Please sign this petition to the CDC! Thank you.
NB/ this post contains sexually graphic content and may not be for the feint-hearted. It’s medical, not pornographic, but if you’re easily offended I’d advise against reading on. In fact, you better close the site altogether…
“Circumcision is a solution in search of a problem.”
– Edward Wallerstein
Many people ask me, upon learning of my staunch opposition to all forms of GM (genital mutilation; male or female [MGM/FGM], baby or child, US or Africa, hospital or village…), “what’s your problem with circumcision?”
It is simply another example of quackery that has somehow survived into the (relatively) enlightened age – I will bundle it in with homeopathy, chiropractic and any other ‘alternative medicines’. It’s a throwback, supported only by myths and ignorance, continued for profit and more sinister reasons.
Firstly, if you can stomach it, watch the procedure being performed on a baby. I’d put a youtube link but if you want one, you can find it. I’m not going to rely entirely on Appeal to Emotion here though so read on if you wish. No one should choose it without knowing exactly what it entails. For the more sinister stuff mentioned, look up circumfetish for starters.
What is MGM?
It’s something pretty much everyone has heard of. Yet few people understand it, especially in Europe where, thankfully, the practice is relatively rare. My issues with it began when we were shown a video of a Jewish circumcision (‘bris’) in an RE class at school. The baby’s strapped down while a mohel, not a qualified physician, removes a substantial amount of the child’s penile skin; just days after he’s born. He cries his eyes out, quite naturally. Apparently this is a necessary initiation into Judaism (though not according to my favourite kinda Jews); something a baby can never understand, let alone consent to. Similar is found in Islam where ‘initiates’ range from babies to teenagers and indeed adult converts. The point regarding medical training is somewhat moot, however – there is no right way to do a wrong thing.
I didn’t think much of it for some time, until I begin to learn about FGM. What horror is this? Girls having their genitals butchered out of tradition, fear of the unknown (it is thought that the clitoris is a dangerous organ capable of growing and killing women or babies should they touch it at birth, or simply that the female sex organs are a source of uncontrollable sexual desire and no woman should be walking around with that) and misogyny.
Isn’t FGM so much worse?
At first glance, it seems so much worse than something 15-30% of the world’s men are living with (depending on whose figures you believe); it carries risks for the girl (she may bleed to death or die of septicaemia) and any future children she may have. There is also the most severe (but thankfully rarest) form called infibulation, in which the external part of the clitoris and labia majora are removed then the vulva sewn shut with only a small hole for urination and menstruation. When a man wishes to have sex with her he will open the wound with a knife and sew it shut again afterwards to make sure she isn’t unfaithful while he’s away.
No doubt FGM has some forms which are truly horrific, but the majority are prepucectomy/female circumcision (directly analogous to MGM). MGM also has some very scary manifestations around the world which often result in death (indeed there are reports to be found of children dying because of their circumcisions weekly but they are not well-publicised e.g. this and this), problems with urination and sex and so on.
The main problem is that people tend to focus on infibulation-type FGM and the commonest/least shocking forms of MGM – which is an uneven comparison. Comparison isn’t even the point; and that is what I wish to highlight with this whole argument.
The ‘maleness’ of a foetus comes into being when certain genes on the Y chromosome are activated during development. This is why men have nipples; they don’t do anything, they just developed before the man-genes kicked in. Male and female sex organs develop from the same tissue in the foetus; for a large portion of development, XX and XY are visually indistinguishable.
Indeed, in some individuals the difference is not clear-cut. Sex and gender are complicated issues beyond the scope of this post, however.
What’s the problem?
The point I wish to make is that the outward appearance of a child should not matter – they should be protected from unnecessary, damaging, permanent genital surgery; cosmetic surgery, chosen by parents (or physicians making a profit from it in the case of the US) for ridiculous ‘reasons’.
These tend to include:
Intact is disgusting! Well, that’s subjective and however many men may have the opinion that the female genitalia are ugly, surgery will never be forced on baby girls in accordance with that. Nor should it.
Intact smells bad! Not if you shower for a few seconds. It’s very simple; lots of men can tell you that. The only people who smell are people who don’t wash themselves at all and in that case, what their penis smells like is one of many problems.
