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Tuli or not tuli: Pinoy views on circumcision

Circumcision dates back to 2300 BC, but the surgical removal of the foreskin of the penis remains a controversial topic around the world.
Just last month, the American Academy of Pediatrics (AAP) issued new guidelines saying that the health benefits of infant circumcision outweigh the risks of the surgery, Reuters reported on August 27.
Lower risk of cancer and STDs  
While the AAP still does not recommend the procedure for all infants, their new statement is in favor of the procedure. Reuters said the change was prompted by scientific evidence that suggests circumcision can reduce the risk of urinary tract infections in infants, as well as cut the risk of penile cancer and sexually transmitted diseases.
In March, Reuters reported that a US study found "circumcised men may have a slightly lower risk of developing prostate cancer than those who still have their foreskin."
However, Jonathan Writer, who led the study, said he "would not go out and advocate for widespread circumcision to prevent prostate cancer."
The report also said that "wives and girlfriends of circumcised men had lower rates of infection with human papollomavirus (HPV), which in rare cases may lead to cervical and other cancers." Pinoy tradition
In the Philippines, circumcision, or tuli, is a widespread practice, and is considered a rite of passage for Filipino boys.
According to a report on State of the Nation in May last year, 93 percent of Filipino males are circumcised.
Many Pinoys are circumcised during summer, when there is more time to recuperate after the surgical procedure. 
A summer custom Dr. Victoria Dimacali told GMA News Online that summer is the ideal time, both for those conducting the medical mission and for those who will be circumcised.
"It's the optimal time for us and the kids, because we're on break, and they have ample recovery time, so their circumcision won't interfere with school," she said.
In most cases, circumcision is done by a doctor, but there are areas where boys resort to the traditional "pukpok," which family physician Dr. Rogel Santiago called "unsanitary" in a report on 24 Oras in April this year.
In Dimacali’s experience, she would join medical missions in connection with her sorority, performing circumcisions on school boys in Grade 6 and below. Dimacali said the medical missions would be held in elementary schools, and there would often be tie-ups with politicians.
Dimacali said young boys should get circumcised primarily for hygiene. "Pag nagcircumcise, di natatrap yung dirt, no accumulation of smegma," she said, adding that there are also links between not being circumcised and cancer.
Apart from hygiene, she noted that circumcision is part of Filipino culture.
Rite of passage  
"We see sometimes that the dads really force their sons to undergo circumcision. Kasi pag hindi, may stigma, itetease sila na supot," she said.
She added that it could also be a "sign of manliness, that they're now macho enough to brave the pain."
In the Philippines, males who have not been circumcised are made fun of by their peers and made to feel embarrassed about not having been circumcised. On the other hand, circumcision is regarded as something to be proud of, to the extent that one city attempted to set a new world record by holding a "Tule Party," where some 1,500 boys aged 12 and up would be circumcised for free.
Boys about to be circumcised gave reasons for wanting to undergo the procedure such as "para maging lalaki ako."
"It's a rite of adolescence. There really is no disadvantage of circumcision, for me," Dimacali said. Dimacali believes there should be a choice, noting that in other countries, circumcision is done at birth. Option or obligation?
Circumcision is a ritual obligation for infant Jewish boys, and is also a common rite among Muslims, who account for the largest share of circumcised men worldwide, Reuters said.
In Germany, a court in Cologne banned the practice in June, ruling in the case of a Muslim boy who suffered bleeding after circumcision. The decision to ban circumcision sparked protests from hundreds of German Jews and Muslims. Jewish religious practice requires boys to be circumcised from eight days old, while for Muslims, the age at which it is carried out varies according to family, country and branch of Islam, Reuters said.
"I think this is what's debatable... at least here, may malay na yung mga tinutulian. I think it's also because no one's actively against circumcision here, that's why there's no issue," she said, noting that young boys are proud after the procedure.
"It makes one more acceptable to peers," she said.
Most parents also want their children to be circumcised. Asked if she plans to have her son circumcised, Nice Buenaventura said she believes it is “a necessary procedure for health reasons and nothing else.” “I have heard of horror stories, too horrific to mention, brought about by the unhygienic consequences of undermining said procedure,” she said.
On the other hand, she also considers that circumcision will help her son adapt socially. “I still remember the boys in my high school cracking jokes about this one person who supposedly didn't get circumcised,” she said.
The World Health Organization says only 30 to 33 percent of males aged 15 and above are circumcised.
Ethical problems  
 Those against circumcision point to "serious ethical problems inherent in doctors removing healthy body parts from children who cannot consent," as Gerorganne Chapin, executive director of anti-circumcision group Intact America, said in a Reuters report.
Meanwhile, a 2000 study by Samuel Ramos and Gregory Boyle suggested that there is a need for the Filipino community to be informed about the serious psychological harm caused by circumcision, after it found strong support for its hypothesis that ritually circumcised boys would exhibit evidence of post traumatic stress disorder. — TJD, GMA News