7 ms·

Why the “circumcision solution” to the AIDS epidemic in Africa may increase it

53 points by isomorph 8y ago

robotbikes 8y ago
Basically I agree with this sentiment "So what should we conclude? Green et al. get it right: “Before circumcising millions of men in regions with high prevalences of HIV infection, it is important to consider alternatives. A comparison of male circumcision to condom use concluded that supplying free condoms is 95 times more cost effective.”"
- isomorph 8y ago
  Says it all, really. Interestingly the same applies back home...
- nostromo 8y ago
  That's as silly as focusing on teaching abstinence. Sure, it'd work... in theory. In practice, people don't like condoms and HIV rates would be largely unchanged. The best hope we have is to work on many fronts at the same time: education, condoms, voluntary circumcision, etc.
  - loeg 8y ago
    People don't like condoms in western countries too but they don't seem to have the same sky-high HIV rates. I don't see how making condoms available for free would hurt.
  - telchar 8y ago
    You're indicting the entire premise of modern safe sex. Either condoms are rarely used and people cannot be taught to use them reliably, or you're wrong. The low infection rate in industrialized countries with good sex education and readily available condoms suggests you're wrong. Contrarily, abstinence hasn't been demonstrated to work anywhere.
ivank 8y ago
http://webcache.googleusercontent.com/search?q=cache:blog.practicalethics.ox.ac.uk/2012/05/when-bad-science-kills-or-how-to-spread-aids/&strip=1&vwsrc=0 http://webcache.googleusercontent.com/search?q=cache:blog.pr... Bill Gates doesn't seem to care that that science behind the project is terrible. It must have been pointed out to him, yet he was still promoting the project in 2015: https://www.youtube.com/watch?v=_ovf8GYfNbw&t=40s https://www.youtube.com/watch?v=_ovf8GYfNbw&t=40s https://www.youtube.com/watch?v=HFtSt862sKY https://www.youtube.com/watch?v=HFtSt862sKY - how much informed consent do you think was involved here? A lawsuit against PSI Zimbabwe, also supported[1] by the Bill & Melinda Gates Foundation http://nehandaradio.com/2018/09/02/400-000-circumcision-lawsuit-family-sues-over-unsanctioned-sons-foreskin-removal/ http://nehandaradio.com/2018/09/02/400-000-circumcision-laws... 15,269,720 "voluntary medical male circumcisions" based on this bogus science http://www.aidsmap.com/PEPFAR-funded-15-million-medical-male-circumcisions-between-2007-and-2017/page/3343169/ http://www.aidsmap.com/PEPFAR-funded-15-million-medical-male... [1] https://www.psi.org/2016/11/using-market-research-for-long-term-sustainability-of-vmmc-in-zimbabwe-and-zambia/ https://www.psi.org/2016/11/using-market-research-for-long-t...
- isomorph 8y ago
  Didn't realise how into it Bill Gates was - thanks for pointing that out. Hearing that boy's sadness in that video is very upsetting.
- valtism 8y ago
  I've heard from people inside WHO that Gates' mentality is that he wants solutions NOW and doesn't concern himself much with potential issues around the solutions. I've heard that they would rather not have his money than be forced to put out vaccines that have questionable manufacturing practices.
  - xkcd-sucks 8y ago
    Well yeah he probably wants to see results before he dies
    - 8y ago
wirrbel 8y ago
The page currently times out loading, but from what I gather from the title, it seems that my distrust in the circumcicion against AIDS stories was on track. It always felt a bit like puritans trying to find empiric evidence for their moral and cultural traditions.
- isomorph 8y ago
  Cached version: http://webcache.googleusercontent.com/search?q=cache:blog.practicalethics.ox.ac.uk/2012/05/when-bad-science-kills-or-how-to-spread-aids/&strip=1&vwsrc=0 http://webcache.googleusercontent.com/search?q=cache:blog.pr... There is a definite neo-colonial shadow hanging over it
- shard972 8y ago
  This is why we need to integrate more africans into modern science fields.
  - isomorph 8y ago
    There are many African students at the London School of Hygiene and Tropical Medicine (an alumnus of which runs the World Health Organization). The discourse at that institution around circumcision, and the taboo of mentioning it alongside FGM/C without saying "circumcision is NOTHING compared to FGM" are difficult
    - telchar 8y ago
      The fallacy that MGM and FGM need to compete rhetorically is a significant hurdle in the discourse. Too many people see it as an unnecessary game of one-upmanship for some reason.
- Analemma_ 8y ago
  It’s unbelievable how far people will twist themselves in knots trying to find utilitarian justifications for what is, at the end of the day, non-consensual mutilation done for no reason other than “because tradition.”
Theodores 8y ago
There is also the aspect of who has a dog in the fight and skin in the game. When you have Americans telling Africans to get themselves circumcised you do have to wonder what is really going on, particularly when there is this dubious level of 'science'. In the U.S. there is always the profit motive. Hence male circumcision is sold to parents as hygienic and beneficial, they go along with it and the hospital makes some money, everyone getting bonuses except for the baby boy. To contrast with this profit-motive-situation you have places like the UK where healthcare is provided by the government - e.g. the NHS. The hospital has no financial incentive to circumcise as many boys as possible, doing so would be a cost, not a profitable thing, so it doesn't happen. Therefore the population ends up being un-circumcised as a general rule. By adulthood men have had long enough to rationalise with what happened to their foreskin. If it has been removed then they tend to want this for others including their own boys. Meanwhile, those with intact foreskin don't talk about such matters in public as they know that open discussion will deeply hurt someone in the room who has been circumcised. I think that this experiment to circumcise millions of African men for their own good would have been easier to get to the bottom of if everyone involved had to explain their viewpoint in just their 'birthday suit'.