It prevents penile cancer! No it doesn’t. It’s an incredibly rare cancer to begin with (<1% cancer cases in the US, but around 10% in Africa, where circumcision is commonest…), and not absent in the circumcised population. Cutting off the foreskin does not protect against it (for an in-depth summary of literature up to 2000). Wallerstein (UCNA, 1985) found the same rate of the cancer in non-circumcising countries as in the US where it is still common. With few quality studies bringing together epidemiological data, it is unjustified to pin down ‘not-being-circumcised’ as a significant risk for penile cancer; an incredibly rare condition best prevented by not smoking and keeping clean; many thousands of children must undergo circumcision to prevent a single case, statistically. That is not acceptable medical practice.
So 1) Sanitation and education alone drastically reduce risk of this cancer anyway 2) there is now an HPV vaccine so for the cases caused by that, vaccination of girls AND boys would be preventative, at no physical cost to individuals.
A clinical trial proposal/analysis written by R.T.D. Oliver (BJUI, 2009. Incidentally, at the same university, medical school and indeed institute as myself) even states at the start:
“…penile cancer has reduced substantially without implementing circumcision. In Denmark, penile and cervical cancer decreased by 28% and 24%, respectively, between 1940 and 1990, coincident with an increase from 35% to 90% in the proportion of dwellings having a bath . In India, high caste and better educated uncircumcised men have less penile cancer than less-educated circumcised Muslims, and the prevalence of cervical cancer in equivalent females mirrors this trend . In Brazil, where there has been considerable investment in sanitation facilities , there is a gradient of increasing penile and cervical cancer in the areas of the country that have least provision of sanitation. In China, where before 1951 penile cancer was the most frequent urological malignancy, accounting for 39.5% of cases, it had declined to the least frequent, and only accounted for 1.6% of urological malignancies by 2000 , due at least in part to the better domestic sanitation facilities for a larger proportion of the population.”
Another major problem is with suggesting to already poorly-educated individuals that “circumcision could prevent the spread of HIV!” (another widely-cited benefit) is that a kind of invincibility complex begins to form, where people believe they are resistant and therefore end up spreading the virus even more. Also one of the studies was ended early due to the finding of increased male-female transmission, so women are put at even greater risk of becoming HIV positive with circumcision in some cases. Really nice articles in Lay Scientist and on BBC.
It really is a solution in search of a problem. STD spread is best tackled with education, barrier contraception availability and use and reproductive autonomy for women. Things we should be striving for anyway, not trying to shoe-horn in an outdated surgical procedure that some people want to justify any way they can.
No medical organisation recommends it as a prophylactic treatment. Just as we wouldn’t remove girls’ breasts at the first opportunity – and breast cancer is incredibly common by comparison.
It stops UTIs! Again, it doesn’t*. Plus, UTIs are not life-threatening and are easily treatable with antibiotics and good hygiene. Women get far more UTIs than men anyway.
*Edit: This analysis states “Given a risk in normal boys of about 1%, the number-needed-to-treat to prevent one UTI is 111″ – meaning you have to circumcise 111 boys to prevent just one UTI, which are as I said generally not that serious anyway. That’s 110 put at risk of serious complications, left without an extremely sensitive part of their anatomy that was perfectly healthy – to theoretically prevent one transient infection.
I don’t want my son teased at school! Kids will lay into anyone for any reason. They’re cruel, it’s what they do. Better be teased for it than be without that part of your body forever. Again, if some classmate is studying your privates that intently, their making fun may not be your only worry.
It’s a family tradition/we want him to look like his dad! That’s a big reason FGM is still performed, too. An invalid one, in my view. How messed up is it to want your son’s genitalia to match your partner’s?! It’s pretty sick to read women’s comments about their sexual preferences and using it as a reason to force something like this on their children. If a man confesses to saving up to get his daughter a boob job we’d be disgusted, right? We don’t do this with any other body part. Also I don’t think dads and sons spend much time comparing their members. Again, if they do, there are more problems afoot.
