Category: Circumcision

I predicted this a few hours ago, but I claim no credit for something so obvious. I want to highlight some of the ignorance and irresponsibility in reporting the NIH’s announcement on circumcision, which includes Adult Male Circumcision … in the title. I’m going to report the headlines from news media (including press releases and derivations), since that’s the extent of what I suspect most people willing to circumcise will read. It’s the key word, so it should be in every headline. Without further ado:

Continue reading “Key Word Omission Watch – News”

Uh-oh:

Circumcising adult men is an effective way to limit transmission of the virus that causes AIDS. The National Institutes of Health announced today that two clinical trials in Africa have been stopped because an independent monitoring board determined the treatment was so effective that it would be unethical to continue the experiment.

“We now have confirmation — from large, carefully controlled, randomized clinical trials —showing definitively that medically performed circumcision can significantly lower the risk of adult males contracting HIV through heterosexual intercourse,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Disease. “While the initial benefit will be fewer HIV infections in men, ultimately adult male circumcision could lead to fewer infections in women in those areas of the world where HIV is spread primarily through heterosexual intercourse.”

The key word here should be obvious: adult. Ultimately, I don’t care if adult men want to make less-than-optimal choices for themselves regarding circumcision. Personal responsibility (condoms, monogamy, etc.) are much more effective at preventing HIV infection. Adult circumcision is consistent with my position (body, his rights), regardless of the wisdom involved in the adult male’s choice. People should retain the right to be stupid with their own body.

The predictable outcome, though, is that the word adult will inevitably drop out of the article as it’s picked up by other news outlets and blogs. Parents will think that it’s good enough for adults, so better to save their children now. In a worse development, by promoting an idea outside of its legitimate scope, the government will continue its complicity in the unnecessary and unethical surgical alteration of children. The legitimate function of government is to protect the rights of individuals, not encourage parents to violate the rights of their children.

The often-overlooked details, as evidenced by this paragraph, shows how selective information can derail the best of intentions:

This finding appears to apply only to heterosexual transmission which is the main mode of spread in Africa. Officials estimate that at least 25 million people in Africa are currently infected with the AIDS virus.

Both studies undertaken so far apply only to heterosexual transmission. What’s missing here is the key component, that the study investigated female-to-male transmission. Female-to-male is the least common involving men. When someone says circumcision offers a 48% or a 53% reduction in infection, keep in mind that the benefit only applies to a small percentage of the risk. Absolute numbers matter. Women will still become infected. Gay men will still become infected. Straight men will still become infected. There is no immunity. Personal responsibility still matters more.

The findings are useful for scientific progress, given that everyone involved volunteered. But consent is still the primary ingredient. It is absent in America in the overwhelming majority of circumcisions. Those who use this announcement to perpetuate circumcision against non-consenting, sexually inactive infants participate in violating every circumcised child’s rights. That is wrong, no matter the potential protection against HIV.

Because we need research to reach this conclusion:

Newborns probably able to feel pain: research

More interesting is the collective denial involved leading up to such a not-stunning finding:

“New measurement techniques show that even premature babies display all the signs of a conscious experience of pain,” the research institute said in a statement, citing a doctoral thesis by Italian-Swedish researcher Marco Bartocci.

“For many years, doctors have assumed that foetuses, premature babies and fully developed newborn babies do not have the cerebral cortical functions required to feel pain,” it said.

“Babies’ reactions to potentially painful stimuli have been explained away as unconscious reflexes and so doctors have felt it justified to withhold painkillers during surgery and the like so as to avoid adverse reactions,” the institute said.

It’s amazing the number of people who will listen to a baby wail during circumcision and believe that only the restraint generates the crying. Silly and indefensible assumptions should not be tolerated.

But Bartocci’s research shows that the brains of premature babies are far more developed than previously thought.

His studies “using infrared spectroscopy … show that pain signals from a pin prick are processed in the cerebral cortex of premature babies in the same way as in adults.”

This should not be used as an excuse to administer pain relief to babies and sweep the more fundamental flaws of the process aside. Again, it’s useful to accept facts but that does not mean assumptions should remain unchallenged. Non-medical circumcision on a non-consenting individual with pain relief is still unacceptable madness.

For those who say accidents and complications never occur:

The tip of a 10-year-old boy’s penis was accidentally severed during a circumcision at a Malaysian clinic, a newspaper reported Sunday.

Doctors tried to reattach the severed portion in a five-hour operation, but it was not known if the surgery was successful, the New Sunday Times newspaper reported.

Story here. Malaysia and the United States are not the same, but this happened at a clinic, with medical supervision. Nor do I propose that this is common. But is it worth it if it’s your son who becomes the statistic? If nothing else, learn that denying reality does not change reality.

I’m very rarely surprised by bias when reading about circumcision, but this example from the Jerusalem Post is the worst I’ve seen to date.

Israeli experts are urging a visiting World Health Organization (WHO) team to promote circumcisions of both adults and of newborns in the Third World to help reduce HIV transmission.

Current research shows that six in 10 circumcised men are immune to HIV infection, but only about a fifth of men around the world have been circumcised for religious, medical or cultural reasons.

Wrong. Please show me one study, no matter how absurd its foundation, in which the results shows that 60% of circumcised men are immune to HIV infection. So 60% of circumcised men no longer need to wear a condom if they have sex with an HIV-positive partner? One study (yes, just one) suggested that it reduced infection risk by 60%, but that remaining 40% applies to every male. This is irresponsible journalism.

This also raises the larger issue of bias, namely, the assumed bias to promote circumcision on flimsy evidence by anyone who practices ritual circumcision. I ignore these because the pro-circumcision arguments offered are usually the same whether the justification is ritual or cultural. Also, I don’t believe there is anything nefarious in these efforts. Misguided, but not intentionally. Logic is absent, so rarely do the arguments reach beyond trying to make the person feel better about what he wants to do anyway. That’s par. Countering such rigidity from one angle isn’t worth my time. But sometimes, as here, the argument falls into the ridiculous. Passing such nonsense off as science is dangerous.

What’s the downside of such misguided logic?

[Director of the Jerusalem AIDS Project Dr. Inon] Schenker said, however, that “as a public health person, I am very worried from the message to Israeli teenage boys and men who may think that since they’re circumcised, they can go from bed to bed and will be immune to HIV infection. This is not true, as four in 10 will still get infected.”

Regarding the lack of a foreskin as an “invisible condom” could, he said, offer the same sense of false security that comes from sunscreen that can help protect against skin cancer but not completely prevent it; people who use sunscreen may stay out in the sun longer as a result.

Dr. Schenker’s concern highlights one useful facet of human psychology. Promoting circumcision as an immunity, or even as a way to reduce risk, is a sure-fire way to encourage people to engage in risky behavior. Who is surprised by this, other than people who believe, without reservation, that circumcision is always Good&#153 if it’s performed with the silly notion that it’s in his best interest?

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Something else in the article warrants mentioning, although I’m not surprised that someone opposed to infant circumcision has to point it out. Consider:

Dr. Tim Farley of the WHO’s department of reproductive health and research and WHO consultant and University of Edinburg expert Dr. Timothy Hargreaves viewed the ritual circumcision Monday at Jerusalem’s Misgav Ladach surgical clinic of a 21-year-old Jewish immigrant from Russia who had not undergone a brit mila as a baby.
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Dr. Inon Schenker, director of the Jerusalem AIDS Project (JAIP) and a senior HIV/AIDS prevention specialist, told The Jerusalem Post that over the years, 20,000 Israeli males – immigrants from Eastern Europe and Ethiopia and converts – have undergone ritual circumcisions as non-infant children, teenagers and adults.

If the male remains intact until an age when he may choose the surgery himself, is he not a full member of the faith until he is circumcised? All evidence points to “No,” so why the rush to circumcise, other than a fear that it might be set aside? I’ve argued in the past that it’s reasonable to assume that a man who chooses circumcision for himself is more likely to consider it an act of faith, with meaning. I do not comprehend how circumcising infants provides this to the same extent.

Okay, one more point:

The WHO officials said they were most interested in adult male circumcision rather than on infants, as it would take 15 to 20 years for babies in sub-Saharan Africa, where AIDS is endemic, to become sexually active.

However, the two dozen Israeli experts who met the WHO officials urged that infant boys be circumcised in large numbers because the operation involves a very low rate of complications if performed in sanitary environments; anesthesia is not necessary [ed. note: Bullshit.]; a trained non-medical practitioner can learn to do it quickly and safely; and early contact between the infant’s family and family health services can promote health promotion and disease prevention.

That last one is a new argument I’ve not yet heard. I’m fascinated that anyone can promote removing healthy tissue from an infant in order to promote health and disease prevention. Again, the logical extreme is such things as excising breast tissue from little girls. It promotes disease prevention, and does not exclude the families of infant girls. But that’s crazy. No crazier than cutting off healthy foreskins to stay healthy, of course.

Cutting infants should be exclusive to making them healthy when disease is present and no less invasive method will suffice.

This article from the New York Times offers two key points that recent reports on circumcision and STD infection failed to provide. First, the article mentions that the recent study out of New Zealand relied on self-reporting. Mentioning this is commendable.

More important is this quote, which is unfortunately the last paragraph of the story. I fear people will ignore it because the so-called truth is in the beginning. Instead, it should be plastered over every article.

David M. Fergusson, the lead author of the study and a professor of medical psychology at Christchurch School of Medicine, warned that the results were not conclusive. “We are cautious about the findings,” he said. “They depend on self-reports, and not all studies agree with ours. But our results definitely suggest that circumcision may reduce rates of S.T.D.’s. We think we’re correct, but it’s best not to be dogmatic about it.”

Dr. Fergusson declined to offer advice to parents. “Decisions to circumcise children should not be made on the basis of one study,” he said. “They should be based on all the evidence. There is certainly evidence of benefit, but the complicated decision parents face is weighing the benefits against the risks of a surgical procedure. Even if we assumed all the evidence favored circumcision, most children wouldn’t benefit from it. We estimate that you would have to circumcise 20 boys to prevent one case of sexually transmitted disease.”

Safe-sex education and condoms would be wiser actions than cutting off healthy portions of a male child’s genitalia.

It’s damning praise to say that the United Nations cares about stopping violence against children. It doesn’t. It cares about stopping selective, politically correct violence against children. As evidence, consider its latest attempt to do something for the children:

Canada should repeal the law that allows parents to spank and physically discipline their children, United Nations special envoy Stephen Lewis told an appreciative crowd at a world forum on child welfare Monday.

In a wide-ranging speech on violence against children, Lewis condemned Canada for violating its commitment to the United Nations Convention on the Rights of the Child by condoning corporal punishment under section 43 of the Criminal Code.

Lewis argued that under the guise of terms like “reasonable” force, children are subjected to “gratuitous, offensive, and damaging violence.”

That’s quaint. Not what it’s trying to accomplish, for I’m not okay with physical discipline. But it is amusing how sanctimonious the U.N. can be when it gets bothered about something. Quoting anything related to the rights of children is a nice touch. But what about the rights of male children to be free from preventive medically unnecessary genital cutting? Is that not violence against children? Remember, I’ve already addressed the disparity in the U.N.’s view on the circumcision of males and females.

This quote by UNICEF Canada president Nigel Fisher is particularly instructive, given that Mr. Lewis is the United Nations special envoy on HIV/AIDS in Africa, and the U.N. believes that circumcision is a solution for HIV in Africa:

But Fisher said UNICEF’s position is that there is no level of acceptable physical violence against children. “It’s a slippery slope and therefore we believe that there should be no violence at all, and that includes physical punishment at home.

“The thing is we’ve go [sic] to help parents think through how to help children understand cause and effect and the consequences of bad behavior,” he said. “And I think physical punishment is a kind of lazy way out. ‘I’m bigger than you. I can shout louder than you and I’m stronger than you. Therefore, unless you do what I tell you, I’ll whack you.’ I can’t see that that’s actually helping a child understand values and consequences.”

Consider the text I’ve placed in bold. Might that apply to the use of circumcision as a tool to prevent HIV infection? Cause and effect? Consequences of “bad” behavior? Everyone at the United Nations should feel good about themselves. They’ll make the world a safer place so that children won’t get a whack on the butt. But a scalpel to the penis? Yeah, that’ll still be safe.

Is circumcision surgery? Yes or no? Feel free to add any explanation.

Here we go again:

Circumcising all baby boys could cut the rate of sexually transmitted diseases by about half, a study suggests today. The study adds to the growing scientific evidence that challenges a policy against routine circumcision by the American Academy of Pediatrics.

I forget them all the time, so I’m glad to have the opportunity to remind myself of the assumptions that make this allegedly relevant to ethics of routine infant circumcision, rather than some other policy, say adult elective circumcision:

• Infants are having sex, which will expose them to STDs.
• Condoms are not available for adults.
• Personal responsibility is not a viable safe sex concept.
• Parents are unable to teach their children safe sex.
• Fortunately, parents are all-knowing regarding their children sons’ future sexual risk.

There are other, typical claims in the article, including support for cutting children from the usual suspects. What’s interesting is what the article leaves out. And this article. And presumably the majority of the media who rush to point out something “miraculous” before investigating whether the miracle is really there.

Instead, consider the study:

METHODS. Data were gathered as part of the Christchurch Health and Development Study, a 25-year longitudinal study of a birth cohort of New Zealand children. Information was obtained on: (1) the circumcision status of males in the cohort before 15 years old, (2) measures of self-reported sexually transmitted infection from ages 18 to 25 years, and (3) childhood, family, and related covariate factors.

Can you spot the flaw? I don’t claim that self-reported is sufficient to overcome the study’s conclusion, only that it’s a glaring fact that’s being ignored in reports. Just as intact men can become infected, circumcised men can become infected. Personal responsibility matters. Also, if the men involved are competent enough to self-report their STDs, they’re competent enough to practice safe sex. If they do not practice safe sex, the intact males do not have their foreskin to blame.

This should raise ethical questions, but instead, it raises questions of market valuation:

Sadly, my hairline is receding, so my interest was easily piqued when I came across Intercytex (LSE: ICX), a small UK biotech which is developing a promising treatment for hair loss.
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At 88p, Intercytex is valued at £49m, and I don’t think you can justify that valuation on hair loss alone. However, the company is also developing three skin treatments. All of them are based on cells taken from a baby’s foreskin. Intercytex uses about one foreskin a year and replicates cells from that original piece of skin.

The most advanced skin product is ICX-PRO which is for the treatment of chronic “hard to heal” wounds. PRO is a matrix containing cells which promote wound healing. It’s easier to use than current treatments as well as being cheaper and faster to manufacture.

The story isn’t about the treatment itself, or the science behind it, so there’s little information to allow for proper judgment. Similar to my earlier statement, the now foreskin-free boy is unlikely to receive compensation for his contribution lost foreskin. Yet, there is a potential commercial product built around its removal. Even if he did receive compensation, or at least his foreskin needed to be removed (unlikely), that does not sweep aside the ethical reality. Only the boy can make the decision of foreskin versus contributing to science and industry, even if profit is involved for himself.

The utilitarian argument surrounding how many people he might help is irrelevant, but Western culture doesn’t care about irrelevancy. But what does the company squeeze into its utilitarian worldview? Of the two products the article does not mention, ICX-SKN and ICX-RHY, ICX-RHY is for facial rejuvenation. Consider:

ICX-RHY is a novel facial rejuvenation product designed to enhance the skin’s collagen support matrix, thus enabling the appearance of facial wrinkles and folds to be improved. It aims to provide a more youthful appearance, helping to combat the cosmetic effects of aging.

ICX-RHY comprises allogeneic, collagen-secreting human dermal fibroblasts (HDFs) presented in a sterile suspension. It is injected intradermally into the affected area using local anaesthesia. A straightforward and minimally invasive procedure – each injection will deliver a minute volume of ICX-RHY. The benefit is expected to become apparent once injected HDFs have begun to lay down new collagen within the dermis. This effect is expected to be sustained, providing long-term enhancement of the facial appearance. It is anticipated that repeat administrations will be given as required.

I’m well-read in the offensive reasons people circumcise their children, but I’m perpetually stunned by the offensive reasons people will use the suffering of another to help themselves. It’s okay for a child to lose his foreskin so that older, vain people can look a little younger? It’s okay to inject a product derived from the healthy-but-amputated anatomy of an infant? And the selling point is that the facial injection is minimally invasive? I hope to always be stunned by such asinine disregard for logic.

Not surprising is this: If you search for the word foreskin on the Intercytex website, your result will tell you that there are no results. I wonder why.