To more recent news
(More recent items first)
One step at a time...
Frankfurt court finds circumcision an unlawful personal injury
A regional appeals court in Frankfurt am Main found that the circumcision of an 11-year-old Muslim boy without his approval was an unlawful personal injury.
The Sept. 20 decision opened the way toward financial compensation for the boy.
The case may have repercussions for the practice of ritual circumcision in Germany by Muslims and Jews. The court suggested, in part, that it was a punishable offense to subject one's child to teasing by other children for looking different. [This is a red herring.]
The boy, now 14, plans to sue his father for 10,000 Euro (about $14,000), according to a report by the German ddp press agency.
Reportedly, the boy, whose parents are divorced, was visiting his father during a vacation when his father forced the ritual circumcision. The boy lives with his mother, who had always rejected circumcision. Muslim boys are traditionally circumcised at elementary school age.
According to the court, circumcision can "be important in individual cases for the cultural-religious and physical self-image," even if there are no health disadvantages involved. So the decision about whether or not to go through with a circumcision is "a central right of a person to determine his identity and life."
The court did not give an age minimum at which their parents must seek a child's permission to perform a circumcision. The amount of damages depends, said the court, on the extent to which the boy suffered long-term physical or emotional damage, or "whether his peers would tease him for looking different."
Schmerzensgeld wegen unfreiwilliger Beschneidung eines Jungen
Die im muslimischen Lebens- und Kulturkreis übliche Beschneidung von Jungen stellt ohne wirksame Einwilligung in die Vornahme des ärztlichen Eingriffs eine Verletzung des allgemeinen Persönlichkeitsrechts und rechtswidrige Körperverletzung dar, die ein Schmerzensgeld rechtfertigen kann. Dies hat der 4. Zivilsenat des Oberlandesgerichts Frankfurt am Main jetzt in einem Prozesskostenhilfeverfahren entschieden.
Der Antragsteller begehrte Prozesskostenhilfe für eine Klage, mit der er seinen Vater wegen seiner im 12. Lebensjahr veranlassten Beschneidung auf Zahlung eines Schmerzensgeldes in Höhe von 10.000 Euro in Anspruch nehmen will.
Die Eltern des Antragstellers sind geschieden. Der Antragsteller wohnt bei seiner Mutter, die auch das alleinige Sorgerecht für ihn hat. Zum fraglichen Zeitpunkt verbrachte er jedoch die Ferien bei seinem Vater, einem streng gläubigen Moslem. Auf dessen Veranlassung hin wurde der Junge von einem Arzt beschnitten. Die Mutter, die nicht Muslima ist, hatte die Beschneidung stets abgelehnt.
Der Prozesskostenhilfeantrag hatte in 2. Instanz Erfolg, weil dem Antragsteller ein Entschädigungsanspruch wegen Verletzung seines allgemeinen Persönlichkeitsrechts und rechtswidriger Körperverletzung zustehen könne. Sein Vater habe den nicht einsichts- und nicht einwilligungsfähigen Jungen bewogen, sich der Beschneidung zu unterziehen, ohne Inhaber des elterlichen Sorgerechts zu sein und damit rechtswidrig in dessen Selbstbestimmungsrecht eingegriffen. Dabei lässt der Senat ausdrücklich offen, ob generell und bis zu welchem Alter die Einwilligung zu einer Beschneidung durch muslimische Eltern als vom Erziehungs- und Sorgerecht umfasst angesehen werden könnte. Die Beschneidung könne, auch wenn sie keine gesundheitlichen Nachteile mit sich bringe, im Einzelfall für das kulturell-religiöse und körperliche Selbstverständnis des Betroffenen von Bedeutung sein. Die Entscheidung hierüber falle deshalb in den Kernbereich des Rechts einer Person, über sich und ihr Leben zu bestimmen. Die Zubilligung eines Schmerzensgeldes setze nicht voraus, dass der Antragsteller tatsächlich körperliche oder seelische Nachteile erlitten habe oder erleiden werde. Angesichts der Schwere der Verletzung des allgemeinen Persönlichkeitsrechtes rechtfertige allein schon die Genugtuungsfunktion eine Geldentschädigung. In welcher Höhe ein Schmerzensgeld letztlich gerechtfertigt sei, hänge davon ab, ob und inwieweit der Antragsteller langfristig körperliche oder seelische Nachteile erleide oder, wie er behauptet, wegen seiner Andersartigkeit von gleichaltrigen verspottet werde. Diese Umstände bedürfen nach Auffassung des Senats noch der Darlegung im Einzelnen. Zu berücksichtigen sei dabei auch, dass die Beschneidung im Allgemeinen für die Sexualität des Mannes keine Bedeutung habe und der Antragsteller noch darlegen müsse, worin gerade für ihn in der Beschneidung ein Leiden liege. Über die endgültige Höhe des Schmerzensgeldes ist daher nunmehr im Klageverfahren zu befinden.
Oberlandesgericht Frankfurt am Main, Beschluss vom 21. August 2007 - Az: 4 W 12/07
Die Entscheidung ist in der Landesrechtssprechungsdatenbank (www.rechtssprechung.hessen.de) abrufbar.
Pressesprecher des Oberlandesgerichts: Dr. Wolfgang Weber
Though it's obviously unprepared...
Zambia forges ahead with circumcision plans
There is standing room only in Room 3 of the urology clinic at the University Teaching Hospital (UTH) in Lusaka, Zambia's capital. About 30 young men and a handful of mothers with male children listen attentively as Sitali Mulope, clinical officer, briefs them on the benefits of surgically removing the foreskin of the penis.
Although he downplays this particular benefit, he and his colleagues are well aware it is one of the main reasons why the room is so full.
Like other countries in the region, Zambia has a high HIV infection rate of about 17%, while male circumcision is only practiced by about 20% of the population, mostly as part of a traditional rite of passage for boys in the country's North Western Province. [In Europe, the proportions are reversed, and in Lesotho and Ethopia, a high circumcision rate has failed to prevent a high HIV rate.]
The initial phases of both clinics were supported by JHPIEGO, an international health organisation affiliated with John Hopkins University in Baltimore, with funding from the United States Agency for International Development (USAid). Zambia's Health Department has since taken over the costs of the two clinics, where patients pay 10 000 kwacha (about $2,50), a fraction of the actual cost of the procedure.
At an estimated $69 per person, Bowa described circumcision as highly cost-effective, considering it is a one-time, permanent intervention unlike, for example, life-long antiretroviral treatment. [Bad example. How about the cost of condoms?]
Until funding for more clinics can be found, the government is reluctant to launch an education campaign promoting male circumcision as a means of HIV prevention, while emphasising that it only provides partial protection against HIV and other sexually transmitted infections.
In the absence of such campaigns, Richard Hughes, country director for JHPIEGO in Zambia, worries that "people are taking information where they can find it".
Simpungwe confirmed that research by the Health Department found that some Zambians believed they could have unprotected sex after being circumcised. "It worries us a lot, because then we think we'll be reversing our achievements," he said. "When we start doing mass circumcision we will bombard them with the correct health education."
Mulope's session in Room 3 is part of the information UTH gives men before and after surgery. There is also a one-on-one session with the doctor or clinical officer who will perform the surgery and several follow-up appointments.
He appears to be struggling to provide information that is relevant and appropriate to the young men in the room as well as the mothers with small children. Asked how long the wound will take to heal, he advises adults to be "very reserved" for at least a month after the surgery. Only towards the end of the session, in response to a question, does he bring up the necessity of continued condom use after circumcision.
In the absence of detailed guidelines from the WHO, Bowa admitted "we struggle with what is the minimum counselling message, because the period we have to deal with these clients is very short and if the message is too long people get discouraged".
Staff shortages are another obstacle. "Normally, if we have enough manpower, we separate the guardians with kids from the adult men," said Chipo Musiwa, who doubles as clerk and counsellor at the UTH clinic. "We could do with at least two more counsellors."
Some of the pressure on the UTH clinic will be relieved when a stand-alone adult male circumcision unit opens at the nearby "New Start" HIV voluntary counselling and testing (VCT) centre, funded by the Society for Family Health, an affiliate of the non-profit social marketing organisation, Population Services International (PSI) [based in Washington, DC].