It’s easier to deal with this way! Guess what, kids get messy. Raising children is difficult. There are lots of nasty things we have to learn to cope with and lots of reasons they get ill. We don’t insist on shaving their hair off all the time (hooray, head lice), removing all nails, laser-treating the armpits, taking out teeth, cutting off ears and so forth. We all have to learn to wash ourselves; taking care of the penis is no different. Doctors telling mothers to force their son’s foreskin back when it doesn’t naturally detach until puberty does not help. Women can talk to each other (and thanks to the age of communication, now are) and physicians can stop giving people bad advice. Medical training and indeed lower education can stop shying away from sexual health. The functions of this part of the body (VERY graphically explained & demonstrated here, don’t click at work!) should not be taken lightly.
He won’t remember if we do it when he’s a baby! Well, some people don’t remember being raped if they’re drugged up enough. Also, your baby won’t remember much at all, doesn’t mean you can abuse them in any way you see fit. This is not an argument at all.
Below are examples of ‘clinical’ and tribal instruments of circumcision.
I do not care whether we’re talking about a baby in a hospital in the US who may not remember much of it or a 15 year-old stood in front of his tribe not permitted to show pain in order to be considered a man. I do not care if we’re talking about a girl held down by her female relatives while they ‘operate’ on her then tie her legs together to make sure the wounds heal together or a baby undergoing a ritual, ceremonial pin-prick. I do not care if it’s scalpels and clamps or razor blades and glass. All are unacceptable – gender, age, location, manner, extent of damage, ‘reasoning’. Unacceptable because it removes an individual’s choice. Cosmetic surgery should only ever be elective and no child can choose this, much less understand it. Medical necessity is a different issue, but this procedure is currently ‘over-prescribed’ mainly due to ignorance, in the US it’s profitable and yet again religion is an acceptable trump card to overcome questionable (to say the least) ethics.
Genital mutilation is a human rights issue; it’s a throwback to even more ignorant times than we currently know. People need to be outraged by it and stop legitimising some forms by being tolerant of others. This is not the extent of it, but I hope it’s somewhat educational and helps people to understand my personal views.
It is not my intent to make anyone feel negatively about themselves (though the resistance to feeling like a victim is a big part of what keeps such traditions going), but to condemn this ‘tradition’ and break the vicious cycle. We cannot change the past but we can spread knowledge and make future lives better.
This facebook group has a great list of links for FGM-oriented charities and organisations etc.
http://www.intactamerica.org/ is probably the biggest anti-MGM movement currently and well worth keeping up-to-date with. Some major changes may be happening in the US soon, thankfully.
Thank you for reading. Edit 2014: Brian Earp has this excellent post that calmly addresses the “but they’re not the same!” knee-jerk reaction. Do read it.
Timeline of ridiculous ‘justifications’ for circumcision through medical history is also shown (click to read on below), for those who are interested. Why the WHO recommends male circ but not female circ, despite similar ‘benefits’ being reported for both. Also how the anti-ageing industry comes into play.
The following provides an overview of how doctors’ reasons for circumcising children and babies have changed drastically since the time when they first began promoting it. Thanks to my friend Laura, who runs these forums (also full of loads of information and discussion) for finding it.
Most of the timeline was assembled by Dan Bollinger from the Fall 2003 article: Circumcision Timeline – A History of Medical Error, Medical Fraud, and Medical Abuse by Frederick Hodges in issue 71 of The Complete Mother.
“Between the mid 18th century and the late 19th century, the foreskin was transformed from an adornment that brought pleasure to its owner and his partners… to a useless bit of flesh and an enemy of the state.”
