Circumcision – Page 13 – Rolling Doughnut

“Just a ‘little’ off the top” is subjective.

In an essay discussing a magazine article reviewing the origin of circumcision, the author demonstrates – parenthetically – why it continues.

(The most logical explanation is simple. The male organ [sic] simply looks better post-circumcision than it does pre-circumcision. And looks matter: Consider how visual an animal the human male is and just how much time he spends gazing at himself.)

That’s not logic. That’s a subjective preference rationalized from an ex post facto analysis fueled by cultural conditioning, as well as a refusal to accept that what is common is not necessarily normal and may, in fact, be harmful.

(For my own parenthetical, the last sentence of the excerpt warrants a response, but it is beyond the scope of my more fundamental argument. If you understand my objection to the first two sentences, my critique of the third sentence is obvious.)

Then, this:

I put the magazine back on the stack, fishing for my handkerchief to deal with the chilly sweat now covering my forehead. [ed. note: There is slightly more context to this excerpt, before and after, but excluding it does not alter the meaning.]

I will never understand how circumcised men react to discussion of the topic this way, only to defend imposing on infant boys what would be so objectionable to them now. What makes a man express relief because he doesn’t remember rather than disbelief that something so objectively offensive could be forced on him? And where is the empathy, the moment of thought for other individuals that might make us ask whether or not he wants his healthy penis cut?

This “flexible and compassionate” is misdirected.

This article appeared in the Boston Globe last week. It’s a discussion of efforts to train new mohels in Massachusetts. Two particular passages are relevant to my focus. First:

Be flexible and compassionate, [Dr. Bob] Levenson told the doctors. … Gently tell the truth when a tearful, post-partum mother asks if babies can feel pain. (The answer is “yes, but I’ll be as quick as possible”). And it is perfectly OK – recommended, even – to anesthetize the infant with a little kosher wine dabbed on the lips.

Beyond wanting to see evidence that wine dabbed on the lips of an infant male will anesthetize him from the pain of surgery, this issue raises a large ethical red flag. There must be an objective reason to inflict pain on another, particularly a child who can’t offer (his) consent. And does the infant male’s soon-to-be-removed foreskin serve a purpose? The answer is “yes,” no parenthesis necessary or appropriate.

Second:

But for doctors, the work is not considered particularly lucrative. Mohels must secure their own malpractice insurance, spend significant time counseling families, travel, perform the ceremony on the eighth day of a child’s [sic – male] life, all for a fee of $350 or $400.

If a religious observation requires medical malpractice insurance, it is only legitimate to perform on consenting adults. The individual right of minors to be free from (medically unnecessary) harm must remain the exclusive standard, superior to any religious requirements, because risk is objectively inherent. The evaluation of that medically unnecessary risk against unverifiable religious benefits is subjective. The conclusion is only legitimate from the individual giving up his foreskin.

Kenyan government to roll out human rights violations.

The Kenyan government is rolling out a plan that overlooks a few key issues.

The Kenyan government has embarked on an ambitious national programme to fast track the national rollout of male circumcision as a means of preventing HIV.
…

According to the new policy document, circumcision will be rolled out for males of all ages in a culturally sensitive way and in a clinically safe setting.

I searched for the policy document but haven’t been able to find it. Still, this says everything. Males of all ages. And they’re more worried about culturally sensitive ways than they are about human rights or common sense. These children aren’t having sex. And there are other, more important (the only?) reasons for the HIV epidemic in Kenya (italics added):

Why is there more AIDS in some parts of the country than in others?

Infection levels are generally higher in urban areas than in nearby rural areas, and some parts of western Kenya have the highest recorded rates in the country. HIV is still spreading in Kenya, so that many rural and urban areas that had low infection levels in the past are now experiencing higher infection rates. Many factors may contribute to these differences, such as high population density, more movement of people because of trading and migration routes, non-practice of circumcision, sexual networks within communities, and cultural practices such as wife-sharing and widow inheritance.

Fixing the “non-practice” of circumcision will solve nothing as long as the last two remain in practice. If, at the very least, the last two are properly compensated for with condoms, fixing the “non-practice” of circumcision will be unnecessary.

Worse, this mentality:

“Our pilot is a free mobile outreach, where a team of five members – a doctor, clinical officer, care assistant, nurse and driver – goes into various communities and sets up camp in a room at a local medical centre or in a tent, and invites people to come or bring their children for circumcision,” said George Obhai, monitoring and evaluation manager at Marie Stopes Kenya.

Before the mobile team arrives, the local hospital or clinic is contacted to conduct community mobilisation, and on the day every man getting circumcised receives counselling from a trained member of staff before the procedure is carried out.

“Interestingly, many of the ideas people have about male circumcision work in our favour, even among the Luo; for example, people believe that it improves the sexual experience and that ladies prefer circumcised men,” he added.

I respect the idea that moving from traditional circumcision to clinical circumcision will improve the situation for boys, however small the improvement. But to willingly embrace subjective nonsense because it works in your favor is absurd. Medical procedures on children must be based in science alone. There is medical need or there is not. Everything else is irrelevant and should be explained and disregarded as such when it appears.

This plan – as will all similar efforts around the world – will be properly seen as worthless failures when we analyze the long-term results many years from now.

**********

In somewhat related news, this bit of genius (link via by way of Male Circumcision and HIV:

It is now illegal to encourage the use of condoms in southeast Nigeria’s Anambra State. The state government has also banned the advocacy and distribution of other forms of contraceptives including IUDs (intrauterine device) and any other “un-natural” birth control.

“Instead of teaching children how to use condoms to enjoy sex they should be taught total abstinence,” the state commissioner for health, Amobi Ilika said when announcing the measures in late March at the state capital, Awka. “The use of condoms has greatly encouraged immorality,” he said.

The question of proper governmental role aside and an understanding that condoms are still available, what could possibly go wrong?

I wouldn’t use the word “debate”.

Following on today’s earlier entry, how many pro-circumcision myths does this short essay, “The Debate Over Circumcision,” inadvertently expose as flawed?

My first son had what can only be described as a bad circumcision. While he was still in diapers, the skin at the tip of his penis started to get sticky and when we changed him, we were unable to pull the skin back to do an adequate cleaning. “It’s a problem,” the pediatric urologist explained. I am sure there is some medical term for the condition, but all I can remember is that it required a trip to Boston’s Children’s Hospital where, in the office, my little boy had to get “re-snipped.”

This was very, very difficult to for me watch. Despite receiving a local anesthetic, my son cried a lot. So did I. When I found out I was expecting another boy, I did more research on circumcision and stumbled across countless websites arguing both for and against the procedure. Given that my husband and I are not of the Jewish or Islamic faith, where circumcision is customary, there was no real reason to choose circumcision other than family tradition. The medical arguments don’t really hold all that much weight, in my opinion.

The complications the author’s son experienced are easily explained. At birth, the foreskin adheres to the glans thanks to synechia. The inner foreskin is mucosal tissue, just like the nose, mouth, and female genitals. It doesn’t magically stop being mucosal tissue after circumcision. It only stops acting like mucosal tissue through years of keratinization. Until that occurs, any loose foreskin will tend to re-adhere because it is moist mucosal tissue. As the author discovered, this can require further surgical intervention. It can also lead to complications (NSFW – graphic images).

This is objective harm. Even when parents understand some of the risks – through the experience of their previously healthy sons – from medically unnecessary infant circumcision, they’re willing to proceed again. The risk of it becoming reality for the boy is inherent in every infant circumcision. No one has the right to impose this risk on him without medical need. No one should have the legal option to impose this risk on him, either.

A libertarian argument for a new law.

Mark, who writes the excellent Publius Endures, left an excellent (and appreciated) comment over the weekend. Normally I would reply there, as I do with most comments. But Mark included one point that I’d like to discuss (emphasis added).

I must say that the circumcision debate (to the extent it can even be called that) has made me feel relieved that my wife and I are having a girl since we don’t even have to consider the issue. Circumcision is frequently done almost without thought, essentially as a ritual. Until Andrew Sullivan started blogging about it in the last few years, it was an issue that I didn’t even consider – I thought it was something that was just what was done. People like you and Sully are starting to open eyes that the practice largely lacks any kind of basis other than as a cultural norm.
The main reason to perform circumcision, as far as I can tell, is that it may create some awkwardness when the child becomes a sexually active adult. The thing is that by the time that becomes an issue, the child will be more than capable of making the decision on his own.
If we had our child a year ago (and it was a boy), I think I would have opted for circumcision just based on the fact that it is a social norm and that there is little publicity about the arguments against circumcision. Were the decision to come up now, I would almost certainly not circumcize.
I’m not sure the procedure should be made illegal, though, but only because I’m generally opposed to adding new laws. However, parents need to be better informed about the risks and generally nonexistent benefits of circumcision.

