance companies, which can choose to cover it or not. Those are the complex facts about medical circumcision itself, fees and what's charged.

[Noah]

Georgeann says circumcision is pushed heavily on expecting mothers. Part of Intact America's work is conducting a lot of research, surveys, and she cited some of their data on this point.

[Georgianne Chapin]

So another study, Intact America, another survey we did, found that mothers are asked 8.4 times on average whether they don't want to circumcise. What? You know you're going to circumcise your baby, right? Sign here. Of course you're going to circumcise him, right? What do you mean you're not going to circumcise him? An average of 8.4 times during the perinatal period immediately preceding the birth and immediately after the birth. This is really important. Circumcision is marketed to new moms. It's sold aggressively to women. So when people say to me, it's not a women's issue, it's like, it wouldn't be happening if it wasn't for moms. New moms, they are asked to sign off on it. They are told it's important. They are told that it's part of being a good parent. They are told it's good for the baby. The same way diapers, children's clothing are marketed to new moms. Toys, we have a bumper sticker that says 10 out of 10 babies say no to circumcision. So the ethics of circumcision. Bioethics says that if you're not sick, a doctor shouldn't be performing procedure if you're not sick and if you can't get consent and proxy consent, parental consent is invalid for a procedure that does not save the life or health of a child. And because circumcision is non therapeutic, parental consent is legally and technically invalid. But we have given the surgery an enormous pass.

[Noah]

I asked Dr. Grabowski, the epidemiologist at Johns Hopkins, about this profit motive idea to hear her view as someone on the medical establishment side of things, and she was doubtful.

[Dr. Kate Grabowski]

Here's the thing, it's like circumcision has all these downstream medical benefits that would that actually save the health care system a lot of money at the end of the day and save future more expensive billable procedures. So I'm very, very skeptical of that claim. Like it's, it's pretty cheap and I takes time. So I think, yeah, I don't think Hopkins is banking money off of circumcision,

[Noah]

but now might be a good time to talk about the alleged health impacts of circumcision. So here's what Dr. Grabowski told me. The research says, I think we should

[Dr. Kate Grabowski]

step back and talk about what the foreskin is. The foreskin is basically a piece of skin on the tip of the penis. And circumcision removes that. So the foreskin, it's a thinner tissue that's more susceptible to abrasions and tears during sex. It also is very rich in target cells for viral sexually transmitted infections. It also is a really nice environment for anaerobic bacter that are associated with BV in women. But for men, they can produce inflammatory environments that make it a very nice area for these viral sexually transmitted infections to take hold. So the randomized trials, randomized men one to one. These are men who are willing to undergo the circumcision procedure. So I think it's really important that people understand that participation in these studies is voluntary. And what we're measuring is voluntary medical male circumcision. They're choosing to enroll in these studies. And so these randomized trials are like really what we consider the gold standard of evidence because you are sort of balancing factors across groups that might otherwise obscure whatever findings you're hoping to look at. So we enrolled thousands of men in these trials in Uganda, Kenya and South Africa. And then they followed the circumcised men and the uncircumcised men. And then they looked to see how many cases of HIV, HSV2, HPV, genital ulcers they observed in these men afterwards. And then they also followed the partners of these men in Many cases to look at the secondary impacts of circumcision. The really big finding was that it reduced risk of HIV acquisition by 60%. It's incredible. Right. It's a one time intervention that provides a sort of lifetime risk. We also found a 30% reduced risk of HSV2, 25 to 30% reduced risk of HPV. And that's associated with penile cancer and cervical cancer in women. The other thing, reduce genital ulcers by 50%. Genital ulcer disease is really, really painful for some people. Specifically ulcers caused by HSV2 can be awful and very stigmatizing. So that's another benefit in women, female partners. We found reduced rates and levels of bacterial vaginosis and trich as well, and also hpv. So there are these downstream benefits to partners and then there were also these direct benefits to the men themselves, themselves.

[Manny]

Those are huge numbers.

[Noah]

Yeah.

[Manny]

If you're wanting to make the decision, you might just be like, well whatever, I work on them anyways. Yeah. So I'm not.

[Noah]

Yeah. I mean certainly these things are avoidable, of course, with or without circumcision.

[Manny]

But I was surprised that there, there was such a drastic difference.

[Noah]

Yeah.

[Devin]

But 60 for HIV.

[Noah]

Yeah.

[Manny]

Which makes sense. She was, when she was saying like the extra skin is thinner and more susceptible to like.

[Noah]

Yeah. Tears and stuff. And like, you know in your head you're picturing like these huge tear. But I think it's like more like mini tiny abrasions that you probably wouldn't even notice.

[Manny]

Yeah.

[Noah]

Or like see as an issue necessarily. Not that I would know. So. Yeah, so I thought that was interesting and helpful at least in understanding kind of.

[Manny]

Yeah.

[Noah]

How this is even what the actual theory is on how that works. And we wanted to know what are the impacts on sexual pleasure beyond just health. Here's what Dr. Grabowski's research shows.

