Norway Plans New Rules on Circumcision of Boys

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Norway will promote new legislation to “regulate ritual circumcision,” the country’s health minister said.

Minister Bent Hoie said the new legislation on non-medical circumcision of boys under 18 will be introduced before April 20, 2014, according to a report by the Norwegian daily Aftenposten.

“We will review submissions on the matter before we can decide what should be the government’s position. We aim to present a bill before Easter,” Hoie told Aftenposten last week. He did not say whether the regulations would introduce new restrictions.

His announcement follows renewed calls by Norway’s Children’s Ombudswoman Anne Lindboe to ban non-medical circumcision of minors without their consent, which she says violates their rights.

“This is not due to any lack of understanding of minorities or religious traditions, but because the procedure is irreversible, painful and risky,” Lindboe told Aftenposten.

Written By: JTA
continue to source article at forward.com

69 COMMENTS

  1. Ervin Kohn, president of the Jewish Community in Oslo, told JTA that he considers the issue “an existential matter” for the Jewish community of about 700 members.

    existential crisese are quite rare among 8 day old babies

  2. I hope Norway follows through and legislates on the issue of male genital mutilation. MGM is a violation of the child’s human rights, and where Norway leads, the rest of the civilised world will follow.

  3. I’m waiting for the howls and wingeing to begin.

    Looks like we could be moving into a new era when stupid, cruel and pointless things will no longer be tolerated simply on the grounds of them being part of a religious tradition; although I’m not holding my breath.

    There seem always to be do gooding apologists who’ll kowtow and give in to emotional blackmail and speak up for the unspeakable.

    Ooooh, it makes me so angry I could tear paper!

    • *In reply to #6 by Stafford Gordon:

      There seem always to be do gooding apologists who’ll kowtow and give in to emotional blackmail and speak up for the unspeakable.

      Ooooh, it makes me so angry I could tear paper!

      From the end of the source article:

      In France, meanwhile, President François Hollande strongly affirmed his support for the protection of Jewish rights to circumcision in an Oct. 30 letter to the Consistoire, which oversees religious services for the Jewish community.

      Start tearing it! Tear, tear away!

  4. Its interesting that none of the comments to the source article seem to cover the fact of the damage circumcision does to male and female sexual pleasure. A google search shows increasing evidence that it does have a dramatic negative effect including possible erectile dysfunction. While those who have been circumcised as infants will furiously deny this, I think those of us who have not been circumcised would definitley not want it done and are grateful to our parents that they did not do so as the foreskin has one of the highest concentrations of nerves in the body and is a very sensitive erotic zone. It apparently also improves pleasure for the woman so it is conceivable that one day women will avoid men who have been circumcised just as men will avoid women who have been subject to genital mutilation.
    For a parent to deliberately do something that may damage their childs future sexual pleasure is disgusting and cruel!

    • I needed a circumcision last year when I was 15. Reading propaganda like this comment used to scare the life out of me. You cannot speak for the risks, health concerns etc if you yourself never had it done. My friend has just had a circumcision several weeks ago and he would tell you that what you’ve just said in the comment I’ve quoted couldn’t be more wrong. In reply to #8 by Richard01:

      Its interesting that none of the comments to the source article seem to cover the fact of the damage circumcision does to male and female sexual pleasure. A google search shows increasing evidence that it does have a dramatic negative effect including possible erectile dysfunction. While those…

      • Stuart, I’m afraid small samples do not provide particularly useful evidence. Anyone who has it done for medical reasons may have no option. Anyone else who has it done might conceivably feel the need to justify their action as unfortunately it is not reversable. Its a bit unlikely that someone would admit that it was a mistake? The story that it prevents HIV infection is questionable unless it simply compensates for poor hygiene thereby reducing risk of infection.
        The point is really that circumcision should be a personal decision as in your case or your friends and should not be done to infants but left until they are old enough to decide for themselves..

        In reply to #19 by Stuart:

        I needed a circumcision last year when I was 15. Reading propaganda like this comment used to scare the life out of me. You cannot speak for the risks, health concerns etc if you yourself never had it done. My friend has just had a circumcision several weeks ago and he would tell you that what you’v…

        • I needed it done because it was too tight. My friend was the opposite as it was too sensitive. Admittedly, it does seem a bit cruel to say they must get it done at birth without their consent. I agree with that. My main point was that to say all the negatives when you haven’t gone through it yourself isn’t very rational.. I read comments saying it was child abuse as well. I can see why they think that, but there’s a difference from getting an operation for religious reasons which has benefits such as cleanliness and (arguably) sexual pleasure, depending on the individual. In reply to #22 by Richard01:

          Stuart, I’m afraid small samples do not provide particularly useful evidence. Anyone who has it done for medical reasons may have no option. Anyone else who has it done might conceivably feel the need to justify their action as unfortunately it is not reversable. Its a bit unlikely that someone wo…

      • In reply to #19 by Stuart:

        I needed a circumcision last year when I was 15. Reading propaganda like this comment used to scare the life out of me. You cannot speak for the risks, health concerns etc if you yourself never had it done. My friend has just had a circumcision several weeks ago and he would tell you that what you’v…

        Stuart, you are a healthy 16 year old with presumably completely normal teen interests in what your tackle is there for. Good for you.

        I’m 59, circumcised for no good reason (not even religious) at or around birth, and at some time in the last decade sexual arousal and sensitivity has indeed declined. Some of this may just be natural. But some I at least ascribe to circumcision.

        I don’t know how to put this less bluntly: if your most sensitive bits are not covered up as nature intended, they’re going to end up less sensitive when it matters most to you. And may be a few more of us need to be upfront and honest about that.

        It has quite possibly cost me a marriage.

        • It’s not your circumcision that has caused your marriage to end. Not everyone – when they’re older – become really sensitive due to circumcision. It could be some sort of medical reason, lack of sleep, food types etc or just you as an individual that has effected some way that this problem has occurred. I’m not saying those are definitely the cause I’m just suggesting.In reply to #24 by Stevehill:

          In reply to #19 by Stuart:

          I needed a circumcision last year when I was 15. Reading propaganda like this comment used to scare the life out of me. You cannot speak for the risks, health concerns etc if you yourself never had it done. My friend has just had a circumcision several weeks ago and he wo…

      • In reply to #19 by Stuart:

        I needed a circumcision last year when I was 15. Reading propaganda like this comment used to scare the life out of me. …
        My friend has just had a circumcision several weeks ago and he would tell you that what you’ve just said in the comment I’ve quoted couldn’t be more wrong.

        What the hell is wrong with you? This is about banning FORCED circumcision! And there are plenty who feel robbed for having been put through this disgusting act of barbarism. You DECIDED to go through a cosmetic procedure, millions didn’t and that’s what the issue is about!

        If you don’t mind could you detail as to why you needed a circumcision?
        Were there no alternatives to this practice?

        • In reply to #26 by Terra Watt:

          In reply to #19 by Stuart:

          I needed a circumcision last year when I was 15. Reading propaganda like this comment used to scare the life out of me. …
          My friend has just had a circumcision several weeks ago and he would tell you that what you’ve just said in the comment I’ve quoted couldn’t be more… Oh I’ve caught a clever one! A tight foreskin. I could’ve waited or given medicine to getting it stretched. Instead, I chose to get a circumcision as I was told of the pros and cons. At the end of the day, you don’t need foreskin, and you can live without it. [Last sentence removed by moderator to bring within terms of use.]

          • In reply to #46 by Stuart:

            Stuart: "Idiots like you who are so passionate about things that you don't know about and are unimportant is what's wrong with the world."
            

            Its not idiotic of me to be informed on the alternatives to medical circumcision.
            This is not just about non-surgical procedures, but also about being informed on the variety of alternative surgical procedures, that are less intrusive than the complete removal of the foreskin. As for passion, I WILL continue to be passionate against blatant violations of our fundamental rights! As should you!

             Stuart:  "Admittedly, it does seem a bit cruel to say they must get it done at birth without their consent."
            

            No, no, its not just a “bit” cruel, its simply cruel!
            What concerns me about some who elected to have circumcision, is that some of them begin to resent and complain about the pain during the recovery period.
            I mean it’s a surgical procedure, some pain during recovery is inevitable. And it is a procedure that was elected by the individual! But instead of being patient and putting up with the recovery period, some go as far as to wish it were done to them while they were infants! And then some continue to slip even further, and go as far as to propose that it be mandatory to circumcise infants! That’s when we have a serious human rights issue! I’m not accusing you of being such a person, and really I do hope that everything went well, and that you are fully satisfied with the procedure. I simply mentioned a slippery path, in hoping that you too are a person in agreement with with what this Norway party is trying to accomplish. That individuals should not be robbed of their fundamental rights.
            Also in mentioning other solutions for phimosis, I’m not trying to say what is best and worst but what is less and more intrusive.
            The actual benefits for each procedure is to be assessed by the consenting individual.

             Stuart:   "...Reading propaganda like this comment used to scare the life out of me..."
            

            And lastly, regarding propaganda, I have to say that its usually found on the side of circumcision promoters.
            If I had been circumcised as an infant, I would have felt robbed as an adult.
            And this is coming from someone who had phimosis with both a tight foreskin and a frenlum breve(its solved now).

            I’m glad that my parents did not succumb to fears or guilt drives over spreading HIV or exaggerated dangers of phimosis.
            But this is what I assume a lot of parents, especially those in Africa now face.
            These are people bullied by the church to not use condoms, but will now will further experience bullying by “experts” to circumcise their
            infants, to hinder the spread of HIV. Little mentioning of other STD’s and that its for preventing Female to Male infections.
            However when even educated people, succumb to believing these exaggerated claims, what chance do the uneducated in Africa have?
            So its where circumcision is pushed and promoted that we usually find propaganda, not where it is banned or cautioned.

          • It isn’t cruel though. It sounds cruel the way people put it on this, but at the end of the day it isn’t. You say it’s such a pain experience etc when really it isn’t. Are 80% of Americans not circumcised for non religious reasons? I’m sure it’s around that figure. Furthermore, speaking from experience, read this several times please: CIRCUMCISION IS NOY A PAINFUL PROCEDURE”. You feel sensitive for a few days and that’s all. I was told to take 7-10 days off school but I took 5 days. The reason I’m so passionate against your views is because you really don’t have a clue as well as several people on this. Your propoganda and ignorance of this subject is laughable.In reply to #51 by Terra Watt:

            In reply to #46 by Stuart:

            Stuart: “Idiots like you who are so passionate about things that you don’t know about and are unimportant is what’s wrong with the world.”

            Its not idiotic of me to be informed on the alternatives to medical circumcision.
            This is not just about non-surgical procedures, b…

          • In reply to #58 by Stuart:

            “CIRCUMCISION IS NOY A PAINFUL PROCEDURE”…
            It isn’t cruel though. It sounds cruel the way people put it on this, but at the end of the day it isn’t. You say it’s such a pain experience etc when really it isn’t.

            TO YOU IT MAY HAVE NOT BEEN PAINFUL!

            Are 80% of Americans not circumcised for non religious reasons? I’m sure it’s around that figure.

            Where are you pulling these values from and you are blatantly assuming that those Americans had it done with their consent,
            when its likely that it was done to most of them when they were infants!

            You feel sensitive for a few days and that’s all. I was told to take 7-10 days off school but I took 5 days.

            Awesome! Glad it went well for you!

            The reason I’m so passionate against your views is because you really don’t have a clue as well as several people on this. Your propoganda and ignorance of this subject is laughable

            Laugh all you want, just make sure to keep your hands to yourself!
            What’s really laughable is how you seem to be incapable of doing anything other than throwing blatant assertions and accusations,
            in response to well made points by others. No, actually that’s not laughable at all, that’s quite disturbing!

          • In reply to #60 by Terra Watt:

            The American Society of Pediatrics position Paper on Circumcision is a continuation of their earlier opinion but bolstered by research up to 2010. Their modest view is one reason that the US has a circumcision rate of approximately 50% for males currently and 70% for gay males. European rates are very much lower.

