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چرا مردها ختنه می‌شوند؟ — Transcript

by Primal Spark · 3,158 words · 562 segments · language en · Watch on YouTube

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0:00Imagine being born into a world where
0:02one of the very first decisions made
0:04about your body has nothing to do with
0:06your body itself. Not about your genes,
0:08nor your health, but about the country,
0:11religion, and family into which you
0:13were born. This image may seem distant
0:15to you, but for millions of boys, it is
0:17exactly what happens. In some parts of
0:20the world, almost all male infants
0:22undergo a procedure that changes their
0:24bodies forever. In other parts, this
0:28procedure is rare, and in some cultures
0:30, boys undergo it years later amidst
0:33rituals that celebrate their entry into
0:35adulthood. The name of this procedure
0:38is circumcision. It means the removal
0:40of the foreskin of the male penis, and
0:41it has been practiced for thousands of
0:43years. So why are men circumcised? You
0:45might say it's because religion
0:47dictates it or because it’s more
0:48hygienic. But the real answer is much
0:50more complex than that. The answer is
0:52hidden in four forces. Religion,
0:54cultural tradition, medical treatment,
0:56and medical prevention. Circumcision
0:58can reduce certain health risks.
1:00Sometimes it treats a specific medical
1:02condition. But for millions of families
1:04, its meaning has nothing to do with
1:06disease. Its meaning is identity,
1:08ancestry, and belonging. To understand
1:11this ancient tradition, we must first
1:13see exactly what changes. Almost every
1:15boy is born with a foreskin. This
1:17flexible layer of skin covers the head
1:20of the penis. A place that doctors call
1:22the glans. The foreskin is not an extra
1:25or random piece of tissue. It is a
1:27natural part of male anatomy,
1:28containing blood vessels, connective
1:31tissue, nerve endings, and specialized
1:33surfaces. In infants, the foreskin is
1:35usually attached to the glans, and its
1:37opening may be naturally tight. This is
1:40a completely normal stage of
1:41development. As the boy grows, these
1:43adhesions gradually separate, and the
1:46foreskin retracts more easily. For some
1:48children, this happens early. For
1:50others, it takes until adolescence, and
1:52if you force the foreskin back before
1:55it is ready, it can cause pain, injury,
1:57and scarring. What is its natural
1:59function? It protects the glans. It
2:03reduces direct friction against
2:04clothing and allows the skin to glide
2:06during sexual activity. But having a
2:09function does not mean that removing a
2:11tissue always causes serious harm.
2:14Millions of circumcised men live
2:16healthy lives, with entirely normal
2:18urinary, reproductive, and sexual
2:20functions. In circumcision, a medical
2:23professional removes part or all of the
2:25foreskin, leaving the glans exposed. In
2:28infants, the procedure is shorter than
2:30in adults, but it still requires pain
2:32management and precise technique.
2:35Recovery in adults is longer, and the
2:37result is permanent. The tissue that
2:39has been removed will never grow back.
2:42So why did humans begin doing this
2:43thousands of years before the advent of
2:46modern surgery? For the oldest
2:48documented chapter of this story, we
2:50must travel to ancient Egypt. Over
2:524,000 years ago, Egyptian civilization
2:54had complex religious rituals,
2:56organized social classes, and a
2:58remarkable understanding of practical
3:01medicine. Archaeological evidence shows
3:03circumcision was practiced long before
3:05hospitals and antibiotics. One of the
3:08most interesting pieces of evidence is
3:10the tomb of Ankhmahor in Saqqara,
3:12dating back to around the 24th century
3:14BCE. Its carvings are widely considered
3:17to depict the ritual of circumcision.
3:20Thousands of years before anyone knew
3:23about bacteria and viruses, humans were
3:25consciously altering the male body. In
3:27Egypt, circumcision was apparently
3:29linked to rituals of social identity
3:31and notions of purity and cleanliness.
