Circumcision Articles and Discussions

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alchemy

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What the imprinting ability of circumcision might be on an adult I am not sure. If you read further down the article there appears to be NO confirmation that circumcision is actually effective in preventing AIDS, but that didn't stop Bill Clinton from announcing that it did ...

From the Guardian:


Guardian UK said:
Swazi men queue at clinics to find a cure for Aids - through circumcision

Research cited by Clinton suggests simple procedure reduces chances of infection

Leila Lak in Mbabane
Wednesday August 23, 2006
The Guardian

Sephiwe Shabange, 22, sat patiently with four other men in a busy clinic in Mbabane, Swaziland's capital. The doctor was two hours late and the small airless waiting room was getting hot. They were surprisingly calm considering they were there to be circumcised. "I do this to reduce the chance of getting HIV/Aids," he said, admitting he was nervous.

Mr Shabange, a student and mechanic, was the youngest; the others ranged from their late 20s to late 40s. Next to him was Musa Dwane, 29, an electrician. Both men had signed up for the procedure after health workers visited their workplace to extol the virtues of circumcision. "We've heard about it from friends who have done it. They say it doesn't hurt," said Mr Dwane.

The procedure takes 30 minutes under local anaesthetic. The patient waits a further 30 minutes to monitor bleeding. An hour after the operation, a pleased Mr Shabange left the clinic. "It's pain, but really it is not so bad," he said.

He is one of a growing number of Swazi men signing up for circumcision in the hope they will not become another Aids victim. Waiting times in state-run hospitals are from six to nine months, but in private or NGO-run clinics - where the procedure is done each day - the wait is two to three weeks.

The demand for circumcision rose last year when local press reported the findings of a South African study showing circumcised men to be 61-75% less likely to be infected by the virus.

"If you take those results with the observational studies you have a rather persuasive package of evidence," said George Schmid, a scientist at the HIV/ Aids department at the World Health Organisation.

Studies had compared the high rates of circumcision and low rates of HIV infection in regions such as west Africa with the low rates of circumcision and high rates of HIV infection in the south. The South African study's authors said the work showed 2m new HIV infections would be averted if circumcision were introduced across Africa. "There are a lot of assumptions involved," said Dr Helen Weiss of the London School of Hygiene and Tropical Medicine. "But it gives us an idea how potentially important male circumcision is."

Two further studies are under way in Kenya and Uganda. The results will determine whether male circumcision is put forward as part of an HIV/Aids prevention package, along with abstinence, partner reduction and condom use.

No one is sure why circumcision is preventive. One explanation is that the soft tissue of the foreskin is vulnerable to tearing and bleeding, so this can facilitate the spread of the virus. Another is that the foreskin contains a higher density of cells called Langerhan cells, which are thought to be the doorway for HIV to enter the body.

At last week's International Aids Conference in Toronto, Bill Clinton spoke of the potential benefits: "Should this be shown to be effective, we will have another means to prevent the spread of the disease and to save lives."

In Swaziland, with a population of some 1 million, and an infection rate of more than 40%, it is no wonder the population is looking for ways to beat HIV.

"The scientific community hasn't come out and said it definitely works," said Dr Mark Mills, head of the Mbabane clinic private hospital, but somehow, he said, the population heard it on the news and "it's spreading like wildfire." Demand at the clinic has risen from about one request a month last year to 50-100 a month.

"Everybody is interested because of this epidemic," said Mr Dwane, as he waited to get circumcised. "[The] problem is for those who are employed it is affordable, for those who are not it's too much. In government hospitals it is affordable but the queue is very long."

Mr Dwane paid about
 
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Compelling Evidence That Male Circumcision Prevents HIV Spread
Medical News Today - 7 hours ago
The scientific case for circumcising men as a way to prevent HIV from spreading in Africa is compelling. The realizaton of this evidence is as dramatic as the discovery of HIV and AIDS in the first place.

Intersting and probably true, as most who are not cut have hygiene issues if they are not very thorough in their cleaning of themselves.
 
With all the press on how male genital mutilation allegedly cuts HIV risk I became suspicious and did a little searching. I found this two article of interest. Africa is not only a dumping ground for tossed out vaccines which cause innumerable health problems and other experimental drugs the West doesn't want to use on its own people, but now a dubious "prevention" of HIV just so happens to be a prime source for lucrative cosmetics.

Circumcision Fight: Profit, Pleasure, or Population Control?
By Kuumba Chi Nia

“It is important that, while circumcision interventions are being planned, several points must be considered carefully. If the experiment fails, Africans are likely to feel abused and exploited by scientists who recommended the circumcision policy. In a region highly sensitive to previous colonial exploitation and suspicious of the biological warfare origin of the virus, failure of circumcision is likely to be a big issue. Those recommending it should know how to handle the political implications.� - James P.M. Ntozi.

Using circumcision to prevent HIV infection in sub-Saharan Africa

African people worldwide know about experimentation in the name of scientific advancement. However, often-vital information goes without mention and the outcome devastates the victim as in the case with the Tuskegee Syphilis Experiment in Alabama, USA. This is precisely why suspicion remains around HIV\AIDS reduction experiments, but with little investigative attention by the corporate media groups.

The good scientists would have us to believe that their efforts are to reduce HIV in the most vulnerable areas in the world.

Africa is the death basket of HIV, but my hypothesis is that the current misuse of science is driven more so by profit and population control. More than 1.2 million babies are circumcised in the U.S. per year at the cost range for $150 million to $270 million. The procedure is optional, but it is strongly suggested by medical doctors. What happens to foreskin? Foreskin removal represents a bio material waste management issue, but what scientist would simply discard of the all this skin? They would not discard it so easily as long as it can be sold and used for beautifying women.

Alternet posted a story February 9, 2007 Foreskin Face Cream and Future Beauty Products, which illustrates the profitability of foreskin as follows:

“The Coriell Institute is only one of dozens of websites that offer foreskin fibroblast for sale." Foreskin flakes cost $85.00 -- plus shipping and handling. Foreskin fibroblasts are big business. A fibroblast is a piece of human skin that is used as a culture to grow other skin or cells -- like human yogurt kits.

According to the Alternet article Foreskin Face Cream and Future Beauty Products, “human foreskin fibroblast is used in all kinds of medical procedures.� For example, foreskin is used for burn victims and for eyelid replacement and for those with diabetic ulcers (who need replacement skin to cover ulcers that won't heal), to making creams and collagens in the cosmetics industry (yes, the product that is injected into puffy movie-starlet lips).

One foreskin can be used for decades to produce miles of skin and generate as much as $100,000
-- that's not the fee from a one-time sale, but the fees from the fibroblasts that are created from those original skin cells.

One of the most publicized examples of the foreskin-for-sale trend involves a skin cream that has been promoted by none other than Oprah Winfrey, according to the article. SkinMedica, a face cream, costs more than $100 for a 0.63-oz. bottle, used by many high-profile celebrities (such as Winfrey and Barbara Walters) as an alternative to cosmetic surgery. Winfrey has promoted the SkinMedica product several times on her show, and her website, which raves about "a new product that boosts collagen production and can rejuvenate skin called TNS Recovery Complex. TNS is comprised from six natural human growth factors found in normal healthy skin ... the factors are engineered from human foreskin!"

On Winfrey’s show, the doctor promoting SkinMedica cream warned that some people may have ethical questions regarding using a product that is made from the derivative of foreskins (to which Winfrey made no response). Why is an ethical question? The foreskins come from circumcisions, and male circumcision is now a controversial topic. In a discussion on Mothering.com, the question raised, "If the cream was made from the bi-product of baby Afro-American clitoral skin, would Oprah still be promoting it?" There's no answer to that question on Mothering or Winfrey's site, and Winfrey declined a request for an interview for this article.� The next question is what is the science of circumcision?

“WebMD Medical News,� June 9, 2000 article “The Foreskin: An Open Door for HIV� pointed out the “The foreskin of the uncircumcised penis is a welcome mat for HIV,� at the time of a study. “The finding [at the time] strengthens a growing consensus among public health experts that both infant and adolescent circumcision programs ought to be a major tool in the fight to stop AIDS, especially in countries where HIV is rampant.�

Roger V. Short, ScD, professor of obstetrics/gynecology at the University of Melbourne Royal Women’s Hospital in Melbourne, Australia, and Robert Szabo, “analyzed penis tissues from autopsies of 13 men age 60 to 96 years, seven of whom had been circumcised.� Among their findings was that the inner side foreskin is rich in a type of cell that carries HIV to T cells. The T cell is the cell where the virus replicates itself.

