“Cutting Edge Science” as an Excuse for Circumcision on World AIDS Day.

by  on  in Circumcision • 5 Comments

I talk a lot about not judging others for their personal choices. It comes up a lot in terms of birth. I advocate for the creation of a gentle, informed birth culture, one where we do not see birth as an illness that needs medical management, one where women are encouraged to birth with the instinctive guidance of their bodies and not with artificial induction, the side-effects of epidurals, or the traumatic births that often result from unnecessary medical intervention in birth. But I also talk about women’s choice, and my focus is to educate women on birth so they can make informed decisions about the type of birth they want, be it medical or more “natural” birth.  I wrote a blog post on this topic recently, Do Doulas Trust Women?.

There is one topic I not quite so open to “personal” choice over when it comes to birth. And that is deciding to circumcise your child. I will not say “well, everyone has the right to make up their own mind about this”. Why? The same reason I don’t think female genital mutilation is acceptable.  I do not think it is a parent’s right to mutilate part of their healthy, defenseless newborn’s genitals, no matter what their personal beliefs or rationales are.

There is a lot of misinformation out there when it comes to circumcision. World AIDS Day was December 1st, 10 days ago. As a result, there is a lot of talk about circumcision in the air. In this case, however, the focus is not on the medically unnecessary circumcision of newborns. Here, we are talking about implementing pro-circumcision programs in Africa for the prevention of HIV.

In a World AIDS Day press release from the Whitehouse, Barack Obama proudly proclaims using “cutting edge science” (ummm, was that pun intentional, Barack?) to fight the AIDS problem. One of the most advocated-for approaches on the agenda is “Voluntary Medical Male Circumcision”.  Personally, I’m not sure how voluntary it will be, when you take a population with limited access to information / education about this topic and bombard them with anti-AIDS propaganda. Additionally, I’m not convinced trying to convince an entire nation’s men to  get circumcised “voluntarily” will not result in increased infant circumcision if it is believed to reduce the spread of HIV.

Hilary Clinton gave a speech not long ago promoting the importance of putting a stop to the AIDS epidemic. She had lots of ideas for taking steps towards minimizing the spread of HIV. One of her top three suggestions for this: circumcision. What wasn’t on the top three? Condoms. Excuse me? (Note: Thanks to Barefoot Intactivist for pointing that little gem out on his facebook page).

Let’s point out the obvious. Condoms prevent the transmission of HIV, whether or not part of your penis is cut off. Circumcision will not prevent HIV transmission if you are having sex without condoms.

In fact, there is the huge risk of telling a population with limited access to sexual health education that circumcision lowers their risk of HIV. It is certainly possible that this perceived decreased risk of contracting HIV with a circumcised penis will decrease condom use.  Since circumcision also decreases sensitivity, the use of condoms interferes with sexual stimulation even more than on an uncircumcised penis. Shouldn’t we be encouraging condom use, not giving men more reasons to avoid condoms? The Journal of Public Health In Africa published a paper this year on How The Circumcision Solution in Africa Will Incease HIV Infections, which “concluded that the circumcision solution is a wasteful distraction that takes resources away from more effective, less expensive, less invasive alternatives. By diverting attention away from more effective interventions, circumcision programs will likely increase the number of HIV infections.”

Circumcision has been said to be “the cure looking for a disease”. Would you like to know the history of circumcision? This quote from a Huffington Post article sums it up nicely:

Having started among ancient Egyptians and ancient Semitic peoples as a religious sacrificial ritual, the practice didn’t take hold in Western societies until the late 1800s, when Western society was mired in masturbation-related hysteria. Dr. John Kellogg (yes, the Corn Flakes guy) was seminally (ahem) influential in the fight against what he called the “practice of solitary vice”, to prevent which he ardently recommended circumcision, writing:

“The operation should be performed by a surgeon without administering an anesthetic, as the brief pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment, as it may well be in some cases. The soreness which continues for several weeks interrupts the practice, and if it had not previously become too firmly fixed, it may be forgotten and not resumed.”

Now, over 200 years later, we finally have come up with some shaky evidence that circumcision is a medically effective procedure for preventing arguably the worst medical condition our species has to contend with.

And the evidence IS shaky. A much-quoted study showed that male circumcision reduced HIV infection by 60%. If that was based in good science, we could forgive Clinton and Obama for trying to save the world by cutting off African foreskin.

Unfortunately, this pro-circumcision initiative is not based in good science. Here are a few articles to explain why:

Let’s look at circumcision for what it is: genital mutilation. It is genital mutilation whether it is being done for religious reasons, aesthetic reasons, or the false belief that in reduces risk of contracting sexually transmitted infections. Selling circumcision as an anti-AIDS weapon to a vulnerable population that is desperate to reduce their exposure to the virus is irresponsible and unethical.

Please feel free to contact your friendly neighbourhood White House if you would like to put in a request that we focus on sexual health education and condom use in Africa as opposed to the unethical, ineffective, expensive, invasive and unnecessary removal of part of African men’s genitals.

Phew. All this and I haven’t even talked about the circumcision of infants in North America! Maybe another time. If you’d like to check some more resources for circumcision information, have a look at some of these links: