Should all males be circumcised?
Some U.S. doctors are reconsidering their position
...two years ago, a consortium of experts convened by the World Health Organization and UNAIDS (the United Nations' HIV program) announced that circumcision should indeed "be part of a comprehensive HIV prevention package." It did so because three separate, meticulous medical trials in Kenya, Uganda, and South Africa, involving more than 10,000 men, had proved that circumcision could reduce the risk of female-to-male HIV infection by approximately 60 percent. This discovery is one that, over the next two decades, could save three million lives in Africa alone.
...A team of researchers from the CDC, Johns Hopkins, and the Baltimore health department examined the records of more than 1,000 African American males — all heterosexual — who tested positive for HIV at Maryland clinics. Uncircumcised men were 50 percent more likely to be infected.
These results have caused many U.S. doctors to reconsider their positions...says Lise Johnson, M.D., the director of healthy-newborn nurseries at Boston's Brigham and Women's Hospital. "But I find these HIV studies pretty striking. The weight of scientific evidence might be shifting in favor of circumcision."
...according to the AAP, circumcised boys have a lower risk of urinary-tract infections and penile cancer, and, indeed, "a slightly lower risk of getting sexually transmitted infections (STIs), including HIV, the virus that causes AIDS." But weighed against the potential risks, says the AAP, "these benefits are not sufficient ... to recommend that all infant boys be circumcised." (The AAP is now reviewing its guidelines, in light of recent scientific news.)
...Archeological evidence suggests that the practice may be at least 6,000 years old. Muslims and Jews, along with the aborigines of Australia, the Aztecs and Mayans of this hemisphere, and many other cultures all independently adopted this squirm-inducing practice, and it seems unlikely they'd have done so unless they were convinced that it conferred some earthly benefit.
Circumcision became routine, but anesthesia wasn't part of the plan. That, more than any other factor, may have provoked the fiery anti-circumcision movement that casts its long shadow over the Internet.
...Fortunately, Dr. Wang says, circumcision is no longer performed in American hospitals without anesthesia, as Milos described it. After a quick examination of Isaac's manhood (if that's the right word for it), Dr. Wang administers four evenly spaced injections of lidocaine around the base of the baby's penis; Isaac shows no distress...
...Daniel Halperin, Ph.D., spent much of the 1990s poring over epidemiological studies of AIDS, looking for places in Africa and Asia where HIV rates were relatively low and then trying to figure out why. Halperin, a senior research scientist at Harvard's school of public health, concluded that circumcision played a role...
...All of this makes many public-health experts in the United States lament the decision of some states to withdraw Medicaid coverage for routine circumcision. "Because uncircumcised males face greater risk of HIV and other sexually transmitted infections," a different study concludes, "lack of Medicaid coverage for circumcision may translate into future health disparities for children born to poor families."...
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To be honest, I've seen a few penises in my day. Some, who were circumcised, had horrible scarring. I'm now married to a European, who isn't, and frankly, it works better with the skin left on. We are expecting a son and won't have him snipped. THis report is specific to places where unprotected sex is rampant with high-risk partners. This report doesn't really apply to America and the AMA doesn't recommend or disavow circumcision saying simply that the pros and cons are about equal and so, it should be a personal choice.
Okay... so, the doctor's name is really Dr. Wang?
Irrespective of the lady who is speaking from the experience of her little study of men's penises I vote in favor of them. My son is and I was not. I wish I had been. Look up phimosis in the, ahem, dictionary and you'll see why I wish I had been.
Just as we men get shut out of the abortion debate (that is, if we're against it) you get to be shut out of this one, lady.
I've experienced both circumcised and uncircumcised, and yes, it does work better with uncircumcised. I am a woman and an American. I don't want my statement to be slight on all the circumcised men out there. Obviously, they had no say in the matter. But it DOES work better as God created it. This is why if I ever have a son, I am leaving his body alone. His body, his decision.
Without being overly graphic in your description, what does it mean when you say better? Better for the male? The female? Both? Longer pre-ejacuation time? What is better?
The researchers circumcised half of the 10,900 men and after less than two years, 64 of the circumcised men and 137 of the non-circumcised control group had HIV. That is the whole basis of the claim - about 50 circumcisions to prevent each case, in Africa, where HIV is rampant. More than twice as many circumcised men dropped out of the study, their HIV status unknown to researchers, as non-circumcised men were infected. And they'd given more attention to the circumcised men. "Meticulous" maybe, but they all knew what they wanted to prove. In seven African countries, a higher proportion of the circumcised men has HIV than the non-circumcised.
Only within a tiny subset of the Baltimore men, those "at known risk", were circumcised men less likely to have HIV, and of that subset only 50 were not circumcised, and so the 22% who got HIV is ELEVEN men. Chance could easily account for the difference in such a small number. We're not talking about lab rats given controlled matings here. In the great majority "at no known risk" there was no significant difference.
It's not enough to say circumcision "reduces the risk". You'd have to circumcise more than 1000 babies to prevent one old man getting penile cancer, if circumcised men never get it, and they do. (Considerably fewer men get it in Denmark, where they don't circumcise.)
YMedad: Men circumcised in adulthood say the difference is like going colourblind; it's not just the quantity, it's the quality. It's been called "a symphony of sensation".
Or you could compare circumcision to taking out the accelerator pedal and leaving an on-off switch. Sure, you get there, but the journey isn't as much fun.
1) I'm tired of circumcised men trying to justify cutting parts off other people's bodies. Babies aren't going to be getting any STI's before they're old enough to decide for themselves whether or not they want part of their genitals cutting off. It's their body; it should be their decision.
2) These latest studies are from Africa. A 29 year study of males in New Zealand showed a slightly *higher* rate of STI's among circumcised men:
http://www.jpeds.com/article/S0022-3476(07)00707-X/abstract
3) If we found out that cutting off part of a girl's genitals reduced her risk of contracting an STI, would that make it acceptable?
This study shows exactly that: http://www.ias-2005.org/planner/Abstracts.aspx?AID=3138
If female circumcision had caught on in the USA (it was promoted in medical papers till at least 1959, and practised till the early 70's), and western researchers were now looking for benefits of female circumcision as enthusiastically as they are looking for benefits of male circumcision, we'd now be getting news articles about how female circumcision help prevent STI's. It wouldn't mean that there aren't better ways to prevent STI's, and it wouldn't make it right.
News just in this week: A jury in Atlanta has awarded $1.8 million to a boy whose penis was severed in a botched circumcision five years ago. The Fulton County jury also awarded the boy's mother another $500,000.
You might also want to check out the following:
Canadian Paediatric Society
"Recommendation: Circumcision of newborns should not be routinely performed."
http://www.caringforkids.cps.ca/pregnancy&babies/circumcision.htm
"Circumcision is a 'non-therapeutic' procedure, which means it is not medically necessary."
"After reviewing the scientific evidence for and against circumcision, the CPS does not recommend routine circumcision for newborn boys. Many paediatricians no longer perform circumcisions.
RACP Policy Statement on Circumcision
"After extensive review of the literature the Royal Australasian College of Physicians reaffirms that there is no medical indication for routine neonatal circumcision."
(those last nine words are in bold on their website, and almost all the men responsible for this statement will be circumcised themselves, as the male circumcision rate in Australia in 1950 was about 90%. "Routine" circumcision is now *banned* in public hospitals in Australia in all states except one.)
British Medical Association: The law and ethics of male circumcision - guidance for doctors
"to circumcise for therapeutic reasons where medical research has shown other techniques to be at least as effective and less invasive would be unethical and inappropriate."
The article quoted Robert Bailey, Ph.D., a professor of epidemiology at the University of Illinois at Chicago, but the author neglected to point out that Bailey is very connected to those very groups that he decried as radical!
(PS: YMedad, good question! I thought of asking that myself.)
Wow, there's more response in this topic then in the average political topic... Would that mean something?
For 3000 years, Jewish males (and for 1500 years Mulsim males) have been circumcised. I would think that that statistical group would at least prove that there's nothing wrong in being circumcised, that trauma in later life is minimal, and that given the amount of babies people have, it doesn't interfere.
And I wonder about those ladies having experienced with and without: how many males is statistically influential enough?
Haha, surprised to see such high activity on this topic, almost irrelevant to me personally.
I'd rather celebrate my sons birth by cutting of his earlobes.
As a male who was circumcised at the age of 30, I must say that I find sex without the foreskin much more pleasureful than sex with the foreskin intact. I had the procedure done because I kept getting infections under the foreskin. Since the operation I have not once had a problem. My penis now looks better, stays cleaner, and feels so much better during sex. I am glad I got to experience sex with and without a foreskin, but did not hesitate to have my sons cut to prevent them from having the problems that I had.
I'm sceptical of comments like that last one. I live in a country where over 90% of men are intact, so why have I never heard stories like that over here? In the UK, only about 1 in 140 males left intact as a baby ever needs to be circumcised later. It's getting rarer as alternatives to circumcision are discovered, and the rates are less than 1 in 1000 in at least two other countries.
Kim and Pang published a paper in the British Journal of Urology which studied 255 Korean men circumcised as adults, and found that "About 6% answered that their sex lives improved, while 20% reported a worse sex life after circumcision."
Didn't England give us the term "Initiation Society"? And I always thought royal progeny were always circumcised.
The Initiation Society is indeed based in the UK, but is for Jewish circumcision only.
Royal sons used to be circumcised, but this ended when Prince William and Prince Harry were born
The UK circumcision rate has dropped from about 35% to less than 5%, and is probably down to around 1% for people who are not Muslim or Jewish.
so, it's the Flappers' Society now?
Ha! I think a lot is being taken for granted here, though. I must say I don't see how all this justifies such an invasive procedure, which would hardly be easy or cheap to implement globally, anyway.
And who in their right mind would advocate this as an effective method of preventing STD infection?
Given the so-called complications rate given by circumcisers, there are thousands of seriously damaged men in the U.S. alone who did not consent to the amputation of part of their penis. Scars, insufficient skin for erection, urethral laceration, glans injuries, . . .
Where's the outrage? Get circumcised. Get circumcised twice. But removing sexual tissue from non-consenting boys or girls is a practice that should be left in the stone age.
-J
I am just trying to get all of the facts here - Your article repeatedly mentions that circumcision reduces the risk of transmitting HIV and other STI's - but has not said how or why circumcision would accomplish this. Pardon me if I am wrong here, but I am under the impression that it is bodily fluids that transmit these diseases, and how would extra skin reduce infection? Additionally, why is the distinction made that it reduces the risk of 'female-to-male' HIV infection? I suppose this is because they were only studying this part of the population? Also, who were the participants of these studies? Were they all from the same socio-economic and educational backgrounds? Were any of them using protection, or were they all having unprotected intercourse?
And finally, I don't think that archeological evidence showing that cultures practicing circumcision should conclude that 'they were convinced that it conferred some earthly benefit'. It very well could have a been a spiritual practice.
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