Africa became the logical experimental lab namely Uganda. On July 10, 2000, more questions surfaced in light of the experiment. “WebMD Medical News,� printed the article, “Male Circumcision as the Answer to the African AIDS Epidemic?� However, the push was still for removing the foreskin. The article read that “About 25 million Africans [had] AIDS or are infected with the HIV virus . . . many of [them lived] . . . where circumcision� was not a regular practice. In Gauteng province of Azania\South Africa the Orange Farm experiment took in 3000 or better African males from a town’s population of 350,000. Circumcision is supposed to reduce the disease by millions yearly. In Gauteng the estimated HIV prevalence among antenatal clinical attendees in the year 2000 was 29.4 percent and increased to 32.4% in 2005. The Orange Farm snip happy pappy proved wrong, with the notable increase of HIV and AIDS statistics for South Africa.

More than 20-years passed since the initial claim surfaced that there is a correlation between a lack of circumcised African men and HIV versus circumcised African men. The French and U.S. are leading the way with World Health Organization support.

The “San Francisco Chronicle� reported on July 6, 2005, “Medical anthropologists began noticing as early as 1989 that the highest rates of HIV infection in Africa were occurring in regions of the continent where the predominant tribal or religious cultures did not practice circumcision.�

The lead medical scientists are Dr. Betran Auvert of the University of Paris and Adrian Puren of South Africa’s National Institute for Communicable Diseases and Ronald Gray a Johns Hopkins University epidemiologist Ronald Gray are conducting an experiment in Uganda of 5,000 men in the Rakai district. The same experiment occurred in Kenya with more than 2,700 men being snipped. The experiments termination date is in 2007. The findings are generalizations that are neither conclusive nor exhaustive and therefore represent a problem in male circumcision and the role in HIV prevention?

In the tradition of bogus science, the data that was presented by advocates of circumcision remained inconclusive and dangerous as pointed out by De Vincenzi and Mertens (1994) with “the salient point that most of the quoted studies were not designed to test a hypothesis about circumcision and did not report their methodological details for evaluation.�

Furthermore, “there is no evidence that enough statistical rigors (sic) were applied to the data.� That is inconclusive information. Meanwhile, “where, in small-scale studies, this was done by controlling for several variables like age, number of partners, [and] contact with prostitutes, ethnic origin and findings that did not fit into the conventional thinking of the hypothesis were rejected by the journals as not interesting, or the researchers did not submit them for publication for fear of rejection.�

The good doctors know that there is nothing conclusive about their work as admitted by Dr. Auvert: Circumcision "prevented six to seven out of 10 potential HIV infections," said Auvert. He said the study did not analyze the effect of circumcision on male-to-female transmission or if circumcision provides effective protection over the long term. At least three more studies are under way to confirm the effectiveness of circumcision. Dr. Auvert and company said the study was cause for guarded optimism.

These experiments continue but do not work. An experiment like this should have never been practiced and funded, and represents bad science. It is more likely to isolate the African masses from medical scientist, and treatments that touted as lifesavers, while they fall short of reducing HIV/AIDS in Africa.

“It is important that, while circumcision interventions are being planned, several points must be considered carefully. If the experiment fails, Africans are likely to feel abused and exploited by scientists who recommended the circumcision policy. In a region highly sensitive to previous colonial exploitation and suspicious of the biological warfare origin of the virus, failure of circumcision is likely to be a big issue. Those recommending it should know how to handle the political implications.� - James P.M. Ntozi

link

Apparently, the procedure is not without its risks...

Week-old baby dies of heart attack after circumcision
SCOTLAND Yard officers are investigating after a Golders Green baby stopped breathing, minutes after he was circumcised.

Eight-day-old Amitai Moshe is thought to have suffered a heart attack after the ceremony at the Golders Green Synagogue on Dunstan Road earlier this month.

He was rushed to the Royal Free hospital, but was later transferred to the University College Hospital, where initial tests suggested the cause of death was a heart attack. He died there on February 9, eight days after the ceremony.

Although Jewish leaders say there is no link between the circumcision and the baby's death, Specialist Crime Directorate officers have been called in.

Amitai's father Ran, 32 and his mother Yotvet, 30, were too distraught to comment this week, but the community has rallied around the grieving family.

Rabbi Harvey Belovsky from Golders Green Synagogue said: "Our main task has been to help the family in as sensitive a way as possible at this time.

"It is reassuring to see that they feel so supported by the members of our congregation, who have rallied to their side throughout this trying and difficult period.

"Our hope is that we can continue to provide everything they need to help them overcome this tragic experience."

Jewish baby boys traditionally undergo the ceremony, known as the Brith Milah, on the eighth day of their lives.

A spokesman for the Board of Deputies of British Jews said: "First and foremost this is a family tragedy and our deepest sympathies go out to everyone concerned.

"The circumcision was carried out safely in accordance with the usual scrupulous adherence to the rules governing both the procedure and the mohel (circumciser).''

link
 
While there may be a negative correlation between circumcision and HIV, this is kind of like saying, in a country where lice is epidemic, shaving your entire body helps to prevent lice spreading. It may be true, but perhaps there are other problems with being totally hairless/circumcised, or more efficient methods?
 
It often distresses me that we are so willing to take a pill or alter our body in some way so as to "heal" or "protect ourselves". While I understand the serious nature of HIV and the need for prevention strategies I still, as a "natural healer" am taken back by our desire to continually control the outcome of anything in this world by directly interfering with the natural process. I hope that this article that shows a reduction in the spread of AIDS through the use of circumcision is not implying that men be forced into this procedure. People have decisions to make, many of these decisions are made poorly resulting in unfortunate circumstances. This does not mean we take away the right to choose our own path. You may say "what about those who are innocently hurt in the process?" While I agree that many that have not actively engaged in "high risk" behaviour will be affected most of them will have made the choice to engage in an activity with someone who has. We must all be careful in finding the choices we are most comfortable with and then deciding on one of them. Unfortunately, all we continue to do is muddy the waters and there is no easy answer, only more questions. Understand, I have compassion for all and feel pain for those who suffer but with that I also believe at no time should we eliminate peoples right to choose the path on which they want to live.

Hope that stayed on topic.
 
Well we are speaking of cleanliness. It Is harder to clean hidden area and folds. Doctors in certain locals regularly meet patients who in 20 years have never removed thier socks/stockings!! When I heard that I was floored, but much of humanity is simply brain dead and anything that helps ... well if it helps and has no bad point it seems to make sense, They are not clean even being cut. Without the procedure it has to be worse of a problem, if they are not clean with it. Anything beyond the waist will take care of itself with a simple rinse, they think.

Muslums are all trained at an early age to keep all of that area clean. Many other religions are totally afraid of the genetalia area as they are paralized with fear at the thought of dealing with sex at all. Talk about backwards.

Our space brothers had this to say about religion:

"Religion is only a primitive concoction by man to command, suppress and exploit others, to which only spiritually weak life forms succumb."
Semjase
 
The damage from circumcision far outweighs any claimed protection from aids. That's like saying one armed men never die in plane crashes, so all the men go out and get an arm cut off without stopping to consider the fact that the odds of dying in a plane crash are vanishingly remote relative to the population numbers.

Not to mention that there are some relatively simple ways to avoid getting AIDS... that do not involve mutilation of an important cluster of nerve endings that map to the brain.

But, since you have brought up the subject - and I am absolutely, categorically AGAINST it - (I was present once when an infant boy was circumcised and I have NEVER forgotten the horror of it!) - I think I will use this thread to collect the evidence AGAINST circumcision, beginning with my own thoughts on the subject.

You will find discussion of circumcision on the following pages:

http://www.cassiopaea.org/cass/biblewho4.htm

http://www.cassiopaea.org/cass/biblewho6.htm

and

http://www.cassiopaea.org/cass/wave13e.htm

where you will read the following:

The first stage, or circuit, is the oral-passive-receptive, and is imprinted by what is perceived to be the mother or first mothering object. It can be conditioned by nourishment or threat, and is mostly concerned with bodily security. Trauma during this phase can cause an unconsciously motivated mechanical retreat from anything threatening to physical safety.

In recent times I have given a lot of thought to this particular circuit because of the matter of circumcision. Having come to the tentative idea that the whole Judeo-Christian monotheistic rant was a major control program, I came face to face with the question: how and why has it worked so well for so many thousands of years? More than that, how was it imposed in the first place?

