Heroin and Cornflakes

Circumcision that is performed for any reason other than physical clinical need is termed ‘non-therapeutic’ (or sometimes ‘ritual’) circumcision.

Some people ask for non-therapeutic circumcision for religious reasons, some to incorporate a child into a community, and some want their sons to be like their fathers.(1)

Most circumcisions are performed during adolescence.  In some countries, they are more commonly performed during infancy.

The United States circumcises a majority of its male infants.  Circumcision is an American cultural value and is accepted as “normal.”(2)

In Canada, statistics show more Canadian parents are not having their infant sons circumcised.  The rate for male infants in Canada has dropped from about 50% in 1998, to about 20% in 2000.  The overall incidence of male circumcision for all of Canada declined to about 13.9 % for the year 2003.(3)

It is the position of the Canadian Children’s Rights Council that “circumcision” of male or female children is genital mutilation of children.

Dr David Shaw, a lecturer in ethics at Glasgow University, recently wrote in the journal Clinical Ethics that any doctor who does perform circumcision without a medical reason could be guilty of negligence and in breach of the Human Rights Act as the child cannot consent to the operation and it can be argued it is not in their best interests.(4)

Dr Shaw, wrote: “Imagine a situation where two adherents of a minority religion ask their doctor to pull off their son’s thumbnails, as this is part of the religion in which they want to bring up their son.

The pain will be transient, and the nails will grow back, but the parents claim that it is an important rite of passage.  I think it is reasonable to say that the doctor would send them packing.

In the case of non-therapeutic circumcision, the foreskin will not grow back; why should this procedure be treated differently simply because of the weight of religious tradition?”

In females, the ancient practice of circumcision is still performed each year on millions of girls.  Opponents call it a human rights abuse that destroys a woman’s ability to enjoy sex, is sometimes fatal, and frequently leads to lifelong pain and disability.

In 2000, two sisters in Kenya, Edna and Beatrice Kandie, were told by their father that they would soon be circumcised.  They sought help from human rights lawyer Ken Wafula, director of the Center for Human Rights and Democracy, who successfully sued to stop the procedure from taking place.

Although Kenya subsequently outlawed female genital mutilation (FGM) for girls under 18, the practice is still routine there. “I was forcefully cut when I was 14 years,” says Kenyan anti-FGM activist Agnes Pareyio. “I tried to resist; everybody was calling me a coward. There was a lot of peer pressure on me that forced me to prove to them that I was not a coward.  But I hated it.  So, I grew up hating it and made sure that not my daughter, not anybody who can listen to me, will undergo FGM.”(5)

She now heads  grassroots campaigns that involve reaching out to circumcisers, who are usually illiterate village women, to teach them that FGM is wrong, and to help them find other ways to earn money.

In the United States, the Circumcision Resource Center, a nonprofit educational organization, also serves the purpose of informing the public and professionals about the practice of circumcision.

Their Directors (majority is Jewish) and Professional Advisory Board members (one-third is Jewish) consist of researchers and clinicians in the fields of medicine, mental health, and social science.

They state:

Based on a review of medical and psychological literature and our own research and experience, we conclude that circumcision causes serious, generally unrecognized harm and is not advisable.

The 1989 United Nations Convention on the Rights of the Child advises that;

“State parties should take all effective and appropriate measures with a view to abolishing traditional practices prejudicial to the health of children.”

Against such advice it has to be asked why is this ancient ritual still practiced throughout the world today particularly in so called ‘advanced’ cultures such as North America?

Lets see if we can gain an understanding by focusing on male circumcision.

Circumcision has been a religious ritual for thousands of years.

Due to religious beliefs, Jewish children are circumcised by the seventh day of life, as a mark of dedication to God.  In the book of Genesis (17: 10-14), circumcision represents the covenant made by God with Abraham and his descendants.

However, Jewish circumcision (bris or brit milah) is dependent on the acceptance of cultural myths. The Jewish Circumcision Resource Center stress that since open communication about circumcision is discouraged, there is virtually no awareness among Jewish parents that circumcision is a choice.(6)

Followers of the Islamic religion are another peoples who indulge in the ritual of circumcision.  In Malaysia for example, the ritual takes place in November when thousands of Malaysian boys attend mass circumcision ceremonies throughout this mainly Muslim South-east Asian nation.