[Dr. Kate Grabowski]

We did ask men about sexual pleasure and sexual function before and after the trial and the majority of men reported no difference at all. And some reported increased sexual pleasure, likely because they weren't dealing with all the STIs that that impact sexual pleasure at the end of the day. And women also reported a lot of increased sexual pleasure because they weren't getting these infections either. So the data was, was shockingly good and it was very consistent across all of the three trials. So there were three simultaneously trials going on at the same time. Uganda, Kenya and South Africa. And yeah, it was. I mean it's kind of amazing. They all found the exact same effect and like that never happens.

[Manny]

For us, the increased pleasure is because you don't have.

[Noah]

Yeah, I don't, I don't think it's really an argument that it's like it's going to feel better to do this if, if all else being equal, I

[Manny]

want to know the difference between like, you know, two people, one uncircumcised one, not that are. That don't have. Like, that's what I'm curious about.

[Noah]

I'll look, I'll dig around to see

[Devin]

if there's a little more. But yeah, it's not a noticeable amount from us.

[Manny]

From a medical perspective, it's worth the trade off.

[Noah]

Yeah, I think that's the main idea there. Now, on the other hand, here's what Georgeanne from intact America had to say about these studies.

[Georgianne Chapin]

So those original studies in three African countries, those studies have basically gone by the wayside. And there is no association anywhere in the world, including studies done in the American military, major studies done in Canada, the entire European continent, that shows any kind of an association between HIV and circumcision status. So it doesn't show more HIV or less HIV with circumcised men vs non circumcised men or intact men. So those studies have been ignored and discredited. These are people in sub Saharan Africa where access to basic medical care is lacking. Children and mothers dying in childbirth. And to take a whole posse of American researchers, all circumcised themselves and anxious to prove that it was for some good reason to sub Saharan Africa to round up black men and cut off part of their penises is the height of medical colonialism and really horrifying. And the African campaign to circumcise black men in Africa will go down in history as profoundly damaging and unethical. Follow up lasted maybe a couple months. Most men were, were lost to follow up. They were given a few dollars to have the circumcision. It was disguised as, I don't know, covering their transportation costs or something. And many of the men undoubtedly had serious complications. Then they conducted a survey that found that these men had very high satisfaction rates from their circumcisions. These were men who never had problems, never had a problem before. And I thought to myself, you know, you don't even want to complain about a bad haircut. You know, you go to the bar, you might change barbers, right? But you know, these men said, oh yeah, you know, I'm cool, I like it. You know, I don't know. So those studies are, I mean, taken with a grain of salt. Those studies need to be taken with a pound of salt. You know, they're very unreliable. And other claims for circumcision, you know, reducing urinary tract infections in babies. Well, girls get urinary tract infections and higher rates than boys, and they're cured by a dollar worth of antibiotics. And there is no therapeutic or preventive purpose to removing a healthy, normal foreskin, which is the most sensitive part of the male penis. The most erogenous part of the male genitalia is the foreskin.

[Devin]

These studies that she references in regards to US Military, I will say that was my. It felt a little bit like, okay, you're doing a study in Africa where, you know, we don't fall too much into stereotypes, but it's just different. The circumstances are different. Yeah, I wanna, you know, there are people who have, you know, clean water and access to healthcare, but there are people who don't.

[Noah]

My assumption is it's basically hygiene and that sort of stuff. But that's also why the HIV rates are so different also.

[Devin]

Yes, exactly.

[Noah]

That's my impression.

[Manny]

Part of me wishes some of her counterpoints weren't so anecdotal. Like, yo, you won't even complain about your haircut. Like. Like, let's say in the worst scenario, like, they, you know, this is an immoral study. Yeah, but you still get these results that are so drastic. Yeah, I want to hear some counterpoints that are like, well, the reason these are unreliable is because this data set is too small or whatever. Yeah, it seemed like she.

[Noah]

Her.

[Manny]

Most of her beefs were just about like, well, yeah, a guy's going to say he likes sex no matter what, but. But I don't know if that's actually what that study showed. Maybe the study did show people who said that the sex was worse, but it just wasn't the full.

[Noah]

Yeah.

[Manny]

Sample size.

[Noah]

So I followed up with Dr. Grabowski about some of these concerns. Here's what she said. She says those studies have not been discredited. In fact, the three randomized controlled trials in Uganda, Kenya and South Africa are considered among the strongest pieces of evidence in HIV prevention research and demonstrated a substantial reduction in HIV acquisition among heterosexual men. These findings were sufficiently consistent that the trials were stopped early because of clear benefit. So this is the question, why. You know, the common discussion point comes up, and we talk about this too, where. Why do we not see these huge numbers, you know, in the United States or other countries, like in Europe, we don't see these sorts of same rates. As far as the decline of HIV transmission even in countries that are mostly uncircumcised. Main reason results differ from studies conducted in North America or Europe is that the epidemics and predominant modes of transmission are very different. In Sub Saharan Africa, the trials were conducted primarily among heterosexual men acquiring HIV through vaginal intercourse. In contrast, HIV epidemics in North America and much of Europe are concentrated among men who have sex with men msm, where anal intercourse is the predominant mode of transmission. The biological protection associated with circumcision appears much stronger for vaginal sex than for receptive anal sex, which carries substantially higher transmission risk through different mucosal mechanisms.