3:34But historical evidence doesn't allow
3:35us to assume all Egyptian men were
3:37circumcised or that the ritual meant
3:39the same thing everywhere. In some
3:41contexts, it may have been a sign of
3:43social status, a transition to
3:45adulthood, or preparation for religious
3:47service. Centuries later, the Greek
3:49historian Herodotus wrote about the
3:51circumcision of Egyptians and
3:53attributed it to cleanliness. His
3:55account shows us how ancient people
3:57understood this practice, but it
3:59doesn't prove that its primary goal was
4:01preventing infection. The important
4:04point is that circumcision had become
4:06an established cultural practice
4:08centuries before the rise of many later
4:10civilizations. But Egypt was just one
4:13corner of a much larger story. In
4:16different societies, circumcision took
4:18on meanings that went beyond the
4:20surgery itself. In Judaism,
4:22circumcision became a central religious
4:25duty. The Hebrew Bible identifies it as
4:28a sign of God's covenant with Abraham.
4:31Jewish tradition established the rite
4:33of Brit Milah, usually performed on the
4:35eighth day after a boy's birth.
4:37Provided, of course, the infant is
4:39healthy. Here, the act is not a
4:41response to a medical problem. It is a
4:43religious act that connects the child
4:45to a community. A boy born into a
4:48religious family might be circumcised
4:50simply because his parents consider it
4:52an essential part of their faith. In
4:54Islam, there is also a long-standing
4:56tradition of male circumcision. The
4:59practice became widespread among
5:01Muslims through religious tradition,
5:03and many jurists consider it mandatory
5:05or highly emphasized. The age at which
5:07it is performed varies among families
5:09and countries. Some boys are
5:11circumcised as infants, and others
5:13during childhood. Perhaps you have seen
5:15this same tradition in Iran.
5:16Circumcision is performed for almost
5:19all boys and, in many families, is
5:21accompanied by a celebration called "
5:23Khatna Suran." It is so common that few
5:25people ask why. In both religious
5:28traditions, this act is a sign of
5:30membership in a community and a
5:32connection to ancestors, and rates
5:34among neighboring populations can
5:36differ significantly, even when their
5:38climate, diet, and biological traits
5:40are similar. Human anatomy does not
5:43suddenly change by crossing a country's
5:45border; culture does. But circumcision
5:48is not limited to Judaism and Islam;
5:50many African societies have long
5:52considered it part of rites of passage.
5:54In these societies, circumcision shows
5:56that the child is from today accepting
5:58the responsibilities of adulthood. This
6:01ritual may include education, community
6:03participation, and the recognition of
6:05maturity. Details vary from culture to
6:09culture, and some traditional methods
6:11carry higher medical risks if performed
6:13without sterile conditions, anesthesia,
6:16or trained practitioners. The same
6:19physical alteration can be a religious
6:21covenant in one society. A rite of
6:23passage in another, and a routine
6:25medical procedure in a third. Now look
6:28at the United States, where
6:29circumcision took a different
6:31historical path. In the nineteenth and
6:33twentieth centuries, circumcision
6:35became increasingly linked with
6:36medicine. Physicians promoted it for
6:38various reasons, from hygiene to the
6:40prevention of certain diseases. Some
6:43claims had weak scientific backing, and
6:46at parts of this period, ideas about
6:48controlling sexual behavior also
6:50influenced doctors 'attitudes.
6:52Gradually, infant circumcision became
6:54normalized in American hospitals.
6:57Parents who were circumcised themselves
6:59chose the same for their sons.
7:01Hospitals established standard
7:03procedures. This is why the pattern of
7:05circumcision in the US differs from
7:07many European countries, where routine
7:09infant circumcision is far less common.
7:12A practice can become common due to
7:14medical history, family expectations,
7:16and institutional habits. Even when it
7:19is not necessary for everyone. But what
7:21does modern medicine actually say? To
7:23answer, we must return to the foreskin
7:25itself. The foreskin creates a covered
7:28space around the glans, and this space
7:30has its own microbial environment. Like
7:32other surfaces of the body. The genital
7:35area also naturally harbors microbes.
7:37Their presence does not automatically
7:39mean disease. Moisture, skin surface,
7:42and inflammation can determine which
7:44microbes inhabit that area.
7:46Circumcision alters this environment.
7:48Studies have shown that after
7:50circumcision, the composition of penile
7:52microbes changes, and some anaerobic
7:54bacteria decrease. But this does not
7:57mean every uncircumcised man is dirty
7:59or infectious. An uncircumcised man can
8:02practice perfectly normal hygiene.