Before I respond, allow me to clarify that this is in no way meant to condescend on this (or any) point. Although I’m certain that I’m right in all facets of my approach, I’ve thought about this every day for many years. I’ve read a lot of bad arguments on both sides. Reading through them can be tiresome, and without self-monitoring, my response can fall into frustration. (I try to avoid outright disdain, even though there are places where it’s richly deserved.) Mark’s comment is none of that. He shows an open mind that demonstrates genuine intellectual curiousity. He grasps the fundamental argument against male infant circumcision and is willing to act based on that new knowledge. Or to not act, based on that new knowledge. I wish more people had that kind of integrity.

Nor am I suggesting that he does not understand any of the libertarian approach I advocate here. Allow me to reiterate, if you’re not reading Mark’s blog, add it to your RSS feed today. His libertarian credentials are well written in his entries. Here, I’m only offering how I think a libertarian approach must be applied. I’ve read that libertarian arguments don’t apply to children. I find that strange, so this is at least tangentially a refutation of that.

To his comment, though, I think there’s an easy libertarian argument that demands legal prohibition. The Female Genital Mutilation Act of 1995 exists. As long as it is valid law, restricting all medically unnecessary genital cutting on female minors, even at the request of parents, the 14th Amendment demands that the government treat citizens equally. The only choices are to repeal the FGM Act or make the law gender neutral. Since we all agree that the former is unacceptable, we’re left with the latter. (Take a look at the work Matthew Hess is doing to achieve an MGM Bill.)

Beyond that, viewing government through a libertarian goal of maximizing liberty, I’m against any law that would restrict people from making that decision for himself (or herself). I can form whatever opinion I want about someone’s decision, but it’s irrelevant to what he should be able to do to himself. Weigh the benefits against the harm with whatever consideration makes sense. But the issue at hand is that medically unnecessary surgery is objectively identifiable as harm. There is cutting. There is an inherent risk of complications, both minor and severe. And infants do not have their choice. Objective harm is forced on them without their consent with no medical need or objective benefit.

Statistics demonstrate that, when left with their choice, males almost never choose or need circumcision. Any reasonable person standard must side with not removing healthy body parts from children. They have the same individual rights that every adult has to the extent that a right is inherent and inalienable. For minors, those rights should be viewed as held in trust rather than created upon reaching the age of majority. Since the first legitimate purpose of government is to protect the rights of each citizen against infringement by other citizens, there is no reason to overlook that just because the person imposing the harm is a parent who views the imposition as beneficial in some (subjective) manner.

Again, I don’t think Mark’s comment indicates that he’s willing to overlook anything. He’s not rejecting a law. But as he points out there is a societal norm in the United States that male circumcision is just an inconsequential snip. As I’ve demonstrated throughout my circumcision category, it’s not true that it’s inconsequential. Even though most American men are content to be circumcised, we are a nation of individuals before any other examination. Adding a new law to include boys protects them as individuals in the same we already protect girls. It is a law that actively advances individual liberty, while actively rejecting an incoherent narrative of liberty dressed in parental “rights”.

We shouldn’t need a law to protect against infant circumcision. But in a perfect world, parents wouldn’t remove healthy body parts from their children out of fear, superstition and conformity. We must legislate for the world we have, with the foundation of individual rights that we know is valid. I could make an argument that existing assault laws cover unnecessary infant circumcision, but no prosecutor is going to pursue that in the common circumstances of male infant circumcision in America. So, barring a sudden shift to rational action by parents, this is an area where the government must legitimately exercise its authority in defense of rights.

Post Script: There’s a little more to Mark’s comment than what I posted here. I left an additional response there, but it was more anecdotal.

How far do parental “rights” extend? What is the basis for limitation?

Passed to me by a friend, let’s draw the natural comparison on this story:

Thailand’s Health Ministry ordered hospitals and medical clinics to temporarily stop performing castrations for non-medical reasons, saying Wednesday that the procedure performed on transsexuals needs stricter monitoring.
…

“As of today, doctors can perform the surgery if there is a medical reason to do so — not for any other reason,” ministry spokesman Suphan Srithamma said.