– Robert Darby
* 1832 Claude-Francois Lallemand circumcises a patient to cure him from nocturnal seminal emissions. [Des Pertes Seminales Involontaires. Jeune 1836 (1):463-7; 1839 (2):70-162; 1842 (3):266-7, 280-9]
* 1845 Edward H. Dixon declares that circumcision prevents masturbation. [A Treatise on Diseases of the Sexual Organs. New York: Stringer & Co 1845 pp 158-65]
* 1855 Jonathon Hutchinson publishes his theory that circumcision prevents syphilis. [On the Influence of Circumcision in Preventing Syphilis. Medical Times and Gazette 1855;32(844):542-543]
* 1865 Nathaniel Heckford claims that circumcision cures epilepsy. [Circumcision as a remedial measure in certain cases of epilepsy and chorea. Clinical Lectures and Reports by the Medical and Surgical Staff of the London Hospital 1865;2:58-64]
* 1870 Lewis A. Sayre publishes a paper ‘proving’ that circumcision cures epilepsy. [Circumcision versus epilepsy, etc; Transcription of the New York Pathological Society meeting of June 8, 1870. Medical Record 1870 Jul 15;5(10):231-4]
* 1870 Lewis A. Sayre declares that circumcision prevents spinal paralysis. [Partial paralysis from reflex irritation, caused by congenital phimosis and adherent prepuce. Transactions of the American Medical Association 1870;21:205-11]
* 1871 M.J. Moses declares that Jews are immune to masturbation because of circumcision. [The value of circumcision as a hygienic and therapeutic measure. New York Medical Journal 1871 Nov;14(4):368-74]
* 1873 Joseph Bell announces his discovery that circumcision cures bed wetting. [Nocturnal incontinence of urine cured by circumcision. Edinburgh Medical Journal 1873 May;1(9):1034]
* 1875 Lewis A. Sayre declares that foreskin causes curvature of the spine, paralysis of the bladder, and clubfoot. [Spinal anaemia with partial paralysis and want of coordination, from irritation of the genital organs. Transactions of the American Medical Association 1875;26:255-74]
* 1879 H.H. Kane ‘discovers’ that circumcision cures nocturnal emissions and abdominal neuralgia. [Seminal emissions, abdominal neuralgia: circumcision: cure. Southern Clinic 1879 Oct;2(1):8-11]
* 1881 Maximillian Landesburg announces that circumcision cures eye problems that he believed were caused by masturbation. [On affections of the eye caused by masturbation. Medical Bulletin 1881 Apr;3(4):79-81]
* 1886 William G. Eggleston declares that foreskin causes crossed eyes. [Two cases of reflex paraplegia(one with aphasia) from tape-worm and phimosis. Journal of the American Medical Association 1886 May 8;6(19):511-5]
* 1888 John Harvey Kellogg promotes circumcision as punishment for boys to discourage them from masturbating. [Treatment for Self-abuse and Its Effects, Plain Facts for Old and Young, Burlington, Iowa, F. Segner & Co. (1888) p. 107]
* 1890 William D. Gentry declares that circumcision cures blindness, deafness and dumbness. [Nervous derangements produced by sexual irregularities in boys. Medical Current 1890 Jul;6(7):268-74]
* 1891 Johnathan Hutchinson declares that foreskin encourages boys to masturbate. [On circumcision as preventive of masturbation. Archives of Surgery 1891 Jan;2(7):267-9]
* 1893 Mark J. Lehman demands immediate implementation of mass circumcision of all American boys. [A plea for circumcision. Medical Review 1893 Jul 22;28(4):64-5]
* 1894 P.C. Remondino says circumcising blacks will help prevent them from raping whites. [Negro rapes and their social problems. National Popular Review 1894 Jan;4(1):3-6]
* 1894 H.L. Rosenberry publishes paper ‘proving’ that circumcision cures urinary and rectal incontinence. [Incontinence of the urine and faeces, cured by circumcision. Medical Record 1894 Aug 11;4(6):173]
* 1898 T. Scott McFarland says he has “circumcised as many girls as boys, and always with happy results.” [Circumcision of girls. Journal of Orificial Surgery, 1898 Jul;7:31-33]
* 1900 Jonathan Hutchinson advises circumcision as way to decrease the pleasure of sex, and hence to discourage sexual immorality. [The advantages of circumcision. The Polyclinic 1900 Sep;3(9):129-31]
* 1901 Ernest G. Mark notes that the “pleasurable sensations that are elicited from the extremely sensitive” inner lining of the foreskin may encourage a child to masturbate, which is why he recommends circumcision since it “lessens the sensitiveness of the organ”. [Circumcision. American Practitioner and News 1901 Feb 15;31(4):122-6]
* 1902 Roswell Park publishes paper ‘proving’ that foreskin causes epilepsy and that circumcision cures it. [The surgical treatment of epilepsy. American Medicine 1902 Nov 22;4(21):807-9]