[Manny]

Wow.

[Noah]

So we're talking about different things essentially

[Devin]

anal sex versus vaginal sex.

[Noah]

Dr. Grabowski shared a bit more details on this point as well. We'll be sharing the full text of her responses along with research in the newsletter. And while while we're here, it seems worth noting that there are advancements like PrEP, which can reduce chances of getting HIV as much as 99%, and doxy pep, which can be used to reduce your chances of getting STIs. Links on that below as well. In regards to Georgan's statements about a lack of proper follow up with participants and reimbursement, here's what Dr. Grabowski had to follow up across the three major trials was approximately 90%, which is considered excellent retention for longitudinal clinical research. Participants were not paid to be circumcised as is standard in biomedical research. Men in both study arms received modest reimbursement for transportation and time spent attending study visits. These reimbursements were reviewed and approved by ethical review boards and were not considered coercive. Importantly, compensation was not contingent on choosing circumcision. With regard to adverse events, the trials carefully monitored complications and published detailed safety data in the world's top medical journals. Serious adverse events were uncommon across all three studies. On satisfaction surveys, it is always possible that some degree of social desirability or white coat bias influences self reported outcomes in clinical studies. However, if there had been widespread regret or major dissatisfaction, one would expect that to emerge more clearly across multiple studies and long term follow up evaluations. It largely did not. Then, because Geor mentioned this earlier and it comes up frequently in this debate. I asked about how female genital mutilation, sometimes called female circumcision, compares to male circumcision. Like is it actually a fair thing to equate?

[Manny]

Yeah.

[Noah]

So this is what Dr. Grasky had to say to that. First she said, I really would suggest avoiding the term female circumcision and instead use the term female genital mutilation, fgm, which is the standard terminology used by major international health organizations. The comparison between male circumcision and FGM is medically and anatomically misleading because the procedures are fundamentally different in extent, intent and consequences. FGM typically involves partial or complete removal of the clitoris and or other external female genital tissue, often with the explicit purpose of suppressing female sexuality and sexual pleasure. Many forms of FGM are associated with with substantial immediate and long term harms, including severe pain, infection, childbirth complications, sexual dysfunction and psychological trauma. There are no recognized medical benefits. Safe medical Male circumcision, by contrast, involves removal of the foreskin covering the tip of the penis. It does not remove the glans itself, which is the primary structure involved in sexual sensation for men. The foreskin does not contain nerve endings associated with with light touch sensitivity and Researchers appropriately evaluated sexual satisfaction and function in the HIV prevention trials to assess whether circumcision negatively affected sexual experience. Overall, those studies did not demonstrate major reductions in sexual satisfaction or function. Honestly, I think equating the two procedures really minimizes the severity and harms of FGM from a medical and public health standpoint. They are distinct procedures with very different impressions, implications, risk profiles and ethical contexts. So her view is it's not really fair to compare them.

[Manny]

Yeah, which makes sense based on, you know, what we just heard. It's a completely different process.

[Noah]

Okay, so we've heard about the rise of circumcision, the backlash to it, and the potential health impacts of the procedure. We're going to take a break and then when we're back, we're going to hear about why rates are declining.

[Sponsor/Advertisement Voice]

Amazon Health AI presents painful thoughts I

[Laura Carpenter]

I can't stop scratching my downtown. Yeah, but I'm not itching to go downtown and tell a receptionist I'm here

[Noah]

to talk about my downtown.

[Laura Carpenter]

Some things you'd rather type than say out loud.

[Sponsor/Advertisement Voice]

There's no question too embarrassing For Amazon Health AI, chat your symptoms and get virtual care 24. 7 Healthcare just got less painful. Support for the show comes from Public, the investing platform for those who take it seriously. On public, you can build a multi asset portfolio of stocks, bonds, options, crypto and now generated assets which allow you to turn any idea into an investable index. With AI, it'll be it all starts with your prompt. From renewable energy companies with high free cash flow to semiconductor suppliers growing revenue over 20% year over year, you can literally type any prompt and put the AI to work. It screens thousands of stocks, builds a one of a kind index and lets you back test it against the S&P 500. Then you can invest in a few clicks. Generated assets are like ETFs with infinite possibilities, completely customizable and based on your thesis, not someone else's. Go to public.com podcast and earn an uncapped 1% bonus when you transfer your portfolio. That's public.com podcast paid for by Public Investing Brokerage Services by Open to the Public Investing Inc. Member FINRA and SIPC Advisory Services by Public Advisors llc. SEC Registered Advisor Generated Assets is an interactive analysis tool. Output is for informational purposes only and is not an investment recommendation or advice. Complete disclosures available at public.com disclosures this

[Noah]

is Jacob Goldstein from what's yous Problem? Business software is expensive and when you buy software from lots of different companies, it's not only expensive, it gets confusing.