I puzzled over this for weeks. I thought about several things that Friedrich Nietzsche had said that struck me like thunderbolts of truth once I was able to really step back and look at the matter:

Neitzsche said:
The Jews are the most remarkable nation of world history because, faced with the question of being or not being, they preferred, with a perfectly uncanny conviction, being at any price; the price they had to pay was the radical falsification of all nature, all naturalness, all reality, the entire inner world as well as the outer, They defined themselves counter to all those conditions under which a nation was previously able to live, was permitted to live; they made of themselves an antithesis of natural conditions - they inverted religion, religious worship, morality, history, psychology, one after the other, in an irreparable way into the contradiction of their natural values.

...Christianity has waged a deadly war against the higher type of man. It has put a ban on all his fundamental instincts. It has distilled evil out of these instincts. It makes the strong and efficient man its typical outcast man. It has taken the part of the weak and the low; it has made an ideal out of its antagonism to the very instincts which tend to preserve life and well-being... It has taught men to regard their highest impulses as sinful - as temptations.

...What is Jewish, what is Christian morality? Chance robbed of its innocence; unhappiness polluted with the idea of "sin;" well-being represented as a danger, as a "temptation," a physiological disorder produced by the canker worm of conscience. [The Anti-Christ, 1888]
But, that's not to say that Nietzsche was any paragon himself, with his mysogynistic, misanthropic rants! He was, in fact declared insane in 1888.

Revolt against the whole civilized environment in which he was born is the keynote to Nietzsche's literary career. [Britannica, 11th ed.]
Nevertheless, he had a point about Judaism and Christianity (and any and all other monotheistic, dominator religions.)

So, there I was, pondering this and trying to figure out HOW and WHY people could be so completely taken in by this utter nonsense? How can educated members of the human race, in this day and age, with all the resources of knowledge and awareness available to those who have the desire and energy to search for truth, possibly buy into such myths?

It just staggered my mind to think about it.

I went back in my thinking to the whole Jehovah-I AM deal; the Moses story and all that; and went over the details as they are presented in the Bible for clues. And I came up against that most interesting demand of that crafty Lizard, Jehovah/Yahweh: circumcision - on the 8th day, no less.

What better way to ensure a deep, subconscious, distrust of women - not to mention an overwhelming terror at the very mention of the pain and suffering that might ensue from breaking the monotheistic covenant - than whacking a guy's pee-pee when he is interested only in being warm, cozy, and filling his tummy with warm, sweet milk from mother?!

Whoah! Talk about your basic abyssal cunning there!

The first "circuit" is concerned with what is safe and what is not safe. In our society, money is one of the primary items that is intimately tied to survival and biological security. Money represents survival. In addition to that, people who have been traumatized during the imprinting phase of the first circuit tend to view other people in an abstract way. It is "us and them." They also tend to be very easily threatened by disapproval of any sort because disapproval suggests the idea of extinction or loss of food supply. And, finally, those who have been negatively imprinted at this stage tend to have a chronic muscular armoring that prevents proper, relaxed breathing; they are "up tight."

One of the main characteristics of people who are heavily controlled by this circuit, or are "stuck" in this "oral phases," is that when they sense danger of any sort, whether actual or conceptual, all mental activity comes to a halt. Such people are chronically anxious and dependent - mostly on religion. They are not able to really understand what other people are feeling or what can happen in the future in regard to relationships, given a certain present situation. They only understand what is happening "now," and they can only feel what THEY feel. They cannot accurately grasp what others feel because they relate to others only as sensory objects.

And, how many men are circumcised? A LOT, I can tell you. And, besides the Jews, for years, the AMA advocated and urged circumcision of American babies for "hygienic" reasons. Hmmm...

As a side note, trauma or failure to bond at this oral phase tends to also lead to weight issues - either overweight or underweight.

The expression of healthy growth through this phase is the ability to retain the state of consciousness of the "natural child" who feels safe in the world no matter what they encounter.
I later discussed this with a Jewish doctor who had become interested in the matter. He did some research on "neural sheets" and discovered the idea that every part of the body maps to an area of the brain and that the area of the brain that is "connected" or "maps to" the foreskin is one that is particularly rich in the types of brain cells that are apparently involved in achieving states of higher consciousness. He was absolutely appalled to learn this.

So, considering that, as well as my own speculations about circumcision, we are not surprised that they have come up with a scare tactic to get every man on the planet to whack his pee-pee.
 
You might want to move this post to here:
http://www.cassiopaea.org/forum/index.php?topic=5242.msg34840#msg34840
where I plan to collect and archive more information.

Thanks.
 
Now, to collect and archive some material that may otherwise disappear with the push to get every man whacked...

http://www.cirp.org/library/cultural/goodman1999/

Jewish circumcision: an alternative perspective

J. GOODMAN

Introduction

As a Jew, I used to take ritual circumcision completely for granted. I watched the procedure many times, when a son was born to family or friends. It is unusual for a woman to watch, but I was a young medical student, unafraid, curious and, eventually horrified. My concern about this issue has arisen slowly, simply from what I have seen.

In the first section, I examine the reasons for circumcision, and compare some of the physiological and clinical findings about the procedure with popular Jewish beliefs about its nature and consequences. I consider the effect of the procedure on the mother as well as the child, and discuss the ethical implications. In the second section, I discuss some Jewish texts and traditions that could surprisingly, lend support to challenging the established practice of circumcision.

In the third section, I describe the historical and psychosocial factors that make challenging Jewish circumcision so problematic, and that sometimes lead to intensely negative responses to new information about it. I also discuss the vexed question of whether challenging Jewish circumcision is necessarily anti-Semitic.

In the penultimate section, I examine the received view that Jewish people practise circumcision because of God’s commandment to Abraham (in Genesis 17:11–14). I show that for most Jewish people, the reasons have more to do with a sense of belonging than with a sense of being divinely commanded. I then argue that circumcision is, nevertheless, not as essential to our Jewish identity as most of us have assumed. Finally, I consider the possibility of cultural evolution, providing examples from within and outside the Jewish community of how, despite the difficulties, customs can and do change.

Reasons for questioning religious circumcision

There are several reasons to reconsider the practice of religious circumcision, including the pain, trauma and complications associated with the procedure, the lack of previously supposed medical benefits, and the effect of circumcision upon the mother of the circumcised child.

Pain and trauma

Jewish boys are circumcised at 8 days of age, i.e. well within the neonatal period; no anaesthetic is used. The level of pain associated with the operation, whether judged by the babies screams or by objective physiologically indices such as heart rate and plasma cortisol levels, is severe. Even using a lignocaine injection for neonatal circumcision, Stang et al. [1] showed plasma cortisol levels of 331 nmol/L. whereas the normal level is 28-138 nmol/L. Similarly Benini et al. [2] found heart rates of 180 bpm in recently circumcised babies, which were only slightly reduced (to 160) by anaesthetic. Paediatrician Paul Fleiss, writing in Lancet, considers these cortisol levels and heart rates to be ‘consistent with torture’ [3].

Other researchers have found comparable physiological responses indicative of severe stress during circumcision, including dramatic rises in respiratory rate and trancutaneous oxygen, as well as plasma cortisol level and heart rate [4–6]. Circumcision is so painful that it has now, according to Stang et al. ‘become a model for the analysis of pain and stress responses in the newborn’ [1].

These findings contrast starkly with the beliefs commonly expressed in the Jewish community that ‘its only a little snip that doesn’t hurt’, and ‘it’s just like changing their nappy or cutting their fingernails’. Even though most babies scream, tremble and go pale or ever blue, many Jewish people will describe a circumcision they attended at which ‘the baby didn’t cry, in fact he just went to sleep’. This is taken to mean that the baby felt no pain. However, studies suggest that rother than feeling fine, these babies may actually be lapsing into a lethargic, semicomatose state as a reaction to overwhelming stress [7-9].

Another popular belief, perpetuated even by those Mohelim (ritual circumcisers) who are also doctors, is that ‘there are no nerve endings in the foreskin, so it can’t possibly hurt’. However, it has been clearly show that the foreskin is a complex and important sensory organ, containing many nerve endings, including the specialized Meissner’s corpuscles, similar to those found in the fingertips and lips [10].

In conversations about circumcision, many Jewish people claim that Jewish circumcision is less traumatic than, say, Muslim circumcision, precisely because it is performed at such an early age. The underlying myth, common until recently in the wider community, is that newborn babies simply do not feel pain. But medical research contradicts the wishful thinking of folk beliefs. Not only do newborn babies feel pain, they feel it more intensely, for longer and over a wider area of the body than do older children or adults subjected to the same stimulus. Fitzgerald and her team at University College London, have shown clearly that the nervous system of a newborn baby differs from that of an older child or adult, both anatomically and physiologically, so that what would constitute a light or harmless stimulus to the older child or adult actually produces pain in the newborn. Furthermore, newborns lack the inhibitory or ‘damping down’ mechanisms of the more mature nervous system, so they cannot protect themselves from the experience of pain in the way they could at a later stage. [11].