* 1914 Abraham L. Wolbarst claims that circumcision prevents tuberculosis and demands the compulsory circumcision of all children in America. [Universal circumcision as a sanitary measure. Journal of the American Medical Association 1914 Jan 10;62(2):92-7]
* 1915 Benjamin E. Dawson says that since the clitoral hood is the source of many neuroses, female circumcision is necessary. [Circumcision in the Female: Its Necessity and How to Perform It. American Journal of Clinical Medicine, 1915 Jun;22(6):520-523]
* 1918 Belle Eskridge concludes circumcision will relieve one of the greatest causes of masturbation in girls. [Why not circumcise the girl as well as the boy?, Texas State Journal of Medicine, 1918 May;14:17-19]
* 1926 Abraham L. Wolbarst claims that circumcision prevents penile cancer. [Is circumcision a prophylactic against penis cancer? Cancer 1926 Jul;3(4):301-10]
* 1930 Norton Henry Bare claims that he has cured a boy of epilepsy by circumcising him. [Surgical treatment of epilepsy with report of case. The China Medical Journal 1930 Nov;4(11):1109-13]
* 1934 Aaron Goldstein and Hiram S. Yellen invent and mass market the Gomco clamp which makes it easier for doctors to cut off even more skin than in traditional circumcisions. [Bloodless circumcision of the newborn. American Journal of Obstetrics and Gynecology, July 1935;30(1):146-7]
* 1935 R.W. Cockshut demands that all boys be circumcised in order to desensitize the penis and promote chastity. [Circumcision. British Medical Journal 1935 Oct 19;2(3902):764]
* 1941 Allan F. Guttmacher promotes mass circumcision as a means of blunting male sexual sensitivity. He also spreads the false claim that a baby’s foreskin must be forcibly retracted and scrubbed daily. [Should the baby be circumcised? Parents Magazine 1941 Sept;16(9):26,76-8]
* 1942 Abraham Ravich claims that circumcision prevents prostate cancer. [The relationship of circumcision to cancer of the prostate. Journal of Urology 1942 Sep;48(3):298-9]
* 1949 Eugene H. Hand declares that circumcision prevents venereal disease and cancer of the tongue. [Circumcision and venereal disease. Archives of Dermatology and Syphilology 1949 Sep;60(3):341-6]
* 1949 Douglas Gairdner points out that the previous year’s cases of infant circumcision deaths were not necessary given the lack of medical justification for circumcision. (Note: This paper helped encourage the National Health Service to drop coverage for infant circumcision which led to the practical elimination of non- religious circumcision in the United Kingdom.) [The fate of the foreskin. British Medical Journal 1949 2:1433-7]
* 1951 Abraham Ravich invents claims that circumcision prevents cervical cancer in women. [Prophylaxis of cancer of the prostate, penis, and cervix by circumcision. New York State Journal of Medicine 1951 Jun;51(12):1519-20]
* 1953 R.L. Miller and D.C. Snyder unleash their plans to circumcise all male babies immediately after birth while still in the delivery room to prevent masturbation and provide “immunity to nearly all physical and mental illness.” [Immediate circumcision of the newborn male. American Journal of Obstetrics and Gynecology 1953, Jan;6(1):1-11]
* 1954 Ernest L. Wydner claims that male circumcision prevents cervical cancer in women. [A study of enviromental factors of carcinoma of the cervix. American Journal of Obstetrics and Gynecology 1954 Oct;68(4):1016-52]
* 1956 Raymond Creelman invents the Circumstraint which straps down and immobilizes the baby’s arms and legs. [USPTO patent number RE24,377]
* 1958 C.F. McDonald says “the same reasons that apply for the circumcision of males are generally valid when considered for the female.” [Circumcision of the female. General Practitioner 1958 Sep;18(3):98-99]
* 1959 W.G. Rathmann finds that among the many benefits of female circumcision is that it will make the clitoris easier for the husband to find. [Female Circumcision: Indications and a New Technique. General Practitioner 1959 Sep;20(9):115-120]
* 1966 Masters and Johnson claim that there is no difference in sensitivity between penises with and without foreskin. (Note: Their work helps the medical dogma that circumcision has no effect on sexuality go practically unquestioned for nearly the next four decades.) [Human Sexual Response, Boston, Ma: Little Brown & Co, 1966]
* 1969 Morris Fishbein calls for circumcision to prevent nervousness and of course also masturbation. [Sex hygiene. Modern Home Medical Adviser. Garden City, New York: Doubleday & Co: 1969 pp 90, 119]
* 1971 Abraham Ravich claims that circumcision prevents cancer of the bladder and rectum. [Viral carcinogenesis in venereally susceptible organs. Cancer 1971 Jun;27(6)1493-6]