The events, held to coincide with the year-end school holidays which run into December, are a rite of passage for Muslim boys aged between 6 and 12 whose faith requires removing the foreskin of the penis.

However, whilst circumcision for new born Muslim boys is recommended, as in the Jewish faith, it is not compulsory. Circumcision is not mentioned in the Koran, but has the status of sunnah (Arabic word that means habit or usual practice).(7)

Therefore, if a child born to a Muslim family is not circumcised and he remains so until his death, it is not regarded as a sin. (8)

In the West, circumcision was not linked to religious ritual.  It began as a “cure” for masturbation late in the 19th century in England.  Since Biblical times, masturbation had been regarded as a religious sin and in late 19th century Samuel Tissot, a Swiss doctor, increased concern when he took the medical view and argued that the unnatural loss of semen weakened mind and body and led to masturbatory insanity.(9)

The “cure” soon crossed the Atlantic to North America.

Circumcision rates have varied from year to year in the United States. It peaked at 90% in 1964, according to a Laumann et al (1997) study, which examined a National Health and Social Life Survey (NHSLS), a unique data source on the sexual, attitudinal, and health-related experiences of circumcised and uncircumcised Americans .(11)

Another set of circumcision statistics were published by Wirth (1980), obtained between July 1963 to December 1965 by the Cycle III of the Health Examination Service of the Department of Health, Education, and Welfare, a result of physical examinations of 12- to 17-year-old boys.

The numbers relate to the incidence of circumcision in the late 1940’s and early 1950’s. The findings are below:

In 2004, according to data compiled by the federal Agency for Healthcare Research and Quality, more than 79% of newborn boys in the Midwest were circumcised before leaving the hospital.  Michigan and Kentucky had the highest rates, at 85%.

Usually, the procedure for circumcision in America involves the baby being strapped spread-eagle to a plastic board, with his arms and legs immobilized by Velcro straps. A nurse scrubs his genitals with an antiseptic solution and places a surgical drape – with a hole in it to expose his penis – across his body.

The doctor grasps the tip of the foreskin with one hemostat and inserts another hemostat between the foreskin and the glans.  In 96% of newborns, these two structures are attached to one another by a continuous layer of epithelium, which protects the sensitive glans from urine and feces in infancy and childhood. (12)

The foreskin is then torn from the glans. The hemostat is used to crush an area of the foreskin lengthwise, which prevents bleeding when the doctor cuts through the tissue to enlarge the foreskin opening. This allows insertion of the circumcision instrument. The foreskin is crushed against this device and amputated.

Anesthesia was not used to alleviate infant suffering until recently because it was believed that babies do not feel pain. Additionally, it was recognized that anesthesia was risky for the newborn, thus contributing to the medical reluctance to use it for painful procedures on infants, such as circumcision.

According to a comprehensive study, newborn responses to pain are “similar to but greater than those observed in adult subjects.” Some infants do not cry because they go into traumatic shock from the overwhelming pain of the surgery. No experimental anesthetic has been found to be safe and effective in preventing circumcision pain in infants.(13)

Currently, some doctors use a dorsal penile nerve block to numb the penis during infant circumcision.

While not always effective, this anesthesia may afford some pain relief during the surgery, although it offers no pain relief during the recovery period (which can last up to 14 days) when the baby urinates and defecates into the raw wound.(14)

In the 1930’s, doubts about mental health and circumcision were beginning to surface.  However, this level of thought was replaced with a new rationale that linked the uncleaned penis and cancer.

A.L. Wolbarst published an article in the English medical journal Lancet that showed national and religious groups that routinely practiced circumcision had lower rates of penile cancer than groups that did not circumcise their boys.

The carcinogenic agent that Wolbarst implicated was smegma and other “debris” that accumulates between the foreskin and the glans of the penis. The sooner a boy is circumcised, Wolbarst idealized, the less chance he has of infecting himself or his partner with this dirty substance.