8:05Proper washing means cleaning under the
8:07foreskin once it retracts easily, and a
8:09circumcised man still requires normal
8:12hygiene. The claim that circumcision is
8:15the only way to stay clean is medically
8:17incorrect. However, there are a few
8:20health outcomes on which circumcision
8:22has a measurable effect. One of the
8:25most studied is HIV prevention. In the
8:28early twenty-first century, researchers
8:31conducted three large randomized
8:33controlled trials on heterosexual men.
8:36Bertran Auvert in South Africa, Robert
8:38Bailey in Kenya, and Ronald Gray in
8:41Uganda. These studies compared HIV
8:44acquisition between circumcised and
8:46uncircumcised men. The result was
8:49striking. Under the conditions of those
8:52studies, medical circumcision reduced
8:54the risk of acquiring HIV through
8:56heterosexual contact by about 50 to 60
8:58percent. This finding shaped World
9:01Health Organization recommendations.
9:04The WHO and UNAIDS recognized voluntary
9:07medical male circumcision as a
9:09component of HIV prevention. These
9:13programs are mostly implemented in
9:14countries that have a high burden of
9:16heterosexual transmission of the virus.
9:19But the 50 to 60 percent figure must be
9:21understood correctly. A 60 percent
9:23reduction doesn't mean it makes a man
9:2660 percent immune to HIV. It does not
9:29bring the risk to zero. It only
9:31describes a relative risk reduction
9:33under specific conditions. Circumcision
9:35does not replace condoms, HIV testing,
9:37and effective treatment. Preventive
9:40medications also remain important. The
9:42benefit of circumcision depends on the
9:44population and the mode of transmission
9:46. Why does removing the foreskin change
9:48the risk? The inner surface of the
9:50foreskin has immune cells that can play
9:52a role in HIV infection. The local
9:55environment and the level of
9:56sensitivity to inflammation may also
9:58have an effect. Circumcision alters
10:00several of these factors simultaneously
10:02and changes the microbial community
10:04around the glans. So the protective
10:07effect is linked to measurable anatomic
10:10and biological changes, and HIV is not
10:12the only infection studied.
10:14Circumcision has also been linked to a
10:16reduced risk of some sexually
10:17transmitted infections. Including some
10:20types of human papillomavirus, known as
10:22HPV, and genital herpes in the
10:24populations studied. The extent of
10:26these benefits varies, and circumcision
10:28does not provide complete protection.
10:30The HPV vaccine and safe sexual
10:32behavior remain important. Another
10:35benefit relates to urinary tract
10:36infections in infants. Boys can also
10:39get these infections. Although the
10:41overall risk in infancy is relatively
10:43low. Research has shown that
10:45circumcised male infants develop
10:47urinary tract infections less often
10:49than uncircumcised ones. The relative
10:51difference can be large, but the
10:53absolute benefit for a healthy infant
10:55is smaller. Because most boys never get
10:57an infection at all. Perhaps for a
11:00child with urinary tract abnormalities
11:02or recurrent infections, the balance is
11:04different. The difference between
11:06relative risk and absolute risk is
11:08important. A procedure can reduce the
11:10likelihood of a problem without being
11:12necessary for every individual. A link
11:14has also been observed between
11:15circumcision and penile cancer. This
11:17cancer is rare in many countries. Some
11:20studies have found a lower risk among
11:23men circumcised in childhood, but the
11:25risk of cancer depends on several
11:27factors: HPV infection, smoking,
11:29chronic inflammation, and certain
11:32foreskin diseases. Routine circumcision
11:35of infants is not medically necessary
11:37just to prevent these cancers; it is
11:39certainly not a guarantee against
11:41cancer, and preventing a rare disease
11:43is different from treating a disease
11:45that already exists. Now we reach one
11:47of the clearest medical reasons for
11:49circumcision: problems with the
11:50foreskin itself. Phimosis occurs when
11:53the foreskin cannot retract due to a
11:55tight opening, but there is an
11:57important difference between normal
11:59childhood development and pathological
12:01phimosis. In young boys, a foreskin
12:04that does not retract is often
12:06completely normal. Pathological
12:08phimosis is associated with problems
12:10such as scarring, recurrent
12:12inflammation, pain, or functional
12:14impairment. Some cases are treated with
12:16topical steroid creams and gentle care
12:19under a doctor's supervision. Surgery
12:22is not always the first treatment, but
12:24when significant scarring or persistent
12:26symptoms make non-surgical treatment
12:28ineffective, circumcision can be a
12:30lasting solution. Another condition is
12:33balanitis, which is inflammation of the
12:35glans, and balanoposthitis, which
12:37involves both the glans and the
12:39foreskin. Causes can include irritation
12:42, infection, or inflammatory skin
12:44conditions. Treatment depends on the
12:46underlying cause. In severe or
12:47recurrent cases, circumcision is
12:49sometimes recommended. Another
12:51important example is lichen sclerosus.