            I stand corrected a little. The data is all here.

  5. In France, meanwhile, President François Hollande strongly affirmed his support for the protection of Jewish rights to circumcision in an Oct. 30 letter to the Consistoire, which oversees religious services for the Jewish community.

    Shouldn’t he be supporting the rights of infants to not be butchered?

    In many respects, the people of the future will not be able to distinguish our era from that of the Middle Ages.

  6. Sorry but I have just had a nice dinner with good company and the thought of some rabbi sucking/ biting off my foreskin just makes me feel sick. I suppose an 8 day old has little resistance, but I would bloody well resist ! As Levitucus would have it about eating shell fish, – it’s a bloody abomination !

    Nor do I care a shite about Covenants with a non-existent God.

    • Yes – God gave little baby boys foreskins so he could demand they be cut off. It’s intelligent design, right? Makes perfect sense.

      In reply to #14 by Free Speech:

      Oh, yes, God wants you to cut the foreskin from the penises of little boys. He told me so himself.

      • In reply to #16 by Sue Blue:

        Yes – God gave little baby boys foreskins so he could demand they be cut off. It’s intelligent design, right? Makes perfect sense.

        In reply to #14 by Free Speech:

        Oh, yes, God wants you to cut the foreskin from the penises of little boys. He told me so himself.

        It’s the 21st century. Why are people still following barbaric rituals from the bronze age???

      • In reply to #16 by Sue Blue:

        Yes – God gave little baby boys foreskins so he could demand they be cut off. It’s intelligent design, right? Makes perfect sense.

        People wouldn’t have free will if they couldn’t decide to cut or not to cut part of they genitals.

        • In reply to #18 by Maki:
          >

          People wouldn’t have free will if they couldn’t decide to cut or not to cut part of they genitals.

          More importantly in gods divine view is of course your free will to decide to cut or not cut part of other peoples genitals, in particular those of totally helpless other people.

          • In reply to #20 by foundationist:

            In reply to #18 by Maki:

            People wouldn’t have free will if they couldn’t decide to cut or not to cut part of they genitals.

            More importantly in gods divine view is of course your free will to decide to cut or not cut part of other peoples genitals, in particular those of totally helpless other people…

            The same could be said for cutting throats!

  7. Neither I nor any of my five sons has been circumcised, neither has any one of my three male grand-sons, nor has my one and only,( to date), male great-grand-son suffered MGM – just sayin’.

  8. In reply to #22 by Richard01:
    >

    In reply to #19 by Stuart:

    …The story that it prevents HIV infection is questionable unless it simply compensates for poor hygiene thereby reducing risk of infection.

    I’m sorry, Richard, but is this view based on medical evidence or is it just what you ‘reckon’?

    Perhaps you should inform the World Health Organisation that instead of reccommending circumcision as a buttress against the spread of HIV throughout the world, what they should be doing is educating those most at risk from this disease about proper genital hygiene.

    If the storybook the WHO is getting its information from is as inaccurate as you suggest, and the advice being given based on flawed science, an awful lot of males will be unnecessarily mutilated as a result.

    Was it you who taught Vatican scientists about condoms and AIDS?

    • In reply to #25 by Katy Cordeth:

      In reply to #22 by Richard01:
      ….
      Perhaps you should inform the World Health Organisation that instead of reccommending circumcision as a buttress against the spread of HIV throughout the world, what they should be doing is educating those most at risk from this disease about proper genital hygiene.

      Yes, exactly! There should be a great deal of emphasis placed on good sex education that teaches people how to correctly wear a condom among other things. Its frustrating how there’s little to no demonstration of how to put a condom on if you have an intact penis.

      How to put a condom on an intact

      The video link above is safe and contain no images of genitalia but understandably does use the words
      penis, foreskin, condom etc.

      If the storybook the WHO is getting its information from is as inaccurate as you suggest, and the advice being given based on flawed science, an awful lot of males will be unnecessarily mutilated as a result.
      Was it you who taught Vatican scientists about condoms and AIDS?

      Yes, these studies are very poor!

      1. They risk inadvertently advocating people to NOT use condoms.
      2. They ignore other STDs.
      3. They risk inadvertently advocating a practice on infants and children that is utterly irrelevant to them!
      4. They make little to NO effort in comparing circumcision to the use of CONDOMS of all things!
      5. They spew ambiguous percentage values.

      When you wear a condom, being circumcised or intact no longer factors in as a dependent variable,
      since both types are now covered and taken out of the equation so to speak!

      Now, the main issue of this article is about free will and the right to ones own body!
      That is to say, should we ban male circumcision from being forced onto individuals?
      So that being the case, what is your view? Are you against forcing circumcision on others?
      Please give a clear answer because we’ve discussed circumcision on numerous articles before,
      and it was never entirely clear as to where you stand on circumcision on the grounds of ethics and human rights.

      • In reply to #27 by Terra Watt:

        In reply to #25 by Katy Cordeth:

        Yes, exactly! There should be a great deal of emphasis placed on good sex education that teaches people how to correctly wear a condom among other things. Its frustrating how there’s little to no demonstration of how to put a condom on if you have an intact penis.

        That isn’t much help if your church teaches that condom use will give you AIDS and you’ll go to Hell for wearing one anyway.

        Now, the main issue of this article is about free will and the right to ones own body! That is to say, should we ban male circumcision from being forced onto individuals? So that being the case, what is your view? Are you against forcing circumcision on others? Please give a clear answer because we’ve discussed circumcision on numerous articles before, and it was never entirely clear as to where you stand on circumcision on the grounds of ethics and human rights.

        The truth is I honestly don’t know what to think about male circumcision. I would say in areas where HIV is prevalent and religion teaches contraception is a sin, the practice is a necessary evil. In places where HIV is under control and there’s a plentiful supply of accurate information about how it’s spread, there’s less of a need to butcher boys’ genitals. Should it be banned in the latter case? Again, I don’t know. Viruses mutate, they grow resistant to treatment. Who can say if twenty years from now the cocktail of drugs used to treat patients with HIV no longer works and we’re back where we were when diagnosis meant a death sentence?

        It’s all very well to say it should be the choice of the individual whether he has a part of his anatomy removed. But kids become sexually active quite a while before many of them are capable of making an informed decision about this sort of thing, and most ten-year-old boys would balk at such a procedure. What about the girls with whom they’ll be having sex? Doesn’t society owe them a duty of care too? Boys and girls are taught about contraception nowadays in most liberal countries, but girls still become pregnant.

        Let me ask you, in an AIDS-ravaged future America, would it be acceptable to perform circumcisions on babies, under anesthetic and in hygienic conditions of course, to prevent the further spread of the disease, even if they won’t be at risk for a number of years; even if the link between circumcision and reduced chance of becoming infected still isn’t decided one way or the other? If it is acceptable, why is it wrong in, say, present-day Botswana?

        I hope that answers your question on where I stand.

        If I may leave the parameters of the thread you so kindly if narrowly delineated for a moment, what troubles me about the reaction of many on this site to the subject of male circumcision is that it puts me in mind of the way our religious friends treat issues like abortion. What I mean is that, unlike FGM (sorry, Neodarwinian), which is a black and white issue, that is to say there’s no suggestion it may produce any beneficial results, the case against male circumcision isn’t nearly as straightforward; but because it has its origins in religion, that’s enough for our side to swiftly make up our mind and declare it morally unacceptable. That’s the same mindset which informs Christian attitudes to women’s ownership of their bodies: it’s complicated so let’s just go with what the Bible says.

        • In reply to #29 by Katy Cordeth:

          I think I have never commented on this issue (MGM) because I find it difficult to be objective. Whilst in hospital for some minor hernia surgery age two or three my parents were given a two for one offer and took it. I got the snip as well as a tuck. My enthusiasm for this aesthetic arrangement has remained unbounded and through my sexually “ambidextrous” teens, tweens and threens strongly influenced my choices. I find it difficult to emotionally engage with the intellectually correct position that when imposed on a child or adult, it must be termed Male Genital Mutilation, this given my nagging sense of gratitude. So, with that out on the table, as it were -

          “Natural” is not synonymous with “best”.

          Evolutionary legacies can be a bit of a mixed bag.

          What if health outcomes are as you hypothesise, favouring circumcision?

          What if the data favoured early interventions for reasons to do with efficacy and minimised trauma?

          What if fMRI and other data conclusively indicated greater sexual satisfaction amongst the snipped? because

          “Natural” is not synonymous with “best”.

          The absolute horror of FGM needs to be dealt with with as great a force as we can muster and childhood MGM and its (currently) intellectually clear argument against it can be co-opted nicely. But, with you I worry that this could become more of a moral nightmare in the HIV area. Early prophylactic circumcision may be the least harmful to those circumcised as well as aiding others.

          Evidence not dogma is still the required principal and the promotion of the concept of MGM needs promoting here mindful that things can change in other circumstances and in the light of new evidence..

          With all such moral issues, sometimes intellectual clarity can be more than a little compromised by inaccurately assessed harms. The hyper-prosocial (highly empathic) frequently over-read the hurt done to others and in the cool calculation of least harm can get the wrong answer. It cuts the other way too with a possible under-reading of all harms…

          I also tend to avoid discussion about abortion for similar personal reasons. Its not that the moral issue is muddled, it is not. A woman’s right to her own body and Pete Singer’s “moral duty to the previously or currently conscious”, are clear. BUT our emotional attachment to, and the up-fucking oxytocin caused by, that little implanted and growing blastocyst can get to hurt a lot. The moral clarity of abortion rights is unquestionable, but needed also is a caveat that with these rights comes also the need for society to better minimise the possible resultant emotional harms. (Morning after pills all round!)

        • In reply to #25 by Katy Cordeth:

          It’s all very well to say it should be the choice of the individual whether he has a part of his anatomy removed.

          I disagree. It is not very well whenever anyone thinks it is ok to have another person’s healthy anatomy or part thereof removed without their consent. It is simple – under NO circumstance is this ok regardless of the persons age.

          The HIV issue must be taken up with those responsible for keeping condoms out of areas that desperately need them. How much more effective are condoms in the control of the spread of the disease compared to circumcision? Sounds like sacrificing foreskins while ignoring the real problem here.

          Male circumcision needs to stop as much FGM, both need to validated on their varying degrees – I don’t deny that male circumcision is largely not as dangerous and prone to further medical issues later in life as is the case for FGM, but there are risks, sometimes fatal. The truth is that both are very wrong practices. Men and women should support each other in the issue and agree that more should be done for all those at risk – support the end of human genital mutation for all the worlds’ children.

          It’s disgusting IMHO that anyone could think it’s ok to cut a baby’s or a child’s genitals no matter what the sex no matter what the excuse.

          • In reply to #33 by Nightsky Majesty:

            In reply to #25 by Katy Cordeth:

            It’s disgusting IMHO that anyone could think it’s ok to cut a baby’s or a child’s genitals no matter what the sex no matter what the excuse.

            You may want to modify that in relation to boys a little given the surprisingly variable manufacturing tolerance in that neck of the woods. Certainly 5 % of boys suffer from balanoposthitis caused most often by phimosis. Adhesions may be persistent and circumcision is the reliable cure. Evolution does no better than it need. Functional and non-lethal is good enough here.

            Now fingers….fingers evolution gets right. (The equivalent failure, syndactyly, is a 0.05% incidence) These are far more generally useful tools.

          • In reply to #34 by phil rimmer:

            You may want to modify that in relation to boys a little…

            I thought it would be understood from the first sentence that I am referring to a healthy anatomy, balanoposthitis can be diagnosed in both circumcised and uncircumcised males, like phimosis there are a number of topical treatments that have proven successful for the condition. Reoccurring problems may require a doctor to recommend circumcision as a treatment in which case I doubt anyone could argue that it does not qualify as a genuine medical reason. Frenulum breve is a more severe condition that is generally recognized in more mature males, frenuloplasty, not just circumcision has shown to be successful for this condition. It is important for parents and men to understand the options that are available to them but regardless none of the information suggests that removal of healthy males foreskin offers prevention against further penile problems later in life.

