Category: Circumcision

From the first two paragraphs, the rehashing of the same vile pablum is inevitable:

Family gatherings for Collins Omondi once were boisterous affairs here on the verdant shores of Lake Victoria. But in just 11 years, AIDS has killed seven of his uncles, six aunts, five cousins and both his parents. His extended family now consists of one surviving uncle, an aunt and their 2-year-old child — all of whom have AIDS.

Fear is the first rule in propaganda. If you don’t get circumcised, you are going to die of HIV. You don’t want to die of HIV, do you? You don’t want your children to die of HIV, do you?

Omondi, 28, a tall, broad-shouldered fish trader, has come to believe that a quirk of culture contributed to the decimation of his family. They were Luos, members of the only major tribe in Kenya that does not routinely circumcise boys. The absence of this ritual, Omondi said, helps explain why Luos are dying from AIDS at a rate unheard of among other Kenyans and rare in East Africa.

The lack of genital surgery is not the problem. Promiscuous, unprotected sex in an HIV-packed community explains why Luos are dying from AIDS.

That doesn’t dismiss the horror of HIV or the need to reverse the trend, but if the Luos – or anyone – thinks they can keep the same habits that created the HIV epidemic after undergoing circumcision, their future will be as horrific as the present. Behavior must change, not genitals.

Buried in the article, long after several examples of how lack of circumcision “helps explain” the HIV epidemic, this:

Lake Victoria’s fishermen, following the winds, often kept girlfriends at several different beaches. The men generally were among the few in villages with steady supplies of cash, arriving home each day with $10 or $20 — sometimes much more — in areas where many earn less than $1 a day.

“With the fishermen, you can’t trust them,” said Mary Achieng Bunde, 41, a former fish trader and an AIDS activist whose husband died of the disease.

Of the women who trade in fish, she said, sexual favors were expected and generally granted. “Most of them, they are ready to do because maybe your husband has died, your children have school fees. . . . What can you do?”

Let’s keep pretending that the foreskin is the problem and not promiscuous sex without condoms. Rule number two in propaganda: lie.

She said attitudes are changing on the beaches because of fear and aggressive education programs. More fishermen are living in family houses, with their wives and children, rather than in communal dorms. The carousing has quieted as the toll of AIDS has grown.

Should I assume that this change in sexual behavior will be considered as a potentially dominant factor in the causation/correlation conclusion, should the HIV rate suddenly drop among the Luos after circumcision? I suspect that’s too much to ask. Rule number three in propaganda: ignore inconvenient evidence refuting the lies.

Unsurprisingly, the article closes with mention of a funeral for a fisherman who died of AIDS. Trite and manipulative like the rest of the article, it’s a shining example of yellow journalism.

A writer at PC Magazine offers a circumcision analogy to discuss the possibility of implanting RFID chips into children.

I have two children, a boy and a girl. When my son was born 12 years ago, the obstetrician asked within hours of his birth if I wanted to have him circumcised. This is a common practice for boys, so I didn’t hesitate to say yes. Of course, it is a medical procedure, and in hindsight, I wish I’d thought about it for more than 35 seconds.

I wonder if his son will wish he’d thought about it more.

Now imagine a world where the doctor had, instead, asked me if I wanted my son “chipped.” Here’s how that conversation might have gone:

Doctor: “Mr. Ulanoff, it’s a simple and virtually painless procedure.”

Me: “You mean there’s no cutting? No blood?”

Doctor: “Well, no. There is cutting and blood, but it’s a small incision and there’s very little blood.”

Cutting and blood. Nothing major, per the usual nonsense. It could happen.

Have we reached the point where ethics might step in yet, regardless of the potential benefits the parent is trying to achieve for the boy? Does the boy’s desire – or lack of desire – not matter if the boy could have GPS, a unique identifier, and his credit information stored under his skin? Cool isn’t a compelling justification.

A hint of suspicion from the author starts sneaking through with mention of Department of Homeland [sic] Security near the end. Then this:

Me: “But, Doc, he can have it removed at any time, right?”

It’s a shame this can be so obvious in one situation but so ignored in another.

Doctor: “Yes, but I wouldn’t recommend it. It’s not easily removed, and the scar might be larger than you or he really want.”

About that scar and what he wants…

Doctor: “Uh, yes, Mr. Ulanoff, but let’s remember that this is about your son. I need your permission. Keep in mind that 35 percent of today’s children get the implant and most before the age of 2.”

Your decision about his body? Check. “Most” people are having it done? Check. Before the child can object While the child is young enough to forget the procedure? Check.