The move came after a leading gay activist, Natee Teerarojjanapongs, called on the Medical Council to take action against clinics that perform castrations on underage boys.

I don’t have any knowledge of this topic beyond what this story offers. I assume it’s true that some number of males undergo castration to achieve “feminine qualities”. Like medically unnecessary circumcision, neither parental proxy nor choice by a legally incompetent individual should factor. Unlike medically unnecessary circumcision, this appears to be at the male’s request. But this is important to remember:

“It’s a totally wrong perception that castration will make boys more feminine,” Natee told The Bangkok Post last week. “These youngsters should wait until they are mature enough to thoroughly consider the pros and cons of such an operation.”

Unfortunately the real problem appears to be doctors overlooking the existing rule requiring parental consent for boys until they reach age 18. I don’t think there’s contention that enforcing this is reasonable.

So, instead, a thought experiment. I would like to assume that parents are rational enough not to sign off on this type of stupidity. I don’t assume that, of course, because the evidence proving otherwise is too strong. But apart from the distinction¹ on future reproductive capability from the two procedures, how is it any more reasonable to permit parents to impose circumcision than to permit them to impose castration? We can discuss degrees of violation, but that’s a distraction from the truth that they’re the same kind of violation. We don’t debate the depth to which it’s acceptable to stick a knife into someone, even though differences exist in probable outcome from the depth of the assault.

When considering surgery on minors, any intellectual journey towards acceptance after establishing medically unnecessary is unethical and illegitimate. There is no objective justification, so any legal permission granted to parents by society is subjective reasoning devoid of reason. It doesn’t matter if the topic is castration, genital cutting, breast augmentation or any other unnecessary intervention a second-party prefers. The individual isn’t just supreme, he is all that matters.

¹ Reproduction is not necessary for the individual to live, so its foundation is subjective, exactly like medically unnecessary circumcision.

Overheard on the Internet

Anyone who follows discussion of circumcision on the Internet will encounter regular moments of an overwhelming desire to hate mankind. It’s impossible to avoid. People are so devoid of any logic or consideration for the child that disgust is the kindest emotion I can achieve. For example:

But I was also thinking, for all you mummies to be out there, are you thinking of getting your son circumcised? And for those of you with girls or who don’t know what you’re having, would you get your baby circumcised ? Does anybody know the pros and cons in doing so ?

If you’ve paid attention to my Circumcision category, you know that actual discussion of pros [sic?] and cons will likely not follow, which is how it plays out. Like here:

It’s completely a personal decision … You cannot make your decision based off of anyone elses opinion. …

I am here in the US and it is a very common practice. It wasn’t even a question for us. Here it is done one day after birth. Neither one of my boys even flinched when it was done. The PlastiBel that they use here takes all of 2 seconds to perform and it’s done.

You should really research it so that that you and OH feel that you have made the decision that best suits your beliefs. Good Luck!

Notice¹ that this response ignores the original question. Instead, it’s a typical defense of parents making a “personal decision” not based on any other person’s opinion, with any other person being inclusive of the healthy child. Whatever suits them is somehow acceptable.

But it gets more blatant:

…

I am not the sort of person to push my views on anyone else but that is what we would do.

Hope you make a decision that you and babies (sic) daddy are happy with.

…

She is mistaken; she is exactly the type of person to push her views on someone else. Her husband is that type of person, too. Neither of them considered that their son might not want to be circumcised. They imagine that only their opinion about his body mattered.

Some inject a little sanity into the discussion, saying it should be illegal. But then comes the inevitable softening to saying it should be a personal decision for the parents based on good reasons. Why? Has one parent on this board who chose to circumcise given any indication that common sense intervened? It should be illegal. That is the only reasonable stance based on more than one analytical approach. Why step away from that? To avoid offending? The legally-permitted violation will continue for some time. There is no reason to enable it longer. Don’t be afraid to call people out on their selfish delusions².

<sarcasm> With all of these arguments for and against the procedure </sarcasm>, I can’t say I’m surprised by the original commenter’s decision:

yeah I think I’m going to get my boy circumcised, seeing as it protects him from all sorts of infections and sexually transmitted diseases, but I heard a story about a man who lived here in winnipeg
He got circumcised when he was a baby and they ‘accidentally’ cut his penis off! Can you believe it ?

