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Is infant male circumcision an abuse of the rights of the child?
December 10, 2007Circumcision is one of the commonest surgical procedures performed on males. Opponents argue that infant circumcision can cause both physical and psychological harm, while recent evidence shows that circumcision is medically beneficial. Two doctors debate the issue in this week's BMJ.
There is now rarely a therapeutic indication for infant circumcision, yet ritual (non-therapeutic) male circumcision continues unchecked throughout the world, long after female circumcision, facial scarification, and other ritual forms of infant abuse have been made illegal, writes Geoff Hinchley, a consultant at Barnet & Chase Farm NHS Trust.
The law and principles pertaining to child protection should apply equally to both sexes, so why do society and the medical profession collude with this unnecessary mutilating practise, he asks"
In addition to religious justification, there have been many spurious and now unsupported claims for circumcision including the prevention of penile cancer, masturbation, blindness, and insanity, most of which relate to adult sexual behaviour and not to the genital anatomy or best interest of a child, he adds.
There may be a case that male circumcision reduces HIV risk in sexually active adults, however the decision on whether an individual wishes to have this procedure should be left until they are old enough to make their own informed health care choices.
Male genital mutilation is not a risk-free procedure, he adds. Far from being a harmless traditional practice, circumcision damages young boys.
And in terms of legal protection, he argues that both the US and the UK legal systems discriminate between the sexes when it comes to protecting boys and girls from damaging ritual genital mutilation.
The unpalatable truth is that logic and the rights of the child play little part in determining the acceptability of male genital mutilation in our society, he writes. The profession needs to recognise this and champion the argument on behalf of boys that was so successful for girls.
But Kirsten Patrick of the BMJ argues that, if competently performed, circumcision carries little risk and cannot be compared with female circumcision.
Although any surgical operation can be painful and do harm, the pain of circumcision, if done under local anaesthesia, is comparable to that from an injection for immunisation, she writes.
In terms of evidence of benefit, male circumcision has been associated with a reduced risk of sexually transmitted infections, such as human papilloma virus, chancroid and syphilis. Robust research has also shown that circumcision can reduce the spread of HIV.
And although the complication rate for infant circumcision is essentially unknown (because most operations are unregistered) data suggest that it is between 0.2% and 3%, with most complications being minor. Furthermore, she says, no robust research exists examining the long term psychological effects of male infant circumcision.
Despite the fact that no medical body advocates routine male infant circumcision, most agree that it is safe and acceptable and recommend that the procedure is carried out by a competent operator using adequate anaesthesia.
Male circumcision is not illegal anywhere in the world. It is a choice that parents will make on behalf of their male children, for cultural or other reasons, and regulating its provision is the wisest course of action, she concludes.
An accompanying clinical review concludes that medical indications for male circumcision in both childhood and adulthood are rare, but that complications can be drastic.
BMJ-British Medical Journal
In addition to religious justification, there have been many spurious and now unsupported claims for circumcision including the prevention of penile cancer, masturbation, blindness, and insanity, most of which relate to adult sexual behaviour and not to the genital anatomy or best interest of a child, he adds.
There may be a case that male circumcision reduces HIV risk in sexually active adults, however the decision on whether an individual wishes to have this procedure should be left until they are old enough to make their own informed health care choices.
Male genital mutilation is not a risk-free procedure, he adds. Far from being a harmless traditional practice, circumcision damages young boys.
And in terms of legal protection, he argues that both the US and the UK legal systems discriminate between the sexes when it comes to protecting boys and girls from damaging ritual genital mutilation.
The unpalatable truth is that logic and the rights of the child play little part in determining the acceptability of male genital mutilation in our society, he writes. The profession needs to recognise this and champion the argument on behalf of boys that was so successful for girls.
But Kirsten Patrick of the BMJ argues that, if competently performed, circumcision carries little risk and cannot be compared with female circumcision.
Although any surgical operation can be painful and do harm, the pain of circumcision, if done under local anaesthesia, is comparable to that from an injection for immunisation, she writes.
In terms of evidence of benefit, male circumcision has been associated with a reduced risk of sexually transmitted infections, such as human papilloma virus, chancroid and syphilis. Robust research has also shown that circumcision can reduce the spread of HIV.
And although the complication rate for infant circumcision is essentially unknown (because most operations are unregistered) data suggest that it is between 0.2% and 3%, with most complications being minor. Furthermore, she says, no robust research exists examining the long term psychological effects of male infant circumcision.
Despite the fact that no medical body advocates routine male infant circumcision, most agree that it is safe and acceptable and recommend that the procedure is carried out by a competent operator using adequate anaesthesia.
Male circumcision is not illegal anywhere in the world. It is a choice that parents will make on behalf of their male children, for cultural or other reasons, and regulating its provision is the wisest course of action, she concludes.
An accompanying clinical review concludes that medical indications for male circumcision in both childhood and adulthood are rare, but that complications can be drastic.
BMJ-British Medical Journal
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New Male Circumcision Device for HIV Prevention Studied by NewYork-Presbyterian/Weill Cornell
With the recent endorsement by the World Health Organization (WHO) and scientists worldwide of adult male circumcision as an important strategy for HIV prevention, there is increased urgency to develop safe and cost-effective circumcision services. This is especially the case in Africa where HIV/AIDS continues to spread at an epidemic rate.
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Male circumcision for HIV prevention and more
Three clinical trials in Africa found that adult male circumcision reduced the risk of men acquiring HIV infection from heterosexual sex by 51-60%.