[Devin]

Slow to use, hard to integrate. Odoo solves that because all Odoo software is connected on a single affordable platform.

[Sponsor/Advertisement Voice]

Save money without missing out on the features you need.

[Noah]

Odoo has no hidden costs and no limit on features or data. Odoo has over 60 apps available for

[Devin]

any needs your business might have, all

[Noah]

at no additional charge. Everything from websites to sales to inventory to accounting.

[Devin]

All linked and talking to each other.

[Noah]

Check out odoo d o o.com that's o d o o.com. Alright, so we've heard a lot already, but now it's time to talk about the decline. So first we're going to hear from Dr. Grabowski about the Johns Hopkins research measuring the decline. She's going to go back into the history, back to that peak in the 50s and 60s, and then look at why things started going down.

[Dr. Kate Grabowski]

So remember we were talking earlier about 80 to 90% of boys being circumcised in the 50s to 60s. You know, in the 70s and 80s people started to become really skeptical of the procedure. There wasn't good data at the time, like people were doing it for cultural and anecdotal reasons and there wasn't good medical science behind it. So you started to see people question the practice. And in the early 80s California was among the leaders in stopping Medicaid coverage for circumcision. And so you started to see huge drop off in coverage, particularly on the west coast and in areas where Medicaid stopped covering the procedure. Then like you had at the same time this like raging epidemic in Africa. And then people were observing that there was lower levels of HIV in men who were circumcised but they didn't know if it was because they were circumcised or because they were Muslim because there was so much confounded by religion. There was. So that sort of prompted the trials. And then by the mid 2000s, we got all this evidence that it actually was beneficial, and it did reduce SDI's, like, LO and behold. So, like, it's been kind of declining in the US For a while, but it's still steadily declining, even though we have this new medical evidence available to us. A lot of that, I think, has to do with the fact that Medicaid isn't covering the procedure in a lot of settings, but also cultural differences and changes, changing demographics, like people migrating into these countries who don't traditionally circumcise. So there's a lot of things going on.

[Noah]

So the study found that in 2012, 54.1% of neonatal males were circumcised, and by 2022, that percentage was down to 49.3. She also highlighted some interesting demographic differences. So, on the West coast, only 25% of newborns are circumcised, compared to around 70% in the Midwest. Declines are happening broadly among most groups, but the group with the biggest drop off is wealthy white males. So I thought the Medicaid thing was interesting because. Yeah, if you don't feel strongly either way, but now you're paying out of pocket, then it kind of makes sense that you might. You might skip on something like that.

[Manny]

Yeah.

[Noah]

Like, the.

[Manny]

The number of circumcisions might decrease if.

[Devin]

If.

[Manny]

If it's not covered by insurance. And that's kind of like how RFK Jr. Is recommending that they stop recommending the Hep B vaccine right after births in the hospital. There's some data that shows that if you don't recommend the Hep B vaccine right after the birth, people just don't get it.

[Noah]

Right. Yeah. And along those lines, I did ask Dr. Grabowski if she thinks because of this and other factors, rates will continue to decline. Do you think rates are going to continue to decrease at the rate they have been?

[Dr. Kate Grabowski]

No. Given what's going on in public health right now, probably.

[Georgianne Chapin]

Yeah.

[Dr. Kate Grabowski]

Yeah. I mean, I don't want to come off as some, like, huge, like, pro circumcision. I think everybody needs to get circumcised kind of thing. Like, I. I'm sort of in line with the 2012 AAP recommendations, which are like, this is a procedure that has medical benefits, and if you want to do it, you should have access to it. Like, that's how I feel about it. And I think parents should have that choice and they should decide for them. You know, there are some risks. They're very, you know, if they're done in a safe, sterile environment, they're very, very low. And the AAP's conclusion was that the benefits, like the cumulative benefits of 90% reduced urinary tract infections in infants, plus all these other STI benefits, reduced inflammation, easier hygiene, etc, like those benefits sort of outweighed the risk. But they ultimately felt like, you know, this is. Like this is someone's penis. Like it's got. It's tied to all these religious and cultural practices. Like it really should be a decision that's left to parents and adults, right? So that's kind of where I sit. I'm like, if, you know, if you want to do it, if it's for you, you should do it. I think like, Medicaid should cover it. Like, people should have access to it if they want it because of these medical benefits. And when I see people saying, oh, you shouldn't have access, or it's genital mutilation, that's just not true. And I think it, it reduces the ability of some people to get preventative health care. That's not fair. And that's, you know, this is a controversial topic. Obviously, people feel really, really strongly about it sometimes in one direction or the other. And I just think people should be armed with all the information, right? Like, they should know that there are medical benefits, they should know that there are risks and they should make the best decision for their families.