* 1971 The American Academy of Pediatrics Committee on Fetus and Newborn issues a warning to the Nation that, “There are no valid medical indications for circumcision in the neonatal period.” [Committee on Fetus and Newborn Issues. Circumcision. Hospital Care of Newborn Infants 5th Edition. Evanston, Ill: American Academy of Pediatrics; 1971 p 110]
* 1973 R. Dagher, Melvin Selzer, and Jack Lapides declare that anyone who disagrees with their agenda to impose mass circumcision on America is deluded. [Carcinoma of the penis and the anti-circumcision crusade. Journal of Urology 1973 Jul;110(1):79-80]
* 1975 The American Academy of Pediatrics Task force on Circumcision declares, “There are no medical indications for routine circumcisions and the procedure cannot be considered an essential component of health care.” [Report on the ad hoc task force on circumcision. Pediatrics 1975;56:610-1]
* 1976 Benjamin Spock, after recommending circumcision for thirty years, revises his best-selling parenting book: “I strongly recommend leaving the foreskin alone. Parents should insist on convincing reasons for circumcision — and there are no convincing reasons that I know of.” [Baby and Child Care, New York, E P Dutten, 1946-76]
* 1985 Thomas E. Wiswell claims that circumcision prevents urinary tract infections. [Decreased incidence of urinary tract infections in circumcised male infants. Pediatrics 1985 May;75(5):901-3]
* 1986 Aaron J. Fink claims that circumcision prevents AIDS. [A possible explanation for hetereosexual male infection with AIDS. New England Journal of Medicine 1986 Oct 30;31(18):1167]
* 1988 Aaron J. Fink invents the falsehood that circumcision prevents neonatal group B streptococcal disease. [Is hygiene enough? Circumcision as a possible strategy to prevent group B streptococcal disease. American Journal of Obstetrics and Gynecology. 1988 Aug;159 (2):534-5]
* 1989 Under the direction of Edgar J. Schoen, the American Academy of Pediatrics Task Force on Circumcision declares circumcision is necessary. [Report of the Task Force on Circumcision. Pediatrics 1989 Aug;84(2):388-91]
* 1991 Edgar J. Schoen tries and fails to convince European countries to institute mass circumcision. [Is it time for Europe to reconsider newborn circumcision? Acta Paediatrica Scandanavian 1991 May;8(5)573-7]
* 1991 Aaron J. Fink declares mass circumcision is necessary to prevent sand from getting into the soldiers’ foreskins. [Circumcision and sand. Journal of the Royal Society of Medicine 1991 Nov;84(11):696]
* 1996 J.R. Taylor finds that the average amount of amputated foreskin was nearly half of the total penile skin. [The prepuce: Specialized mucosa of the penis and its loss to circumcision. British Journal of Urology 1996 Feb;77:291-5]
* 1997 Edgar J. Schoen tries and fails once again to convince European countries to institute mass circumcision. [Benefits of newborn circumcision: Is Europe ignoring the medical evidence? Archives of Diseases of Childhood 1997 Sep;7(3):258-60]
* 1997 Janice Lander discovers that circumcision without anesthesia is traumatic for babies. (Note: Before this, almost all infant circumcisions were done without anesthetic do to the widespread belief among circumcisers that babies are not capable of feeling significant pain and if they could it doesn’t matter since they won’t be able to remember it.) [Comparison of ring block, dorsal penile nerve block, and topical anesthesia for neonatal circumcision. Journal of the American Medical Association 1997 Dec;274(24):2157-2162]
* 1998 Howard Stang, inventor of an upright circumcision restraint fails to mention this conflict of interest in his article promoting infant circumcision. [Patent 5,160,185, Infant support and restraint system 1992] [Circumcision Practice Patterns in the United States, Pediatrics, 1998 Jun;101(6):E5]
* 1999 J. R. Taylor, after studying the foreskin’s specialized innervation, concludes that it is the “primary erogenous tissue necessary for normal sexual function.” [The prepuce. British Journal of Urology 1999 Jan;83(1):34-44]
* 1999 The American Academy of Pediatrics Task Force on Circumcision, after reviewing 40 years worth of medical studies, concluded that the “potential medical benefits of newborn male circumcision… are not sufficient to recommend routine neonatal circumcision.” This report is also the first time the AAP has acknowledged(after decades of doctors mindlessly repeating the belief that babies don’t feel significant pain) that circumcision without anaesthesia is traumatic and if circumcision is to be done, anaesthesia should be used.