The developmental anatomy of the penis also suggests that the earlier circumcision is performed the more painful it will be. In the neonatal period, only 4% of children have a retractable foreskin. For 96% of Jewish babies therefore, circumcision will involve the forcible tearing of the foreskin from its attachment to the glans, as well as the cutting of its attachment to the sulcus. However, at the age of 3 years, 90% of boys have a retractable foreskin and this trauma would only apply to 10% of them [12].

Closely following (and contradicting) the ‘no pain’ story, one frequently encounters the following statement: ‘Alright, maybe it hurts, but it only lasts a moment and they forget about it the minute its over. They’re too young to have any memory of it’. In fact, the raw surface of the glans may bleed and be painful for several days after the circumcision, so the pain is far from momentary. Further, there is ample evidence that newborns do have some memory of the event, which takes the form, not of conscious remembering, but of a permanent restructuring of the nervous system. The result is an intensification of the behavioural response to subsequent painful stimuli, as though the nervous system has been ‘sensitized’. Thus, for example, Taddio et al. [13] found that pain responses in children being vaccinated were significantly greater in those who had been circumcised (several months previously) than in those who had not. Other studies show that pain experienced in early infancy can disrupt breast-feeding, mother-infant bonding [14] and sleeping patterns [15].

In addition to pain, circumcision is traumatic because it constitutes an experience of utter helplessness [16]. Not only is the child in great pain, but nothing he does can help to avoid or reduce the pain. His cries have no effect and movement to escape is impossible, because he is held down; he learns that he is powerless.

Complications

Many serious complications of ritual circumcision have been reported. [17], including haemorrhage, infection, meatal stenosis [18], amputation of the penis [19,20], trapped penis [21], urinary retention (frequently from tight bandaging) and renal impairment (rarely [22], UTI [23], septicaemia [24], and four cases of acute heart failure [25], Williams and Kapila [26] reported a horrifying list of surgical disasters leading to permanent severe damage to the penis.

I have listened to several Jewish women describe how their sons hemorrhaged severely after circumcision, requiring hospital admission and blood transfusion. In one case, an orthodox Jewish woman, whose only child had bled nearly to death, felt so traumatized that she chose to have no more children although deeply wanting them. She said ‘if I had another boy, I couldn’t bear to have him circumcised. But I also could not bear not to have him circumcised’. Her son is 16 years old now and has no siblings.

While haemorrhage, infection and the occasional tragic accident may be acceptable risks in surgery performed to treat disease, and to save life and limb, i.e. where the risks clearly outweigh the risks, they are unacceptable risks in ‘surgery’ that has no such healing function. As far as I have been able to ascertain, neither the Jewish nor the Muslim community in Britain keep any statistical records of the complications of circumcision performed by their practitioners.

Lack of presumed medical benefits

According to the Jewish religion, circumcision should be carried out purely for reasons of faith, not for any real or imagined medical benefits. Nevertheless, in conversations with secular and non-orthodox Jewish people, ‘hygiene’ and ‘preventive medicine’ are frequently given as reasons for continuing the practice. Most Jewish people seem unaware that claims for the prevention of cervical cancer, penile cancer, UTI, etc., have been thoroughly discredited [27], as were the claims for prevention of asthma, epilepsy and ‘masturbatory insanity’ which preceded them. In any case, preventive medicine is normally about choices that a free adult can make, relating to diet, lifestyle, screening programmes, etc. It is not usually about removing healthy body parts from infants.

Effects on the mother

The strongest instinct of the new mother is to hold, cherish and protect her baby. In the Jewish world, this natural and vital desire is brought into immediate and painful conflict with the demands of tradition. In gatherings of Jewish women over the past several years, I have listened to scores of Jewish mothers and grandmothers describing how they felt torn between loyalty to their child and loyalty to their tradition, at what should have been a time of resting and rejoicing. I have heard African and Muslim mothers describe the same agonizing dilemma. Usually, the circumcision goes ahead and the mother feels impotent, guilty, and full of regret, even many decades later. Many mothers say they only consented because they had been told it was a painless, minor procedure. Had they realized the degree of blood and trauma involved, they would never have agreed; they felt betrayed.

In Jewish law, it is the father not the mother, who is commanded to circumcise the boy. It is a rite of male bonding, designed (unconsciously), as are all such rites worldwide, to separate the baby boy from his mother and to claim him as ‘one of the men’ of the tribe. It was Abraham, not Sarah, who was commanded to circumcise. It is Jewish men, not the woman or children, who have defined circumcision as sacred. As Pollack points out [28], Jewish women now need to redefine what is sacred, and every mother knows in her heart that there is nothing sacred about taking a knife to a child’s genitals. There is nothing sacred about shattering a child’s inborn trust, his basic assumption that his parents will do their utmost to protect him from harm. Pollack states, ‘Circumision is fundamental to patricarchy, but it is not holy’ [29].

Ethical implications

Anyone subjecting an adult to what is permitted in regard to an 8-day-old baby would be charged with assault. If children and babies are to be regarded as fully human beings, then it must surely be unethical for them to be held down forcibly while a healthy functional part of their body is excised. It is not only that babies are helpless, or that they are too young to give consent. Their reactions, their screams, and that they have to be held down at all, are best and only way of indicating that they are actually withholding their consent.

Judaism, like all religious traditions, has many layers and many strands. In the next section, I show that despite the Biblical injunction to circumcise, support can be found from many Jewish sources for the view that circumcision of infants is unethical and should therefore be abandoned.

Textual support for change within Judaism

In Judaism, and in Islam, the human being is considered to be made in the image of God, and God is conceptualized as perfect. So one could not argue that interfering with God’s perfect creation is a form of blasphemy. In Judaism there is a law of ‘Shmirat Ha Guf’, the guarding or protecting of the body. Body-piercing, tattooing and amputation are all forbidden for this reason. Further, there is the Talmudic concept of ‘Tsa’ar ba’alei chayyim’, compassion for all living creatures. If compassion in all its fullness were applied to 8-day-old babies, circumcision would become impossible.

The literal commandment to circumcise that is found in Genesis appears in the later books of Deuteronomy and Isaiah with a metaphorical meaning. The prophet Isaiah urges people to ‘circumcise the foreskin of your hearts’, i.e. to melt the hard shell of defensive insensitivity with which each of us armours our innermost selves. This is highly inapplicable today; as we ‘circumcise the foreskins of our hearts’, we become able to hear the anguished cries of our babies.

The Shulchan Aruch, the authoritative Code of Jewish Law, says: ‘Extreme care should be taken not to circumcise an infant who is ailing, as the fulfilment of all ordinances is suspended if there is danger to human life. Moreover, the circumcision can be performed at a later date, but the life of a human being can never be restored’. [30] (emphasis added by present author).

The Talmud discusses at length the imperative of ‘Pikuach Nefesh’, the obligation to save human life in any situation in which it is endangered, whether the danger is immediate or only potential, as in the case of a condition which is not dangerous now but could suddenly deteriorate [31]. The rabbis derive this ruling from Leviticus 19:16; ‘Neither shalt thou stand idly by the blood of thy neighbour’. It could certainly be argued that circumcision of an 8-day-old baby constitutes a condition which could, and sometimes does, suddenly deteriorate.

The Talmud goes on to say (Hul. 10a) that ‘One should be more particular about matters concerning life and health than about ritual observances’. It insists, for example, that even the laws of the Sabbath must be broken to give medical treatment or comfort to a sick person or a postpartum woman (Yoma 85a). This is despite the fact that keeping the Sabbath is of the Ten Commandments; circumcision, significantly, is not.

Jewish law is an evolving process that has always taken into account new developments in science and understanding, and attempted to integrate them. Given what is known about life-threatening complications of neonatal circumcision, there is an argument from within Judaism to adapt Jewish law, so that the circumcision of helpless, non-consenting babies becomes forbidden, not demanded.

The medieval rabbi Maimonides, regarded as the greatest Jewish sage of all time, writes of circumcision: ‘……one of its objects is to limit sexual intercourse, and to weaken the organ … the use of the foreskin to that organ is evident … there is no doubt that circumcision weakens the power of sexual excitement, and sometimes lessens the natural enjoyment; the organ necessarily becomes weak when it loses blood and is deprived of its covering from the beginning’ [32]. Maimonides was a physician as well as a rabbi. His words foreshadow current medical understanding of the protective and sexual functions of the foreskin. Although he was writing in defence of circumcision, the text might be interpreted very differently today.