- dane-pgp 8y ago
  > everyone getting bonuses except for the baby boy. The baby boy may not get a bonus, but he does leave a tip.
- isomorph 8y ago
  True, regarding the UK. There are some complex dynamics at work 1. a conflict of interest when there is a financial incentive to do a surgery 2. a pattern of doctors / father who are circumcised feeling the need to promote it to others 3. an issue where men circumcised as infants are never approached for follow-up consent by healthcare professionals, so never know what happened 4. an issue where men circumcised as infants know what happened but rationalise it
- telchar 8y ago
  You can add to that a large part of why circumcision was promoted in the US originally was to control men's sexuality (see: Dr. Kellogg[1] - incidentally he also promoted using acid to circumcise girls). You can bet that the idea of desexualizing African men appeals to a certain subset of fearful white Americans. That may be an inflammatory statement but if one looks at some of the more extreme corners of internet opinion it's not hard to believe. That said I wouldn't expect most people who the idea appeals to to admit it, but given that science is obviously not on the side of those promoting circumcision one has to look for possible motivation elsewhere. [1] https://www.psychologytoday.com/us/blog/moral-landscapes/201109/circumcision-social-sexual-psychological-realities https://www.psychologytoday.com/us/blog/moral-landscapes/201...
deleted 8y ago
[deleted]
deleted 8y ago
[deleted]
isomorph 8y ago
Site has been overwhelmed by traffic - cached version: http://webcache.googleusercontent.com/search?q=cache:blog.practicalethics.ox.ac.uk/2012/05/when-bad-science-kills-or-how-to-spread-aids/&strip=1&vwsrc=0 http://webcache.googleusercontent.com/search?q=cache:blog.pr...
nostromo 8y ago
This article is FUD. If the article raised some questions about the (multiple) studies that show the effect, I would just shrug and let it go. But then to go on and say it "may increase it" is irresponsible. There is zero evidence for this -- and in fact a lot of evidence to the contrary. [1] Yes, every study has limitations. The fact that you can't do a blind study or a placebo control with circumcision is just a fact of life -- people tend to know if they're circumcised or not. This does not refute the many studies' findings. Can you imagine the outrage if the author published a paper questioning the effect of smoking on lung cancer, and then wondered if smoking actually reduces your chances for lung cancer? That's what this article is doing. I'm glad that Gates is standing on the side of science here. 1. http://www.croiconference.org/sessions/impact-male-circumcision-scale-community-level-hiv-incidence-rakai-uganda http://www.croiconference.org/sessions/impact-male-circumcis...
- notahacker 8y ago
  > Can you imagine the outrage if the author published a paper questioning the effect of smoking on lung cancer, and then wondered if smoking actually reduces your chances for lung cancer? That's what this article is doing. I don't think the evidence bases are exactly comparable (even acknowledging that the study you've linked to doesn't sound quite as appallingly constructed as the one described by the blog). And people argue about whether recommendations with thin justifications around stuff like diets have counterproductive side effects all the time, especially when the recommendations are pretty drastic.
  - nostromo 8y ago
    The article is very old now, so that was a fair point... when it was published. But in 2018 we have a lot of evidence that show the effect on transmission is real -- and we also have evidence that circumcised people do not engage in more risky behavior. [1] So that's why I think this is similar to denying climate change or claiming vaccines cause autism. It could have a real impact on public health. I suspect I'm getting downvoted because some people are passionately anti-circumcision. And that's fine! Nobody is going to make you get circumcised. But the science doesn't care about one's personal views regarding circumcision. 1. https://www.fhi360.org/sites/default/files/media/documents/MCC_ResearchBrief_SHABS.pdf https://www.fhi360.org/sites/default/files/media/documents/M...
jesssse 8y ago
Mutilating baby penis is a tragedy.
ummonk 8y ago
I mean, I'm sure FGM reduces AIDS rates too, since women who were subjected to it are going to be less interested in sexual activity...
DrJaws 8y ago
circumcision is just mutilation
stephengillie 8y ago
> After all, if someone knows (or thinks) that they’re getting a great big helping of medicine, they might act in various ways—whether consciously or unconsciously—that have the effect of generating positive health outcomes but which have nothing to do with the intervention itself. That sounds strangely like the Hawthorne Effect[∆]. [∆]https://en.m.wikipedia.org/wiki/Hawthorne_effect https://en.m.wikipedia.org/wiki/Hawthorne_effect
jes 8y ago