It protects him from UTIs in the first year of life, but the risk is minute without circumcision. (Girls suffer more than intact boys.) And the data on STDs is equivocal, at best. (Condoms? Bueller? Bueller?)

The man she speaks of is David Reimer. His circumcision was attempted using cauterization, which is not an accepted method. While he is important to remember because he was a victim of a botched, unnecessary circumcision, there is (unfortunately) at least one recent example from Canada. The child died.

To the first response I quoted above, the circumcising doctor used a PlastiBell ring on the child.

¹ Notice also that the (unverifiable) claim that it didn’t hurt the child is irrelevant. The ability to make a surgical intervention pain-free could justify any number of barbaric procedures. Need matters first, which didn’t exist here. Then, when need exists, a scientific conclusion that the most extreme intervention that is circumcision is warranted because no lesser interventions will correct the malady.

Also, did the child suffer any during the healing period?

² From one mother’s rambling comment excusing her selfishness:

I am happy with my decision, and I am sure my sons will never come to me saying they wish they still had their foreskin.

I’ve heard this so many times. No parent ever thinks it will happen to them. I know she’s psychic enough to know what her son will want, but what if he asks? And what if he asks because he’s not happy about it? Or is he not allowed an independent thought?

Delicate Decision: Post 4 of 4

On Monday the Los Angeles Times offered a typical analysis of infant male circumcision. There are many points to address from this story, so I’ve broken them up into multiple posts. (Posts 1, 2, and 3.)

Point four:

FOR nearly all of Nada Mouallem’s pregnancy, she and her husband, Tony, had a running argument. She wanted to have their son circumcised. He didn’t. “Many days, I’d go off and research all the pros. He’d go and research all the cons. Then we’d get together at night and fight,” she says.
…

For the Mouallems, family tradition and religion were not factors. “We kept those separate and focused only on the scientific reasons,” says Tony Mouallem, who was against circumcising his son because he didn’t think it was necessary. Plus, he’s not circumcised. “You have to work a little harder to keep it clean, but that’s not a big deal.”

His wife, Nada, however, worried about the responsibility of keeping her newborn’s penis clean. She thought circumcision would help reduce the risk of infection and disease. “I wasn’t keen on my baby having a surgical procedure, but then I thought, why not if we can offer him more protection?”

In the end, Tony sided with his wife. Their son was born Feb. 10, and was circumcised the next day. Tony held him during the procedure. “There was no bleeding and he didn’t even cry,” he says. “I’m still not convinced it was medically necessary, but I didn’t want to burden my wife with the worry of cleaning it. And maybe it will be easier for him in the locker room.”

Choosing surgery over responsibility is the abdication of an obligation when having children. No one states that an intact penis can’t be kept clean. Even ignoring the absurdity that it’s more difficult to clean in his early years when his foreskin adheres to his glans and shouldn’t be retracted, keeping your children clean and eventually teaching them to care for themselves is parenting. Anything else is the selfish subjugation of the child’s needs to the parents’ whims. In this case, that whim is further discredited because the father presumably understands how to keep an intact penis clean.

Post Script: This most fits the “typical” analysis. These “balanced” articles always contain a couple who can’t decide. And the couple always chooses “yes”.

More analysis of this article and the CDC’s obtuse approach can be found here and here at Male Circumcision and HIV.

Delicate Decision: Post 3 of 4

Point three:

Robert and Cara Moffat of Los Angeles, who are expecting their first child, a boy, in May, had no trouble deciding, and plan to have their son circumcised. Robert, who is 30 and circumcised, said, “I grew up with it, and my wife has a preference for it, so that’s what we’ll do. We’re doing what the family is comfortable doing.”

His father is happy being circumcised, so the boy will be happy with it. This is an unverifiable assumption at birth. His mother prefers having sex with circumcised partners. This is irrelevant because I presume she does not intend to have sex with her son. So it leaves the conclusion that his future sex partner(s), who they apparently know will be female, will prefer that he be circumcised. This is an unverifiable assumption at birth. Finally, “what the family is comfortable doing” is hardly a principle of ethics, liberty, or science.

Also note that the parents have said nothing about (potential) medical benefits in forcing this on their son. Yet, they’re allegedly qualified to decide that their son will want this. And legally we’re all supposed to think this is reasonable.