            Clitoral phimosis that may require a hoodectomy, this is not to be confused with FGM which is designed to cause a loss of sensation whereas a hoodectomy is done under proper medical care to restore a lack of sensation. Clitoral phimosis may be more common than phimosis presented in males but unfortunately the taboo around female sexuality prevents many from seeking the help available to them. Both male and female conditions can be considered an abnormality that may require medical treatment and or surgery and I fear the lines are being blurred between medical treatment and procedures that are performed on healthy infants and children both male and female for non medical reasons.

            Voluntary MMC for mature males to help prevent the spread of HIV especially in nations that are high risk is quite different to circumcisions performed without the foreskin owners consent. Circumcision however, does not offer protection for male to female sexual contact and shows mixed results for male to male sexual contact which leans toward a statistically nonsignificant protective association. Condoms when used correctly (through education) are more effective at preventing contracting HIV while controlling the spread of many other STDs most of which circumcision does not address.

            Would you support circumcision to slow the spread of HIV if it meant holding down a male against his wishes? Would you support MFC (Medical Female Circumcision?) if it was shown to be prophylactic and the procedure medically sound and not so traumatic? Of course not, yet children do not get a say in what is taken from them and that is the real point of the issue for me. Adults can make decisions about their genitals no problem, piercings, tattoos whatever its their business, pierce or tattoo a childs and the same people advocating infant male circumcision will rightly join the rest of us in recognizing this as child abuse.

            Preventing latex condoms and contraceptives because of religious dogma is an act worthy of the title of sin, MMC is at very best a band aid decision to derail attention and action where it is most needed.

          • In reply to #38 by Nightsky Majesty:

            In reply to #34 by phil rimmer:

            You may want to modify that in relation to boys a little…

            I thought it would be understood from the first sentence that I am referring to a healthy anatomy,

            No. It wasn’t. Therapeutic circumcisions will remain fairly common.

            Condoms when used correctly (through education) are more effective at preventing contracting HIV while controlling the spread of many other STDs most of which circumcision does not address.

            Indeed, and the hope from some is that with the triple whammy of condoms, MMC and antivirals the multiplicative effect of which I spoke may see an end to the problem of HIV in that community. The trick is to get the reinfection factor below 1 (each incidence of the disease is responsible for less than one additional case). This statistics game requires all the help it can get when people can’t get/afford/remember to take their retrovirals, or won’t wear a condom on every occasion. Every trick to increase herd immunity for such a killer counts and to stand on a principle (for a harm that left me unharmed) seems a less moral position IF the numbers do indeed stack up in the multiple treatment hypotheses. (They will of course be entirely dependent on many local factors as acknowledged in the literature.)

            Would you support MFC (Medical Female Circumcision?) if it was shown to be prophylactic and the procedure medically sound and not so traumatic?

            Depends entirely of the trauma. If it were as un-traumatic then and now as my experience has been then I would certainly consider offering it in specific circumstances.

            yet children do not get a say in what is taken from them and that is the real point of the issue for me.

            And for me. You may have forgotten I said-

            “when imposed on a child or adult, it must be termed Male Genital Mutilation”

            Only religion gets away with absolutes (like the RCC) and consequently, on occasions, produces more net harm than needed. There may be circumstances where a thoroughly good principle may get bent to reduce the net harm. Don’t kill innocent children. Yet we do when an unknown but quantifiable few die from inoculations given to avert thousands of unknown but quantifiable deaths. Our moral calculus seeking to maximally reduce harms is never easy.

          • In reply to #40 by phil rimmer:

            In reply to #38 by Nightsky Majesty:
            No. It wasn’t. Therapeutic circumcisions will remain fairly common….

            I can’t see that happening because people generally tend to desire non intrusive methods.
            Even with phimosis there are a whole number of non surgical and less intrusive surgical options for dealing with a tight foreskin.

            Non Surgical Procedures:

            1. Topical steroid creams such as betamethasone, mometasone furoate and cortisone
            2. Manual stretching

            Surgical Procedures:

            1. Dorsal slit
            2. Ventral slit
            3. Frenuloplasty
            4. Preputioplasty,
            5. Circumcision,

            I had a problem with a tight foreskin and short frenlum, and the method I relied to solve it was manual stretching.
            It took about 2-3 months to first see results, and in about 1 and half to 2 years the problem was solved.
            This was done with two, 60sec repetitions every night during shower.
            That’s pulling the foreskin out not folding it back, with tolerable pressure for a duration of 60 seconds and releasing it.
            And then doing it once more. If I had done it more frequently every day then I may have gotten results faster.

            So I personally can’t see how therapeutic circumcision could become more common, other than on the basis
            of not knowing about non-surgical and less intrusive surgical methods.

          • In reply to #43 by Terra Watt:

            In reply to #40 by phil rimmer:

            The problem with foreskins can be many and varied. Re-attachment is one of the main reasons to opt for the complete solution of circumcision, that coupled with a preference or even just an indifference to the final state.

          • In reply to #38 by Nightsky Majesty:
            >

            Clitoral phimosis that may require a hoodectomy, this is not to be confused with FGM which is designed to cause a loss of sensation whereas a hoodectomy is done under proper medical care to restore a lack of sensation. Clitoral phimosis may be more common than phimosis presented in males but unfortunately the taboo around female sexuality prevents many from seeking the help available to them.

            Related to this I see a new recommendation on funding from the UK NHS where procedures are purely cosmetic:-

            ‘Designer vagina surgery not to be carried out on NHS’ – http://www.bbc.co.uk/news/health-24942981

            “Designer vagina” surgery should not be carried out on the NHS or on girls under the age of 18, the Royal College of Obstetricians and Gynaecologists has said.

            In a paper looking at female genital cosmetic surgery, it says women and girls should realise that female genitalia come in all shapes and sizes.

            They should also be told of the risks of this type of surgery.

            Labiaplasties on the NHS have risen fivefold in the past 10 years.

            Labiaplasty is the most common type of female genital cosmetic surgery, in which the size of the labia minora is reduced.

            It can be a treatment for women who have concerns with hygiene, difficulties during sexual intercourse or discomfort when exercising, but some women and girls want surgery because of concerns about the way their genitalia look.

        • In reply to #29 by Katy Cordeth:

          The truth is I honestly don’t know what to think about male circumcision. I would say in areas where HIV is prevalent and religion teaches contraception is a sin, the practice is a necessary evil…
          ….What about the girls with whom they’ll be having sex? Doesn’t society owe them a duty of care too? Boys and girls are taught about contraception nowadays in most liberal countries, but girls still become pregnant.

          Pardon me, but you are highly misinformed on the supposed benefits of circumcision.
          Most likely because you have given these studies unearned credibility!
          Are you aware at all of the fact that the studies refer to ‘Female to male’ HIV infections?
          Circumcision doesn’t do anything to reduce ‘Male to female’ HIV infections nor do they take into account the plethora of other STD’s.
          Much of which mostly affect women than men. In fact its likely to increase ‘Male to female’ infections since some males will be mislead in to believing,
          that they no longer need to wear condoms!

          As for girls becoming pregnant, I don’t understand the point you were trying to make.

          Let me ask you, in an AIDS-ravaged future America, would it be acceptable to perform circumcisions on babies, under anesthetic and in hygienic conditions of course, to prevent the further spread of the disease, even if they won’t be at risk for a number of years; even if the link between circumcision and reduced chance of becoming infected still isn’t decided one way or the other? If it is acceptable, why is it wrong in, say, present-day Botswana?

          I believe that it is self destructive to have a bargaining attitude with abuse.
          The act we speak of, is an intrusion upon the body of another human being, that will stay with that person for the rest of their life.
          Even if there was a crystal clear link between circumcision and reduction in male to female HIV infections, it would be unacceptable.
          In medicine, it is unethical to force a procedure on a person under the interests of someone else.
          With regards to a baby, all that medicine should be concerned about is the babys’ immediate survivability and STDs are not an immediate issue for a baby.

          Secondly, It seems clear to me that you are mislead by the false belief that circumcision poses a health benefit for females!

          …What I mean is that, unlike FGM (sorry, Neodarwinian), which is a black and white issue, that is to say there’s no suggestion it may produce any beneficial results, the case against male circumcision isn’t nearly as straightforward; but because it has its origins in religion, that’s enough for our side to swiftly make up our mind and declare it morally unacceptable. That’s the same mindset which informs Christian attitudes to women’s ownership of their bodies: it’s complicated so let’s just go with what the Bible says.

          “…but because it has its origins in religion,…”

          I’m sorry but you couldn’t be more wrong! I am outraged by these acts when they blatantly violate our most fundamental rights, and not because they happen
          to have religious roots. I also show outrage when ethical concerns regarding MGM, are put aside because they are not as harmful as some forms of FGM.

          FGM is often brought up on a topic to not try and invalidate ethical concerns regarding it, but to try and remove the blind spots most people have towards MGM.
          But I assume some end up having a knee jerk reaction to this, because they maybe thinking that, people are trying to get them to view FGM with the same lack of concern as they have for MGM, when its the reverse that’s true.

          .

          I hope that answers your question on where I stand.

          .

          Thank you for taking your time to explain your position, I feel much more informed of your views and thoughts.
          However I’d like to know a bit more detail about your thoughts regarding these issues.
          So again, I would really appreciate it, if you could answer the following.

          Q1: Are you aware that these studies about circumcision and HIV, mostly concern themselves with ‘Female to male” infections.
          That circumcision has little to no relevance in reducing chances of infecting a female with HIV?

          Q2: On the basis of the argument that “the less harmful an act is the more acceptable it becomes”, would you agree if one were to say that,
          removal of the clitoral hood is more acceptable than cutting off the clitoral glans and/or vaginal walls, because its not as harmful?
          Or would you believe that removal of the clitoral hood happening to be less harmful than other forms, doesn’t make it anymore acceptable?

          Q3: Would you be negatively affected or effected in anyway, if MGM or male circumcision were to be banned from being forced on non consenting adults, children and infants. can you give details as well.

          Q4: Lastly, are you for or against the banning of MGM or male circumcision on non consenting adults, children and infants.

          Please do, feel free to ask any relevant questions from me as well, if you wish to have me clarify my position on these issues.

          • In reply to #42 by Terra Watt:

            In reply to #29 by Katy Cordeth:

            The truth is I honestly don’t know what to think about male circumcision. I would say in areas where HIV is prevalent and religion teaches contraception is a sin, the practice is a necessary evil… ….What about the girls with whom they’ll be having sex? Doesn’t society owe them a duty of care too? Boys and girls are taught about contraception nowadays in most liberal countries, but girls still become pregnant.

            Pardon me, but you are highly misinformed on the supposed benefits of circumcision. Most likely because you have given these studies unearned credibility! Are you aware at all of the fact that the studies refer to ‘Female to male’ HIV infections? Circumcision doesn’t do anything to reduce ‘Male to female’ HIV infections nor do they take into account the plethora of other STD’s. Much of which mostly affect women than men. In fact its likely to increase ‘Male to female’ infections since some males will be mislead in to believing, that they no longer need to wear condoms!

            I’m afraid I haven’t read any of the studies you’re talking about; I’m not even sure what they are. My support, if that’s what it is, for male circumcision is entirely predicated on the fact it’s recommended by as august a body as the World Health Organisation as a weapon in the fight against AIDS. The WHO is not some obscure think tank; it’s a highly respected agency whose massive body of scientists, medical professionals and ethicists one assumes did read every study under the sun and factored in every variable before making the recommendation that a stone-age procedure involving deliberate injury to infants’ genitalia could be helpful. I’m very much putting my trust in them rather than relying on study after partisan study I can find on the internet.