It was not until 1949 that a fundamental medical understanding concerning circumcision began to emerge with publication in the British Medical Journal of Dr. Douglas Gairdner’s article, “The Fate of the Foreskin”.

Gairdner declared that ‘the foreskin is normal, healthy tissue, and its adherence to the glans (head of the penis) by a common epithelium (synechia) serves the important function of protecting the glans penis from urine and feces in infancy and early childhood.  Subsequently, the British National Health Service discontinued payment for the surgery and the practice ceased. (15)

In America, some 30 years later, the American Academy of Pediatrics produced a pamphlet  “Care of the Uncircumcised Penis.”

The section on the function of the foreskin read:

“The glans at birth is delicate and easily irritated by urine and feces. The foreskin shields the glans; with circumcision, this protection is lost. In such cases, the glans and especially the urinary opening (meatus) may become irritated or infected, causing ulcers, meatitis (inflammation of the meatus), and meatal stenosis (a narrowing of the urinary opening).  Such problems virtually never occur in uncircumcised penises.  The foreskin protects the glans throughout life.” (16)

In 2007, the British Association of Paediatric Surgeons advised that there is rarely a clinical indication for circumcision and doctors should be aware of this.(17)

The American Academy of Pediatrics (AAP) states that “there is little evidence to affirm the association between circumcision status and optimal penile hygiene,” and “the uncircumcised penis is easy to keep clean.” (17/1)

What about when a child reaches manhood?

A recent report in the New England Journal of Medicine by researchers from Johns Hopkins University in the United States, and Makerere University in Uganda says; circumcision protects men from genital herpes, and a human papilloma virus (HPV) that causes genital warts and cancer, but it does not appear to guard against syphilis. (18)

The  results of the studies looking at more than 3,000 men showed circumcision reduced the risk of herpes by 25%, and of HPV by one-third.  HPV also causes anal and penile cancers.(19)

Anthony Fauci of the National Institutes of Health in the United States, which funded the study says; “This new research provides compelling evidence that circumcision can provide some protection against genital herpes and human papillomavirus infections as well.”

This may be true, but the report did not state whether the individuals engaged in sexual contact with partners infected with sexually transmitted diseases. Some caution needs to be taken when interpreting these kind of studies.

The study in Uganda was built on related research showing that circumcision cuts a man’s risk of HIV infection through heterosexual intercourse by more than 50%.

Since 2007, circumcision has been promoted by the World Health Organization and the United Nations Program on HIV/AIDS as a way to reduce the risk of AIDS in areas where heterosexual transmission is high. Reduction in HIV acquisition provided by male circumcision may be explained by the removal of vulnerable foreskin tissue containing HIV target cells. (20)

However, another cause for reduction that has been overlooked is that nearly five million new cases annually are caused by erratic health practices, according to the authors of a series of papers in a publication backed by the Royal Society of Medicine.  One in five HIV sufferers in Africa was infected by medical staff using dirty needles and clinical equipment, new research has found.

Researchers say the findings raise questions on the international effort to combat HIV and Aids, which focuses largely on trying to stop virus transmission through unsafe sex or from mothers to their unborn children. They accused governments of ignoring the problem so as not to undermine existing health schemes.

John Potterat, an epidemiologist and one of the editors of the International Journal of STD and HIV, said: “Governments and international health agencies have deliberately chosen to ignore the evidence”.

The studies now show directly that many Africans are at risk from a wide range of common skin puncturing practices that may involve contaminated instruments and materials. “By uncritically accepting the orthodox view that HIV is almost exclusively transmitted by sex, public health workers and researchers are complicit in prolonging avoidable suffering.” (21).

Why is this a problem?

An estimated 33.4 million people worldwide, two thirds of them in sub-Saharan Africa, are infected with the AIDS virus, an annual United Nations report said last week.

AIDS Response Seacoast Executive Director, Richard Wagner, states that a lot of 18- to 25-year-old’s are being infected with HIV, when it could easily be prevented by using protection and not making bad decisions when picking partners or with the use of drugs and alcohol.