[Noah]

Here's what Laura Carpenter, the Vanderbilt professor, had to say about the declining rates and why this issue in particular seems to get people so fired up. Data shows that circumcision rates are decreasing, I think about 5% in the past 10 years or so. Do you think this is the result of the intactivist movement or is it kind of maybe something that was going to happen or a mixture, I guess. How do you read, like, the efficacy of this?

[Laura Carpenter]

I think the declining rates are a result of a number of things. I mean, I think the antactivist movement has been influential in terms of getting people just to sort of question this, oh, hey, why are we doing this? And at least now you're thinking, oh, wait, okay, this is a decision as opposed to something that happens automatically, you know, and certainly fewer physicians, I think, think that it's. You know, many may not oppose it, but they're not actively in favor of it either. The changing attitudes about it is important, I think thinking about sort of the idea that people are supposed to be, and parents in particular are supposed to be these, like, very intense consumers of healthcare for their kids and sort of intense decision makers is maybe part of it too. There is probably some association with vaccine resistance.

[Noah]

Yeah, I was going to ask how it compares to say that and just general kind of questioning of maybe. You already said medical orthodoxy. Yeah. If you can maybe pull out that thread of like, how does it compare to, say, a movement like that?

[Laura Carpenter]

If we think about the kind of early vaccine resistance, we see it mostly in sort of natural mothering, natural childbirth circles, and it tends to be a liberal left decision, you know, healthy living and homeopathic medicine, and all of these things will be enough to keep our kids healthy. They don't really need vaccines. Or we're more worried about the small risks associated with vaccines. And, you know, again, we might be more worried about the small risks associated with circumcision than we are with preventing STIs through circumcision because we're gonna teach our kids to use condoms. So this was sort of sense about, like, what, what the parenting mission is and how health goals can be accomplished.

[Noah]

Right.

[Laura Carpenter]

So anti circumcision is kind of associated more with that part of vaccine resistance than it is with sort of the current wave of vaccine resistance. And then there's a complicated relationship to opposition to abortion.

[Noah]

Yeah, that. That's also on my list because it's between that or then even like something like animal rights activate. Like, I see a lot of parallels, at least in terms of methodology, tactics. So, like, can you speak a little bit about, say, the abortion piece then too? Like, how does that compare? That's obviously more of a conservative or right wing leaning movement, especially in the past, than vaccines, which is now all jumbled, it seems like.

[Laura Carpenter]

Right, right. Vaccines is very complicated right now.

[Noah]

Yeah. Can you talk a little bit about that then?

[Dr. Kate Grabowski]

Yeah.

[Laura Carpenter]

So my sense of the relationship between the intactivist movement and opposition to abortion is the antactivist movement sort of has like these two camps and they try not to talk about it very much. Particularly people who came in through the women's health movement or natural childbirth or bodily autonomy tend to be pro choice. And, you know, you should get to choose about whether or not you keep a pregnancy, and you should get to choose about whether or not you get to keep your foreskin.

[Noah]

Right.

[Laura Carpenter]

And see that as a consistent message. But there's also a save the babies strand in the intactivist movement, and they tend to be a Little bit more. Save the fetus. The fetus is a baby. Save the fetus babies. And so they're kind of in this uneasy tension. And again, my experience attending meetings and talking to various people is they just try not to.

[Sponsor/Advertisement Voice]

Yeah.

[Laura Carpenter]

Like, I've seen it burst out a couple times at meetings.

[Noah]

Yeah.

[Laura Carpenter]

And it's very. I mean, it's very tense. Like, the. I mean, the opinions are.

[Noah]

Are really a passionate group of people. I think we can say they are

[Laura Carpenter]

a very passionate group of people.

[Devin]

You.

[Laura Carpenter]

The thing I find most striking, like the reason I ended up studying this as a scholar at all, and the thing I think I find most striking about this is the intensity and durability of the battle. And we see that around circumcision for some of the same reasons. We see intense, intense feelings around childhood vaccination, intense feelings around abortion. Intense feelings about sex. Education is another. Another good example. They help people fight about all kinds of things that aren't just that thing itself. I mean, absolutely. People who are pro circumcision or anti circumcision have strong feelings about circumcision itself and. And think it is beneficial or think it as harmful, specifically as. As it is. But because of the nature of the practice and how people think about it, fighting about it also helps you fight about whether there's too much medical overreach. It helps you fight about what is good evidence in medicine. You know, are stories of men enough, or do we need, you know, big random control trials? It helps people fight about how much different societies can tolerate. It helps people fight about whether their natural bodies are better than altered and quote, unquote, improved bodies. It enables people to fight about the importance of sexual pleasure. And, you know, it like there's. There's almost nothing you can't fight about with it. So I think that that is some of where the intensity comes from with a lot of these. These issues. It's not just the thing itself, but we're fighting about women's roles in society or about what. How much control parents should have over their kids or, you know, all of these other kinds of things.

[Noah]

Right. It's almost proxy. Seems dismissive, but it's almost a proxy for these bigger, more kind of almost existential questions.