            As for girls becoming pregnant, I don’t understand the point you were trying to make.

            My point was that even in the first world where a plethora of information is available about sexual health and pregnancy, plenty of children and adults still ignore it. If education about condom use were all it took, we would expect no incidences of unplanned pregnancy to occur, but that’s far from the case. What applies to pregnancy applies to infection from STIs. What hope do those in the developing world have of avoiding becoming infected when misinformation from bodies such as the Catholic Church is the order of the day; when they’re told that condoms are responsible for the spread of HIV and God proscribes their use anyway, even when they’re employed as a prophylactic not against pregnancy, but disease?

            Let me ask you, in an AIDS-ravaged future America, would it be acceptable to perform circumcisions on babies, under anesthetic and in hygienic conditions of course, to prevent the further spread of the disease, even if they won’t be at risk for a number of years; even if the link between circumcision and reduced chance of becoming infected still isn’t decided one way or the other? If it is acceptable, why is it wrong in, say, present-day Botswana?

            I believe that it is self destructive to have a bargaining attitude with abuse. The act we speak of, is an intrusion upon the body of another human being, that will stay with that person for the rest of their life. Even if there was a crystal clear link between circumcision and reduction in male to female HIV infections, it would be unacceptable.

            You’re rather begging the question when you talk about bargaining with abuse, though I guess your cards are firmly on the table. The WHO are definitely wrong in your opinion, and are complicit in child abuse on a massive scale. Isn’t this tantamount to a crime against humanity on their part?

            In medicine, it is unethical to force a procedure on a person under the interests of someone else. With regards to a baby, all that medicine should be concerned about is the babys’ immediate survivability and STDs are not an immediate issue for a baby.

            I find it hard to refute any of this, so I’ll have to leave it hanging. What I will say is there have been cases where the parents of a child with a serious disease have deliberately gotten pregnant in order to harvest the resultant offspring’s bone marrow or similar. The procedures have then gone ahead, so obviously didn’t contravene any medical ethical standards. Make of that what you will.

            Secondly, It seems clear to me that you are mislead by the false belief that circumcision poses a health benefit for females!

            …What I mean is that, unlike FGM (sorry, Neodarwinian), which is a black and white issue, that is to say there’s no suggestion it may produce any beneficial results, the case against male circumcision isn’t nearly as straightforward; but because it has its origins in religion, that’s enough for our side to swiftly make up our mind and declare it morally unacceptable. That’s the same mindset which informs Christian attitudes to women’s ownership of their bodies: it’s complicated so let’s just go with what the Bible says.

            No, you’ve misunderstood. I’m under no illusion that FGM presents any health benefits to females. I’ve no idea how you could have garnered that impression; I don’t think I’ve said anything that could lead you to think I believed such a thing. This is why I’ve been so adamant that male circumcision should be kept out of the FGM debate: the fact there’s no question FGM confers any benefit of any kind means as an issue it’s simple; black and white as I think I put it. Male circumcision is more complex, as these recent threads have shown, because of the possible benefit to health.

            “…but because it has its origins in religion,…”

            I’m sorry but you couldn’t be more wrong! I am outraged by these acts when they blatantly violate our most fundamental rights, and not because they happen to have religious roots. I also show outrage when ethical concerns regarding MGM, are put aside because they are not as harmful as some forms of FGM.

            And you speak for everyone here? You clearly have a lot emotionally and intellectually invested in this issue, but there are many who will comment on a thread just for the sake of commenting. These are the ones who aren’t as exercised by the issue as yourself, haven’t particularly thought things through, and make the snap decision that if something is rooted in religion, it’s by definition bad. Comment made. Voice heard. Move on. That’s the mindset I was talking about.

            FGM is often brought up on a topic to not try and invalidate ethical concerns regarding it, but to try and remove the blind spots most people have towards MGM. But I assume some end up having a knee jerk reaction to this, because they maybe thinking that, people are trying to get them to view FGM with the same lack of concern as they have for MGM, when its the reverse that’s true.

            I know why FGM is brought up in such cases, and it’s perhaps natural that it is. What I object to is a monstrous evil, as I believe I referred to it on a related thread, being used to engender awareness of a lesser one. That doesn’t translate to “So, the logical conclusion to your statement is that some genital mutilations are okay.” I don’t know, maybe part of it is that it just bugs me to see once again a serious issue about women usurped by men. You guys can’t seem to resist horning in and making everything about yourselves. And yes, I’m aware that’s sexist. So shoot me.

            .

            I hope that answers your question on where I stand.

            .

            Thank you for taking your time to explain your position, I feel much more informed of your views and thoughts. However I’d like to know a bit more detail about your thoughts regarding these issues. So again, I would really appreciate it, if you could answer the following.

            Christ, if I’d known there was going to be a pop quiz, I’d’ve studied.

            Q1: Are you aware that these studies about circumcision and HIV, mostly concern themselves with ‘Female to male” infections. That circumcision has little to no relevance in reducing chances of infecting a female with HIV?

            That’s only pertinent when dealing with individual cases of the disease. Less so when talking about entire communities riddled with HIV. Presumably in most cases a woman who infects a man with HIV will herself have caught it from another man.

            Q2: On the basis of the argument that “the less harmful an act is the more acceptable it becomes”, would you agree if one were to say that, removal of the clitoral hood is more acceptable than cutting off the clitoral glans and/or vaginal walls, because its not as harmful? Or would you believe that removal of the clitoral hood happening to be less harmful than other forms, doesn’t make it anymore acceptable?

            Why do I feel that’s a loaded question and I’m being tricked into saying something for which you already have a comeback prepared? I can only say this is how societies throughout history have tended to deal with offences against the person: the more harm caused by a crime, the greater the punishment meted out. I see no reason to take issue with this approach. That doesn’t mean any of the things you mention is acceptable; there’re just different degrees of brutality. A rapist who physically tortures his victim with lit cigarettes as he carries out the act will receive a harsher sentence than a drunk kid who comes across an unconscious girl at a party and violates her as she sleeps. That doesn’t make the latter example acceptable. This of course raises the question, if the more severe form of FGM were carried out using anesthetic and no pain resulted, would that be worse than the other kind performed without an anodyne. I don’t have an answer to that.

            Q3: Would you be negatively affected or effected in anyway, if MGM or male circumcision were to be banned from being forced on non consenting adults, children and infants. can you give details as well.

            What does my being affected have to do with anything? I can have an opinion on something without having had it personally impact on me. I do hope you aren’t going to try and argue again that because I don’t have a penis and am lucky enough not to have experienced FGM, I’m not qualified to comment, as you did here. I abhor homophobia too; that doesn’t mean I’m gay.

            Q4: Lastly, are you for or against the banning of MGM or male circumcision on non consenting adults, children and infants.

            Infants can neither consent to nor dissent from anything, so that’s moot. A child by definition is legally below the age of consent; decisions about medical procedures are its parents’ responsibility, so this is moot also. No adult competent to refuse surgery should be made to undergo it.

            Please do, feel free to ask any relevant questions from me as well, if you wish to have me clarify my position on these issues.

            Thank you.


            I am again peeved, miffed even… no, that’s too harsh; just peeved… that the related content (above) is nothing of the sort. The actual related links can be found here in case your memory needs refreshing.

          • In reply to #49 by Katy Cordeth:

            I’m afraid I haven’t read any of the studies you’re talking about; I’m not even sure what they are. My support,… for male circumcision is entirely predicated on … World Health Organisation as a weapon in the fight against AIDS. The WHO is not some obscure think tank; … I’m very much putting my trust in them …

            This is why I previously stated,

                             "...you are highly misinformed on the supposed benefits of circumcision. Most likely because you have given these studies unearned credibility! "
            

            You are relying on the WHO as a proxy for ignoring criticisms made against these supposed beneficial claims.
            This is your error. If you were to approach their claims with a conservative mentality and exercise a reasonable level of skepticism, you would see that their claims have a poor and incompetent basis.

            My point was that even in the first world where a plethora of information is available about sexual health and pregnancy, plenty >of children and adults still ignore it. If education about condom use were all it took, we would expect no incidences of unplanned >pregnancy to occur, but that’s far from the case. … What hope do those in the developing world have … when misinformation >from bodies such as the Catholic Church is the order of the day; …

            That’s a good point. This problem in the first world I think is a sign that sex education inadequate at informing students.
            I for one have yet to see a proper video demonstrating how to use a condom, if you have an intact/uncircumcised penis.
            The video I linked earlier was to an amateur youtube video, done by some college girl. Its better than nothing but hardly professional. And yes I agree, the misinformation problem is terrible in Africa. However we mustn’t see the compromising of our inalienable rights, as a means for compensating these short comings in society.

            You’re rather begging the question when you talk about bargaining with abuse, though I guess your cards are firmly on the table. >The WHO are definitely wrong in your opinion, and are complicit in child abuse on a massive scale. Isn’t this tantamount to a >crime against humanity on their part?

            I think its quite clear what is meant when I say, that there’s to be no bargaining with abuse.
            I’m particularly talking about fundamental rights here. So even if it turns out a brand new means of circumcising was invented that didn’t cause any pain whatsoever either during or after the procedure, I would still stand against it, the moment it involves non-consenting individuals. I believe that we have to stand firm with our fundamental rights as practically as possible, because any openings could inadvertently risk being exploited.

            I find it hard to refute any of this, so I’ll have to leave it hanging. What I will say is there have been cases where the parents of a >child with a serious disease have deliberately gotten pregnant in order to harvest the resultant offspring’s bone marrow or >similar…

            Look that’s sad for the parent, but from the details you’ve given, it clearly seems like a case of organ harvesting and is wrong!
            I really don’t like insinuations, I’d rather that one detailed their own points.

            No, you’ve misunderstood. I’m under no illusion that FGM presents any health benefits to females.
            I’ve no idea how you could have garnered that impression;…

            facepalm x 10^googol! No, seriously, you couldn’t have misunderstood my statement anymore wrong than that!
            I was talking about “male” circumcision when I said,

                  "...you are mislead by the false belief that circumcision poses a health benefit for females!"
            

            As in you seem to be under the belief that male circumcision poses a health benefit for females, specifically regarding HIV infections.

            And you speak for everyone here? You clearly have a lot emotionally and intellectually invested in this issue, but there are many >who will comment on a thread just for the sake of commenting…that if something is rooted in religion, it’s by definition bad…

            I spoke in defense of myself and it likely defended others who also voiced against this practice.
            I for one can’t recall a single commenter here who cited religion as the main reason for being against this practice.
            Correct me if I’m wrong.

            I know why FGM is brought up in such cases, and it’s perhaps natural that it is. What I object to is a monstrous evil, as I believe I >referred to it on a related thread, being used to engender awareness of a lesser one… I don’t know, maybe part of it is that it >just bugs me to see once again a serious issue about women usurped by men…And yes, I’m aware that’s sexist. So shoot me.

            You feeling like you have to compete to get issues addressed, is the exact problem in the west and why there must be no bargaining with abuse!
            Yes, in real life, you can’t attend to every single problem simultaneously, thus competition is inevitable.
            And in the wilderness a mother most likely can’t attend to the cries of all her offspring, she will have to assess, who needs my attention the most. Another example is how Doctors will have to attend to their patients in terms of severity and likewise with other professions.

            But here we are talking about rights and legal boundaries! When it comes to fundamental rights, individuals in society can’t afford to function by treating abuse as a form of currency, with those being abused the most having the best ability to “purchase” legal attention. That is to say, in light of our fundamental rights NO abuse is to be deemed acceptable. This is NOT an act of denying the differences in harm caused by different acts.
            Its purely and simply saying that abuse is non-negotiable!