About one-third of people who are HIV-positive don’t know it, Wagner said.

“People don’t realize 40% of clients are now women,” he added.  “A lot contract it by partners who were HIV-positive and they were infected unknowingly.”

In the U.S., more than one million people have been diagnosed with HIV since the start of the epidemic in 1984, according to the Centers for Disease Control and Prevention (CDC).  The CDC also predicts 25 to 27 % of that figure are undiagnosed. (22)

This also the case elsewhere.

In Germany, with its population of 82 million, some 3,000 people became infected with HIV in 2008, nearly double the number registered in 2001, according to the Robert Koch Institute, the federal institution in Germany responsible for disease control and prevention.

“At greatest risk are men who have sex with men,” noted Joerg Litwinschuh, spokesman for Deutsche AIDS-Hilfe (German AIDS Help), an HIV/AIDS self-help association in Berlin.  He said that about a third of the approximately 65,000 HIV-infected people in Germany were unaware of their infection and could unwittingly transmit the virus to others.

“You can’t tell outwardly that someone’s infected,” pointed out Elisabeth Pott, director of the Federal Center for Health Education  in Cologne, so having safe sex means using a condom. Other contraceptives can “prevent pregnancies but not HIV,” Litwinschuh said.

This advice appears to have been heeded in Thailand.  Thai girls aged 15 to 19 will be offered 30 million free condoms next year in a bid to cut down the transmission of the HIV/AIDS virus, Deputy Public Health Minister Manite Nopamornbodi said Tuesday.(23)

About 84% of infected Thais caught the virus after having sex without using a condom, the minister noted.  A total of 358,260 people suffer from AIDS in Thailand; 95,983 of them have died, the ministry said. The infection rate among girls in their late teens was twice that of boys because they did not dare refuse sex and felt awkward about demanding that a condom be used, Manite said.

Among all women in the United States living with HIV/AIDS, 64% are African-American.  The rate of AIDS diagnosis for African-American women nationwide is 22 times the rate for white women.

Richard Wolitski, acting director, Division of HIV/AIDS Prevention at Centers for Disease Control and Prevention (CDC) puts forward an explanation;

“A range of issues may contribute to the disproportionate HIV risk for African-Americans in the United States, including poverty, stigma, limited access to health care, [an already existing] higher HIV prevalence among African-Americans, higher rates of other sexually transmitted diseases and drug abuse.

Many black women face additional challenges such as power imbalances with men in sexual relationships, which can limit their ability to protect themselves, like using condoms.” (24)

The CDC reports that nearly half of the more than 1 million Americans living with HIV/AIDS are African- American and that 40% of the nearly 563,000 Americans with AIDS who died in 2007 were black.  African Americans make up around 14% of the population.

This problem is more pronounced in places like Washington, D. C., where the prevalence of HIV and AIDS among African- American women rivals that of Nigeria.(25)

According to the CDC, regularly testing those most at risk for HIV—and then providing antiretroviral drugs for HIV/AIDS patients — dramatically lowers the number of infected people. Without treatment or education, people will continue to transmit the virus to their partners.

They recommend and advise:

• Preventing HIV is not complicated. If you’re sexually active, get tested. Don’t use Intravenous drugs or share needles.  Abstain or practice safer sex. With preventive care, you and your health care provider can fight and manage this disease and slow its spread.

• Perhaps the best advice is to get educated.

This seems sensible advice especially where children are concerned because around 90% of all children living with HIV acquired the infection from their mothers during pregnancy, birth or breastfeeding.

• At the end of 2008, there were 2.1 million children living with HIV around the world.
• An estimated 430,000 children became newly infected with HIV in 2008.
• Of the 2 million people who died of AIDS during 2008, more than one in seven were children. Every hour, around 31 children die as a result of AIDS.(²⁶⁾

Some countries are considering more stringent methods in restricting infection from AIDS.

Take for example new legislation being put forward in Uganda.