[Laura Carpenter]

Our term is symbolic politics.

[Noah]

Okay.

[Dr. Kate Grabowski]

Yeah, yeah.

[Laura Carpenter]

But. But proxy war. I mean, proxy war is. Is.

[Manny]

Yeah.

[Laura Carpenter]

Oh, who should make medical decisions? Yeah. I think the thing I've been. One of the things I've really been struck with is that people in the intactivist movement and people generally medicine, who are in favor of routine circumcision. They all have really the same goal, Right. They actually want kids to be healthy and happy.

[Noah]

Right.

[Laura Carpenter]

They want adults to be healthy and happy. They disagree about the role of circumcision in that. You know, I mean, if there's any main message from my research, I mean, it really is just the intensity coming from this sort of symbolic resonance of circumcision. How many, how many think people are concerned about the specific issue, but it, how much it touches on all these other factors that are things that are controversial in themselves.

[Noah]

Right, right.

[Laura Carpenter]

And circumcision seems to be a particularly dense with those meanings. Right. I mean, it involves a genital, it involves gender, it involves parenthood, it involves religion, it's bodies, all these things, you know, so I think we see like, like a particular, you know, particular fuhrer thing here.

[Noah]

And now to take it back to Geor, as far as the work her group Intact America is doing, where does she see that group's role in the current decline? So as far as kind of your group and the actual work you're doing, I mean, what would you say is the, what are your main goals? Like are you trying to pass legislation or get some policies input as far as public health, what's your kind of mission?

[Georgianne Chapin]

You know, I believe that legislation follows popular opinion. I mean, think of how long it took to get same sex marriage legislation for same sex marriage, and now the popular outcry against some of the things that we were able to achieve. Some kinds of human rights advances we were able to achieve. And all kinds of reproductive rights are under assault. So I believe that it's gonna be a long time before we're gonna get any laws against male circumcision. I believe that the advocacy that we do influences people. We certainly wanna say babies. We want people to not think that they need to circumcise their sons in order to be good Americans or good parents. And people need to be educated about this. And once you start talking about it and you say, you know, this is a normal body and you know, sexuality is, you know, something we should be discussing, and doctors need to understand what that body part is. They need to understand you shouldn't have to tell a doctor or a nurse that cutting off a normal part of somebody's genitals is excruciatingly painful and damaging. But as a culture, we're so ignorant and in such denial that this needs to be done. We need to talk about this, we need to talk about it all the time. So that's what Intact America does. We talk about it all the time. I'll talk to anybody who wants to talk about it. And there is undoubtedly a trend to a lowering trend of circumcision, although we're not confident about the numbers. But at the same time, the medical establishment continues to promote infant circumcision.

[Noah]

So I asked if the rise of distrust of public health in recent years has enlivened her cause. I was like, social mores seem to be changing. So this her response on the questioning of the medical establishment that we're seeing.

[Georgianne Chapin]

I do believe that all this questioning is good. I think some of it is very suppositional and there's not a lot of evidence or there's evidence contrary. There is no evidence that circumcising a baby is a beneficial health procedure. None. None anywhere. So I don't see it as a controversy. Circumcision is not controversial from a medical standpoint. It, it's only controversial from a sociocultural standpoint because it's taken hold. But, oh, people are definitely questioning. And that's why you see the medical industry continuing to push it, because there are vested interests. And the vested interests are not just financial, there are also sociocultural and psychological. So if you've circumcised five sons, if you've conducted thousands of circumcisions in your career, right, you have skin in the game and not, not in a positive way. So it's hard to change cultural norms. And that's why it's so important for people. This is so important what you're doing, talking about it, and I'm sure we'll have people listening. It's so important to think about this stuff and think, what exactly am I defending? If I defend circumcision, I'm defending the mutilation of a helpless baby's natural, normal body that evolved over millions of years. This is a normal, sensual body part that we are chopping off. And if we come back to feeling compassion for this newborn child or this child, that goes a long way to setting your instincts where they should be. And if we go to what we all really subscribe to, an ethical co op, which is that you don't assault, you don't assault people. You know, you don't assault people's bodies. If you don't just willy nilly remove body parts from somebody, then that tells you what we should not be doing, which is assaulting a newborn baby and removing part of his or her genitalia.

[Manny]

I think she probably would have won a jury over trial I mean, our thing here, it's like that study that Kate did where it showed a drastic decrease in transmission of STIs. It just doesn't, like. That's nice, but it just doesn't feel like enough of a reason to do it to, like, the babies.

[Noah]

Right.

[Manny]

Like, if you become older, sexually active,

[Devin]

and then you make that.

[Manny]

Yeah.

[Devin]

How to make the decision later on.

[Manny]

But what she was saying about, like, this is how we naturally enter the world. This is, like, naturally occurring. It's everywhere in nature, every primate. It's compelling.

[Noah]

Yeah. And it's. It's totally fair. And it's like, so. So much of this is like, you're a father, whatever, so you just do the same for your son.