Difficulties of questioning circumcision in the Jewish community

Many Jewish people, when they encounter the arguments outlined in the first section about the pain, trauma, and dangers of circumcision, say something along the lines of: ‘Well, you’re quite right. I can’t disagree with you. — I know its completely irrational, but I just feel we must carry on doing it’. Others become very angry, dismissing solid medical evidence and genuine humane concern as an anti-Semitic attack. To make sense of these responses, and of the tremendous resistance (i.e. fear manifesting as defensiveness) which will be encountered by any person challenging Jewish circumcision, whether from within or outside the community, the psychological meaning of circumcision for the Jewish people must be understood. To understand that requires some knowledge of Jewish history.

Persecutors of the Jews have always attempted to ban circumcision. That their motivation was the extermination of the Jewish people, rather than any humanitarian concern for children, is shown by the fact that circumcision is frequently punishable by death. In 168 BCE, Antiochus IV Epiphanes of Syria ordered his soldiers to execute circumcised Jewish babies and their parents. In CE 135, the Roman Emperor Hadrian forbade Jewish religious teaching and the keeping of the Sabbath, and made circumcision an offence punishable by death. Jews defied these decrees, and thousands were tortured and died the death of martyrs, refusing to abandon this symbol of their faith. The story was repeated in the Spanish Inquisition, under the Soviet government and under the Nazis. Circumcision thus became an emblem not just of faith, but of loyalty, courage and the defiant fight for freedom against terrible oppression. Even in the cattle-cars on the way to Auschwitz, Jews circumcised their children. They were doing what they believed to be right, affirming their identity and faith even in the depths of hell.

All Jewish people, including myself, carry this history in our collective memory, and any challenge to circumcision evokes it, whether consciously or unconsciously. Even the most well intentioned criticism can therefore sound like a massive threat. Circumcision has become, in Pollack’s words, ‘laminated to our psyches by generations upon generations of trauma’ [28].

As well as those features that are specific to Jewish history, there are other powerful reasons why ritual circumcision continues, i.e. psychological mechanisms common to any communities practising circumcision or equivalent rites. Familiarity breeds numbness and denial. The men present at a Bris Milah (Covenant of Circumcision; women are usually absent, from choice in the Reform Jewish world and by exclusion in Orthodox circles) have all been circumcised themselves. To them, it is the ‘normal’ state. They are present at a ‘celebration’, bringing their child into the Covenant. In a very real sense they do not hear the child’s screams of agony. This desensitization is a cross-cultural phenomenon; it was apparent in the obstetric wards of the 1970s and 1980s, where nurseries full of screaming newborn, isolated from human touch in cribs far away from their mothers, were approvingly dismissed with phrases such as ‘healthy pair of lungs’. This was also ‘normal’. For the circumcised Jewish man, therefore, it takes tremendous courage and insight to say ‘I have been damaged. My parents made a mistake. I won’t pass this wound on to my son’.

Fear of anti-Semitism must not be allowed to stifle dissent. Nevertheless, for those choosing to challenge Jewish circumcision from outside, it is necessary to know the history outlined above and to be aware of how any criticism may therefore be misinterpreted. It is also crucial to be absolutely certain that the message and motivation are free from racism in the present. Specifically, criticizing a custom must to degenerate into attacking or demonizing those who practise it. They are good-hearted people who love their children, but have grown up with a different set of rules. Most people of all races and religions do what they have always done, unquestioningly most of the time, and Jews, Muslims and others who circumcise are no exception. One way to avoid racism is to take the broad multicultural view, that we all have something to learn from each other. An example will make this clearer; many African mothers have their daughters genitally mutilated. White westerners find this appalling and wonder secretly whether the parents can really love their daughters. But then, many white western parents even now leave their young children to sob, alone, behind a closed door, night after night, because it is past 7.30 pm and ‘they must learn that bed-time means bed-time’. Any African mother would be appalled and would wonder secretly whether the parents can really love their children. She would tell us that young children need human contact, carrying and cuddling, whatever time of day or night; she would tell us that we are doing something wrong.

Anti-Semitism is a particularly virulent form of racism and avoiding it while challenging Jewish circumcision must be a matter of deep intent, not merely of style. This is not only because racism is counterproductive in the effort to educate people fully about the reality of circumcision, but because racism is itself as cruel and unethical as the circumcision of helpless babies. I am challenging circumcision because it is the particular form of violence to children that occurs in my own culture: however, every culture has its own form of oppression that needs attention.

Religious circumcision and Jewish identity

The usual defence advanced for Jewish circumcision is that it is commanded by God (Genesis 17: 11–14) so it simply must be done. However, on closer examination, this statement (which in any case is not amenable to rational argument) turns out not to be the real reason, except for the tiny minority of Jews who take the Bible literally. Surveys show that even among traditional Jewish women (those attending orthodox synagogues), only 32% consider belief in God to be central to being a good Jew [33]. Most Jewish people do not carry out most of the 613 biblical commandments. Even the ultra-orthodox would not dream of carrying out the whole of the circumcision commandment, which actually states that servants and non-Jewish house-guests must also be circumcised! (Genesis 17: 12).

The inconsistency is even more striking when considering Reform, Liberal, atheist and unaffiliated Jewish people. The Reform and Liberal movements select freely among commandments, modernizing the tradition and re-interpreting biblical texts in metaphorical, socially conscious ways. Atheist and unaffiliated Jewish people have often abandoned all contact with the tradition. Yet all these groups still circumcise their sons, indicating that they feel psychologically just as ‘bound’ as the strictest traditionalist. What binds them is not a sense of divine command, but a fear of not belonging; there is a real terror of being the one to ‘break the chain’. The weight of history and the resultant social pressure mediated through the family are very difficult forces to resist.

For all of these reasons, and those discussed in the previous section, circumcision seems to be inextricably welded to Jewish identity and challenges to that identity are experienced as challenges to Jewish survival itself. Yet there are arguments to show that Jewish identity is not, after all, as dependent upon continuing circumcision as it might appear.

First, whose Jewish identity? Only that of the men. Jewish women have maintained their identity perfectly well for 4000 years, with no equivalent marking or scarring, and to say that ‘circumcision is vital to Jewish identity’ is to exclude 52% of the Jewish population. Second, although Jewish people like to think of circumcision as an identifying sign unique to them, it clearly is not. It is also practised by Muslims, non-Muslim Africans, Australian Aborgines and much of white North America (and Korea, see Kim and Pang, this supplement), and is described in Egyptian papri from 4000 BCE. Thirdly, although some rabbis still believe that circumcision will keep Jewish males ‘within the fold’, the reality is that it has not stopped many young Jewish men from leaving the faith. Lastly, in Jewish law (Halacha), the son of a Jewish mother is de facto Jewish, whether circumcised or not.

Conclusion: Possibilities of cultural change

All cultures evolve and change, and what was indepensible in one era becomes redundant in the next. Generations of Chinese women were crippled by footbinding, a practice that was considered absolutely essential to the Chinese way of life, until the 1920s, when feminist campaigners successfully stopped it, and the predicted ‘collapse of the culture’ failed to materialize. Similarly, the Sabine people of Eastern Uganda have recently abandoned their long-entrenched, traditional practice of female genital mutilation; their culture, too, has survived.

In the British Jewish community, a small but growing member of young parents are refusing to circumcise their baby boys. They are beginning to create alternative non-violent rituals, gentle ceremonies to welcome babies of both sexes into the Jewish community and the wider world. The greatest fear of Jewish parents, that their child will be ostracized from the community if he is not circumcised turns out to be a circular, self-perpetuating argument, only true so long as everyone believes it. As more parents have the courage to say ‘no’, then the intact Jewish boy becomes no longer the exception, no longer the ‘odd one out’. In fact, the uncircumcised Jewish boys and their families have remained firmly within the Jewish community. Judaism has many joyful and life-affirming customs to maintain and pass on, and I believe Jewish culture will be strengthened, not weakened, by our outgrowing of neonatal circumcision.

I have shown that circumcision is painful, traumatic and potentially dangerous, but that because of our past, it carries huge symbolic significance to the collective Jewish psyche. However, I suggest that our tremendous historical suffering does not negate or justify the continuing pain of our baby boys. Chief Rabbi Jonathan Sacks, interviewed on the BBC [34], stated that the purpose of circumcision was to ‘sanctify sexuality’. When asked how it could do so, he replied, ‘It’s not causal, its symbolic’. However, in the final analysis, circumcision is not symbolic for the baby: it is horribly real. Now is the time to lay the knife aside and to move forward into the 21st century with a form of ritual that is truly welcoming and that is truly purely symbolic.