Phiri worries that without guidelines, men circumcised at most private clinics and public health facilities are not receiving counselling or the offer of an HIV test.
"It's a challenge to inform clinicians that the WHO says, 'Now we recommend male circumcision as a prevention tool', but also emphasising the counselling part of it," he said. "We're going to be informing private practitioners of the importance of the counselling component but we have to do this carefully, so we don't create too much publicity and a demand that will swamp us."
According Bowa: "Health workers are already overstretched ... We really need to expand the staffing levels to roll out [a national circumcision programme]."
"Everything we do is a human resource constraint," pointed out Hughes. "Nobody would have dreamed of doing what we've done with antiretroviral therapy, with the kind of resources that were there. You have to make choices, and you have to choose the things that are going to make the most difference."
Circumcision and its bedfellows
Catholic World News
Islamic party forms in Finland
Helsinki, Sep. 12, 2007 (CWNews.com) - Europe's first Islamic political party has formed in Finland.
The Finnish Islamic Party plans to collect 5,000 signatures in order to qualify for official registration by the end of the year. Counting on support from the 55,000 Muslims living in Finland, the party anticipates some success in next year's municipal elections as well as in the 2011 parliamentary elections. Party spokesman Abdullah Tammi acknowledged to reporters that to date the party has enrolled only a few dozen members.
The Finnish Islamic Party platform supports a ban on alcohol sales, the option for Muslim children to be excused from school music classes and outings to swimming pools, legal status for ritual animal killing and male circumcision, and the eventual introduction of shari'a law in Finland. Tammi added that the purpose of Sharia law was to prevent crime.
Circumcision at all costs
Jewish groups join circumcision fight
Posted by dlane September 12, 2007 13:54PM
The Anti-Defamation League and several national Jewish organizations filed a friend-of-the-court brief in support of a Washington man who wants to circumcise his son against the wishes of the boy's Oregon mother.
The dispute is pending before the Oregon Supreme Court, which has scheduled oral arguments for Nov. 6.
The groups agree with James Boldt, a Jewish convert who says he should be able to make the decision for his 12-year-old son because he is the custodial parent.
Lia Boldt says the boy is afraid to tell her ex-husband that he does not want to be circumcised. She also says circumcision is dangerous.
The Anti-Defamation League says that "routine male circumcision is the type of religious and medical decision [routine circumcision is not a medical procedure] that is squarely within the rights of the custodial parent," according to a news release. "Enabling the circumcision of a child ["Enabling"? As if the boy is asking the father's permission to be circumcised. How about "imposing" or "enforcing"?], whether as part of a religious conversion or for medical reasons, cannot as a matter of law indicate any infirmity in a parent's ability to function as a parent. Moreover, any decision to single out circumcision as a basis for questioning the fitness of the custodial parent would violate the First Amendment's guarantee of freedom of religion." [- assuming that only the parent has freedom of religion - what about the son's freedom of, and from, religion?]
The American Jewish Congress, American Jewish Committee and the Union of Orthodox Jewish Congregations of America also signed the brief.
-- Ashbel S. Green
[Since the boy's mother is not Jewish, and not planning to convert, then according to Orthodoxy, the boy is not Jewish. Why is that not the end of the story? Or from the ADL's brief itself (p12),
A stone under the wheel of the juggernaut?
S.Africa on course with AIDS plan: deputy president
13 hours ago
PRETORIA (AFP) — South Africa's deputy president said Monday the AIDS-blighted country was on course in efforts to combat the disease despite a slew of recent controversies in the health ministry.
Phumzile Mlambo-Ngcuka, chaired the first meeting of the newly formed South African National Aids Council (SANAC), which was attended by the controversial health minister Manto Tshabalala-Msimang and members of civil society in the capital Pretoria.
"We are on course. There is work in progress... up until 2011," said Mlambo-Ngcuka.
Tshabalala-Msimang, who came under constant criticism over her AIDS policies especially her promotion of vegetables over the use of anti-retrovirals, said SANAC had been briefed on major policy issues such as the role of male circumcision as a prevention tool.
She said that despite several studies showing that male circumcision could lessen chances of contracting HIV, there was a need to study the socio-cultural impacts of rolling out a circumcision plan.
She said a meeting with the World Health Organisation had decided to view results of several studies as "unfolding" rather than "overwhelming" evidence to investigate further before taking policy decisions on male circumcision in Africa.
Slowly, word gets out...
Daily Nation (Kenya)
This is a land where women prefer to be known as men
Story by CHARLES ONYANGO-OBBO
THERE ARE TWO REWARDS one gets from writing columns in newspapers. First, it is one of the best ways to develop a thick skin. After nearly every article, there will be many letters from dissatisfied readers calling you moron and a joker. After some years, you get used to the insults and they no longer injure your self-esteem or ego, if you have one.
Secondly, no matter the subject you write about, there will be thousands of people out there who know more about it than you do. A few will always write in to give you useful education. It’s amazing some of the things you sometimes find out.
Not too long ago, I wrote an article in Nation’s sister publication The EastAfrican, basically railing against studies that were claiming that circumcision can help reduce Aids infection in Africa by over 50 per cent. I didn’t know that there is an international organisation called Catholics Against Circumcision (CAC).
CAC’s director Petrina Fadel wrote in to say: “The media has written extensively about this research that claims that circumcision is the cure-all for preventing HIV, but very little about the flaws within these studies.”
Turns out, there are many studies showing that either circumcision does not make a difference to the spread of Aids, or might actually increase it.
A Dutch study in March cast serious doubts on the wisdom of promoting male circumcision to prevent HIV infection, not only because of the risk of increasing HIV in women, but also because circumcision removes a natural HIV-1 barrier from men.
The more scientifically minded can learn more about this study at www.cirp.org /news/healthday2007-03-05/.
At about the same time, the medical journal, ‘Annals of Epidemiology’, found that circumcision is actually “likely to spread” HIV.
The main line in most of these studies is that if too many men got to believe that circumcision truly helped prevent HIV, then circumcised men would not need to worry about other methods of HIV prevention.
This would put more women at risk. In the end, this false sense of security that circumcision provides could increase the incidence of HIV in Africa.
Fadel cited a preliminary study in Malawi, which suggested that the incidence of HIV is highest where male circumcision is highest.
The United States, we learn, has a long history and experience with circumcising millions of men in the past century under hygienic medical conditions. This has not prevented circumcised males from acquiring HIV.
INSTEAD, THE US HAS ONE OF THE highest rates of HIV in the developed world, despite the fact that male circumcision there has been widespread. This is in contrast to Europe where male circumcision is rare and HIV rates are relatively low.
CAC is also sceptical about the medical value of circumcision because, it says, in the late 1800s, medical luminaries promoted circumcision to prevent a variety of problems/diseases.
All that scientists are doing now is to add HIV to the historical list of diseases circumcision will purportedly prevent — epilepsy, spinal paralysis, curvature of the spine, club foot, rectal prolapse, malnutrition, cancer, eye problems, nervous disorders, and tuberculosis!
Of course, we know that it didn’t cure any of these diseases. In the interests of full disclosure, we must report that as a Catholic organisation, CAC doesn’t think much of condoms, and believes that “behaviour is the key component in preventing HIV”.
To even more intriguing matters, we go next to Albania, ...
Not all are swallowing it...
Papua New Guinea Post-Courier
DOCTORS are in disagreement over whether male circumcision should be encouraged as one way to prevent the spread of HIV in this country. Many doctors talked to by the Post-Courier gave differing views, following a paper presented by senior gynaecologist Professor Glen Mola at the medical symposium in Port Moresby yesterday.
Professor Mola’s paper was based on the findings of studies conducted on male circumcision in three places in Africa which had generally shown that the chances of circumcised male getting HIV infection [in one year] was 60 per cent [of the chance of an intact man getting it.]. Professor Mola argues that this was not as strong as use of a condom which has something like 99.9 per cent of reducing a person’s chances of getting infected. Professor Mola had also argued that male circumcision could not be encouraged as a HIV prevention method because one could still use condoms even after he had a circumcision, while at the same time the country did not have enough doctors to perform circumcision on so many people.