            Let me give you an example,
            If a violent person approaches me and tries to kill me at first, I will no doubt immediately feel alarmed and alert.
            But then he stops and tries to punch me in the stomach, etc etc. At each point he lessens his violent advance and relatively speaking, my repulsion would lessen. Simply taking a punch to the stomach is much better than being killed.
            The point is that when it comes to rights, one’s response should not lessen in that manner, as its akin to bargaining with an abuser. At no point should one tolerate an abuser attempting to use you to vent their anger!
            In reality this maybe quite difficult, but at least as far as rights and legal boundaries go, this must be standard stern stance made against abuse.

            Also there’s no such thing as male issues and female issues, they are human issues!
            It is callous of any person to feel unaffected by the issues of the opposite sex, because it doesn’t affect their own genitals.
            So please don’t be like that.

            Christ, if I’d known there was going to be a pop quiz, I’d’ve studied.

            Your time and effort is much appreciated! :)

            Q1: Are you aware that these studies about circumcision and HIV, mostly concern themselves with ‘Female to male” infections. >That circumcision has little to no relevance in reducing chances of infecting a female with HIV?
            That’s only pertinent when dealing with individual cases of the disease. Less so when talking about entire communities riddled >with HIV. Presumably in most cases a woman who infects a man with HIV will herself have caught it from another man.

            So you are not concerned that male circumcision poses little to no advantage to females in reducing HIV infections?
            And I assure you it most certainly is pertinent, especially when considering the sheer amount of hype being generated with regards to HIV reduction.
            I managed to find a study related to this question.
            Male circumcision and risk of male-to-female HIV-1 transmission

            “Conclusions: Male circumcision was associated with a reduction in HIV incidence that was not statistically significant.

            “Q2: On the basis of the argument that “the less harmful an act is the more acceptable it becomes”,… would you believe that >removal of the clitoral hood happening to be less harmful than other forms, doesn’t make it anymore acceptable?”

            …I can only say this is how societies throughout history have tended to deal with offences against the person: the more harm >caused by a crime, the greater the punishment meted out. I see no reason to take issue with this approach. That doesn’t mean >any of the things you mention is acceptable; there’re just different degrees of brutality…

            Get ready, I’m about to trumpet it again, there’s no bargaining with abuse!
            Yes, offenses are punished according to severity but the issue is about acceptability, rights and individual boundaries.
            So I’m glad to hear you say,

                    "That doesn't mean any of the things you mention is acceptable; there're just different degrees of brutality. "
            

            This is how I would like you to consider male circumcision being forced on non-consenting individuals.

            Q3: Would you be negatively affected or effected in anyway, if MGM or male circumcision were to be banned from being forced >on non consenting adults, children and infants. can you give details as well.
            What does my being affected have to do with anything? I can have an opinion on something without having had it personally >impact on me. …

            Katy, you didn’t answer the question…
            I simply want to know whether you had any personal reasons for supporting male circumcision.
            Ex: tradition, human health, aesthetics, pleasure, sexual function, etc.
            Sexually speaking, sometime ago, you mentioned, light heartdly I assume, how you are glad “it” doesn’t go up like a pan of milk in reference to a circumcised penis.
            i.e. I assume you were suggesting that foreskin makes males bad in bed or something…
            So I’d like to know whether you’d be personally affected, if male circumcision was banned?
            For example banning FGM has no negative affect whatsoever on me.

            Q4: Lastly, are you for or against the banning of MGM or male circumcision on non consenting adults, children and infants.

            Infants can neither consent to nor dissent from anything, so that’s moot. A child by definition is legally below the age of consent; >decisions about medical procedures are its parents’ responsibility, so this is moot also. No adult competent to refuse surgery >should be made to undergo it.

            Surely, repulsion to pain is the clearest sign of dissent. And yes, Parents are responsible for providing children with health care,
            but are you suggesting that parental consent overrides, a child’s consent?
            If so, I have to say, I disagree with you. I mean would you be saying the same, if we were talking about FGM, and if FGM in some parallel dimension had some medically justifiable excuse? Is it a parents right to subject their daughter to that kind of treatment.

            Thank you.

            And thank you for taking the time to respond to my questions. :)

            I am again peeved, miffed even… no, that’s too harsh; just peeved… that the related content (above) is nothing of the sort. The >actual related links can be found here in case your memory needs refreshing.

            I have no clue about what you are talking about or what it is that you are upset about… My memory does need refreshing.

            [Last para removed by moderator]

          • In reply to #52 by Terra Watt:

            And still the HIV virtues of MMC are sustained.

            What you continually fail to appreciate is that herd immunity is the key and getting the re-infection rate below 1. (Please go back and look at the thoroughgoing Lancet report of combination treatments.) Everyone benefits with even partial improvements of part of the population. The problem is entirely statistical. Low cost, low impact treatments that reliably halve the risk in the treated population added to more expensive retrovirals where affordable and condom use and abstinence taken together may get HIV on the run. That is the hope.

            The “unfairness” of one of the treatments is not the issue when your concern is disease eradication. The asymmetry in effect means that fewer men get infected who will thus go on to infect fewer women.

            The asymmetry also neatly hints at a credible mechanism for the male foreskin in disease transmission. HIV is slow to transmit. It seems it requires a high enough dose of infected blood serum or semen (in contact area and contact time) to get to the tipping point of infection. Male blood serum and semen retained internally by the female maybe particularly effective here. Foreskins may do a similar job of retention in men. If this were the case their removal would indeed reduce male risk and do nothing (per each intromission) for women.

          • In reply to #53 by phil rimmer:

            In reply to #52 by Terra Watt:
            And still the HIV virtues of MMC are sustained.
            What you continually fail to appreciate is that herd immunity is the key and getting the re-infection rate below 1….

            What needs to be made crystal clear is the context of that statistical figure, and the degree to which the 58% figure is relevant.
            And it seems to me that this figure is exaggerated! I’m no math wizard, but I know that a percentage by itself is meaningless, without clearly stating the reference to which it is compared to. The value 58% by itself sounds significant, but when you begin to factor in all the other relevant variables and concerns involved with sex; other STD’s, condoms, vaccines and pharmaceutical drugs; one can begin to see, that the value in question gets smaller and smaller.

            Condoms alone give a 80% reduction on HIV, over not using condoms!
            Then we also have to question the 58% figure itself, we need to ask, questions like, “did the subjects wear condoms? and if so did they control against the merits of the condoms” and “did the experts have knowledge of the rate of infection in that area”, “Did they know specifically who was infected and who wasn’t before the study?”. etc.

            So I’m going to hazard a guess that with condom use, circumcision contributes to pretty much 0% reduction.
            That is to say that condoms take foreskin out of the equation.
            So much so that, I assume any relevance would be, with regards to the chances of a circumcised penis breaking a condom,
            vs an intact penis breaking a condom. However even in such a case, one would be jumping the gun to suggest circumcision as a solution; when pressure would fall on manufactures to address the issue. If there’s a great chance of intact penises breaking condoms, then that’s an issue to be raised to the manufacture and for them to research and engineer a sturdier solution.

            Again, I haven’t done the math, but I’m sure that the 58% figure will translate to a much smaller figure in the overall context of sex.

            Lastly, I’m a little disturbed by how quickly you dismissed concern for the fact that, this procedure has no benefit in reducing,
            male-to-female infections! The lack of thought to the individual female in light of the supposed greater good is a bit alarming!
            Are you not concerned that not many seem to make a clear note of this to avoid potential misleadings?

            Another poster, Katy mentioned how even in the first world with sex education, that there are teens who foolishly risk their sex lives.
            So how much more should we be cautious when touting bloated figures to 3rd world nations, dominated by religion and superstition? I think people should exercise some healthy skepticism and conservatively approach these attention grabbing claims!

          • In reply to #59 by Terra Watt:

            So I’m going to hazard a guess….

            Then I’m out. This is a contentless set of conjectures that additionally and unfathomably presumes MMC researchers are witless and may not have considered sources of error in their data. This is not how this kind of research runs. The BMJ, The Lancet, Pub Med, WHO, the American Society of Pediatricians do not publish or endorse material that could so easily reduce them to a laughing stock.

            I am, though, happy to discuss science even on hot button topics like this, when there is evidence on the table.

            Lest people confuse my position on the OP. Norway has it spot on.

          • In reply to #61 by phil rimmer:

            In reply to #59 by Terra Watt:

            So I’m going to hazard a guess….

            Then I’m out. This is a contentless set of conjectures that additionally and unfathomably presumes MMC researchers are witless and may not have considered sources of error in their data. This is not how this kind of research runs. The BMJ, The Lancet, Pub Med, WHO, the American Society of Pediatricians do not publish or endorse material that could so easily reduce them to a laughing stock. (…)

            Hi Phil, I don’t believe Terra Watt’s ‘hazarding a guess’ to be a conversation stopper. I also do not believe that researchers cannot be witless, or indeed miss sources of error in their data – or their logic.

            If it is logical to assume that condom use is equally necessary on circumcised African males as it is on uncircumcised African males then it brings into question a practise (mass pan African male infant and mass pan African male adult circumcision programs) that inhibits the use of condoms, infects more African females, makes it harder to eradicate female genital mutilation, and takes billions in scarce aid funding away from interventions that have proven efficacy elsewhere and, were they implemented have great, and obvious, secondary effects.

            Also, to roll out these programs in multiple and differing nations based on unfinished studies (from just three nations) by groups of researchers from yet still other nations (nations where male infant circumcision is seen as a normative and medicalised procedure) does not control well for cognitive/cultural bias.

            No wonder this would lead to charges of Circumciser’s looking to promote Circumcision as an export.

            Further, studies outside of the three African studies do not point to the promotion of circumcision in the fight against the transmission of HIV/AIDS, even in countries with high rates of transmission such as the USA (a country with high rates of male circumcision). When you do see papers that suggest this link they always reference the African studies as the studies from their own countries do not support this.

            Over and over we see three constants that have efficacy in the fight against HIV/AIDS; behaviour, hygiene, and education. Look at Japan – no circumcision and low rates of HIV/AIDS.

            So we are left looking at what actually is different between these African nations and the rest of the world. Why, in the fight against HIV/AIDS, do we not promote male infant and adult circumcision in Japan? Or America? Or the UK, Or Australia?

            How are ‘they’ different from ‘us’? The answer seems obvious – they’re not.

            As for laughing stocks, didn’t the AAP propose a form of FGM in America, and fairly recently, too? I laughed till I cried.

            Anvil.

          • In reply to #63 by Anvil:
            Please, please, please offer evidence. Assertions get us nowhere.

            a practise (mass pan African male infant and mass pan African male adult circumcision programs) that inhibits the use of condoms,

            Please evidence your refutation (if thats what it was) of the Lancet discussion on the promotion of condoms and MMC. What is this inhibitory mechanism of their combined use? A South African MMC program that reduced HIV incidence by 20% in three years, found condom use by the circumcised at 44% and by the uncircumcised at 45.4%, a difference within the statistical noise.

            And don’t over-claim when you do supply evidence…

            As for laughing stocks, didn’t the AAP propose a form of FGM in America, and fairly recently, too? I laughed till I cried.

            “In an official statement that the AAP released to Medscape Pediatrics, the board writes: “The AAP does not endorse the practice of offering a ‘clitoral nick.’ This minimal pinprick is forbidden under federal law and the AAP does not recommend it to its members.”

            “The ethics committee will do a rewrite, which will reassert the AAP opposition to all forms of female genital cutting,” stated Dr. Palfrey, a pediatrician at Children’s Hospital Boston.

            During a telephone interview with Medscape Pediatrics, Dr. Palfrey said the original comment about performing a medically unnecessary nick represented an academic discussion of options to stop this “awful” practice.”

            The suggestion had been to produce an essentially symbolic act that would serve as substitute ritual. Of course, the nonsense was seen for what it was fairly quickly.

            I’m not going to cover the other un-evidenced assertions but the question over “why Africa and not others” may have a lot to do with hygiene and access to adequate and immediately accessible clean water etc. You have to ask yourself in similar fashion, why has the profile of the disease been so much more devastating in Africa, even in the decades before it became treatable for rich folk.