The Anti-Homosexuality Bill 2009, is going through Uganda’s Parliament after receiving its first reading last month. According to Clause 2 of the Bill, a person who is convicted of gay sex is liable to life imprisonment.  If that person is also HIV positive, the penalty — under the heading “aggravated homosexuality” — is death.(27)

However, some countries including Britain and Canada, have raised objections.  Stephen Harper, the Canadian Prime Minister, has told Uganda that the legislation was unacceptable.

A Canadian government spokesman said: “If adopted, a Bill further criminalizing homosexuality would constitute a significant step backwards for the protection of human rights in Uganda.”

That’s all well and good, but what about the protection of human rights elsewhere in the world, namely children’s rights?

Lets look at a few of these human rights he talks about.

Human Rights Act incorporated Articles of the European Convention on Human Rights.  It was introduced into English law in 2000. These included:

* Article 3: “No one shall be subjected to torture or to inhuman or degrading treatment or punishment”.
* Article 5(1): “Everyone has the right to liberty and security of the person”.
* Article 8: “Everyone has the right to respect for his private and family life” except for the “protection of health or morals, or for the protection of the rights and freedoms of others”.
* Article 9(1): “Everyone has the right to freedom of thought, conscience and religion”.
* Article 9(2): “Freedom to manifest one’s religion or beliefs shall be subject only to such limitations as are prescribed by law and are necessary in a democratic society in the interests of public safety, for the protection of public order, health or morals, or for the protection of the rights and freedoms of others”.(III)

What about the rights of newborn babies and children?

Don’t they need protection?

The newborn child has the right not to be infected with a disease such as HIV.

Surely the onus must be on preventing the mother from being infected. This must include greater education for those groups where the risk is greatest.  Mandatory screening would seem a matter to consider because it seems there are a lot of people unaware of their condition. The practice of unsafe medical procedures must also be addressed.

If the medical procedure used in circumcision was inflicted on a terror/criminal suspect to garner information, it would be regarded as torture.

It should be left to the individual, not the parent, to make the decision to undergo mutilation of their body.

It’s time to move on from this barbaric tradition and end the traumatic experience of circumcision of  newborns and children.

Time to tell those that carry out the operation to find other ways of making money, or run the risk human rights prosecution.

Related article, ‘Circumcision: Should it be Illegal for Under 18’s?

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Summary of General Circumcision Information

http://www.circumcision.org/information.htm#5

Circumcision Information and Resource Pages

The most extensive archive of information on circumcision on the Web.

NOCIRC Home Page

The National Organization of Circumcision Information Resource Centers (NOCIRC) home page.

NOHARMM Home Page

National Organization to Halt the Abuse and Routine Mutilation of Male

The Intact Boy

Series of recorded PowerPoint presentations.

Circumcision Video: Whose Body, Whose Rights?
Available for online viewing, examines ethics and human rights issues
National Organization of Restoring Men (NORM)
Support group for men interested in foreskin restoration. See also NORM-UK.
Circumcision Information Resource Centre

Website in Montreal, Canada, in English and French.

Doctors Opposing Circumcision (D.O.C.) Home Page

Homepage of an organization of physicians opposing circumcision.

Attorneys for the Rights of the Child
Works to secure equal protection for children’s rights to bodily integrity.
International Coalition for Genital Integrity
Alliance of  organizations working for genital integrity.
Circumcision: The Virtual Journal

The first peer-reviewed medical journal appearing exclusively in virtual format.

Nurses for the Rights of the Child

Home Page of this organization.

Mothers Against Circumcision

Home Page of this organization

Association for Genital Integrity
Canadian group committed to genital integrity for all children
www.circumstitions.com
Information supporting genital integrity for all children
Historical Medical Quotes on Circumcision
Statements from medical professionals and parents
BoysToo
Supports equal protection for male children
MGMbill
A bill to end male genital mutilation in the U.S.
Peaceful Beginnings
Website of Rosemary M. Romberg Wiener, first intactivistic wiki
History of Circumcision
Focuses mainly on the history of circumcision in English-speaking countries

For Hebrew speaking visitors

Brit Milah includes translation of article Circumcision: A Source of Jewish Pain.

Israel Newsletter Against Circumcision

NOCIRC‹Israel

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