I can see the scenario where implanting RFID chips into children takes a similar path to acceptance as male circumcision. I’d obviously be against it, since children aren’t property and implanting an RFID chip can hardly be considered a medical necessity. There are also identifiable, easily imagined concerns about privacy and government, especially given our current national opinion that if you haven’t done anything wrong, you don’t have anything to hide.

**********

It was bound to happen. In the forums, this:

And, I can assure you that the circumcision at 0 years is better than one at 24 years due to yucky things.

That’s why the path to acceptance of such lunacy with RFID chips is easy to see. “I know better than you what you need” is an irrational flaw embraced present in too many.

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

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

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

Continuing:

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

Ditto what I said above.

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

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

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

Returning mid-sentence:

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

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

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

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

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

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

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

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

In researching today’s entry on animal rights and “happy meat”, I stumbled on this fact sheet (pdf) from Certified Humane. It explains Certified Humane’s position on trimming the beaks of laying hens.

Early studies showed that hens that were beak-trimmed at 12-16 weeks of age experienced chronic pain after trimming. However, in 1997 Dr. M.J. Gentle of the Roslin Institute in Edinburgh, UK, conducted research that showed that, although chicks beak-trimmed before 10 days of age may experience short-term pain, they do not experience the longterm pain that was associated with trimming chicks at ages older than 10 days.

Our standards require that, if chicks are to be trimmed, the trimming must occur at 10 days of age or younger. …

The comparison to circumcision is not perfect, of course, but the basic mindset is quite similar. If we can do it so they don’t remember it, the common belief is that any remaining ethical questions¹ simply disappear. That’s too easy because it’s one-sided and rigged to reach a predefined conclusion.

To be fair, this is the opening paragraph of the fact sheet:

HFAC allows minimal beak trimming in order to avoid heavy feather pecking and cannibalism among laying hen flocks. Feather pecking can occur in flocks of any size, and in any production system. Cannibalism is more common in large flocks (flocks of over 60-120 birds) but can also occur in flocks of any size. Cannibalism is more common in non-cage than cage systems.

Animals act in weird, barbaric ways. I wouldn’t attempt to pretend that nature is pretty or idyllic. But when assessing something like beak trimming, we’re supposed to look at cannibalism within flocks. Production system is the wizard behind the curtain we’re supposed to ignore. Why is that?

Fitting anatomy to the system becomes the goal, not fitting the system to anatomy. In that respect, it’s exactly like routine infant circumcision.

¹ For example (pdf):

The ability of beak-trimmed and intact laying hens to ingest feed pellets was examined by highspeed video filming of feeding birds. The birds were exposed to either a deep layer of pellets or a single layer of pellets. In the single layer treatment, there was a negative correlation between mandible asymmetry and feeding success. These data have important implications for poultry welfare, since the degree of bill asymmetry caused by beak trimming may, under certain circumstances, result in inadvertent feed deprivation.

Is adequate feeding relevant to humane treatment?

Reports like this always rely on a belief that the eureka moment can be whatever we want it to be.

A study in Uganda has come up with a surprising finding about sex and H.I.V. Washing the penis minutes after sex increased the risk of acquiring H.I.V. in uncircumcised men.
…

Men who washed within three minutes had a 2.3 percent risk of H.I.V. infection compared with 0.4 percent among those who delayed washing for 10 or more minutes. The National Institute of Allergy and Infectious Diseases paid for the study.

Is it so hard to point out that this only matters for men who have unprotected sex with HIV+ female partners? What is the statistical context¹ for an intelligent comparison of 2.3% versus 0.4%?

Lacking what every news item over the last two years has lacked, the foreskin, by itself, is not the problem. Behavior matters. HIV is not going to miraculously jump onto his penis and infect him if he hasn’t picked it up already. Don’t have unprotected sex with HIV+ partners. It’s not complicated. A male will need neither surgery nor stopwatch to stay healthy if he follows that simple, time-tested strategy.

¹ I suppose we’re to assume the authors of the study controlled for the incidence of intact men engaging in unprotected sex with HIV+ female partners.

Because of a slip-up, the researchers did not ask details of how the cleansing was done or directly about using soap, said Dr. Ronald H. Gray, a co-author from the Johns Hopkins Bloomberg School of Public Health. Some soaps used in Africa are more irritating than those used elsewhere.

Small detail, that. But I’m sure everything else can be trusted to adhere to rigorous standards and should be presumed correct.

Finally, a government official who is intellectually able to understand a most basic idea of equality:

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.”

I don’t have anything to add that I haven’t already said. Bravo to Mr. Mason.

A spokesman says the Government is not currently considering laws in relation to the issue.

I’d be angrier than I am angry if I was shocked.