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Circumcision, The Hidden Trauma : How an American Cultural Practice Affects Infants and Ultimately Us All by Ronald Goldman (Author) Circumcision: The Hidden Trauma is the first intensive exploration of the unrecognized psychological and social effects of this American cultural practice. The book has been endorsed by dozens of professionals in the fields of psychology, psychiatry, child development, pediatrics, obstetrics, childbirth education, sociology, and anthropology. Plain facts and recent research results revealed in the book conflict with popular beliefs and raise serious questions. Goldman's application of psychological and social research coherently explains both the tenacity of circumcision and the contradictory information and beliefs about it. He discusses the potential adverse effects of circumcision not only on infants, men, and sexuality, but also on mother-child relationships,... |
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Circumcision: A History of the World's Most Controversial Surgery by David Gollaher (Author), David L. Gollaher (Author) This worldwide history of circumcision, from ancient times to the present, looks at the procedure as initiation, religious and social ritual, and indicator of ethnic and social status. How has a medical practice that carries substantial risk to the patient and offers very little actual benefit become so widely accepted by parents and fiercely advocated by the medical community? Historian of medicine David Gollaher tells the strange history of medicine's oldest enigma and most persistent ritual in Circumcision. From the extraordinarily painful initiation rite of the ancient Egyptians, through the Hebrew purification ritual, through circumcision's use by the rising medical community in the nineteenth century as prevention for ailments ranging from bedwetting to paralysis, the great mystery... |
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What Your Doctor May Not Tell You About Circumcision: Untold Facts on America's Most Widely Performed-and Most Unnecessary-Surgery by M.D. Paul M. Fleiss (Author), D.Phil Frederick M. Hodges (Author) |
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Marked in Your Flesh: Circumcision from Ancient Judea to Modern America by Leonard B. Glick (Author) The book of Genesis tells us that God made a covenant with Abraham, promising him a glorious posterity on the condition that he and all his male descendents must be circumcised. For thousands of years thereafter, the distinctive practice of circumcision served to set the Jews apart from their neighbors. The apostle Paul rejected it as a worthless practice, emblematic of Judaism's fixation on physical matters. Christian theologians followed his lead, arguing that whereas Christians sought spiritual fulfillment, Jews remained mired in such pointless concerns as diet and circumcision. As time went on, Europeans developed folklore about malicious Jews who performed sacrificial murders of Christian children and delighted in genital mutilation. But Jews held unwaveringly to the belief that... |
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Circumcision Exposed: Rethinking a Medical and Cultural Tradition by Billy Ray Boyd (Author) An emotionally literate, culturally sensitive, yet fearless exploration of why the United States is the only country in the world to circumcise a majority of its baby boys for supposedly medical reasons. Includes various aspects of the practice, including its impact on sexuality. |
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A Surgical Temptation: The Demonization of the Foreskin and the Rise of Circumcision in Britain by Robert Darby (Author) In the eighteenth century, the Western world viewed circumcision as an embarrassing disfigurement peculiar to Jews. A century later, British doctors urged parents to circumcise their sons as a routine precaution against every imaginable sexual dysfunction, from syphilis and phimosis to masturbation and bed-wetting. Thirty years later the procedure again came under hostile scrutiny, culminating in its disappearance during the 1960s. Why Britain adopted a practice it had traditionally abhorred and then abandoned it after only two generations is the subject of A Surgical Temptation. Robert Darby reveals that circumcision has always been related to the question of how to control male sexuality. This study explores the process by which the male genitals, and the foreskin especially,... |
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In Favour of Circumcision by Brian Morris (Author), Brian J. Morris (Author) Gives direct answers to long-held questions about the controversial operation: circumcision. What does the operation involve? How painful is it? What does it cost? What are the benefits & drawbacks? Does circumcision affect sexual activity? |
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Questioning Circumcision: A Jewish Perspective by Ronald Goldman (Author) Endorsed by five rabbis, Questioning Circumcision: A Jewish Perspective is the first critical examination of the growing controversy of male infant circumcision with special attention to contemporary concerns of Jews. Consider these facts: Circumcision is not universal among Jews. Jewish press articles have questioned circumcision. A male child born of a Jewish mother is a Jew, whether he is circumcised or not. Jewish circumcision has never had anything to do with health concerns. Circumcision conflicts with significant Jewish laws and values. An Israeli organization publicly opposes circumcision. The circumcision debate in the Jewish community is visible and growing. An increasing number of Jews are choosing not to circumcise their... |
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The Joy of Uncircumcising!: Exploring Circumcision : History, Myths, Psychology, Restoration, Sexual Pleasure, and Human Rights by Jim Bigelow (Author) |
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Circumcision, Sex, God, and Science: Modern Health Benefits of an Ancient Ritual by Edgar J. Schoen MD (Author) Newborn circumcision results in lifetime medical benefits. There are many health advantages, and surgical risks are minimal. Of greatest benefit is 60% protection against acquiring HIV/AIDS, and 6 African countries have started mass circumcision programs. Other sexually transmitted infections with protection include human papilloma virus (the cause of penile and cervical cancer) and genital herpes, which can result in death or brain damage in newborns. There is prevention of infant kidney infections, foreskin infections, local skin diseases and retraction problems, along with ease of genital hygiene. Women prefer the circumcised penis- cleaner sex is better and more varied. The newborn period is the window of opportunity since the foreskin is thinner (no sutures needed), and... |
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