            Again a reminder for all. We are not intelligently designed. Evolution only ever does just-good-enough.

          • In reply to #64 by phil rimmer:

            In reply to #63 by Anvil:
            Please, please, please offer evidence. Assertions get us nowhere.

            a practise (mass pan African male infant and mass pan African male adult circumcision programs) that inhibits the use of condoms,

            I can’t do that I’m afraid, I’m out in the land of nod – no internet. The short up-time I have is mainly spent downloading this page and then responding to whatever the last post was as quick as I can before the connection is lost. You can of course choose to ignore the arguments, or assertions, but I’m basing them on studies and focus groups that I’ve used in this discussion both here and elsewhere and that I would presume have been linked to either earlier on this thread or on others on this site.

            Please evidence your refutation (if thats what it was) of the Lancet discussion on the promotion of condoms and MMC. What is this inhibitory mechanism of their combined use? A South African MMC program that reduced HIV incidence by 20% in three years, found condom use by the circumcised at 44% and by the uncircumcised at 45.4%, a difference within the statistical noise.

            No. That’s not what it was. I wasn’t aware you had posted a link to a Lancet discussion – and if you had I couldn’t have followed it.

            I can only try and reiterate the argument. I’ll try and do so by using points that are non-contentious.

            It is not contentious that behaviour is a major factor – if not ‘the’ major factor in the spread of HIV/AIDS.

            It is not contentious that mass circumcision roll outs are promoted, and seen by the people it targets, as a surgical vaccine. This is even reflected in the west by the constant use of the magic, yet controversial ’60%’ by both western media, academia, and organisations such as USAID and the WHO. Again, apologies for the lack of links but Google is at least your friend if not mine.

            It is not contentious that adult male circumcision has no significance in lowering the transmission of HIV/AIDS from Male to Female – indeed studies since show a correlation between circumcision and an increase in female infection rates. Again, I’m at a loss for the study. Try Greene et al AJPM? (Green???). This reflects the nonsense of generalising from the original three studies to the diverse African situation.

            It is not contentious that infant male circumcision has no effect whatsoever on transmission rates of HIV/AIDS of present day adults.

            It is not contentious that infant male circumcision is a factor in the transmission of HIV/AIDS and, additionally, can cause trauma disfiguration and death.

            It is not contentious that budgets for the roll out are often larger than the national health budgets themselves and skew the focus of those budgets.

            It is not contentious that African women are under pressure from Africa men to not demand the use of condoms during intercourse.

            It is not contentious that other forms of intervention are cheaper, non controversial, and proven.

            It would be useful to parallel this with a list of contentious points, the original studies themselves, surgical intrusion on the sexually inactive, neocolonialism, and cost benefit analyses, spring instantly to mind – but there are many others that unfortunately I don’t believe this connection will allow. I recall reading an informative paper last year on the small cost of providing Africa with a clean blood supply system, again an opportunity cost lost in the billions spent on circumcision roll out. Sadly, from my position I cannot supply you with this evidence.

            And don’t over-claim when you do supply evidence…

            As for laughing stocks, didn’t the AAP propose a form of FGM in America, and fairly recently, too? I laughed till I cried.

            I’m unsure as to what you mean here by over-claim? The AAP did propose a clitoral nick. This is a matter of historical fact, isn’t it? People pointed and laughed and the AAP went into damage limitation and spin mode. You should be able to (again from memory so apologies if I’m wrong) follow their breadcrumb system through the AAP’s policy proposal revisions. If you can’t then they have whitewashed their own history. Another reason to point and laugh?

            “In an official statement that the AAP released to Medscape Pediatrics, the board writes: “The AAP does not endorse the practice of offering a ‘clitoral nick.’ This minimal pinprick is forbidden under federal law and the AAP does not recommend it to its members.”

            “The ethics committee will do a rewrite, which will reassert the AAP opposition to all forms of female genital cutting,” stated Dr. Palfrey, a pediatrician at Children’s Hospital Boston.

            During a telephone interview with Medscape Pediatrics, Dr. Palfrey said the original comment about performing a medically unnecessary nick represented an academic discussion of options to stop this “awful” practice.”

            The suggestion had been to produce an essentially symbolic act that would serve as substitute ritual. Of course, the nonsense was seen for what it was fairly quickly.

            Yes, spin and damage limitation. At least the BMJ and the Lancet won’t erase their many studies on the efficacy of Homeopathy.

            I’m not going to cover the other un-evidenced assertions (…)

            It is hardly un-evidenced to suggest that there is a limited amount of aid, or to state that studies have shown no correlation between circumcision and HIV/AIDS transmission in western countries with both high transmission rates and high levels of circumcision, such as the USA, or vice versa, such as Japan, so I take this sentence to mean my position on the massive western promotion of male circumcision in Africa making it harder to eradicate female genital mutilation in the same continent. I would also presume this includes my assertion of western cognitive and cultural bias in the application and promotion of this policy. This is indeed my position.

            I think it is of the utmost importance, it is certainly hardly moot, and I will not apologise for asserting it. There is, again from memory, a paper in the AAP, either this year or last that questions cultural bias in their pro circumcision policy. It is at least worth a read.

            (…) but the question over “why Africa and not others” may have a lot to do with hygiene and access to adequate and immediately accessible clean water etc. You have to ask yourself in similar fashion, why has the profile of the disease been so much more devastating in Africa, even in the decades before it became treatable for rich folk.

            I had no intention to obfuscate. This was my very point. Why are we not combating HIV/AIDS transmission with proven and non-contentious interventions that are cheaper, produce earlier results, and have obvious (and hardly un-evidenced) benefits to the public health systems of many African nations?

            Again a reminder for all. We are not intelligently designed. Evolution only ever does just-good-enough.

            But not just-good-enough in the case of prepuces? That is an extraordinary claim. I start from the default position that prepuces are evolved organs and it would take extraordinary evidence to persuade me that we should take a knife to them – be they male, female, black, white, infant, child, or adult.

            I’ve not seen any.

            Anvil.

          • In reply to #65 by Anvil:

            Nearly missed this. Sorry for delay. I also owe ml66uk a response too. I’d never make a plate juggler or the proverbial multitasking woman.

            I’m out in the land of nod – no internet.

            No probs. I’ll wait until perhaps someone else can point me in the right direction.

            It is not contentious that mass circumcision roll outs are promoted, and seen by the people it targets, as a surgical vaccine.

            contentious

            This is even reflected in the west by the constant use of the magic, yet controversial ’60%’

            So you would rather believe this an indicator of dishonest hand waving rather than of the reliable predictability of the effect?

            It is not contentious that adult male circumcision has no significance in lowering the transmission of HIV/AIDS from Male to Female – indeed studies since show a correlation between circumcision and an increase in female infection rates. Again, I’m at a loss for the study. Try Greene et al AJPM? (Green???). This reflects the nonsense of generalising from the original three studies to the diverse African situation.

            I can’t find that, but Boyle and Hill seems to be the main source of this argument. A full repudiation of all their points is available in this very detailed and thoroughgoing account and meta-analysis (From about page 15/16 for the specific account of the outlier status of one of 12 reports and the problem of sex before wound healing)

            It is not contentious that infant male circumcision has no effect whatsoever on transmission rates of HIV/AIDS of present day adults.

            Contentious. Uncontentious only in highly developed countries. The work hasn’t been done and possibly does not need to be done.

            It is not contentious that infant male circumcision is a factor in the transmission of HIV/AIDS

            Dealt with above. RMC is very likely to cause cross infection.

            …and, additionally, can cause trauma disfiguration and death.

            RMC is what we are trying to stamp out here. All medical procedures carry risks, but we still inoculate after we have done the sums.

            It is not contentious that budgets for the roll out are often larger than the national health budgets themselves and skew the focus of those budgets.

            Don’t understand your point. I’ll have to wait for the details.

            It is not contentious that African women are under pressure from Africa men to not demand the use of condoms during intercourse.

            As they would be from say TasP (anti retroviral Treatment as Prevention) currently proposed and dumber still with ART (anti retroviral treatment) for HIV+ men. The problem is not an MMC one specifically.

            (On a brighter note here. Bill Gates is nicely covering all the bases here for both MMC and contraception. He is putting his money into super pleasurable/super safe condoms, putting graphene in the latex. Very strong, they can be thinner. Impermeable to everything but water. The investment community over here is very excited.)

            It is not contentious that other forms of intervention are cheaper, non controversial, and proven.

            Fully contentious.

            The cost per preventible death MMC versus TasP is about $5k each but for each preventible infection is $1k versus $5k respectively. ART does not prevent infections unless utilised as TasP.

            I’m unsure as to what you mean here by over-claim? The AAP did propose a clitoral nick.

            Over-claim is not accurate. Sorry. I meant as phrased could be presumed rather worse than the symbolic act described. I will wait on anything offered to detail worse.

            There is, again from memory, a paper in the AAP, either this year or last that questions cultural bias in their pro circumcision policy.

            That would be interesting. Another question to answer might be the ethnic background of the clitoral nick proposer. Opposing PC may need a little caution within such an organisation, but if its ethics committee are doing its job the problem will be correctly resolved. I applaud the process and its outcome on the clitoral nick.

            Why are we not combating HIV/AIDS transmission with proven and non-contentious interventions that are cheaper, produce earlier results, and have obvious (and hardly un-evidenced) benefits to the public health systems of many African nations?

            Show me the numbers. I haven’t seen anything yet. We have a duty from what we know as corroborated evidence to mitigate harm now. Supplying clean and sufficiently plentiful water is no low cost matter and its virtues run way beyond its impact on HIV.

            Better condoms that people (men) would more want to use is brilliant. My own view is that each condom should be supplied with a five tissue antiseptic wet-wipe for him’n’her before and after. At least a test program of such could be very interesting.

            Its problems though are as before. Using a wet-wipe is nicer than using a condom. Isn’t that good enough? Are they always to hand? Aren’t they most likely to be used to clean up the baby?

            The point about circumcised penises is that they don’t get lost and when it comes to penetrative sex, they will be used.

            But not just-good-enough in the case of prepuces? That is an extraordinary claim.

            My point is that any evolved organ is no better than it need be. The prepuce is not perfect like many of our bits. Currently its tasks seems simple. Certainly reproductive organs are manufactured with much wider mechanical tolerances than say fingers, because of this simplicity of function. Only recently, with extended childcare after about 35,000 BCE, when grandparents became statistically important in the well-being of the young of our species might there be evolutionary pressure to longevity and the elimination of any second order health risks they may allegedly have. Not long enough for what would clearly be only a very slight selection pressure under limited circumstances.

            The Lamarkian evolution experiment carried out by the Jews for the last three thousand years has been an abject failure though.

    • In reply to #25 by Katy Cordeth:

      In reply to #22 by Richard01:

      In reply to #19 by Stuart:

      …The story that it prevents HIV infection is questionable unless it simply compensates for poor hygiene thereby reducing risk of infection.

      I’m sorry, Richard, but is this view based on medical evidence or is it just what you ‘reckon’?

      P…

      I see that you did not derail this discussion onto the tracks of FGM, or that no one else did this either. I wonder what that says about those who went the other way on the last FGM post?

      I thought highly of you on that last FGM post that turned into a bit of a war and now I think even more highly of you on this thread.

      • In reply to #28 by Neodarwinian:

        In reply to #25 by Katy Cordeth:

        I see that you did not derail this discussion onto the tracks of FGM, or that no one else did this either. I wonder what that says about those who went the other way on the last FGM post?

        I thought highly of you on that last FGM post that turned into a bit of a war and now I think even more highly of you on this thread.

        Thank you. I’m blushing. The sentiment is mutual.

        I was having a look at Richard Dawkins’ Twitter feed yesterday for no reason in particular and was pleased to see he seems to share our view that shoehorning male circumcision into the debate about FGM isn’t particularly helpful.