[Manny]

Yeah.

[Noah]

And you're the same as your dad before you or, you know, what have you. So that makes sense. Like, it is just a. Like she says, a sociocultural norm. That's why you go to France. It's not going to be the same. Or wherever. You know, there's something to it for sure. I think I. I line up basically with Dr. Kate where it's kind of like. I think it's good to know possible impacts. And if. If these rates continue to decline and end up being basically only Muslims and Jews in America doing it, I don't think that's gonna mean there's going to be, you know.

[Manny]

Yeah.

[Noah]

Surging rates of STIs or. Or other negative outcomes. Yeah. So I think it's. It's. To me, it's just like, you should do what you want. And I personally, I don't think it's. Whatever. Barriers in my head. I can't. Parents have to make decisions for their kids all the time.

[Devin]

Yeah.

[Manny]

Yeah.

[Noah]

And it's. It's. To me, it's not so dissimilar from, like, when a. B. When a parent gets their baby's ears pierced and they do it when they're really young instead of older because it's like, they'll just get over it then. Yeah, that's. That's my view.

[Manny]

Yeah. It's a really interesting issue. It's like, if I have a boy, I probably would not circum. I would not get him circumcised, but I don't. But I personally also don't feel like I'm missing out on literally anything or like, you know, it just doesn't feel like a. I wouldn't do it because it's like, there's not enough. There's not enough of a reason to do it.

[Noah]

Yeah.

[Manny]

The Baby. And it's not. I wouldn't do it. Not because the baby's in pain.

[Noah]

Yeah. It's more general.

[Manny]

Crying for three months straight after being bored no matter what happens. But. But yeah. I don't know. It just doesn't feel like if you don't do this then, you know, there doesn't seem to be an immediate reason to do it.

[Devin]

Your is your thinking basically let them make the decision if they want to do it later on.

[Manny]

Yeah.

[Devin]

Or that like basically they're not going to get it done.

[Manny]

They're probably not.

[Noah]

Most likely. I would assume not. Yeah.

[Manny]

Because. But that's kind of why I wouldn't do it.

[Noah]

Yeah.

[Manny]

If you get to age 18 or whatever and it's your choice and you're not going to do it, probably then I'm not going to do it.

[Noah]

It early on.

[Devin]

No, it makes sense.

[Noah]

Yeah. It's extremely logical.

[Manny]

Like if I didn't get circumcised and I was at 18, I probably wouldn't get circumcised.

[Noah]

Oh, yeah. I, I would.

[Manny]

Now. That doesn't mean, you know, if you're circumcised that you're like, you're living a much worse life but like, well, you're

[Devin]

living different, you know. Yeah. It's not worse.

[Noah]

Necessary. Yeah.

[Manny]

It's a, you know, doesn't feel like a thing that needs to be done.

[Devin]

This is interesting. I don't think I'm gonna get my kids circumcised because, you know, following dad's footsteps.

[Noah]

Yeah, it's pretty fair.

[Devin]

Yeah, it's. It's, you know, as someone who's had my own sort of transformation on this issue, at least thought wise where at one point I was like, oh yeah, no way that I was not circumcised. And you know, it is interesting to hear both sides, I think. Yeah. People should. I'm not someone who at this point, I don't think there's enough that I've heard to say that people should not have the option.

[Noah]

Yeah.

[Manny]

Right.

[Noah]

I think that's what's. That's something that was interesting to me because like here we are, we're talking about it. These people, like, people are very strongly. I mean, I guess it's like if you think something really horrible is happening, you want to stop it. Even if it's, even if it's. You don't necessarily need it to be illegal.

[Devin]

No.

[Noah]

So it makes, it's like, it's like being vegan or something where like if you really believe this Is so horrible. This is going to be your cause. Because it's like, yeah, like she's not pushing legislation now or to ban it.

[Devin]

Yeah.

[Noah]

Because I imagine. I think the downstream effect of that would. Then it's like, well, there's a. It's a religious thing. Whatever it would be. It'd be challenging to get it banned on those means. Yeah. Or like, once you hit that wall. But yeah, because it's interesting. Because it's like, well, everyone has the option. I guess it depends how. How heavily you think the doctors are pushing it or not.

[Manny]

Yeah.

[Noah]

Well, that's where it really comes down

[Devin]

to, like, the pressure. I understand making it. If you want to do it, you can have it. But I think part of the. Was this intactivist. I think part of what it sounds like your messaging is like, basically, we need to do more education.

[Noah]

Yeah.

[Devin]

It sounds like they don't trust the medical establishment right now. It feels like they think there's a lot of misinformation. They're telling people things they shouldn't do which are harming their kids. They have these preconceived notions. They're relying on these studies which they feel are unreliable. So there's like this education proponent of like, hey, we need to let these people know that what they are saying is incorrect because they have a lot of influence. When you're going through the process of having a child, you're gonna. You know, most people. I know now we're in this. Maha.

[Noah]

Yeah.

[Laura Carpenter]

Yeah.