12:55A chronic inflammatory skin condition
12:56that can cause scarring and tightening
12:58of the foreskin. When it affects the
13:01male genital area and the disease is
13:04limited to the foreskin, circumcision
13:06can be an effective treatment, as is
13:08the case with paraphimosis. A condition
13:10where the retracted foreskin gets stuck
13:13behind the glans and cannot return to
13:14its original position. The resulting
13:17swelling can restrict blood flow and
13:19requires urgent medical attention.
13:21Circumcision might be considered later
13:23in specific cases, but immediate
13:25treatment focuses on releasing the
13:27constriction. These examples show why
13:29circumcision has a legitimate place in
13:32modern surgery. For some patients, it
13:34directly treats a painful or dangerous
13:37condition. So why is it not recommended
13:39for every baby boy? The answer is this.
13:42Every surgery has trade-offs.
13:43Circumcision can cause bleeding,
13:46infection, pain, and healing problems.
13:49When qualified specialists perform it
13:51correctly, more serious complications
13:53are rare but can still occur. Risk
13:57depends on the patient's age and health
13:59, the surgical technique, and the
14:01provider's experience. Removing too
14:03much or too little skin, scarring, and
14:06damage to surrounding tissues are known
14:08complications. Anesthesia and pain
14:11control are essential because infants
14:13feel pain even when they cannot
14:15describe it. Circumcision in infants
14:19with certain anatomical differences,
14:21including some forms of hypospadias
14:23where the urethra is not at the tip of
14:25the penis, is usually postponed or not
14:27performed. In these cases, the foreskin
14:31may be needed for future reconstructive
14:33surgery. These are the practical
14:35medical reasons why every circumcision
14:37requires a proper assessment. Another
14:39discussion is sexual sensation. Because
14:41the foreskin has nerve endings and
14:43specialized tissue, circumcision
14:45permanently changes the anatomy related
14:48to sexual stimulation. Some men report
14:50a difference in sensation, friction, or
14:52sexual experience after circumcision.
14:55However, clinical research has not
14:57generally found a significant reduction
14:59in erectile function, orgasm, or sexual
15:01satisfaction in circumcised men. Each
15:04individual's experience can differ, and
15:06removing the foreskin changes the
15:08tissue available for sensation and
15:10movement. But circumcision does not
15:12inherently cause sexual dysfunction,
15:14infertility, or the inability to
15:15experience pleasure, and this brings us
15:18to another important distinction.
15:19Circumcision is not sterilization. The
15:22testicles continue to produce sperm.
15:24The reproductive organs continue to
15:25function, and the procedure does not
15:27remove the structures responsible for
15:29fertility. A circumcised man can become
15:31a father. The procedure is performed on
15:33the foreskin, not on the organs that
15:35produce sperm and testosterone. So why
15:38do parents choose circumcision for an
15:40infant with no medical issues? Some
15:43families consider the preventive
15:45benefits sufficient to justify the
15:47procedure. Others do so due to
15:49religious obligations, cultural
15:51expectations, or family tradition. Some
15:55want their son to look like other men
15:57in the family, while others don't; they
15:59see the foreskin as a healthy part of
16:01the body and prefer to leave the
16:02decision to the son in adulthood. This
16:07raises an ethical question: an infant
16:09cannot give informed consent for an
16:11elective and irreversible procedure.
