Sunday, October 4, 2009

The US wants your foreskin [updated again]

The New York Times reported that public health officials are contemplating promoting circumcision for all baby boys born in the United States as a method of controlling the spread of HIV (Medicaid doesn't currently cover circumcision) (http://www.nytimes.com/2009/08/24/health/policy/24circumcision.html?_r=2&partner=rss&emc=rss).  The officials examined studies in Africa that showed circumcised heterosexual men have lower HIV infection rates.

Any proposal is not going to be available until the end of the year, but should it go ahead, I have a problem with this.

As detailed in American Prospect (http://prospect.org/csnc/blogs/tapped_archive?month=08&year=2009&base_name=should_the_cdc_recommend_circu), the problem with the studies being applied to males in the United States is that there is a huge discrepancy between available medical care in the United States and the countries studied in Africa. There is also a difference in the populations most at risk. While heterosexual males are at risk in Kenya, South Africa, and Uganda, homosexual males are more at risk in the United States. The also study shows that circumcision does not affect the risk level for homosexual men. Gay men apparently make up more than half of new HIV infections in the United States, so making circumcision mandatory may not actually result in lower infection rates.

There is a higher percentage of males circumcised in the U.S. than many other countries, primarily because of the influence of Judaism. About 79% of adult men in the United States have been circumcised. Even so, the numbers have dropped off since a high of 80% of newborn boys being circumcised right after World War II. White males are more likely to be circumcised than Black or Hispanic males.

Why should ALL newborn boys be exposed to unnecessary surgery? Circumcision might potentially reduce the AIDS epidemic in Africa, but would it make a difference in the United States? It is reported that the largest 'at risk' population in the United States would not benefit from circumcision. So what is the point of requiring such an intrusive policy?

It would be more useful to provide education on risks and benefits of circumcision, and allow parents to make informed decisions about whether or not to have their child circumcised for religious or health reasons. The money spent on requiring this procedure would be better spent on research and productive preventative medicines.

Perhaps it goes without saying, but the biggest problem I have with this is that requiring something as personal as circumcision decreed by government regulation is state intrusion gone WAY too far. What next? I can't bear to think of any examples. I am hoping the conclusion of this will be to let parents decide let the individual boy decide when he is at an age where he can make an informed decision himself do nothing.

10 comments:

Mark Lyndon said...

In Europe, almost no-one circumcises unless they're Muslim or Jewish, and they have significantly lower rates of almost all STI's including HIV.

Even in Africa, there are six countries where men are more likely to be HIV+ if they've been circumcised: Cameroon, Ghana, Lesotho, Malawi, Rwanda, and Swaziland. Eg in Malawi, the HIV rate is 13.2% among circumcised men, but only 9.5% among intact men. In Rwanda, the HIV rate is 3.5% among circumcised men, but only 2.1% among intact men. If circumcision really worked against AIDS, this just wouldn't happen. We now have people calling circumcision a "vaccine" or "invisible condom", and viewing circumcision as an alternative to condoms.

The one study into male-to-female transmission showed a 50% higher rate in the group where the men had been circumcised btw.

ABC (Abstinence, Being faithful, Condoms) is the way forward. Promoting genital surgery will cost lives, not save them.

Anonymous said...

In Africa, the words "let the parents decide" has resulted in millions of females being subjected to female genital mutilation, in all its various forms.

In the U.S., letting the parents decide has resulted in about half of males being subject to male genital mutilation (male circumcision) tody.

The time is long overdue for the owner of the foreskin to decide what he wants to do with his own body when he becomes an adult. It is HIS body, not his parents' or the doctor's or the mohel's, and the decision should rightfully and ethically rest with HIM.

Anonymous said...

Thanks for your wise comments with one exception.
All males are born with a foreskin because it's part of Natures Design. Having a foreskin is not some kind of flaw...it's Natures default setting.
A parents responsibility and obligation is not to tamper with Natures design(their sons intact penis), but to accept it for what it is...as natural as anything else Nature has created.
Except for extreme medical reasons, it should be left up to the owner to alter what he has inherited. It's no one else's business.

Mark.V. said...

I have no problem with circumcision, if a man wants to get circumcised let him go for it.

Opinionated Mummy said...

Thank you all for your comments. I agree that a person should be in charge of their own body. But this proposal is for all new born baby boys to be circumcised. It's a little hard for a 1 day old baby to push for their personal rights!

But, yes, I take your point. It should not be for the parents to decide - it should be up to the individual boy to decide when they get older. The stance I took in my blog is one that I would not normally take, and I can only assume I said so because I was horrified that it would be a decision made by government decree.

Sus said...

"It should not be for the parents to decide - it should be up to the individual boy to decide when they get older."

Hmmm. An interesting point.

I've always thought that circumcision remains in the same basket as (child) vaccination and discipline: not the business of the state, but the individual parents concerned.

However, enacting a law to allow the young adult to decide is precisely an act of force against parents ...

Now there's a conundrum. Isn't it?

Caroline said...

Medicaid has stopped covering circumcision in 16 states, not all 50. If you're tired of your tax dollars (roughly $1-2 million a year per state), being wasted this way, read this and take action.

http://www.coloradonocirc.org/files/handouts/Medicaid_and_Circumcision.pdf

libertyscott said...

If circumcision is not for directly related medical reasons then it absolutely should not be up to the parents. It should be left well alone, it is invasive and morally unjustifiable. Why should a baby go through a procedure to remove a piece of his genitalia because the parents want him to?

If it was a similar size portion of a girl's genitalia it would be treated as oppressive and violent.

After all, if circumcision is ok, why not removal of a testicle, or make genitalia be pierced from a young age.

It is body modification for non medical purposes and permanent body modification is for an adult to decide for oneself, not for an adult to decide for anyone else.

Sus said...

I have sympathy with your comment, LS, and also the two anonymous comments sandwiched btwn the Marks. But I still have questions.

"It should be left well alone, it is invasive and morally unjustifiable."

This is precisely what some adults think of vaccination. Drawing a long bow? Perhaps. But we don't believe that it's morally right to prevent others from vaccinating their children, just as we would never support the call for all children to be forcibly vaccinated.

"If circumcision is not for directly related medical reasons .."

Fair point, but it wouldn't stop sympathetic medics from acting in accordance with parental wishes, though, would it? I can't imagine that OM has legions of Muslim readers (although I could be wrong!), but I'd be interested to hear a Jewish perspective in that this is something they traditionally do -- and presumably still do.

AFAIC, I think circumcision is an abhorrent procedure for either sex. So while I want to be persuaded that it should be outlawed (for non-med reasons), I'm trying to be consistent with regard to my position on state force.

Do you see what I'm saying?

Anonymous said...

As for vaccinations, parents should be free to choose. State subsidy of childhood immunisations does not bother me.

As for routine circumcision, parents should again be free to choose. But Medicaid and the like should not cover the cost. Painful circumcision should be deemed an assault, and as grounds for medical malpractice. Babies shrieking behind closed doors should stop immediately.

Parents should also be told the following before having their babies cut. A small fraction of baby circs results in a penis damaged for life. The sexual consequences of routine circ have yet to be researched. Anecdotal evidence from gay men and from sexually sophisticated women suggests that the foreskin and frenulum are important actors on the sexual stage.