        Those people saying male circumcision & FGM equally bad, please read http://bit.ly/19Z91Pl (perhaps change your mind) & sign the petition.

        Twitter: Richard Dawkins

    • Katy, without wanting to derail the discussion, in many of the the countries (Africa in particular) where circumsion is supposed to reduce HIV, reasonable genital hygiene is virtually impossible due to lack of facilities.
      In countries where hygiene facilities are available, the prevalence of HIV is relatively low in any case and I doubt if any research has been done on the correlation between Hiv and circumcision,
      I think it is criminal to mutilate the body of a child on any grounds whatsoever unless it is for genuine medical reasons. I doubt if anyone would dispute that most childhood circumcison and FGM is performed for religious or cultural reasons or basic ignorance. Where legislation is proposed to stop it like in Germany and now Norway, the resistance is almost entirely from religious groups… with no credible medical justification whatsoever. I hope this clarifies your uncertainty.
      In reply to #25 by Katy Cordeth:

      In reply to #22 by Richard01:

      In reply to #19 by Stuart:

      …The story that it prevents HIV infection is questionable unless it simply compensates for poor hygiene thereby reducing risk of infection.

      I’m sorry, Richard, but is this view based on medical evidence or is it just what you ‘reckon’?

      P…

  9. Of course, there will be no more suitable argument than tradition. Mr. Smith, why have you cut your son’s ears off? Why, it’s a tradition in our family. Oh… well then, it’s a tradition in my family to punch idiots in the face.

  10. It’s illegal to cut off a girl’s prepuce, or to make any incision on a girl’s genitals, even if no tissue is removed, and even if the parents think it’s their religious right or obligation. Even a pinprick is banned. Why don’t boys get the same protection? Everyone should be able to decide for themselves whether or not they want parts of their genitals cut off. It’s their body.

    It’s not like it can’t wait. The USA and Israel are the only two countries in the world where more than half of baby boys are circumcised. Other countries circumcise males, but usually not till anywhere from the age of seven to late puberty or adolescence.

    Different from female circumcision? The US and UK doctors who were still promoting severe forms of female circumcision up until at least the 1960′s didn’t think so eg:

    Circumcision of the Female
    (“If the male needs circumcision for cleanliness and hygiene, why not the female?”)
    C.F. McDonald, M.D. – Milwaukee, Wisconsin
    GP, Vol. XVIII No. 3, p. 98-99, September, 1958

    Female Circumcision: Indications and a New Technique
    W.G. Rathmann, M.D.
    GP, vol. XX, no. 3, pp 115-120 , September, 1959

    Today, there are intelligent, educated, articulate women who will passionately defend it, and as well as using the exact same reasons that are used to defend male circumcision in the US, they will also point to male circumcision itself, as well as labiaplasty and breast operations, as evidence of western hypocrisy regarding female circumcision.

    Female and male circumcision are more comparable than some people think. Firstly, in countries where female circumcision is done under unhygienic conditions, male circumcision is too (broken glass, no anaesthesia, etc). Many boys die each year in Africa from tribal circumcisions – over 100 young men died last year in just one province of South Africa. In some countries though female circumcision only involves the removal of the clitoral hood – the anatomical equivalent of the foreskin – and is done to babies in sterile conditions, even with pain relief. Check out how it’s done in Egypt, Malaysia or Brunei, for example. Circumcised women choose to have their daughters circumcised, citing how it’s cleaner, good sexually, reduces secretions and smegma and is generally hygienic, and also mentioning studies showing circumcised women have lower infection rates. Basically the same reasons that people use to defend male circumcision. It’s just a cultural difference.

    HIV?
    From a USAID report:
    “There appears no clear pattern of association between male circumcision and HIV prevalence—in 8 of 18 countries with data, HIV prevalence is lower among circumcised men, while in the remaining 10 countries it is higher.”
    http://www.measuredhs.com/pubs/pdf/CR22/CR22.pdf

    It seems highly unrealistic to expect that there will be no risk compensation. The South African National Communication Survey on HIV/AIDS, 2009 found that 15% of adults across age groups “believe that circumcised men do not need to use condoms”.
    http://www.info.gov.za/issues/hiv/survey_2009.htm

    It is unclear if circumcised men are more likely to infect women. The only ever randomized controlled trial into male-to-female transmission showed a 54% higher rate in the group where the men had been circumcised:
    http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60998-3/abstract

    ABC (Abstinence, Being faithful, and especially Condoms) is the way forward. Promoting genital surgery seems likely to cost African lives rather than save them.

    Recent news from Botswana
    “There is an upsurge of cases of people who got infected with HIV following circumcision.”
    http://www.gabzfm.com/circumcised-men-still-run-risk-hiv-infection

    and from Zimbabwe:
    “SOME circumcised men are contracting HIV and Aids after ditching the use of condoms, under a misguided belief that male circumcision (MC) would prevent them from getting infected”
    http://www.thestandard.co.zw/2013/11/10/circumcised-men-indulge-risky-sexual-behaviour/

    Having genital surgery on a newborn baby boy to prevent HIV seems indefensible. It can’t possibly help unless he later in life has unsafe sex with an HIV+ partner, and it’s far from settled that it could help then.

    Would we even consider it for baby girls? There’s evidence that female circumcision could help against HIV:

    Stallings 2005
    ” A lowered risk of HIV infection among circumcised women was not attributable to confounding with another risk factor in these data.”
    http://www.iasociety.org/Default.aspx?pageId=11&abstractId=2177677

    Kanki et al. reported that, in Senegalese prostitutes, women who had undergone female circumcison had a significantly decreased risk of HIV-2 infection compared to those who had not. (Kanki P, M’Boup S, Marlink R, et al. “Prevalence and risk determinants of human immunodeficiency virus type 2 (HIV-2) and human immunodeficiency virus type 1 (HIV-1) in west African female prostitutes”. Am. J. Epidemiol. 136 (7): 895-907. PMID)
    http://www.ncbi.nlm.nih.gov/pubmed/1442755

    • In reply to #35 by ml66uk:

      Well its taken a while to go through your links and whilst one or two looked a little disappointing I think they don’t address the substantial and positive achievements of MMC, merely address the need to tighten up on post circumcision behaviour counseling (already acknowledged in the literature.). A great deal of work is being done on the multiplicative effects of combinatorial approaches and this recent Lancet review puts it into a reliable perspective.

      Any treatment for an STD risks compensatory behaviour. That is no reason not to treat.

      No-one here (at present!) is advocating anything other than consensual MMC as a possible prophylactic treatment (hopefully in combination with others) for HIV. (The term MGM will be counterproductive here despite its help with FGM.)

      No-one here would advocate FGM for HIV prophylaxis because it is far more traumatic. There is certainly no other proven medical reason for its use. There is no proven mechanism despite the commonality of the Islets of Langerhans in both prepuces. The fact that the male prepuce is actively involved in intromission indicates an entirely different potential mechanism.

      Stallings is useless as a retrospective study with no control group. Though he adjusts for many things he does not adjust for frequency of sex which is staggering, given less fun, less sex.

      Kanki is a meaningless mess.

      • In reply to #36 by phil rimmer:

        I thought the links I posted very much call into question the “substantial and positive achivements of VMMC”, and it seems that many African men think that circumcision make them immune to HIV regardless of any counselling. Remember that many men have undergone traditional circumcision and won’t even have this counselling.

        It’s hardly “voluntary” when they do it to babies btw, and that’s being promoted too, though there could well be a cure by the time anyone circumcised now is sexually active.

        Even more concerning is the fact that we simply don’t know how MC affects male-to-female HIV transmission, and there is evidence to suggest that it might increase the risk. This 1993 study found that “partner circumcision” was “strongly associated with HIV-1 infection [in women] even when simultaneously controlling for other covariates.”

        http://ije.oxfordjournals.org/cgi/content/abstract/23/2/371

        How then can it be ethical to seek $2B funding to circumcise 38 million Africans? Every million dollars spent on genital surgery is money that could have been spent on education, condoms, ART and PMTCT.

        Your Lancet review, like similar projections, assumes both that MC won’t increase male-to-female transmission, which seems questionable, and also that there will be a large reduction in female-to-male transmission, which seems unlikely if behavior described in one my links is common:

        [
        One of the sex workers, who only identified herself as Memory told a United Nations Populations Fund (UNFPA) media training workshop in Bulawayo last week, that most of her circumcised clients were not willing to use condoms.
        “I have problems with circumcised men because they do not want to use condoms. They always argue that because they have been circumcised they did not need to use condoms,” said the heavily pregnant Memory, who is also HIV-positive.

        Memory said even after disclosing her HIV status, they still insisted on sleeping with her without any form of protection.
        ]

        Remember that 15% of South African adults across age groups in 2009 “believe(d) that circumcised men do not need to use condoms”. http://www.info.gov.za/issues/hiv/survey_2009.htm

        If MC really does result in a significant drop in F->M transmission, and no increase in M->F transmission, why would there be so many countries where circumcised men have higher rates of HIV than intact men?
        “in 8 of 18 countries with data, HIV prevalence is lower among circumcised men, while in the remaining 10 countries it is higher.”

        Why do you say that FGM is “far more traumatic”? I already pointed out that over 100 males died of circumcision last year in just one province of South Africa. This links says that “Since 2006, 462 initiates have died in the Eastern Cape, while more than 200 have had penile amputations.” There was also at least one castration this year. Is FGM really “far more traumatic” than that?
        http://www.dispatch.co.za/doctors-to-help-reduce-summer-initiate-deaths/

        Here’s one very mild form of female circumcision (or FGM as you call it):
        https://web.archive.org/web/20130307104149/http://aandes.blogspot.com/2010/04/circumcision.html

        Why would the procedure in that link be illegal in most western countries, yet this is legal:

        You question the Stallings and Kanki studies, but Stallings seems to have tried everything to explain away the lower rates of HIV among circumcised women but was unable to:
        “By self-report, 17.7 percent of women were circumcised. Circumcision status varied significantly by region, household wealth, age, education, years resident, religion, years sexually active, union status, polygamy, number of recent and lifetime sex partners, recent injection or abnormal discharge, use of alcohol and ability to say no to sex. In the final logistic model, circumcision remained highly significant [OR=0.60; 95% CI 0.41,0.88] while adjusted for region, household wealth, age, lifetime partners, union status, and recent ulcer. “

        There’s no way there could be a randomized controlled trial of even mild forms of FGC to have better data. To me though, an RCT into MC doesn’t seem much different. Why would be investigating genital surgery to fight HIV, when there are far better ways to prevent infection, most notably condoms? Remember that even if MC did work, it will only help men who are having unsafe sex with HIV+ partners. HIV doesn’t strike at random. Even a small increase in number of partners or a small decrease in condom usage will result in more risk to circumcised men and thus their partners, regardless of the effects of the surgery itself.

        • In reply to #54 by ml66uk:

          >

          Thanks for taking the time here. It’ll take me the evening at least to review the materials.

          As a general comment though I will say that it is important not to see any negatives as necessarily defeating a clear tested and retested win. A sixty percent risk reduction amongst men, all other things being equal, should make one review what it would actually take to make things more nearly equal. Again this is a statistics game and annecdata is not an appropriate weapon of negation, merely a goad to better research and improved methodology that can bring the numbers up.

          Back later.

        • In reply to #54 by ml66uk:

          My apologies, I’m not going to pick through this is detail. Most of the points are covered in this comprehensive survey of the Boyle and Hill complaints regarding MMC as part of an anti HIV strategy.-

          http://www.ghdonline.org/uploads/JLM2012_Male_circ_does_prevent_HIV_infection.pdf

          I strongly urge all to read it to understand why all the big medical institutions and the bulk of doctors/scientists with an interest in the field endorse VMMC as part of an anti HIV strategy in sub-Saharan Africa.