16:14Parents typically make medical
16:16decisions for their children, but
16:18circumcision can be performed without
16:20illness, permanently removing natural
16:22tissue. Proponents of routine neonatal
16:24circumcision emphasize potential health
16:27benefits, low complication rates in
16:29clinical settings, and parental
16:31religious freedom. Critics emphasize
16:34bodily autonomy, the lack of medical
16:36necessity for most healthy infants, and
16:39the option to postpone an elective
16:41procedure. Medical institutions and
16:44healthcare systems weigh these
16:46considerations differently, which
16:47explains why this routine circumcision
16:50is common in some countries and rare in
16:52others. Now, look at a fascinating
16:54historical contrast. For ancient
16:56Egyptians, circumcision could be a
16:58symbol of ritual purity or social
17:00identity. For Jewish communities, it
17:03became a sacred covenant. For many
17:05Muslim families, it is a religious
17:07tradition. In some African societies,
17:10it marks an important social transition
17:12. In American medical history, it
17:16became a standard procedure for infants
17:18, and in public health programs today,
17:20it can be a way to reduce heterosexual
17:23HIV transmission in specific
17:25populations. The procedure itself is
17:28recognizable in all these places, but
17:31the reason for it varies wildly. This
17:33is what distinguishes circumcision from
17:35many other surgeries. An appendectomy
17:38is performed because the appendix is
17:40inflamed. A broken bone is operated on
17:42to restore its function. But
17:44circumcision can be performed on a
17:46healthy infant for religious reasons.
17:48It can be performed on an adolescent in
17:50a cultural ceremony. On an adult who
17:53wants preventive benefits, or it can
17:55treat a condition where the foreskin
17:57has developed a painful problem. One
17:59procedure, multiple purposes. There is
18:02also an evolutionary lesson hidden in
18:04this story. The foreskin is a part of
18:06normal male genital development. In
18:09infants, that doesn't mean nature
18:11intended for every man to keep it for
18:13life. Just as removing it doesn't prove
18:16that this tissue is useless. Biology
18:18explains what the foreskin is and how
18:20it functions. Medicine evaluates the
18:23impact of its removal. Culture and
18:25religion explain why specific societies
18:27choose to do this. These are different
18:31questions, and conflating them leads to
18:33misleading results. The strongest
18:35scientific explanation for circumcision
18:38is not a dramatic theory about
18:40prehistoric humans discovering a hidden
18:42benefit. It is a combination of
18:44documented historical traditions and
18:46measurable medical outcomes. Ancient
18:48societies created customs that became
18:50deeply intertwined with identity.
18:52Subsequent generations inherited them.
18:54Then medicine examined their effects
18:57using anatomy, epidemiology, and
18:59clinical trials. Some traditional
19:01claims regarding cleanliness were
19:03exaggerated. Some medical benefits were
19:06real and measurable, while other claims
19:08, especially grand promises about
19:10sexual health or disease prevention,
19:12require much more careful
19:13interpretation, and the result of this
19:16history is visible today. Two men can
19:19have identical reproductive anatomy at
19:21birth, and simply because their
19:23families belong to different cultures,
19:25they grow up with different
19:26circumcision statuses. One is never
19:29operated on and remains perfectly
19:31healthy. The other is circumcised
19:33shortly after birth and also remains
19:35perfectly healthy. Neither of these two
19:37outcomes proves on its own. That one of
19:39the two bodies is natural and the other
19:41unnatural. Circumcised and
19:43uncircumcised men can both have healthy
19:46sexual and reproductive lives. So why
19:49are men circumcised? Some because their
19:51religion has maintained this tradition
19:53for centuries. Some because their
19:55society considers it a milestone of
19:56growing up. Some because their family
19:59follows a familiar family or medical
20:01tradition, and for some, the procedure
20:03treats a specific condition or has a
20:06measurable preventive benefit under
20:08certain circumstances. It is certainly
20:11not something every male body requires,
20:13but it is also not a practice without
20:15legitimate medical use. Its story
20:18stretches from ancient Egyptian reliefs
20:20to today's operating rooms. From
20:23religious rituals to randomized
20:24clinical trials, and perhaps the most
20:27surprising part is that a small
20:29anatomical structure is tied to so many
20:31diverse aspects of human civilization.
20:34The foreskin belongs to biology.
20:36Circumcision belongs to the history of
20:38human choices about biology, and
20:40understanding this difference reveals
20:42something extraordinary about our
20:44species. Humans have not inherited
20:46their bodies only from evolution. Now
20:49you know that one of the first
20:51decisions about your body may have
20:52never been about your body. It was
20:55about which story you belong to. Yeah.

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