I am a 59 y/o male and an "Intactivist." Tomorrow morning, I'll be flying from my home in Kirkland, Washington, to Orlando, Florida, to join my colleagues in protesting non-therapeutic circumcision at the site where the AAP is hosting its convention. I routinely join the Bloodstained Men and their Friends in their various protests / education events. I also carry my various signs in front of a local hospital (Evergreen Hospital, Kirkland, WA) which performs NTC on healthy male infants and neonates when their parents request it. I also routinely speak against NTC in the public meetings of the Board of Commissioners for EGH. I'm currently contemplating what kind of legal action I could take against the Board of Commissioners of the Public Hospital District that oversees the EvergreenHealth organization. Over the last year, I have been sharing information with them. The management team of EGH has been relying on the AAP 2012 Circumcision Policy Statement as their justification for offering the harm they offer to parents. I have informed them that the Policy Statement expired in 2017, but they continue to defend the offering of this harm. I also submitted copies of a statement-by-statement refutation of the Policy Statement written by Dr. Robert S. Van Howe, who was (may still be) the Interim Chairman of the Department of Pediatrics at the Central Michigan College of Medicine. If anyone has any suggestions for me as regards what kind of legal action might be considered, to compel / encourage the Board of Commissioners to do the work necessary to decide for themselves whether they are harming healthy infants and neonates by continuing to offer this harm, I would appreciate it.
- isomorph 8y ago
  The legal system cannot help at this stage. I have met this guy http://www.oldsquare.co.uk/our-people/profile/james-chegwidden http://www.oldsquare.co.uk/our-people/profile/james-chegwidd... who successfully defended two boys’ right to choose in the UK (this was only made possible because their mother DIDN’T want them circumcised and their dad did). There is no legal basis for circumcision but unfortunately the law cannot help in this case as it reflects public opinion. Check this out written by the author of this article https://youtu.be/sQQTIpBWqvY https://youtu.be/sQQTIpBWqvY I am considering retraining from software engineering into health policy to combat non-therapeutic infant circumcision in the UK
deleted 8y ago
[deleted]
erichocean 8y ago
Circumcision of children should be banned entirely. If adults want to do it, fine.
Fundlab 8y ago
These is personal experience and views; Male circumcision is prevalent in Africa mostly as as the norm. It is painless at childhood but gruesome when done to older kids. In some cultures around the world male circumcision is akin to piercing the ears of a baby girl for earrings. In places where circumcision is a ritual, it gets done to older kids (early teens) as a rite of passage into adulthood. To me that will be more agonizing considering the awareness of the pain eg. when your dick gets caught in a zipper. I personally dont find male circumcision at birth repugnant because I literally have no memory of it and I but I appreciate it was done to me appropriately. According to https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5422680/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5422680/ "The timing and reason for circumcision in boys or men vary across the continent. Circumcision is prevalent in as much as 93% of the countries in Northern Africa compared to 62% of countries in sub-Saharan Africa. Whereas the procedure is done for religious purposes in Western and Northern parts of Africa, it is seldom performed in neonates in Eastern and Southern regions of the continent where circumcision is, often, a rite of passage into adulthood" What I'll love to see if the comparative AIDS footprint between countries with varying degrees of circumcision.
jzl 8y ago
This piece from 2012 (posted now why?) loses all credibility in the section called "2. Misleading results": It is tempting to think that the 60% figure that’s being thrown around in media reports is just too large a percentage to ignore–even if the studies had some flaws. But do you know what the “60%” statistic is actually referring to? Boyle and Hill explain: What does the frequently cited “60% relative reduction” in HIV infections actually mean? Across all three female-to-male trials, of the 5,411 men subjected to male circumcision, 64 (1.18%) became HIV-positive. Among the 5,497 controls, 137 (2.49%) became HIV-positive, so the absolute decrease in HIV infection was only 1.31%. That’s right: 60% is the relative reduction in infection rates, comparing two very small percentages I don't even know where to begin. What does he think people will interpret it to mean? His entire point here is made in bad faith. What he's saying basically comes down to "the infection rate in this trial was low to begin with, therefore there's no point trying to make it lower," which is preposterous. The authors claim a reduction, which any speaker of the English language should know how to interpret. I think it's entirely valid to argue the validity of the study and the blowback issue, but his sloppy argumentation throughout the article is underscored here.
- FabHK 8y ago
  Not sure why you are being downvoted. That part of the article is indeed disingenuous (I'm not sure whether it's sloppy or purposely misleading). Of course the 60% reduction is a relative reduction in infection rates. In fact, the "absolute decrease [of] only 1.31%" claimed by the article, if anything, is misleading, because that number (representing 60% of the 2.49%) is over a certain small amount of time, and therefore will only grow larger as time passes.
FabHK 8y ago
Mods: maybe add (2012)