References

1 Stang HJ, Gunnar MR, Snellman L, Condon LM, Kestenbaum R. Local anaesthesia for neonatal circumcision: Effects on stress and cortisol response. JAMA 1988; 259: 1507–11

2 Benini F, Johnson C, Faucher D, Aranda JV. Topical anaesthesia during circumcision of newborn infants. JAMA 1993; 270: 850–3

3 Fleiss PM. Letter. Lancet 1995; 345: 927

4 Rawlings DJ, Miller PA, Engle RR. The effect of circumcision on transcutaneous PO2 in term infants. Am J Dis Child 1980; 134: 676–8

5 Gunnar MR, Fisch RO, Korsvik S et al. The effects of circumcision on serum cortisol and behaviour. Psychoneuroendocrinology 1981; 6: 265–75

6 Talbert LM, Kraybill EN, Potter HD. Adrenal cortical response to circumcision in the neonate. Obstet Gynecol 1976; 48: 208–10

7 Emde RN, Harmon RJ, Metcalf D et al. Stress and neonatal sleep. Psychosom Med 1971; 33: 491–7

8 Gunnar MR, Malone S, Vance G et al. Quiet sleep and levels of plasma durining recovery from circumcision in newborns. Child Dev 1985; 56: 824–34

9 Marshall RE, Stratton WC, Moore JA et al. Circumcision: 1. Effects on newborn behaviour. Infant Behav Dev 1980; 3: 1–14

10 Taylor JR, Lockwood AP, Taylor AJ. The prepuce: Specialised mucosa of the penis and its loss to circumcision. Br J Urol 1996; 77: 291—5

11 Fitzgerald M. The birth of pain. MRC News 1998: 78: 20–3

12 Gairdner D. The fate of the foreskin. Br Med J 1949; 2: 1433–7

13 Taddio A, Goldbach M, Ipp M, Stevens BB, Koren G. Effects of neonatal circumcision on pain response during vaccination in boys. Lancet 1995; 345: 291-2

14 Anand KJS, Hickey PR. Pain and its effects in the human neonate and fetus. N Engl J Med 1987; 317: 1321–29

15 Anders T, Chalemian R. The effects of circumcision on sleep-wake states in human neonates. Psychosom Med 1974; 36: 174–

16. Odent M. Learned helplessness: a concept of the fuhure. In Denniston GC, Milos MF, eds, Sexual Mutilations – A Human Tragedy. Chapt. 10. New York: Plenum Press, 1997: 121-4

17 Kaplan GW. Complications of circumcision. Urol Clin North Am 1983; 10: 543–9

18 Robson WL, Leung AK. The circumcision question. Postgrad Med 1992; 91: 237–44

19 Audry G, Buis J, Vazquez MP, Gruner M. Amputation of penis after circumcision — penoplasty using expandable prosthesis. Eur J Pediatr Surg 1994; 4: 44–5

20 Yilmaz AF, Sarikaya S, Yildiz S, Buyakalpelli R. Rare complication of circumcision: penile amputation and reattachment. Eur Urol 1993; 23: 423–4

21 Bergeson PS, Hopkin RJ, Bailey RB Jr, McGill LC, Platt JP. The inconspicuous penis. Pediatrics 1993; 92: 794–9

22 Craig JC, Grigor CW, Knight JF. Acute obstructive uropathy — a rare complication of circumcision. Eur J Pediatr 1994; 153: 369-71.

23 Cohen HA, Drucker MM, Vainer S et al. Post-circumcision urinary tract infection. Clin Pediatr Phila 1992; 31: 322–4

24 Menahem S. Complications from ritual circumcision: pathogenesis and possible prevention. Isr J Med Science 1981; 17: 45–8

25 Mor A, Eshel G, Aladjem M, Mundel G. Tachycardia and heart failure after ritual circumcision. Arch Dis Child 1987; 62: 80–1

26 Williams N, Kapila L. Complications of circumcision. Br J Surg 1993: 80: 1231-6

27 Warren JP. NORM UK and the medical case against circumcision. In Denniston GC, Milos MF, eds. Sexual Mutilations — A Human Tragedy. Chapt 7, New York: Plenum Press, 1997: 96–8

28 Pollack M. Redefining the sacred. In: Denniston GC, Milos MF, eds. Sexual Mutilations — A Human Tragedy. Chapt 16. New York: Plenum Press, 1997: 163–72

29 Pollack M. Circumcision: A Jewish Feminist Perspective. In Weiner K, Moon A, eds, Jewish Women Speak Out. Seattle: Canopy Press, 1995: 185

30 Ganzfried S. (translated Goldin HE). Kitzur Shulchan Aruch, Code of Jewish Law. Chapt. 163, New York: Dover Publications, 1904, 1956: 378.

31 Encyclopedia Judaica, Vol. 13, Jerusalem: Keter Publishing House 1971: 510

32 Maimonides M. The Guide for the Perplexed. (Translated by Friedlander M). New York: Dover Publications, 1904, 1956: 378

33 Schmool M, Miller S. Women in the Jewish Community: Survey Report. London: Adler House, 1994: 23

34. Sacks J. BBC Radio 4. Interview 19th Sept. 1992

Author

J. Goodman, MA, MBChB, Full-time mother.
Correspondence: J. Goodman, c/o BJU, 25 John St. London WC1N 2BL, UK.


Citation:

* Goodman J. Jewish circumcision: an alternative perspective. BJU Int 1999;83 Suppl 1:22-27.
 
http://www.circinfo.org/parents.html

Circumcision: A Guide for expectant Parents

Introduction

Parents want to make the best decision for the health of their children, but not all Australian state health departments and medical bodies are equally forthcoming with information for parents on the risks of circumcision and care of the normal (intact) penis. This brochure answers frequently asked questions about male circumcision, and complements the recent leaflet (Circumcision: A parents’ guide) issued by the Royal Australasian College of Physicians (RACP).

What is male circumcision?

The word circumcision means “to cut aroundᾠ. In male infants, circumcision is an operation which involves tearing the foreskin* away from the glans (head) of the penis, cutting along the top of the foreskin, then clamping the foreskin and cutting it off. The skin of the penis is a complex movable sheath with no clear indication of where it should be cut during a circumcision. This means that the amount of foreskin removed from one circumcision to the next can be very different, and no two circumcisions are the same.
Does any medical organisation recommend circumcision of boys?

No medical organisation anywhere in the world recommends routine circumcision of boys. Many organisations state that there is no medical indication for routine circumcision, including the RACP, the British Medical Association, and the American Academy of Paediatrics. For full details see www.cirp.org/library/statements
Is circumcision less painful for a baby than for an adult?

Infants experience excruciating pain during circumcision and for weeks afterwards, and they can show behavioural changes such as frequent crying, avoidance of physical contact, reduced feeding, and sleep disturbance. Local anaesthetic creams such as EMLA are not adequate, and a general anaesthetic poses a significant risk for infants under the age of six months. Adult circumcision is less painful as men can undergo general anaesthesia and receive pain relief during the post-operative period.
Isn’t circumcision just a “tiny snipᾠ with no risks?

The risks of circumcision include bleeding, infection, damage to the glans and frenulum**, excessive skin removal, scarring, loss of penis, and even death. Infant circumcision carries more risks than adult circumcision, as a baby’s penis is very small and difficult to operate on, and more penile skin is removed than in adults. Excessive tissue removal is a common problem, and this can cause painful erections and even restrict the growth of the penis at puberty.
Will a boy feel upset if he looks different to Dad?

All penises are different, just like noses. Boys don’t have plastic surgery so that their noses look like their fathers’, so why would a baby need his penis to look the same? Different doctors perform circumcision differently, and some remove a lot of skin while others remove only a little. This means the chance of a circumcised boy looking exactly like his father is very slight.
Can circumcision prevent UTIs in infants?

Some research suggests that circumcised infants may have a lower incidence of urinary tract infections (UTIs). Approximately 0.188% of circumcised infants and 0.702% of intact infants develop a UTI. However, this difference is slight, and female infants have a far higher incidence of UTI than circumcised or intact boys (5%). Mothers will be happy to know that immediate breastfeeding protects male and female infants from such infections. If a UTI does occur, the most conservative treatment is with antibiotics and more rigorous follow-up in rare cases of recurrent infections. Chronic UTIs are often the result of abnormalities in the urethra or bladder which will usually require surgery.
Should a boy’s foreskin be retracted everyday for cleaning with soap and water?

