Selective Consideration

The Centers for Disease Control addresses the issue of the United States in its factsheet on male circumcision and HIV:

There are a number of important differences that must be considered in the possible role of male circumcision in HIV prevention in the U.S. Notably, the overall risk of HIV infection is considerably lower in the United States, changing risk-benefit and cost-effectiveness considerations.

You don’t say? So why is it that this is most often buried in the bottom of news stories, in those cases where it does appear? If an article is skewed to a population, it should not use the context of another population to make its point. The case of male circumcision and HIV in America does exactly that.

Continuing:

Also, studies to date have focused on heterosexual, penile-vaginal sex, the predominant mode of HIV transmission in Africa, while the predominant mode of sexual HIV transmission in the United States is by penile-anal sex among MSM.

Ditto what I said above.

In addition, while the prevalence of circumcision may be somewhat lower in racial and ethnic groups with higher rates of HIV infection, most Americans are already circumcised, …

There’s an important bit coming up, so I’m going to briefly digress here. First, a sic surely needs to be inserted in the statement I’ve bolded. “Most Americans” are not circumcised. Most male Americans are circumcised. That’s a huge difference in this nation of equal rights. It’s telling that the CDC omits such a key word that would lead any honest person to question whether routine infant male circumcision and federal prohibitions against any non-medical genital cutting on females should co-exist.

Second, would it not makes sense to study the impact that near-universal infant male circumcision throughout the latter half of the 20th century had in reducing the transmission of HIV in America? I will concede that such a study is probably impossible. But addressing the question with at least a reasonable theory and supporting assumptions is not. That it’s missing is also telling.

Returning mid-sentence:

… and it is not known if men at higher risk for HIV infection would be willing to be circumcised, …

Aren’t most (male) Americans circumcised? Clearly there’s that disconnect in this argument, leading back to my last request of appropriate studies. But the largest point in all of this rests specifically with the acknowledged concession that men at higher risk of any risk would be willing to be circumcised. Consider that with the remaining piece of the sentence:

nor if parents would be willing to have their infants circumcised to reduce possible future HIV infection risk.

Most (male) Americans are circumcised, so parents have clearly shown their willingness to have their infants circumcised. Most of those were for far stupider reasons than potential future benefits. I’m willing to bet that parents who circumcise their son so that he’ll look like daddy are more than willing to have him cut in the face of even the most irrational medical hysteria.

We understand that a man could choose not to be circumcised, even if it might, just maybe, someday save him from his minute risk of becoming HIV+ through insertive vaginal sex with an HIV+ female. Or that parents might not agree to circumcise. Yet, the two thoughts never form enough of a logical tag-team to combat the irrational-but-accepted notion that an infant isn’t an independent person who might object to medically unnecessary, invasive genital cutting? Ridiculous. It’s is rational, and correct, to presume that a male would not want part of his genitals cut away to provide a non-guaranteed protection he probably won’t need and can achieve with methods other than surgery.

Lastly, whether the effect of male circumcision differs by HIV-1 subtype, predominately subtype B in the U.S. and subtypes A, C, and D in Africa, is also unknown.

That seems like it might matter, no? Ditto my earlier statement on skewing to a population based on the context of another population.

If you favor male circumcision as a means of reducing HIV risk, fine. Advocate your case to adult males and allow them to determine for themselves, based on their own situation. But leave infants males out of it. Including them in any advocacy shows a lack of intellectual depth and fairness. Infant males are neither sexually active nor capable of consenting to a medically unnecessary genital surgery.

2 thoughts on “Selective Consideration”

  1. So why is it that this is most often buried in the bottom of news stories, in those cases where it does appear?
    You know why.

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