53 points by isomorph 8y ago

Basically I agree with this sentiment "So what should we conclude? Green et al. get it right: “Before circumcising millions of men in regions with high prevalences of HIV infection, it is important to consider alternatives. A comparison of male circumcision to condom use concluded that supplying free condoms is 95 times more cost effective.”"

isomorph 8y ago
Says it all, really. Interestingly the same applies back home...
nostromo 8y ago
That's as silly as focusing on teaching abstinence. Sure, it'd work... in theory. In practice, people don't like condoms and HIV rates would be largely unchanged. The best hope we have is to work on many fronts at the same time: education, condoms, voluntary circumcision, etc.
- loeg 8y ago
  People don't like condoms in western countries too but they don't seem to have the same sky-high HIV rates. I don't see how making condoms available for free would hurt.
- telchar 8y ago
  You're indicting the entire premise of modern safe sex. Either condoms are rarely used and people cannot be taught to use them reliably, or you're wrong. The low infection rate in industrialized countries with good sex education and readily available condoms suggests you're wrong. Contrarily, abstinence hasn't been demonstrated to work anywhere.

ivank 8y ago

http://webcache.googleusercontent.com/search?q=cache:blog.practicalethics.ox.ac.uk/2012/05/when-bad-science-kills-or-how-to-spread-aids/&strip=1&vwsrc=0 http://webcache.googleusercontent.com/search?q=cache:blog.pr... Bill Gates doesn't seem to care that that science behind the project is terrible. It must have been pointed out to him, yet he was still promoting the project in 2015: https://www.youtube.com/watch?v=_ovf8GYfNbw&t=40s https://www.youtube.com/watch?v=_ovf8GYfNbw&t=40s https://www.youtube.com/watch?v=HFtSt862sKY https://www.youtube.com/watch?v=HFtSt862sKY - how much informed consent do you think was involved here? A lawsuit against PSI Zimbabwe, also supported[1] by the Bill & Melinda Gates Foundation http://nehandaradio.com/2018/09/02/400-000-circumcision-lawsuit-family-sues-over-unsanctioned-sons-foreskin-removal/ http://nehandaradio.com/2018/09/02/400-000-circumcision-laws... 15,269,720 "voluntary medical male circumcisions" based on this bogus science http://www.aidsmap.com/PEPFAR-funded-15-million-medical-male-circumcisions-between-2007-and-2017/page/3343169/ http://www.aidsmap.com/PEPFAR-funded-15-million-medical-male... [1] https://www.psi.org/2016/11/using-market-research-for-long-term-sustainability-of-vmmc-in-zimbabwe-and-zambia/ https://www.psi.org/2016/11/using-market-research-for-long-t...