The prepuce* of most newborn boys is still adhered to the glans and cannot be retracted. Forcible retraction can result in tearing, scarring and infection, with the result that circumcision may becomes medically necessary because of foreskin damage. A boy will retract his foreskin when he is ready to do so, and it is normal for this to happen any time between the ages of 3 and 13. After the foreskin has become retractable boys can be shown how to gently retract and wash under the foreskin with water. Diluted soap can help with cleaning, but it must be thoroughly rinsed away to avoid irritation of the foreskin’s sensitive inner surface. Too much soap can cause skin problems such as eczema which used to be blamed on the foreskin.
Are most men in the world circumcised?

Only about 20% of men worldwide are circumcised. Most men (80%) are not circumcised, including the vast majority in Britain, Europe, non-Moslem Asia, and South America. Circumcised men are a minority confined to the Middle East, some African tribes, Islamic regions of Asia, and the USA. The number of circumcised men in Australia and Canada is in steady decline.
Do women prefer circumcised partners?

Women in circumcising countries sometimes state a preference for circumcised partners, because this is what they are accustomed to. This effect of cultural conditioning should not legitimise the practice. Many women also report smoother intercourse and greater sexual satisfaction with intact partners compared to circumcised partners (1). Most women are more interested in whether their partner is loving and kind.
Does circumcision affect a man’s sexual function and pleasure?

Circumcision removes complex tissue containing thousands of highly specialised fine touch receptors and nerve fibres. The loss of sexual sensitivity is proportional to the amount of foreskin removed; a tight circumcision that prevents movement of the foreskin during intercourse and other sexual activity is particularly damaging. Men circumcised as infants may be unaware of this, but many men circumcised as adults report a definite loss of feeling and versatility.
Can circumcision prevent penile or cervical cancer?

The risk factors for penile and cervical cancer are cigarette smoking and exposure to various strains of the human papilloma or wart virus (HPV), through unprotected sex with multiple partners. Penile cancer is an extremely rare disease with less than 1 case per 100,000 men and a median age of diagnosis of 64 years. Circumcised men do develop penile cancer, which can develop on the circumcision scar.
Can circumcision prevent HIV and other STDs?

Circumcision does not prevent the transmission of sexually transmitted diseases (STDs), but many studies claim that circumcision can reduce a man’s risk of acquiring an STD. These studies are often done in poor and under-developed countries and do not take into account personal hygiene, complex social customs, education level, medical services, traditional sexual practices, and genetic factors in susceptibility to disease. Similar studies in industrialised nations, such as Australia, find that circumcision does not reduce the risk of STD transmission.
What about phimosis and paraphimosis?

A small percentage of boys and men have foreskins with an unusually small opening, which can be difficult to retract (phimosis) or become stuck behind the glans and cause swelling (paraphimosis). For paraphimosis, a doctor can compress the glans and let the foreskin return to its normal position. In both cases, the opening of the foreskin can then be increased by twice daily application of a steroid cream for 4-6 weeks (2). In severe but rare cases where scarring has occurred, a small incision may also be needed. Although paraphimosis is a rare problem, it can be serious, and urgent medical attention is required.
Is an intact penis longer?

Yes. An Australian survey (3) found that circumcised men had shorter erect penises than intact men, and the difference was statistically significant. This makes good sense as many circumcisions in Australia are too severe, and a tight result can restrict growth of the penis during puberty.
How did circumcision start in Australia?

During the prudish Victorian era, doctors in Britain (and colonies) and the USA adopted circumcision and other genital mutilations to control sexual behaviour in boys and girls, and to prevent STDs in adult men and women. Circumcision, clitoridectomy and hysterectomy were prescribed in the false belief that they could prevent or to cure masturbation, tuberculosis, mental illness, and an array of other unlikely diseases. Not all British doctors supported these treatments, and female circumcision was banned in 1867, when a woman’s right to make decisions about her own body was recognised. In contrast, male circumcision was continued into the 20th century by misguided physicians who claimed it was necessary in all cases of infantile phimosis and that it could protect men and women from STDs and cancer.
Why are most Australian boys not circumcised?

Male circumcision lost favour in Britain in 1949, when the lack of necessity and the dangers of the operation were recognised These included bleeding, damage to the glans, excessive skin removal and 16 deaths a year in Britain alone (4). Australian paediatricians have discouraged the practice since the 1960s, and the incidence of circumcision has fallen from over 70% of boys during the 1960s to 49% in 1973 and 39% in 1980. In 2002 about 12% of boys were circumcised, but there is wide variation among the states.
Why are more boys circumcised in Queensland and NSW?

Western Australia and Victoria have the lowest incidence of circumcision, at around 5%, Queensland has the highest at 20%, and New South Wales the second highest at 15%. Infants born in rural areas are also more likely to be circumcised than those born in a capital city (5). An Australia-wide medical investigation should be conducted to account for this variation in circumcision practice. Doctors and hospitals in all regions of Australia have a duty of care to give parents full information on the risks and lack of benefits of circumcision, and instructions on how to care for the normal penis.
Who has the right to decide?

During the decision making process, the most important point for parents to remember is that, just as it is a woman’s right to choose in matters concerning her own body, so it is a man’s right to choose in matters concerning his body, including his penis. Circumcision Information Australia (CIA) has received many complaints from adult men who are unhappy about having been circumcised as infants or children. Circumcision is cosmetic surgery, and the appearance of the penis is a matter of personal preference. Only the owner of the penis has the right to decide if he would like its appearance, structure and function altered by circumcision or any other needless procedure.

How can parents get more help with their decision?

Expectant parents should read both the this leaflet and the full Policy Statement on Circumcision issued by the Royal Australasian College of Physicians in September 2002. These documents are available on the internet or can be obtained in print form by contacting the RACP. For a more comprehensive discussion on circumcision, see the short book Doctors Re-examine Circumcision, at your local or state library.

After reading this material, parents should not hesitate to take these documents along to their family physician for discussion. Alternatively, you can email us at circinfoaust(AT)yahoo.com.au or phone Dr George Williams on 02 9543 0222.
Glossary

* Prepuce or Foreskin: the section of the movable sheath of skin on the penis which covers and protects the glans while the penis is not erect (flaccid).

** Frenulum: a very sensitive band of tissue connecting the inner foreskin to the glans on the underside of the penis, often referred to as the male G-spot.
References

1. O’Hara, K. & O’Hara J. (1999) The effect of male circumcision on the sexual enjoyment of the female partner, BJU Int. 83, Suppl. 1, 79-84.

2. Berdeu, D., Sauze, L., Ha-Vinh, P. & Blum-Boisgard, C. (2001) Cost effectiveness analysis of treatment for phimosis: a comparison of surgical and medicinal approaches and their economic effect, BJU Int., 87, 3, 239-244.

3. Richters, J., Gerofi, J., Donovan, B. (1995) Are condoms the right size(s)? A method for self-measurement of the erect penis, Venereology, 8(2), 77-81

4. Gairdner, D. (1949) The fate of the foreskin: a study of circumcision, BMJ, 2, 1433-1437.

5. Spilsbury, K., Semmens, J. B., Wisniewski, Z. S., and Holman, C. D. (2003) Circumcision for phimosis and other medical indications in Western Australian boys, Med J Aust 178(4), 155-8
Recommended reading

At the RACP website

Circumcision: A parents’ guide to routine circumcision of male infants and boys Policy Statement on Circumcision
At your local or state library

Doctors Re-Examine Circumcision (2002) by Thomas Ritter & George Denniston, Third Millennium Publishing Company ISBN 0-9711878

This FAQ was written by Dr George Williams and Shane Peterson for Circumcision Information Australia, June 2003
About the authors

George Williams is a paediatrician in Menai NSW, and also works at the Children’s Hospital in Sydney. While completing postgraduate medical training in Canada, George heard of a baby who died because his circumcision wound became infected with gangrene. George has read many other reports of deaths and serious injuries following infant circumcision, and he feels obliged to educate parents about this unethical and unnecessary practice. George established NOCIRC of Australia in 1992, and has since consulted with media and written a number of articles for textbooks and parenting magazines. He was awarded the Australia’s Parents Magazine Award of Merit in 1996 for his “efforts to make the world a better place for childrenᾠ.