Here are some highlights from the report:
Role of Hygiene: “there is little evidence to affirm the association between circumcision status and optimum penile hygiene.”
STDs including HIV:”behavioural factors appear to be far more important than circumcision status.”
Penile Cancer: “in a developed country such as the United States, penile cancer is a rare disease and the risk of penile cancer developing in an uncircumcised man, although increased compared with a circumcised man, is low.”
Urinary Tract Infections: “breastfeeding was shown to have a threefold protective effect on the incidence of UTI in a sample of uncircumcised infants. However, breastfeeding status has not been evaluated systematically in studies assessing UTI and circumcision status.” meaning that the earlier UTIs studies results were confounded. Even if their numbers were accurate, in order to prevent one UTI during the first year of life by circumcising a baby boy, approximately 195 babies who will not get a UTI would need to be circumcised. Also infant girls commonly develop UTIs (in some studies at even higher rates than infant boys) and the standard treatment for them is antibiotics, which work just as well for infant boys with UTIs. The AAP concludes this section noting that “the absolute risk of developing a UTI in an uncircumcised male infant is low (at most, ~1%)”.
Ethics: Here they say while even though cutting off part of your baby’s genitalia “is not essential to the child’s current well-being” they are perfectly fine with parents and doctors using cultural tradition as justification. (Note: The report does not mention whether they also think cultural tradition is an acceptable reason to anesthetize infant girls and then cut off their clitoral hoods, which are biologically analogous to foreskin). [Task Force on Circumcision. Circumcision Policy Statement. Paediatrics 1999;103 (3):686-693]
* 2002 W.K. Nahm extends the storage life of specialized cell cultures derived from “freshly harvested neonatal foreskin tissue.” (Note: Since the 1980s, some amputated infant foreskins have been sold without the knowledge of the parents to biomedical companies for research and even use in commercial cosmetic products such as anti-wrinkle creams.) [Sustained ability for fibroblast outgrowth from stored neonatal foreskin. Journal of Dermatology Science. 2002 Feb;28(2):152-8]
* 2003 Edgar J. Schoen steps up pressure on American Academy of Paediatrics to reverse its policy on circumcision, claiming that circumcision prevents AIDS. [It’s wise to circumcise: time to change policy. Paediatrics. 2003 Jun;111(6 Pt 1):1490 -1]
* 2005 R.Y. Stallings finds that HIV rates are significantly lower in circumcised women. (Note: There is no WHO call for mass female circumcision to help prevent AIDS) [Female circumcision and HIV infection in Tanzania: for better or for worse? Third International AIDS Society Conference on HIV Pathogenesis and Treatment. Rio de Janeiro, 25-27 July 2005]
* 2007 R.C. Bailey ends his study early with the conclusion touting circumcision as a ‘vaccine’ that prevents HIV infection. (Note: This and other similar studies were widely reported throughout the American media.) [Male circumcision for HIV prevention for young men in Kisumu, Kenya. Lancet 2007;369 (9562):643-56]
* 2007 L. de Witte finds that Langerhans cells found in the foreskin are a natural barrier to HIV infection. (Note: this and other similar studies were widely ignored throughout the American media.) [Langerin is a natural barrier to HIV-1 transmission by Langerhans cells. Nature Medicine 2007;(13):367-371]
* 2007 M. Sorrells tests the relative sensitivity of the penis and finds that the foreskin is the most sensitive part of the penis and the glans is the least. [Fine touch pressure thresholds in the adult penis. British Journal of Urology International. 2007;99:864-9]