isomorph 8y ago
Didn't realise how into it Bill Gates was - thanks for pointing that out. Hearing that boy's sadness in that video is very upsetting.
valtism 8y ago
I've heard from people inside WHO that Gates' mentality is that he wants solutions NOW and doesn't concern himself much with potential issues around the solutions. I've heard that they would rather not have his money than be forced to put out vaccines that have questionable manufacturing practices.
- xkcd-sucks 8y ago
  Well yeah he probably wants to see results before he dies
  - 8y ago

wirrbel 8y ago

The page currently times out loading, but from what I gather from the title, it seems that my distrust in the circumcicion against AIDS stories was on track. It always felt a bit like puritans trying to find empiric evidence for their moral and cultural traditions.

isomorph 8y ago
Cached version: http://webcache.googleusercontent.com/search?q=cache:blog.practicalethics.ox.ac.uk/2012/05/when-bad-science-kills-or-how-to-spread-aids/&strip=1&vwsrc=0 http://webcache.googleusercontent.com/search?q=cache:blog.pr... There is a definite neo-colonial shadow hanging over it
shard972 8y ago
This is why we need to integrate more africans into modern science fields.
- isomorph 8y ago
  There are many African students at the London School of Hygiene and Tropical Medicine (an alumnus of which runs the World Health Organization). The discourse at that institution around circumcision, and the taboo of mentioning it alongside FGM/C without saying "circumcision is NOTHING compared to FGM" are difficult
  - telchar 8y ago
    The fallacy that MGM and FGM need to compete rhetorically is a significant hurdle in the discourse. Too many people see it as an unnecessary game of one-upmanship for some reason.
Analemma_ 8y ago
It’s unbelievable how far people will twist themselves in knots trying to find utilitarian justifications for what is, at the end of the day, non-consensual mutilation done for no reason other than “because tradition.”

Theodores 8y ago

There is also the aspect of who has a dog in the fight and skin in the game. When you have Americans telling Africans to get themselves circumcised you do have to wonder what is really going on, particularly when there is this dubious level of 'science'. In the U.S. there is always the profit motive. Hence male circumcision is sold to parents as hygienic and beneficial, they go along with it and the hospital makes some money, everyone getting bonuses except for the baby boy. To contrast with this profit-motive-situation you have places like the UK where healthcare is provided by the government - e.g. the NHS. The hospital has no financial incentive to circumcise as many boys as possible, doing so would be a cost, not a profitable thing, so it doesn't happen. Therefore the population ends up being un-circumcised as a general rule. By adulthood men have had long enough to rationalise with what happened to their foreskin. If it has been removed then they tend to want this for others including their own boys. Meanwhile, those with intact foreskin don't talk about such matters in public as they know that open discussion will deeply hurt someone in the room who has been circumcised. I think that this experiment to circumcise millions of African men for their own good would have been easier to get to the bottom of if everyone involved had to explain their viewpoint in just their 'birthday suit'.

dane-pgp 8y ago
> everyone getting bonuses except for the baby boy. The baby boy may not get a bonus, but he does leave a tip.
isomorph 8y ago
True, regarding the UK. There are some complex dynamics at work 1. a conflict of interest when there is a financial incentive to do a surgery 2. a pattern of doctors / father who are circumcised feeling the need to promote it to others 3. an issue where men circumcised as infants are never approached for follow-up consent by healthcare professionals, so never know what happened 4. an issue where men circumcised as infants know what happened but rationalise it
telchar 8y ago
You can add to that a large part of why circumcision was promoted in the US originally was to control men's sexuality (see: Dr. Kellogg[1] - incidentally he also promoted using acid to circumcise girls). You can bet that the idea of desexualizing African men appeals to a certain subset of fearful white Americans. That may be an inflammatory statement but if one looks at some of the more extreme corners of internet opinion it's not hard to believe. That said I wouldn't expect most people who the idea appeals to to admit it, but given that science is obviously not on the side of those promoting circumcision one has to look for possible motivation elsewhere. [1] https://www.psychologytoday.com/us/blog/moral-landscapes/201109/circumcision-social-sexual-psychological-realities https://www.psychologytoday.com/us/blog/moral-landscapes/201...