In other words, the country’s health services could not afford to encourage this practice simply because it did not have the capacity to do so.
“It is estimated that the lifetime HIV infection prevented per circumcision in a community approximately equals the prevalence of HIV in the community,’’ Professor Mola said.
“The complications of male circumcision include sepsis, hemorrhage and penile skin problems of delayed healing and scarring.
“In the healing phase (and possibly up to two years when full keratinisation of the penis occurs after circumcision) HIV transmission will actually be increased,’’ he said. Chairman of the organising committee of the Medical Symposium and senior surgeon at the Port Moresby General Hospital Dr George Gende said he was at the recent International AIDS Society Conference in Sydney where there was a lot of excitement about the findings on the study into circumcision in Africa.
The demonstrations shown at the time also indicated promising results and therefore he would not hesitate to help if someone came to him and asked for a circumcision.
Raise the double standard high!
Women urged to shun trendy plastic surgeryDoctors assail genital procedures
By Judith Graham
Issuing a strong warning to women, a prominent physicians' group stated Friday that there is no evidence cosmetic genital surgery is safe or effective.
The statement by the American College of Obstetricians and Gynecologists (ACOG) says it is "deceptive to give the impression" that these procedures, which by some accounts are among the hottest new trends in plastic surgery, are "accepted and routine surgical practices."
"Vaginal rejuvenation," "designer vaginoplasty," "revirgination" and "G-spot amplification" are being marketed to women on late-night TV, in magazines and on the Internet. Doctors offering the procedures say they can enhance women's sexual pleasure and alleviate uncomfortable symptoms, and many of their patients agree.
But critics say these women are exposing extraordinarily sensitive body parts to interventions with questionable benefits and unknown risks.
"Absence of data supporting the safety and efficacy of these procedures makes their recommendation untenable," the medical group's Committee on Gynecologic Practice concluded in a two-page statement published in the September issue of its magazine.
Other experts express concern that practitioners are offering surgical fixes to problems better addressed by correcting women's misconceptions about their bodies and boosting their self-esteem.
The risk, of course, is that patients could suffer harm from the surgeries, including bleeding, scarring, infection and altered sensation, while experiencing little or no benefit.
The British Medical Journal weighed in on the topic with a May article calling cosmetic genital surgeries an "extreme and unproved intervention" that "could undermine the development of other ways to help women and girls to deal with concerns about their appearance."
Male circumcision has no role in the Australian HIV epidemic
Background: Male circumcision is a surgical procedure that involves the removal of all or part of the foreskin from the head of the penis. It is an ancient practice that has been performed in some cultures for millennia – well before the advent of sterile surgery.1 It has ritual significance in some cultures, and so its practice may be ceremonial, performed with non-surgical instruments by elders rather than doctors, and without anaesthesia.2 It is an irreversible procedure. Different cultures have performed the rite at different stages of life: commonly in preadolescence as part of a ritual of becoming a man; sometimes for older adult men as a sign of status; and in more recent history, in infancy. Cultural identity may also be entwined with non-circumcision. 3 In the twentieth century in industrialized countries such as Australia and the United States, circumcision became very popular for reasons that are not clear but do not appear to be directly related to religious or specific ethnocultural affiliation. This trend was reversed in Australia in the 1980s and 90s due to increased acceptance that circumcision provided no medical benefit.
Recent data from three major trials in Africa challenges the notion that it is of no benefit. Adult male circumcision has been found to reduce the risk of acquiring HIV in men by around 55-60% in three randomised controlled studies4 5 6. These trials were conducted in African countries where HIV is endemic – Uganda, South Africa and Kenya. Heterosexual vaginal intercourse is the predominant mode of HIV transmission in these countries. Circumcision did not provide complete protection against HIV, but researchers concluded that circumcision reduced the risk of HIV acquisition in the study groups. While there were high rates of HIV acquisition in both arms of these studies – the circumcised and the uncircumcised – rates were lower in the former group7. Following the release of these trial results UNAIDS and the World Health Organisation held an international consultation to analyse the data and consider policy implications. Mass circumcision programs are being proposed throughout the sub-Saharan region. 8 While consideration is being given to making such programs culturally sensitive, the proposed implementation of male circumcision raises complex moral problems relating to cultural practice, gender equity, informed consent, and the just allocation of limited resources.
The Australian epidemic
Circumcision to reduce HIV risk for heterosexual men in Australia?
The African epidemic
A Growing Number Of Activists Are Hesitant To Decry Female Genital Mutilation
Academia's fixation on cultural sensitivity is changing the debate around female genital mutilation, with a growing number of professors and women's rights activists becoming hesitant to condemn the practice. [Or developing more effective ways to condemn it?]
Where feminists rallied against the operation from the pages of Ms. magazine in the 1970s, today's critics are infinitely more cautious, with most suggesting that the Western world butt out until Muslim African communities are ready to reconsider what they are doing to their daughters.
The shift in attitudes about the practice-- which in the worst of cases involves the carving out of a woman's clitoris and inner labia and can cause lifelong urinary tract infections, sterility and even death -- comes at a time when high-profile victims of the operation such as writer Ayaan Hirsi Ali and model Waris Dirie, both Somalis, have launched very public campaigns against the practice.
The issue is so explosive, it has two names -- female genital mutilation, or FGM, to those most vociferously opposed to the practice; and female genital cutting, or FGC, to those in the less-condemning camp. [No, the more objective name is used tactically, to reach those who would not accept the m- word.]
The latter includes the chair of anthropology at the University of Toronto, who has written a new book on the subject. Although not prepared to defend what she calls FGC, Janice Boddy defends women who undergo the operation and want the practice to continue in future generations.
Today, Prof. Boddy says, the battle cry is human rights. Back then, it was colonial notions of civilizing the other. It's a stance that pits her against many critics, including the World Health Organization, which called for the absolute abolition of the practice in the 1970s.
The human rights group Amnesty International considers FGM a form of violence against women, and the end result of discriminatory attitudes and beliefs. But even their representatives are careful when speaking of the operation.
"The motivation is not one of malice or desire to hurt but really to make sure that the daughter is taken care of," says Cheryl Hotchkiss, women's rights campaigner with Amnesty International Canada.
"But what needs to be examined from a human rights perspective is why is it that in order for a woman to live a good life does she have to undergo such an extreme experience?
Ms. Hotchkiss says the key lies in changing those notions of desirability, likely through a combination of state law, grassroots efforts and intervention by the medical community.
"[These societies] see women's bodies used as the holders of tradition? That's still because the society sees women's bodies as not their own. They see them as a tool.
"What Amnesty's desperately trying to get across, along with women's human rights activists the world over, is that women's bodies are their own and they need the right to say what is and what isn't going to happen to them."
[These arguments are equally applicable to males.]
Voices of sanity start to emerge...
Conseils nationals du sida (French National Committee on AIDS
Report on Male Circumcision:
"repeated study visits and intensive behavioural counselling" - are they the real key?
Circumcision Age-old surgery touted to reduce HIV
For more than four millennia different cultures have practised male circumcision. But the simple procedure in which the foreskin - the sleeve of skin covering the tip of the penis [No, the foreskin is an integral part of the penis. It covers the glans.] - is removed, emerged during the recently-concluded HIV science conference as the most exciting news in prevention.
Scientists in the field are now convinced that circumcision reduces female to male transmission of the virus. University of Illinois epidemiologist Prof Robert C Bailey gave the go-ahead for the rapid roll-out of circumcision in 14 sub-Saharan countries where prevalence rates of HIV are high and heterosexual sex is the epidemic's main vehicle.
Africa herself suggested the strategy. For just over a decade researchers have actively investigated why the virus hadn't managed a strangle hold in those African countries where circumcision is widely practised. [This is nonsense. It has.] In fact, despite similarities with countries where as many as one in four adults is infected, the adult HIV prevalence rate has never been higher then eight per cent in states with nearly universal circumcision. [A figure achieved by careful choice of countries. This is correlation, not causation.]
Observational studies conducted in the latter half of the 1990s found that there was between a two and eight-fold risk of HIV infection for uncircumcised men. But there were still questions. Were other cultural factors really responsible for lower HIV infection rates among circumcised men?
The answer [No, an answer] came from three recent [prematurely curtailed] studies in South Africa, Kenya and Uganda. When circumcised men were compared with control[led] groups of the uncircumcised, researchers found a 50 to 60 per cent reduction in HIV incidence.
But this isn't foolproof. There are concerns that the procedure will lead men to increase sexual risk-taking, thereby reversing any positive impact of the procedure.
"Aah," one subject said during trials, "I have a natural condom."
Bailey admitted that the studies in South Africa, Uganda and Kenya found an increase in the number [of] sexual encounters, less consistent condom use and an increase in unprotected sex respectively among the circumcised. But he said that with repeated study visits and intensive behavioural counselling there were eventually reductions in risk behaviours.
[And who would get the repeated study visits and intensive behavioural counselling, but the men thought most likely to need them, the circumcised experimental group?]
"Male circumcision is not a stand alone procedure," he emphasised. "It should be integrated with other HIV and STI prevention strategies."
There are also concerns that the message could lead to a surge in procedures performed by unqualified providers. There is a low risk of bleeding or infection among men circumcised by experienced practitioners in the west-around two to three per cent. That number rises alarmingly when lay providers step in.
Things could horribly wrong in another way. A trial in Rakai, Uganda involving couples in which men were HIV positive and the women were not was stopped recently. The men resumed sexual activity before their wounds had healed properly, causing an increase in transmission to their partners.
In a telephone interview recently Prof Courtenay Bartholomew of the Medical Research Foundation (MRF) was reserved in on-record commentary about the relevance of these findings to Trinidad and Tobago.
"At this stage the MRF is not considering recommending male circumcision as a means of lessening the risk of HIV transmission," he said.
And how much for condoms ... ?
Anti-AIDS Program To Fund Circumcision
U.S. Initiative Targets African Men
By Craig Timberg
JOHANNESBURG, Aug. 19 -- President Bush's $15 billion anti-AIDS program will begin investing significant money in making circumcision available to African men seeking to protect themselves from HIV, top U.S. health officials said Sunday.
Recent research showing that circumcision dramatically cuts the rate of HIV infection is highly convincing, a delegation of U.S. officials, led by Health and Human Services Secretary Mike Leavitt, told reporters in Johannesburg.
Countries taking part in the President's Emergency Program For AIDS Relief have been invited to seek money to expand access to the procedure.
Circumcision funding would be small at first, with budgets in the hundreds of thousands of dollars for individual countries. But it is likely to grow to be "an important part" of the program in coming months and years, said Kent R. Hill, an assistant administrator for the U.S. Agency for International Development.
The cells in the foreskin of a penis are especially vulnerable to HIV [... yet they are protective against it ...], and removing the foreskin makes a man about 60 percent less likely to contract the virus, studies in South Africa, Kenya and Uganda have shown. The research reinforces studies showing that regions with high circumcision rates generally have lower rates of HIV. [by ignoring the regions that don't]
In Kenya, men from the Luo tribe, which does not circumcise its boys, have an HIV rate of 24 percent compared to a national rate of 7 percent. Kenya is among the nations preparing to expand circumcision services, Hill said.
Some other African nations have reacted warily to the studies. Most tribes in Africa once routinely circumcised boys in manhood rituals but the practice has declined in southern Africa, in part because of the influence of European missionaries who discouraged the practice as primitive.
Last year, before the recent studies, the Bush administration cut funding for a small program that was offering circumcision to men in Swaziland, where an estimated one in three adults is infected with HIV, the highest rate in the world. Swazis do not generally circumcise their boys.
The Bush administration had been reluctant to support circumcision services until there was broad international consensus on the issue, Hill said. But the recent studies [which all have the same faults] made clear that "this is going to be one of the major interventions in the international arsenal" against AIDS, he added.
In the same meeting with reporters, Leavitt declined to comment on mounting criticism here of the personal behavior of South African Health Minister Manto Tshabalala-Msimang....
Or does it increase it?
Circumcision Status Does Not Affect Women's STI Risk
Medscape Medical News 2007. © 2007 Medscape
August 7, 2007 (Seattle) — Male circumcision (MC) has been found to reduce risk of HIV acquisition for the men themselves, and the emerging body of evidence — 3 recent randomized [but not double-blind] controlled trials and scores of observational studies — supporting this has spawned strong interest in employing the surgical procedure as a preventive measure. Little has been known, however, about whether MC reduces the risk of non-HIV sexually transmitted infections (STIs) in women. A new study, presented here at the 17th Meeting of the International Society for Sexually Transmitted Diseases Research, suggests that the protective effect of MC may not transfer to STI risk reduction in female sexual partners.
The multicenter study, analyzing data from a prospective cohort study (the HC-HIV Study) of 5925 African and Thai women on the association between hormonal contraception and HIV or STI, found that MC did not significantly reduce women's risk of acquiring gonococcal, trichomonal, or chlamydial infections.
"There was little difference [in STI incidence] between the women with circumcised partners and those with uncircumcised partners — so we concluded that there really was no effect of circumcision in this population," said study coauthor William C. Miller, MD, PhD, MPH, associate professor of medicine at the University of North Carolina at Chapel Hill. He noted that there also is no conclusive evidence that MC is protective against men's acquisition of the 3 STIs studied, despite the fact that male foreskin is known to be a "hospitable" environment for pathogen growth. [How is it "known"?]
The study was conducted in a population of women who were primarily at low risk for an STI (mean age, 25 years). The participants underwent clinical examination and specimen collection at baseline and every 3 months for a period of 15 to 24 months. Overall, 52% of participants reported having a circumcised partner, and 87% cohabited with their partner. Only 9 of the women were found to have an STI at enrollment.
At endpoint, the incidence of chlamydia per 100 person years (PY) was 4.5 in women with circumcised partners compared with 3.9 per 100 PY in the women with uncircumcised partners. [Looks like more partners of circumcised men got chlamydia.] Respective results for gonococcal infection were 3.7 and 3.1 [Looks like more partners of circumcised men got gonorrhoea.] and were 4.7 and 3.9 for trichomonas [Looks like more partners of circumcised men got tricomonas.] . In multivariate analysis, after controlling for contraceptive method, age, coital debut age, and country, the adjusted hazard ratio (HR), comparing women with circumcised partners with those with uncircumcised partners, was 1.22 for chlamydia and 0.93 for gonococcal infection. Interestingly, in analyses of the women who reported having only 1 sexual partner, women with circumcised partners appeared to have slightly higher risk of chlamydia (1.01 vs 1.75; HR, 1.33) than those with uncircumcised partners. [If this had gone the other way, they would have called it "the highly protective effect of circumcision against chlamydia." And Laumann et al. found that circumcised men were at considerably higher risk of chlamydia, but they too discounted that finding.]
Overall, the findings did not surprise King Holmes, MD, PhD, director of the Center for AIDS and Sexually Transmitted Diseases at the University of Washington in Seattle, but they did, he suggested, indicate the need for longer-term study. "The study is interesting, but one point to make is that chlamydia and gonorrhea involve the urethra and not the penile epithelium, so they're not the prime suspects for diseases that are affected by male circumcision," he said, unlike diseases such as chancroid, herpes, and syphilis. "The question that remains, I think, is whether male circumcision will be associated with increased risk of bacterial vaginosis — some data have suggested that women with uncircumcised partners have an increased risk." [So, ignore an apparent protective effect of non-circumcision, and look for some other disease for circumcision to be good for.]
Dr. Miller acknowledged the study's limitations, particularly its reliance on both secondary data and self-reported sexual and behavioral data. He also noted that although MC interventions are being planned worldwide to stem transmission of HIV, "the effect of [male] circumcision on women's STI risk is not yet known." [So they're proposing a major and expensive campaign of surgery on men which might increase women's risk of contracting sexually transmitted diseases....]
Dr. Miller and Dr. Holmes report no relevant financial relationships. [But are they circumcised?]
17th Meeting of the International Society for Sexually Transmitted Diseases Research: Abstract 449. Presented July 30, 2007.
A voice of humanity ...
Children's Commissioner wants circumcision banned
Tasmania's Children's Commissioner, Paul Mason, wants the State Government to ban the non-medical circumcision of young boys.
Female genital mutilation is illegal in Tasmania.
Mr Mason said it's unfair that boys aren't given the same protection.
"We're discriminating against the little baby boys themselves, because they're not safe whereas the little girls are," he said.
He said circumcision is an abuse of human rights and should be outlawed until the person is old enough to decide for themselves.
"It's a permanent procedure. They get no choice. It's painful - even under anaesthetic."
Mr Mason has prepared a report on the issue for the Council of Obstetric and Paediatric Mortality and Morbidity.
The Council will forward a recommendation to the State Government.
A spokesman says the Government is not currently considering laws in relation to the issue.
The Commisioner's press release of December 6, 2008
The dominoes start falling ... ?
SOUTH Australia's Health Department is reviewing its position on circumcision.
Victoria announced yesterday ...
An SA Health Department spokeswoman said the issue was under review, with a report to be finalised within a month or two.
While circumcision is obtainable in the state's public hospitals, printed information for parents discourages the practice.
The Child and Youth Health website says medical opinion states there is "no medical reason for routine male circumcision".
That's one small step for boys ...
Snip 'not worth cost'
Suellen Hinde and Kelvin Healey
CIRCUMCISION will be banned in Victorian public hospitals unless it is for medical reasons.
The State Government has ordered the ban, which starts next month, following medical advice that circumcision of baby boys was unnecessary.
Health Minister Daniel Andrews said circumcisions would be performed only when doctors were concerned about infection or disease.
"Nationally and overseas, doctors agree there is no medical benefit to routine circumcision, and studies show the complication rate is about 5 per cent," Mr Andrews said.
The $2 million a year saved by the ban will be spent on urgent elective surgery.
"It is important to ensure hospital services are prioritised towards treating patients who have a clinical need for surgery to improve their health," Mr Andrews said.
Ministerial Advisory Committee on Elective Surgery chairman Prof Michael Grigg said it was hard to justify spending taxpayers' money on routine circumcision.
"We should be spending relatively scarce health dollars as effectively as we can to benefit the maximum number of people," he said.
Prof Grigg said circumcision had marginal health benefits for some people, but also had a risk of complication.
About 2200 circumcisions were performed by Victorian public hospitals in the 2005-06 financial year.
Parents who want to have their sons circumcised for religious reasons will have to use a private hospital.
The Age, Melbourne
Victoria to scrap funded circumcision
From next month, Victoria will be the fourth Australian state to no longer provide circumcisions at public hospitals for non-medical reasons.
While recent studies of African countries suggested circumcision can reduce the rates of HIV, a report by the World Health Organisation concluded that in countries such as Australia, where HIV rates are low in the general population, limited benefit would result from routine circumcision, according to the Victorian government.
The Jerusalem Post
Second Egyptian girl dies during circumcision
By ASSOCIATED PRESS
A 13-year-old Egyptian girl died during a circumcision operation, the second such case reported over the past two months, local media said Saturday.
The doctor involved has been referred to the state prosecutor for investigation and his clinic in the rural Gharbiyah province has been closed down, state-owned al-Gomhoria daily reported.
The earlier death of a 12-year-old girl during a circumcision operation in June sparked a public outcry and prompted the government to officially ban hospitals from performing the traditional procedure which is widespread throughout Egypt.
Forward to the past!
Health benefits of male circumcision should be recognised by public health system
Press Release: Massey University
Massey's Director Pasifika wants the Government to consider making circumcision available through the public health system in light of studies suggesting the procedure has health benefits for men and women as well as being considered important to Pacific people.
Professor Sitaleki Finau says studies show male circumcision helps prevent the spread of sexually transmitted diseases, including Aids, and there is a proven [false] link between circumcised men and a decrease in cervical cancer caused by the human pampilloma virus.
He says New Zealand health authorities should take note of World Health Organisation backing for United States trials in Uganda, Kenya and South Africa confirming male circumcision can cut heterosexual HIV transmission by up to 60 per cent.
In a paper titled Circumcision of Pacific Boys: Tradition at the Cutting Edge, presented at a recent Public Health Association Conference in Auckland, Professor Finau provided insights into why most Pacific boys in New Zealand and in the islands continue to be circumcised.
This is despite a dramatic swerve away from the procedure that was almost standard for all army recruits [??] and newborn boys born in New Zealand in the 1940s.
About 95 per cent of newborn boys were circumcised in that decade, but the numbers started to decline about 1950 to the point where circumcision rates in public hospitals last decade were about 0.35 per cent of total male births. [Those figures are almost certainly taken from this very site - they aren't available together anywhere else.]
Currently, circumcision on social or religious grounds is unavailable in the New Zealand public health system and although virtually all of the 100,000 Samoan and Tongan males living in New Zealand are circumcised, the procedure must be paid for at private surgeries and health clinics.
Professor Finau thinks the Ministry of Health should review its policy - despite the climate of heightened emotion about human rights and the non-therapeutic removal of foreskin described by some men's groups as genital mutilation.
Evidence that circumcision lowers a boy's chance of suffering urinary tract infections, eliminates the risk of infections under the foreskin, decreases the risk of developing cancer of the penis (although a very rare condition) and reduces the risk for men of contracting sexually transmitted diseases are grounds for making male circumcision, he says.
"It's in the national interest to circumcise men to protect men and women, and save on cervical cancer management. Women would be getting a good deal if more men were circumcised."
Professor Finau says male circumcision among Pacificans is "a solemn ritual" and an important male rite of passage carried out between the ages of seven and 15 years. "Being circumcised is sign of manliness and sexual prowess. Not to be circumcised can bring shame on a man and his partner and family."
He says there is evidence male circumcision [No, supercision, which removes no tissue] was being done in the Pacific before the arrival of Europeans. The use of bone, bamboo and shell tools has been replaced by modern medical methods available in designated clinics such as the Langimalie Clinic, run by the Tongan Health Society in Onehunga, Auckland. ["Langimalie" means "peace" ...]
Before joining Massey last year, Professor Finau was Professor of Public Health at the Fiji School of Medicine in Suva and has previously held academic appointments at the Universities of Otago and Auckland.
He has a medical degree from the University of Queensland as well as Fellowships from the Australasian College of Tropical Medicine, and the Australasian Faculty of Public Health Medicine.
Remuera gynacologist [specialist in the ailments of women] John Thomson is also in favour of circumcision becoming available through the public health system as an effective method of preventing the spread of sexually transmitted diseases.
Dr Thomson has performed more than 6000 circumcisions in his private clinic in the past 30 years using a non-surgical [but not non-cutting] device attached to the penis that causes the foreskin to [die and] come off in a few days.
The procedure costs from $170 for very small babies and more for older infants. He recommends babies be circumcised by six weeks of age. Most of the circumcisions he carries out are on Muslim boys.
More impossibly mixed messages. How about saying "Don't get cut, get condoms!"?
Kaiser Daily HIV/AIDS Report
Experts in Senegal Concerned About Effect of Male Circumcision Studies on Sexual Behavior of M[en who have ]S[ex with ]M[en]
HIV/AIDS experts are warning men who have sex with men in Senegal that male circumcision alone does not prevent HIV transmission and are urging MSM to use other methods to protect themselves against the virus, IRIN News reports. According to IRIN News, the warning comes after research indicated that circumcision could help prevent HIV transmission; however, the research was conducted among heterosexual men (IRIN News, 8/8).
According to final data from two NIH-funded studies -- conducted in Uganda and Kenya and published in the Feb. 23 issue of the journal Lancet -- routine male circumcision could reduce a man's risk of HIV infection through heterosexual sex by [up to] 65%. The results of the Uganda and Kenya studies mirrored similar results of a study conducted in South Africa in 2005. In response to the findings, the World Health Organization and UNAIDS in March recommended the procedure as a way to help reduce transmission of the virus through heterosexual sex (Kaiser Daily HIV/AIDS Report, 6/22).
According to the French Institute for Applied Medicine and Epidemiology, about 21.5% of Senegalese MSM are HIV-positive, compared with 0.7% of the general population. HIV/AIDS experts are concerned that the study's findings could confuse MSM and lead to more risky sexual behavior, as well as a higher HIV prevalence among the population. A 2003 study conducted by Cheikh Niang of the Cheikh Anta Diop University in Senegal's capital, Dakar, found that 23% of MSM used a condom during their most recent sexual encounter. In addition, many Senegalese MSM also have wives or girlfriends to be accepted by society -- placing more people at risk of contracting HIV -- IRIN News reports.
According to some observational research, male circumcision could reduce the risk of HIV among MSM by about 50%. However, Bertran Auvert, an author for the 2005 South Africa study, said that because the studies were observational, they "prove nothing." Auvert added that experts "can merely suppose" that circumcision offers a "certain level of protection."
Jean-Louis Rodriguez -- former executive secretary of And Ligeey, a Senegalese association that promotes the rights of MSM -- said experts do "not want to encourage people to hide behind the idea that circumcision completely prevents the transmission of HIV." Rodriguez added that HIV prevention messages "must always be targeted" toward MSM. Khoudia Sow, WHO's HIV/AIDS director in Senegal, said that targeting HIV prevention messages at MSM is "not a question of revising all our prevention techniques," adding that "circumcision could play a part in the range of existing measures, but in no instance would it substitute them" (IRIN News, 8/8).
And the contradiction comes into sharp focus ...
International Herald Tribune
Norway pledges funds to help UN fight female circumcision
OSLO, Norway: Norway pledged 20 million kroner (US$3.4 million, €2.5 million) on Wednesday to help the United Nations fight the genital mutilation of young girls through female circumcision.
The U.N. children's agency, UNICEF, has reported that 130 million girls and women have undergone such mutilation worldwide.
"Genital mutilation is a brutal violation of the basic human rights of women and children," Norwegian Aid Minister Erik Solheim said in announcing the pledge. "According to the World Health Organization, 6,000 girls are circumcised daily."
The Norwegian donation is earmarked for a special fund recently created by the U.N. Population Fund and the U.N. children's fund, UNICEF.
Solheim said the fund will work with national and local officials, religious leaders, the news media and local residents in the countries where the practice is most widespread.
A separate Norwegian-led effort launched in 2003 to curb the practice is already showing results in Kenya and Tanzania, as well as in parts Ethiopia and Eritrea, where the number of female circumcisions is declining, a news release said.
Support for Circumcision Proposal
A controversial proposal by Sweden's National Board of Health and Welfare regarding the circumcision of young boys is gaining support among political parties.
The plan, announced earlier this year, would oblige local councils to carry out a circumcision if the boy's family wanted the procedure.
It's aimed at halting the increasing number of circumcisions taking place outside of the health service, which leaves boys at a greater risk of infection.
The Minister for Health and Social Affairs, Göran Hägglund, is yet to take a stand on the issue, but fellow Christian Democrat Chatrine Pålsson Ahlgren, who sits on the parliamentary committee for social affairs, supports the proposal.
The committee's chairperson, Kenneth Johansson of the Center Party, told Swedish Radio News that he wants to see greater availability of circumcisions within the health service, and more information published to challenge some parents' belief that circumcision is prohibited in Sweden.
Circumcision Debate Cuts Deep
By Adam Voiland
Each year, at least 1.2 million American infants lose their foreskin - that retractable fold of skin and mucous membrane that covers the end of the penis - to a doctor's scalpel. Though circumcision is one of the most commonly performed procedures in the country, it's also among the most controversial. That particular patch of skin happens to lie at the intersection of conflicting notions about personal hygiene, sexually transmitted diseases, masculinity, sexuality, and religion.
Controversy over the foreskin's role in sexuality recently flared anew. A study published last week in the Journal of Sexual Medicine suggests that circumcision, contrary to popular belief, does not reduce the sensitivity of the penis. It follows on the heels of another study, sponsored by critics of circumcision and published in the urology journal BJU International in April, that reached the opposite conclusion.
Against this backdrop, the medical community is digesting research from recent trials in Africa that show circumcision can cut the risk of HIV transmission from infected women to uninfected men by as much as 60 percent. Other research has linked circumcision to slightly reduced risk of certain other infections, including human papillomavirus, which causes cervical cancer. Recent findings have prompted the American Academy of Pediatricians, an influential medical organization that represents some 60,000 doctors, to re-evaluate its policy on circumcision. The revised policy, expected within a year, could affect the availability of funding to cover the controversial operation.
The pediatrics group's existing position states that scientific evidence demonstrates potential benefits as well as drawbacks to circumcision but that those benefits are not sufficient to recommend routine circumcision. Since 1999, when the AAP adopted that stance, Medicaid programs in 16 states have stopped covering the procedure. In 2006, two states - Hawaii and Vermont - introduced resolutions questioning the need for public funding of male circumcision. Western states, which have long had lower rates of circumcision than other parts of the country, have been especially apt to drop coverage, which may have hastened the plunging rate of circumcision there: Only 32 percent of newborns are circumcised in the western United States, in comparison with 80 percent in the Midwest and 57 percent nationally, one study found.
Jewish and Muslim people have practiced circumcision for millennia, and many consider it an essential ritual. But various groups oppose the practice. "A child has a right to his own body. That's the bottom line," says Marilyn Milos, the founder of the National Organization of Circumcision Information Resource Centers, a nonprofit "intactivist" organization that maintains circumcision is an unnecessary procedure and not unlike female circumcision.
"Sorting through this has turned out to be a bit more time consuming than we may have initially thought," says AAP President Jay Berkelhamer. "The thing that makes this a difficult issue is that it's not just science. There is a level of emotion and passion on both sides of this issue."
Beyond the ethical realm, scientists are also debating the relevance of the evidence from Africa to the American context. "You have to be careful about taking data done in one environment and extrapolating them to another," says Patrick Sullivan, a branch chief in the Division of HIV/AIDS Prevention at the Centers for Disease Control and Prevention. He and other scientists emphasize that the AIDS epidemics in Africa and the epidemic in America are two very different beasts: While heterosexual sex accounts for the majority of transmission in Africa, men having sex with men drives transmission here. Scientists have not yet determined whether circumcision would reduce the latter mode of transmission, though some evidence suggests it may. His bottom line: Even people at high risk of contracting HIV shouldn't necessarily race out and get either themselves or their children circumcised.
The latest research - on the procedure's effect on pleasure - won't answer any looming medical questions, but it has rekindled other areas of debate. In last week's study, researchers at McGill University tested 20 circumcised and 20 uncircumcised male volunteers. While the men watched either pornography or a control video, Kimberly Payne and her colleagues used a thermal imaging camera and graded filaments to monitor the penis's temperature and sensitivity to touch and pain. Using the filament to test one point on the shaft of the penis and one point on the glans, they found that there was no difference between the two groups in terms of sensitivity to touch or pain. "The present data do cast doubt on the notion that the glans penis is more sensitive in the uncircumcised man," the researchers conclude.
It's unlikely, however, that the study will be the last word on the topic. Milos of NOCIRC argues it isn't even relevant to the discussion: "They didn't test the foreskin; they tested the glans," she contends. [Contends? Nobody claims they did.] In the study published in April, which her group supported, researchers concluded that circumcision destroys the most sensitive part of the penis, which they say lies on the foreskin. Payne, meanwhile, says she's already receiving hate mail about her new study. Ironically, she strongly opposes circumcision, calling the practice "barbaric."
Study: Circumcision Doesn't Reduce Sexual Sensation
New Research Fuels Continuing Debate Over Foreskin Removal
Aug. 2, 2007 -
Controversial new research casts doubt on the long-held belief that circumcision reduces sexual sensitivity for men who have undergone the procedure.
Circumcision, a procedure performed throughout history - for reasons ranging from the fulfillment of a biblical covenant to a means of curbing masturbation - has received both praise by those who tout its supposed medical benefits and scorn from those who claim it has traumatic aftereffects.