[Devin]

Moment. But most people are gonna defer to whatever the doctor says. Right. And both me and Manny's case, that was kind of like, that's why we are where we are today. My mom's doctor was like, ah, whatever. You don't really have to do it now. He can do it down the line if he really wants to do it. And Manny's doctor was like, you should do it.

[Noah]

Right.

[Devin]

Our parents weren't googling things back then. Right. They weren't reading up on it. They were just like, this is what the doctor told me. Obviously, people can do more of their own research now, but I think people should just be. Yeah. Be able to make their own decisions, but also have access to all the information. Information to make that decision.

[Noah]

Because I feel like this. This kind of movement would basically be happy if it was. Instead of being something that was asked, was basically something you have to ask, you opt into. And I think. I think that small. Basically small shift would probably.

[Manny]

It would destroy the rights of.

[Noah]

Yeah, it would probably. Yeah. Probably have pretty big impacts, especially if you get, you know, maybe one or two generations down where, I mean, even now it's under 50%.

[Devin]

Yeah. I think the big thing, I think that's going to be big. It's going to be cultural stuff, too. I think maybe that will become even more important than what the doctors say. Right. If all of your peers circumcised, it doesn't really matter what the doctor says. You're gonna say, well, most of these people are not.

[Noah]

Yeah. So if the rate, if the rate goes down to say, let's see, you went down 5% in 10 years. If it goes down another 10% in the next 20 years or whatever.

[Devin]

Yeah.

[Noah]

Then it's pretty low.

[Devin]

Yeah. You know, then you come the odd one out too.

[Georgianne Chapin]

Yeah.

[Noah]

So it's like, then it's like it really is a decision versus like kind of the default.

[Manny]

Yeah, exactly. Yep.

[Noah]

So time will tell. We'll, you know, on episode 3000, we'll check back in. No Such Thing is a production of Kaleidoscope Content. Our executive producers are Kate Osborne and Mangesh Hatakedur. The show is created by Manny Fadal, Noah Friedman and Devin Joseph. Theme and credits Song by Manny Mixing by Steve Bone Our guests this week were Kate Grabowski, Laura Carpenter and Georgianne Chapin. Thank you sincerely to all of you for your help help with this episode. Visit Nosuchthing show to subscribe to our newsletter. I'll be adding tons of links to research so you can dive in yourself to read more. There is tons of stuff that we weren't able to include in the episode, so if you have questions, please check it out. If you have feedback for us or a question you'd like us to answer, our email is mannynoadevinmail.com or leave us a voicemail by calling the number in our show notes. We'll be back next week with a new episode.

[Devin]

Bye.

[Laura Carpenter]

Hot take.

[Georgianne Chapin]

You can disagree with someone and not hate them. I know.

[Noah]

Really groundbreaking stuff. But lately that line seems blurry because hate is rising across communities in all

[Georgianne Chapin]

kinds of ways and Jewish communities are

[Laura Carpenter]

getting a lot of it right now. You don't have to agree with people, you just have to not be awful. The blue square is a simple way to say, I'm with you and I

[Noah]

don't tolerate hate of any kind. Go to bluesquarealliance.org, get a pin, share

[Georgianne Chapin]

it and stand up.

[Noah]

I'm U.S. transportation Secretary Sean Duffy. We all seem to be in a rush these days, from work to driving our kids around. But when you're behind the wheel. Please do not speed.

[Devin]

A few minutes saved by going faster is never worth the risk.

[Noah]

So follow the speed limit, enjoy the drive, maybe bring some snacks for the kids. And know that along the way you're

[Manny]

getting quality time with your family.

[Noah]

Paid for by nhtsa.

[Dr. Kate Grabowski]

This is Sophia Donner from OK Storytime this Summer.

[Laura Carpenter]

Find your next obsession on Prime Video and listen. We're not saying you need another obsession, but there could be a lot worse ones. Steamy romance, addictive love stories, and the

[Dr. Kate Grabowski]

book to screen favorites you've already read

[Laura Carpenter]

twice, so why not watch them a third time off campus?

[Dr. Kate Grabowski]

L the Love Hypothesis and more Slow Burns Second Chances chemistry you can feel

[Noah]

through the screen and it makes you

[Dr. Kate Grabowski]

wish you were actually in that movie. We've got binge worthy series can't miss

[Laura Carpenter]

movies perfect for when you're ignoring your own problems or procrastinating as one does. Your next obsession is waiting.

[Georgianne Chapin]

Watch only on Prime.

[Dr. Kate Grabowski]

Aging doesn't stop, and neither should you with vital proteins, collagen and protein shakes because around the age of 30, your body needs more support for movement and recovery. On workout and rest days, reach for a 30 gram total protein shake or go with our classic collagen peptides help support healthy hair, skin, nails, bones and joints so you can stay vital. Stay you. Visit vitalproteins.com to learn more and where to buy. These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease. This is an I Heart Podcast.

[Laura Carpenter]

Guaranteed human.