          Most certainly the biggest argument against it is in hampering the fight against FGM. Clear policy and education are needed. And an opportunity to discuss the singular virtues of VMMC say is an opportunity to talk also of the dire health risks of ritual genital mutilation. The general fight against ritual genital mutilation of either sex must be maintained and extended where ever possible, not least (nor most) for the anti HIV-through-cross-contamination effects of such a fight.

          Weak and uncorroborated correlations between FGM and HIV resistance are just that and with no credible mechanism are easily discarded.

      • In reply to #36 by phil rimmer:

        I thought the links I posted very much call into question the “substantial and positive achivements of VMMC”, and it seems that many African men think that circumcision make them immune to HIV regardless of any counselling. Remember that many men have undergone traditional circumcision and won’t even have this counselling.

        It’s hardly “voluntary” when they do it to babies btw, and that’s being promoted too, though there could well be a cure by the time anyone circumcised now is sexually active.

        Even more concerning is the fact that we simply don’t know how MC affects male-to-female HIV transmission, and there is evidence to suggest that it might increase the risk. This 1993 study found that “partner circumcision” was “strongly associated with HIV-1 infection [in women] even when simultaneously controlling for other covariates.”

        http://ije.oxfordjournals.org/cgi/content/abstract/23/2/371

        How then can it be ethical to seek $2B funding to circumcise 38 million Africans? Every million dollars spent on genital surgery is money that could have been spent on education, condoms, ART and PMTCT.

        Your Lancet review, like similar projections, assumes both that MC won’t increase male-to-female transmission, which seems questionable, and also that there will be a large reduction in female-to-male transmission, which seems unlikely if behavior described in one my links is common:

        One of the sex workers, who only identified herself as Memory told a United Nations Populations Fund (UNFPA) media training workshop in Bulawayo last week, that most of her circumcised clients were not willing to use condoms.
        “I have problems with circumcised men because they do not want to use condoms. They always argue that because they have been circumcised they did not need to use condoms,” said the heavily pregnant Memory, who is also HIV-positive.

        Memory said even after disclosing her HIV status, they still insisted on sleeping with her without any form of protection.

        Remember that 15% of South African adults across age groups in 2009 “believe(d) that circumcised men do not need to use condoms”. http://www.info.gov.za/issues/hiv/survey_2009.htm

        If MC really does result in a significant drop in F->M transmission, and no increase in M->F transmission, why would there be so many countries where circumcised men have higher rates of HIV than intact men?
        “in 8 of 18 countries with data, HIV prevalence is lower among circumcised men, while in the remaining 10 countries it is higher.”

        Why do you say that FGM is “far more traumatic”? I already pointed out that over 100 males died of circumcision last year in just one province of South Africa. This links says that “Since 2006, 462 initiates have died in the Eastern Cape, while more than 200 have had penile amputations.” There was also at least one castration this year. Is FGM really “far more traumatic” than that?
        http://www.dispatch.co.za/doctors-to-help-reduce-summer-initiate-deaths/

        Here’s one very mild form of female circumcision (or FGM as you call it):
        https://web.archive.org/web/20130307104149/http://aandes.blogspot.com/2010/04/circumcision.html

        Why would the procedure in that link be illegal in most western countries, yet this is legal:

        You question the Stallings and Kanki studies, but Stallings seems to have tried everything to explain away the lower rates of HIV among circumcised women but was unable to:
        “By self-report, 17.7 percent of women were circumcised. Circumcision status varied significantly by region, household wealth, age, education, years resident, religion, years sexually active, union status, polygamy, number of recent and lifetime sex partners, recent injection or abnormal discharge, use of alcohol and ability to say no to sex. In the final logistic model, circumcision remained highly significant [OR=0.60; 95% CI 0.41,0.88] while adjusted for region, household wealth, age, lifetime partners, union status, and recent ulcer. “

        There’s no way there could be a randomized controlled trial of even mild forms of FGC to have better data. To me though, an RCT into MC doesn’t seem much different. Why would be investigating genital surgery to fight HIV, when there are far better ways to prevent infection, most notably condoms? Remember that even if MC did work, it will only help men who are having unsafe sex with HIV+ partners. HIV doesn’t strike at random. Even a small increase in number of partners or a small decrease in condom usage will result in more risk to circumcised men and thus their partners, regardless of the effects of the surgery itself.

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  12. In reply to #67 by phil rimmer:

    In reply to #54 by ml66uk:

    My apologies, I’m not going to pick through this is detail. Most of the points are covered in this comprehensive survey of the Boyle and Hill complaints regarding MMC as part of an anti HIV strategy.-

    http://www.ghdonline.org/uploads/JLM2012MalecircdoespreventHIVinfectio

    Thanks for replying at all, but you won’t be surprised to learn that I’ve read that paper already, and wasn’t impressed.

    The biggest argument to me against promoting MGC is not that it will hamper the fight against FGC, but rather that it simply will not work, and will result in more AIDS deaths, not fewer. Real world figures show at least ten African countries where the circumcised men have higher rates of HIV than the intact men. The same also applies to Puerto Rico and Malaysia. How then can it make sense to be promoting MGC against HIV? Every million dollars spent on MC not only diverts away from things that do work, but is a million dollars that could have been spent on education, condoms, testing, or treatment. Even without risk compensation, which we already know is happening as men are using circumcision as an excuse not to use condoms, spending money on promoting MC will kill people not save them.

    There is no such thing as “voluntary” for infants being circumcised btw.

    Many of the people most aggressively promoting MGC in Africa have a long history of promoting male circumcision in developed countries too btw, even though most national medical organizations outside the USA are against it (and medical organizations in seven European countries would prefer non-religious circumcision to be banned!). Daniel Halperin is the grandson of a mohel for instance, and is on record as saying that finding that out “was a weird kind of confirmation that I’m maybe in some small way ‘destined’ to help pass along this health benefit”. It’s hard to escape the thought that he and some of the others might be more interested in promoting male circumcision than in fighting AIDS. It’s been a cure looking for a disease for decades, ever since people realised that masturbation wasn’t actually a health risk. There are also some very rich and influential people in the USA looking for any way of fighting AIDS which isn’t condoms, and I think they care more about promoting their religious agenda than they do about fighting AIDS. I know there are religious groups on the ground (Catholics included) who are actively promoting condom use, but there are people high up who are totally against this. At one point, a third of the entire PEPFAR HIV prevention budget had to be spent on abstinence programmes, probably the least effective way of countering AIDS. Male circumcision appeals to American males anyway, as most of them are circumcised themselves.

    “Weak and uncorroborated correlations between FGM and HIV resistance are just that and with no credible mechanism are easily discarded.” -
    I’d say the exact same thing about MGC and HIV though, and it’s far from clear why cutting off foreskins should affect HIV transmission. If there weren’t so many circumcised men in the USA, there’s no way on earth this whole MC to stop HIV would ever have got started. There was better evidence ten years ago that female circumcision might protect against HIV than male circumcision btw, but it was male circumcision that got the funding to run three large trials. They chose countries where the circumcised men have lower rates of HIV btw, rather than countries where they have higher rates, even though it’s the latter countries where most money is being spent on MC. When the trial into male-to-female transmission was showing the wrong results, they simply abandoned it due to “futility”. Why would it be futile to find out whether or not HIV+ men are more likely to infect women if they’ve been circumcised? There was no rational reason for the trial not to continue, especially since it’s no longer possible to repeat such a trial on ethical grounds. Somehow though, it’s deemed ethical to circumcise 38 million males without knowing whether or not it increases the risk of M->F transmission.

    Imagine a world where many of the researchers and largest donors are circumcised women from the middle east, many of whom believe in FGC for religious reasons, and they investigate cutting off female labia or maybe clitoral hoods to see if that helps against HIV (I believe they could get such results without too much difficulty), and they were trying to spend two billion dollars trying to get 38 million females circumcised (those are the figures Population Services International are targeting). They’d probably pay female celebrities to get circumcised and talk about how much better it was, and put up posters of a man supposedly looking at a woman and saying “What, you’re not circumcised!?” with a shocked look on his face. That’s the exact equivalent of what’s happening right now, but your likely reaction would be that it made no sense at all, especially if real-world figures showed lots of countries where the intact women had lower rates of HIV, and there’d only ever been completed trials in male-to-female transmission and not other other way round.

    I’d be surprised if the current male circumcision drive isn’t regarded as a bizarre aberration within fifty years (just as we now find it strange that MC was ever promoted to prevent masturbation), but a lot of men and women will have died from AIDS unnecessarily before that happens.

    Meanwhile, AIDS killed an estimated 1.6 million people worldwide in 2012, but an estimated 6.6 million children under 5 died last year from diarrheal diseases, malaria, and pneumonia. Those don’t affect people in the developed world though, and there’s no way to use them as an excuse to promote a controversial genital surgery.

    Consider this, and let me know how it can make any sense:
    Rwanda has one doctor for every 50,000 people, and one nurse for every 3,900 people.
    The HIV rate in circumcised Rwandan men is 3.5%, but 2.1% in intact men.
    Rwanda is implementing a mass male circumcision programme.

    • In reply to #68 by ml66uk:

      There is indeed evidence to show RMC can be associated with worse HIV rates. There is only one in 12 studies relating MMC to worse rates (in women rather than men) due to pre-wound-healing sex.

      If after 3 years in a South African trial total population HIV rates have fallen 20% and treated and untreated males have the same rate of condom use (44 to 45%), how will more people die of AIDS?

      Modelling like this shows clearly how wildly different can be the cost benefit analysis because of demographics. Viewed up to 2025 (only) and with a cost of $70 per VMMC it takes 40 VMMCs to avert one HIV infection in Rwanda but only 4 in Zimbabwe. This is not a technique for every country. There seem no strong contenders outside Africa.

      Your Rwanda circumcision and HIV rate has no bearing on this as RMC is implicated in cross infections. Its low current HIV rate makes it a marginal candidate (bottom of the list) for VMMC, though it makes it a contender to have HIV eliminated effectively outright.

      All treatments for the amelioration of HIV (both infective and symptomatic) will be used by men to wriggle out of their duty to wear a condom.

      There is no such thing as “voluntary” for infants being circumcised btw.

      Wow! That’s a cheap smear…

      it’s far from clear why cutting off foreskins should affect HIV transmission.

      Not to the modellers. The retention of infective agents in quantity and duration makes it very credible and fully explains the asymmetric infection.

      We pro condom advocates are led from the front now by Melinda Gates who cuts through the old Catholic crap. Hubby Bill is investing in graphene condoms for her to distribute. Thinner more pleasurable, safer less permeable. Brilliant. Fingers crossed, When available it will change the numbers again by lifting condom use hopefully over the 50% rate and into VMMC efficacy levels.

      Investment in VMMC is seen entirely as that netting greater than a $10bn return in benefits.

      I’d be surprised if the current male circumcision drive isn’t regarded as a bizarre aberration within fifty years

      I’d be surprised at that, given the hard evidence in its favour and 3,000 years of it not being a big personal problem and it being the preferred aesthetic (70+%) amongst those avid secular connoisseurs of male sexuality, gay American men (all quite unlike FMG).

      Meanwhile, AIDS killed an estimated 1.6 million people worldwide in 2012, but an estimated 6.6 million children under 5 died last year from diarrheal diseases, malaria, and pneumonia. Those don’t affect people in the developed world though, and there’s no way to use them as an excuse to promote a controversial genital surgery.

      MMC is the gift that keeps giving, which is why its life saving value for money makes sense in correctly selected countries. Averaged over the target countries at $1k/infection averted to 2025. For many countries though it dipped below $560/infection down to $280/infection.

      Treatments for mitigating the effects of malaria and pneumonia diarrhoea appear to be in a similar cost bracket. The best I found was an untested strategy at $460/death which is promising, but unsupported by any real trials as yet.

      Not sure about your comparative mortality rates either. This says AIDS kills more kids than diarrhoea.

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