Now, in a Canadian study appearing in the most recent issue of the Journal of Sexual Medicine, researchers found that the glans, or head of the penis, is just as sensitive on a circumcised man as on an uncircumcised one.
"It's probably the best study I've seen of this kind of work," said June Reinisch, the former director of the Kinsey Institute. Reinisch was not involved with the study.
Reinisch praised the study for using the best available technology, for matching circumcised and uncircumcised subjects on a number of important factors and for taking measurements where subjects were in an aroused state - something not done in previous studies.
"It's the state in which we're all interested," said Reinisch. "We're not interested in how [men] feel when they hold themselves when they pee."
Still, the benefits of circumcision remain controversial. Research in recent years has suggested circumcision might benefit men by lowering their risk for AIDS and other STDs. Other studies suggest that the procedure may limit the risk of passing the cancer-causing human papilloma virus (HPV) onto female partners, although the merit of those studies has been disputed.
The American Academy of Pediatrics reflects that doubt in its official policy, which states: "Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision."
The Tip of the Iceberg?
In order to test the sensitivity of the penis, researchers had men disrobe and watch an erotic film. Cameras were used to measure the men's arousal.
Once aroused, researchers pressed increasingly firmer filaments against the erect penises until the subjects indicated they felt the touch, and then at the point where they felt pain.
In addition to comparable sensitivity between circumcised and uncircumcised men, the study also showed that the penis becomes less sensitive when aroused.
"When God invented sexual activity, the arousal response is actually a form of anesthesia," said Irwin Goldstein, editor of the Journal of Sexual Medicine.
"It actually makes more sense when you think of it that way," he said, explaining that if the penis became more sensitive, it might limit sexual activity and, therefore, reproduction.
While psychologist Kimberley Payne, one of the study's authors, said the research seems to refute the idea that the foreskin keeps the penis sensitive, she was hesitant to draw a broader conclusion from her study.
"This just scratched the surface, and there is so much more to look at," she said.
She said ultimately she hoped someone would be able to measure the full range of sexual sensation in circumcised and uncircumcised men during sex, but was unsure how that would be done.
Because her study only looked at two locations on the penis, Payne said future research would likely look at more areas and utilize more subjects.
A Rising Controversy
Anti-circumcision groups were quick to criticize Payne's study.
The International Coalition for Genital Integrity released a statement saying, "Poor research investigating the sensitivity of the intact [not circumcised] and circumcised penis does not serve men."
ICGI director Dan Bollinger, who in the past has called circumcision "parental-elected penile reduction surgery," pointed out that the researchers did not measure the sensitivity of the foreskin, which previous research had said was the most sensitive area.
"All of us in the movement are rather surprised that this even got published," he said.
He points to a recent study published in the British Journal of Urology, which showed uncircumcised men had four times more sensitivity, as a better measure.
Dr. Robert Van Howe, a pediatrician at Marquette General Hospital in Michigan and one of the author's of the urology journal's study, said that the findings in his study had more relevance because of the larger number of patients involved and the greater number of areas on the penis measured.
He urges parents not to circumcise their children, but to allow the children to make that decision when they reach age 18. At that point, he said, only three out of every 1,000 males elect to be circumcised.
But both Payne and Reinisch criticized the Van Howe's study, which was funded by the anti-circumcision group the National Organization of Circumcision Information Research Centers, as biased.
"Scientific study must be conducted dispassionately and without bias. The motivation of this group is highly suspect," said Payne.
Van Howe rejected the notion of bias in his study.
"The study was based on an objective finding," he said. "There's no way you can change what a person felt or didn't feel."
But Reinisch said researchers could very easily have affected data because it was apparent to researchers which men were circumcised and which were not. [This is equally true of the Payne study.] She also pointed to the fact that men in the Van Howe's study were not aroused at the time of measurement as a possible source for the difference.
As for the failure to measure the foreskin's sensitivity, Reinisch said that was irrelevant, as it rolls back from the glans during arousal. [Yes, but it doesn't come off!]
"The foreskin's job is to cover the penis and protect it," she said. "Its job is not to be a part of the sensitivity." [Says who? Isn't that what a study like this should be designed to find out?]
"Of course nerve endings are lost," she said of circumcision. "The question is: Does it make any difference in satisfaction? In pleasure?"
Missing the Point?
In the end, Reinisch said, circumcision will not affect a man's ability to be aroused or experience sexual pleasure.
"Nature has certainly provided an enormous amount of sexually sensitive tissue," she said, [and circumcision removes about half of it] calling the brain the most powerful sex organ of all. [Sure, but the brain is not much use without the penis.]
"I'm not suggesting everyone be circumcised," said Reinisch. "I'm suggesting that there are some benefits. & I believe it's really a personal choice." [Yes, and the person who gets to make that choice is ... ?]
Payne, meanwhile, said that she personally is opposed to circumcision, calling it "a barbaric practice."
"I sympathize with the efforts of [the National Organization of Circumcision Information Research Centers]," she said. "I would have loved to find evidence in my study to dispel the practice, but I did not and must report the findings accordingly."
"I hope that we will one day be able to establish some sexual drawbacks to this procedure, but these studies do not."
Ignoring the elephant's trunk in the room...
Circumcision [May Or] May Not Impact Sexual Sensation
Montreal – July 26, 2007 - According to a new study published in The Journal of Sexual Medicine, sexual sensation in circumcised and uncircumcised men may not be so different after all. The research, performed in the Department of Psychology of McGill University in Montreal, consisted of genital sensory testing conducted on circumcised and uncircumcised men during states of sexual arousal and non-arousal. Results showed that no difference between the two groups was found in sensitivity to touch or pain. [This study replicates that of Masters and Johnson. Both ignore the foreskin.]
“This study suggests that preconceptions of penile sensory differences between circumcised and uncircumcised men may be unfounded,” says Kimberley Payne, Ph.D, principal author of the study.
“People have been arguing about the sexual effects of circumcision for at least 1,000 years [Actually, till about 100 years ago, they were just about unanimous that it is deleterious] and I hope these data will encourage more research,” says Dr. Yitzchak M. Binik, co-author of the research and Professor of Psychology at McGill and Director of the Sex and Couple Therapy Service of the McGill University Health Center.
Circumcision may not affect sensation
Posted : Thu, 26 Jul 2007 17:51:15 GMT
MONTREAL, July 26 Canadian scientists have determined circumcision might not have any affect on sexual sensation.
Talbott's claim borne out
Zimbabwean inflation helps curb HIV rate
Researchers trace drop in infections to men's inability to pay for mistresses, prostitutes
July 16, 2007
CHITUNGWIZA, Zimbabwe–It's not only the prices of bread and eggs that are out of control in Zimbabwe, land of 4,000 per cent inflation. For the man inclined to cheat on his wife, these are trying times.
Keeping a mistress, visiting a prostitute or even taking a girlfriend out for beers is simply becoming too expensive, men say.
But their strain is Zimbabwe's gain in its fight against AIDS. Alone among southern African countries, Zimbabwe has shown a significant drop in its HIV rate in recent years. A major reason, researchers say, is the changing sexual habits of men forced to abandon costly multiple relationships.
"Those extramarital relationships, they're getting tough to sustain," said Thomas Muza, 37, who is struggling to support his wife and a mistress on the shrinking value of a math teacher's paycheque. Worth $50 (U.S.) a month at the beginning of June, it's now worth $17 and falling almost every day.
AIDS activists and some researchers long blamed the continent's high poverty rates for its unusually widespread HIV epidemics, arguing that poor medical care and hunger made Africans especially vulnerable to the virus, while financial need accelerated its spread by pushing women into prostitution.
Yet Zimbabwe's experience shows that the connection between AIDS and economics is not nearly so straightforward. The country has made strides against HIV during eight years of steep recession. Wealthier neighbours such as South Africa and Botswana, meanwhile, have struggled to curb new infections despite much higher levels of development and massive spending on the disease.