Shane Peterson underwent reconstructive surgery at the age of 18 to repair an over-generous circumcision that took place a week after his birth in Western Australia during the 1970s. Shane studied science in Perth then moved to Canberra for postgraduate studies in medical science. He has extensively researched the available literature on circumcision. Shane’s surgical experience as an adult has made him very aware of the loss of sexual enjoyment when sensory tissue is removed from the penis. Shane and George aim to increase public awareness of the negative affects of circumcision, and the value of the foreskin as a sensory organ for male sexual function.
 
http://www.mothersagainstcirc.org/death.htm

Circumcision That Didn't Heal Kills Boy

NewsNet5 - Cleveland, OH
October 20, 1998

NOTE: NewsNet5 subsequently revised it's headline to:
Anesthesia Complications Killed Baby

CLEVELAND, Posted 6:46 a.m. October 20, 1998 -- A 3-week-old boy died while doctors were trying to fix a problem with his circumcision.

[Note: NewsNet5 subsequently revised this first paragraph to:"Doctors say anesthesia complications killed a 3-week-old boy while doctors were trying to fix a problem with his circumcision."While anesthesia may have been the immediate cause of death, the death was secondary to complications arising from a useless and non-medically indicated circumcision.]

A pediatrician noticed the circumcision performed on Dustin Evans two weeks ago wasn't healing properly and the urethra was blocked. A routine surgical procedure was needed to correct the problem and clear the hole.

While being administered anesthesia on Friday, the boy's heart stopped, said his father, Dustin Evans Sr., 27. Doctors at Rainbow Babies Childrens Hospital attempted to save the baby by massaging his heart and inserting breathing tubes.

He was kept on a life-support ventilator system during the day until it was determined that his heart was healthy, but he had suffered massive brain damage. Dustin was disconnected from life support about 7:30 p.m. Friday.

"You think, 'What could go wrong with a circumcision?' " Evans said."The next thing I know he's dead."

Hospital spokeswoman Eileen Korey said Monday she was limited in what she could say about his death. "We express the hospital's deepest condolences to the family," she said. "But in this case, as in all others, we are unable to talk about details because of confidentiality reasons."

Cuyahoga County Coroner Elizabeth Balraj said she has no autopsy findings to disclose and says the matter is still under investigation. Denver physician Randall Clark with the American Society of Anesthesiologists says 25 percent of all anesthesia complications in children occur in those under one month old.

The above piece was copied from NOHARMM
National Organization to Halt the Abuse and Routine Mutilation of Males

---------------------------------------------------------------------------------------

This tragic loss is now being blamed on anesthesia and it's been stated that the death was unrelated to circumcision.

Imagine someone getting hit by a drunk driver. The victim requires surgery and then dies from the anesthesia. It would be ludicrous to then claim that the death was unrelated to the drunk driver.

Had the boy not been circumcised, he would not have been subjected to the dangers of anesthesia which was required to repair the complications of a circumcision.
 
http://www.scidev.net/EditorLetters/index.cfm?fuseaction=readeditorletter&itemid=94&language=1

The dangers of promoting male circumcision against HIV/AIDS
*
Author: Bernard Coetzee
Affiliation: Masters student in ecology
University of Pretoria, South Africa
Date: 25 July 2006

You recently reported on a study that advocated widespread male circumcision in Africa to prevent the spread of HIV/AIDS (see Male circumcision could save millions from HIV/AIDS).

While I am very open to pragmatic solutions to the diversity of problems faced by the African continent, I would caution against sweeping statements such as: "Increasing circumcision to include all men in Africa could prevent six million HIV infections and three million deaths over 20 years, say researchers".

My concern is that the public might see this as justification for gruesome circumcisions used in traditional initiation rituals in Africa.

Three boys have died this year in South Africa's Limpopo province during such rituals. In the Eastern Cape province, circumcisions have claimed 19 lives (see links below).

Furthermore, men might think that they are 'immune' to HIV/AIDS if they are circumcised. The study suggests that if "all" men in Africa are circumcised, it will help to curb HIV/AIDS. But would it not be more practical, and more ethical, to encourage all men to use protection?

As Victor Hugo said, science has the first word on everything, but the last word on nothing. While the researchers whose study you reported present a means of helping curb HIV transmission, they appear to have failed to assess the societal implications of their proposals.

While I am sure that the researchers did not imply that that every man should be circumcised, the assumption that circumcisions could be actively promoted is, bluntly stated, ridiculous.

While the HIV/AIDS situation is horrible, the researchers' 'scientific' solution is even more so.
 
http://forum.fathermag.com/circ/086/forum/messages/220673.shtml

Boy's Death Highlights New Dangers of Neonatal Circumcision

Posted by PRWEB news

Increased Dangers of Neonatal Circumcision

Infants experiencing circumcision are more subject to Hypovolemic Shock and Methicillin Resistant Staphyloccus Aureus (MSRA)

(PRWEB) March 30, 2004--The present medical policy in the United States and some other English-speaking nations is to offer and perform elective non-therapeutic circumcision of infant males at the request of the parents. New evidence of increased risks associated with that surgical procedure has emerged. This statement's purpose is to inform hospital administrators, medical doctors, and parents of those increased risks.

Hypovolemic Shock. The recent, highly publicized, death by hypovolemic shock of a healthy Canadian boy caused by hemorrhage from his circumcision wound has forced a reexamination of the risks occurred from bleeding.

The prepuce is highly vascularized, so it is likely to hemorrhage when cut, and severing the frenular artery is very common. Infants can tolerate only about a 20 percent blood loss before hypovolemia, hypovolemic shock, and death. A 4000 gram male newborn has only 11.5oz (340 ml) of total blood volume at birth, 85 ml per kilogram of weight. Blood loss of only 2.3oz, (68 ml) less than one-quarter of a cup, 20% of total blood volume at birth is sufficient to cause hypovolemia. The quantity of blood loss that might kill an infant (85ml) is easily concealed in today's highly absorbent disposable diaper. Many newborns, and especially premature infants, weigh much less and a smaller amount of blood loss would be sufficient to trigger hypovolemic shock in those infants. Circumcision of infants, therefore, carries the inherent danger of hypovolemic shock and death.

Methicillin Resistant Staphyloccus Aureus. This month's edition of Archives of Disease in Childhood (London) reports a substantial increase in bacteremia (viable bacteria circulating in the blood) caused by Methcillin Resistant Staphyloccus aureus (MRSA) in children. The article (Archives of Disease in Childhood 2004;89:378-379) identifies vancomycin as the treatment of choice against MRSA, but the authors caution that vancomycin resistant Staphyloccus aureus is now emerging. The authors report that "MRSA bacteremia is associated with a higher mortality rate, longer hospital stays and is a significant independent risk factor for death."

St. Catherine's Hospital on Long Island experienced an outbreak of MRSA infection among circumcised boys in the newborn nursery in 2003; Arlington Hospital in Arlington, VA had a similar outbreak in 1995; and the naval hospital in North Carolina had an outbreak of non-resistant S. aureus in 1998.
 
http://cat.inist.fr/?aModele=afficheN&cpsidt=3460049

Titre du document / Document title

Serious complications of routine ritual circumcision in a neonate : hydro-ureteronephrosis, amputation of glans penis, and hyponatraemia

Auteur(s) / Author(s)

HANUKOGLU A. (1) ; DANIELLI L. ; KATZIR Z. ; GORENSTEIN A. ; FRIED D. ;
Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)
(1) E. Wolfson medical cent., dep. paediatrics, Holon 58100, ISRAEL

Résumé / Abstract

A 13-day-old infant developed bilateral hydroureteronephrosis, severe hyponatraemia, hyperkalaemia, and acidosis, as a result of urethral damage following circumcision. The hydroureteronephrosis and biochemical abnormalities normalized after resolution of the penile injury. Conclusion Infants with urinary retention following circumcision may develop hydroureteronephrosis and electrolyte disturbances. An awareness of the potential dangers of circumcision may help to limit its complications

Revue / Journal Title

European journal of pediatrics (Eur. j. pediatr.) ISSN 0340-6199 CODEN EJPEDT

Source / Source

1995, vol. 154, no4, pp. 314-315 (6 ref.)

Langue / Language

Anglais

Editeur / Publisher

Springer, Berlin, ALLEMAGNE (1975) (Revue)
 
http://www.sabcnews.com/south_africa/crime1justice/0,2172,131305,00.html

Circumcision claims yet another life in Limpopo
July 16, 2006, 14:15

Another initiate has died in Limpopo. The 14-year-old initiate died at the Mooiplass initiation school outside Lebowakgomo.

This brings to three the number of initiates who have died at initiation schools in the province this year. Five initiates died at initiation schools in the province last year.

Motlafela Mojapelo, a provincial police spokesperson, says an inquest to investigate will be opened and the post-mortem will be conducted to determine the cause of death.
 
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