deleted 8y ago

[deleted]

deleted 8y ago

[deleted]

isomorph 8y ago

Site has been overwhelmed by traffic - cached version: http://webcache.googleusercontent.com/search?q=cache:blog.practicalethics.ox.ac.uk/2012/05/when-bad-science-kills-or-how-to-spread-aids/&strip=1&vwsrc=0 http://webcache.googleusercontent.com/search?q=cache:blog.pr...

nostromo 8y ago

This article is FUD. If the article raised some questions about the (multiple) studies that show the effect, I would just shrug and let it go. But then to go on and say it "may increase it" is irresponsible. There is zero evidence for this -- and in fact a lot of evidence to the contrary. [1] Yes, every study has limitations. The fact that you can't do a blind study or a placebo control with circumcision is just a fact of life -- people tend to know if they're circumcised or not. This does not refute the many studies' findings. Can you imagine the outrage if the author published a paper questioning the effect of smoking on lung cancer, and then wondered if smoking actually reduces your chances for lung cancer? That's what this article is doing. I'm glad that Gates is standing on the side of science here. 1. http://www.croiconference.org/sessions/impact-male-circumcision-scale-community-level-hiv-incidence-rakai-uganda http://www.croiconference.org/sessions/impact-male-circumcis...

notahacker 8y ago
> Can you imagine the outrage if the author published a paper questioning the effect of smoking on lung cancer, and then wondered if smoking actually reduces your chances for lung cancer? That's what this article is doing. I don't think the evidence bases are exactly comparable (even acknowledging that the study you've linked to doesn't sound quite as appallingly constructed as the one described by the blog). And people argue about whether recommendations with thin justifications around stuff like diets have counterproductive side effects all the time, especially when the recommendations are pretty drastic.
- nostromo 8y ago
  The article is very old now, so that was a fair point... when it was published. But in 2018 we have a lot of evidence that show the effect on transmission is real -- and we also have evidence that circumcised people do not engage in more risky behavior. [1] So that's why I think this is similar to denying climate change or claiming vaccines cause autism. It could have a real impact on public health. I suspect I'm getting downvoted because some people are passionately anti-circumcision. And that's fine! Nobody is going to make you get circumcised. But the science doesn't care about one's personal views regarding circumcision. 1. https://www.fhi360.org/sites/default/files/media/documents/MCC_ResearchBrief_SHABS.pdf https://www.fhi360.org/sites/default/files/media/documents/M...

jesssse 8y ago

Mutilating baby penis is a tragedy.

ummonk 8y ago

I mean, I'm sure FGM reduces AIDS rates too, since women who were subjected to it are going to be less interested in sexual activity...

DrJaws 8y ago

circumcision is just mutilation

stephengillie 8y ago

> After all, if someone knows (or thinks) that they’re getting a great big helping of medicine, they might act in various ways—whether consciously or unconsciously—that have the effect of generating positive health outcomes but which have nothing to do with the intervention itself. That sounds strangely like the Hawthorne Effect[∆]. [∆]https://en.m.wikipedia.org/wiki/Hawthorne_effect https://en.m.wikipedia.org/wiki/Hawthorne_effect