Many researchers now suspect that economic vitality – expressed in rising truck traffic, burgeoning bar scenes and widening income disparity – encourages the behaviours that fuel a sexually transmitted epidemic. But as men get poorer, they pare back their relationships, making them less likely to contract or spread HIV.
AIDS remains severe here, with an estimated one in five Zimbabwean adults infected with the virus that causes the disease, but surveys show the number of new infections has fallen. Men report fewer girlfriends, fewer visits to prostitutes and less casual sex – all indicators that in other countries have accompanied a retreating epidemic.
Nightclubs, cinemas and brothels have closed in Harare, the capital, and in some cases evangelical churches have taken over the buildings. Less visibly, men say they are abandoning what Zimbabweans call "small houses," a legacy of the polygamous marriages once common here.
In these relationships, married men pay rent and other living expenses for a second or even third regular sex partner. As in marriages, condoms rarely are used, creating webs of unprotected sex easily infiltrated by HIV if the man or any of the women become infected.
"Having a lot of girlfriends or having `small houses,' you've got to have a degree of disposable income," said Godfrey Woelk, an epidemiologist at the University of Zimbabwe. "Being poor and being in love does not really work, no matter what the romantics say.''
Muza once was part of Zimbabwe's broad middle class that also included the bureaucrats, engineers and factory managers whom the country's schools, once the best in Africa, turned out by the tens of thousands.
Now these same men find prices rising so much faster than their salaries that many are slipping below the poverty line.
Muza earns 2.5 million Zimbabwean dollars a month teaching, and about half goes to the rent, groceries and other expenses of his "small house.''
"It's very difficult," Muza said softly, his voice trailing off.
Among the initial skeptics about the falling HIV rate was Zimbabwean AIDS researcher Exnevia Gomo. He recalled the early speculation: Perhaps it was caused by a surge of death in the absence of effective treatment.
Or maybe the exodus of young, well-educated people to other countries explained the trend.
But several studies show that shifts in sexual behaviour drove the HIV decline in Zimbabwe. This finding echoes the changes experienced in Uganda during the early 1990s, when its rate of new infections fell sharply.
"That behaviour is changing significantly is clear," Gomo said from Blantyre, Malawi, where he teaches at the University of Malawi's medical school. "The question is: What has caused that change?''
With unemployment estimated at 80 per cent, trading sex for money remains an appealing choice for some women, said Tsitsi, a sassy 23-year-old who gets about $75 a month from her married businessman boyfriend.
"He's like an ATM," Tsitsi said. "You just go and punch money and it comes out.''
But such relationships are getting harder to find and maintain, she said. When a man gets low on cash, "he'll just take care of his wife.''
Yet another ablation...
Circumcision Atrocity Suit Filed Against Coles County Hospital
Posted : Wed, 18 Jul 2007 16:26:04 GMT
MATTOON, Ill., July 18 /PRNewswire/ -- The day after birth on February 15, 2007, an infant at Sarah Bush Hospital had a standard circumcision procedure performed by Dr. Sherif Malek. However, what should have been a forgotten memory for the boy became a lifelong nightmare. Due to negligence, Dr. Malek severed the entire glans, commonly termed the head, of the infant's penis. Today, Jerry A. Latherow of Latherow Law Office on behalf of plaintiffs Boy Doe (the infant) and his mother, Jane Doe, filed a complaint for compensation for damages against Sarah Bush Lincoln Health System, Inc, 1000 Health Center Drive, Mattoon, IL, and Sherif Malek, D.O. in the Circuit Court of Coles County, Illinois.
The infant was a healthy seven pound newborn who was delivered without complications on February 14, 2007. The following day, a routine circumcision was performed on the infant by Dr. Malek using a Mogen clamp, a metal, hinge-shaped device used during the procedure. At the completion of the circumcision, hospital records indicated there was significant bleeding. Inspection of the penis revealed nearly all of the glans had been amputated at the time of the circumcision. Three months later, the infant required penile skin transfer surgery at the University of Illinois, with need for future procedures, some of which are only appropriate at the age of puberty.
According to medical expert witness, Dr. David Zbaraz with Northwestern Memorial Hospital in Chicago, who reviewed the Sarah Bush medical records of the infant, "The Mogen clamp when used properly cannot amputate a male infant's glans. [Walking a high wire across Niagara Falls without a safety wire, when done properly, cannot result in death. The devil is in the details.] The injury to this boy was completely preventable." [... only by not circumcising]
Across the United States major settlements have been made for botched circumcisions. In 1991, a hospital in Atlanta, GA, agreed to pay $22.8 million because of negligence during a circumcision. Also in New York City a boy received $1.2 million for a circumcision error, and in Lake Charles, LA a family received $2.75 million after a boy's penis was burned during a routine circumcision.
"Through simple carelessness at Sarah Bush Hospital, a boy will face physical disfigurement and psychological trauma throughout his life," said Jerry A. Latherow, the attorney representing Boy Doe and Jane Doe, "Unfortunately, caps on medical malpractice cases in Illinois will prevent the boy from recovering more than $500,000 against the physician for the lifelong deformity and urological care, and any associated psychological problems. Sadly, the hospital's liability for such damages is capped at $1 million. Even before the case is tried, a mother and her child have been robbed."
A complete copy of the complaint is available upon request.
CONTACT: Jerry A. Latherow, attorney for plaintiffs, +1-312-372-0052,
Only one sex to go ...
Police plea on genital mutilation
The Metropolitan Police is offering a £20,000 reward for information which would bring to justice anyone involved in female genital mutilation.
The campaign is being launched at the start of the summer holidays, during which young girls - mainly from African communities - are thought most at risk.
Mutilation involves the partial or total removal of external female genitalia for cultural reasons.
Up to 7,000 girls in the UK are seen as at risk of this form of circumcision.
The long summer holiday is seen as the most likely time for parents to seek the procedure for their daughter as she has time to recover from what is usually a brutal ordeal before returning to school.
She can be sent abroad for the treatment, but police say they know it is also being carried out within the UK itself.
A new law was introduced in 2003, which not only repeated 1985 legislation banning the procedure, but also criminalised those who took a child outside the country for mutilation to be performed.
No-one has been prosecuted under the new legislation.
"It's a hidden act," said Alastair Jeffrey, head of the Child Abuse Investigation Command, as he announced the reward. "And that's why it's so hard to uncover.
"This is child abuse. It is not an attack on anyone's culture, it is an attack on anyone who commits this horrendous abuse of children."
The police said they were anxious not to arrive at a situation where young girls returning from holidays in Africa were routinely checked at airports, and that they desperately needed grassroots support to stamp out the practice.
Female genital mutilation is practised in a number of mainly Muslim African communities, and the tradition can travel when immigrants settle abroad.
Islamic scholars say it has no justification in the Koran [implying that if it had, that would make it all right...], and several have recently spoken out against the practice.
Yet many families apparently believe it is an essential part of initiation into adulthood and the only way to ensure their daughter is seen as "pure" and thus desirable by potential husbands.
One London youth worker within the Somali community said this was so ingrained that she had even come across young women who had wanted to be circumcised.
"You want to be part of the community," said Leyla Hussein. "You want to be married, and you don't want to be considered dirty."
There are several types of mutilation, ranging from a minor piercing of the clitoris to the complete removal of all the external genitalia.
In some cases, what remains is then stitched up with coarse thread - leaving a tiny hole, perhaps just the size of a matchstick, for urinating and menstruation.
The procedure is in most cases carried out by older women who have no medical training. Anaesthetic is rarely used and the cuts are sometimes made with the most basic of tools such as razors or even pieces of glass.
It can have a range of short and long-term consequences including infection, incontinence and infertility, as well as causing significant psychological damage.
And it can be fatal.
Egypt, where as many as 90% of women have been circumcised, has just announced a full ban on the practice after a 12-year-old girl died last month.
Daily Times (Pakistan)
Baby dies during circumcision
Rawalpindi: A baby died in Muslim Town Police Station jurisdiction due to the loss of blood, as the doctor failed to carry out the circumcision operation properly. According to sources, the doctor carried out the operation at the child’s home. A conciliation jirga will be held to mediate between the child’s father and the doctor.
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