As parents and task forces sort through the variables surrounding this intimate decision, [Dr. Andrew] Freedman offers parents in turmoil this comforting advice: “Rest assured. No matter what decision parents make for their son, most men think whatever they have is just fine.”

There are four potential realities for an adult male when he is finally legally protected to make his own genital decisions the way females are protected from birth. He can be intact and happy. He can be circumcised and happy. He can be intact and unhappy. He can be circumcised and unhappy. In the first scenario, he could do something but he wouldn’t. In the second, he can’t do anything but he doesn’t care. In the third, he can do something and he will choose either the perceived benefits of circumcision he seeks or not facing the drawbacks from adult circumcision. In the fourth, he can do nothing and society rejects his opinion as an individual.

In the first two scenarios, we conclude that the child validates the parents’ decision. We mistake an unrelated outcome for causation. In the third scenario, whatever we conclude, we’ve achieved the minimum standard of liberty that the male retains his right to choose (or reject) medically unnecessary procedures. In the fourth scenario, we either deny its validity or babble on about the rights of the parents. This generally involves some hand-wringing about parents making lots of tough choices while actively missing that none of the other choices involve removing parts of his anatomy. (You didn’t forget that parental rights are greater when speaking of sons, did you?)

Dr. Freedman’s opinion tells every man in scenario four his parents’ opinions about his penis matter more than his own. Anyone who argues this refuses to reconcile the complete lack of medical need with any notion of ethics and individual rights. Just because science can (allegedly and potentially) achieve an outcome does not mean it should try to achieve that outcome. That is a slippery slope unbounded by any consistent rule or principle.

More analysis of this article and the CDC’s obtuse approach can be found here and here at Male Circumcision and HIV.

Delicate Decision: Post 2 of 4

Point two:

In the first year of life, 1 in 100 uncircumcised [sic] boys will develop a urinary tract infection. Only 1 in 1,000 circumcised boys will. “While that’s a tenfold reduction, you have to keep in mind that the risk was only 1% to begin with,” says Dr. Andrew Freedman, pediatric urologist at Cedars-Sinai Medical Center. Proper hygiene can prevent most infections.

When considering potential benefits, context matters more than an isolated statistic. For example:

The downside of letting the child make the decision later is that adult circumcision is more expensive, painful and extensive. During an infant circumcision, practitioners numb the site with local anesthesia, then attach a bell-shaped clamp to the foreskin and excise the skin over the clamp. The clamp helps prevent bleeding. In adults, the procedure involves two incisions, above and below the glans (tip of the penis), stitches and a longer recovery. The cost is about 10 times that of a newborn procedure.

Let’s ignore the rights of the individual for the moment. I don’t, but the hypothetical does, so I’ll stick with it. The cost is about 10 times that of a newborn procedure. So what? As a fact on its own, it means nothing. How likely is it that an intact male will need circumcision in his lifetime? If it’s less than 10%, and it is, then a basic cost-benefit analysis shows that we will spend less overall by circumcising only those males who medically require circumcision. The “ten times more expensive” meme is worthless upon minimal inspection.

Dr. Freedman seems to understand this:

“The HIV data is the most compelling to date that circumcision can help prevent the transmission of the virus in male-female sex,” Freedman says. “While this is important to sub-Saharan Africa, the question is how many infant boys need to be circumcised in the United States to prevent one case of HIV transmission 25 years from now? Factoring in even the rare complication that can occur with circumcision may render this study insignificant.”

No kidding. Aside from not being able to predict who (or if) circumcision will help prevent HIV, we can also not predict who will suffer a complication. I seriously doubt the few children who suffer a significant mutilation of the penis care that most circumcisions are “successful”. Nor do I suspect the few boys who die from circumcision care about the general outcome. Of course, this should matter now, even before reducing a child to his (unknown) place in the statistical herd.

But he might not get it:

If parents do opt for the procedure, Freedman advises that they do it when the baby is a newborn, have someone trained and experienced perform the procedure, and use pain control. “The older a child gets, the less benefit there is, and the greater the risk,” he says. “I would ask parents of an older child to strongly reconsider if the only reason they’re doing this is cosmetic.”

The parents of a newborn who choose circumcision for cosmetic reasons? Those are somehow okay? Again, the individual – the patient – matters. When he is healthy, every other outside opinion is meaningless to the consideration of his body.

More analysis of this article and the CDC’s obtuse approach can be found here and here at Male Circumcision and HIV.