jes 8y ago

I am a 59 y/o male and an "Intactivist." Tomorrow morning, I'll be flying from my home in Kirkland, Washington, to Orlando, Florida, to join my colleagues in protesting non-therapeutic circumcision at the site where the AAP is hosting its convention. I routinely join the Bloodstained Men and their Friends in their various protests / education events. I also carry my various signs in front of a local hospital (Evergreen Hospital, Kirkland, WA) which performs NTC on healthy male infants and neonates when their parents request it. I also routinely speak against NTC in the public meetings of the Board of Commissioners for EGH. I'm currently contemplating what kind of legal action I could take against the Board of Commissioners of the Public Hospital District that oversees the EvergreenHealth organization. Over the last year, I have been sharing information with them. The management team of EGH has been relying on the AAP 2012 Circumcision Policy Statement as their justification for offering the harm they offer to parents. I have informed them that the Policy Statement expired in 2017, but they continue to defend the offering of this harm. I also submitted copies of a statement-by-statement refutation of the Policy Statement written by Dr. Robert S. Van Howe, who was (may still be) the Interim Chairman of the Department of Pediatrics at the Central Michigan College of Medicine. If anyone has any suggestions for me as regards what kind of legal action might be considered, to compel / encourage the Board of Commissioners to do the work necessary to decide for themselves whether they are harming healthy infants and neonates by continuing to offer this harm, I would appreciate it.

isomorph 8y ago
The legal system cannot help at this stage. I have met this guy http://www.oldsquare.co.uk/our-people/profile/james-chegwidden http://www.oldsquare.co.uk/our-people/profile/james-chegwidd... who successfully defended two boys’ right to choose in the UK (this was only made possible because their mother DIDN’T want them circumcised and their dad did). There is no legal basis for circumcision but unfortunately the law cannot help in this case as it reflects public opinion. Check this out written by the author of this article https://youtu.be/sQQTIpBWqvY https://youtu.be/sQQTIpBWqvY I am considering retraining from software engineering into health policy to combat non-therapeutic infant circumcision in the UK

deleted 8y ago

[deleted]

erichocean 8y ago

Circumcision of children should be banned entirely. If adults want to do it, fine.

Fundlab 8y ago

These is personal experience and views; Male circumcision is prevalent in Africa mostly as as the norm. It is painless at childhood but gruesome when done to older kids. In some cultures around the world male circumcision is akin to piercing the ears of a baby girl for earrings. In places where circumcision is a ritual, it gets done to older kids (early teens) as a rite of passage into adulthood. To me that will be more agonizing considering the awareness of the pain eg. when your dick gets caught in a zipper. I personally dont find male circumcision at birth repugnant because I literally have no memory of it and I but I appreciate it was done to me appropriately. According to https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5422680/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5422680/ "The timing and reason for circumcision in boys or men vary across the continent. Circumcision is prevalent in as much as 93% of the countries in Northern Africa compared to 62% of countries in sub-Saharan Africa. Whereas the procedure is done for religious purposes in Western and Northern parts of Africa, it is seldom performed in neonates in Eastern and Southern regions of the continent where circumcision is, often, a rite of passage into adulthood" What I'll love to see if the comparative AIDS footprint between countries with varying degrees of circumcision.

jzl 8y ago

This piece from 2012 (posted now why?) loses all credibility in the section called "2. Misleading results": It is tempting to think that the 60% figure that’s being thrown around in media reports is just too large a percentage to ignore–even if the studies had some flaws. But do you know what the “60%” statistic is actually referring to? Boyle and Hill explain: What does the frequently cited “60% relative reduction” in HIV infections actually mean? Across all three female-to-male trials, of the 5,411 men subjected to male circumcision, 64 (1.18%) became HIV-positive. Among the 5,497 controls, 137 (2.49%) became HIV-positive, so the absolute decrease in HIV infection was only 1.31%. That’s right: 60% is the relative reduction in infection rates, comparing two very small percentages I don't even know where to begin. What does he think people will interpret it to mean? His entire point here is made in bad faith. What he's saying basically comes down to "the infection rate in this trial was low to begin with, therefore there's no point trying to make it lower," which is preposterous. The authors claim a reduction, which any speaker of the English language should know how to interpret. I think it's entirely valid to argue the validity of the study and the blowback issue, but his sloppy argumentation throughout the article is underscored here.

FabHK 8y ago
Not sure why you are being downvoted. That part of the article is indeed disingenuous (I'm not sure whether it's sloppy or purposely misleading). Of course the 60% reduction is a relative reduction in infection rates. In fact, the "absolute decrease [of] only 1.31%" claimed by the article, if anything, is misleading, because that number (representing 60% of the 2.49%) is over a certain small amount of time, and therefore will only grow larger as time passes.

FabHK 8y ago

Mods: maybe add (2012)